[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:11.66,0:00:16.44,Default,,0000,0000,0000,,>> In Dissection 6, we're going to open\Nthe abdomen, examine some of the structure
Dialogue: 0,0:00:16.44,0:00:19.07,Default,,0000,0000,0000,,of the peritoneal cavity\Nincluding the mesenteries.
Dialogue: 0,0:00:19.60,0:00:23.24,Default,,0000,0000,0000,,And also take a look at the inguinal\Nregion and the femoral region.
Dialogue: 0,0:00:24.08,0:00:28.69,Default,,0000,0000,0000,,Now the first step in this process is to reflect\Nsome of the anterior abdominal wall muscles
Dialogue: 0,0:00:28.73,0:00:31.92,Default,,0000,0000,0000,,such as rectus abdominis that\Nyou did in a previous dissection.
Dialogue: 0,0:00:31.92,0:00:37.32,Default,,0000,0000,0000,,And then to make a large X shaped incision\Nthrough the anterior abdominal wall.
Dialogue: 0,0:00:37.74,0:00:42.49,Default,,0000,0000,0000,,And now we've removed the umbilicus in this\Ncadaver, but make that cut of the X just
Dialogue: 0,0:00:42.49,0:00:48.14,Default,,0000,0000,0000,,above the umbilicus so that, later, we\Ncan watch how the umbilical vessels come
Dialogue: 0,0:00:48.39,0:00:50.02,Default,,0000,0000,0000,,to and from the umbilicus.
Dialogue: 0,0:00:50.93,0:00:58.12,Default,,0000,0000,0000,,Now if you reflect these flaps back, you can\Nsee that there are 2 layers to the perineal sac,
Dialogue: 0,0:00:58.12,0:01:02.10,Default,,0000,0000,0000,,just like there were up in the chest\Nfor the pleural and pericardial sacs.
Dialogue: 0,0:01:02.55,0:01:07.54,Default,,0000,0000,0000,,And we've left a piece of these parietal\Nperitoneum, a nice filmy layer here,
Dialogue: 0,0:01:07.54,0:01:10.32,Default,,0000,0000,0000,,the outer layer of the peritoneal sac, okay?
Dialogue: 0,0:01:10.60,0:01:13.71,Default,,0000,0000,0000,,There is a layer of connective\Ntissue called transversalis fascia
Dialogue: 0,0:01:13.71,0:01:18.14,Default,,0000,0000,0000,,that would bind this parietal\Nperitoneum to all the inner surfaces
Dialogue: 0,0:01:18.14,0:01:20.15,Default,,0000,0000,0000,,of the abdominal and pelvic cavities.
Dialogue: 0,0:01:21.07,0:01:26.59,Default,,0000,0000,0000,,Now if we pull that back, you can appreciate\Nthe visceral layer of the peritoneal sac
Dialogue: 0,0:01:26.92,0:01:29.30,Default,,0000,0000,0000,,that is coating all the internal organs.
Dialogue: 0,0:01:29.94,0:01:34.79,Default,,0000,0000,0000,,Now for all these organs to\Nreceive their adequate blood supply,
Dialogue: 0,0:01:34.79,0:01:40.18,Default,,0000,0000,0000,,there are structures called mesenteries where\Nthe peritoneum is going to form a double layer
Dialogue: 0,0:01:40.58,0:01:45.38,Default,,0000,0000,0000,,that the vessels and nerves can run through to\Napproach all of these organs and provide them
Dialogue: 0,0:01:45.38,0:01:47.79,Default,,0000,0000,0000,,with the innervation and the\Nblood supply that they need.
Dialogue: 0,0:01:48.28,0:01:52.97,Default,,0000,0000,0000,,Now to get better exposure of the abdominal\Ncavity so that you can see in here,
Dialogue: 0,0:01:53.40,0:01:56.23,Default,,0000,0000,0000,,I'm going to do something that's\Nreally not part of the dissection,
Dialogue: 0,0:01:56.23,0:01:58.54,Default,,0000,0000,0000,,but will help us expose the abdomen better.
