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What is covered by layers of abdominal wall?
- Vas deferens
- venous drainage-plexus
- testicular artery
- lymphatic autonomic n. fibers
attachment of inguinal ligament
what muscle is underneath inguinal ligament and lateral?
what is underneath te inguinal ligament and medial?
arteries, nerves, and veins
Is the inguinal ligament actually a ligament?
No, it is the free edge of the external oblique muscle
skin layer becomes what in scrotum?
stays skin layer
Campor's Fascia (superficial fascia Membranous Fatty) becomes what in scrotum?
Dartos muscle-smooth muscle-works with cremaster muscle
What does Scorpa's Fascia become in scrotum?
What does External Oblique aponeurosis become in scrotum?
External spermatic fascia
What does Internal Oblique become in scrotum?
Cremaster muscle-works with dartos muscle
What does Transversus Abdominis become in scrotum?
No layer in scrotum
What does transversalis fascia become in scrotum?
Internal spermatic fascia
What does subperitoneum fat and center become in scrotum?
center of cord
What does peritoneum become in scrotum?
median, medial, and lateral
what are the layers of the inguinal triangle?
inferior epigastric vessels, rectus abdominus sheath, and inguinal ligament
nerves 7-12 lie in plane between?
- internal oblique and transversus
- penetrates posterior sheath then anterior sheath and splits
Nerves 7-12 supply?
Nerves 7-12 emerge as?
anterior cutaneous which overlap with lateral cutaneous and anterior cutaneous of other side
Branches of L1 penetrate?
internal oblique and ASIS and lie between obliques
T6-T8 ascend and astomose where?
in rectus abdominis
Descent of testis
- gubernaculum-attaches undifferentiated gonad to presumptive scrotum or labium majus (before abdominal muscles are present)
- muscles migrate to surround gubernaculum
- late in embryonic life-tongue of peritoneum, processus vaginalis, invades scrotum
- testis follows preformed pathway about time of birth
- processus seals up leaving cavity in scrotum lined by tunica vaginalis
what part is undifferentiated and is either female or male?
attach to gonads and skin
transversus, internal oblique and external oblique
migrate (linea alba) from somite from back and surround gubernaculum-great slide for processus vagninalis
processus vaginalis seals up and leaves?
tunica vaginalis (sac)
without androgen processus vaginalis does what?
continutes to grow-uterus gets stuck-nothing descends through wall and canal is a remnant of gubernaculum-now round ligament of uterus
the best surgical incision is made where?
- semihorizontal or linea alba
- semihorizontal: cut across rectus abdominis-can heal up, not much bleeding after tie off and can cut between nerves
- linea alba-easily done, overlap of nerves-cutaneous nerves, not much bleeding-downfall is tension on sutures
apeneurosis of inguinal canal
- anterior superior iliac spine to pubic tubercle
- continuations=lacunar and pectineal ligament
- continuations attach to pectineal line
medial and lateral crura
- combined fibers of internal oblique and transversus
- attaches to pectinal line
floor of inguinal canal
- inguinal ligament
- lacunar ligament
roof of inguinal canal
arching fibers of interior oblique and transversus
anterior wall of inguinal canal
external oblique and internal oblique
posterior wall of inguinal canal
- conjoined tendon
- transversalis fascia
superficial inguinal ring
- not complete opening
- in external oblique
- surrounded by medial crus and lateral crus (door post)
if oben external oblique muscle will see?
deep ring with spermatic cord coming out of deep ring
funnel of transversalis fascia
opening in external oblique aponerosis
coverings of cord
- external spermatic fascia
- internal speramtic fascia
follows pathway of processus vaginalis and testis and tends to go into scrotum
- originates medial to inferior epigastric artery
- bulges posterior wall of inguinal canal and remains on anterior abdominal wall
- in medial inguinal fossa or supravesical fossa
- in supravesical fossa rub up against conjoint tendon-does not go into scrotum
- *pass through inguinal triangle and stretches conjoint tendon or transversalis fascia lateral to conjoint tendon
if indirect hernias don't get treated what can happen?
- if untreated long enough can go into scrotum
- can cause fusion/adhesion of parietal and visceral layers-gut rotation here-occlusion of blood vessels supplying gut-3 days to live
how hernias occur
- valsalva maneuver-weak spot
- occurs gradually-why it does not hurt