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Inguinal Reg.

Anatomy of the Inguinal region

The ________ is a 3-5 oblique passageway occuring in the inquinal region of the anterior body wall Inguinal canal
How is the inguinal canal formed? During fetal development the gonads (testes or ovaries) descend from the posterior abdominal wall through the inquinal canal (males-->scrotum; females-->round ligament of the uterus)
The spermatic cord contains vasculature and the ________ which transverse the inguinal canal and connect the testes to structures within the pelvis spermatic cord
Describe the descent of the testes: initial location and position Start in upper lumbar region (posterior abdominal wall); covered with a peritoneum (hence retroperitoneal)
* Describe the descent of the testes: role of the gubernaculum ligamentous cord condenses along the posterior abdominal wall; connect the inferior surface of each testis to the bottom of the scrotum; growth of embryo causes it to shorten-->testes pulled inferiorly-->forms processus vaginalis (by peritoneum)
The __________ forms immediately anterior to the gubernaculum and precedes the testis as it moves toward the scrotum processus vaginalis
What structures does the processus vaginalis push through? Transversalis fascia, internal oblique muscle, and external oblique muscle; together invest layers through the inquinal canal
The opening by the processus vaginalis in the trasversalis fascia becomes the ___ deep inguinal ring
The opening in the aponeurosis of the external abdominal oblique becomes the ___ superficial inguinal ring
In the male the transversalis fascia, the internal oblique muscle and the external oblique muscle contribue layers to form the ________ coverings of the spermatic cord and testes
Describe the formation of the two layers of the tunica vaginalis The testis embeds itself into the processus vaginalis and thus obtains two layers of peritoneum, the visceral and the parietal layers of the tunic vaginalis
What is the ultimate fate of the processus vaginalis? It is obliterated shortly after birth leaving only the tunica vaginalis
What is the ultimate fate of the gubernaculum? what is its function Remains in the adult male as the scrotal ligament (secures testis to the most inferior portion of the scrotum)
What is the condition where a testis remains in the pelvic cavity or the inguinal canal? Cryptochidism ("hidden testis" Gr.)
How many concentric layers of fascia cover the spermatic cord? What are they? Where are they derived from? 3; internal spermatic fascia (from trasnversalis fascia), cremasteric muscle and fascia (from internal abdominal oblique), and the external spermatic fascia (external abdominal oblique)
What is the internal spermatic fascia? It is the filmy innermost covering of the spermatic cord; forms as the processus vaginalis evaginates the transversalis fascia
What is the cremasteric muscle and fascia? What does it do? middle covering of the spermatic cord which contains loops of cremaster muscle; skeletal muscles that raise the testis (in cold or due to stroking of inner thighs)
What is the external spermatic fascia? Thin outermost covering of the spermatic cord, formed from the external oblique aponeurosis; attached superior to the crura of the superficial inguinal ring; continous with the fascia of the external abdominal oblique muscle
Describe the descent of the ovaries Start in upper lumbar region, covered in peritoneum, gubernaculum (at 7 weeks) condenses along posterior abdominal wall and connect inferior surface of ovary to labia majora; migrate to just below pelvic brim; doesn't pass inguinal canal
What is the ultimate fate of the gubernaculum in the female body? Becomes incorporated into the wall of the uterus as the round ligament of the uterus and the ovary
The ________ passes through the inguinal canal and continues on to the labia majora round ligament of the uterus
What are the boundaries of the inguinal canal: beginning and end deep (internal) ring opening in the transversalis fascia, superficial (external) ring opening in the aponeurosis of the external oblique muscle
What are the boundaries of the inguinal canal: anterior wall external abdominal oblique over entire length (aponeurosis of); internal abdominal oblique on lateral one-third
What are the boundaries of the inguinal canal: posterior wall transversalis fascia over entire length, conjoint tendon on medial one-third, reflected inguinal ligament of the external abdominal oblique on medial one third
What are the boundaries of the inguinal canal: roof arched fibers of the internal abdominal oblique muscle and trasnversus abdominis muscle
What are the boundaries of the inguinal canal: floor inguinal ligament of the external abdominal oblique, lacunar ligament of the external abdominal oblique
What is a hernia? The potrusion of tissue (e.g. internal organ) through an abnormal opening or a weakened anterior abdominal wall (often the inguinal canal)
What causes an indirect inguinal hernia? when the processus vaginalis remains patent->internal oran passes through the deep inguinal ring
