Hernias

Question 1

What is a hernia?

Answer 1

Abnormal protrusion of peritoneum - lined sac through abdomen. Weakness in wall results in inability to contain visceral contents within abdominal cavity.

Question 2

Most common hernia? In which sex? And where?

Answer 2

Inguinal, males, right side

Question 3

Explain how an inguinal hernia may arise (describe structures and becomes weakened).

Answer 3

In the inguinal canal there is transversalis muscle and fascia. The spermatic cord in males, and the round ligament in females enter the inguinal canal through the internal ring (in abdomen at beginning of canal) of the transversalis fascia and exit through its external ring (natural opening at end of canal). The posterior floor of the inguinal canal can become defective

Question 4

What is the difference between direct and indirect hernias?

Answer 4

Direct - happen in the hasselbach triangle. They protrude into the Inguinal canal but rarely ever into the spermatic cord therefore rarely entering the scrotum. Usually from heavy lifting.

Indirect - can be found laterally to deep epicanthic vessels. They pass through the internal ring and down the canal with the spermatic cord. Therefore they usually end up in scrotum.

Question 5

Why do central hernias occur?

Answer 5

Weakness in abdominal fascia

Question 6

When can ventral hernias occur and what are some risk factors?

Answer 6

Can occur spontaneously or after previous surgery.

Risk factors include infection, steroid use, lung disease, poor nutrition.

Question 7

With umbilical hernias there is a defect in what?

Answer 7

The linia alba

Question 8

Umbilical hernias are repaired with mesh. T/F

Answer 8

False. Done with sutures. Need layer by layer sutures.