anatomy 4-Femoral region- Inguinal canal- Hernias Flashcards
What structure forms the superior border of the femoral triangle?
The inguinal ligament
What structure forms the lateral border of the femoral triangle?
The sartorius muscle
What three main structures are contained within the femoral sheath?
Femoral artery, femoral vein, and femoral canal
What femoral triangle structure lies outside of the femoral sheath?
The femoral nerve
Name, from lateral to medial, the organization of vasculature, lymphatics, and nerves in the femoral region.
Nerve, Artery, Vein, Empty space, and Lymphatics (go from lateral to medial to find your NAVEL)
A man is stabbed. The femoral triangle is punctured, but the femoral sheath is intact. What part of the femoral triangle may be damaged?
Femoral nerve
Which of the following is most medial: femoral artery, femoral vein, or femoral nerve?
Femoral vein (venous near the penis, in the sense that they are both medial)
A patient has an indirect hernia. Through which structure does this hernia protrude?
The internal inguinal ring
Name the layers that compose the spermatic cord, from the most superficial to the deepest layer
External spermatic fascia, cremasteric muscle and fascia, internal spermatic fascia
From the most superficial layer to the deepest, what are the three muscles that cover the internal (deep) inguinal ring?
External oblique, internal oblique, and transversus abdominis
A male patient has a direct inguinal hernia. Between which two structures do you typically find a direct inguinal hernia?
The inferior epigastric vessels and the rectus abdominis
A male patient has a direct inguinal hernia. Through what structure does the hernia protrude?
Abdominal wall
What muscle layer does the internal spermatic fascia derive from?
Transversalis fascia
A patient has a damaged cremasteric muscle in the spermatic cord. What muscle layer does the cremasteric muscle originate from?
Internal oblique
What is a hernia?
A protrusion of peritoneum through an opening, usually a site of weakness
A baby boy is brought to your clinic with a type of hernia. How did this hernia likely develop?
Failure of the process vaginalis to close (male Infant = Indirect hernia)
How do sliding hernias and paraesophageal hernias each affect the gastroesophageal junction?
Sliding hernias cause a displaced gastroesophageal junction, paraesophageal hernias have normal gastroesophageal junction
Which type of hiatal hernia is associated with gastroesophageal reflux disease refractory to medical treatment?
Sliding hernias (“hourglass stomach”) result in a displaced gastroesophageal junction, increasing risk for gastroesophageal reflux disease
What structures are displaced in a paraesophageal hernia?
The fundus of the stomach is displaced into the thorax, whereas the gastroesophageal junction is unaffected
In a boy, an indirect hernia travels through the internal inguinal ring, then the external inguinal ring, and finally into the ____.
Scrotum
Through which structure do both direct and indirect hernias pass?
The external (superficial) inguinal ring
What structure is a useful landmark for differentiating direct inguinal hernias from indirect inguinal hernias?
The inferior epigastric artery (Medial to inferior epigastric = Direct, Lateral toInferior epigastric = Indirect—MDs don’t LIe)
An indirect inguinal hernia enters the internal inguinal ring ____ (medial/lateral) to the inferior epigastric artery.
Lateral
You examine a boy with an indirect inguinal hernia. Given the affected developmental structure, what complication is possible?
Hydrocele (indirect inguinal hernia is caused by incomplete closure of the processus vaginalis)
A direct inguinal hernia bulges directly through the abdominal wall ____ (medial/lateral) to the inferior epigastric artery
Medial
If an elderly man presents to your clinic with an inguinal hernia, what type of hernia is most likely observed?
Direct inguinal hernia
Relative to the pubic tubercle, where is a femoral hernia typically located?
Inferior and lateral to the pubic tubercle (through the femoral canal)
A patient is found to have an incarcerated bowel due to a hernia. What is the patient’s most likely gender?
Female, as this is a femoral hernia (most likely cause of bowel incarceration, and femoral hernia is more common in females)
How many layers of the spermatic fascia cover the sac of an indirect hernia? A direct hernia?
Indirect hernia = all three layers; direct hernia = only the external spermatic fascia
An elderly man presents with a hernia through the inguinal triangle. How many layers of spermatic fascia cover this hernia?
Only the external spermatic fascia covers a direct inguinal hernia, which courses through the inguinal (Hesselbach) triangle
