Posted by clp on October 02, 2017 at 18:02:40:
In Reply to: Inguinal Region Part I posted by lae2 on September 23, 2017 at 14:55:04:
1. Each of the three digastric muscles that make up the anterior abdominal wall contribute a tunic to the spermatic cord.
i. External oblique: external spermatic fascia
ii. Internal oblique: cremasteric muscle and fascia
iii. Transversalis abdominus: internal spermatic fascia
2. The processes vaginalis, if entirely patent, provides a communication between the peritoneal cavity and the tunica vaginalis.
3. The deep ring is of the parietal peritoneum.
a. False: transversalis fascia
4. The posterior boundary of the inguinal canal is formed by the conjoint tendon.
a. True: the medial 1/3 is from the conjoint tendon of internal oblique and transversis abdominis
5. Hernias that occur at either the medial inguinal fossa or the supravesical fossa are indirect inguinal hernias.
a. False: this is a direct inguinal hernia
i. Indirect will go through the deep ring and reach superficial ring
6. Direct inguinal hernias may be palpated from the anterior surface of the scrotum.
a. False : it is difficult to palpate
7. An indirect hernia passes deep to internal spermatic fascia.
8. The cremasteric artery is found superficial to internal spermatic fascia and deep to external spermatic fascia.
9. The pampiniform plexus is deep to the internal spermatic fascia.
10. The deferential artery and plexus are found within the internal spermatic fascia.
11. The testicular artery is within the internal spermatic fascia.
12. The genital branch of the genitofemoral nerve is superficial to the cremasteric fascia.
a. False: genital branch is deep to internal spermatic fascia. Runs along side vas deferens
13. The inferior boundary of the inguinal canal is the inguinal ligament.
14. Commonly, a direct inguinal hernia contained between external spermatic fascia and cremasteric fascia.
a. False: must be w/in inguinal canal and deep to internal spermatic fascia
15. The afferent limb of cremasteric reflex is, in part, mediated by the femoral branch of the genitofemoral nerve.
a. True and ilioinguinal nerve
16. The efferent limb of the cremasteric reflex is mediated by the anterior scrotal branch of the ilioinguinal nerve.
a. False: Genital branch of genitofemoral that supplies cremaster muscle
17. In the female, the processes vaginalis precedes the ovary in following the gubernaculum.
a. False: this occurs in males. Women tend not to form a proper processes vaginalis
18. Lymph vessels accompany the round ligament of the female to the region of the mons pubis.
19. Metastatic disease from the inferior pole of the ovary may follow a lymphatic pathway through the inguinal canal and then to the superficial inguinal lymph nodes.
20. The reflected inguinal ligament is found medial and superior to the pubic tubercle.
21. The lacunar ligament is lateral and inferior to the pubic tubercle.
22. Direct inguinal hernias are palpated inferior and lateral to the pubic tubercle.
a. False: direct hernia needs to be palpated through the superficial ring and then make sure it doesn’t go through the deep ring. Usually goes through Hesselbach’s triangle supero-later to pubic tubercle.
23. Femoral hernias are palpated medial and superior to the pubic tubercle.
a. False: lateral and inferior
24. Femoral hernias are more common in males than in females.
a. False: more common in females
25. In the case of femoral and inguinal hernias, the innermost layer of the hernial sac is transversalis fascia.
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