2. Abdominal Wall Hernias Flashcards
What is the definition of a hernia?
A protrusion of part of the abdominal contents beyond the normal confines of the abdominal wall
What are the 3 components of a hernia?
Contents of the sac
The sac
Coverings of the sac
What are the signs and symptoms of a hernia?
Fullness/swelling
Increase in size with increased intra-abdominal pressure
Discomfort
Nausea/vomiting if bowel obstruction
What are the common abdominal wall hernias?
Inguinal
Femoral
Umbilical
Incisional
Describe the process of the testis descending
Processus vaginalis proceeds descent of testis
Testis are initially retroperitoneal
Gubernaculum guides descent of testis
Processus vaginalis finally obliterates
What issues arise if the processus vaginalis doesn’t obliterate?
Increased risk of inguinal hernia
What is the inguinal ligament formed from?
Thickened interior aspect of external oblique muscle
What forms the inguinal canal?
Anterior wall - aponeurosis of external oblique muscle
Base - curved edge of inguinal ligament
Roof - internal oblique muscle, transverse abdominus
Posterior wall - transversals fascia
Where is the entrance/deep ring of the inguinal canal?
Mid point of inguinal ligament
Where is the exit/superficial ring of the inguinal canal?
Just above the pubic tubercle
What is an indirect inguinal hernia?
Enters inguinal canal via deep ring
Herniated to varying degree related to obliteration of processus vaginalis
Lies lateral to inferior epigastric vessels
What is a direct inguinal hernia?
Protrudes through weakness in Hesselbach’s triangle
Lie medial to inferior epigastric vessels
What are Hesselbach’s triangle borders?
Medial - lateral abdominal rectus
Supero-lateral - inferior epigastric vessels
Inferior - inguinal ligament
Who are femoral hernias more likely in?
Females
Where does the femoral hernia move through?
Into femoral ring down the femoral canal, into saphenous opening
