The Inguinal Region/Canal Flashcards
Why is the anatomy of the inguinal region/canal clinically important?
Due to the frequency of inguinal hernae.
What forms the inguinal ligament? How?
The aponeurosis of the external oblique; by folding over on itself forming a taut ligament-like structure.
To which bony structures does the inguinal ligament attach?
Superolaterally to the anterior superior iliac spine of the hip bone, and inferomedially to the pubic tubercle.
A deficiency in each of the three layers on the anterolateral abdominal wall, in the region of the inguinal ligament, forms what specific passage?
The inguinal canal - an obliquely flattened passageway.
In which layer is the superficial inguinal ring formed?
The aponeurosis of the external oblique - the outermost (superficial) layer.
In which layer is the deep inguinal ring formed?
It is a slit in the fascia transversalis.
What structure forms the floor of the inguinal canal?
The inguinal ligament.
What structure forms the posterior wall of the inguinal canal?
The conjoint tendon (joined aponeuroses of the internal oblique and transversus abdominis).
What passes through this inguinal canal in the neonatal male?
TESTIS BALLS
In the adult male what structure is found within the inguinal canal?
Spermatic cord
In the adult female what structure is found within the inguinal canal?
The Round Ligament
Which layer(s) of the anterior abdominal wall contribute to the sheaths of the spermatic cord?
All but the transversus abdominis.
What does each participating layer of the anterior abdominal wall contribute to the spermatic cord?
External oblique - external spermatic fascia; internal oblique - cremasteric muscle and/or fascia; transversus abdominis - nil; fascia transversalis - internal spermatic fascia.
Which layer of the anterior abdominal wall does not contribute to the spermatic cord?
Transversus abdominis.
What are the main components found within the spermatic cord?
The ductus deferens, testicular a., pampiniform plexus of (testicular) veins.
What feature of embryological development allows the formation of a congenital hernia?
The processus vaginalis (a finger-like extension of the peritoneum that extends down into the scrotum via the inguinal canal.
In what age groups is the formation of a congenital hernia common?
Up to the early 30’s
What is the actual function of the processus vaginalis?
It provides a serous (slippery) lining for the inside aspect of the scrotal wall and the visceral surface of the testicle for friction-free movement.
What typically extends from the body cavity in a hernia?
A loop of small intestine.
What is the clinical implication of an inguinal hernia?
The loop of bowel may become trapped in the inguinal canal, squeezed by intra-abdominal pressure on the canal walls and cause loss of blood supply - gangrene may ensue.
How does an acquired inguinal hernia differ from the congenital type?
An inguinal hernia slides down the oblique inguinal canal due to the presence of a patent processus vaginalis (passing through the anterior abdominal wall indirectly), the acquired inguinal hernia protrudes directly through a defect that develops in the posterior wall of the inguinal canal (the conjoint tendon) and out through the superficial inguinal ring.
Through what component of the inguinal canal does the hernia protrude?
The superficial inguinal ring after penetrating the posterior wall (conjoined tendon).
Where would the inferior epigastric a. pulse be found in each type of herniation?
In the congenital (indirect) inguinal hernia the arterial pulse is medial to the hernia whereas in the acquired (direct) inguinal hernia the pulse is felt lateral to the hernia.
How do inguinal herniae differ in presentation from femoral herniae?
Inguinal hernia present above the inguinal ligament whereas a femoral hernia presents under the inguinal ligament.
Name the boundaries of the inguinal triangle.
Lateral: inferior epigastric a.; medial: lateral border of the rectus abdominis; inferior: inguinal ligament.
What structure(s) typically traverse this space in the normal condition?
The spermatic cord passes through the triangle just above the inferior boundary - the inguinal ligament.
Where is the location of the deep inguinal ring with relation to the inferior epigastric artery?
The deep inguinal ring is lateral to the inferior epigastric a.
Where is the inferior epigastric artery going?
Up into the posterior aspect of the rectus sheath, between it the posterior leaf of the sheath and the rectus abdominis muscle, gaining access via the arcuate line.
