PAKHOVY CHANNEL

From Big Medical Encyclopedia

PAKHOVY CHANNEL [canalis inguinalis (PNA, JNA, BNA)] — a crack between muscles and fastion of a front abdominal wall in an inguinal triangle over a medial half of an inguinal sheaf. The item to. has length of 4 — 5 cm and takes place in the slanting direction — from top to down and outside inside. In it distinguish four walls (front, back, top and bottom) and two rings — deep (anulus inguinalis profundus) and superficial (anulus inguinalis superficialis). Funkts, value of walls of P. to. consists in their resistance to intra belly pressure. The muscles forming P.'s walls to., being reduced and approaching an inguinal sheaf, squeeze P. to. Features of a structure of P. to. depend on a form of an inguinal interval (see. Inguinal area ). So, at a slit-like and oval form of an inguinal interval a front wall of P. to. the aponeurosis of an outside oblique muscle of a stomach (m. obliquus ext. abdominis) and partially internal oblique muscle of a stomach (m. obliquus int. abdominis) form, the back wall is formed by a cross fascia and an inguinal arch — a muscular part of a cross muscle of a stomach (m. transversus abdominis); an upper wall throughout P. to. it is formed dugoobrazno by the located bottom edges of internal slanting and cross muscles of a stomach; the lower wall of P. to. it is formed by a trench of an inguinal sheaf. In an internal half of P. to. its front wall is formed only by an aponeurosis of an outside oblique muscle of a stomach, and the back wall is formed by a cross fascia and a crescent aponeurosis — an inguinal sickle (falx inguinalis). The inguinal sheaf at a slit-like and oval form of an inguinal interval is well developed. At triangular shape of an inguinal interval a front wall of P. to. on all its extent make an aponeurosis of an outside oblique muscle of a stomach, a back wall — a cross fascia, an upper wall — bottom edges of internal slanting and cross muscles of a stomach. At such structure of P. to. the inguinal sheaf is thinned and there is no back department of its trench. As a result of it tendency to developing of inguinal hernias can be observed.

The deep abdominal ring corresponds to a lateral inguinal pole (see. Abdominal wall ) also is located 1 — 2 cm above and on 1 piece of a knutra from the middle of an inguinal sheaf. From an abdominal cavity this ring represents the deepening covered with a cross fascia, separated from a medial inguinal pole by a mezhjyamochkovy sheaf (lig. interfoveolare) and lower epigastriß artery (. epigastrica inf.). At well developed copular and muscular and tendinous device the deep abdominal ring is strengthened by sheaves and tendinous fibers — an inguinal sickle, the mezhjyamochkovy sheaf bent by a sheaf (lig. reflexum).

The superficial abdominal ring is formed by medial and lateral legs of an aponeurosis of an outside oblique muscle of a stomach, intercrural fibers and the bent sheaf.

Fig. 2. Superficial vessels, nerves to lymph nodes of inguinal area: 1 — an aponeurosis of an outside oblique muscle of a stomach; 2 — a superficial epigastriß artery and a vein; 3 — a superficial abdominal ring; 4 — medial and 5 — lateral legs of an aponeurosis; 6 — a seed cord; 7 — an ilioinguinal nerve; 8 — an outside sexual artery and a vein; 9 — a big saphena of a leg; 10 — a lateral cutaneous nerve of a hip; 11 — superficial inguinal lymph nodes; 12 — the superficial artery and a vein which are bending around an ileal bone; 13 — an inguinal sheaf.

In P. to. at men pass seed cord (see), the directing linking of a small egg (gubernaculum testis) and a zarashchenny vulval shoot of a peritoneum; women have a round ligament of a uterus (lig. teres uteri) and also a zarashchenny vulval shoot of a peritoneum (see fig. 2). Feature of an anatomic structure of P. to. at women durability of an aponeurosis of a front wall of the channel and an obliteration of a superficial abdominal ring is.

Pathology

Through P. to. leave inguinal hernias (see). Slanting inguinal hernias enter it through a deep abdominal ring, direct inguinal hernias — through a medial inguinal pole; there are inguinal hernias through a superficial abdominal ring.

Not fusion of the vulval shoot of a peritoneum lying in the inguinal canal at men can lead to formation of inborn inguinal hernias, and women — to formation have so-called canalis Nucki, to-ry can become an origin of cysts of big vulvar lips or is more rare than inborn inguinal hernias.



Bibliography: Obysov A. S. About interposition of some anatomic formations of the inguinal channel of the person, Surgery, No. 10, page 54, 1952; Surgical anatomy of a stomach, under the editorship of A. N. Maksimenkov, page 46, JI., 1972.


A. A. Travin.

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