Serrat - Inguinal Region

Question 1

A defect or opening in fascia that permits the passage of structures thru the inguinal canal. There are superficial and deep found in external oblique aponeurosis and transversalis fascia, respectively.

Answer 1

Inguinal ring

Question 2

The deep inguinal ring is found in the region of the ___________

Answer 2

Lateral inguinal fossa

Question 3

The folded lower border of the aponeurosis of the external oblique muscle. Dense band of aponeurosis extends from the ASIS to the pubic tubercle.

Floor of inguinal canal

Aka Poupart’s ligament

Answer 3

Inguinal ligament

Question 4

Medial extension of the inguinal ligament attaches to the pectineal line on the pubis. Its sharp free edge forms the medial border of the femoral ring. Continuous w/ the pectineal ligament

Answer 4

Lacunar ligament.

Question 5

The inguinal canal is larger in _____ than in _______

Answer 5

Males

Females

Question 6

The inguinal canal transmits

Answer 6

Genitofemoral nerve

Ilioinguinal nerve

Spermatic cord (male)

Round ligament of uterus (females)

Question 7

Describe the course of the ilioinguinal nerve through the inguinal canal

Answer 7

Enters canal laterally by piercing the transversus abdominus and internal oblique muscles, travels through the canal and then exits through the superficial ring.

Question 8

The beginning of the inguinal canal

Answer 8

Deep inguinal ring

Question 9

The deep ring protrudes thru the abdominal wall ________ to the inferior epigastric vessels

Answer 9

Lateral

Question 10

The two sides of the triangle that is the superficial inguinal ring, are called the medial and lateral crus. They are help together by ___-__ which prevent widening of the superficial ring

Answer 10

Crossing intercural fibers

Question 11

The medial crus attaches to the ________

Answer 11

Pubic symphysis

Question 12

The lateral crus connects to the __———

Answer 12

Pubic tubercle

Question 13

Anterior wall of the inguinal canal

Answer 13

Aponeurosis of external oblique muscle (thru/o length of canal)

Aponeurosis of internal oblique muscle (lateral 1/3 of canal)

Question 14

Posterior wall of the inguinal canal

Answer 14

Transversalis fascia thru/o length of canal

Conjoint tendon in medial 1/3 of canal

Question 15

Roof of the inguinal canal

Answer 15

Muscle fibers and aponeurosis of the internal oblique muscle and the aponeurosis of the transversus abdominis muscle as they arch from anterior to posterior

Question 16

Floor of the inguinal canal

Answer 16

Inguinal ligament (thru/o length of canal)

Lacunar ligament (medial 1/3 of canal)

Question 17

What is the cremasteric reflex and what nerves does it test?

Answer 17

Stroking the medial aspect of thigh produces a reflex contraction of cremaster muscle and ipsilateral elevation of the testis and scrotum

Tests; ilioinguinal (L1) which is sensory to inner thigh

Genitofemoral (genital branch) (L1-L2) - motor to cremaster muscle that retracts testis

Question 18

An evagination of peritoneum into ventral abdominal wall that occurs independent of tests descent.

Answer 18

Process vaginalis

Question 19

The evagination of the ____- ______ forms the inguinal canal and is normally obliterated between the deep inguinal ring and superior aspect of the testes during the first postnatal year.

Answer 19

Processus vaginalis

Question 20

A condensed band of mesenchyme that extends from the lower pole of the developing gonad thru the inguinal canal to the labioscrotal swelling

Answer 20

Gubernaculum

Question 21

In the adult male, the gubernaculum is :

Answer 21

The fibrous cord connection the testes to the scrotum

Question 22

In the adult female, the gubernaculum is :

Answer 22

The round ligament of the uterus

Question 23

Testis enter the deep ring of the inguinal canal at about -_____ months gestation

Answer 23

3

Question 24

Gonadal development begins where ?

Answer 24

High in the lumbar region (L1) on the posterior abdominal wall, deep to the transversalis fascia

Question 25

The testis descend thru the inguinal canal at about ______ months gestation, carrying layers of the abdominal wall in its descent into the scrotum

Answer 25

7 mos gestation

Question 26

When does the stalk of the processus vaginalis degenerate?

Answer 26

About within the first year

Question 27

Layers of the scrotum

Answer 27

Skin Fascia - dartos fascia and muscle

Question 28

The outer capsule around the testis is called the ?

Answer 28

Tunica albuginea

Question 29

Site of sperm production

Answer 29

Seminiferous tubules

Question 30

Network of canals that conduct sperm

Answer 30

Rete testis

Question 31

Sperm storage and maturation Head - coiled ends of efferent ductules Body - convoluted ducts Tail - continuous w/ ductus deferens

Answer 31

Epididymis

Question 32

Transport sperm to ejaculatory duct

Answer 32

Ductus (vas) deferens

Question 33

Arteries of the testis

Answer 33

Cremasteric (from inferior epigastric) Testicular (from abdominal aorta) Artery of ductus deferens (from inferior vesicle artery)

Question 34

Function of testis

Answer 34

Sperm production in seminiferous tubules Androgen production in Leydig cells

Question 35

The white fibrous capsule that surrounds the testis like the rind of an orange. Covered by the visceral layer of the tunica vaginalis

Answer 35

Tunica albuginea

Question 36

Derived from parietal peritoneum, has two layers A shiny visceral layer, immediately covering the tunica albuginea and a parietal layer that is separated from the visceral layer by a cavity of the tunica vaginalis

Answer 36

Tunica vaginalis

Question 37

Genital branch of genitofemoral nerve provides motor innervation to ?

