Inguinal Region/Spermatic Cord

Question 1

layers over testes

Answer 1

1. superficial/dartos fascia
2. external spermatic fascia
3. cremaster muscle and fascia
4. internal spermatic fascia
5. parietal layer tunica vaginalis
6. epididymis
7. testis covered by visceral layer

Question 2

inguinal ligament

Answer 2

made from aponeurosis of external oblique

ASIS to pubic tubercule

Question 3

conjoint tendon

Answer 3

from aponeuroses of internal oblique and TA
attaches to linguinal

Question 4

inguinal canal

Answer 4

passageway for spermatic cord and round ligament in abdominal wall

floor of canal is ligament

Question 5

order of testes passage

Answer 5

transversalis fascia
transversus abdominus (TA)
internal oblique
external oblique

Question 6

arches

Answer 6

under the 3 muscles:
TA
internal oblique
external oblique

Question 7

rings

Answer 7

deep: in transversalis fascia ENTER canal
superficial: external oblique EXIT to scrotum

Question 8

rings

location

Answer 8

deep: 1/2 way b/t ASIS and pubic tubercule
superficial: medial to pubic tubercule

Question 9

transversalis fascia

becomes

Answer 9

deep ring
internal spermatic fascia (deepest of the 4 fascia layers)

Question 10

transversus abdominis

becomes

Answer 10

nothing
just arches over canal to conjoint tendon

Question 11

internal oblique

becomes

Answer 11

cremaster muscle and fascia (3rd layer of fascia)

cremaster raises testes based on temp

Question 12

external oblique

becomes

Answer 12

external spermatic fascia (2nd layer)
superficial ring

Question 13

arterial supply

Answer 13

testicular arteries
off aorta

Question 14

venous return

Answer 14

pampiniform plexus
right drains into IVC
left drains into left renal canal

cremaster vessels from inferior epigastric vasculature too?

Question 15

anterior cutaneous branch iliohypogastric

Answer 15

skin of canal

L1

Question 16

genital branch genitofemoral

Answer 16

cremaster muscle

L1-2

Question 17

anterior scrotal branch iliolinguinal

Answer 17

inside canal?

L1

Question 18

spermatic cord contents

Answer 18

vas deferens (+ art and vein)
genital branch-genitofemoral
external and internal spermatic fascia
cremaster muscle/art/vein
vestige processus vaginalis, tunica vaginalis
testicular plexus
testicular artery
testicular vein/pampiniform plexus

Question 19

muscles

inguinal region

Answer 19

pyramidalis
cremaster
dartos

Question 20

pyramidalis

Answer 20

tenses linea alba
subcostal T12

not important

Question 21

dartos muscle

Answer 21

shrivels testes when cold to hold heat

from scarpa’s fasica

Question 22

gubernaculum

Answer 22

ligamentous primordia attaches developing testis/ovary and scrotal/labial folds

marks site of future inguinal canal

Question 23

inguinal canal formation

Answer 23

7th week- parietal peritoneum projects out into processus vaginalis to make pocket thru body wall
9th month- pocket/procesus vaginalis seals

next to gubernaculum

Question 24

peritoneum

becomes

Answer 24

tunica vaginalis

Question 25

camper's fascia | becomes

Answer 25

nothing in spermatic cord

Question 26

layers in labia majora

Answer 26

external fascia cremasteric muscle and fascia internal fascia round ligament | labia major same as scrotum round lig from gubernaculum

Question 27

inguinal canal in females | formation

Answer 27

upper gubernaculum > ovarian ligament lower gubernaculumm > round ligament 8th week start > 15th week end

Question 28

hernia

Answer 28

protrusion of tissue or organ thru weakness or opening in layers normally contained in

Question 29

hernia | causes

Answer 29

erect posture inc intra-ab pressure (constipation, birth, coughing) processus vaginalis not sealing muscular deficiency tissue abnormality

Question 30

common hernias

Answer 30

direct inguinal indirect inguinal femoral

Question 31

direct hernias

Answer 31

thru weaking in hasselbach triange thru body wall parallel to cord never within unilateral bc acquired somehow

Question 32

hasselbach triangle borders

Answer 32

inferior epigastric superior rectus abdominus medial inguinal ligament lateral/inferior

Question 33

indirect hernia | congenital

Answer 33

thru deep ring within cord bilateral presentation

Question 34

femoral hernia

Answer 34

thru femoral ring more common in older women

Question 35

hydrocele | clinical correlate

Answer 35

build up of fluid can go away on it's own less dangerous can be associated w/ hernias

Question 36

hematocele | clinical correlate

Answer 36

filled with blood more dangerous

Question 37

spermatocele | clinical correlate

Answer 37

epididymis cyst build up of sperm and assoc fluids feels hard so mistaken for cancer common