Hernias Flashcards
what is littre’s hernia
hernia of meckel’s diverticulum
what is a ricter’s hernia
partial herniation of the bowel whereby the anti-mesenteric border becomes strangulated, patients will present with a tender irreducible mass at herniating orifice with varying levels of obstruction
direct hernia travels where
through Hasselbach’s triangle
where does indirect hernia travel
incomplete closure of the processus vaginalis, ano outpouching of the peritoneum allowing for embryonic testicular development
where is an epigastric hernia
upper midline through fibres of linea alba
what is a spigelian hernia
at semi-lunar line, tendinous lateral border of rectus where aponeuroses fuse around the level of arcuate line
high risk of strnagulation and should be repaired urgently
what are the borders of hasselbach’s triangle
Medial – lateral border of the rectus abdominis muscle.
Lateral – inferior epigastric vessels.
Inferior – inguinal ligament.
how can you clinically differentiate between direct and indirect hernia
reduce hernia and then place pressure over deep inguinal ring and then ask patient to cough
if hernia protrudes then direct hernia if doesnt protrude then indirect
how are hernias usually repaired
often open Lichetenstein technique
where are femoral hernias located
infero-lateral to the pubic tubercle (and medial to the femoral pulse)
what are the management options for femoral hernias
ow approach – the incision is made below the inguinal ligament, which has the advantage of not interfering with the inguinal structures but does result in limited space for the removal of any compromised small bowel
High approach – the incision is made above the inguinal ligament is the preferred technique in an emergency intervention due to the easy access to compromised small bowel
whats in the femoral canal
Lymphatic vessels – draining the deep inguinal lymph nodes.
Deep lymph node – the lacunar node.
Empty space.
Loose connective tissue.
