The Inguinal Canal

Question 1

Testicular migration

Answer 1

Gonads develop in posterior abdominal wall from IM.

Passes thru muscles and fascia via Inguinal canal and ends in scrotum.

Question 2

Gonads follow which structure?

Answer 2

Gubernaculum

Question 3

Deep to superficial layers (6)

Answer 3

Peritoneum
Transversalis fascia
Transversus abdominus m.
IO m.
EO m.
Scarpa’s fascia

Question 4

Peritoneum forms:

Answer 4

Tunica vaginalis

Question 5

IO m becomes:

Answer 5

Cremasteric fascia

Question 6

EO m becomes:

Answer 6

External spermatic fascia

Question 7

Scarpa’s fascia becomes:

Answer 7

Dartos

Question 8

Blood supply tot the scrotum (3)

Answer 8

Posterior scrotal branches from the pudendal a.
Anterior scrotal branches from deep external pudendal a.
Cremasteric a.

Question 9

Nervous supply to the scrotum (4) and area it supplies:

Answer 9

Posterior scrotal branches (posterior surface)
Perineal branches of posterior cutaneous n of thigh (postero-inferior surface)
Anterior scrotal nerves (anterior surface)
Genital branch of genitofemoral n (anterolateral surface)

Question 10

Hydrocele

Answer 10

Fluid in persistent processus vaginalis.

Detected via transillumination.

Question 11

Varicocele

Answer 11

Scrotal fullness (bag of worms).
Can be associated w/ dull aching scrotal pain.
Usually occurs on left side.

Question 12

Floor of inguinal canal (3)

Answer 12

Iliopubic tract
Inguinal ligament
Lacunar ligament

Question 13

Sub inguinal space includes (4)

Answer 13

Hip flexors

Femoral a, n, v.

Question 14

Contents of inguinal cord (3)

Answer 14

Spermatic cord/round ligament of uterus

Blood/Lymphatics

Question 15

What makes the anterior wall of inguinal canal?

Answer 15

EO aponeurosis

Question 16

Lacunar ligament is:

Attaches:

Answer 16

Continuation of inguinal ligament.

Superior pubic ramus.

Question 17

Pectinate ligament is:

Runs along:

Answer 17

Continuation of lacunar ligament.

Runs along pectineal line.

Question 18

Medial crus attaches:

Answer 18

Pubic crest

Question 19

Lateral crus attaches:

Answer 19

Pubic tubercle

Question 20

Superficial inguinal ring is an opening for:

Answer 20

External oblique aponeurosis

Question 21

What forms the conjoint tendon?
Where does it insert (2)?
What does is contribute to form?

Answer 21

IO m and transversus abdominis m.
Pubic crest and pectineal line
Posterior wall of inguinal canal (w/ transversalis fascia)

Question 22

Cremaster m is a continuation of which muscle?

What innervates it?

Answer 22

IO m.

Genital branch of genitofemoral n.

Question 23

What makes the posterior wall of inguinal canal?

Answer 23

Transversalis fascia

Question 24

How is the iliopubic tract formed?

Answer 24

It is a thickened inferior margin of transversalis fascia.

Question 25

What passes thru the deep inguinal ring?

Answer 25

Vas deferens, testicular vessels (males) | Round ligament of the uterus (females)

Question 26

Indirect inguinal hernia

Answer 26

Protrusion through the deep inguinal ring. More common in males. Lateral to inferior epigastric a.

Question 27

Direct inguinal hernia

Answer 27

Protrusion directly through anterior abdominal wall. Usually due to weakened conjoint tendon. Medial to inferior epigastric a.

Question 28

Boundaries of the inguinal (Hasselbach’s) triangle (3)

Answer 28

Inguinal l. (Inferior) Lateral border of rectus abdominis m. (Medial) Inferior epigastric a. (Lateral)

Question 29

Femoral hernia (3)

Answer 29

More common in females. Inferior to inguinal l. 40% present as emergencies (incarceration/strangulation).

Question 30

Contents of spermatic cord

Answer 30

``` Vas deferens Artery to vas deferens Testicular a. Pampiniform plexus of veins Cremasteric a/v Genital branch of genitofemoral n. Sympathetics Lymphatics Remnants of processus vaginalis ```

Question 31

Lumbar nodes drain:

Answer 31

Gonads

Question 32

Superficial inguinal nodes drain (4)

Answer 32

Lower limb, inferolateral trunk, gluteal region, scrotum.