Hernia Flashcards
What is an abdominal hernia
Protrusion of part of the abdominal contens beyond its normal confines of the abdominal wall
What does a hernia consist of
A sac
Contents of the sac
Coverings of the sac
Name the areas of weakness in the abdominal wall
Inguinal canal
Femoral canal
Umbilicus
Previous incision in the abdominal wall
What forms the walls of the inguinal canal
Anterior wall - aponeurosis of external obilque
Floor - inguinal ligament. Lacunar ligament helps to form medial part of floor
Roof - internal oblique and transverse abdominus
Posterior wall - transversalis fascia. Conjoint tendon reinforces medial aspect of posterior wall
What rings are found in the inguinal canal
Superficial ring - found on anterior wall
Deep ring - found on posterior wall
Name the types of hernias
Inguinal hernia - direct and indirect
Umbilical hernia
Para-umbilical hernia
Femoral hernia
Incision hernia
Describe indirect inguinal hernias
Mainly on the right side and more common in men
Indirect inguinal hernias are found lateral to inferior epigastric vessels
The hernias leave their containing cavity through deep inguinal ring -> travel through canal -> leave via superifical inguinal ring
Depending on where processus vaginalis was oblitered, it can potentially descend into the scrotum
Describe direct inguinal hernias
Found medial to inferior epigastric vessels
Direct inguinal hernias leave their containing cavity by going through Hasselbachs triangle
Why is the clinical presentation for direct and indirect hernias similar
Because they exit in generally the same place
They both exit near the superficial inguinal ring
Describe umbilical hernias
Herniation at the site of the umbilicus
Usually not painful
Usually closes by 3yrs
Describe para-umbilical hernias
Herniation through the linea alba region of the umbilicus
More common in females
Caused by increases in intra-abdominal pressure
Describe femoral hernias
Femoral hernias are more common in females due to their pelvic anatomy - pelvic angle is wider
Hernia is easily incarcerated
Hernia enters femoral canal through the femoral ring and then can leave via saphenous opening
Describe omphalocele
Failure of the midgut to return to the abdomen during development
Viscera persist outside the abdominal cavity but within the umbilical ring -> abdominal cavity may not grow to the correct size to accomodate the viscera
Viscera are covered in peritoneum -> can develop normally
Often associated with other genetic problems
Describe gastroschisis
Defect in ventral abdominal wall
Abdominal viscera are not covered in peritoneum -> are exposed and damaged by amniotic fluid
Tend to have problems with gut development
What are the causes of hernias
Weakness in containing cavity
Anything that increases intra-abdominal pressure
