Inguinal Canal, Testes, and Scrotum

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name the parasympathetic (rest and digest) functions in testis

--erectile tissues of the penis and prostate gland receive parasympathetic innervation from pelvic splanchic nerves --promotes sexual arousal

name the sympathetic (fight or flight) functions in testes

--promotes ejaculation --increases glandular secretions

what are the things entering the testicular mediastinum

--testicular artery --Pampiniform plexus of veins

what are the contents of the spermatic cord

1) Artery to ductus deferens 2) Ductus vas deferens 3) Lymphatics 4) Testicular artery 5) Cremasteric artery and vein 6) Remnant of obliterated processus vaginalis 7) Pampiniform plexus of veins 8) Genital branch of genitofemoral nerve (GSE) **All Doctors Love Taking Care Of Patients Genitals

what are the three coverings of the spermatic cord (from superficial to deep)

1) External spermatic fascia 2) Cremaster fascia and muscle 3) Internal spermatic fascia

what are the two repairs for a hernia and describe them

1) Hernioplasty --this is a no-tension technique where you put a mesh around the hernia and create this sort of fake abdominal wall 2) Herniorrhaphy --This is where you suture it and put tension on the area but there is no mesh or anything involved

what are the 6 testes coverings (from superficial to deep)

1) Skin 2) Tunica Dartos (Dartos muscle fascia) 3) External spermatic fascia 4) Cremaster muscle and fascia 5) Internal spermatic fascia 6) Tunica vaginalis

indirect inguinal herniated content is covered by __________1________ which makes it ___2___ likely to enter the scrotum

1) all 3 layers of the spermatic cord plus periotneum 2) more

the inguinal ligament extends from ________1_____ to ______2_____

1) anteior superior iliac spine 2) pubic tubercle

the inguinal region of the abdominal wall is the area between the ___________1________________ and _________2_______

1) anterior superior iliac spine 2) pubic tubercle

Again for review, the opening of the inguinal canal is the ________1____________ and the exit of the inguinal canal is the _________2____________

1) deep inguinal ring 2) superficial inguinal ring

the conjoint tendon is formed from what two things

1) fibers from the intenal oblique 2) fibers from the transversus abdominis aponeurosis

Again to review, what are the three things that are in the inguinal canal that males and females have in common

1) ilioinguiinal nerve 2) genital branch of the genitofemoral nerve 3) blood and lymphatic vessels

what are the other four contributions to the descent of the testis and coverings ( in descending order-from deep to superficial) of the spermatic cord and scrotum

1) internal abdominal oblique muscle 2) external abdominal oblique muscle 3) Scarpa's fascia 4) skin

So the venous drainage differs for the right and left testis. The left testicular vein drains into _____1_______. The right testicular vein is lazy and drains into ________2________.

1) left renal vein 2) inferior vena cava

what are the contents of the female inguinal canal

1) round ligament of the uterus 2) ilioinguinal nerve 3) genital branch of genitofemoral nerve 4) blood and lymphatic vessels

the scrotum develops from which two labioscrotal swellings that eventually fuse to form a pouch

1) scrotal septum 2) scrotal raphe

what are the 5 scrotum coverings (superficial to deep)

1) skin 2) Dartos muscle and superficial fascia 3) External spermatic fascia 4) Cremaster fascia and muscle 5) Internal spermatic fascia

name the general contents of the inguinal canal. You will be quizzed on the different male and female contents later on in the deck

1) spermatic cord 2) round ligament of the uterus 3) inguinal nerve 4) blood and lymphatic vessels

what are the contents of the male inguinal canal

1) spermatic cord 2) ilioinguinal nerve 3) genital branch of genitofemoral nerve 4) blood and lymphatic vessels

Cremaster muscle is _____1___ and innervated by the ___________________2____________________ to elevate the testis

1) striated 2) genital branch of the genitofemoral nerve

the _____1____ jumps on the ______2_____, and ends up in the scrotum which hangs outside the male body and is the optimum temperature for sperm production since being inside the body is not the best for sperm production because that temperature is too high

1) testis 2) gubernaculum

the herniated content in a direct inguinal hernia is covered by _________________1__________________ which makes it ___2___ likely to enter the scrotum

1) transversalis fascia and parietal peritoneum 2) less

name the veins in the anterior portion of the scrotrum and what they drain into

Anterior scrotal veins draining into external pudendal veins

the testicular arteries branch directly from the abdominal aorta at approximately ____

L2

Lymph from the testis drains into which lymph nodes

Para-aortic (lumbar) lymph nodes

where is dartos muscle and superficial fascia derived from

Scarpa's fascia

where is tunica dartos (dartos muscle fascia) derived from

Scarpa's fascia

name the flow of the neurovascular structures enter and leave the testis

Seminiferous tubule---->straight tubule---->Rete testis----->efferent ductules---->head of epididymis---->ductus (vas) deferens

the anterior portion of the scrotum is supplied by which artery

anterior scrotal artery

the testes are visceral organs and therefore receive _____________ innervation

autonomic

testis function optimally ________ body temperature

below

which muscle helps elevate the testis

cremaster muscle

what works in conjuction with the striated cremaster muscle

dartos muscle

where does the spermatic cord begin

deep inguinal ring

what are the two types of inguinal hernias

direct inguinal hernia and indirect inguinal hernia

the tail of the epididymis is continuous with what and what does that mean

ductus deferens, so the sperm goes from the ductus deferens up to the penis so it could be expelled during sex

describe the epididymis

elongated and tightly coiled

where is external spermatic fascia derived from

external oblique muscle fascia

femoral hernia is more common in __________

females

name the pathway that the anterior scrotal artery comes from

femoral artery------>external pudendal artery-------->anterior scrotal artery

what are the three parts of the epididymis

head, body and tail

explain where the hernia pushes through depending on whether it is acquired or congenital

if it is acquired, it pushes through the posterior wall of the inguinal canal and if it is congenital, it moves through a open processus vaginalis

what is the anterior scrotal nerve

ilioinguinal nerve

the inguinal canal starts deep and lateral to the ____________ _______________ artery

inferior epigastric

the ____________ ______________ is a passageway from the abdominal cavity through the anterior abdominal wall

inguinal canal

where does the spermatic cord travel through

inguinal canal

what does the inguinal ligament sit on (what is on the floor of the inguinal canal)?

