Anatomy of Herniation

Question 1

factors required for the development of a hernia

Answer 1

structural weakness

increased pressure

Question 2

where is structural weakness in the development of a hernia

Answer 2

commonly in body wall

Question 3

where is increased pressure in the development of a hernia

Answer 3

on that part of the wall where structural weakness is located

Question 4

types of structural weakness in development of a hernia

Answer 4

normal anatomical weakness

abnormal weakness

Question 5

describe normal anatomical weaknesses in development of a hernia

Answer 5

diaphragm 
umbilicus 
spigelian herna
inguinal canal
femoral canal

Question 6

describe abnormal weaknesses in development of a hernia

Answer 6

congenital diaphragmatic hernia

surgical scars - incisional hernia

Question 7

what is herniation

Answer 7

any structure passing through another, ending up in the wrong place

Question 8

describe increased pressure in development of a hernia

Answer 8

repeated bouts of increased intra-abdominal pressure

Question 9

describe causes of increased pressure in development of a hernia

Answer 9

chronic cough
pregnancy
strenuous activity
staring during bowel movements or urination

Question 10

describe external oblique muscle

Answer 10

superficial

anterior inferior fibre direction

Question 11

describe internal oblique muscle

Answer 11

middle layer

anterior superior fibre direction

Question 12

describe transversas abdominis muscle

Answer 12

deep

horizontal fibre direction

Question 13

what is the inguinal ligament

Answer 13

an inferior thickening of an external oblique muscle

Question 14

what does the inguinal ligament mark

Answer 14

an anterior boundary between the abdomen and the thigh

Question 15

describe the medial half of the inguinal ligament

Answer 15

it is curved to become the floor of the inguinal canal

Question 16

communication of the inguinal canal

Answer 16

abdominal communication with perineum

Question 17

where does inguinal ligament extend from

Answer 17

anterior superior iliac spine to pubic tubercle

Question 18

entrance of the inguinal canal

Answer 18

via deep inguinal ring

Question 19

exit of inguinal canal

Answer 19

superficial inguinal ring

Question 20

describe the inguinal canal

Answer 20

an oblique passage between the abdomen and perineum - directed inferomedially

Question 21

where does the inguinal canal lie

Answer 21

along the superior border of inguinal ligament

Question 22

contents of inguinal canal

Answer 22

spermatic cord
round ligament of uterus
blood and lymphatic vessels
ilioinguinal nerve

Question 23

where does the testes develop in foetus

Answer 23

on posterior abdominal wall then descend during fatal development and puberty pulling layers of the abdominal wall along with it which contributes to layers of spermatic cord

Question 24

layers of the anterior abdominal wall contributing to layers of the spermatic cod

Answer 24

skin 
subcutaneous tissue 
external oblique muscle and fascia
internal oblique muscle and fasciae of both superficial and deep surfaces
peritoneum 
dartos muscle/fascia 
external spermatic fascia 
cremaster muscle
cremasteric fascia 
internal spermatic fascia 
vestige f processus vaginalis

Question 25

boundaries of the inguinal canal - posterior wall

Answer 25

transversalis fascia - laterally

conjoint tendon - medially

Question 26

boundaries of inguinal canal - anterior wall

Answer 26

external oblique aponeurosis - total

internal oblique muscle - laterally

Question 27

boundaries of inguinal canal - roof

Answer 27

Transversalis fascia - laterally
Arches of internal oblique and transversus abdominis aponeurosis - centrally
External oblique aponeurosis - medially

Question 28

boundaries of inguinal canal - floor

Answer 28

gutter of infolded inguinal ligament

Question 29

what is hesselbach’s triangle (inguinal triangle)

Answer 29

site of direct inguinal herniation

Question 30

borders of hesselbach’s triangle

Answer 30

inferior epigastric artery
lateral border of recess abdominis
inguinal ligament

Question 31

describe pathway of a direct inguinal hernia (herniating bowel)

Answer 31

directly through abdominal wall structures
medial to inferior epigastric artery
passes through hesselbach’s triangle to superficial ring
parallel to spermatic cord

Question 32

describe pathway of an indirect hernia (herniating bowel)

Answer 32

uses inguinal canal and deep inguinal ring
lateral to inferior epigastric artery
passes through superficial ring
within spermatic cord or layers of abdominal wall

Question 33

where is the sublingual space

Answer 33

posterior and inferior to inguinal ligament

Question 34

contents of sublingual space

Answer 34

hip flexors
femoral artery and vein
lymphatics
nerves

Question 35

what lies medial to the vessels of the sublingual space

Answer 35

the femoral canal (containing lymphatics)

Question 36

what is the myopectineal orifice

Answer 36

area of innate weakness

Question 37

where is deep inguinal ring located - surface anatomy

Answer 37

superior to half way point along the inguinal ligament

Question 38

where is superficial inguinal ring located - surface anatomy

Answer 38

superior and lateral to pubic triangle