Abdo Flashcards
Anatomy of the inguinal canal
Anterior: external oblique and internal oblique for the lateral third
Posterior: transversalis fascia and conjoint tendon for medial third
Floor: inguinal ligament
Roof: arching fibre of transversus and internal oblique
Contents of the spermatic cord
Three layers of fascia: 1. External spermatic fascia 2. Cremestatic fascia 3. Internal spermatic Three ateries and three viens 1. Testicular 2. Cresmenteric 3. Vas Two nerves 1. Sympathetic 2. Gential branch of gen fem nerve Lymphatic Vas Process vaginalis
Contents of inguinal canal
M: spermatic cord and illoinguinal nerve
F: round ligament, illoinguinal nerve , gen branch of gen fem nerve
Hesselbach’s triangle
Medial: rectus abdominis
Lateral: inferior epigastric artery
Inferior: inguinal ligament
Classification of inguinal hernia
Indirect - 80% - patent processus vaginalis - arise lateral to inferior epigastric artery Direct -20% - emerge through hesselbach's triangle - due to acquired weak wall of canal
Laparoscopic techniques for inguinal hernia
TEP: totally extra peritoneal
TAPP: transabdominal pre- peritoneal
Complications of inguinal hernia repair
Early - urinary retention - haematoma/ seroma formation - 10% - infection - 1% - intrabdominal Injury - lap Late - reoccurrence
Borders of the femoral canal
Medial: lacunar ligament
Lateral: femoral vien
Anterior: inguinal ligament
Posterior: pectineal ligament of cooper
Operative management of a femoral hernia
Elective: Lockwood low approach
Emergency: McEvedy high approach
Definition of an inguinal hernia
Extrusion of peritoneum and abdominal contents through a previously acquired defect
Risk factors for incscional hernias
Pre-op: increased age, co-mobrdities ( malignancy and obesity )
Intra - op: surgical technique ( width of suture bites, suture material, midline, placing drain through wounds )
Post op: incensed IAP, infection, heamatoma
Cause of a paraumbilcal hernia
Acquired defect in linea Alba just above or below the umbilicus
Definition of a hernia
Protrusion of a viscus or part of a viscus into an abnormal position through a defect in its containing cavity
Risk factor for umbilical hernias
Afro-carribean
Trisomy 21
Congenital hypothyroidism
Definition of a hydroele
Accumulation of fluid within the tunica vaginalis
Tunica vaginalis is a rememant of the processus vaginalis