What is the superficial fascia reinforced by?
What does the fascia contain?
below the umbilicus, the superficial fascia is reinforced by elastic and collagen fibers, thus
the fascia contains a deep membranous layer (Scarpa’s fascia) and a superficial fatty layer (Camper’s fascia).
What nerves (and give their spinal level) supply the muscles of the abdominal wall muscles?
What do the somatic sensory fibers reside in?
What do DRG in T5-T9 supply? T10-T11? T12-L2?
the intercostal nerves (T5-T11), subcostal nerve (T12), and iliohypogastric and ilioinguinal nerves (L1) supply the muscles of the abdominal wall muscles.
somatic sensory fibers reside in Camper’s fascia
those from DRG at T5-T9 supply the epigastric region, those from the DRG at T10-T11 supply the umbilical region, and those from DRG at T12-L2 supply the hypogastric (pubic) region.
Where do superficial lymphatic vessels reside?
in Camper’s fascia.
What does endoabdominal fascia line?
What is transversalis fascia?
What is the parietal peritoneum?
Name the tissue layer that separates the parietal peritoneum from the transversalis fascia
1) endoabdominal fascia lines the internal surface of the musculotendinous sheet and is called transversalis fascia where it lines the internal surface of the transverse abdominis muscle (ignore the other regional names).
2) the parietal peritoneum is analogous to the parietal pleura of the thoracic cavity.
3) the extraperitoneal fat
What do the umbilical folds cover?
Name the structures covered by the respective folds
the folds cover embryonic remnants and blood vessels
median umbilical fold covers the median umbilical ligament, a fibrous remnant of the urachus that joined the apex of the fetal bladder to the umbilicus
Two medial umbilical folds, lateral to the median umbilical fold, cover the medial umbilical ligaments, formed by occluded parts of the umbilical arteries.
Two lateral umbilical folds, lateral to the medial umbilical folds, cover the inferior epigastric vessels and therefore bleed if cut.
What is the falciform ligament?
Cite the patent and obliterated veins in its inferior free edge.
the falciform ligament is a reflection of parietal peritoneum that extends between the superoanterior abdominal wall and liver.
It encloses the round ligament of the liver (L. ligamentum teres hepatis) and paraumbilical veins in its inferior free edge. The round ligament is a fibrous remnant of the umbilical vein, which passed from the umbilicus to the liver prenatally
What does the dense inferiormost part of the external oblique aponeurosis form?
the dense inferiormost part of the external oblique aponeurosis forms the inguinal ligament that extends between the ASIS and pubic tubercle.
Where is the inguinal canal?
Where is the superficial inguinal ring?
Where is the deep inguinal ring?
the inguinal canal is parallel and just superior to the medial half of the inguinal ligament.
the superficial inguinal ring is just superolateral to the pubic tubercle.
the deep inguinal ring is superior to the midpoint of the inguinal ligament (observe it is positioned lateral to the inferior epigastric artery).
What is the main occupant of the inguinal canal in males?
the spermatic cord
Spermatic Cord includes:
Arteries: testicular artery, deferential artery
Nerves: nerve to (genital branch of the genitofemoral nerve), testicular nerves (sympathetic nerves)
Vas deferens (ductus deferens)
Tunica vaginalis (remains of the processus vaginalis)
What is the main occupant of the inguinal canal in females?
the round ligament of the uterus
What do the testis and attached spermatic cord traverse?
the deep inguinal ring to enter the inguinal canal
How does the spermatic cord exit the inguinal canal?
What is the anterior wall of the inguinal canal formed by?
the spermatic cord exit the canal via the superficial inguinal ring.
the anterior wall of the canal is formed by external oblique aponeurosis.
What is the posterior wall of the inguinal canal formed by? What forms the conjoint tendon (inguinal falx)?
What does pubic attachment of the tendon do?
the posterior wall of the inguinal canal is formed by the aponeuroesis of the transverse abdominal muscles (may include transversalis fascia) that merges medially with the internal oblique aponeurosis to form the conjoint tendon
pubic attachment of the tendon serves to reinforce the posterior wall of the canal.
What is the processus vaginalis? What does it do?
locate the deep inguinal ring
the testis creates a diverticulum in the parietal peritoneum called the processus vaginalis that pushes the muscular and fascial layers of the anterolateral wall ahead of it into the inguinal canal.
processus vaginalis becomes tunica vaginalis
What is the processus vaginalis immediately surrounded by?
What does the internal oblique muscle and aponeurosis form?
What is the external spermatic fascia formed by and what is it for?
the processus vaginalis is immediately surrounded by the internal spermatic fascia formed by the aponeurosis of the transverse abdominis muscle.
the internal oblique muscle and aponeurosis form the cremaster muscle and fascia that surround the internal spermatic fascia.
the external spermatic fascia, which is formed by the external oblique aponeurosis, surrounds the cremaster and cremasteric fascia
order of layers deep --> superficial: PISCES
processus vaginalis > internal spermatic fascia > cremaster muscle/fascia > external spermatic fascia > scrotum
What does the stalk part of the processus vaginalis normally collapse around?
What does the distal saccular part of the process vaginalis form?
the stalk part of the processus vaginalis normally collapses around the fascial/muscular covering of the spermatic cord
its distal saccular part forms the tunica vaginalis that closely adheres to the testis and epididymis
What is somatic motor to the cremaster muscle ?
the genital branch of the genitofemoral nerve is somatic motor to the cremaster muscle
What does the ilioinguinal nerve provide somatic sensory innervation to?
What do the nerves constitute motor and sensory components of?
the ilioinguinal nerve provides somatic sensory innervation to the skin of the superomedial thigh.
the genital branch of the genitofemoral and ilioinguinal nerves constitute motor and sensory components (respectively) of the cremasteric reflex
- The normal response is an immediate contraction of the cremaster muscle that pulls up the testis on the side stroked
What does the spermatic cord contain?
What does the pampiniform plexus do?
the spermatic cord contains the ductus (aka vas) deferens, testicular artery, and pampiniform venous plexus.
the pampiniform plexus cools blood in the testicular artery to maintain the testis a few degrees below body temperature to insure normal spermatozoa production
What does the pampiniform plexus converges superiorly as?
the plexus converges superiorly as the testicular vein