Pelvis and Perineum: Part 1

Question 1

What nerves innervate the anterior abdominal wall?

Answer 1

Lower 6 Thoracic Nerves (T7-11)
Subcostal Nerve (T12)
Ilioinguinal & Iliohypogastric (L1 Plexus)

Question 2

What are the branches of the external iliac artery?

Answer 2

Inferior Epigastric Artery
Deep Iliac Circumflex Artery

Question 3

What artery is the dominant vascular supply of the anterior abdominal wall? (VERY IMPORTANT)

Answer 3

Inferior Epigastric Artery

Question 4

Where is the Inferior Epigastric Artery located?

Answer 4

Immediately above the Inguinal Ligament

Question 5

What artery is a branch of the External Iliac Artery that lies behind the inguinal ligament?

Answer 5

Deep Iliac Circumflex Artery

Question 6

What are the two branches of the Femoral Artery?

Answer 6

Superficial Epigastric Artery
Superficial External Pudendal Artery

Question 7

What is the Inguinal Canal comprised of?

Answer 7

Inguinal Ligament (inferior wall)
External Oblique aponeurosis (anterior)
Internal Oblique (anterior + superior & some posterior)
Transerve Abdominus (anterior + superior & some posterior)
Transversalis Fascia (Posterior Wall)

Question 8

What is the Deep Inguinal Ring formed by?

Answer 8

Transversalis Fascia
(above inguinal ligament)

Question 9

What is the Superficial Inguinal Ring formed by?

Answer 9

External Oblique aponeurosis

Question 10

What runs through the inguinal canal?

Answer 10

Ilioinguinal Nerve
Spermatic Cord (males)
Round Ligament of the Uterus (females)

Question 11

Thick, enrolled border of the aponeurosis of the external oblique muscle? Also makes up the inferior wall of the inguinal canal.

Answer 11

Inguinal Ligament

Question 12

Area between the anterior superior iliac spine (ASIS) and the Pubic Tubercle.

Answer 12

Inguinal Region

Question 13

Out-pouching of the peritoneum that occurs at about the 12th week of fetal life

Answer 13

Processus Vaginalis

Question 14

Where do the testis form?

Answer 14

Posterior wall
(deep to transversalis fascia and peritoneum)

Question 15

What is the path of migration of the testis?

Answer 15

Migrate to the inguinal region
- passes through abdominal wall
- then to the scrotum

Question 16

What do the ductus deferens, the testis, and the processes vaginalis all have in common?

Answer 16

Same coverings all the way to the scrotum

Question 17

What happens when the testes reach the scrotum?

Answer 17

Proximal part of the processus vaginalis obliterates

Question 18

What reproductive organ never leaves the abdomen?

Answer 18

Ovary

Question 19

What happens if the processus vaginalis fails to obliterate at birth?

Answer 19

More likely to have a congenital inguinal hernia
(both sexes)

Question 20

What does Camper’s fascia become in the scrotum?

Answer 20

Dartos (smooth muscle)
- scrotal rugae for temperature regulation
- involuntary

Question 21

What does Scarpa’s fascia become in the scrotum?

Answer 21

Colle’s Fascia (membranous)

Question 22

Hernia that passes through the deep inguinal ring, LATERAL to the inferior epigastric vessels.

Answer 22

Indirect Inguinal Hernia

Question 23

What side of the body do you typically find Indirect Inguinal Hernias on?

Answer 23

Right

Question 24

What age group is more likely to develop an indirect inguinal hernia?

Answer 24

Children
Young Adults

Question 25

What type of hernia may be congenital?

Answer 25

Indirect Inguinal Hernia

Question 26

What type of hernia often extends to the scrotum or labia majus?

Answer 26

Indirect Inguinal Hernia

Question 27

What type of hernia commonly has strangulation with it?

Answer 27

Indirect Inguinal Hernia

Question 28

What type of hernia passes through the posterior wall of the inguinal canal, MEDIAL to inferior epigastric vessels?

Answer 28

Direct Inguinal Hernia

Question 29

What side of the body are Direct Inguinal Hernias usually found on?

Answer 29

Bilaterally

Question 30

What age group is more likely to develop a Direct Inguinal Hernia?

Answer 30

Old Man (weak abdominal muscles)

Question 31

What type of hernia is ALWAYS ACQUIRED?

Answer 31

Direct Inguinal Hernia

Question 32

What type of hernia rarely extends to the scrotum or labium majus?

Answer 32

Direct Inguinal Hernia

Question 33

What type of hernia rarely has strangulation?

Answer 33

Direct Inguinal Hernia

Question 34

What is the name of the location where direct abdominal hernias can protrude through the abdominal wall?

Answer 34

Inguinal Triangle (Hasselbach Triangle)

Question 35

A remnant of the processus vaginalis that envelopes the testis in 2 layers.

Answer 35

Tunica Vaginalis

Question 36

An accumulation of fluid from inflammation or trauma may fill the space between the parietal and visceral layers.

Answer 36

Hydrocele

Question 37

Name the structure that produces sperm in the testis.

Answer 37

Seminiferous Tubules

Question 38

Where are mature sperm stored until they are ejaculated?

Answer 38

Epididymis

Question 39

Testicular cancer may produce what if it has spread to the Aortic lymph nodes?

Answer 39

Large mass in the Abdominal Wall (Young men most at risk)

Question 40

What age does an undescended testicle (Cryptorchidism) need to be fixed by?

Answer 40

3 - 4 years old (surgically)

Question 41

What temperature do the testicles need to be at for normal spermatogenesis?

Answer 41

2-3 degrees cooler than the body

Question 42

What are the 5 muscles of the posterior abdominal wall? TEST QUESTION!

Answer 42

Psoas Major Psoas Minor Iliacus Quadratus Lumborum Diaphragm

Question 43

What actions does the Psoas Major allow for?

Answer 43

Flexion of thigh at the hip Lateral Flexion of Vertebral Column

Question 44

What action does the Psoas Minor allow for?

Answer 44

Flexion of the Vertebral Column (only present in 60% of the population)

Question 45

What is the action of the Iliacus? (Fan Shaped Muscle)

Answer 45

Flexion of the thigh at the hip joint