Plating 4 (Part 2)

Covers: Inguinal region, peritoneum

Inguinal canal

Oblique passage through lower abdominal wall

Spermatic cord

The inguinal canal transmits __ in males

Round ligament of uterus

The inguinal canal transmits __ in females

Superficial inguinal ring

Triangular defect in aponeurosis of external oblique muscle layer; opening of the inguinal canal

Male

The superficial inguinal ring is larger in what gender?

Deep inguinal ring

Opening of the invagination of transversalis fascia; lies above inguinal ligament

Direct inguinal hernia

Hernia that occurs in older men, rarely in women

Direct inguinal hernia

Hernia due to weakness in abdominal wall behind or lateral to superficial inguinal ring

Direct inguinal hernia

Hernia that passes directly through abdominal wall to superficial inguinal ring

Direct inguinal hernia

Hernia that doesn’t extend into scrotum

Indirect inguinal hernia

Hernia that transverses deep and superficial inguinal rings and inguinal canal

Indirect inguinal hernia

Hernia that lies within coverings of spermatic cord

Indirect inguinal hernia

Hernia that may descend into scrotum

False

True or false: direct inguinal hernia is more common than indirect inguinal hernia

Indirect inguinal hernia

Hernia that is more common in boys and young men; may be congenital

Femoral hernia

Hernia that occurs within femoral canal; more common in females

Umbilical hernia

Hernia that occurs at site where umbilical cord penetrates between muscles and fascia of anterior abdominal wall

Median umbilical fold

Medial umbilical fold

Lateral umbilical fold

Falciform ligament

4 folds of posterior surface of anterior wall

Median umbilical fold

Midline peritoneal fold in inner abdominal wall above bladder

Medial umbilical fold

Paired peritoneal folds on either side of median fold

Lateral umbilical fold

Paired peritoneal folds lateral to medial folds

Falciform ligament

Double layer of peritoneum; attaches liver to anterior abdominal wall and to inferior surface of diaphragm

Median umbilical ligament

Remnants of embryonic urachus

Medial umbilical ligaments

Remnants of umbilical arteries

Ligamentum teres hepatis

Remnants of left umbilical vein

Ilioinguinal nerve

The inguinal canal transmits what nerve in both sexes?

Passage of spermatic cord from testis to male abdomen

Passage of round ligament of uterus from uterus to female labium majus

Functions of inguinal canal

Crura

Margins of superficial inguinal ring sometimes called __

External spermatic fascia

Crura of superficial inguinal ring gives attachment to __

Internal spermatic fascia

Margins of deep inguinal ring gives attachment to __

Aponeurosis of external oblique muscle

Anterior wall of inguinal ring formed along its entire length by what muscle?

Superficial inguinal ring

Strongest point of anterior wall of inguinal ring

Deep inguinal ring

Weakest point of anterior wall of inguinal ring

Transversalis fascia

The posterior wall of inguinal ring is primarily formed by?

Inguinal ligament and lacunar ligament

The inferior wall (floor) of the inguinal canal is formed by?

Internal oblique and transversus abdominis muscles

The superior wall of inguinal canal (roof) is formed by what muscle/s?

Medial

Superolateral

Inferior

Three borders of inguinal triangle (Hasselbach’s triangle)

Linea semilunaris

What is the medial border of inguinal triangle?

Inferior epigastric vessels

What is the superolateral border of inguinal triangle?

Inguinal ligament

What is the inferior border of inguinal triangle?

Hernia

Protrusion of part of abdominal contents beyond the normal confines of abdominal wall

External spermatic fascia

Covering of spermatic cord derived from external oblique aponeurosis

Cremasteric fascia

Covering of spermatic cord derived from internal oblique ms

Internal spermatic fascia

Covering of spermatic cord derived from transversalis fascia

Processus vaginalis

Temporary, pouch-like extension of the abdominal lining (peritoneum) that develops during fetal growth

Right

Indirect inguinal hernia is more common on what side?

Direct inguinal hernia

Its hernia sac passes directly through Hasselbach’s triangle and may disrupt the inguinal canal floor

Indirect inguinal hernia

Its hernia sac passes outside the borders of Hasselbach’s triangle and follows the course of spermatic cord

Peritoneum

Thin, continuous, glistening serous membrane lining the abdominopelvic cavities

Parietal peritoneum

Visceral peritoneum

Layers of peritoneum

Parietal peritoneum

Lines the abdominopelvic wall

Visceral peritoneum

Lines the investing viscera

Peritoneal cavity

Potential space between visceral and parietal peritoneum

Greater sac

Peritoneal cavity sac that extends from diaphragm down into pelvis

Lesser sac

Peritoneal cavity sac that lies behind the stomach

Foramen of Winslow / epiploic foramen

The only natural opening connecting greater sac to lesser sac

Mesentry

Double layer of peritoneum connecting organs to posterior abdominal wall

Omentum

Double layer of peritoneum fold that passes from stomach and proximal part of duodenum to adjacent organs in abdominal cavity

Lesser omentum

Connects lesser curvature of stomach and proximal part of duodenum → liver

Greater omentum

Prominent fold that hangs from greater curvature of stomach and duodenum and folds back and attaches to anterior surface of transverse colon

Hepatogastric ligament

Ligament that connects liver and stomach

Gastrophrenic ligament

Ligament that connects stomach to diaphragm

Ascites

Excessive accumulation of peritoneal fluid within peritoneal cavity

Paracentesis

Test for ascites

Diuretics, antibiotics

Treatment for ascites

T6-T12 and L1 spinal nerves

Innervation of abdominal wall/peritoneum

Autonomic afferent nerves

Innervation of visceral peritoneum

Deep inguinal ring

Strongest point of posterior wall of inguinal ring

Superficial inguinal ring

Weakest point of posterior wall of inguinal ring

Medial

Relation of inferior epigastric vessels to direct inguinal hernia

Lateral

Relation of inferior epigastric vessels to indirect inguinal hernia