Hernias

Question 1

Sliding Hiatal Hernia

Answer 1

GE junction displaced upward

Hourglass appearance of stomach

Question 2

Paraesophageal Hernia

Answer 2

GE junction normal but fundus protrudes into thorax

L > R b/c no protection by liver

Question 3

Direct Inguinal Hernia

Answer 3

Thru Hesselbach triangle (ab rectus muscle, inguinal ligament and inferior epigastric vessels)

MEDIAL to inferior epigastrics

Thru external ring only - covered by external spermatic fascia (of external obliques)

Often seen in old men

Question 4

Indirect Inguinal Hernia

Answer 4

LATERAL to inferior epigastrics

Thru internal and external rings -> into scrotum

Often seen in infants

Question 5

Femoral Hernia

Answer 5

Less common overall but more common in women

Protrudes below inguinal ligament thru femoral canal (w/ lymphatics)

More likely to strangulate