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Gross II Unit 3 > Groin (Inguinal) Region > Flashcards

Groin (Inguinal) Region Flashcards

1
Q

The inguinal ligament is formed by what?

A

The lower edge of the external oblique aponeurosis

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2
Q

The inguinal ligament extends from what two structures?

A

ASIS to the pubic tubercle

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3
Q

What is the lacunar ligament?

A

The most medial fibers of the inguinal ligament which are inserted into the superior pubic ramus

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4
Q

What is the pectineal ligament?

A

A lateral extension of the lacunar ligament along the pecten pubis (pectineal line)

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5
Q

How long is the inguinal canal?

A

3-5cm

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6
Q

Where does the inguinal canal begin and end?

A

Begins at the deep inguinal ring and ends at the superficial inguinal ring

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7
Q

Within the anterior abdominal wall, how does the deep inguinal ring lie?

A

Lateral and internal

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8
Q

Within the anterior abdominal wall, how does the superficial inguinal ring lie?

A

Medial and external

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9
Q

Is the inguinal canal larger in males or females?

A

Males

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10
Q

Why is the inguinal canal larger in males?

A

Because it also transmit the spermatic cord

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11
Q

What three things can the inguinal canal transmit?

A

Spermatic cord (male), round ligament of the uterus (female), and ilioinguinal nerve (both sexes)

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12
Q

What is another name for the conjoint tendon?

A

Inguinal Falx

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13
Q

The conjoint tendon is formed by the fusion of what two muscles as they insert into the pubic crest and pecten pubis deep to the inguinal ligament?

A

Internal oblique and transversus abdominis muscles

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14
Q

What is the function of the conjoint tendon?

A

It strengthens the posterior wall of the medial half of the inguinal canal

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15
Q

What can the conjoint tendon prevent?

A

Direct inguinal hernias

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16
Q

What makes up the anterior wall boundary of the inguinal canal?

A

The aponeurosis of the external oblique muscle

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17
Q

What makes up the posterior wall boundary of the inguinal canal?

A

The conjoint tendon and transversalis fascia

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18
Q

What makes up the roof of the inguinal canal?

A

The arching fibers of the internal oblique and transversus abdominis muscles

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19
Q

What makes up the floor of the inguinal canal?

A

The inguinal and lacunar ligaments

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20
Q

What is the superficial inguinal ring?

A

Triangular opening in the external oblique aponeurosis located immediately lateral to the pubic tubercle

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21
Q

The superficial inguinal ring is formed by the splitting of which muscle’s aponeurosis?

A

External oblique muscle

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22
Q

Where does the lateral crus of the splitting of the external oblique muscle’s aponeurosis insert?

A

Into the pubic tubercle, and some of its fibers reflect to the superior pubic ramus as the lacunar ligament

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23
Q

Where does the medial curs of the splitting of the external oblique muscle’s aponeurosis insert?

A

Into the pubic crest

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24
Q

What is the function of the intercrural fibers?

A

Strengthen the apex of the superficial inguinal ring

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25
Q

The deep inguinal ring is located in what layer of the abdominal wall?

A

Transversalis fascia

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26
Q

The deep inguinal ring is located above the inguinal ligament midway between what two structures?

A

ASIS and pubic symphysis

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27
Q

The deep inguinal ring lies just lateral to which vessels?

A

Inferior epigastric vessels

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28
Q

What binds the inguinal triangle medially?

A

Lateral edge of the rectus abdominis muscle

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29
Q

What binds the inguinal triangle laterally?

A

Inferior epigastric vessels

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30
Q

What binds the inguinal triangle inferiorly?

A

Inguinal ligament

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31
Q

What is an area of potential weakness in the anterior abdominal wall where direct inguinal hernias occur?

A

Inguinal triangle

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32
Q

Is the inguinal canal present before birth?

A

Yes; it is shorter and much less oblique, however.

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33
Q

Before birth, how do the superficial and deep inguinal rings lie relative to each other?

A

The superficial inguinal ring lies almost directly anterior to the deep inguinal ring.

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34
Q

Why it is important for the inguinal canal to be oblique in adults?

A

To allow the canal to be compressed by the muscles of the anterior abdominal wall when they contract

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35
Q

What is paradoxical about the muscles that increase intra-abdominal pressure, thus promoting hernia?

A

They also narrow the inguinal canal to prevent hernia

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36
Q

What is a hernia?

A

Abnormal protrusion of tissue through an opening

37
Q

During inguinal hernias, what is usually protruding through the inguinal region?

A

Abdominal viscera, usually the small intestine

38
Q

Are inguinal hernias more common in males or females?

A

Males

39
Q

Why are hernias more common in males than females?

A

The inguinal canal is larger in males, and the scrotum creates a large potential space for abdominal viscera to fill because it’s an outpouching

40
Q

What can lead to hernias?

A

Anything that increases intra-abdominal pressure, such as pregnancy or constipation

41
Q

Why don’t the labia majora of the female, which are homologous to the scrotum of the male, make the females more likely to get hernias?

A

They are mostly filled with fat and therefore aren’t a potential space like the scrotum

42
Q

Which type of inguinal hernia passes through the deep inguinal ring, inguinal canal, and superficial inguinal ring before descending into the scrotum or labia majora?

A

Indirect inguinal hernia

43
Q

Which type of inguinal hernia punches directly through the posterior wall of the inguinal canal, by passing the deep inguinal ring?

