Anterior wall/ inguinal canal

Question 1

Navel Dermatome

Answer 1

T10

Question 2

Gubernaculum

Answer 2

is a fibrous band extend from the caudal part of testis. It plays a role in the decent of the testis

Question 3

Processus vaginalis

Answer 3

is a diverticulum or out pouching of the peritoneum

Question 4

Abdominal wall derivative of dartos fascia and dartos muscle?

Answer 4

Subcutaneous tissue
(campers fascia = superficial, forms dartos fascia) 
(scarpa's fascia = deep, forms dartos muscle, continuous with fascia of perineum aka Colle's fascia)

Question 5

Abdominal wall derivative of external spermatic fascia?

Answer 5

External oblique muscle

Question 6

Abdominal wall derivative of cremaster muscle/ fascia?

Answer 6

Internal oblique muscle/ fascia of internal oblique muscle

Question 7

Abdominal wall derivative of internal spermatic fascia?

Answer 7

Transversalis fascia

Question 8

Abdominal wall derivative of tunica vaginalis?

Answer 8

Peritoneum

Question 9

Tunica vaginalis

Answer 9

is the pouch of serous membrane that covers the testes. It is derived from the vaginal process of the peritoneum, which in the fetus precedes the descent of the testes from the abdomen into the scrotum

Question 10

Tunica albuginea

Answer 10

connective tissue covering testis

Question 11

Inguinal canal

Answer 11

• oblique passage in the lower anterior abdominal wall
• 4cm long
• directed downward, forward, and medially
• greater in men than women

Question 12

Fascia transversalis

Answer 12

• has the deep inguinal ring
• forms the posterior wall of the canal
• represented in the scrotal layers as internal spermatic fascia

Question 13

Inguinal triangle (Hesselbach’s triangle)

Answer 13

Medially: linea semilunaris
Laterally: inferior epigastric vessels
Inferiorly: inguinal ligament

Question 14

Deep inguinal ring

Answer 14

Males: spermatic cord
Females: round ligament

oval opening which lies in the transversalis fascia

Question 15

Internal oblique features:

Answer 15

• directed up
• low arching fibers
• forms roof of the canal
• represented in scrotal layers as cremaster

Question 16

Transversus abdominis features:

Answer 16

• directed transverse
• high arching fivers, together with the internal oblique forms Conjoint Tendon
• forms roof of the canal

Question 17

External oblique features:

Answer 17

• directed “putting your hands in your pocket”
• superficial inguinal ring
• forms the anterior wall of the canal
• forms inguinal ligament which is the floor of the canal
• represented as external spermatic fascia

Question 18

What 2 structures pass through the superficial inguinal ring?

Answer 18

Spermatic cord/ round ligament

Ilioinguinal nerve

Question 19

What passes through the deep inguinal ring?

Answer 19

Spermatic cord/ round ligament

Question 20

Inguinal canal boundaries?

Answer 20

Anterior: EO aponeurosis, IO fibers
Posterior: Transversalis fascia, conjoint tendon
Roof: arched fibers of IO (low arched) and transverses abdomens (high arched)
Floor: inguinal ligament

Question 21

Spermatic cord 3 coverings?

Answer 21

external spermatic fascia, cremaster fascia, internal spermatic fascia

Question 22

Spermatic cord 3 arteries?

Answer 22

testicular artery, cremastric artery, artery of vas

Question 23

Spermatic cord 3 nerves?

Answer 23

Genital branch of genitofemoral
sympathetic plexus around testicular A
Sympathetic plexus around artery of Vas

Question 24

Inguinal hernia

Answer 24

Protrusion of abdominal contents (usually intestine) within a sac of peritoneum into the inguinal region

Question 25

Indirect inguinal hernia

Answer 25

Traverses inguinal canal within the spermatic cord (lateral to inferior epigastric vessels)

Question 26

Direct inguinal hernia

Answer 26

External and parallel to the spermatic cord (medial to inferior epigastric vessel)

Question 27

Conjoint tendon

Answer 27

descends behind the superficial inguinal ring to be attached to pubic crest & pectineal line so it aids extra support to the superficial inguinal ring

Question 28

Direct: predisposing factors

Answer 28

weakness of anterior abdominal wall in inguinal triangle (ex. owing to distended superficial ring, narrow, inguinal falx, or attenuation of aponeurosis in males >40 years of age)

Question 29

Indirect: predisposing factors

Answer 29

Potency of processus vaginalis (complete or at least superior part) in younger persons, the great majority of which are males

Question 30

Hernia frequency

Answer 30

Direct: less common, 1/3 Indirect: more common, 2/3

Question 31

Hernia exit from abdominal cavity

Answer 31

Direct: peritoneum plus transversalis fascia (lies outside inner one or tow fascial coverings of cord) Indirect: peritoneum of persistent processus vaginalis plus all three fascial coverings of cord/ round ligament

Question 32

Direct hernia course

Answer 32

passes through or around inguinal canal, usually traversing only medial third of canal, external and parallel to vestige of processes vaginalis

Question 33

Indirect hernia course

Answer 33

traverses inguinal canal (entire canal if it is of sufficient size) within processes vaginalis

Question 34

Exit from anterior abdominal wall

Answer 34

Direct: via superficial ring, lateral to cord, rarely enters scrotum Indirect: via superficial ring inside cord, commonly passing into scrotum/ labium majus

Question 35

Contents of the rectus sheath

Answer 35

Rectus abdominis and pyramidalis Superior and inferior epigastric vessels Lower 6 intercostal nerves

Question 36

Rectus sheath above arcuate line

Answer 36

Anterior: internal and external oblique fuse Posterior: internal and transverse fuse

Question 37

Rectus sheath below arcuate line

Answer 37

Anterior: internal, external, and transverse fuse Posterior: rectus abdominis contacts with transversals fascia

Question 38

Linea alba

Answer 38

tendinous median raphe between the two rectus abdominis muscles, from by the fusion of the aponeuroses of the external, internal, and transverse muscles extends from xiphoid process to the pubic symphysis

Question 39

Linea semilunaris

Answer 39

curved line along the lateral border of rectus abdominis

Question 40

Arcuate line

Answer 40

crescent shaped line marking the inferior limit of the posterior layer of the rectus sheath; anterior to line that inferior epigastric artery to enter sheath

Question 41

Inguinal triangle

Answer 41

Medially: linea semilunaris (lateral edge of rectus abdomenus) Laterally: lateral umbilical fold (formed by the inferior epigastric vessels) Inferiorly: inguinal ligament

Question 42

Umbilical folds

Answer 42

in the suprapubic region, the parietal peritoneum is raised into 5 folds by 5 structures and run in the extra peritoneal tissue

Question 43

Median umbilical fold

Answer 43

raised by median umbilical ligament (fibroses urachus) | extends from apex of the urinary bladder towards the umbilicus

Question 44

Medial umbilical folds (2)

Answer 44

raised by medial umbilical ligaments (obliterated umbilical artery)

Question 45

Lateral umbilical ligaments (2)

Answer 45

raised by the inferior epigastric arteries in their way to rectus sheath