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S&F 4 test 1 > Serrat - Inguinal Region > Flashcards

Serrat - Inguinal Region Flashcards

1
Q

A defect or opening in fascia that permits the passage of structures thru the inguinal canal. There are superficial and deep found in external oblique aponeurosis and transversalis fascia, respectively.

A

Inguinal ring

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2
Q

The deep inguinal ring is found in the region of the ___________

A

Lateral inguinal fossa

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3
Q

The folded lower border of the aponeurosis of the external oblique muscle. Dense band of aponeurosis extends from the ASIS to the pubic tubercle.

Floor of inguinal canal

Aka Poupart’s ligament

A

Inguinal ligament

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4
Q

Medial extension of the inguinal ligament attaches to the pectineal line on the pubis. Its sharp free edge forms the medial border of the femoral ring. Continuous w/ the pectineal ligament

A

Lacunar ligament.

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5
Q

The inguinal canal is larger in _____ than in _______

A

Males

Females

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6
Q

The inguinal canal transmits

A

Genitofemoral nerve

Ilioinguinal nerve

Spermatic cord (male)

Round ligament of uterus (females)

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7
Q

Describe the course of the ilioinguinal nerve through the inguinal canal

A

Enters canal laterally by piercing the transversus abdominus and internal oblique muscles, travels through the canal and then exits through the superficial ring.

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8
Q

The beginning of the inguinal canal

A

Deep inguinal ring

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9
Q

The deep ring protrudes thru the abdominal wall ________ to the inferior epigastric vessels

A

Lateral

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10
Q

The two sides of the triangle that is the superficial inguinal ring, are called the medial and lateral crus. They are help together by ___-__ which prevent widening of the superficial ring

A

Crossing intercural fibers

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11
Q

The medial crus attaches to the ________

A

Pubic symphysis

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12
Q

The lateral crus connects to the __———

A

Pubic tubercle

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13
Q

Anterior wall of the inguinal canal

A

Aponeurosis of external oblique muscle (thru/o length of canal)

Aponeurosis of internal oblique muscle (lateral 1/3 of canal)

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14
Q

Posterior wall of the inguinal canal

A

Transversalis fascia thru/o length of canal

Conjoint tendon in medial 1/3 of canal

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15
Q

Roof of the inguinal canal

A

Muscle fibers and aponeurosis of the internal oblique muscle and the aponeurosis of the transversus abdominis muscle as they arch from anterior to posterior

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16
Q

Floor of the inguinal canal

A

Inguinal ligament (thru/o length of canal)

Lacunar ligament (medial 1/3 of canal)

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17
Q

What is the cremasteric reflex and what nerves does it test?

A

Stroking the medial aspect of thigh produces a reflex contraction of cremaster muscle and ipsilateral elevation of the testis and scrotum

Tests; ilioinguinal (L1) which is sensory to inner thigh

Genitofemoral (genital branch) (L1-L2) - motor to cremaster muscle that retracts testis

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18
Q

An evagination of peritoneum into ventral abdominal wall that occurs independent of tests descent.

A

Process vaginalis

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19
Q

The evagination of the ____- ______ forms the inguinal canal and is normally obliterated between the deep inguinal ring and superior aspect of the testes during the first postnatal year.

A

Processus vaginalis

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20
Q

A condensed band of mesenchyme that extends from the lower pole of the developing gonad thru the inguinal canal to the labioscrotal swelling

A

Gubernaculum

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21
Q

In the adult male, the gubernaculum is :

A

The fibrous cord connection the testes to the scrotum

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22
Q

In the adult female, the gubernaculum is :

A

The round ligament of the uterus

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23
Q

Testis enter the deep ring of the inguinal canal at about -_____ months gestation

A

3

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24
Q

Gonadal development begins where ?

A

High in the lumbar region (L1) on the posterior abdominal wall, deep to the transversalis fascia

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25
Q

The testis descend thru the inguinal canal at about ______ months gestation, carrying layers of the abdominal wall in its descent into the scrotum

A

7 mos gestation

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26
Q

When does the stalk of the processus vaginalis degenerate?

A

About within the first year

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27
Q

Layers of the scrotum

A

Skin

Fascia - dartos fascia and muscle

28
Q

The outer capsule around the testis is called the ?

A

Tunica albuginea

29
Q

Site of sperm production

A

Seminiferous tubules

30
Q

Network of canals that conduct sperm

A

Rete testis

31
Q

Sperm storage and maturation

Head - coiled ends of efferent ductules

Body - convoluted ducts

Tail - continuous w/ ductus deferens

A

Epididymis

32
Q

Transport sperm to ejaculatory duct

A

Ductus (vas) deferens

33
Q

Arteries of the testis

A

Cremasteric (from inferior epigastric)

Testicular (from abdominal aorta)

Artery of ductus deferens (from inferior vesicle artery)

34
Q

Function of testis

A

Sperm production in seminiferous tubules

Androgen production in Leydig cells

35
Q

The white fibrous capsule that surrounds the testis like the rind of an orange. Covered by the visceral layer of the tunica vaginalis

A

Tunica albuginea

36
Q

Derived from parietal peritoneum, has two layers
A shiny visceral layer, immediately covering the tunica albuginea and a parietal layer that is separated from the visceral layer by a cavity of the tunica vaginalis

A

Tunica vaginalis

37
Q

Genital branch of genitofemoral nerve provides motor innervation to ?