Dialogue: 0,0:01:58.88,0:02:04.34,Default,,0000,0000,0000,,And that is to cut off some of these dangling\Nabdominal wall muscles so that we can see
Dialogue: 0,0:02:04.34,0:02:09.57,Default,,0000,0000,0000,,down inside as we're trying to instruct\Nyou how to do the dissection here.
Dialogue: 0,0:02:20.27,0:02:21.73,Default,,0000,0000,0000,,Now that the abdomen is opened well,
Dialogue: 0,0:02:21.73,0:02:24.74,Default,,0000,0000,0000,,we can see some of the derivatives\Nof the embryonic mesenteries.
Dialogue: 0,0:02:25.28,0:02:27.06,Default,,0000,0000,0000,,Remember from the embryology lectures,
Dialogue: 0,0:02:27.11,0:02:31.31,Default,,0000,0000,0000,,that the ventral mesentery only\Npersists in the region of the foregut.
Dialogue: 0,0:02:31.79,0:02:36.65,Default,,0000,0000,0000,,That portion of the digestive tract that\Ncontinues down through about the, you know,
Dialogue: 0,0:02:36.65,0:02:38.54,Default,,0000,0000,0000,,first or second portion of the duodenum.
Dialogue: 0,0:02:38.93,0:02:41.51,Default,,0000,0000,0000,,So beyond that level, at the\Nlevels of the mid and hindguts,
Dialogue: 0,0:02:41.51,0:02:43.19,Default,,0000,0000,0000,,there will be no ventral mesentery.
Dialogue: 0,0:02:43.86,0:02:45.65,Default,,0000,0000,0000,,Now here we can see the adult derivatives
Dialogue: 0,0:02:45.65,0:02:49.41,Default,,0000,0000,0000,,of the ventral mesogastrium\Nor mesentery of the foregut.
Dialogue: 0,0:02:49.93,0:02:54.15,Default,,0000,0000,0000,,I'm pulling back the ventral body wall here\Nand there's a portion of that mesentery
Dialogue: 0,0:02:54.15,0:02:56.60,Default,,0000,0000,0000,,that continues down to the liver.
Dialogue: 0,0:02:56.64,0:02:58.09,Default,,0000,0000,0000,,It's called the falciform ligament.
Dialogue: 0,0:02:58.09,0:03:02.67,Default,,0000,0000,0000,,And there seems to be some scar tissue\Nin this cadaver so that it's shrunken up
Dialogue: 0,0:03:02.67,0:03:05.80,Default,,0000,0000,0000,,and a little bit more tight\Nthan it is on most cadavers.
Dialogue: 0,0:03:06.15,0:03:09.93,Default,,0000,0000,0000,,But this falciform ligament would be\Na portion of the ventral mesentery.
Dialogue: 0,0:03:10.50,0:03:14.99,Default,,0000,0000,0000,,And the liver develops within that ventral\Nmesentery so we'll see another portion
Dialogue: 0,0:03:14.99,0:03:19.01,Default,,0000,0000,0000,,of it spanning between the\Nliver and the main gut tube,
Dialogue: 0,0:03:19.04,0:03:21.05,Default,,0000,0000,0000,,the stomach and the duodenum at this level.
Dialogue: 0,0:03:21.83,0:03:26.62,Default,,0000,0000,0000,,Okay, so this derivative of the ventral\Nmesogastrium is called the lesser omentum.
Dialogue: 0,0:03:27.15,0:03:32.34,Default,,0000,0000,0000,,And I'm sticking my finger through an opening\Ncalled the epiploic foramen so all the tissue
Dialogue: 0,0:03:32.34,0:03:34.54,Default,,0000,0000,0000,,between my finger, which you can't see,
Dialogue: 0,0:03:34.96,0:03:38.28,Default,,0000,0000,0000,,and right about in here is\Ncalled the lesser omentum.
Dialogue: 0,0:03:38.44,0:03:43.10,Default,,0000,0000,0000,,And there are 2 segments to it based\Non the organs that it's attaching to.
