The Inguinal Region

Question 1

inguinal canal

Answer 1

3-5 cm oblique passageway occurring in the inguinal region of the anterior body wall

Question 2

formation of inguinal canal:

inguinal canal is formed during ___ when the ___ (___) descend form the posterior abdominal wall

in prenatal males, the ___ will pass through the inguinal canal & come to rest in the ___

the ___ contains vasculature & the ___, which traverse the inguinal canal & connect the testes to structures within the pelvis

in females, the ___ traverses the inguinal canal

Answer 2

fetal development, gonads (testes or ovaries)

testes, scrotum

spermatic cord, ductas (vas) deferens

round ligament of the uterus

Question 3

descent of the testes:

the testes start in the ___

they are situated on the ___

they are covered with a ___ & are termed ___

Answer 3

upper lumbar region

posterior abdominal wall

peritoneum, retroperitoneal

Question 4

descent of the testes:

during embryonic week 7, the ___ (___) condenses along the posterior abdominal wall

the paired ___ connect the inferior surface of each testis to the ___

Answer 4

gubernaculum (a ligamentous cord)

gubernacula, scrotum

Question 5

descent of the testes:

growth of the __ & shortening of the ___ results in peritoneum & testes being pulled ___ & the formation of the ___ (___)

Answer 5

embryo, gubernaculum, inferiorly, processus vaginalis (outpouching of peritoneum)

Question 6

descent of the testes:

the ___ forms immediately anterior to the gubernaculum & precedes the ___ as it moves toward the scrotum

this results in the ___ pushing through the ___ fascia, the ___ muscle, & the ___ muscle & the formation of the ___ canal

Answer 6

processus vaginalis, testis

processus vaginalis, transversalis, internal oblique, external oblique, inguinal

Question 7

descent of the testes:

the opening produced by the processus vaginalis in the transversalis fascia becomes the ___

the opening in the aponeurosis of the external abdominal oblique becomes the ___

the processus vaginalis carries extensions of the layers of the ___ fascia, the ___ muscle, & the ___ muscle as it descends

Answer 7

deep inguinal ring

superficial inguinal ring

transversalis, internal oblique, external oblique

Question 8

descent of the testes:

in the male, the transversalis fascia, the internal oblique muscle, & the external oblique muscle contribute layers to form the ___ & testes

the testis continues its descent & comes to lie on the ___ of this processus vaginalis

the testis then embeds itself into the processus vaginalis & thus obtains two layers of peritoneum known as the ___: the ___ (on the tesits) & the ___

Answer 8

coverings of the spermatic cord

inferior extent

tunica vaginalis, visceral, parietal layer

Question 9

descent of the testes:

the testes is at the deep inguinal ring at about ___ of intrauterine life

the descent of the testes is virtually concluded by the ___ of intrauterine life

the processus vaginalis obliterates shortly after birth leaving only the ___

the gubernaculum remains in the adult male as the ___ or “___” (this ligament secures the testis to the most inferior portion of the scrotum)

Answer 9

7 months

8th month

tunica vaginalis

gubernaculum testis, “scrotal ligament”

Question 10

cryptorchidism

Answer 10

usually, the tests have descended into the scrotum at birth, but occasionally one or both may remain in the pelvic cavity or inguinal canal

cryptorchidism = “hidden testis”

this can be remedied surgically

Question 11

coverings of the spermatic cord:

the spermatic cord is covered by ___ layers derived from the anterior abdominal wall

these layers form as the ___ evaginated the abdominal wall & carried part of each of its layers into the ___

Answer 11

3 concentric

processus vaginalis, scrotum

Question 12

coverings of the spermatic cord:
internal spermatic fascia:

forms as the ___ evaginates the transversalis fascia

the ___ covering of the spermatic cord

Answer 12

processus vaginalis

filmy innermost

Question 13

coverings of the spermatic cord:
cremasteric muscle & fascia:

the ___ covering of the spermatic cord which contains ___

as the processus vaginalis w/ its covering of ___ evaginates the internal abdominal oblique muscle, it acquired a few of the muscle fibers & some ___ of this muscle

the cremasteric muscles are not usually under ___ control but are ___ muscles & when contracted raise the ___ (particularly in the cold)

