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Question 1

Give three sites of potential weakness in the abdominal wall?

Answer 1

• Inguinal canal, femoral ring and umbilicus

Question 2

What is the inguinal canal?

Answer 2

• The canal through which structures leave and enter the abdomiopelvic cavity

Question 3

In which direction does the inguinal canal travel?

Answer 3

• Downward and medial direction

Question 4

Where does the inguinal canal begin and end

Answer 4

• Starts at the deep inguinal ring • Continues 4cmEnds at superficial inguinal ring

Question 5

Where does the inguinal canal lie?

Answer 5

• In between the muscles of the anterior abdominal wall and runs parallel and superior to the medial half of the inguinal ligament

Question 6

What runs through the inguinal canal in men?

Answer 6

• The spermatic cord • The ilioinguinal nerve

Question 7

What runs through the inguinal canal in women?

Answer 7

• The round ligament of the uterus • The iliolinguinal nerve

Question 8

What is a hernia?

Answer 8

• A protrusion of part of the abdominal viscus through a defect in the abdominal wall

Question 9

What is a hernial sac usually covered in?

Answer 9

• Skin • Subcutaneous tissue • Layers of the abdominal wall

Question 10

Give three common locations of hernias

Answer 10

• Inguinal • Umbilical • Epigastric

Question 11

What is a direct inguinal hernia?

Answer 11

• Gut protrudes into the inguinal canal through a weakened area in the transversalis fascia near the medial inguinal fossa within an anatomical region know as Hesselbach’s triangle

Question 12

What are the borders of Hesselbachs triangle?

Answer 12

• Inferiorly - Medial half of the inguinal ligament • Medially - Lower lateral border of rectus abdominis • Laterally - Inferior epigastric artery

Question 13

What is an indirect inguinal hernia?

Answer 13

• Protrudes throught he deep inguinal ring

Question 14

Why do indirect inguinal hernias often occur?

Answer 14

• Result of the failure of embryonic closure of the deep inguinal ring after the testicle has passed through

Question 15

What is an epigastric hernia?

Answer 15

• Hernia which occurs in the epigstric region in the midline between the xiphoid process and the umbilicus, through the linea alba

Question 16

What are the two primary risk factors?

Answer 16

• Primary risk factors are obesity and pregnancy

Question 17

What is an umbilical hernia?

Answer 17

• Occur through the umbilical ring

Question 18

Why do umbilical hernias occur?

Answer 18

• As a result of a increased intra-abdominal pressure in the presence of weakness and incomplete closure of the anterior abdominal wall after ligation of the umbilical cord at birth

Question 19

What causes an acquired umbilical hernia?

Answer 19

• Pregnant womenObese people

Question 20

Where do femoral hernias occur?

Answer 20

Occur through femoral ring into femoral canal

Question 21

What are femoral hernias bounded by laterally and medially?

Answer 21

• Femoral vein laterallyLacunar ligament mediall

Question 22

What can femoral hernia do?

Answer 22

• Compresses the contents of the femoral canal and distends the wall

Question 23

How are femorl hernias enlarged?

Answer 23

• By passing through saphenous opening into subcutaneous tissue of the thigh

Question 24

Why are femoral hernias more common in female?

Answer 24

• Wider pelvis

Question 25

Why does strangulation of femoral hernias occur?

Answer 25

• Sharp, rigid boundaries of femoral ring

Question 26

What are two main complications of hernia?

Answer 26

• Strangulation • Incarceration

Question 27

What is strangulation?

Answer 27

• The constriction of blood vessels, preventing flow of blood to tissue

Question 28

What is incarceration?

Answer 28

Hernia cannot be reduced, or pushed back into place.

Question 29

What is the commonest hernia in females?

Answer 29

• Indirect Hernia

Question 30

What is a divarication hernia?

Answer 30

• Weakness of lina alba

Question 31

What is a richter’s hernia?

Answer 31

• Part of bowel strangulates through herniaNo bowel obstruction

Question 32

What is a spigelian hernia?

Answer 32

• Area of weakness in linea semilunaris

Question 33

Why operate on hernias?

Answer 33

• Strangulation can cause ischaemia

Question 34

What is an incisional hernia?

Answer 34

• Post-surgical weakness in muscle wall