Inguinal Canal

Question 1

What germ layer gives rise to the testes and overaies?

Answer 1

Intermediate mesoderm
(Develop in the posterior abdominal wall

Question 2

Gubernaculum

Answer 2

“little man that leads” - testes follow the gubernaculum in migration as it passes through muscle layers.

Ends migration in the scrotum.

Question 3

Layers of migration, superficial to deep

Answer 3

Skin
Scarpa's fascia
External Obliques
Internal Abdominal Obliques
Transversus Abdominus
Transversalis Fascia
Peritoneum

Question 4

Layers around testes, superficial to deep

Answer 4

Scrotum: Skin and Dartos
External spermatic fascia
Cremasteric fascia
Internal spermatic fascia
Tunica vaginalis (parietal)
Tunica vaginalis (visceral)

Question 5

Which abdominal layers give rise to each layer around the testes?

Answer 5

External Oblique aponeurosis: External spermatic fascia
Internal Oblique: Cremasteric fascia
Transversalis fascia: Internal spermatic fascia
Peritoneum: Tunica vaginalis (parietal and visceral)

Question 6

Blood supply to the scrotum

Answer 6

Cremasteric artery
Anterior scrotal branches (from deep external pudendal artery)
Posterior scrotal branches (from pudendal artery)

Question 7

Scrotum innervation

Answer 7

Posterior scrotal nerves - posterior surface
Perineal branches of posterior cutaneous N. - posteroinferior surface
Anterior scrotal nerves - anterior surface
Genial branch of genitofemoral n - anterolateral surface

Question 8

Hydrocele

Answer 8

• Excess fluid accumulated in scrotum

- Persistent processus vaginalis

Question 9

What 9 contents are found in the spermatic cord?

Answer 9

1. Ductus deferens
2. Artery to ductus deferens
3. Testicular A.
4. Pampiniform plexus of veins
5. Cremasteric A and V
6. Genital branch of genitofemoral N.
7. Sympathetics and visceral afferents
8. Lymphatics
9. Remnants of processus vaginalis

Question 10

Variocele

Answer 10

Scrotum feels like a “bag of worms”

- Generally on left side

Question 11

What structures are remnants of the gubernaculum?

Answer 11

Males: scrotal ligament (prevents twisting)
Females: Round ligament of the uterus

Question 12

Posterior wall of inguinal canal

Answer 12

Transversalis fascia

Question 13

Inguinal canal location

Answer 13

ASIS –> pubic tubercle

Question 14

Roof of inguinal canal

Answer 14

Transversalis fascia

Question 15

Floor of inguinal canal

Answer 15

Lateral third: Iliopubic tract
Middle third: Inguinal ligament
Medial Third: Lacunar ligament (extension of inguinal ligament)

Question 16

Contents of inguinal canal

Answer 16

Spermatic cord (males)
round ligament of the uterus (females)
blood and lymphatic vessels

Question 17

Conjoint tendon

Answer 17

formed by aponeurosis of internal oblique and transversus abdominus muscle

Question 18

Where do indirect inguinal hernias usually occur?

Answer 18

Lateral to the inferior epigastric A

Question 19

Where do direct inguinal hernias occur?

Answer 19

Medial to inferior epigastric A

In Hesselbach’s Triangle

Question 20

What layers of the testes cover indirect inguinal hernias?

Answer 20

All the layers surrounding the spermatic cord

since it goes through the deep inguinal ring

Question 21

What layers cover direct inguinal hernias?

Answer 21

Parietal peritoneum and Transversalis fascia

because the hernia is outside the deep inguinal ring

Question 22

What type of hernia is more common in women?

Answer 22

Femoral hernias