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ESA 3 - Gastrointestinal System > Hernias > Flashcards

Hernias Flashcards

1
Q

What are the chief sites of hernia?

A
  • Inguinal
  • Femoral
  • Umbilical
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2
Q

What is the potential area of weakness causing an inguinal hernia?

A

Inguinal canal

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3
Q

What is the potential area of weakness causing a femoral hernia?

A

Femoral ring

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4
Q

What is the potential area of weakness causing an umbilical hernia?

A

The umbilicus

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5
Q

What is the inguinal canal?

A

An oblique passageway

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6
Q

In what direction does the inguinal canal extend?

A

Downward and medial

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7
Q

Where does the inguinal canal begin?

A

At the deep (internal) inguinal ring

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8
Q

How long is the inguinal canal?

A

Approx 4cm

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9
Q

Where does the inguinal canal end?

A

Superficial (external) inguinal ring

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10
Q

Where does inguinal canal lie relative to other structures?

A
  1. In between the muscles of the anterior abdominal wall
  2. Runs parallel and superior to medial half of inguinal ligament
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11
Q

What border does the inguinal ligament constitute?

A

The inferior border of the aponeurosis of the external oblique muscle

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12
Q

Where does the inguinal ligament attach?

A

The ASIS and the pubic tubercle

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13
Q

What passes through the inguinal canal?

A
  • The ilioinguinal nerve (through part)
  • In males, the spermatic cord
  • In females, the round ligament of the uterus
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14
Q

Label this diagram

A
  • Anterior superior iliac spine
  • External oblique aponeurosis
  • Deep membranous layer of subcutaneous tissue
  • Itercrural fibres
  • Superficial inguinal ring
  • Ilioinguinal nerve
  • Spermatic cord
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15
Q

Label this diagram

A
  • Aponeurosis of external oblique
  • Location of deep inguinal ring
  • Femoral vein
  • Outline of sublingual space
  • Intercrural fibres
  • Outline of myopectineal orifice
  • Medial crus
  • Superficial inguinal ring (with reflected inguinal ligament in posterior wall)
  • Pubic tubercle
  • Lateral crus
  • Lacunar ligament
  • Pectineal ligament
  • Pectineus
  • Femoral canal
  • Iliopubic eminence
  • Acetabulum
  • Femoral sheath
  • Psoas major
  • Anterior inferior iliac spine
  • Femoral artery
  • Femoral nerve
  • Iliacus
  • Inguinal ligament
  • Lateral cutaneous nerve of thigh
  • Anterior superior iliac spine
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16
Q

What is an inguinal hernia?

A

A protrusion of the abdominal cavity contents through the inguinal canal

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17
Q

How common are inguinal hernias?

Give lifetime risks

A

Very common

  • Lifetime risk 27% for men
  • Lifetime risk 3% for women
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18
Q

What is a direct inguinal hernia?

A

Protrusion into the inguinal canal through a weakened area in the transversalis fasica near the medial inguinal fossa, within an anatomical region known as the inguinal/Hesselbach’s triangle

19
Q

What are the borders of the Hesselbach’s triangle?

A
  • Inferiorly- Medial half of the inguinal ligament
  • Medially- Lower lateral border of rectus abdominis
  • Laterally- Inferior epigastric artery
20
Q

What is an indirect inguinal hernia?

A

Protrudes through the deep inguinal ring, within the diverging arms of the transversalis fascial sling

21
Q

What are most indirect inguinal hernias a result of?

A

The failure of the embryonic closure of the deep inguinal ring after the testicle has passed through it

22
Q

Label this diagram illustrating the common sites of hernia

A
  • A - Epigastric hernia
  • B - Incisional hernia
  • C - Umbilical hernia
  • D - Indirect inguinal hernia
  • E - Direct inguinal hernia
  • F - Femoral hernia
23
Q

Where do epigastric hernias occur?

A

In the epigastric region, in the midline between the xiphoid process and the umbilicus, through the linea alba

24
Q

What are the primary risk factors for epigastric hernias?

A
  • Obesity
  • Pregnancy
25
Q

Where do umbilical hernias occur?

A

Through the umbilical ring

26
Q

What size are umbilical hernias?

A

Usually small

27
Q

What do umbilical hernias result from?

A

Increased intra-abdominal pressure in the presence of weakness and incomplete closure of the anterior abdominal wall after ligation of the umbilical cord at birth

28
Q

Who do acquired umbilical hernias occur in?

A

Adults, most commonly women and obese people

29
Q

What is a femoral hernia?

A

A protrusion of abdominal viscera into the femoral canal

30
Q

Where does a femoral hernia occur?

A

Through the femoral ring

31
Q

What is a femoral hernia bound by?

A
  • Femoral vein laterally
  • Lacunar ligament medially
32
Q

What is the effect of a femoral hernia?

A
  • Compresses the contents of the femoral canal
  • Distends the wall of the canal
33
Q

What is the contents of the femoral canal?

A
  • Loose connective tissue
  • Fat
  • Lymphatics
34
Q

What size are femoral hernias?

A

Initially, they are small, but can enlarge

35
Q

Why are femoral hernias initially small?

A

Because they are contained within the canal

36
Q

How can femoral hernias enlarge?

A

By passing inferiorly through the saphenous opening into the subcutaneous tissue of the thigh

37
Q

Who are femoral hernias more common in?

A

Women

38
Q

Why are femoral hernias more common in women?

A

They have wider pelves

39
Q

Label this diagram

A
  • A - Femoral hernia
  • B - Inguinal ligament
  • C - Adductus longus
  • D - Sartorius
  • E - Transversalis fascia
  • F - Fascia lata
  • G - Inguinal ligament
  • H - Femoral artery and vein
  • I - Saphenous opening
  • J - Great saphenous vein
  • K - Femoral hernia
  • L - Femoral sheath
  • M - Pubic tubercle
  • N - Pubic symphysis
  • O - Lacunar ligament
  • P - Femoral ring
  • Q - Aberrant obturator artery
  • R - Intestine
  • S - Inferior epigastric artery
  • T - External iliac artery and vein (cut)
  • U - Femoral nerve
  • V - Iliopsoas muscle and fascia
40
Q

What are the potential complications of hernias?

A
  • Strangulation
  • Incarceration
41
Q

What is strangulation?

A

The constriction of blood vessels, preventing blood flow to the tissue

42
Q

Why can strangulation occur with femoral hernias?

A

Because of the sharp, rigid boundaries of the femoral ring

43
Q

What is incarceration of a hernia?

A

When the hernia cannot be reduced, or pushed back into place, at least not without very much external effort

44
Q
A

ESA 3 - Gastrointestinal System (12 decks)

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