Inguinal Region and Descent of the Gonads Flashcards Preview

Structure and Function Test 1 > Inguinal Region and Descent of the Gonads > Flashcards

Flashcards in Inguinal Region and Descent of the Gonads Deck (107)
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1
Q

What are the 8 layers of the anterolateral abdominal wall?

A
  1. ) Skin
  2. ) Superficial Fascia
  3. ) External oblique
  4. ) Internal oblique
  5. ) Transverse abdominus
  6. ) Transverse Fascia
  7. ) Extraperitoneal
  8. ) Parietal Peritoneum
2
Q

What are the two layers of the superficial fascia?

A
  1. ) Camper’s Fascia

2. ) Scarpa’s Fascia

3
Q

The outer fatty layer of superficial fascia

A

Camper’s Fascia

4
Q

The inner fibrous layer of superficial fascia

A

Scarpa’s Fascia

5
Q

What are the three parts of the external oblique layer?

A
  1. ) External oblique muscle
  2. ) External oblique Aponeurosis
  3. ) External oblique Fascia
6
Q

What are the three parts of the internal oblique layer?

A
  1. ) Internal oblique muscle
  2. ) Internal oblique Aponeurosis
  3. ) Internal oblique Fascia
7
Q

What are the three parts of the transverse abdominis layer?

A
  1. ) Muscle
  2. ) Aponeurosis
  3. ) Fascia
8
Q

The transversalis fascia is also known as the

A

Endoabdominal fascia

9
Q

The Scarpa’s fascia of the anterior abdomnal wall is continuous inferiorly as the

A
  1. ) Dartos fascia of scrota and penis

2. ) Colle’s fascia of perineum

10
Q

In the anterior midline, and covered by anterior and posterior rectus sheaths

A

Rectus Abdominis muscles

11
Q

Splits at the lateral border of the rectus abdominus, above the arcuate line (upper three fourths)

A

Internal oblique aponeurosis

12
Q

Formed by the external oblique aponeurosis and the anterior lamina of the internal oblique aponeurosis

A

Anterior rectus sheath

13
Q

Formed by the posterior lamina of the internal oblique

aponeurosis and the transversus abdominis aponeurosis

A

Posterior rectus sheath

14
Q

Below the arcuate line (lower one-fourth) the internal oblique aponeurosis does not split at the lateral border of the muscle and all three aponeuroses pass

A

Anterior to the rectus abdominus

15
Q

Below the arcuate line (lower one-fourth) the internal oblique aponeurosis does not split at the lateral border of the muscle and all three aponeuroses pass anterior to the rectus abdominis to form the

A

Anterior sheath

16
Q

There is no posterior sheath, and the muscle lies directly against the

A

Transversalis fascia

17
Q

The inferior epigastric vessels lie between the

A

Posterior rectus sheath and the rectus abdominis muscle

18
Q

The inferior epigastric vessels gain entrance to the rectus sheath at the

A

Arcuate line

19
Q

Below the arcuate line, the inferior epigastric vessels lie between the

A

Transversalis fascia and rectus abdominis

20
Q

The inferior epigastric vessels anastomose with the

A

Superior epigastric vessels

21
Q

The downward continuation of the internal thoracic vessels

A

Superior epigastric vessels

22
Q

Thus, there is an anastomotic pathway between

branches of the subclavian vessels (internal thoracic) and branches of the

A

External illiac vessels (inferior epigastric)

23
Q

The external oblique aponeurosis inserts onto the

A

Illiac crest and pubic crest

24
Q

The external oblique aponeurosis has no bony attachment between the

A

Anterior superior illiac spine and the pubic tubercle

25
Q

The external oblique aponeurosis folds under on itself between the

A

Anterior superior illiac spine and the pubic tubercle

26
Q

The edge of this fold is the

A

Inguinal ligament

27
Q

The lateral 2/3 of the folded under portion of the aponeurosis serves as an attachment for the

A

Internal oblique muscle

28
Q

Has no muscle attached to it

A

Medial 1/3 of folded under portion

29
Q

The medial 1/3 of the folded under portion of the external oblique aponeurosis has no muscle attached to it. This leaves a gap for what to pass through?

A

Spermatic cord (males) or round ligament of the uterus (females)

30
Q

This gap (intermediate inguinal ring) is between the inguinal ligament and the lower edge of the internal oblique muscle, called the

A

Falx inguinals

31
Q

The medial portion of the internal oblique aponeurosis and the transversus abdominis aponeurosis are fused into a single tendon called the

A

Conjoint Tendon

32
Q

The conjoint tendon is the medial continuation of the

A

Falx inguinals

33
Q

The pathway through which the testes descends in the male

A

Inguinal canal

34
Q

What does the inguinal canal contain in

  1. ) Males
  2. ) Females
A
  1. ) Spermatic cord

2. ) Round ligament of the uterus

35
Q

The inguinal canal begins internally at the

A

Deep inguinal ring

36
Q

An invagination of the transversalis fascia

A

Deep inguinal ring

37
Q

The inguinal canal ends externally at the

-A gap in the external oblique aponeurosis

A

Superficial inguinal ring

38
Q

Form the superior wall of the inguinal canal

-the lower fibers of the terminal oblique

A

Falx inguinalis

39
Q

What makes up the following walls of the inguinal canal?

