Re: Questions for the Inguinal Canal

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: : : Questions for the Inguinal Canal : : : These questions were not submitted by the lecturer. : : : True/False : : : August 27, 2010 : : : 1. The linea alba lies lateral to the linea semilunaris. : : F - lies medial. The linea semilunaris run up the lateral edges of rectus abdominis. : Agree. : : : 2. The medial and lateral crus are stabilized by the transverse fibers of the internal oblique. : : F - intercrural fibers are from the external oblique : Agree. : : : 3. The inguinal ligament, but not the reflected inguinal ligament, is derived from the external oblique aponeurosis. : : F - both are derived from the external oblique aponeurosis : Agree. : : : 4. The opening of the superficial ring is medial and superior to the pubic tubercle. : : F - just lateral to the pubic tubercle : True. See #5. : : : 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. : : F - these fibers form the posterior wall. : True. The floor, in this case refers to the posterior inferior wall. This poorly written question demonstrates the problem with non-anatomical terminology. : : : 7. A medial gap (lacuna) between the inguinal ligament and pectin line is partly filled by the lacunar ligament. : : Not sure what this means, but yes, part of the gap between the inguinal ligament and pectin line is partially filled by the lacunar ligament. : Agree. Lacunar refers to a gap. : : : 8. Fibers from the lacunar ligament extend onto the pubic pectin as the pectineal ligament. : : T : Agree. Thus forming the posterior boundary of the femoral ring. : : : 9. The internal spermatic fascia, despite its name, lies superficial to the processes vaginalis. : : T : Agree. : : : 10. An indirect inguinal hernia passes indirectly out the superficial ring by way of the deep ring. : : T : Agree. : : : 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. : : F - it will also lie deep to cremasteric fascia : True. In the above case the hernia passes through the superficial ring. Entrapment between the external spermatic fascia and the cremasteric fascia prevents the direct hernia from descending more than a few centimeters into the scrotal sac. In other cases the direct hernia may first enter the inguinal canal and thereby reside deep to cremasteric fascia. I do not have a citation for this case. : : : 12. The indirect hernia lies deep to all the tunics of the cord except for the processes vaginalis. : : T : False. The indirect hernia resides within the patent processes vaginalis. You could argue for true on the basis that the tunica vaginalis is not a tunic. Then again, in the case of a patent tunica vaginalis, it is a diverticulum similar to the other tunics. : : : 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. : : F - not the conjoint tendon? : Agree. : : : 14. The transversus abdominis muscle contributes the processes vaginalis component of the spermatic cord. : : F - the processus vaginalis is an extension of the peritoneum : Agree. : : : 15. The internal oblique, arising from the lateral 1/3 of the inguinal, does not contribute a tunic to the spermatic cord. : : F - this would describe the transversus abdominis : Agree. Internal oblique arises, in part, from the lateral 2/3 of the inguinal ligament. : : : 16. The deep ring lies lateral to the medial umbilical fold and medial to the lateral umbilical fold. : : F - it lies lateral to both? : Agree. This question can be "gamed" without any knowledge of anatomy. : : : 17. The median umbilical fold, caused by a contour of the transversalis fascia, is deep to the obliterated urachus. : : T : False. The fold is caused by a contour of the parietal peritoneum. The transversalis fascia is superficial to the obliterated urachus.

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