Inguinal Region

Question 0

Lacunar Ligament

Answer 0

Medial extension of the inguinal ligament which attaches to the pectineal line; its sharp edge form the femoral ring

Question 1

Inguinal Ligament

Answer 1

Lower border of the E.O. aponeurosis; extends from the ASIS to the pubic tubercle

Question 2

Pectineal Ligament

Answer 2

Thickening of the periosteum that is continuous w/ the lacunar ligament at the pectineal line of the pubis

Question 3

Conjoint tendon

Answer 3

Fused aponeuroses of I.O. and transversus abdominis mucles

Question 4

Hesselbach’s Triangle

Answer 4

Weakness in the abdominal wall vulnerable to a direct inguinal hernia; found in the medial inguinal fossa

Question 5

Deep Inguinal Ring

Answer 5

Found lateral to the inferior epigastric vessels in the lateral inguinal fossa; spermatic cord protrudes thru the transverasalis fascia

Question 6

Superficial Inguinal Ring

Answer 6

Formed by the medial and lateral crus (attached to the pubic symphysis and tubercle) and the pubic crest; technically an evagination of the E.O. aponeurosis

Question 7

Anterior Wall of the Inguinal Canal

Answer 7

E.O. aponeurosis and I.O. aponeurosis (lateral 1/3)

Question 8

Posterior Wall of the Inguinal Canal

Answer 8

Transversalis fascia and conjoint tendon (medial 1/3)

Question 9

Roof of Inguinal Canal

Answer 9

I.O. muscle and aponeurosis and transversus abdominis aponeurosis

Also arching muscle fibers

Question 10

Floor of Inguinal Canal

Answer 10

Ingiuinal and lacunar (medial 1/3) ligament

Question 11

Structures transmitted thru the inguinal canal

Answer 11

Male=Spermatic Cord

Female= Round ligament of the uterus

Both= llioinguinal nerve and gential branch of the genitofemoral nerve

*llioinguinal nerve pierces canal laterally at the transversus abdominis and exits thru the superficial ring

Question 12

Processus vaginalis

Answer 12

Evagination of peritoneum into the ventral abdominal wall that is independent of testes descent; after obliteration, persists as the tunica vaginalis on the testes

Question 13

Gubernaculum

Answer 13

Condense band of mesenchyme that connects the developing gonad to the labioscrotal swellings; becomes the fibrous cord connecting the testest to the scrotum or the round ligament of the uterus

Question 14

Testes descent

Answer 14

Gonads develop at L1 and descend thru the inguinal canal picking up layers of fascia as they travel the the processus vaginalis via the gubernaculum

*Cavity of the tunica vaginalis originates from the peritoneum

Question 15

Camper’s Fascia in scrotum

Answer 15

Dartos muscle

Question 16

Scarpa’s Fascia in scrotum

Answer 16

Colle’s Fascia

-membranous layer of superficial fascia

Question 17

E.O. aponeurosis in scrotum

Answer 17

External Spermatic Fascia

Question 18

I.O. muscle and aponeurosis in scrotum

Answer 18

Cremaster muscle and fascia

Question 19

Transversus abdominis muscle in scrotum

Answer 19

NO CONTRIBUTION

Question 20

Transversalis fascia in scrotum

Answer 20

Internal spermatic fascia

Question 21

Extraperitoneal fat in scrotum

Answer 21

Loose CT

Question 22

Parietal Peritoneum in scrotum

Answer 22

Tunica vaginalis (obliterated processus vaginalis)

Question 23

Dartos muscle

Answer 23

Contracts in response to cold and reduces the surface area of the scrotum

*Stabilizes testis temperature

Question 24

Tunica albuginea

Answer 24

Outer capsule surrounding the testis

Question 25

Site of sperm production

Answer 25

Seminiferous tubules

Question 26

Spermatic Cord Layers and Components

Answer 26

Layers: External spermatic fascia Cremasteric fascia Internal spermatic fascia Components: Testicular artery Ductus deferens and artery Pampiniform plexus (converges as testicular vein) Genital branch of genitofemoral nerve Cremasteric artery Autonomic nerve plexus

Question 27

Indirect Inguinal Hernia

Answer 27

- Neck of hernia passes thru deep inguinal ring in lateral inguinal fossa - Enters lateral to inferior epigastric vessels - Cause is from incomplete obliteration of the processus vaginalis - covering consists of peritoneum * More common hernia

Question 28

Direct Inguinal Hernia

Answer 28

- Neck of hernia passes directly thru inguinal fossa in Hesselbach's triangle - Enters medial to inferior epigastric vessels - Never extends to scrotum - Caused by weak posterior wall of inguinal canal

Question 29

Femoral Hernia

Answer 29

Occurs thru the femoral ring and lies inferolaterally to the pubic tubercle * Dangerous to repair due to possible presence of corona mortis and constriction by tough ligaments * Common in women

Question 30

Cryptochordism

Answer 30

Incomplete testes descent such that one of both testes remain in the body cavity or inguinal canal

Question 31

Cremasteric Reflex

Answer 31

Reflex contraction of the cremaster muscle due to stroking of the medial thigh Ilioinguinal N.-sensory to inner thigh Genital Branch of genitofemoral N.- Motor to cremaster

Question 32

Peritoneal recess infection

Answer 32

Occurs more commonly in women due to communication of Fallopian tubes and peritoneal cavity