anatomy of the inguinal canal

Question 1

what two layers cover the testes?

Answer 1

tunica vaginalis- visceral layer

tunic albuginea- inner, fibrous layer

Question 2

seminiferous tubules

Answer 2

-make sperm

Question 3

describe the path of sperm from production to ejaculation:

Answer 3

• make in seminipherous tubules
• go to straight tubules
• go to rete testes
• go to efferent tubules
• go to epididymis and stored until active
• leave epididymis via the vas deferens (attached to tail of the epididymis) to urethra

Question 4

what are the three arches in the inguinal canal?

Answer 4

-formed by three abdominal muscles- transversus abdominus and internal and external oblique

Question 5

where does the inguinal canal run thru? why were these terms coined?

Answer 5

• thru the deep and superficial ring
• deep- formed by the transversalis fascia
• superficial- formed by the external oblique fascia; it is where the inguinal canal ends and the spermatic cord/round ligament exits into scrotum/lamia majora

Question 6

what runs through the inguinal canal?

Answer 6

• spermatic cord in males and round ligament in females

- they exit via the scrotum in men and labia majora in females at the superficial ring

Question 7

why are testes located outside of the body?

Answer 7

• because the making of semen is more favorable in cooler conditions than body temp
• ALSO, sperm swim better when they are reactivated- therefore held in cold storage and then activated in warm female and swim well

Question 8

what exactly is the purpose of the inguinal region?

Answer 8

-it’s a track that the testes descend thru on their way to the scrotum (basically descend to keep testes out of the body)

Question 9

3 pts of the epididymis?

Answer 9

head, body, tail

Question 10

conjoint tendon

Answer 10

-fusion of aponeuroses of internal oblique and transverus epidominus -fuse onto pubis

Question 11

when males are born, where are the testes located?

Answer 11

• they are located deep to the pariental peritoneum

- must pass through the muscles to reach the outside of the body

Question 12

what are the layers that the testes must pass through referred to as?

Answer 12

-the superficial and deep rings that form the three arches

Question 13

where can we palpate the superficial and deep ring of the inguinal canal?

Answer 13

• superficial ring- lateral to penis

- deep ring- half way between ASIS and superficial ring

Question 14

what are the borders of the inguinal canal?

Answer 14

-anteriorly- aponeurosis of external oblique
-floor- inguinal ligament
floor medially- lacunar ligament
-posteriorly- transversalis fascia
-posterior medially- conjoint tendon

Question 15

as the testes pass thru the abdominal layers,  the layers become the following structures of the spermatic cord:
parietal peritoneum becomes-
transveralis fascia-
transversus abdominus-
internal oblique-
external oblique- 
scarpa's fascia-
camper's fascia-
skin-

Answer 15

parietal peritoneum becomes-tunica vaginalis (visceral layer of penis)
transveralis fascia- inner spermatic fascia
transversus abdominus-0- arches over the inguinal canal
internal oblique-cremasteric muscle and fascia
external oblique- external spermatic fascia
scarpa’s fascia-dartos muscle and fascia
camper’s fascia-0
skin- skin of scrotum

Question 16

gubernaculum

Answer 16

• a ligament attached to the developing testes or ovaries and attaches to the either scrotum or the labial folds
• it pulls both ovaries and testes down through a path that eventually becomes the inguinal canal

Question 17

testicular artery
origin
oxygenates?

Answer 17

• off the aorta below renal arteries

- oxygenates testicles

Question 18

cremasteric artery

Answer 18

• off the inferior epigastric a.

- oxygenates cremaster muscle

Question 19

ductus deferens artery

Answer 19

• off the inferior vesicular artery

- oxygenates the ductus deferens

Question 20

pampiniform plexus
where do the left and right plexuses drain into?
why is the plexus so abundant and important?

