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ANA 534 T2 Inguinal
learning objective answers to inguinal
Question | Answer |
---|---|
Why is the anatomy of the inguinal region/canal clinically important? | Due to the frequency of inguinal hernae. |
What forms the inguinal ligament? How? | The aponeurosis of the external oblique; by folding over on itself forming a taut ligament-like structure. |
To which bony structures does the inguinal ligament attach? | Superolaterally to the anterior superior iliac spine of the hip bone, and inferomedially to the pubic tubercle. |
A deficiency in each of the three layers on the anterolateral abdominal wall, in the region of the inguinal ligament, forms what specific passage? | the inguinal canal- an obliquely flattened passageway |
In which layer is the superficial inguinal ring formed? | The aponeurosis of the external oblique - the outermost (superficial) layer. |
In which layer is the deep inguinal ring formed? | It is a slit in the fascia transversalis. |
What structure forms the floor of the inguinal canal? | The inguinal ligament. |
What structure forms the posterior wall of the inguinal canal? | The conjoint tendon (joined aponeuroses of the internal oblique and transversus abdominis) |
What passes through this inguinal canal in the neonatal male? | The testis. |
In the adult male what structure is found within the inguinal canal? | The spermatic cord. |
In the adult female what structure is found within the inguinal canal? | The round ligament. |
Which layer(s) of the anterior abdominal wall contribute to the sheaths of the spermatic cord? | All but the transversus abdominis. |
What does each participating layer of the anterior abdominal wall contribute to the spermatic cord? | External oblique - external spermatic fascia; internal oblique - cremasteric muscle and/or fascia; transversus abdominis - nil; fascia transversalis - internal spermatic fascia. |
Which layer of the anterior abdominal wall does not contribute to the spermatic cord? | Transversus abdominis. |
What are the main components found within the spermatic cord? | The ductus deferens, testicular a., pampiniform plexus of (testicular) veins. |
What feature of embryological development allows the formation of a congenital hernia? | The processus vaginalis (a finger-like extension of the peritoneum that extends down into the scrotum via the inguinal canal.) |
In what age groups is the formation of a congenital hernia common? | Up to the early 30's |
What is the actual function of the processus vaginalis? | It provides a serous (slippery) lining for the inside aspect of the scrotal wall and the visceral surface of the testicle for friction-free movement. |
What typically extends from the body cavity in a hernia? | A loop of small intestine. |
What is the clinical implication of an inguinal hernia? | The loop of bowel may become trapped in the inguinal canal, squeezed by intra-abdominal pressure on the canal walls and cause loss of blood supply - gangrene may ensue. |
How does an acquired inguinal hernia differ from the congenital type? | congenital slides down the oblique inguinal canal due to the presence of a patent processus vaginalis, acquired protrudes directly through a defect that develops in posterior wall of inguinal canal and out through superficial inguinal ring. |
Through what component of the inguinal canal does the hernia protrude? | The superficial inguinal ring after penetrating the posterior wall (conjoined tendon). |
Where would the inferior epigastric a. pulse be found in each type of herniation? | In the congenital (indirect) inguinal hernia the arterial pulse is medial to the hernia whereas in the acquired (direct) inguinal hernia the pulse is felt lateral to the hernia. |
How do inguinal herniae differ in presentation from femoral herniae? | Inguinal hernia present above the inguinal ligament whereas a femoral hernia presents under the inguinal ligament. |
Name the boundaries of the inguinal triangle. | Lateral: inferior epigastric a.; medial: lateral border of the rectus abdominis; inferior: inguinal ligament. |
What structure(s) typically traverse this space in the normal condition? | The spermatic cord passes through the triangle just above the inferior boundary - the inguinal ligament. |
Where is the location of the deep inguinal ring with relation to the inferior epigastric artery? | The deep inguinal ring is lateral to the inferior epigastric a. |
Where is the inferior epigastric artery going? | Up into the posterior aspect of the rectus sheath, between it the posterior leaf of the sheath and the rectus abdominis muscle, gaining access via the arcuate line. |