inguinal canal & spermatic cord

Question 1

name the layers of the abdominal wall

Answer 1

1. external oblique
2. internal oblique
3. transversus abdominis
4. transversalis fascia
5. parietal peritoneum

Question 2

how is the inguinal ligament formed?

Answer 2

is the rolled edge of the external oblique aponeurosis

Question 3

what ligament connects the inguinal and pectineal ligament together?

Answer 3

lacunar ligament

Question 4

describe inguinal canal in males

Answer 4

oblique passageway carrying structures to/from the testes and abdomen via spermatic cord ( +ilioinguinal nerve)

Question 5

describe inguinal canal in females

Answer 5

carries round ligament of the uterus from the pelvis to the labia majora ( +ilioinguinal nerve)

Question 6

what is the superficial inguinal ring and where would you find it?

Answer 6

• a triangular-shaped defect in the aponeurosis of external oblique
• found superior and lateral to the pubic tubercle

Question 7

what is the deep inguinal ring and where would you find it?

Answer 7

oval defect in transversalis fascia

found half way between ASIS and pubic symphysis (not tubercle), is lateral to inferior epigastric artery

Question 8

what muscular layer does internal oblique give rise to

Answer 8

cremasteric muscle

Question 9

what are the borders of the inguinal canal

Answer 9

anterior wall

• aponeurosis of external oblique
• aponeurosis of internal oblique

Floor

• inguinal ligament
• lacunar ligament

roof

• fibers of internal oblique
• transversus abdominis

posterior wall

• transversalis fascia
• conjoint tendon

Question 10

what forms the conjoint tendon

Answer 10

transversus abdominis + internal oblique

Question 11

define the borders of the hesselbach’s triangle and describe its importance clinically

Answer 11

lateral = rectus abdominis
superior = inferior epigastric artery
inferior = inguinal ligament

direct site of hernia’s

Question 12

define the layers of the spermatic cord

Answer 12

transversalis fascia (D.I.R) = internal spermatic cord
transversus abdominis = no covering
internal oblique = cremaster muscle
external oblique (S.I.R) = external spermatic fascia

Question 13

what is the blood supply to the scrotum

Answer 13

internal and external pudendal arteries

Question 14

describe the content within the spermatic cord

Answer 14

arteries

• artery of vas deferens
• testicular artery
• cremasteric artery

nerves

• genital branch of genitofemoral nerve
• sympathetic nerve

other structures

• lymphatics
• vas deferens
• tunica vaginalis

venous plexus
- pampiniform plexus

Question 15

define testicular torsion and test to identify this

Answer 15

testicular torsion is when the spermatic cord twists around, cutting off blood supply (causing ischemia)

cremasteric reflect would be absent or decreased in a patient with testicular torsion

Question 16

define inguinal hernias

Answer 16

protrusion of abdominal contents through inguinal canal

2 types: direct & indirect

Question 17

describe the differences between direct and indirect hernias

Answer 17

indirect

• goes through the entirety of inguinal canal e.g. through D.I.R (surrounded by all layers of spermatic cord)
• lateral to inferior epigastric
• normally due to a congenital defect
• often seen in younger people

direct

• herniate through weak area = hesselbach triangle
• medial to inferior epigastric
• males 10x more likely
• more commonly in middle age/elderly

Question 18

describe femoral hernias

Answer 18

• affects women more commonly

- below the inguinal ligament, through femoral canal