INGUINAL CANAL DEFINATION It is a musculoaponeurotic tunnel

INGUINAL CANAL

DEFINATION It is a musculo-aponeurotic tunnel which is placed obliquely just above the medial half of inguinal ligament in the lower part of anterior abdominal wall LENGTH 4 CM in length. Directed downwards forwards and medially. It is parallel to medial half inguinal ligament. Extends from deep inguinal EXTENT ring to superficial inguinal ring.

1. Anterior superior illiac spine 2. Pubic symphysis 3. Deep inguinal ring 4. Superficial inguinal ring 5. INGUINAL CANAL

– Oval gap in Fascia Transeversalis – 1. 2 cm above the midinguinal point – Structures entering through it • Spermatic cord along with internal spermatic fascia or • Round ligament of uterus

-Triangular gap in apponurosis of External oblique – Just above pubic crest. – Apex to base- 2. 5 cm – Structures passing through it • Spermatic cord along with internal spermatic fascia or • Round ligament • Ilio-inguinal nerve

• Anterior wall – Skin – superficial fascia – Apponurosis of External oblique – Lateral 1/3 part- fleshy fibres of Internal oblique • Posterior wall– Fascia transversalis – In medial half- Conjoint tendon – In medial one-forth- reflected part of inguinal ligament Inguinal ligament

• Roof – Arched fibres of Internal oblique. – Transverse Abdominis. • Floor– Grooved upper part of Inguinal ligament. – Lacunar ligament. (medially)

• Peculiarities –In female canal is narrow –In newborn canal is straight forward

ENTIRE CONTENTS – • spermatic cord in males • round ligament of uterus in females PARTIAL CONTENT— ilio inguinal nerve

• A tubular sheath containing Vas deferens with vessels and nerves. • Extent- from deep inguinal ring to upper pole of testis. • Length- 7 cm • Contents. Vas deferance testicular artery Arteries of vas Cremasteric artery. Pampiniform plexus of veins Genitofemoral nerve Sympathetic plexus Lymphatics from Testis and Epydidymis. – Remaining of processus vaginalis – – – –

It is a mixed nerve. Root value—L 1 Supplies • Medial side of upper part of thigh • Root of penis and scrotum in males • Mons pubis and labia majora in females • Before piercing internal oblique it is motor. Ilio inguinal nerve

Flap valve mechanism -Obliquity of the canal Keith’s shutter mechanism- Internal oblique Ball – valve mechanism- Cremasteric plug. Slit valve mechanism-Contraction of external oblique • Elongation of canal- contraction of muscles of abdominal wall. • Construction of canal • Hormones • •

INGUINAL HERNIA Inguinal Hernia Indirect Complete direct Incomplete -Congenital funicular -bubonocele Medial lateral

q. Littre’s Hernia q Interstitital Hernia Diverticulum of processes extends SUPERFICIAL INTRAMUSCULAR PREPARITAL

MEDIAL UMBELICAL LIGAMENT PARTS OF HERNIA

INGUINAL HERNIA Indirect inguinal hernia Direct inguinal hernia • entrance through deep inguinal ring • Usually unilateral • Affects young • Directed downwards forward medially • Congenitally –persistance of Processus vaginalis • Entrance through Hesselbach triangle. • Usually bilateral • Affects old ones • Directed straigth forward • Accquired- weakness in conjoint tendon Internal ring occlusion test

DIRECT HERNIA INDIRECT HERNIA