Answer 37

Cremaster muscle

Question 38

Pampiniform plexus does what?

Answer 38

Drains nuts, converges as testicular vein, empties into inferior vena cava Component of spermatic cord

Question 39

What are the components of the spermatic cord?

Answer 39

Ductus deferens and artery Testicular artery Genital branch of genitofemoral nerve (L1, L2) Pampiniform plexus (goes into testicular vein) Lymphatics from testis and epididymis Cremaster A. And V. Plexus of autonomic nerves

Question 40

Fascia contributions of the inguinal canal from the external oblique aponeurosis (x7)

Answer 40

Inguinal ligament Lateral crus Medial crus Lacunar ligament Intercrural fibers External spermatic fascia Superficial inguinal ring

Question 41

Fascia contributions to the inguinal region from the internal abdominal oblique aponeurosis (x2)

Answer 41

Conjoint tendon Cremasteric layer of muscle and fascia

Question 42

Fascia contributions to inguinal region and canal from transversus abdominis aponeurosis

Answer 42

Conjoint tendon

Question 43

What abdominal muscle aponeurosis has no layer contributed to coverings of spermatic cord?

Answer 43

Transversus abdominis aponeurosis

Question 44

What are the fascia contributions to the inguinal region from the transversalis fascia?

Answer 44

Deep inguinal ring Internal spermatic fascia

Question 45

Fascia contributions to the inguinal region from peritoneum

Answer 45

Embryo; processus vaginalis Mature; tunica vaginalis testis

Question 46

What layer of testis and spermatic cord corresponds with skin

Answer 46

Skin

Question 47

What layer of testis and spermatic cord corresponds with fatty layer of superficial fascia

Answer 47

Dartos muscles

Question 48

What layer of testis and spermatic cord corresponds with membranous layer of superficial fascia

Answer 48

Membranous layer of superficial fascia of perineum (colle’s layer)

Question 49

What layer of testis and spermatic cord corresponds with aponeurosis of external abdominal oblique

Answer 49

External spermatic fascia

Question 50

What layer of testis and spermatic cord corresponds with internal abdominal oblique muscle and its aponeurosis

Answer 50

Cremaster muscle and fascia

Question 51

What layer of testis and spermatic cord corresponds with transversus abdominis muscle

Answer 51

No contribution

Question 52

What layer of testis and spermatic cord corresponds with transversalis fascia

Answer 52

Internal spermatic fascia

Question 53

What layer of testis and spermatic cord corresponds with extraperitoneal fat

Answer 53

Loose connective tissue including fat

Question 54

What layer of testis and spermatic cord corresponds with parietal peritoneum

Answer 54

Tunica vaginalis (obliterated processus vaginalis)

Question 55

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

Answer 55

Cryptorchidism

Question 56

What is the cause of indirect inguinal hernia?

Answer 56

Congenital . From incomplete obliteration of processus vaginalis

Question 57

What is cause of direct inguinal hernia ?

Answer 57

Weakness of posterior wall of inguinal canal

Question 58

Type of hernia: Occurs in adults Common in older men Neck of hernia passes thru medial inguinal fossa in hesselbach’s triangle Enters inguinal canal medial to inferior epigastric vessels Transverses only medial 1/3 of inguinal canal. May transverse superficial inguinal ring but won’t enter scrotum. Cause is weakness of posterior wall of inguinal canal

Answer 58

Direct inguinal hernia

Question 59

Type of hernia; Most common type in both children and adults. Males > females Neck of hernia thru deep inguinal ring in lateral inguinal fossa Enters inguinal canal lateral to inferior epigastric vessels Usually transverses entire inguinal canal and may extend into scrotum Cause - congenital, incomplete obliteration of processus vaginalis

Answer 59

Indirect inguinal hernia

Question 60

_______ umbilical folds contain the inferior epigastric vessels

Answer 60

Lateral

Question 61

How do you distinguish a femoral hernia from an inguinal hernia?

Answer 61

The neck of a femoral hernia is always below and lateral to the pubic tubercle

Question 62

Collection of fluid in testes or spermatic cord that can result from persistent processus vaginalis

Answer 62

Hydrocele

Question 63

What layers must you pierce in order to tap a hydrocele?

Answer 63

``` Skin Dartos Colle’s fascia External spermatic fascia Cremaster muscle and fascia Internal spermatic fascia Parietal layer of tunica vaginalis ```

Question 64

Why are most varioceles in the left testicular veins?

Answer 64

The right veins empty into the inferior vena cava which are lower pressure than the left renal vein which is where the left testicular vein empties into

Question 65

Rotation of the testis around the spermatic cord w/in the scrotum Severe pain Obstructed blood flow can lead to necrosis of an entire testicle Often occurs in active young men and children and is accompanied by severe pain

Answer 65

Torsion of the testis

Question 66

Surgical ligation of ductus deferens so that no sperm are contained in ejaculated fluid

Answer 66

Vasectomy