Dialogue: 0,0:03:44.44,0:03:46.79,Default,,0000,0000,0000,,Now this is all stomach, okay.
Dialogue: 0,0:03:46.79,0:03:50.04,Default,,0000,0000,0000,,And you can't really see\Nit visually, necessarily,
Dialogue: 0,0:03:50.11,0:03:53.49,Default,,0000,0000,0000,,but the sphincter between the stomach\Nand the duodenum is right about here.
Dialogue: 0,0:03:53.49,0:03:58.60,Default,,0000,0000,0000,,You feel a nice dense thickening of the\Nsmooth muscle there in the wall of the organ.
Dialogue: 0,0:03:59.23,0:04:03.27,Default,,0000,0000,0000,,So that this portion of the lesser\Nomentum spanning between the liver
Dialogue: 0,0:04:03.27,0:04:05.99,Default,,0000,0000,0000,,and the stomach is the hepatogastric ligament,
Dialogue: 0,0:04:06.59,0:04:11.56,Default,,0000,0000,0000,,whereas this portion a little bit more\Ntoward the right spanning between the liver
Dialogue: 0,0:04:11.56,0:04:14.19,Default,,0000,0000,0000,,and the duodenum is the hepatoduodenal ligament.
Dialogue: 0,0:04:14.19,0:04:18.08,Default,,0000,0000,0000,,And that, in particular, is important\Nbecause it's got the structures
Dialogue: 0,0:04:18.08,0:04:22.85,Default,,0000,0000,0000,,of the portal triad contained\Nwithin it, the common bile duct,
Dialogue: 0,0:04:23.10,0:04:25.50,Default,,0000,0000,0000,,the hepatic artery and the hepatic portal vein.
Dialogue: 0,0:04:26.92,0:04:30.18,Default,,0000,0000,0000,,Now the rest of the mesenteries that\Nwe're going to see are all derivatives
Dialogue: 0,0:04:30.18,0:04:33.44,Default,,0000,0000,0000,,of the dorsal mesenteries\Nthat develop originally.
Dialogue: 0,0:04:33.90,0:04:38.62,Default,,0000,0000,0000,,And there's a very prominent\Nspecialization of the dorsal mesentery
Dialogue: 0,0:04:38.62,0:04:41.64,Default,,0000,0000,0000,,of the foregut here, it's\Ncalled the greater omentum.
Dialogue: 0,0:04:42.33,0:04:47.36,Default,,0000,0000,0000,,It's attached to the greater curvature\Nof the stomach and then balloons out
Dialogue: 0,0:04:47.36,0:04:54.65,Default,,0000,0000,0000,,and forms this apron-like structure hanging down\Nover many of the other abdominal organs, okay?
Dialogue: 0,0:04:54.83,0:04:57.19,Default,,0000,0000,0000,,Among them would be the transverse colon,
Dialogue: 0,0:04:57.27,0:05:00.49,Default,,0000,0000,0000,,part of the large intestine\Nthat we see a glimpse of here.
Dialogue: 0,0:05:01.15,0:05:06.25,Default,,0000,0000,0000,,So that, again, by naming these ligaments\Naccording to the organs that they attach,
Dialogue: 0,0:05:06.61,0:05:11.27,Default,,0000,0000,0000,,we've got this ligament attaching from\Nthe stomach to the transverse colon
Dialogue: 0,0:05:11.58,0:05:17.04,Default,,0000,0000,0000,,and we would call that portion of the greater\Nomentum, the gastrocolic ligament, okay?
Dialogue: 0,0:05:17.16,0:05:21.44,Default,,0000,0000,0000,,Another portion of this dorsal\Nmesentery spans between the stomach
Dialogue: 0,0:05:21.44,0:05:24.01,Default,,0000,0000,0000,,and the spleen which we can see down here.
Dialogue: 0,0:05:24.44,0:05:26.66,Default,,0000,0000,0000,,So, again, by simply naming those organs,
Dialogue: 0,0:05:26.70,0:05:29.71,Default,,0000,0000,0000,,we would have a gastrosplenic\Nligament in this case.
