Inguinal Canal

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Questions for the Inguinal Canal

True/False - August 26, 2011

1. The external oblique contributes fibers to the formation of the linea alba, inguinal ligament, and the posterior wall of the rectus sheath.
2. The external oblique contributes fibers to the formation of the superficial inguinal ring, the reflected inguinal ligament, and the cremasteric fascia.
3. The external oblique contributes fibers to the formation of the pectineal ligament, lacunar ligament and the conjoint tendon.
4. The external oblique contributes fibers to the boundaries of the superficial ring, femoral ring, and the deep ring.
5. The external oblique contributes fibers that define three of the four boundaries of the femoral ring.
6. The intercrural fibers secure the aponeuronsis of the external oblique to the conjoint tendon of the internal oblique.
7. The internal oblique and the transversus abdominis arise, in part, from the external oblique.
8. The transversus abdominis muscle contributes a layer of transversalis fascia to the layers of the spermatic cord.
9. The cremasteric muscle/fascia shares an innervation with the internal oblique muscle.
10. The conjoint tendon has origins partly from the inguinal ligament.
11. The transversalis fascia refers to the investing fascia of the transversus abdominis muscle.
12. An extended hip tightens the anterior abdominal wall and may cause strangulation of an inguinal hernia.
13. The artery of the ductus deferens is of the pelvic cavity.
14. The testicular artery is of the abdominal cavity.
15. When residing inside the abdominal cavity, the testis is retroperitoneal, but has a peritonealized surface.
16. The vascular supply to the non-descended testis is retroperitoneal.
17. The processes vaginalis is a diverticulum of transversalis fascia.
18. A patent processes vaginalis invites an indirect inguinal hernia.
19. The transversus abdominis muscle contributes the layer of internal spermatic fascia to the spermatic cord.
20. Scarpa's fascia takes on smooth muscle as it transitions into Dartos fascia.
21. The processes vaginalis of the spermatic cord is deep to the internal spermatic fascia.t
22. The cremasteric fascia, but not the external spermatic fascia, makes up part of the spermatic cord within the inguinal canal.
23. The deep ring is located medial to the inferiorepigastic artery.
24. The obliterated umbilical artery creates a fold of visceral peritoneum named the medial umbilical fold.
25. The urachus obliterates to form the median abdominal ligament.
26. The median umbilical folds define the medial inguinal fossa between them.
27. The cremasteric artery is deep to the internal spermatic fascia and deep to the processes vaginalis.
28. A patent processes vaginalis may transmit a direct inguinal hernia.
29. The external spermatic fascia is in contact with Dartos fascia.
30. Lymphatic drainage from the superior pole of the testis is to the upper lumbar nodes and lymphatic drainage from the inferior pole is to internal iliac nodes.
31. The parietal layer of the tunica vaginalis is superficial to the internal spermatic fascia.

True/False

1. The linea alba lies lateral to the linea semilunaris.
2. The medial and lateral crus are stabilized by the transverse fibers of the internal oblique.
3. The inguinal ligament, but not the reflected inguinal ligament, is derived from the external oblique aponeurosis.
4. The opening of the superficial ring is medial and superior to the pubic tubercle.
5. The inguinal ligament gives rise to fibers that extend medial to the pubic tubercle and these fibers contribute to the "floor" of the superficial ring and are named the reflected inguinal ligament.
6. A medial gap between the inguinal ligament and the pectin line
7. A medial gap (lacuna) between the inguinal ligament and pectin line partly filled by the lacunar ligament.
8. Fibers from the lacunar ligament extend onto the pubic pectin as the pectineal ligament.
9. The internal spermatic fascia, despite its name, lies superficial to the processes vaginalis.
10. An indirect inguinal hernia passes indirectly out the superficial ring by way of the deep ring.
11. A direct hernia is often described as pushing the conjoint tendon medially and then slipping past the lateral side; the hernial sac lies deep to the external spermatic fascia and superficial to the cremasteric fascia.
12. The indirect hernia lies deep to all the tunics of the cord except for the processes vaginalis.
13. The external oblique, directly or indirectly, gives rise to the inguinal ligament, reflected inguinal ligament, pectineal ligament, lateral, medial, and intercrural fibers, anterior lamina of rectus sheath, linea alba, linea semilunaris, and the conjoint tendon.
14. The transversus abdominis muscle contributes the processes vaginalis component of the spermatic cord.
15. The internal oblique, arising from the lateral 1/3 of the inguinal, does not contribute a tunic to the spermatic cord.
16. The deep ring lies lateral to the medial umbilical fold and medial to the lateral umbilical fold.
17. The median umbilical fold, caused by a contour of the transversalis fascia, is deep to the obliterated urachus.

