Hernia + Miscellaneous Flashcards
Two types of inguinal hernia
Direct and indirect
Difference between indirect and direct hernia [4]
Direct hernias project through Hesselbach’s triangle, exits thru superficial inguinal ring - which is medial to inferior epigastric artery
Indirect hernias project from the deep inguinal ring through the superficial inguinal ring
How do you know it is indirect
Press down on deep ring + reduce
Won’t refill on cough impulse
How do you know it is direct
Will refill on cough
Doesn;t hang into sctroum
Where is the external ring
Above and medial to pubic symphsis
Where is the femoral ring
Below and lateral to PS
This is where femoral hernia is
Where is deep ring of inguinal canal
Between ASIS and PS
Where is superfiical (external) ring
Superior and medial to pubic tubercle
What is the anatomy of inguinal canal
External oblique = infront
Inguinal ligament = floor
Transverse abdominis
What are the contents of inguinal canal [4]
Vas deferens
Testicular artery and vein
Genitofemoral nerve
Ilioinguinal nerve
What are the symptoms of inguinal hernia [5]
Bulge Increases with cough Reduces lying flat May become irreducible and painful May obstruct
What is a strangulated hernia
In which hernias is this a rare complication
In which hernias is this a common complication
Blood supply cut of
Rare in inguinal
Common in femoral
What are the symptoms of strangulation [5]
Tender scrotum so always ask for this Red Sudden pain Fever Tachycardia
How do you examine a hernia [3]
Stand and get to cough
Lie flat and cough while pressing
Compare bilaterally
What are the RF for hernia
Male, Obesity Older as ring gets bigger Weight lifting, Manual job Chronic cough and constipation Obstruction Past abdo surgery Ascites
What are women with hernia likely to have
Inguinal hernia
Who is most likely to have a femoral
Women