Dialogue: 0,0:05:30.38,0:05:35.26,Default,,0000,0000,0000,,Now, remember, the reason that these mesenteries\Npersist is because they contain blood vessels
Dialogue: 0,0:05:35.26,0:05:38.68,Default,,0000,0000,0000,,that are supplying the organs\Nthat they're passing between.
Dialogue: 0,0:05:40.04,0:05:45.82,Default,,0000,0000,0000,,Now let's pull up the greater omentum and we can\Ncatch a glimpse of the transverse colon portion
Dialogue: 0,0:05:45.82,0:05:47.59,Default,,0000,0000,0000,,of the large intestine coming across.
Dialogue: 0,0:05:48.11,0:05:50.22,Default,,0000,0000,0000,,And it's got its own dorsal mesentery.
Dialogue: 0,0:05:50.70,0:05:56.57,Default,,0000,0000,0000,,This would be the mesocolon,\Ntransverse mesocolon extending
Dialogue: 0,0:05:56.61,0:06:00.57,Default,,0000,0000,0000,,from the posterior body wall\Nup to the transverse colon.
Dialogue: 0,0:06:01.08,0:06:04.90,Default,,0000,0000,0000,,And in the next dissection, what we're going\Nto find is, as we peel apart the layers
Dialogue: 0,0:06:04.90,0:06:10.20,Default,,0000,0000,0000,,of these different mesenteries, we're going to\Nexpose the blood vessels that supply them, okay?
Dialogue: 0,0:06:10.20,0:06:15.87,Default,,0000,0000,0000,,The last major mesentery that you can find\Nwithin the cadaver is the dorsal mesentery
Dialogue: 0,0:06:15.87,0:06:20.27,Default,,0000,0000,0000,,of the small intestine, the\Nso-called mesentery proper, okay?
Dialogue: 0,0:06:20.62,0:06:23.21,Default,,0000,0000,0000,,And, again, when we peel apart\Nthe layers of this mesentery,
Dialogue: 0,0:06:23.21,0:06:25.03,Default,,0000,0000,0000,,we'll see very elaborate blood supply
Dialogue: 0,0:06:25.03,0:06:28.26,Default,,0000,0000,0000,,and nerve supply innervating\Nall of these different organs.
Dialogue: 0,0:06:28.87,0:06:35.68,Default,,0000,0000,0000,,Cut. We're going to take you on a quick tour of\Nthe abdominal organs just so you have seen them
Dialogue: 0,0:06:35.68,0:06:37.84,Default,,0000,0000,0000,,and are oriented and find\Nthem in your own cadaver.
Dialogue: 0,0:06:37.84,0:06:41.76,Default,,0000,0000,0000,,Of course, we've got the stomach\Nhere in the upper left quadrant.
Dialogue: 0,0:06:42.15,0:06:44.25,Default,,0000,0000,0000,,And we've already taken a look at the liver.
Dialogue: 0,0:06:44.59,0:06:47.88,Default,,0000,0000,0000,,And this would be the gallbladder\Ntucked underneath its inferior edge.
Dialogue: 0,0:06:48.100,0:06:53.79,Default,,0000,0000,0000,,Now let's follow along the length of\Nthe GI tract and we've got the stomach.
Dialogue: 0,0:06:53.79,0:06:57.87,Default,,0000,0000,0000,,Again, you can't necessarily see it, but\Nyou can palpate that pyloric sphincter
Dialogue: 0,0:06:57.87,0:07:00.55,Default,,0000,0000,0000,,that separates the stomach from the duodenum.
Dialogue: 0,0:07:00.98,0:07:04.48,Default,,0000,0000,0000,,And I can follow the duodenum a certain\Ndistance, but then it disappears
Dialogue: 0,0:07:04.48,0:07:07.58,Default,,0000,0000,0000,,where it travels right along\Nthe posterior abdominal wall
Dialogue: 0,0:07:07.58,0:07:09.66,Default,,0000,0000,0000,,and will cross to the opposite side.
