Posted by lae2 on October 06, 2017 at 07:11:44:
In Reply to: Re: Inguinal Region Part I posted by clp on October 02, 2017 at 18:02:40:
: 1. Each of the three digastric muscles that make up the anterior abdominal wall contribute a tunic to the spermatic cord.
: a. True: Disagree. Know the origin of transversus abdominis and relation to deep ring. Internal spermatic fascia by ????
: 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.
: a. True Agree.
: 3. The deep ring is of the parietal peritoneum.
: a. False: transversalis fascia Agree. Contributes a tunic?
: 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 Agree.
: 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 Agree.
: 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 Agree. But direct can be palpated at superficial ring.
: 7. An indirect hernia passes deep to internal spermatic fascia.
: a. True Agree. patent processes vaginalis.
: 8. The cremasteric artery is found superficial to internal spermatic fascia and deep to external spermatic fascia.
: a. True Agree. Within cremasteric fascia.
: 9. The pampiniform plexus is deep to the internal spermatic fascia.
: a. True Agree. Know why this must be. Think development, retroperitoneal, extraperitoneal connective tissue.
: 10. The deferential artery and plexus are found within the internal spermatic fascia.
: a. True Agree. Again, think about development and descent.
: 11. The testicular artery is within the internal spermatic fascia.
: a. True Agree.
: 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 Disagree. Genital branch is motor to cremasteric fascia. Within the fascia. Dicey question. Think about development and descent.
: 13. The inferior boundary of the inguinal canal is the inguinal ligament.
: a. True Agree. Sometimes called the floor - argh.
: 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 Disagree. Direct. Directly out superficial ring. Usually between cremasteric and external 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 Agree.
: 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 Agree.
: 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 Disagree. Account for indirect hernia in the female.
: 18. Lymph vessels accompany the round ligament of the female to the region of the mons pubis.
: a. True Agree. Thus, lymph drainage from the ovary??
: 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.
: a.True Agree.
: 20. The reflected inguinal ligament is found medial and superior to the pubic tubercle.
: a. True Agree. Relationship to superficial ring?
: 21. The lacunar ligament is lateral and inferior to the pubic tubercle.
: a. True Agree. Why are questions 20 and 21 consecutive?
: 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. Agree. Know the relationships of the pubic tubercle to the superficial ring and the femoral ring.
: 23. Femoral hernias are palpated medial and superior to the pubic tubercle.
: a. False: lateral and inferior Agree. See #22.
: 24. Femoral hernias are more common in males than in females.
: a. False: more common in females Agree. Account for this in terms of anatomy.
: 25. In the case of femoral and inguinal hernias, the innermost layer of the hernial sac is transversalis fascia.
: a. True Agree. Disagree. Please understand this. Not easy.
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