Hernias

Question 1

what is a hernia

Answer 1

protrusion of part of the abdominal contents beyond it containing cavity

Question 2

what 3 parts does a hernia consist of

Answer 2

the peritoneal sac, abdominal contents and abdominal wall layers covering the sac

Question 3

what weaknesses in the abdominal wall do hernias occur at

Answer 3

inguinal canal, femoral canal, umbilicus and at previous incisions

Question 4

true or false: femoral canal hernias are more common in women

Answer 4

true - as they have a larger femoral canal due too their wider pelvis (still not very common though)

Question 5

what is omphalocoele

Answer 5

where the herniation of the midgut through the umbilicus in development persists

Question 6

what is Gastroschsis

Answer 6

where the abdominal wall fails to close during development so the protruding contents has no peritoneal coverings

Question 7

what is umbilical hernia

Answer 7

where the bowel herniates through the weakness of the umbilical scar

Question 8

what treatment to you give for umbilical hernias

Answer 8

none - they should resolve themselves within a couple of years after birth

Question 9

where do epigastric hernias occur

Answer 9

through the linea alba

Question 10

what makes the floor of the inguinal canal

Answer 10

inguinal ligament

Question 11

what makes the roof of the inguinal canal

Answer 11

internal oblique and transverse abdominis

Question 12

what makes the posterior wall of the inguinal canal

Answer 12

transversalis fascia

Question 13

what makes the anterior wall of the inguinal canal

Answer 13

aponeurosis of external oblique

Question 14

what are indirect inguinal hernias

Answer 14

hernias that go through the deep and superficial ring of the inguinal canal

Question 15

what are the 2 holes in the inguinal canal

Answer 15

the deep ring in the transversalis fascia and the superficial ring in the aponeurosis

Question 16

when do indirect inguinal hernias move into the scrotum

Answer 16

when the processus vaginalis fails to regress

Question 17

describe the descent of the processus vaginalis

Answer 17

the processus vaginalis is a pouch of peritoneum that should descend down

after descent part should remain covering some of the testis to form the tunica vaginalis - the rest should regress

Question 18

where will an indirect inguinal hernia be in relation to the epigastric vessels

Answer 18

lateral

Question 19

what are direct inguinal hernias

Answer 19

a hernia that protrudes through a weakness in the abdominal wall known as Hesselbach triangle

they do not enter the inguinal canal

Question 20

what are the borders of the Hesselbach triangle

Answer 20

medial= rectus abominis 
superior = inferior epigastric artery
inferior = inguinal ligament

Question 21

where will a direct inguinal hernia be in relation to the epigastric vessels

Answer 21

medial

Question 22

what are likely to form if the processus vaginalis doesn’t regress fully

Answer 22

indirect inguinal hernias

Question 23

what does it mean for a hernia to become incarcerated

Answer 23

it has become stuck and cannot be reduced

Question 24

what does it mean if a hernia becomes strangulated

Answer 24

blood supply has been disrupted and can lead to tissue necrosis and infection

Question 27

true or false: femoral hernias are more likely to become incarcerated

Answer 27

true - it’s a more narrow space and can easily become stuck