Answer 13

middle, loops of cremaster muscle

internal spermatic fascia, investing fascia

voluntary, skeletal, testis

Question 14

coverings of the spermatic cord:
cremasteric muscle & fascia:

the ___ is a contraction of cremasteric muscle after stroking the inner thigh results ina lifting of the scrotum & testis on the side stroked

the nerve is ___

the artery is ___

Answer 14

cremasteric reflex

genitofemoral nerve - efferent fibers

cremasteric artery - from the inferior epigastric artery

Question 15

coverings of the spermatic cord:
external spermatic fascia

the ___ covering of the spermatic cord

as the processus vaginalis evaginates the ___ & forms the ___ it carries an extension of this aponeurosis which becomes the ___

it is attached superior to the ___

it is continuous w/ the fascia covering the ___ muscle

Answer 15

thin outermost

external oblique aponeruosis, superficial inguinal ring, external spermatic fascia

crura of the superficial inguinal ring

external abdominal oblique

Question 16

descent of the ovaries:

ovaries start in the ___

they are covered with a ___ & are termed ___

during embryonic week 7, the ___ (___) condenses along the posterior abdominal wall

the paired ___ connect the inferior surface of each ovary to the ___

Answer 16

upper lumbar region

peritoneum, retroperitoneal

gubernaculum (a ligamentous cord)

gubernacula, bottom of the labia majora

Question 17

descent of the ovaries:

ovaries migrate from the ___ to a point just below the ___

they do not pass through the ___

the ___ becomes incorporated into the wall of the uterus

the remnants of the gubernaculum in the female are the ___ & the ___

the ___ passes through the inguinal canal & continues on to the ___

Answer 17

lumbar region, pelvic brim

inguinal canal

gubernaculum

round ligament of the uterus, ligament of the ovary

round ligament of the uterus, labia majora

Question 18

boundaries of the inguinal canal:

deep (internal) ring

Answer 18

an opening in the transversalis fascia

Question 19

boundaries of the inguinal canal:

superficial (external) ring

Answer 19

an opening in the aponeruosis of the external oblique msucle

Question 20

boundaries of the inguinal canal:
anterior wall:

___ abdominal oblique ___

___ abdominal oblique ___

Answer 20

external, over entire length (aponeurosis of)

internal, on lateral one-third

Question 21

boundaries of the inguinal canal:
posterior wall

___ fascia ___

___ tendon ___

___ ligament of the ___ oblique ___

Answer 21

transversalis, over entire length

conjoint, on medial one-third

reflected inguinal, external abdominal, on medial one-third

Question 22

boundaries of the inguinal canal:

roof

Answer 22

arched fibers of the internal abdominal oblique muscle & transversus abdominis muscle

Question 23

boundaries of the inguinal canal:
floor

___ ligament of the ___ oblique

___ ligament of the ___ oblique

Answer 23

inguinal, external

lacunar, external

Question 24

direct & indirect inguinal hernias:

a hernia is a protrusion of ___ (___) through an ___, or a weakened ___

the inguinal canal is the point where the ___ is weakened

Answer 24

tissue (internal organ), abnormal opening, anterior abdominal wall

inguinal canal, anterior abdominal wall

Question 25

direct & indirect inguinal hernias:
indirect inguinal hernia:

may occur when the ___ remains patent, & an internal organ (e.g. a loop of intestine) passes through the ___

occurs ___ to the ___ vessels

an internal organ may pass completely through the ___ (i.e. through both ___ & ___ inguinal rings) & lie in its ___

Answer 25

processus vaginalis, deep inguinal ring

lateral, inferior epigastric

inguinal canal, (deep & superficial), scrotum

Question 26

direct & indirect inguinal hernias:
direct inguinal hernia:

occurs when an internal organ pushes directly through the ___ w/o traversing the ___

occurs ___ to the ___ vessels, & lies in a small area known as ___

produces a bulge deep to the ___

when abdominal contents put pressure on transversalis fascia (& subserous fascia & peritoneum), an internal organ may traverse the ___

Answer 26

superficial inguinal ring, inguinal canal

medial, inferior epigastric, Hesselbach’s triangle

conjoined tendon

posterior wall of inguinal canal

Question 27

direct & indirect inguinal hernias:
direct inguinal hernia:

the contents of the hernia will enter the inguinal canal along side the ___ distal to the origin of the ___

contents of the hernia are located between the ___ & the ___ layer

this is an acquired condition due to the weakness of the ___ of the ___

more common in ___

Answer 27

spermatic cord, internal spermatic fascia

internal spermatic, cremasteric fascia

posterior wall, inguinal canal

older men

Question 28

the scrotum:

an extension of the ___

on its surface, the scrotum is divided by a ___ into right & left havles

the scrotum is a ___ sac that consists of ___ & ___

Answer 28

anterior abdominal wall

scrotal raphe

pendulous, skin, superficial fascia

Question 29

layers of the scrotum (2)

Answer 29

skin

superficial fascia

Question 30

layers of the scrotum:

skin

Answer 30

the skin in this area is dark in color & wrinkled (rugosa)

