RCSI Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in

Éirinn

Class JC2
Course GB
Code GB1
Title Anterior Abdominal Wall & Surface Anatomy
Lecturer Professor Clive Lee
Date 14/01/20
 Learning Outcomes
• Describe the anterior abdominal wall
• Describe the anatomy of the inguinal canal
• Demonstrate an understanding of how inguinal
hernias develop and explain the anatomy and
clinical findings
• Describe the layers and contents of the scrotum
• Explain the embryology of testicular descent,
and why this is clinically relevant
 Inguinal Canal Contents
• Female
– Ilioinguinal nerve
– Round ligament of the uterus
• Male
– Ilioinguinal nerve
– Spermatic cord
• Spermatic Cord
– 3 Arteries
• Testicular – from Aorta at L2
• Cremesteric – from Inferior Epigastric
• Artery of Vas – from Superior Vesical
– 3 Nerves
• Nerve to cremaster – from Genitofemoral
• Sympathetics – deep pain sensation
• (Ilioinguinal – separate)
– 3 other things
• Vas deferens
• Pampiniform plexus of veins – asymmetric, variocosities
• Lymphatics to paraaortic nodes at L2
 Hernia -Definition
• Hernia
– a protrusion of an organ in part or in whole through a defect in the cavity
that normally contains it
• Groin Hernias
– Common 75% of hernias
– 25% of males and 2% of females have inguinal hernias in their lifetime

• Adductor longus attaches to the pubic tubercle

• Inguinal
– Neck is above & medial to pubic tubercle
• Femoral Canal
– Neck is below and lateral to pubic tubercle
 Inguinal Hernia - Indirect
• Indirect
– Inguinal canal
– Congenital
– Through deep ring,
along inguinal canal,
superficial ring to
scrotum
– If reduced, can be
controlled at deep ring
 Inguinal hernia - Direct
• Through weakness in
transversalis fascia &
superficial ring

• Acquired
– Heavy lifting
– Constipation
– Sports eg Rugby
 Testis Clinical
• Undescended testis
• Torsion
• Testicular carcinoma
• Swellings
– Hydrocoele
• Collection of fluid in
tunica vaginalis
– Varicocoele
• Enlarged dilated veins
• Pampiniform plexus
• L>R ..Renal Vein
– Spermatocole
Go raibh míle maith agaibh
go léir