Answer 20

• plexus of 12ish testicular veins that converge as left or right testicular veins in the vas deferens
• right drains into the IVC
• left drains into the left renal vein
• abundant and important to take the warm arterial blood going into testes away to keep them at the perfect sperm temp

Question 21

what nerve innervates the cremaster muscle and what is it a branch of? spinal level?

Answer 21

• genital branch off of the genitofemoral n. and the anterior scrotal branch of the ilioinguinal
• L1-2
• runs thru inguinal canal

Question 22

what does the cremaster muscle do?

Answer 22

it pulls the testes up

Question 23

what does the dartos muscles do?

Answer 23

wrinkles up the testes

Question 24

what innervates the dartos muscle?

Answer 24

-sympathetics running with illioinguinal n and the posterior scrotal nerves

Question 25

what is the female equivalent to the testicular artery? origin?

Answer 25

- ovarian artery - aorta - does not go thru inguinal canal

Question 26

processus vaginalis and testes descent

Answer 26

- forms around week 7 from the parietal peritoneum near the gubernaculum - gubernauculum does not actually shorten but the developing fetus passively pushes testes down toward developing scrotum - at 8 months, testes halfway down inguinal canal created by gubernaculum - month 9, testes fully in scrotum

Question 27

what is the female version of the testes?

Answer 27

ovaries

Question 28

what does the gubernaculum become in females?

Answer 28

-the cranial part of the gubernaculum becomes the ovarian ligament, caudally it becomes the round ligament

Question 29

what becomes of the cremaster muscle in females?

Answer 29

- a muscle that coils around the round ligament

Question 30

where can the round ligament be found?

Answer 30

in the labia majora

Question 31

what is the female equivalent to the scrotum?

Answer 31

- the labia majora and the round ligament that run thru the inguinal canal - female inguinal canal also has cremasteric muscle and fascia with external and internal fascia

Question 32

what is a hernia and what are some common reasons as to why patients get them?

Answer 32

- weakness along the abdominal wall - could be due to erect posture (gravity), muscle weakness, tissue abdnormality, patent procesus vaginalis, increased abdominal pressure due to parturition or defecation,laughing etc

Question 33

name and describe the three most typical hernias

Answer 33

* Direct- thru Hasselbach's triangle pushing thru the peritoneal and transversalis fascia (acquired and usually due to muscle weakness and pushing-can go down into scrotum and traverse the superficial ring) * indirect- thru patent procesus vaginalis within the spermatic cord ("congenital and almost always in younger males) * femoral-below inguinal ligament thru inguinal ring next to femoral vessels (equally likely in males and females)

Question 34

borders of Hasselbach's triangle (inguinal triangle)

Answer 34

- rectus sheath - inguinal ligament - inferior epigastrics

Question 35

how is a hernia repaired

Answer 35

via a mesh that pushes intestines back into abdominal wall

Question 36

hydrocele vs hematocele

Answer 36

fluid within tunica vaginalis: hydrocele is fluid in the testes- result of birth defect or encephalitis hematocele is blood in the testes- usually due to trauma

Question 37

encephalitis

Answer 37

-mosquito causes it- round worms that invade ducts and cause hydrocele

Question 38

what are most lumps in the testicles?

Answer 38

-spermatocele- a clogged sperm duct in the head of the epididymis

Question 39

sebaceous cyst

Answer 39

-infection of a hair follicle that forma a cyst within the epidermis

Question 40

chryptorchidism

Answer 40

- mnemonic- orchid means testes and chrypt sounds like crypt and that's where your sperms going if it's not fixed! - lack of the testes to drop - 3 % of full term babies, 30% of prematures - 80% eventually drop on own within a yr

Question 41

monorchidism vs polyorchidism

Answer 41

- one testicle | - more than two testicles

Question 42

ectopic testes

Answer 42

-testes where they don't belong in the abdominal cavity

Question 43

vasectomy

Answer 43

- ductus (vas) deferens in the epididymis is cut and tied or not - if not tied, semen comes out into the scrotum and is eventually reabsorbed by the body - open is more comfortable