Inguinal Canal, Scrotum, & Testis

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True / False: fetal testes are retroperitoneal in the posterior abdominal wall before they descend into the scrotum

True
Components of the superficial inguinal ring
- Intercrural fibers
- Lateral crus
- Medial crus
Forms the medial border of the femoral canal

Lacunar ligament
Contents of inguinal canal
- Spermatic cord / Round ligament of uterus
- Cremasteric fascia / muscle
- Ductus (vas) deferens
- Artery of ductus deferens
- Testicular a./v.
- Pampiniform plexus
- Ilioinguinal n.
- Genital branch of genitofemoral n.
Round ligament of the uterus attachment

Attach within labia majora
Landmark - Deep inguinal ring
- Superior to inguinal ligament
- Medial to femoral a.
- Lateral to inferior epigastric vessels
- Midway between ASIS / pubic symphysis
Landmark - Superficial inguinal ring
- Superior to the pubic tubercle
- Medial to the femoral canal
Forms deep inguinal ring

Transversus abdominis m.
Forms superficial inguinal ring

External oblique aponeurosis
Innervates upper medial thigh and anterior scrotum

Ilioinguinal n. (L1)
How does the ilioinguinal n. enter the inguinal canal?

Enters between transversus abdominus / internal oblique mm.
Contraction of inguinal canal
- Occurs w/ increased abdominal pressure
- Prevents herniation of bowel
Origins of inferior epigastric vessels
- Artery arises from external iliac a.
- Vein drains into external iliac v.
Blood supply to the ductus deferens

Artery to ductus deferens (branch of inferior epigastric a.)
Origin of testicular a/v

Branch of lumbar aorta (supplies testicles)
Cremasteric reflex
- Ilioinguinal n. (L1)
- Genitofemoral n. (L2)
Innervates cremasteric muscle and lateral scrotum

Genital branch of Genitofemoral n. (L1-L2)
Which muscle does not contribute anything to inguinal canal?

Transversus abdominis
Contributes fibers to the cremasteric muscle / fascia

Internal oblique
Contributes fibers to internal spermatic fascia

Transversalis fascia
Contributes fibers to external spermatic fascia

external oblique m.
What is the round ligament of the uterus a remnant of?

Gubernaculum
Floor of inguinal canal
- Medial 1/2 of inguinal ligament
- Lacunar ligament
Roof of inguinal canal

Arching fibers of transversus abdominis / internal oblique mm. on their way to form conjoint tendond
Anterior wall of inguinal canal
- External oblique aponeurosis
- Reinforced laterally by internal oblique
Posterior wall of inguinal canal
- Transversalis fascia
- Reinforced medially by conjoint tendon
What is the processes vaginalis? How do testes descend in relation to it?
- Evagination of peritoneum into scrotum
- Testes descend from posterior body wall posterior to processes vaginalis
- (behind two layers of peritoneum)
Gubernaculum in adult testes
- Gubernaculum guides testes as it descends
- Remnant will help attach testes to scrotal wall
Remnants of the processes vaginalis

Obliterates except for visceral / parietal layers around the testes (tunica vaginalis)
Contents of spermatic cord
- External spermatic fascia
- Cremasteric fascia
- Genitofemoral n.
- Internal spermatic fascia
- Testicular a.
- Pampiniform plexus
- Ductus deferens (w/artery)
- Lymphatics & ANS
Innervation of the testis
- Testis innervated by ANS (T10 - L1/2)
- Vagal parasympathetics! (nausea)
- Visceral afferents (sympathetics) from T7
- Pain fibers travel w/ sympathetics
Why is tunica vaginalis present only on anterolateral surface of testes?

Testes descended behind both layers of processes vaginalis
Tunica albuginea
- "White tunic"
- Thick CT deep to visceral layer of tunica vaginalis
What type of muscle makes the dartos muscle

smooth muscle
What type of muscle makes the cremasteric muscle

Skeletal muscle
Site of direct hernias

Hesselbach's traingle (medial to epigastric vessels)
Hernial coverings: direct vs. indirect
- Direct: covered by peritoneum
- Indirect: covered by peritoneum and layers of spermatic cord

Author

mnm2186

34980

Card Set

Inguinal Canal, Scrotum, & Testis

Description

Exam 3

Updated

2010-09-16T20:50:35Z

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