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Gastrointestinal Tract > 6) Hernias > Flashcards

6) Hernias Flashcards

1
Q

What is a hernia?

A

Protrusion of part of the abdominal contents beyond the normal confines of the abdominal wall

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2
Q

What 3 parts does a hernia consist of?

A

Sac
Contents
Covering

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3
Q

What is the sac?

A

Pouch of peritoneum

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4
Q

Generally, what are the contents for a hernia?

A

Any structures found within the abdominal cavity

Commonly, loops of bowel or ommentum

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5
Q

What is the covering of a hernia?

A

Layers of abdominal wall through which the hernia has passed

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6
Q

What weaknesses in the abdominal wall may a hernia pass through?

A

Inguinal canal
Femoral canal
Umbilicus
Previous incisions

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7
Q

What is the inguinal canal?

A

Oblique passage through lower part of abdominal wall, extends from inside peritoneal cavity to scrotum in males

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8
Q

What passes through inguinal canal in males?

A

Ilioinguinal nerve and spermatic cord

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9
Q

What passes through inguinal canal in females?

A

Ilioinguinal nerve and round ligament (from uterus to labum majus)

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10
Q

Why is an inguinal hernia more likely in men?

A

Larger and more prominent

Failure of processus vaginalis to obliterate

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11
Q

Where are the testes located before descent?

A

Posterior abdominal wall, retroperitoneal

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12
Q

What is the gubernaculum?

A

Condensed band of mesenchyme that connects testes to scrotal pouch

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13
Q

How do the testes descend?

A

Gubernaculum shortens

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14
Q

What is the processus vaginalis?

A

Outpouching of peritoneum which is anterior to testes

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15
Q

What usually happens to the processus vaginalis?

A

Obliterates to form tunica vaginalis - small amount of peritoneum covering an aspect of testicle

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16
Q

What leads to increased risk of inguinal hernia?

A

Partial recession of processus vaginalis

17
Q

Why does partial recession of processus vaginalis increase risk of hernia?

A

Leaves a peritoneal lined pathway from peritoneal cavity to scrotum

18
Q

What forms the floor of the inguinal canal?

A

Inguinal ligament (a rolled edge of external oblique aponeurosis) and thickened medially by the lacunar ligament

19
Q

What forms the roof of the inguinal canal?

A

Internal oblique and transversus abdominis

20
Q

What forms the posterior wall of the inguinal canal?

A

Transversalis fascia, conjoint tendon medially (aponeurosis of IO + TA)

21
Q

What forms the anterior wall of the inguinal canal?

A

Aponeurosis of external oblique

22
Q

What and where is the entrance to the inguinal canal?

A

Deep ring, posterior wall

23
Q

What and where is the exit of the inguinal canal?

A

Superficial ring, anterior wall

24
Q

What is an indirect hernia?

A

Hernia that is lateral to inferior epigastric vessels

25
Q

What is at the mid-inguinal point?

A

Femoral artery, between ASIS and pubic symphysis

26
Q

What is at the mid point of the inguinal ligament?

A

Deep inguinal ring, between ASIS and pubic tubercle

27
Q

Describe the entry point and passage of an indirect hernia:

A

Enters through deep inguinal ring, traverses canal and exits through superficial ring
Can descend into scrotum depending on processus vaginalis obliteration

28
Q

Describe the entry passage of a direct hernia:

A

Through Hesselbach’s triangle

29
Q

What are the borders of Hesselbach’s triangle?

A

Medial - rectus abdominis
Lateral - inferior epigastric vessels
Floor - Inguinal ligament

30
Q

What is an incarcerated hernia?

A

Stuck or irreducible hernia

31
Q

What is a strangulated hernia?

A

Disruption of hernia blood supply, can result in tissue necrosis

32
Q

What is a femoral hernia?

A

Protrusion of abdominal viscera into femoral canal through femoral ring

33
Q

Why are femoral hernias more common in females?

A

Wider pelvis and broader femoral ring

34
Q

Why is strangulation likely in femoral hernias?

A

Femoral ring has rigid boundaries

35
Q

What is an epigastric hernia?

A

Protrusion through linea alba between xiphoid process and umbilicus
Chronic straining forces more fat and peritoneum out

36
Q

What 3 types of umbilical hernia are there?

A

Congenital
Acquire infantile
Acquire adult

37
Q

What is a congenital umbilical hernia?

A

Through umbilical ring, contents herniate into umbilical cord and have peritoneal covering

38
Q

What is an acquire infantile umbilical hernia?

A

Herniation through weakness in scar of umbilicus

39
Q

What is an acquire adult umbilical hernia?

A

Increased intra-abdominal pressure cause herniation through linea alba in region of umbilicus
Causes: chronic cough, obesity

Gastrointestinal Tract (11 decks)

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