Where are indirect inguinal hernias located? How far can they extend? Lateral to the inferior epigastric vessels; an internal organ may pass completely through the inguinal canal (i.e. through both deep and superficial inguinal rings) and lie in the scrotum
What is a direct inguinal hernia and how is it caused? When internal organ pushes directly through the superficial inguinal ring without transversing the inguinal canal; occurs medial to the inferior epigastric vessels; lies in Hesselbach's triangle
What are the boundaries of Hesselbach's triangle? inferiorly by the epigastric artery; laterally by rectus abdominis muscle and inguinal ligament
The direct inguinal hernia produces a bulge deep to the __________ tendon. Conjoined
When abdominal contents put pressure on the ____ fascia (and ____ fascia and ____), an internal organ may transverse the posterior wall of the inguinal canal. transversalis, subserous, peritoneum
True or false: in a direct inguinal hernia, the contents of the hernia will enter the inguinal canal along side the spermatic cord distal to the origin of the internal spermatic fascia True
The contents of a direct inguinal hernia are located between ______ and the _______ fascia layer internal spermatic; cremasteric
Where is the weakness associated with direct inguinal hernia? posterior wall of the inguinal canal
Which type of hernia is more common in older men? Direct inguinal hernia
What structure divides the scrotum into left and right halves? Scrotal raphe
What layer lies immediately deep to the skin of the scrotum? The superficial fascia
What muscle is continaed ithin the superficial fascia? What does it do? What innervates it? The dartos muscle; causes the scrotum to wrinkle when cold; sympathetic nerve fibers
What two fascias of the abdomen is the superficial fascia of the scrotum continous with? The membranous layer of the superficial fascia of the abdomen (Scarpa's fascia) and the perineum (Colle's fascia)
The superficial fascia forms an incomplete _______ that divides the scrotum into a right and left half. Scrotal septum
What are the thee primary contents of the scrotum? The testis, the epididymis, and the vas deferens or ductus referense (vas deferens)
What are the (5) layers covering the testis? external spermatic fascia, cremasteric muscle and fascia, internal spermatic fascia, tunica vaginalis testis (parietal and visceral layers), tunica albuginea
What two structures does the visceral layer of the tunica vaginalis testis cover? It is adherent to the testis and the epididymis
Laterally, the visceral layer passes between the testis and epididymis to form the _____ of the _______ Sinus of the epididymis
What is the tunica albuginea A dense layer of connective tissue surrounding the testes which is found deep to the visceral layer of the tunica vaginalis. Extensions of the tunica albuginea form septa within the testes-->divide testes into lobules
Where is sperm produced? Where are these structures located? Formed within the seminiferous tubules; within lobules formed by the septa in the testes
The seminiferous tubules join to form the _____ _____ rete testis
What structure connects the rete testis to the head of the epididymis? Efferent ductules (15-20)
What is the epididymis? Where is it located? A tightly coiled tube which connects the efferent ducts to the vas deferens; forms on the superior and posterolateral surface of the testis
What three regions can the epididymis be divided into? The body (highly convoluted duct of the epididymis), the tail (continous with the vas deferens), and the head (connects to testes efferent ductules)
What is the vas deferens / ductus deferens? Where is it? transports sperm to the ejaculatory duct; sperm enters the vas deferens during ejaculation; travels through the superficial inguinal ring to the deep inguinal ring and into the abdomen
Where in the spermatic cord does the vas deferens run through? Large duct of the testes runs in the posterior part of the spermatic cord.
What three arteries are carried by the spermatic cord? Testicular artery, artery of the ductus deferens, cremasteric artery
Describe the origin, area supplied, and path of the testicular artery From the front of the aorta; supplies testis and epididymis; runs through inguinal canal
Describe the origin, area supplied, and path of the artery of the ductus deferens From the vesical artery (artery of the bladder); follows ductus deferens; anastomoses with the testicular A. near testes
Describe the origin, area supplied, and path of the cremasteric artery From the inferior epigastric artery; supplies cremasteric muscle and other coverings of the cord
* What is the PAMPINIFORM PLEXUS? Where does it drain? The 12 veins from the posterior surface anastomose to form this; it surrounds the ductus deferens and arteries; drains into left renal vein on left and inferior vena cava on right
What nerves pass through the cord and what do they supply? Ilioinguinal nerve (skin of scrotum/labia major); sympathetic fibers on arteries; sympathetic and parasympathetic via ductus deferens; genitofemoral nerve (cremaster and skin of scrotum/labia)
Where do the lymph vessels that drain the testes drain into? Where do they run through? The lumbar nodes; they pass through the spermatic cord
Created by: karkis77



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