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Abdo > Inguinal canal > Flashcards

Inguinal canal Flashcards

1
Q

what is the inguinal canal?

A

a short passage that extends inferiorly and medially, through the inferior part of the abdominal wall

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2
Q

where is the inguinal canal in relation to the inguinal ligament?

A

superior and parallel to the inguinal ligament

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3
Q

what does the inguinal canal act as?

A

pathway by which structures can pass from the abdominal wall to the external genitalia

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4
Q

what is the clinical importance of the inguinal canal?

A

a potential weakness in the abdominal wall, and therefore a common site of herniation

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5
Q

what happens to the testes during development? where does it occur?

A

testes establish in the posterior abdominal wall, and descend into the scrotum

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6
Q

what guides the descend of the testes?

A

a fibrous cord of tissue called the gubernaculum attaches the inferior portion of the gonad to the future scrotum, and guides them during their descent

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7
Q

what is the significance of the inguinal canal in the development of the testes?

A

the pathway by which the testes are able to leave the abdominal cavity and enter the scrotum

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8
Q

what is the inguinal canal flanked by in the embryological stage? what is it called and it’s fate?

A

an outpocketing of the peritoneum, and the abdominal musculature
outpocketing called processus vaginalis (normally degenerates)

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9
Q

what happens if the processus vaginalis fail to degenerate?

A

result in indirect inguinal hernia

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10
Q

what is the function of the gubernaculum in women?

A

attaches the ovaries to the uterus and future labia majora

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11
Q

what are the ovaries attached to the uterus by?

A

gubernaculum

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12
Q

what does the attachment of ovaries to uterus by gubernaculum prevent?

A

prevented from descending as far as the testes, and instead moving into the pelvic cavity

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13
Q

in females, what does the gubernaculum then become?

A

the ovarian ligament, and round ligament of uterus

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14
Q

what is the mid-inguinal point?

A

halfway between the pubic symphysis and anterior superior iliac spine

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15
Q

which structure is at the mid-inguinal point?

A

femoral artery crosses into the lower limb

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16
Q

what is the midpoint of the inguinal ligament?

A

halfway between ASIS and pubic tubercle (superior rami of pubis)

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17
Q

what is at the midpoint of the inguinal ligament?

A

femoral nerve

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18
Q

where is the opening to the inguinal ligament?

A

just above the midpoint of the inguinal ligament

19
Q

what is the inguinal canal made up of?

A

anterior & posterior walls
superficial & deep rings (openings)
roof and floor (or superior and inferior walls)

20
Q

what forms the anterior wall of the inguinal canal

A

aponeurosis of the external oblique and reinforced by the internal oblique muscle laterally

21
Q

what forms the posterior wall of the inguinal canal?

A

transversalis fascia

22
Q

what forms the roof of the inguinal canal?

A

transversalis fascia, internal oblique & transversus abdominis

23
Q

what forms the floor of the inguinal ligament?

A

a ‘rolled up’ portion of the external oblique aponeurosis & thickened medially by the lacunar ligament

24
Q

what happens during periods of increased intra-abdominal pressure?

A

the abdominal viscera are pushed into the inguinal canal

25
Q

what does the body do during periods of increased intra-abdominal pressure? why?

A

to prevent herniation

the muscles of the anterior & posterior wall contract and ‘clamp down’ on canal

26
Q

what are the 2 openings to the inguinal canal known as?

A

rings

27
Q

where is the deep (internal) ring found?

A

above the midpoint of the inguinal ligament, which is lateral to the epigastric vessels

28
Q

what is the deep internal ring created by?

A

transversalis fascia, which invaginates to form a covering of the contents of the inguinal canal

29
Q

where is the superficial (external) ring found?

A

just superior to the pubic tubercle

30
Q

what does the superficial (external) ring mark?

A

the end of the inguinal canal

31
Q

what does the superficial (external) ring look like?

A

a triangle shaped opening

32
Q

what forms the superficial (external) ring?

A

formed by the evagination of the external oblique, which forms another covering of the inguinal canal contents

33
Q

what does the superficial (external) ring contain?

A

intercrural fibres

34
Q

where do intercrural fibres run? what does it prevent?

A

perpendicular to the aponeurosis of the external oblique and prevent the ring from widening?

35
Q

what passes through the inguinal canal in men? what is it’s function?

A

spermatic cord

supply and drain testes

36
Q

what passes through the inguinal canal in women?

A

round ligament of the uterus transverses

37
Q

what is special about the walls of the inguinal canal? why?

A

walls of inguinal canal are usually collapsed around their contents, preventing other structures from potentially entering the canal and becoming stuck

38
Q

what is a hernia?

A

protrusion of an organ of fascia through the wall of cavity that normally contain it

39
Q

what are the 2 main categories that hernias involving the inguinal canal can be divided into?

A

indirect & direct

40
Q

what is indirect hernia involving the inguinal canal?

A

where the peritoneal sac enters the inguinal canal through the deep inguinal ring

41
Q

what is direct hernia involving the inguinal canal?

A

where the peritoneal sac enters the inguinal canal through the posterior wall of the inguinal canal

42
Q

what can both direct and indirect hernia involving inguinal canal present as?

A

lumps in the scrotum or labia majora

43
Q

explain indirect inguinal hernia

A

more common, has congenital origin
due to failure of the processus vaginalis to regress
peritoneal sac enters the inguinal canal via the deep inguinal ring
degree to which the sac herniates depends on the amount of processus vaginalis still present
as the sac moves through the inguinal canal, it acquires the same 3 coverings as the contents of the canal

44
Q

explain direct inguinal hernias

A

in contrast to the indirect hernia, this is aquired in origin, due to weakening in the abdominal musculature
the peritoneal sac originates from an area medial to the epigastric vessels and bulges into the inguinal canal via the posterior wall

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