Hernia Flashcards
hernia is defined as what?
the protrusion of any body part through a cavity
What are the most common type of hernias, accounting for approximately 75- 80% of all hernias.
Inguinal Hernias
What is the Hasselbach’s Triangle
Inguinal Triangle
(b) Inferior epigastric vessels (superior border)
(c) Lateral aspect of the Rectus Abdominis (medial border)
(d) Inguinal Ligament (inferior border)
True/False
Inguinal hernias are more common in females than males
FALSE
Two main types of Inguinal hernias
Direct hernia
Indirect hernia
What type of inguinal hernia?
Abdominal contents herniate DIRECTLY through Hasselbach’s
triangle
Direct hernia…..
What type of inguinal hernia?
Abdominal contents herniate through the inguinal canal
Indirect hernia
What type of hernia?
(a) Most common (R>L)
(b) Abdominal content herniate through the inguinal canal
1) The spermatic cord and round ligament traverse this canal in males and females respectively.
(c) Caused by a patent processus vaginalis, leaving an open communication between the intraperitoneal and the inguinal canal/scrotum.
1) In males: The testes develop in the peritoneal cavity and then pass through the inguinal canal into the scrotum.
(d) Increases in intra-abdominal pressure force abdominal contents through the widened internal ring into the inguinal canal, resulting in a clinically detectable hernia.
(e) Frequently incarcerate and strangulate, particularly in the first year of life and in females.
(f) These hernias do not herniate directly through a weakness in the abdominal musculature.
Indirect Inguinal Hernia
What type of hernia?
(a) Herniation of abdominal contents through the abdominal wall musculature (Hasselbach’s Triangle). Due to muscular weakness in this location
(b) They are acquired defects that do not involve passage through the inguinal canal.
(c) They occur predominantly in adults and rarely incarcerate and strangulate.
(d) Recurrence after repair is more frequent than for an indirect inguinal hernia.
Direct Inguinal Hernia
What type of hernia?
(a) Typically a congenital hernias (born with it)
1) “out-y belly button”
2) Increased prevalence in African American children.
3) In children majority resolve by 5 years old
4) Rarely incarcerate
(b) May also be acquired (i.e. Pregnancy, laparoscopic surgical incisions).
1) Present in adulthood
2) More likely to incarcerate than congenital
Umbilical Hernia
(a) Patients may have a bulging mass at the site of herniation:
(b) _____: Lower anterior abdominal mass
(c) _____: Scrotal mass
(d) _____: “out-y” belly button
Direct
Indirect
Umbilical
All hernias have the ability to present with signs and symptoms of what?
Small Bowel
Obstruction
Unrelieved strangulation may result in what?
(a) Perforation
(b) Abscess formation
(c) Peritonitis
(d) Septic shock
This issue may have bruising or overlying redness at the location of herniation
-will present with tachycardia +/- fever with extreme pain with palpation of the defect.
Incarcerated hernias
In males, palpation of the inguinal canal is easily performed by _____________________________________________________.
(a) The patient is then asked to _____ or ____.
1) “Turnyour head and cough”
(b) If an indirect inguinal hernia is present the examiner should feel a _________ at the tip of the finger
(c) In a direct inguinal hernia, the hernia will bulge ______, pushing against the side of the finger on examination. You will also be able to see a anterior inferior abdominal bulge with increase in intra-abdominal pressure.
inversion of the scrotal skin and passage of a finger through the external ring.
a) cough or bear downcough or bear down
b) tapping sensation
c) anteriorly