1. The prostate is easier to palpate than is the breast.
2. Compression of the prostate may effect the delivery of fluids from the vas deferens to the urethra.
3. The medial and lateral crura together with the intercrural fibers contribute to the anterior wall of the inguinal canal.
4. The inferior boundary of the superficial ring is superior and medial to the pubic tubercle.
5. The femoral ring is inferior and lateral to the pubic tubercle.
6. A derivation of the external oblique aponeurosis applies to the pectin pubis (pectineal line).
7. A derivation of the internal oblique aponeurosis contributes the lacunar ligament.
8. The external spermatic begins after the deep ring of the inguinal canal.
9. An oblique course is advantageous for thwarting herniation.
10. Arising from the lateral 2/3 of the inguinal ligament is the external oblique muscle whereas arising from the lateral 1/3 is the transversus abdominis.
11. The cremasteric fascia and muscle is derived from the transversus abdominis muscle.
12. The transversalis fascia, the epimysium of the transversus abdominis muscle, contributes the external spermatic fascia.
13. An inferior free edge of the transversus abdominis muscle is superior to the deep ring.
14. The conjoined tendon is formed by a joining of the of the internal and external oblique muscles.
15. The testis, at 3 mo fetal has a a peritonealized surface, is retroperitoneal and is located near the kidney,
16. The peritonealized surface of the testis becomes the parietal layer of tunica vaginalis.
17. A distal part of the processes vaginalis becomes the visceral layer of tunica vaginalis.
18. The gubernaculum becomes the scrotal ligament.
19. An indirect hernia that descends to the tunica vaginalis can be palpated at the anterior margin of the testis.
20. The obliterated umbilical arteries raise a peritoneal fold know at the medial umbilical fold
21. A remnant of the urachus raises a peritoneal fold known as the median umbilical fold.
22. The obliterated inferior epigastric artery raises a peritoneal fold know as the lateral umbilical fold.
23. Between the median and medial umbilical folds is the paravesical fossa; a part of the medial inguinal fossa.
24. Between the medial and lateral umbilical folds if the lateral inguinal fossa, typically to site of herniation for the indirect inguinal hernia.
25. The outermost layer of the spermatic cord is dartos tunic.
26. The vas deferens, deferential plexus, artery of the vas deferens, tail of the epididymis, testicular artery, pampiniform plexus, and testicular plexus, but not the cremasteric artery and the genitofemoral nerve, are within (deep to) the internal spermatic fascia.
27. An indirect inguinal hernia proceeds indirectly out the superficial ring by way of the deep ring and the inguinal canal.
28. The direct inguinal hernia proceeds directly out the superficial ring by compromising the conjoint tendon and the lateral inguinal fossa.
29. The indirect inguinal hernia proceeds directly down an embryological pathway and, thus, is often a congenital condition.
30. A hydrocele reflects a built up of fluid in the testicular coelom.
31. The ovarian ligament, but not the suspensory ligament of the ovary, is derived from the gubernaculum.
32. The round ligament of the uterus proceeds out the deep ring, into the inguinal canal, out the superficial ring, and then ascends to the level of the umbilicus.

Definition and Short Answer

1. Derivations of the external oblique aponeurosis
2. What invaginated fascias form the tunics of the spermatic cord.
3. Deep inguinal ring

Essay

1. First question.

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