Posted by lae2 on October 10, 2017 at 07:37:19:
In Reply to: Re: Inguinal Region Part I posted by MJ on October 08, 2017 at 20:51:35:
: : 1. Each of the three digastric muscles that make up the anterior abdominal wall contribute a tunic to the spermatic cord.
: false Agree. Be able for why the transversus abdominis does not contribute a tunic.
: : 2. The processes vaginalis, if entirely patent, provides a communication between the peritoneal cavity and the tunica vaginalis.
: true Agree. Thus path of completely descended indirect hernia.
: : 3. The deep ring is of the parietal peritoneum.
: true DisAgree. An evagination of peritoneum passes through the deep ring.
: : 4. The posterior boundary of the inguinal canal is formed by the conjoint tendon.
: true Disagree. The conjoint tendon is a relationship at the superficial ring. What about the posterior wall of the inguinal canal?
: : 5. Hernias that occur at either the medial inguinal fossa or the supravesical fossa are indirect inguinal hernias.
: false Agree. Be able to define the hernial sac for direct inguinal hernias.
: : 6. Direct inguinal hernias may be palpated from the anterior surface of the scrotum.
: false Agree. A little dicey. Certainly not palpated at the level of the testis within the scrotum. Direct hernias may be palpated a few centimeters inferior to the superficial ring.
: : 7. An indirect hernia passes deep to internal spermatic fascia.
: true Agree. In fact, within the?
: : 8. The cremasteric artery is found superficial to internal spermatic fascia and deep to external spermatic fascia.
: false Disagree. The cremasteric artery is found within the cremasteric fascia. Within what tunics is the cremasteric fascia?
: : 9. The pampiniform plexus is deep to the internal spermatic fascia.
: true Agree. Thus, the pampiniform is within fat that is continuous with?
: : 10. The deferential artery and plexus are found within the internal spermatic fascia.
: false Disagree. Within what tunic are structures that entered the deep ring? Retroperitoneal structures that enter the deep ring do so with what fatty tissue?
: : 11. The testicular artery is within the internal spermatic fascia.
: false Disagree. See #11.
: : 12. The genital branch of the genitofemoral nerve is superficial to the cremasteric fascia.
: false Agree. Passes within the cremasteric muscle and fascia.
: : 13. The inferior boundary of the inguinal canal is the inguinal ligament.
: true Agree. What about the remaining 5?
: : 14. Commonly, a direct inguinal hernia contained between external spermatic fascia and cremasteric fascia.
: true Agree. A direct may also insinuate between internal spermatic fascia and cremasteric fascia.
: : 15. The afferent limb of cremasteric reflex is, in part, mediated by the femoral branch of the genitofemoral nerve.
: true Agree. If the cremasteric reflex is absent, and the testis descended, what spinal nerves might be compressed by a herniated disc?
: : 16. The efferent limb of the cremasteric reflex is mediated by the anterior scrotal branch of the ilioinguinal nerve.
: true Agree. See #16.
: : 17. In the female, the processes vaginalis precedes the ovary in following the gubernaculum.
: false Agree. Thus, indirect inguinal hernias happen in the female; not just a male event.
: : 18. Lymph vessels accompany the round ligament of the female to the region of the mons pubis.
: true Agree. Thus, lymph from the inferior pole of the ovary may, ultimately, drain to what superficial nodes?
: : 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.
: true Agree. See #19.
: : 20. The reflected inguinal ligament is found medial and superior to the pubic tubercle.
: false Agree. The reflected inguinal ligament consists of fibers from the inguinal ligament that reflect medially and superiorally at the pubic tubercle. This ligament form what boundary of what ring?
: : 21. The lacunar ligament is lateral and inferior to the pubic tubercle.
: true Agree. See #21. Where may a femoral hernia be palpated relative to a direct inguinal hernia?
: : 22. Direct inguinal hernias are palpated inferior and lateral to the pubic tubercle.
: true Disagree. See #22.
: : 23. Femoral hernias are palpated medial and superior to the pubic tubercle.
: true Disagree. See #22.
: : 24. Femoral hernias are more common in males than in females.
: false Agree. Be able to account for the bony anatomy that may account for female and male differences in the incidence of femoral hernias.
: : 25. In the case of femoral and inguinal hernias, the innermost layer of the hernial sac is transversalis fascia.
: true Diasgree. Parietal peritoneum. Know why. What is the innermost layer of the peritoneal cavity wall. Nothing ruptures.
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