21 Questions
Where is the inguinal canal located in the lower part of the abdominal wall?
Above the medial half of the inguinal ligament
What structures form the roof wall of the inguinal canal?
Transverse abdominis and internal oblique muscles
Which muscle does NOT contribute to the anterior wall of the inguinal canal?
Transverse abdominis
What is found in the posterior wall of the inguinal canal, lateral to the deep inguinal ring?
Transversalis fascia
Which structure ascends in the posterior wall of the inguinal canal to reach the rectus sheath?
Inferior epigastric artery
Where is the deep inguinal ring located relative to the inguinal ligament?
Just above the midpoint of the inguinal ligament
What structure passes into the scrotum with the descending testis during development?
Processus vaginalis
Which of the following is the thickened lower free border of the external oblique aponeurosis?
Inguinal (Poupart's) ligament
What structure is a deficiency in the transversalis fascia?
Deep inguinal ring
Which structure is a triangular gap in the external oblique aponeurosis?
Superficial inguinal ring
What structure gives attachment to the internal oblique and transverse abdominis muscles laterally?
Inguinal ligament
What is the distal part of the processus vaginalis called after birth?
Tunica vaginalis of the testis
What structure is located above and medial to the pubic tubercle?
Superficial inguinal ring
What is the spermatic cord in the male formed by?
The testis descending through the inguinal canal carrying its duct, vessels, and nerves
What is the round ligament of the uterus in the female?
A structure analogous to the spermatic cord in males
What type of inguinal hernia is common in young males?
Indirect inguinal hernia
Why is an indirect inguinal hernia called 'indirect'?
Because it extends from the deep ring and follows an oblique course through the inguinal canal
What is the cause of a direct or acquired inguinal hernia?
Weakness of the posterior wall of the inguinal canal (Triangle of Hesselbach)
At what age is a direct inguinal hernia more common?
After 40 years of age
How does a direct inguinal hernia protrude?
It protrudes directly forwards without passing through the deep inguinal ring
Which structure is more common in males than females?
Spermatic cord
Study Notes
Inguinal Canal
- The inguinal canal is an oblique intermuscular passage in the lower part of the anterior abdominal wall, situated just above the medial half of the inguinal ligament.
- It extends from the deep inguinal ring to the superficial inguinal ring.
- The canal is larger in males than in females.
Walls of the Inguinal Canal
Anterior Wall
- Formed by the external oblique aponeurosis and reinforced laterally by the internal oblique
Roof
- Formed by the arched fibers of the internal oblique and transverse abdominis muscles
Posterior Wall
- Medial half: conjoint tendon and reflected part of the inguinal ligament
- Lateral half: transversalis fascia
Contents of the Inguinal Canal
- Ilioinguinal nerve (in both sexes)
- Lateral cutaneous nerve of the thigh (in males)
Development of the Testis
- Gonads descend from the posterior abdominal wall to the pelvis in females and to the scrotum in males
- Processus vaginalis is a tubular process of peritoneum that passes into the scrotum with the descending testis
- Failure of the processus vaginalis to close can lead to hernia
Inguinal Ligament (Poupart's Ligament)
- Thickened lower free border of the external oblique aponeurosis
- Extends between the pubic tubercle and the anterior superior iliac spine
- Gives attachment to two muscles: internal oblique and transverse abdominis
- Has an under-curving fibrous band and a triangular deficiency in the external oblique aponeurosis
Inguinal Rings
Deep Inguinal Ring
- Deficiency in the transversalis fascia, located 1/2 inch above the midpoint of the inguinal ligament
- Oval opening in the fascia transversalis
Superficial Inguinal Ring
- Triangular gap in the external oblique aponeurosis
- Shaped like an obtuse-angled triangle, with the base formed by the pubic crest
Hernias
Indirect Inguinal Hernia
- Common in young males
- Caused by the processus vaginalis remaining open
- Extends from the deep ring and follows an oblique course through the inguinal canal
- Usually extends into the scrotum
Direct Inguinal Hernia
- Less common than indirect inguinal hernia
- Neck of the sac lies medial to the inferior epigastric artery
- Results from weakness of the posterior wall of the inguinal canal (Triangle of Hesselbach)
- Common after 40 years of age
- Hernial sac protrudes directly forward without passing through the deep inguinal ring
Test your knowledge on the development of the testis and the anatomy of the inguinal canal. Learn about the descent of gonads, the processus vaginalis, and the inguinal ligament.
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