Hernias Flashcards
what two factors are usually required for the development of a hernia?
structural weakness
increased pressure
name a congenital hernia
congenital diaphragmatic hernia
what causes a congenital diaphragmatic hernia?
the oesophagus growing slower than the rest of the body during development
what is a hernia at a surgical incision site called?
incisional hernia
name three things that can increase intra-abdominal pressure
chronic cough
pregnancy
straining during bowel movements
what does ASIS stand for?
anterior superior iliac spine
what does EOM stand for?
external oblique muscle
what is the fibre direction in the EOM?
anteroinferior
what is the fibre direction in the internal oblique muscle?
anterosuperior
what is the fibre direction in the transversus abdominis muscle?
horizontal
what marks the anterior boundary between the abdomen and the thigh?
the inguinal ligament
what is the inguinal ligament?
an inferior thickening of the external oblique muscle
why is the medial half of the inguinal ligament curved?
to form the floor of the inguinal canal
what is the inguinal canal?
an oblique passage between the abdomen and the perineum
how long is the inguinal canal?
4cm
what direction does the inguinal canal travel in?
inferomedially
where does the inguinal canal lie?
along the superior border of the inguinal ligament
what two things are found in everyones inguinal canal?
blood and lymphatic vessels
what nerve is found in the inguinal canal?
the ilioinguinal nerve
what is found in the inguinal canal in males?
spermatic cord
what is found in the inguinal canal in females?
the round ligament of the uterus
what does the gubernaculum become in an adult male?
the testicular ligament
what does the gubernaculum become in an adult female?
the round ligament of the uterus
what abdominal muscle makes no contribution to the spermatic cord?
the transversus abdominis
what two things make up the anterior wall of the inguinal canal?
external oblique aponeurosis
internal oblique muscle
what two things make up the posterior wall of the inguinal canal?
transversalis fascia
conjoint tendon
what three things make up the roof of the inguinal canal?
transversalis fascia
arches of the internal oblique and transversus abdominis aponeurosis
external oblique aponeurosis
what makes up the floor of the inguinal canal?
gutter of the infolded inguinal ligament
what is the site of direct inguinal herniation called?
hesselbach’s triangle
what three things make up hesselbach’s triangle?
inferior epigastric artery
inguinal ligament
lateral border of the rectus abdominis
what are the two types of inguinal hernia?
direct and indirect
how does a direct inguinal hernia pass through the abdominal wall?
it passes directly through the structures of the wall
how does an indirect inguinal hernia pass through the abdominal wall?
it uses the inguinal canal and the deep inguinal ring
what is a hernia?
an abnormal protrusion of. a cavity’s contents through a weakness in its wall
what is a reducible hernia?
one that can be easily pushed back into the abdomen
what is an incarcerated/irreducible hernia?
one that cannot be manipulated back into the abdomen
what is a strangulated hernia?
hernia where the vascular supply to the contents is compromised
what is an epigastric hernia?
a fascial defect in the linea alba between the xiphoid process and the umbilicus
what is the main presentation of an epigastric hernia?
a midline lump
what are risk factors for a paraumbilical hernia?
anything that stretches the abdominal wall, such as obesity, pregnancy and ascites
how are paraumbilical hernias almost always managed?
surgically
what is an inguinal hernia?
when a loop of the intestine gets stuck in the inguinal hernia
where does the inguinal canal start and end?
starts at the deep inguinal ring and ends at the superficial inguinal ring
what are the three layers of the outside of the spermatic cord?
internal spermatic fascia
cremasteric fascia
external spermatic fascia
are inguinal hernias more common in men or women?
men
are the majority of inguinal hernias indirect or direct?
indirect
are right or left sided inguinal hernias more common?
right sided
what is the most common complication of a laparotomy?
incisional hernia
