Hernia

Question 1

What is an indirect inguinal hernia?

Answer 1

Enters through internal ring, traverses inguinal canal and may descend into scrotal sac

Question 2

What is a direct hernia?

Answer 2

Pushes through posterior wall of inguinal canal medial to internal ring

Question 3

What is the characteristic of an indirect hernia with respect to reduction?

Answer 3

Can be reduced and held in place with a single finger over the internal ring (1-2cm above femoral pulse)

Question 4

What does the narrow nature of the internal ring mean for indirect hernias?

Answer 4

• Hernia doesn’t reach full size until patient up and around for a little time and does not reduce immediately on lying down - takes time for hernial contents to pass in or out of sac
• Tendency to strangulate

Question 5

What are the characteristics of a direct inguinal hernia?

Answer 5

• Appears immediately on standing, and disappears on lying down
• Large orifice means strangulation rare.

Question 6

How can you differentiate between an Inguinal hernia extending through the external ring, and a femoral hernia?

Answer 6

Inguinal hernia will be felt medial and superior to the pubic tubercule.

Femoral hernias protrude lateral and inferior to pubic tubercule.