Page 14 - herina surgery and possible lawsuits

7) Extra peritoneal space is tilled with loose connective tissue. It contains blood
vessels (inferior epigastric, deep circumflex iliac artery, external spermatic artery),

nerves (iliohypogastric, ilioingunal nerves and genital branch of genitofemoral
nerve) and lymphatics.

8) Parietal Peritoneum

Inguinal canal- it is an oblique passage through the lower part of the anterior abdominal wall

and is present in both sexes. It is about 1.5 inches (4 cm) in length and extends from
the deep inguinal ring in the transversalis fascia to the superficial ring in external
oblique aponeurosis. It is almost parallel and just above the inguinal ligament. The

deep inguinal ring is an opening in the fascia transversalis and it lies about 0.5 inch
(1.3 cm) above the mid inguinal point. Medial to it are the inferior epigastric

vessels. It’s margins give rise to the internal spermatic fascia.
Figure 3: Inguinal canal and spermatic cord anatomy
,er Inguinal Canal and Spermatic Cord

D u ctu s (vas) d eferens c overed by p eritoneum
E xtern*! iliac v e sse ls c o ve re d by p eritoneum T esticular ve ssels c o ve re d by peritoneum
T esticular ve sse ls and genital branch o f
D u ctu s (va s) d eferens
External a bdom inal
Inferior e pigastric v e ssels oblique m uscle
C rem asteric v e ssels
M e dial um bdical ligam ent oblique m uscle
(obliterated u m bilical artery)
U m bilical p revesical fascia
abdom inis m uscle
Urinary bladder
superior iliac
M edian u m bilical
ligam ent (urachus)
R e ctu s a b dom inis m uscle
P yram idalis m uscle
C rem aster m uscle and fascia
(subserous) fascia
o n s perm atic c ord
(areolar tissue)
Superficial
inguinal rings
P ubic sym physis
fascia o n
(oovered by
sperm atic c ord
interm ingling fibers o f
external oblique
aponeurosis)
External s perm atic fascia
enveloping sperm atic cord
P ubic tubercle
Inguinal (P o u p a rt's) ligam ent 4 © N o v a r tis
(Curtsey: Netter Anatomy Images)

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