Innervation, Vasculature and inguinal region

Question 1

Dermatomes of abdomen

Answer 1

Superficial branches of Intercostal nn. T7-11
Subcostal (T12), Ilihypogastric (L1), ilioinguinal (L1)
T7-L1
xyphoid= T6
Umbilcus= T10
Inguinal=L1

Question 2

Course of iliohypogastric and ilioinguinal

Answer 2

L1
Pierce transversus abdominis 
run b/w TA and IAO
pierce IAO near ASIS 
run b/w IAO and EAO
IH terminates in suprapubic region 
II terminates in scrotal branches

Question 3

Superficial epigastric a.

Answer 3

branch of femoral a.
provides superficial part of lower abdomen
held w/in camper’s fascia

Question 4

Superficial circumflex iliac a.

Answer 4

branch of femoral a.
provides superficial part of inguinal region
held w/in the camper’s fascia

Question 5

Superior epigastric a.

Answer 5

branch of internal thoracic a.
runs b/w or w/in RA and rectus sheath
anastomoses with inferior epigastric

Question 6

inferior epigastric a.

Answer 6

branch of iliac a. medial to the deep inguinal ring
ascends the anterior body wall w/in the lateral umbilical fold
pierces posterior rectus sheath to anastomose with superior epigastric

Question 7

Thoracoepigastric vein

Answer 7

superficial venous anastomosis b/w lateral thoracic vein (to SVC) and superficial epigastric v. (to IVC)

Question 8

Superficial lymphatics superior to transumbilical plane

Answer 8

drain into axillary and parasternal lymph nodes

Question 9

Superficial lymphatics inferior to transumbilical plane

Answer 9

drain into superficial inguinal lymph nodes

Question 10

Myopectineal orifice

Answer 10

area of weakness where most hernias occur along the inguinal ligament

Question 11

Inguinal ligament

Answer 11

rolled under portion of external oblique aponeurosis that extends from ASIS to pubic tubercle

neurovascular bundle passes inferior

Question 12

Lacunar ligament

Answer 12

medial fibers of inguinal ligament which attach to pubic tubercle
crescent shaped ligament which forms medial border of femoral canal

Question 13

Pectineal ligament

Answer 13

lateral continuation of lacunar ligament attaching to pectineal line of superior pubic ramus

Question 14

reflected ligament

Answer 14

continuation of inguinal ligament which attaches to linea alba

Question 15

Inguinal canal

Answer 15

oblique passageway for the spermatic cord (or round ligament)
formed during gonadal descent (gubernaculum)

Question 16

Deep inguinal ring

Answer 16

internal entrance to the inguinal canal
formed as an evagination of transversalis fascia
lateral to inferior epigastric
**indirect inguinal hernia

Question 17

superficial inguinal ring

Answer 17

exit from inguinal canal into the scrotum or labia majora

formed from the split in EAO aponeurosis

Question 18

lateral crus

Answer 18

attaches to pubic tubercle

Question 19

medial crus

Answer 19

attaches to pubic crest

Question 20

intercrual fibers

Answer 20

fibers which arch b/w medial and lateral crus

Question 21

Boarders of inguinal canal

Answer 21

Anterior: external oblique apo
Floor: inguinal ligament
roof: IAO and TA
posterior: transversalis fasica laterally, conjoint tendon medially

Question 22

Conjoint tendon

Answer 22

composed of inferior fibers of IAO and TA muscle

reinforces posterior wall of inguinal canal

Question 23

Dartos fascia

Answer 23

from superficial fascia of abdominal wall

Question 24

external spermatic fascia

Answer 24

external abdominal oblique

Question 25

cremaster muscle and fascia

Answer 25

from IAO

Question 26

Tunical vaginalis

Answer 26

evagination of peritoneum which forms serous cavity around testes

Question 27

Canal of Nuck

Answer 27

when the processus vaginalis fails to seal in females

cysts may form here

Question 28

Indirect hernia

Answer 28

2/3 of all hernias
males and on R
congenital, lack of processus vaginalis closure
lateral to inferior epigastric vessels
extends into inguinal canal and possibly out to scrotum or labia

Question 29

direct hernia

Answer 29

more common in males
due to weakness in anterior body wall posterior to superficial inguinal ring
usually prevented by conjoint tendon
occur in medial inguinal fossa (hasselbach’s), medial to the epigastric vessels
do not extend into scrotum