Inguinal Region

Question 1

The inguinal region extends between ___ and ___

Answer 1

ASIS and the pubic tubercle

Question 2

The aponeurosis of external oblique forms:

Answer 2

• Inguinal ligament
• Lacunar ligament
• Superficial inguinal ring

Question 3

The myopectineal orifice is in what region?

Answer 3

Inguinal region

Question 4

Where is the inguinal ligament?

Answer 4

Inferior border of aponeurosis of external oblique between ASIS and pubic tubercle

Question 5

What is the lacunar ligament?

Answer 5

Deeper fibers of inguinal ligament that pass posteriorly attaching to the superior pubic ramus

Question 6

What is the superficial inguinal ring?

Answer 6

Opening in the aponeurosis of external oblique= exit of inguinal canal
Opens inferomedially in lower part of anterior abdominal wall, superolateral to pubic tubercle

Question 7

The superficial inguinal ring is created by what three points of attachment?

Answer 7

• Lateral crus attaches to pubic tubercle
• Medial crus attaches to pubic crest
• Intercrural fibers connect the two

Question 8

What is the inguinal canal?

Answer 8

~4cm long, obliquely oriented, tubular passage parallel to inguinal ligament

Question 9

What are the entrance and exit of the inguinal canal called?

Answer 9

Entrance: deep inguinal ring
Exit: superficial inguinal ring

Question 10

What is the deep inguinal ring?

Answer 10

Entrance of inguinal canal: evagination in transversalis fascia lateral to inferior epigastric artery

Question 11

What is the anterior wall of the inguinal canal?

Answer 11

Aponeurosis of external oblique

Question 12

What is the posterior wall of the inguinal canal?

Answer 12

Transversalis fascia and conjoint tendon (inguinal falx)

Question 13

What is the roof of the inguinal canal?

Answer 13

Arching fibers of aponeurosis of internal oblique and transversus abdominis; medially, medial crus of aponeurosis of external oblique

Question 14

What is the floor of the inguinal canal?

Answer 14

Iliopubic tracts, inguinal ligament, and lacunar ligament

Question 15

The inguinal canal is a passageway for which structures?

Answer 15

• Ilioinguinal nerve
• Spermatic cord in males
• Round ligament of the uterus in females

Question 16

Where do testes and ovaries develop?

Answer 16

In the superior lumbar region of the posterior abdominal wall

Question 17

What is gubernaculum? Where is it in males?

Answer 17

A fibrous CT cord connecting testes to anterolateral abdominal wall at the deep inguinal ring

Question 18

What is gubernaculum? Where is it in females?

Answer 18

A fibrous CT cord connecting ovaries and uterus to labia majora

Question 19

What ligament connects the ovary to the uterus?

Answer 19

Ovarian ligament

Question 20

What ligament connects the uterus to the anterior abdominal wall?

Answer 20

Round ligament of the uterus

Question 21

Where is processus vaginalis?
What is its function in males and females?

Answer 21

Passes through the inguinal canal and carries muscular and fascial layers with it into the primordial scrotum in males and labia majora in females

Question 22

In the development of females, what does gubernaculum become?

Answer 22

Ovarian ligament and round ligament of the uterus

Question 23

With menopause, what happens to the round ligament of the uterus?

Answer 23

It shrinks

Question 24

A direct inguinal hernia is also called…

Answer 24

acquired

Question 25

An indirect inguinal hernia is also called...

Answer 25

congenital

Question 26

Which type of inguinal hernia is most common?

Answer 26

Indirect/congenital

Question 27

What is the typical cause of a direct/acquired inguinal hernia?

Answer 27

Weakening of muscular wall

Question 28

A direct/acquired inguinal hernia is a protusion of... through...

Answer 28

protrusion of **parietal peritoneum** and possibly **abdominal contents** through **anterior abdominal wall in inguinal area**

Question 29

Where are direct/acquired inguinal hernias in relation to inferior epigastric vessels?

Answer 29

Medial

Question 30

What are potential sites for direct/acquired inguinal hernia?

Answer 30

Medial inguinal fossae

Question 31

Where are indirect/congenital inguinal hernias in relation to inferior epigastric vessels?

Answer 31

Lateral

Question 32

What are potential sites for indirect/congenital inguinal hernia?

Answer 32

Lateral inguinal fossae and deep inguinal ring

Question 33

Indirect/congenital hernia is a protusion of... through... into...