Question 31

layers of the scrotum:
superficial fascia:

devoid of ___ & contains ___ muscle called ___

this muscle is an ___ muscle that inserts in the skin & causes scrotum to ___ when cold

muscle is innervated by ___ fibers

Answer 31

fat, smooth, dartos muscle

involuntary, wrinkle

sympathetic nerve

Question 32

layers of the scrotum:
superficial fascia:

continuous w/ the membranous layer of ___ of the abdomen (___) & the ___ (___)

forms an incomplete ___ that divides the scrotum into a right & left half

Answer 32

superficial fascia, scarpa’s fascia, perineum, colle’s fascia

scrotal septum

Question 33

contents of the scrotum:
the testis

an ___ gland

produce ___

secrete ___

Answer 33

ovoid

sperm

sex hormones

Question 34

contents of the scrotum:

the coverings of the testis (5)

Answer 34

external spermatic fascia
cremasteric muscle & fascia
internal spermatic fascia
tunica albuginea

Question 35

contents of the scrotum:
the coverings of the testis:
tunica vaginalis testis

derivative of the ___

composed of 2 layers:

___ layer next to ___

___ layer

• adherent to the ___ & ___ (the coiled structure that houses the sperm)
• laterally passes b/n the above two structures to form the ___

Answer 35

processus vaginalis

parietal, internal spermatic fascia

visceral

• testis, epididymis
• sinus of the epididymis

Question 36

contents of the scrotum:
the coverings of the testis:
tunica albuginea

a ___ layer of ___ tissue surrounding the testes which is found deep to the ___ layer of the ___

extensions of the tunica albuginea form ___ within the testes thus subdividing the testes into ___

Answer 36

dense, connective, visceral, tunica vaginalis

septa, lobules

Question 37

contents of the scrotum:
the testis:

seminiferous tubules

• within ___ formed by the ___ in the testes
• it’s within these tubules that ___ are produced
• join to form the ___

efferent ductules

• number: ___
• connect the ___ to the ___

Answer 37

lobules, septa
sperm
rete testis

15-20
rete testis, head of the epididymis

Question 38

contents of the scrotum:
the epididymis:

a ___ that’s about ___ long which connects the ___ to the ___

forms on the ___ & ___ surface of the testis

can be divided into three regions: ___, ___, & ___

Answer 38

tightly-coiled tube, efferent ducts, vas deferens

superior, posterolateral

body, tail, head

Question 39

contents of the scrotum:
the epididymis:
body:

consists of ___

separated from testes by the ___

Answer 39

the highly convoluted duct of the epididymis

sinus of the epididymis

Question 40

contents of the scrotum:
the epididymis:
tail

Answer 40

continuous w/ the vas deferens (ductus deferens)

Question 41

contents of the scrotum:
the epididymis:
head

Answer 41

connects to testes efferent ductules

Question 42

contents of the scrotum:
vas deferens or ductus deferens (vas deferens):

transports ___ to the ___

___ enters the vas deferens at time of ___

the vas deferens travels through the ___ to the ___ & into the ___

Answer 42

sperm, ejaculatory duct

sperm, ejaculation

superficial inguinal ring, deep inguinal ring, abdomen

Question 43

contents of the spermatic cord:

all the structures attached to the testes before its descent ___

Answer 43

remain attached to the testis after its descent

Question 44

contents of the spermatic cord:
the vas deferens (ductus deferens):

this is a ___ of the testes

it lies in the ___ of the spermatic cord

it can be easily ___ in the ___ of the scrotum

it carries ___ from ___ to the ___

Answer 44

large duct

posterior part

palpated, upper part

sperm, epididymis, urethra

Question 45

contents of the spermatic cord:
arteries:
testicular artery:

a ___ vessel arising from the front of the ___

supplies the ___ & ___

goes through the ___

Answer 45

long slender, aorta

testis, epididymis

inguinal canal

Question 46

contents of the spermatic cord:
arteries:
artery of ductus deferens:

arises from the ___

follows the ___ through its course

anastomoses with the ___ near the testes

Answer 46

inferior vesical artery (artery of the bladder)

ductus deferens

testicular artery

Question 47

contents of the spermatic cord:
arteries:
cremasteric artery

arises from the ___

supplies the ___ muscle & other ___

Answer 47

inferior epigastric artery

cremasteric, coverings of the cord

Question 48

contents of the spermatic cord:
veins:

___ veins from the ___ surface anastomose to form a ___*

surrounds the ___ & ___

ends in the ___

drains into the ___ on the left side

drains into the ___ on the right side

Answer 48

12, posterior, pampiniform plexus

ductus deferens, arteries

testicular vein

left renal vein

inferior vena cav

Question 49

contents of the spermatic cord:
nerves:

ilioinguinal nerve: ___

fibers on arteries: ___

fibers for ductus deferens (pain & sickening sensation when testis is hit): ___

genitofemoral nerve: ___

Answer 49

skin of scrotum & labia major

sympathetic

sympathetic & parasympathetic

passes into the spermatic cord & supplies the cremaster & skin, scrotum, & labia

Question 50

contents of the spermatic cord:
lymph vessels

drain the ___

pass ___ in the spermatic cord to drain into the ___

Answer 50

testis

upward, lumbar nodes