  1. ) Anterior
  2. ) Posterior
  3. ) Superior
  4. ) Inferior
A
  1. ) External oblique aponeurosis
  2. ) Transversalis fascia
  3. ) Arching fibers of falx inguinalis
  4. ) Inguinal ligament
40
Q

What are the 6 contents making up the spermatic cord?

A
  1. ) Ductus deferens
  2. ) Testicular artery
  3. ) Pampiniform plexus (testicular vein)
  4. ) Genital branch of genitofemoral nerve
  5. ) Autonomic nerves
  6. ) Lymphatic vessels
41
Q

Innervates cremaster and provides cutaneous snesation to the anterior scrotum (male) and mons pubis and labia majora (female)

A

Genital branch of genitofemoral nerve (L1 and L2)

42
Q

The genital branch of the genitofemoral nerve (L1 and L2) innervates the

A

Anterior scrotum (male) and mons pubis and labia majora (female)

43
Q

As the testis descends through the inguinal ring, it and the spermatic cord take on coverings that are continuous with elements of the

A

Anterior abdominal wall

44
Q

As the testis passes through the deep inguinal ring, it is covered by the

-continuous with the transversalis fascia

A

Internal spermatic fascia

45
Q

As the testis passes through the intermediate inguinal ring, under the falx inguinalis, it is covered by some of the lower muscle fibers of the internal oblique muscle, which are called the

A

Cremaster muscle

46
Q

The fibers covering the cremaster muscle are called the

A

Cremasteric Fascia

47
Q

As the testis passes through the superficial inguinal ring, it is covered by an invagination of the external oblique fascia called the

A

External spermatic fascia

48
Q

What does contraction of the cremaster muscle do?

A

Elevates the spermatic cord and testis

49
Q

Serves a thermoregulatory function since the testes is warmer closer to the body and cooler when it is lower in the scrotum

A

Cremaster muscle

50
Q

The cremaster will contract reflexly in response to stimulation of the skin of the lower abdominal wall or inner thigh this is called the

A

Cremateric reflex

51
Q

The cremasteric reflex can be used to test the integrity of the

A

L1 spinal cord segment

52
Q

In the female, the round ligament of the uterus occupies the inguinal canal and, after passing through the superficial inguinal ring, it descends to the

A

Labia Majus

53
Q

The round ligament of the uterus ends in the

A

Superficial fascia

54
Q

The round ligament of the uterus is derived from the

A

Caudal genital ligament

55
Q

The round ligament of the uterus is homologous to the

A

Gubernaculum testis in the male

56
Q

The coverings of the round ligament of the uterus are identical to the coverings of the

A

Spermatic cord

57
Q

The gubernaculum attaches to the

A

Scrotum

58
Q

The round ligament of the uterus attaches to the

A

Labia Majora

59
Q

The thin scrotal skin, the absence of fat in the superficial fascia of the scrotum and the abundance
of sweat glands in the scrotal skin all facilitate

A

Heat Loss

60
Q

What are three anatomic mechanisms that allow for regulation of testicular temperature?

A
  1. ) Cremaster muscle
  2. ) Dartos muscle
  3. ) Pampiniform plexus
61
Q

A skeletal muscle in the covering of the spermatic cord that is innervated by the genital branch of the genitofemoral nerve

-causes elevation of the testis upon contraction

A

Cremaster muscle

62
Q

A smooth muscle in the skin of the scrotum that is sympathetically innervated

A

Dartos muscle

63
Q

What does the dartos muscle do?

A

Reduces the size of the scrotal sac and thereby decreases surface area to reduce heat loss

64
Q

The dartos contracts to reduce heat loss in a

A

Cold environment

65
Q

A venous plexus that is the continuation of the testicular vein

A

Pampiniform plexus

66
Q

Forms an elaborate network of veins that surrounds the testicular artery in the spermatic cord

A

Pampiniform plexus

67
Q

The large amount of surface area of contact between the testicular artery and the pampiniform plexus allows for the transfer of heat from the arterial blood in the testicular artery to venous blood in the testicular vein this is called

A

Thermal counter-current

68
Q

Allows for the reduction of temperature of testicular artery blood before it reaches the testis, thus reducing the heat increase in the testis and lowering the thermal gradient between the testis and the environment

A

The thermal counter-current provided by the pampiniform plexus

69
Q

What are the two types of inguinal hernias?

