Hernia's Flashcards
What is visceral pain?
Pain that results from stretching, inflammation and ischaemia.
What are the symptoms of visceral pain?
The pain is diffuse, poorly defined and often in the midline.
It is often accompanied by nausea, vomiting or sweating,
What is a hernia?
A protrusion of part of the abdominal contents beyond the normal confines of the abdominal wall.
(But can occur outside of abdomen)
What are the parts of a hernia?
Sac - pouch of peritoneum
Sac contents - any structure found within the abdominal cavity. Commonly: loops of bowel or omentum
Sac covering - layers of the abdominal wall through which the hernia has passed
What are the most common abdominal hernias?
Inguinal hernia’s
What is the inguinal canal?
Oblique passage through the lower part of the abdominal wall.
In males the structures pass through from abdomen-testes
In females round ligament goes from uterus-labia majus
On what side to inguinal hernias most commonly occur?
The right
How do we describe the location of the hernia?
Where it leaves the abdominal cavity.
Where are indirect hernia found?
Lateral to epigastric vessels.
They pass through the deep inguinal ring into the inguinal canal and out of the superficial inguinal ring.
50% of all hernias are indirect inguinal hernias (mostly men).
Where are direct hernias found?
Medial to epigastric vessels. Bulge through Hesselbachs triangle and generally in vicinity of superficial inguinal ring.
What are the borders of Hesselbacks triangle?
Medial - Inferior border of rectus abdominis
Inferior - Inguinal ligament
Lateral - Inferior epigastric vessels
In who are femoral hernias more common? Why?
Females (although rarer then inguinal hernia’s)
because of wider pelvis (as children).
These hernias can easily get stuck (incarcerated)
What is omphalocele?
Failure of the midgut to return to the abdomen during development.
Viscera persists outside the abdominal cavity within the umbilical ring.
The abdominal cavity may not grow to correct size to accommodate viscera.
Viscera are covered in peritoneum so the gut has a chance to develop relatively normally and feeding can commence.
BUT, often associated with other genetic problems so high mortality rate.
What is gastroschisis?
A defect in ventral abdominal wall.
Abdominal viscera are not covered in peritoneum -exposed to amniotic fluid. This means that there tends to be problems with gut development and around feeding.
BUT, better mortality than omphalocele as less genetic complications. This defect can often be closed at birth.
What is an umbilical hernia?
Hernia (bulge) at site of umbilicus - not usually painful and usually left alone as they often (80-90%) result themselves by age 3