Hernias Flashcards
Inguinal Hernias
- Protrusion of gut or omentum through inguinal canal
- More common in males than females (spermatic cord present in inguinal canal)
Direct inguinal Hernia
- Caused by weakness of posterior wall of inguina canal (weakness of abdominal musculature)
- Less common
- Acquired
- Does not pass through deep inguinal ring
- MEDIAL to inferior epigastric artery
Indirect Inguinal hernia
- Caused by patent processus vaginalis
- More common
- Congenital
- Hernia transverse through entire length of inguinal canal
- LATERAL to inferior epigastric artery
Symptoms of inguinal hernias
1) Lump/swelling in the groin that develops over time
2) Pain/ache on exertion
3) Constipation
4) Heavy discomfort around gut
5) Lump enlarges when coughing or doing heavy lifting
6) Scrotal swelling may occur in males
Femoral Canal Borders
Medial border: Lacunar Ligament
Lateral border: Femoral vein
Anterosuperior border: Inguinal ligament
Floor: Pectineus, adductor longus and iliopsoas muscles
- Situated within the femoral triangle (anterior thigh compartment)
- Provides space for expansion of femoral vein (increase venous return)
Femoral Hernias
- Abdominal viscera or omentum passes through femoral ring and into potential space of femoral canal
- More common in females than males (wider pelvic anatomy)
- Tight space and there is no room for expansion (bordered medially by lacunar ligament)
- Can lead to obstruction and strangulation
Inguinal Hernia vs Femoral Hernia
Inguinal hernia:
-Lump found superomedial to the pubic tubercle
Femoral hernia:
-Lump found inferolateral to pubic tubercle (medial to femoral pulse)
Hesselbach’s Triangle (aka Inguinal Triangle)
Borders:
- Medial: Linea semilunaris (lateral border of rectus abdominis)
- Lateral: Inferior epigastric vessels
- Inferior: Inguinal ligament
-Demarcates an area of potential weakness in the abdominal wall –> can lead to DIRECT inguinal hernias