A

Direct and indirect

70
Q

Follow the course of the descending testis through the inguinal canal

A

Indirect inguinal hernias

71
Q

Enter at the deep inguinal ring and exit at the superficial inguinal ring

A

Indirect inguinal hernias

72
Q

These hernias are covered by all of the same fascial layers as is the spermatic cord and testis since they follow the identical course as the descending testis

A

Indirect inguinal hernias

73
Q

Do not follow the pre-formed path of the inguinal canal, rather they create their own path by tearing through the abdominal wall

A

Direct inguinal hernias

74
Q

Direct inguinal hernias typically occur where the abdominal wall is weakest, which is at the

A

Superficial inguinal ring

75
Q

The region through which direct inguinal hernias occur is called the

A

Inguinal (Hesselbach’s) Triangle

76
Q

What are the following borders of the Inguinal (Hesselbach’s) Triangle?

  1. ) Lateral border
  2. ) Inferior border
  3. ) Medial border
A
  1. ) Inferior epigastric artery
  2. ) Inguinal ligament
  3. ) Lateral border of rectus abdominus
77
Q

Typically, direct inguinal hernias are covered by the

A

External spermatic fascia

78
Q

Prior to the descent of the testis, the parietal peritoneum forms a finger-like evagination called the

-descends through the inguinal canal

A

Processus vaginalis

79
Q

The proximal portion of the processus vaginalis fuses, becomes fibrous and disappears after the

A

Descent of the testis

80
Q

The distal portion of the processus vaginalis is within the

-remains unfused following descent of the testis

A

Scrotum (covers most of the testes)

81
Q

The distal unfused portion of the peritoneum is the

A

Tunica vaginalis

82
Q

A double layer of peritoneum with a small cavity containing fluid

A

Tunica vaginalis

83
Q

The layer of the tunica vaginalis that is in direct contact with the testis is called the

A

Visceral layer

84
Q

The outer layer of the utnica vaginalis is called the

A

Parietal layer

85
Q

The tunica vaginalis covers the anterior, lateral and medial surfaces of the testis, but not the posterior surface, which is the location of the

A

Epididymis

86
Q

When the proximal portion of the processus vaginalis does not fuse we have a

A

Patent processus vaginalis

87
Q

A patent processus vaginalis results in a continuous opening from the peritoneal cavity of the abdomen into the scrotum. This will predispose for a

A

Congenital or acquired indirect inguinal hernia

88
Q

If there is incomplete fusion of the processus vaginalis, leaving a small unfused portion, this results in a

A

Hydrocele of the spermatic cord

89
Q

Distinguished from inguinal hernias because they pass deep to the inguinal ligament

A

Femoral hernias

90
Q

Pass superficial to the inguinal ligament after emerging from the superficial inguinal ring

A

Inguinal hernias

91
Q

Pass through the femoral ring to enter the femoral sheath

A

Femoral hernias

92
Q

What are the following borders of the femoral ring?

  1. ) Anterior
  2. ) Medial
  3. ) Posterior
  4. ) Lateral
A
  1. ) Inguinal ligament
  2. ) Lacunar ligament
  3. ) Pectin pubis
  4. ) Femoral vein
93
Q

The medial reflected portion of the inguinal ligament

A

Lacunar ligament

94
Q

Typically, femoral hernias leave the femoral sheath through the

A

Saphenous hiatus

95
Q

Make up about 75% of abdominal hernias and occur more commonly in men than in women (10:1)

A

Inguinal hernias (most are indirect)

96
Q

Make up about 7% of abdominal hernias and occur more commonly in women than in men (4:1)

A

Femoral hernias

97
Q

Femoral hernias and inguinal hernias have approximately the same frequency in

A

Women

98
Q

If a hernia can be pushed back into the abdomen, it is called a

A

Reducible hernia

99
Q

If a hernia can not be pushed back into the abdomen, it is called an

A

Incarcerated hernia

100
Q

If the blood supply to the herniated organ is compromised, it is a

-will lead to tissue necrosis

A

Strangulated hernia

101
Q

Have a particularly high risk (20% - 30%) of incarceration and strangulation

A

Femoral hernias

102
Q

An outpouching of the skin and superficial fascia of the abdominal wall

A

Scrotum

103
Q

The superficial fascia of the scrotum, the dartos fascia is continuous with

A
  1. ) Scarpa’s fascia in abdominal wall

2. ) Colle’s fascia in perineum

104
Q

Is there fat in the superficial fascia of the scrotum?

A

No

105
Q

Is there muscle in the superficial fascia of the scrotum?

A

Yes; dartos muscle (smooth muscle)

106
Q

In the male, the spermatic cord (including the ductus

deferens, testicular vasculature, lymphatics and nerves) passes through the

A

Inguinal canal

107
Q

The testis is attached to the scrotal wall by the

A

Gubernaculum

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