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Inguinal , femoral and scrotal

regions

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Anatomy of the inguinal canal

The inguinal canal is approximately 4 cm in length and is located 2to 4 cm cephalad to the inguinal ligament. In infants, thesuperficial and deep inguinal rings are almost

superimposed and the obliquity of the canal is slight

The canal extends between the internal (deep) inguinal and theexternal (superficial) inguinal rings.

The superficial inguinal ring is a triangular aperture in theaponeurosis of the external oblique muscle and lies 1.25 cm above

the pubic tubercle. The deep inguinal ring is a U-shaped condensation of the

transversalis fascia and it lies 1.25 cm above the inguinal(Pouparts) ligament, midway between the symphysis pubis andthe anterior superior iliac spine.

The anterior boundary comprises mainly the external obliqueaponeurosis with the conjoined muscle laterally.

The posterior boundary is formed by the fascia transversalis and

the conjoined tendon (internal oblique and transversus abdominusmedially).

The inferior epigastric vessels lie posteriorly and medially to thedeep inguinal ring.

The superior boundary is formed by the conjoined muscles(internal oblique and transversus)

and the inferior boundary is the inguinal ligament.

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Content of the inguinal canal

The inguinal canal contains the spermatic cord

or the round ligament of the uterus.

The spermatic cord is composed of cremasteric

muscle fibers, external and internal spermatic

fascia the testicular artery and accompanying

veins, the genital branch of the genitofemoral

nerve, the vas deferens, the cremasteric vessels,

the lymphatics, and the processus vaginalis.

The iliohypogastric and ilioinguinal nerves and

the genital branch of the genitofemoral nerve

are the important nerves in the groin area

The iliohypogastric and ilioinguinal nerves

provide sensation to the skin of the groin, the

base of the penis, and the ipsilateral upper

medial thigh.

The genital nerve innervates the cremaster

muscle and the skin on the lateral side of the

scrotum and labia

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Covering

Obliterated processus vaginalis

Parietal layer of tunica vaginalis

Visceral layer of tunica vaginalis

Internal spermatic fascia

Cremasteric fascia and muscle

External spermatic fascia

Dartos fascia and muscle Superficialfascia

Membranous layer(Scarpa's)

Fatty layer (Camper's)

Skin

Peritoneum

Transversalis fascia

Transversus abdominis m.

Internal oblique m.

External oblique m.

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The Hesselbach triangle

The inferior epigastric

vessels serve as its

superolateral border, the

rectus sheath as medialborder, and the inguinal

ligamentas the inferior

border. Direct hernias occur

within the Hesselbach

triangle, whereas indirect

inguinal hernias arise lateral

to the triangle

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Femoral Canal

The boundaries of the femoral ring are

anteriorly by the inguinalligament;

posteriorly by Astley Coopers(iliopectineal) ligament, the pubicbone and the fascia over thepectineus muscle;

medially by the concave knife-likeedge ofGimbernats (lacunar)ligament, which is also prolongedalong the iliopectineal line, asAstley Coopers ligament;

laterally by a thin septumseparating it from the femoral vein.

A femoral hernia occurs throughthis space and is medial to thefemoral vessels

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Testis

Spermatic cord

Ductus deferens

Testicular artery

Testicular vein (pampiniform plexus)

Epididymis:Head,Body,Tail

Efferent ductulesRete testis

Seminiferous tubule

Septum

Lobules

Visceral layer of tunica vaginalis

Cavity of tunica vaginalisParietal layer of tunica vaginalis

Tunica albuginea