A

Cremaster muscle

38
Q

Pampiniform plexus does what?

A

Drains nuts, converges as testicular vein, empties into inferior vena cava

Component of spermatic cord

39
Q

What are the components of the spermatic cord?

A

Ductus deferens and artery

Testicular artery

Genital branch of genitofemoral nerve (L1, L2)

Pampiniform plexus (goes into testicular vein)

Lymphatics from testis and epididymis

Cremaster A. And V.

Plexus of autonomic nerves

40
Q

Fascia contributions of the inguinal canal from the external oblique aponeurosis (x7)

A

Inguinal ligament

Lateral crus

Medial crus

Lacunar ligament

Intercrural fibers

External spermatic fascia

Superficial inguinal ring

41
Q

Fascia contributions to the inguinal region from the internal abdominal oblique aponeurosis (x2)

A

Conjoint tendon

Cremasteric layer of muscle and fascia

42
Q

Fascia contributions to inguinal region and canal from transversus abdominis aponeurosis

A

Conjoint tendon

43
Q

What abdominal muscle aponeurosis has no layer contributed to coverings of spermatic cord?

A

Transversus abdominis aponeurosis

44
Q

What are the fascia contributions to the inguinal region from the transversalis fascia?

A

Deep inguinal ring

Internal spermatic fascia

45
Q

Fascia contributions to the inguinal region from peritoneum

A

Embryo; processus vaginalis

Mature; tunica vaginalis testis

46
Q

What layer of testis and spermatic cord corresponds with skin

A

Skin

47
Q

What layer of testis and spermatic cord corresponds with fatty layer of superficial fascia

A

Dartos muscles

48
Q

What layer of testis and spermatic cord corresponds with membranous layer of superficial fascia

A

Membranous layer of superficial fascia of perineum (colle’s layer)

49
Q

What layer of testis and spermatic cord corresponds with aponeurosis of external abdominal oblique

A

External spermatic fascia

50
Q

What layer of testis and spermatic cord corresponds with internal abdominal oblique muscle and its aponeurosis

A

Cremaster muscle and fascia

51
Q

What layer of testis and spermatic cord corresponds with transversus abdominis muscle

A

No contribution

52
Q

What layer of testis and spermatic cord corresponds with transversalis fascia

A

Internal spermatic fascia

53
Q

What layer of testis and spermatic cord corresponds with extraperitoneal fat

A

Loose connective tissue including fat

54
Q

What layer of testis and spermatic cord corresponds with parietal peritoneum

A

Tunica vaginalis (obliterated processus vaginalis)

55
Q

Incomplete testes descent such that one or both testes remain in body cavity or inguinal canal

A

Cryptorchidism

56
Q

What is the cause of indirect inguinal hernia?

A

Congenital . From incomplete obliteration of processus vaginalis

57
Q

What is cause of direct inguinal hernia ?

A

Weakness of posterior wall of inguinal canal

58
Q

Type of hernia:

Occurs in adults

Common in older men

Neck of hernia passes thru medial inguinal fossa in hesselbach’s triangle

Enters inguinal canal medial to inferior epigastric vessels

Transverses only medial 1/3 of inguinal canal.

May transverse superficial inguinal ring but won’t enter scrotum.

Cause is weakness of posterior wall of inguinal canal

A

Direct inguinal hernia

59
Q

Type of hernia;

Most common type in both children and adults.

Males > females

Neck of hernia thru deep inguinal ring in lateral inguinal fossa

Enters inguinal canal lateral to inferior epigastric vessels

Usually transverses entire inguinal canal and may extend into scrotum

Cause - congenital, incomplete obliteration of processus vaginalis

A

Indirect inguinal hernia

60
Q

_______ umbilical folds contain the inferior epigastric vessels

A

Lateral

61
Q

How do you distinguish a femoral hernia from an inguinal hernia?

A

The neck of a femoral hernia is always below and lateral to the pubic tubercle

62
Q

Collection of fluid in testes or spermatic cord that can result from persistent processus vaginalis

A

Hydrocele

63
Q

What layers must you pierce in order to tap a hydrocele?

A 
Skin
Dartos
Colle’s fascia
External spermatic fascia
Cremaster muscle and fascia
Internal spermatic fascia
Parietal layer of tunica vaginalis
64
Q

Why are most varioceles in the left testicular veins?

A

The right veins empty into the inferior vena cava which are lower pressure than the left renal vein which is where the left testicular vein empties into

65
Q

Rotation of the testis around the spermatic cord w/in the scrotum

Severe pain

Obstructed blood flow can lead to necrosis of an entire testicle

Often occurs in active young men and children and is accompanied by severe pain

A

Torsion of the testis

66
Q

Surgical ligation of ductus deferens so that no sperm are contained in ejaculated fluid

A

Vasectomy

S&F 4 test 1 (22 decks)

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