A

Direct inguinal hernia

44
Q

Which type of inguinal hernia passes lateral to the inferior epigastric vessels?

A

Indirect inguinal hernia

45
Q

Which type of inguinal hernia passes medial to the inferior epigastric vessels through the inguinal triangle?

A

Direct inguinal hernia

46
Q

Which type of inguinal hernia can be congenital or acquired?

A

Indirect inguinal hernia

47
Q

Which type of inguinal hernia is always acquired due to weakness of the conjoint tendon or transversalis fascia?

A

Direct

48
Q

What is associated with a congenital indirect inguinal hernia?

A

A patent processus vaginalis

49
Q

Which type of inguinal hernia accounts for 75% of inguinal hernias?

A

Indirect inguinal hernia

50
Q

Which type of inguinal hernia accounts for 25% of inguinal hernias?

A

Direct inguinal hernia

51
Q

Which type of inguinal hernia is most likely to occur to men over 40 years old?

A

Direct inguinal hernia

52
Q

Which type of inguinal hernia causes a general palpable bulging of the anterior abdominal wall but does not descend into the scrotum?

A

Direct inguinal hernia

53
Q

What is the processes vaginalis?

A

Embryological outpouching of the peritoneum that usually obliterates & forms the inguinal canal and the tunica vaginalis of the scrotum

54
Q

Subluxation in which located may affect the functioning of the anterior abdominal wall muscles, thus increasing the risk of inguinal hernias?

A

Lower thoracic and upper lumbar

55
Q

What is a femoral hernia?

A

A hernia that passes through the femoral canal

56
Q

Where does a femoral hernia occur relative to the inguinal ligament?

A

Inferior (inguinal hernias occur superior to the inguinal ligament)

57
Q

Are femoral hernias more common among males or females?

A

Females (due to their larger femoral rings)

58
Q

What is an umbilical hernia?

A

A hernia that usually results from incomplete closure of the anterior abdominal wall after ligation of the umbilicus at birth

59
Q

What is another cause of an umbilical hernia?

A

Defects in the linea alba

60
Q

What results from a minor umbilical hernia?

A

Retraction and growth as an “outie” belly button

61
Q

Where does the spermatic cord end and begin?

A

Begins at the deep inguinal ring an ends at the testis

62
Q

What are the three concentric layers of fascias surround the spermatic cord?

A

External spermatic fascia, cremasteric fascia, and internal spermatic fascia

63
Q

The external spermatic fascia is derived from what structure?

A

External oblique aponeurosis

64
Q

The cremasteric fascia is derived from what structure?

A

Internal oblique aponeurosis

65
Q

How can the cremasteric fascia be recognized?

A

Many bundles of muscle fibers that are collectively referred to as the cremaster muscle (derived from the internal oblique muscle)

66
Q

What is the origin of the cremaster muscle?

A

Internal oblique muscle, inguinal ligament, pubic tubercle, pubic crest

67
Q

What is the insertion of the cremaster muscle?

A

Spermatic cord

68
Q

What is the nerve supply of the cremaster muscle?

A

Genital branch of genitofemoral nerve (L1, L2) from the lumbar plexus

69
Q

What is the function of the cremaster muscle?

A

Retracts testis, therefore functioning in temperature regulation of sperm

70
Q

The internal spermatic fascia is derived from what structure?

A

The transversalis fascia

71
Q

Subluxations of what area may affect male fertility?

A

L1, L2 (genitofemoral nerve)

72
Q

What is the ductus deferens?

A

Muscular duct which transports sperm from the epididymis to the ejaculatory duct

73
Q

The testicular artery is a branch of what?

A

Abdominal aorta

74
Q

What does pampiniform mean?

A

Vine-like

75
Q

What is the name of the extensive network of veins that make up the bulk of the spermatic cord?

A

Pampiniform plexus

76
Q

To where does the left testicular vein drain?

A

Left renal vein

77
Q

To where does the right testicular vein drain?

A

Directly into the inferior vena cava

78
Q

The veins of the pampiniform plexus join together where to form what vein?

A

Join at the deep inguinal ring to form the testicular vein

79
Q

The artery to the ductus deferens is a branch of what artery?

A

Superior vesical artery

80
Q

The cremasteric artery is a branch of what artery?

A

Inferior epigastric artery

81
Q

The lymphatics located in the spermatic cord drain where?

A

Into the lumbar lymph nodes

82
Q

What are the nine things that can be found in the spermatic cord?

A

Ductus deferens, testicular artery, pampiniform plexus of veins, artery to the ductus deferens, cremasteric artery, genital branch of the genitofemoral nerve, remnant of processes vaginalis, autonomic nerves, lymphatics

83
Q

What nerve accompanies the spermatic cord but is not a part of it?

A

Ilioinguinal nerve

84
Q

The ilioinguinal nerve runs through what two structures?

A

Inguinal canal and superficial inguinal ring

85
Q

What are the two branches of the ilioinguinal nerve?

A

Femoral branch and anterior scrotal/anterior labial nerve

86
Q

What does the femoral branch of the ilioinguinal nerve supply?

A

Upper medial part of the thigh

87
Q

What does the anterior scrotal nerve supply?

A

Root of the penis and anterior part of the scrotum

88
Q

What does the anterior labial nerve supply?

A

Mons pubis and anterior part of the labia majora

89
Q

What can often cause a lump that is generally mistaken as cancer in the scrotum?

A

Varicocele (varicose veins within the pampiniform plexus)

Gross II Unit 3 (8 decks)

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