Dialogue: 0,0:07:10.33,0:07:17.08,Default,,0000,0000,0000,,So to find it again, we need to pull the\Ntransverse colon out of the way and now here
Dialogue: 0,0:07:17.08,0:07:20.69,Default,,0000,0000,0000,,on the left side, we've got the\Nduodenum coming back into view.
Dialogue: 0,0:07:21.31,0:07:26.48,Default,,0000,0000,0000,,And, as soon as we get a mesentery established,\Nwe make the transition from duodenum to jejunum.
Dialogue: 0,0:07:26.99,0:07:31.90,Default,,0000,0000,0000,,So looking at all these loops of small\Nbowel, about half of it is jejunum
Dialogue: 0,0:07:32.15,0:07:34.76,Default,,0000,0000,0000,,and then the second half\Nof it would be the ilium.
Dialogue: 0,0:07:35.34,0:07:38.33,Default,,0000,0000,0000,,And we're not really concerned\Nabout looking at these grossly
Dialogue: 0,0:07:38.33,0:07:41.33,Default,,0000,0000,0000,,and making the distinction\Nbetween ilium and jejunum.
Dialogue: 0,0:07:41.68,0:07:44.72,Default,,0000,0000,0000,,Just realize about half is\Njejunum, about half is ilium.
Dialogue: 0,0:07:45.63,0:07:52.51,Default,,0000,0000,0000,,Now as you follow the ilium along, you're\Ngoing to come to an abrupt increase in diameter
Dialogue: 0,0:07:52.88,0:07:54.77,Default,,0000,0000,0000,,where we reach the end of the small intestine
Dialogue: 0,0:07:54.77,0:07:57.63,Default,,0000,0000,0000,,and the beginning of the\Nlarge intestine or colon.
Dialogue: 0,0:07:58.12,0:08:03.30,Default,,0000,0000,0000,,And where this happens, there's always a\Nsegment of the large intestine that hangs down,
Dialogue: 0,0:08:03.30,0:08:06.19,Default,,0000,0000,0000,,or pooches down, a little\Nbit, that's called the cecum.
Dialogue: 0,0:08:06.78,0:08:09.13,Default,,0000,0000,0000,,And, often, this is where you're going
Dialogue: 0,0:08:09.13,0:08:12.100,Default,,0000,0000,0000,,to find the appendix dangling down,\Nright at the ileocecal junction.
Dialogue: 0,0:08:13.53,0:08:16.45,Default,,0000,0000,0000,,Now, from what we've seen, there\Nis no appendix in this cadaver,
Dialogue: 0,0:08:16.58,0:08:19.10,Default,,0000,0000,0000,,but that's where you should expect to find it
Dialogue: 0,0:08:19.10,0:08:22.08,Default,,0000,0000,0000,,if the cadaver's got one that\Nhasn't been removed, okay?
Dialogue: 0,0:08:22.41,0:08:24.28,Default,,0000,0000,0000,,So that would be the home of the appendix.
Dialogue: 0,0:08:24.86,0:08:30.03,Default,,0000,0000,0000,,And now we're going to see that the large\Nintestine travels up along the right side
Dialogue: 0,0:08:30.03,0:08:32.37,Default,,0000,0000,0000,,of the body, this would be the ascending colon.
Dialogue: 0,0:08:33.02,0:08:36.66,Default,,0000,0000,0000,,And then travels across the\Nbody as the transverse colon.
Dialogue: 0,0:08:37.26,0:08:44.21,Default,,0000,0000,0000,,And then travels inferiorly, or descends, on the\Nleft side of the body as the descending colon.
Dialogue: 0,0:08:45.36,0:08:49.64,Default,,0000,0000,0000,,Now, in this particular cadaver,\Nthe descending colon is very small.
Dialogue: 0,0:08:49.64,0:08:52.93,Default,,0000,0000,0000,,It's probably about as big as\None of my fingers in diameter.
