Herniation

Question 1

what is required for herniation to occur

Answer 1

structural weakness and increased pressure in that area

Question 2

where are the points of normal/abnormal structural weakness

Answer 2

normal: diphragmatic, umbilicus, inguinal canal, femoral canal
abnormal: congenital diaphragmatic hernia, surgical scars/insisional hernia

Question 3

where is increased pressure likely to occur

Answer 3

chronic cough
pregnancy
stenuous acitivity
straining defacation or urination

Question 4

lines of herniation

Answer 4

linea alba
linea semilunaris
inguinal region
anterior superior iliac spine

Question 5

external oblique muscle

Answer 5

forwards and down fibre direction (hands in pockets)

Question 6

internal oblique

Answer 6

anterosuperio direction, put you hands over chest

Question 7

transversus abdominus

Answer 7

horizontal fibres

Question 8

what is an aponeurosis and what does it form

Answer 8

large flattened tendon, come together to form rectus sheath to cover rectus abdominus

Question 9

what does the inguinal ligament do

Answer 9

marks the anterior boundary between the abdomen and thigh

Question 10

what is in the inguinal canal in males

Answer 10

spermatocord

Question 11

where does the superficial ring lie

Answer 11

superolateral to the pubic tubercle

Question 12

what is in the inguinal canal in females

Answer 12

round ligament of the uterus

Question 13

two parts to the posterior wall of inguinal canal

Answer 13

transversalis fascia

conjoint tendon

Question 14

what is a site of potential weakness in the anterior abdominal wall

Answer 14

Hesselbach’s triangle

Question 15

where is hesselbachs triangle located

Answer 15

inferior epigastric artery
Inguinal ligament
lateral border of rectus abdominis

Question 16

site of direct inguinal herniation

Answer 16

herniation within the triangle

Question 17

site of indirect inguinal herniation

Answer 17

deep inguinal ring

Question 18

direct inguinal herniation is ____ to the inferior epigastric artery

Answer 18

medial

Question 19

site of indirect inguinal herniation is ____ to the inferior epigastric artery

Answer 19

lateral

Question 20

characteristics of direct inguinal hernias

Answer 20

directly through abdominal wall
medial to inferior epigastric artery
parallel to spermatic cord

Question 21

characteristics of indirect

Answer 21

uses inguinal canal
lateral to infector epigastric artery
within spermatic cord or layers of abdominal wall

Question 22

if you can reduce patient hernia and find deep inguinal ring position, once reduced you ask patient to cough and if the hernia reappears then it is a ____ herniation, if it doesnt reappear it is a ____

Answer 22

direct, indirect

Question 23

where is inguinal ring found

Answer 23

half way between ASIS and pubic tubercle

Question 24

where are femoral herniation occurs in what area of weakness

Answer 24

subinguinal space

inferior and posterior to the inguinal ligament

Question 25

where are lymphatics found

Answer 25

femoral canal

Question 26

what is the myopectineal orifice

Answer 26

area of innate weakness