Inguinal canal and hernia Flashcards
What 2 landmarks form the inguinal ligament? What is the middle called?
ASIS -> Pubic tubercle
Mid point of inguinal ligament
What forms the mid-inguinal point?
ASIS -> Pubic symphysis
How do you find the deep inguinal ring?
Between midpoint of inguinal ligament and mid-inguinal point (1cm above inguinal ligament)
Where is the inguinal canal?
Between the deep and superficial inguinal rings
Where is the superficial inguinal ring located?
Located supero-lateral to the pubic tubercle
Which abdo wall layers do the deep and superficial inguinal ring sit on?
Deep - through transversalis fascia
Superficial - Ext oblique
Which muscles form the roof of the inguinal canal?
Internal oblique and transversus abdominus
What are the common positions of hernia formation through the ant abdo wall?
Umbilical hernia
Inguinal hernia
Femoral hernia
What does a hernial sac most often contain?
Loops of bowel - sometimes hear bowel sounds.
May have torsion
What is the diff between an indirect and direct hernia?
Indirect - pass through deep and superficial rings (into scrotum)
Direct - pass through superficial ring (weakness in conjoint tendon?)
What is the Hessselbach’s triangle?
Indicates the region of bulging with a direct inguinal hernia
Only seen inside of abdo wall
What nerves are at risk of damage during inguinal canal surgery?
Ilioinguinal and iliohypogastric nerves
What is Petit’s triangle? name its borders
Inferior lumbar site for herniation - male 50-70rs
Borders: ext ob, iliac crest, latissmus dorsi
What is Grynfeltt/lesshaft’s triangle? name its borders
Superior lumbar sit for herniation
Borders: rib 12, int ob, quadratus lumborum