C1:S3 - Inguinal Canal

Question 1

When is the inguinal formed?

Answer 1

During relocation of gonads during foetal development

Question 2

What forms the inguinal canal?

Answer 2

Layers of the anterior abdominal wall pushing through obliquely to form the canal

Question 3

How long is the inguinal canal?

Answer 3

Approx 4cm long

Question 4

What does the inguinal canal lie parallel to and above?

Answer 4

Parallel to and above the medial half of the inguinal ligament

Question 5

What two points is the inguinal ligament attached to?

Answer 5

Superolaterally - ASIS Inferiomedially - Pubic Tubercle

Question 6

What forms the anterior wall of the inguinal canal?

Answer 6

Aponeurosis of the internal/external oblique

Question 7

What forms the posterior wall of the inguinal canal?

Answer 7

Transversalis fascia

Question 8

What forms the roof of the inguinal canal?

Answer 8

Transversalis fascia Internal oblique Transversus abdominis

Question 9

What forms the floor of the inguinal canal?

Answer 9

Inguinal ligament

Question 10

MALT

Answer 10

M = Muscles (roof) A = Aponeurosis (anterior) L = Ligament (floor) T = Transversalis (posterior)

Question 11

What is the relationship between the deep inguinal ring and inferior epigastric vessels?

Answer 11

Sit lateral and cross over each other

Question 12

What are the inferior epigastric vessels branches of superiorly?

Answer 12

Internal thoracic artery

Question 13

What are the inferior epigastric vessels branches of inferiorly?

Answer 13

External Iliac artery

Question 14

What does the superficial ring lie in relation to the pubic tubercle?

Answer 14

Superolateral

Question 15

What are the contents of the male inguinal canal?

Answer 15

Ilioinguinal nerve (L1) Genital branch of the genitofemoral nerve Spermatochord Testicular Artery

Question 16

What are the contents of the female inguinal canal?

Answer 16

Ilioinguinal nerve (L1) Genital branch of the genitofemoral nerve Round ligament Blood and lymph vessels

Question 17

What are the two ways of classifying inguinal hernias?

Answer 17

Direct Indirect

Question 18

What hernia is this and how can you tell?

Answer 18

Direct Hernia

• Abdominal contents not in the deep inguinal ring
• They simply push through a weak spot in the muscles that make up the wall of the inguinal canal
• Contents can pass through the external ring

Question 19

What hernia is this and how can you tell?

Answer 19

Indirect

• Congenital weakness in the deep inguinal ring
• Abdo contents in the canal lateral to the inferior epigastric vessels
• Occasionally the abdo contents can also enter through the deep ring into the scrotum

Question 20

What are femoral hernias?

Answer 20

Occur below inguinal ligament Abdo contents pass into the femoral canal through weekend posterior wall Risk of strangulation is high

Question 21

What is an umbilical hernia?

Answer 21

Occur at weakness at site of the passage of the umbilical cord through abdominal wall Acquired rather than congenital Abnormal fibres at lineament alba may contribute to weakness of wall