Flashcards in The Inguinal Region Deck (24)
Which part of the abdomen do the gonads descend during fetal development to give rise to the inguinal canal?
Descend from the posterior abdominal wall
What traverses the inguinal canal in males and in females?
In males, the ductus deferens traverses the inguinal canal.
In females, the round ligament of the uterus traverses the inguinal canal
Are the testes peritoneal or retroperitoneal?
They are covered with peritoneum and are termed retroperitoneal
What causes the downward pull of the testes during development?
Starts in the posterior abdominal wall, where the gubernaculum condenses. The gubernaculum shortens as the embryo develops, pulling the testes inferiorly and forms process vaginalis
What is the role of the process vaginalis during the descend of the testes?
The process vaginalis preceeds the testis as it moves toward the scrotum, forms anterior to the gubernaculum. Pushes through transversalis fascia, the internal oblique, and external oblique to form inguinal canal and picks up these layers eventually forming covering of spermatic cord and testes
What is the name of the opening of the processus vaginalis in the transversalis fascia?
Deep inguinal ring (beginning of inguinal canal)
What is the name of the opening in the aponeurosis of the external abdominal oblique?
Superficial inguinal ring (end of inguinal canal)
What is the name of the processus vaginalis after the testes are embedded into it?
Tunica vaginalis (two layers, visceral and parietal)
What are the three layers of covering of the spermatic cord? And from which muscles do they form?
Internal spermatic fascia (forms as processus vaginalis evaginates transversalis fascia)
Cremasteric muscles and fascia (forms as processus vaginalis evaginates the internal abdominal oblique)
External spermatic fascia (thin outer covering from the external abdominal oblique aponeurosis, which also forms the superficial inguinal ring)
What is the cremasteric reflex?
Contraction of cremasteric muscle after stroking inner thigh causing the scrotum to lift via the genitofemoral nerve and the cremasteric artery (a branch of the inferior epigastric artery)
What are the remnants of the gubernaculum in the female?
Round ligament of the uterus and the ligament of the ovary
Which ligament in females passes through the inguinal canal?
The round ligament of the uterus; continues on to the labia majora
What are the boundaries of the inguinal canal?
Starts the deep inguinal ring, ends at the superficial inguinal ring
Anterior Wall: The aponeurosis of the external abdominal oblique plus the lateral 1/3 by internal abdominal oblique
Posterior Wall Transversalis fascia plus the conjoint tendon on medial 1/3, plus the reflected inguinal ligament on external abdominal oblique
Roof: Internal abdominal oblique muscles and transversus abdominis
Floor: Inguinal ligament and lacunar ligament of the external abdominal oblique
What is an indirect inguinal herina? Does it occur medial or lateral to the inferior epigastric vessels?
Occurs when processus vaginalis remains patent, and an internal organ passes through the deep inguinal ring. Occurs lateral to the inferior epigastric vessles.
What is a direct inguinal hernia? Does it occur medial or lateral to the inferior epigastric vessels?
Occurs when an organ pushes directly through the superficial inguinal ring without traversing the inguinal canal. Occurs medial to the inferior epigastric artery and lies in the Hesselbach's triangle
What are the boundaries of Hesselbach's triangle?
Inferior epigastric artery, the lateral border of rectus abdominis, and the inguinal ligament
Which is acquire and which is congenital for hernias (indirect, direct) (congenital, acquired)
Indirect is congenital
Direct is acquired due to weakening of walls
What are the layers of the scrotum?
Some Damn Englishmen Called it The Testes
Dartos muscle (involunary muscle)
External spermatic fascia
Cremasteric muscle and fascia
Internal spermatic fascia
What are the 3 parts of the epididymis?
The body (highly convoluted duct of epididymis)
The tail (continuous with vas deferens)
The head (connects to testes efferent ductules)
Where does the ductus deferens travel?
Travels through the superficial inguinal ring to the deep inguinal ring and into abdomen
What are the efferent ductules?
Connected rete testis to the head of epididymis
What are the rete testis?
The joining together of the seminiferous tubules
What are contained within the spermatic cord?
"3 arteries, 3 nerves, 3 other things"
Arteries: Testicular artery, artery of ductus deferens, cremasteric artery
Nerves: Ilioinguinal nerve, autonomic nervous system nerves, and genitofemoral nerve
3 other things: pampiniform plexus (forming of 12 veins on posterior surface), the vas deferens, and lymph vessels