Re: Questions for the Inguinal Canal

Comments:
: : : Questions for the Inguinal Canal : : : These questions were not submitted by the lecturer. : : : 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. : : F - anterior wall of rectus sheath : Agree. : : : 2. The external oblique contributes fibers to the formation of the superficial inguinal ring, the reflected inguinal ligament, and the cremasteric fascia. : : F - it doesn't contribute to the cremasteric fascia, that's contributed by the internal oblique : Agree. : : : 3. The external oblique contributes fibers to the formation of the pectineal ligament, lacunar ligament and the conjoint tendon. : : F - the conjoint tendon is formed by the inferior fibers of interal oblique and tranversus abdominis. The lacunar ligament and the pectineal ligament are formed by fibers from the inguinal ligament, which is the reinforced free edge of external oblique, so does this constitute contribution of fibers? : Agree. Yes, the external oblique contributes fibrous material to ligaments, sheaths, and lines that are extensions of the aponeurosis. : : : 4. The external oblique contributes fibers to the boundaries of the superficial ring, femoral ring, and the deep ring. : : F - not the deep inguinal ring. : Agree. : : : 5. The external oblique contributes fibers that define three of the four boundaries of the femoral ring. : : T - medial (lacunar lig), anterior (iliopubic tract), and posterior (pectineal lig) : Agree. Anterior to the femoral ring is the inguinal ligament. : : : 6. The intercrural fibers secure the aponeuronsis of the external oblique to the conjoint tendon of the internal oblique. : : F? - the intercrural fibers are from the external oblique aponeurosis, but they form part of the superficial inguinal ring. The conjoint tendon is relatively deep to this structure. I'm not really able to visualize a connection here, but maybe Gray's would show it better if there is one. : Agree. The intercrural fibers approximate the medial and lateral cura. : : : 7. The internal oblique and the transversus abdominis arise, in part, from the external oblique. : : F - transversus for sure not...internal oblique lies between. The only fuzzy part of this question would be that the aponeuroses of the internal and external fuse to form the anterior part of the rectus sheath, but I don't think that means they arise together. : True. They arise, in part, from the inguinal ligament. : : : 8. The transversus abdominis muscle contributes a layer of transversalis fascia to the layers of the spermatic cord. : : F - the transversus abdominis contributes nothing to the spermatic cord. : Agree. : : : 9. The cremasteric muscle/fascia shares an innervation with the internal oblique muscle. : : F - even though the loops of muscle originate from the internal oblique, this part is innervated by the genitofemoral nerve. Internal oblique is innervated by the lower intercostal nerves, iliohypogastric, and ilioinguinal nerves : True. Not the best question. The genitofemoral nerve shares upper lumbar spinal nerves with the nerves you mention. : : : 10. The conjoint tendon has origins partly from the inguinal ligament. : : F - it originates from the internal oblique and transversus abdominis : True. Lateral 1/3 and lateral 2/3 of inguinal ligament for TA and IO respectively. A tendon does not originate from a muscle; a tendon is part of a muscle. In this case, a muscle may arise from a tendon. : : : 11. The transversalis fascia refers to the investing fascia of the transversus abdominis muscle. : : F? - it's the same kind of fascia as endothoracic - loose areolar tissue : Agree. Except to say that the transversalis fascia is a differentiated membrane. : : : 12. An extended hip tightens the anterior abdominal wall and may cause strangulation of an inguinal hernia. : : F? - Although tightening the abdominal wall increases intrabdominal pressure and can force bowel to herniate more, I'm not sure how extending the hip would 1) cause the wall to tighten and 2)subsequently strangulate the bowel. If you tightened the muscles radiating from the outside of a ring, it would seem like the ring diameter would become larger, not smaller. : True. Extending the hip places traction of the inguinal ligament by the fascia lata. This increases the likelihood of strangulation for all types of inguinal and femoral hernias. Thus, it would be dangerous to lie in bed on your back and place one foot on the floor in an attempt to stabilize your mental world. Especially if you had an inguinal/femoral hernia and was somehow compromised in your response to pain. : : : 13. The artery of the ductus deferens is of the pelvic cavity. : : F? - it commences outside the peritoneum : True. Not the best question. This artery is derived from the internal iliac artery in the pelvic cavity. : : : 14. The testicular artery is of the abdominal cavity. : : Also F? - it commences on the aorta and runs down the posterior abdominal wall, also superficial to the peritoneum. : True. Everything is "superficial" to the peritoneum except perhaps for an episodic egg. The abdominal aorta is of the abdominal cavity. Nevertheless, my use of "of" is awkward. : : : 15. When residing inside the abdominal cavity, the testis is retroperitoneal, but has a peritonealized surface. : : T : Agree. : : : 16. The vascular supply to the non-descended testis is retroperitoneal. : : T : Agree. : : : 17. The processes vaginalis is a diverticulum of transversalis fascia. : : F - of the peritoneum : Agree. : : : 18. A patent processes vaginalis invites an indirect inguinal hernia. : : T : Agree. : : : 19. The transversus abdominis muscle contributes the layer of internal spermatic fascia to the spermatic cord. : : F - this is contributed by the transversalis fascia : Agree. : : : 20. Scarpa's fascia takes on smooth muscle as it transitions into Dartos fascia. : : T : Agree. : : : 21. The processes vaginalis of the spermatic cord is deep to the internal spermatic fascia. : : T : Agree. : : : 22. The cremasteric fascia, but not the external spermatic fascia, makes up part of the spermatic cord within the inguinal canal. : : T - since it's contributed by the internal oblique, and the end of the canal is at the superficial inguinal ring? : Agree. : : : 23. The deep ring is located medial to the inferiorepigastic artery. : : F - it at least looks lateral in the notes... : Agree. It looks lateral on dissection as well. : : : 24. The obliterated umbilical artery creates a fold of visceral peritoneum named the medial umbilical fold. : : T : False. Parietal peritoneum. Sorry about that. : : : 25. The urachus obliterates to form the median abdominal ligament. : : F - median inguinal ligament : Agree. But the median umbilical ligament. : : : 26. The median umbilical folds define the medial inguinal fossa between them. : : F - there's only one median umbilical fold, so there'd have to be some crazy mental gymnastics to make it define multiple borders : Agree. "Crazy mental gymnastics." I can do that. The supravesical fossa lies between the medial umbilical folds. : : : 27. The cremasteric artery is deep to the internal spermatic fascia and deep to the processes vaginalis. : : F - it's superficial to both : Agree. : : : 28. A patent processes vaginalis may transmit a direct inguinal hernia. : : F - these present away from the processus vaginalis, medial to the inferior epigastric artery : Agree. : : : 29. The external spermatic fascia is in contact with Dartos fascia. : : T : Agree. : : : 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. : : F - from testis is to lumbar nodes, from scrotum is to inguinal nodes : True. Lymphatic drainage, in this case, corresponds to blood vascular supply. Nevertheless, be aware that the ovary has lymphatic drainages that follow the round ligament to the mons pubis and then to the region of superficial inguinal nodes. The scrotum can be refined to primary lymphatic drainages for the anterior and posterior regions. : : : 31. The parietal layer of the tunica vaginalis is superficial to the internal spermatic fascia. : : F - it's deep to it, although it's superficial to the visceral layer of tunica vaginalis : Agree. Except, it is poisonous to explain that a structure is superficial to itself.

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