Dialogue: 0,0:08:53.34,0:08:56.43,Default,,0000,0000,0000,,And, normally, it's at least a\Ncouple of inches in diameter.
Dialogue: 0,0:08:56.81,0:08:59.30,Default,,0000,0000,0000,,So there seems to be some\Nobstruction in this cadaver.
Dialogue: 0,0:08:59.30,0:09:01.62,Default,,0000,0000,0000,,You would normally find something larger.
Dialogue: 0,0:09:02.37,0:09:05.29,Default,,0000,0000,0000,,Now notice as I've been flipping\Norgans around here,
Dialogue: 0,0:09:05.69,0:09:09.43,Default,,0000,0000,0000,,some of the organs are really plastered\Nagainst the posterior body wall.
Dialogue: 0,0:09:09.83,0:09:14.96,Default,,0000,0000,0000,,And these are organs such as the descending\Ncolon that have lost their mesenteries
Dialogue: 0,0:09:15.17,0:09:21.51,Default,,0000,0000,0000,,and have become retroperitoneal, or have assumed\Nthis position behind the parietal peritoneum.
Dialogue: 0,0:09:21.86,0:09:25.56,Default,,0000,0000,0000,,And, as you go through your\Ndissection, try to identify those organs
Dialogue: 0,0:09:25.56,0:09:30.32,Default,,0000,0000,0000,,that have lost their mesenteries and\Nare now secondarily retroperitoneal.
Dialogue: 0,0:09:31.73,0:09:37.69,Default,,0000,0000,0000,,Following down the descending colon, the next\Nsegment that we would find is the sigmoid colon.
Dialogue: 0,0:09:38.06,0:09:43.98,Default,,0000,0000,0000,,And, again, the diameter of the sigmoid colon in\Nthis individual seems to be quite reduced, okay?
Dialogue: 0,0:09:44.40,0:09:47.51,Default,,0000,0000,0000,,We do establish a mesentery\Nagain with the sigmoid colon.
Dialogue: 0,0:09:47.88,0:09:51.92,Default,,0000,0000,0000,,And then, as that organ straightens\Nout and heads down into the pelvis,
Dialogue: 0,0:09:52.33,0:09:53.79,Default,,0000,0000,0000,,we get to the level of the rectum.
Dialogue: 0,0:09:54.31,0:10:02.71,Default,,0000,0000,0000,,For the next part of dissection 6, we're going\Nto consider descent of the testis and ovary
Dialogue: 0,0:10:02.71,0:10:06.05,Default,,0000,0000,0000,,and how they affect the layers\Nof the anterior abdominal wall.
Dialogue: 0,0:10:06.60,0:10:09.54,Default,,0000,0000,0000,,So, just as a reminder here, the\Nmost superficial layer of muscle
Dialogue: 0,0:10:09.54,0:10:12.48,Default,,0000,0000,0000,,that you see would be the\Nexternal abdominal oblique.
Dialogue: 0,0:10:12.78,0:10:16.06,Default,,0000,0000,0000,,And, if you follow it medially, you\Nsee the aponeurosis, that broad,
Dialogue: 0,0:10:16.13,0:10:20.31,Default,,0000,0000,0000,,flat tendon continuing toward the\Nmidline, helping to form the rectus sheath
Dialogue: 0,0:10:20.31,0:10:21.94,Default,,0000,0000,0000,,over the rectus abdominous muscle.
Dialogue: 0,0:10:22.87,0:10:26.29,Default,,0000,0000,0000,,Now focus at the inferior\Nedge of this aponeurosis
Dialogue: 0,0:10:26.73,0:10:29.07,Default,,0000,0000,0000,,which is attached to two bony landmarks.
Dialogue: 0,0:10:29.68,0:10:35.76,Default,,0000,0000,0000,,One, the anterior superior iliac\Nspine or ASIS and, medially,
Dialogue: 0,0:10:35.76,0:10:38.74,Default,,0000,0000,0000,,to a bump on the pubis called\Nthe pubic tubercle.