Answer 33

protrusion of **parietal peritoneum** and sometimes **abdominal contents** through **deep inguinal ring** into the **inguinal canal** and possibly **scrotum/ labia majora**

Question 34

The spermatic cord extends from... to ...

Answer 34

from deep inguinal ring to the posterior border of the testis in the scrotum

Question 35

List 8 contents of the spermatic cord

Answer 35

* Ductus (vas) deferens * Artery of ductus deferens * Testicular artery * Cremasteric artery * Pampiniform plexus of veins (converge as testicular veins) * Sympathetic nerve fibers * Lymphatic vessels * Genital branch of the genitofemoral nerve (supplies cremaster muscle)

Question 36

The coverings of the spermatic cord are derived from...

Answer 36

anterior abdominal wall tissues

Question 37

#spermatic cord Dartos fascia and muscle are continuous with...

Answer 37

scarpa's fascia in scrotum

Question 38

#spermatic cord What type of muscle is dartos muscle?

Answer 38

Smooth muscle

Question 39

#spermatic cord External spermatic fascia is derived from what tissue?

Answer 39

External oblique

Question 40

#spermatic cord Cremasteric fascia and cremaster muscle are derived from what tissue?

Answer 40

Internal oblique

Question 41

#spermatic cord Innervation of cremasteric fascia and muscle

Answer 41

Genital branch of genitofemoral nerve (L1, L2)

Question 42

#spermatic cord What type of muscle is cremaster muscle?

Answer 42

Striated muscle

Question 43

#spermatic cord Internal spermatic fascia is derived from what tissue?

Answer 43

Transversalis fascia

Question 44

Name the coverings of the spermatic cord from superficial to deep

Answer 44

* Dartos muscle/fascia * External spermatic fascia * Cremaster muscle * Cremasteric fascia * Internal spermatic fascia * Vestige of processus vaginalis

Question 45

What does the scrotum develop from?

Answer 45

Lumbosacral swellings

Question 46

The internal division of the scrotum is called ___ The externally visible division is called ___

Answer 46

internal division: septum external division: scrotal raphe

Question 47

In the scrotum, what is the dartos fascia continuous with?

Answer 47

Scarpa's fascia

Question 48

What is the dartos muscle in the scrotum? What is its function?

Answer 48

Smooth muscle attached to overlying skin; functions as thermoregulation

Question 49

What ligament is found in the scrotum?

Answer 49

Scrotal ligament

Question 50

What structure is a closed peritoneal sac covering the testis?

Answer 50

Visceral layer of tunica vaginalis

Question 51

What structure is an internal spermatic fascia lining the scrotum?

Answer 51

Parietal layer of tunica vaginalis

Question 52

What is the tough outer surface found deep to visceral tunica vaginalis in the testis?

Answer 52

Tunica albuginea

Question 53

The tunica albuginea in the testis forms a thickened ridge posteriorly. What is this called?

Answer 53

Mediastinum of the testis

Question 54

What is the function of the testes?

Answer 54

Production of spermatozoa and testosterone

Question 55

Innervation of testes

Answer 55

Autonomic nerves arise from testicular plexus of nerves

Question 56

What is included in the testicular plexus of nerves?

Answer 56

* Vagal parasympathetic fibers * Visceral afferent fibers * Sympathetic fibers from spinal level T7

Question 57

The testicular artery is a branch of...

Answer 57

abdominal aorta

Question 58

Describe the path of the testicular artery

Answer 58

Passes through the inguinal canal to spermatic cord

Question 59

The right and left testicular veins are formed from the convergence of...

Answer 59

pampiniform plexus of veins

Question 60

Pampiniform plexus of veins is involved in what function?

Answer 60

Thermoregulation

Question 61

Where does the right testicular vein drain?

Answer 61

Into the IVC

Question 62

Where does the left testicular vein drain?

Answer 62

Into the left renal vein

Question 63

Lymphatic drainage of the testes follows testicular vessels to...

Answer 63

lumbar and preaortic lymph nodes

Question 64

Where does lymph from scrotum drain?

Answer 64

Into superficial inguinal nodes

Question 65

Where is the epididymis?

Answer 65

Along posterior border of testes

Question 66

Where is the head of the epididymis?

Answer 66

Superior expanded part

Question 67

Where is the tail of the epididymis?

Answer 67

Continues to ductus (vas) deferens

Question 68

An indirect hernia that has herniated all the way into the scrotum will pass through...

Answer 68

Deep inguinal ring, inguinal canal, superficial inguinal ring