inguinal ligament

where is cremaster fascia and muscle derived from

internal oblique muscle fascia

one really important thing to remember is that the lymph surrounding the skin of the scrotum initially drains where?

into the superficial inguinal lymph nodes

external spermatic fascia is derived from what

investing fasica of external oblique muscle

what is the inguinal ligament made from

it is basically the fibrous, thickened, folded margin of the external oblique aponeurosis

what is Hesselbach's triangle

it is located between the medial and lateral peritoneal (umbilical) folds and is a weak area in the posterior wall of the inguinal canal

where does a direct inguinal hernia originate from and where is it located

it orginates from Hesselbach's triangle and is located MEDIAL to the inferior epigastric artery

where does an indirect inguinal hernia originate from and where is it located

it originates from the deep inguinal ring, so it is LATERAL to the inferior epigastric artery

describe how the inguinal canal starts and ends

it starts deep and ends superficially

what does the spermatic cord do

it suspends the testis in the scrotum and contains the structures that run to and from the testis

Again just for review, the deep inguinal ring is ____________ to the inferior epigastric vessels (vein and artery)

lateral

Again, just for review, the superficial inguinal ring is __________ to the inferior epigastric vessels (artery and vein)

medial

the inguinal canal ends _________ superficial

medially

Let's talk about the carcinoma of the skin of the scrotum. Where is metastatic spread most likely and be specific

metastatic spread is most likely via the lymphatic system and in the superficial inguinal lymph nodes first!!

the inguinal canal in females is ___________

narrower

in what population is a direct inguinal hernia common

older males

the epididymis is located wher

on the posterior surface and superior pole of the testis

the deepest layer of the testes covering is the Tunica Vaginalis. Name the two layers of the tunica vaginalis

parietal layer and visceral layer

the posterior portion of the scrotum is supplied by which artery

posterior scrotal artery

name the veins in the posterior portion of the scrotum and what they drain into

posterior scrotal veins that drain into internal pudendal vein

what is the posterior scrotal nerve

pudendal nerve

Each testis is anchored inferiorly by the __________________

scrotal ligament

where does the spermatic cord completely end

scrotum

what type of muscle is Dartos musce

smooth

tell me about how the carcinoma of the testis like where it spreads first and where it could eventually reach

so carcinoma of the testis is metastatic spread that is mainly spread by the lymphatic system but could also be spread by the vascular system. It spreads to the lumbar (para-aortic) lymph nodes first but cancer of the testes could eventually reach the lungs and if spread by the vascular system, it could eventually reach the spine and liver and brain

explain why an indirect inguinal hernia originates at the deep inguinal ring

so there is already an opening at the deep inguinal ring which is normal because the opening transmits the ductus deferens or round ligament of the uterus so this opening can make it easier for a hernia to occur here at the deep inguinal ring

what two things do testis product

sperm and male hormones

what suspends the testis within the scrotum

spermatic cord

what is the function of the epididymis

stores spermatozoa until maturation occurs

what type of inguinal rings are there in terms of the formation of the inguinal canal

superficial and deep inguinal rings

where does the spermatic cord emerge

superficial inguinal ring

the scrotum can protect the testes by regulating _____________

temperature

arterial supply for the epididymis is provided by which artery

testicular artery

the ____________________ is where the neurovascular structures enter and leave the testis

testicular mediastinum

the arterial supply for the testis is provided by which artery

testricular arteries

the exit of the inguinal canal is located on which wall with which aponeurosis

the anterior wall with external oblique aponeurosis

what is superior (on the roof) of the inguinal canal

the conjoint tendon

what forms the inguinal canal

the inguinal canal is formed by folds of the external abdominal oblique aponeurosis

describe how the inguinal rings are formed in terms of the formation of the inguinal canal

the inguinal rings are made from the initial folds formed by the external abdominal oblique aponeurosis

cremaster fascia and musce are derived from what

the investing fascia of internal oblique muscle

the testicular mediastinum is NOT covered by what

the tunica vaginalis layers

what contributes to the wrinkled appearance of the scrotum

the wrinkled appearance is due to smooth muscle fibers known as Dartos muscle that are extemely thin and insert into the skin

the internal spermatic fascia is derived from what

transversalis fascia

what is the first and closest fascia that contributes to the descent of the testes and coverings of the spermatic cord and scrotum

transversalis fascia

where is internal spermatic fascia derived from

transversalis fascia

at what fascia does the inguinal canal start

transversalis fascia on the posterior wall (since the inguinal canal starts deep)

the ______________________ muscle does NOT contribute to the descent of the testes and converings of the spermatic cord and scrotum

transversus abdominus muscle

the visceral layer of the tunica vaginalis continues on to become this white layer that is the deepest layer of the testis

tunica albuginea

the inguinal canal in males is ___________

wider

in what population is an indirect inguinal hernia common

young males


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