Dialogue: 0,0:10:39.27,0:10:41.19,Default,,0000,0000,0000,,And this inferior edge, again, spanning
Dialogue: 0,0:10:41.19,0:10:43.97,Default,,0000,0000,0000,,between those bony landmarks is\Ncalled the inguinal ligament.
Dialogue: 0,0:10:45.15,0:10:49.36,Default,,0000,0000,0000,,Now examine this aponeurosis carefully\Nand what you'll see is there's a thin spot
Dialogue: 0,0:10:49.84,0:10:55.02,Default,,0000,0000,0000,,down toward the medial inferior edge of\Nit and that is where there's a defect
Dialogue: 0,0:10:55.02,0:10:58.81,Default,,0000,0000,0000,,in the aponeurosis where the\Nspermatic cord passes through.
Dialogue: 0,0:10:59.45,0:11:04.96,Default,,0000,0000,0000,,Now the spermatic cord is a structure that\Ncontains vessels, ducts, lymphatics nerves all
Dialogue: 0,0:11:04.96,0:11:06.51,Default,,0000,0000,0000,,that are going to serve the testis,
Dialogue: 0,0:11:06.98,0:11:09.88,Default,,0000,0000,0000,,that were dragged down along\Nduring the process of descent.
Dialogue: 0,0:11:10.48,0:11:13.13,Default,,0000,0000,0000,,And a similar process does\Nhappen in the female as well.
Dialogue: 0,0:11:14.56,0:11:18.78,Default,,0000,0000,0000,,So this defect in the external\Nabdominal oblique aponeurosis
Dialogue: 0,0:11:19.31,0:11:24.89,Default,,0000,0000,0000,,where the spermatic cord emerges superficially\Nis called the superficial inguinal ring.
Dialogue: 0,0:11:25.16,0:11:28.47,Default,,0000,0000,0000,,And it's literally an opening in\Nthe external oblique aponeurosis.
Dialogue: 0,0:11:29.64,0:11:35.29,Default,,0000,0000,0000,,Now if we reflect this layer to examine how\Nthe descent process affects the deeper layers
Dialogue: 0,0:11:35.29,0:11:37.80,Default,,0000,0000,0000,,of the abdominal wall, the\Nnext layer, of course,
Dialogue: 0,0:11:37.80,0:11:40.69,Default,,0000,0000,0000,,it will encounter is the\Ninternal abdominal oblique muscle.
Dialogue: 0,0:11:41.49,0:11:45.74,Default,,0000,0000,0000,,And let's just pull the inguinal\Nligament down a bit more.
Dialogue: 0,0:11:46.81,0:11:51.21,Default,,0000,0000,0000,,Now we've got the spermatic cord as\Nit's traveling through the body wall
Dialogue: 0,0:11:51.49,0:11:54.76,Default,,0000,0000,0000,,in a structure called the inguinal canal, okay?
Dialogue: 0,0:11:54.100,0:12:00.35,Default,,0000,0000,0000,,As you can see, the inferior edge of\Nthe internal oblique muscle is right
Dialogue: 0,0:12:00.35,0:12:02.96,Default,,0000,0000,0000,,about at the level where\Nthe descent is occurring.
Dialogue: 0,0:12:03.28,0:12:09.01,Default,,0000,0000,0000,,So a few of the muscle fibers from the internal\Noblique are dragged along and cover the surface
Dialogue: 0,0:12:09.01,0:12:12.27,Default,,0000,0000,0000,,of the spermatic cord as it\Ncontinues down toward the testis.
Dialogue: 0,0:12:12.90,0:12:14.86,Default,,0000,0000,0000,,Okay this is called the cremaster muscle.
Dialogue: 0,0:12:18.96,0:12:23.40,Default,,0000,0000,0000,,Now we've reflected the external\Nabdominal oblique aponeurosis and, again,
Dialogue: 0,0:12:23.40,0:12:24.90,Default,,0000,0000,0000,,are looking at the internal oblique.
Dialogue: 0,0:12:25.21,0:12:26.60,Default,,0000,0000,0000,,Now what we can't see from this angle-- .