 Good day everybody. Dr. Sanjay Sanyal, Professor Department Chair. I'm going to demonstrate the inguinal region and a few of the structures in the rectus abdominis and a unique situation which is visible in this cadaver. This is a supine cadaver. I'm standing on the left side of the cadaver. The camera person is also on the left side. First, let us demonstrate the inguinal ligament in the inguinal region. We can see this muscle here. This is the external oblique muscle on the left side. The external oblique muscle of the abdomen as it goes medially it becomes aponeurotic and we can see the aponeurosis here and here. We have split the aponeurosis. We can see that the lower limit of the aponeurosis is this structure here which is visible. This is the inguinal ligament. This inguinal ligament is a very important structure. It demarcates the abdomen from the thigh. It demarcates the so-called inguinal region. It extends from the anterior superior iliac spine and goes all the way to the pubic tubercle. This inguinal ligament and attached to this inguinal ligament is the facial atta of the thigh. When I have turned the external oblique aponeurosis, we can see the same inguinal ligament has got an upturned surface. Where my finger is located right now, this is called the poopart ligament. This poopart ligament forms the floor of the inguinal canal. Now I am going to put my finger inside this and we can see that my finger is coming out here. This is the opening in the lower part of the external oblique aponeurosis and this opening is referred to as the external ring of the inguinal canal. The external ring of the inguinal canal is got two crura, a medial crust as we can see here. This is the medial crust and this is the lateral crust. The medial crust is attached to the pubic symphysis. The lateral crust is attached to the pubic tubercle and the space between it is bridged over by some inter-cruel fibers. And through that external ring, we can see this structure passing. This is the spermatic cord on the left side. And when we trace the spermatic cord, we can see that the spermatic cord has come into the inguinal canal here. And I have lifted it up here. When I pull here, we can see this is the spermatic cord on the left side. And if we further trace it, we notice that the spermatic cord is disappearing. This is the actual inguinal canal. Therefore, the anterior boundary of the inguinal canal is formed by the external oblique aponeurosis. And laterally, it is formed by the internal oblique partly. Coming to the superior boundary, the superior boundary is formed by these fibers that we can see here. These are called the conjoined tendon. Conjoined tendon are the fused fibers of the lower fibers of the internal oblique and the transverse abdominis. They form the roof and they continue posteriorly and they form part of the posterior wall of the inguinal canal. And we can see again, the spermatic cord is disappearing inside. The posterior wall of the inguinal canal is formed by the fascia transversalis. And just to bring you up to speed, this structure that we can see here, this thin structure that we can see on this side, this is the fascia transversalis. This fascia transversalis forms the posterior wall. And it also reinforced a little bit by a reflected portion of the inguinal ligament called the reflex inguinal ligament. So these are the boundaries of the inguinal canal and through which passes the spermatic cord. Other structure that we can see passing is this nerve here. And when I pull here, we can see it is moving here. This is the ero-inguinal nerve. This is L1 which supplies the lower fibers of the internal oblique and the transverse abdominis. It passes through the inguinal canal and then it comes to the thigh and it supplies the anterior surface of the scrotum where it is called the anterior scrotum nerve. All the labia females where it's called the labial nerve and it also supplies medial thigh and it mediates cremaster reflex in males. So this is what we see about the inguinal ligament and the inguinal canal. This is the rectus abdominis muscle that we have lifted up on the left side. And we can see they had done a surgery and we can see remnants of the suture material here. This whole area was completely obliterated by fatty tissue. Therefore, the lower part of the rectus abdominis is not clearly visible but the upper part is clearly visible. And when we lift it up, we can see the anterior layer of the rectus sheath and we can see the posterior layer of rectus sheath and we can see these blood vessels. These are the inferior epigastric artery and the inferior epigastric vein which run on the posterior wall of the inguinal canal and they run just medial to the internal inguinal ring and they come into the rectus sheath. Therefore, an inguinal hernia which comes later to the inferior epigastric vessels is called an indirect inguinal hernia and that one which comes medial to that is called a direct hernia. The next thing I would like to draw your attention to is in this particular cadaver, he had undergone a very unique surgery and that's why this whole lower portion is completely densely adherent and it took us a long time to dissect it out. We can see this bulbous structure here which they have implanted in the lower part of the rectus abdominis muscle. This is a reservoir. This contains a fluid and we can see this pipe coming out from the reservoir and it goes inside and we can see it is disappearing inside the stratum. Inside the stratum, there is a bulb and there is a pump. From the pump and the bulb, we have this pipe coming out which drains the fluid and we can see the continuation of that pipe here and this pipe then goes into an inflatable device which is located inside the corpora cavernos of the penis. When the patient squeezes the pump, fluid from the reservoir flows in and it goes to this pipe and it goes and fills up this inflatable implant and it causes erection of the penis. After the erection is over, there is a small valve above the pump. The patient turns the valve which is also located in the stratum. The fluid drains back and it goes back to the reservoir. So this is an inflatable three-piece penile implant for erectile dysfunction. Thank you very much for watching Dr. Sanjay Sanyal signing out. Mr. Ken Olkamberbatch is the camera person. If you have any questions or comments, please put them in the comment section below. Have a nice day.