Inguinal Region & Hernias Flashcards
What is a hernia?
In this instance it is a protrusion of bowel through the abdominal wall (but can be intervertebral disc herniations also).
Which area of the anterior abdominal wall is an area of weakness?
The umbilical region.
What is a hiatus hernia?
The ‘hiatus’ is the opening in the diaphragm through which the oesophagus sure passes from the thoracic —> abdominal cavity.
A hiatus hernia occurs when part of the stomach enters the thoracic cavity through this opening due to weakness.
How many types of hiatus hernia exist?
What are their names and how are they formed?
X2:
(1) Sliding hiatus hernia = occurs where the gastro-oesophageal junction ‘slides’ above the diaphragm
(2) Rolling hiatus hernia = occurs where the fundus of the stomach enters the thoracic cavity above the diaphragm
What are the X3 most common types of hernia?
Of these, which is the MOST common?
(1) Umbilical
(2) Inguinal (most common)
(3) Femoral
What does it mean for a hernia to be strangulates?
It is a tightening around the ‘neck’ of the hernia.
Why is there a weakness in the inguinal/femoral region allowing for hernias to sometimes occur?
Due to gonad development as they descend.
Which structure is involved in femoral and inguinal hernias?
The inguinal canal.
What are the X3 boundaries of the inguinal canal?
Anteriorly = the inguinal ligament formed by external obliques aponeurosis
Posteriorly = the CONJOINT TENDON (a tendon which joins the internal oblique and the transversus abdominus)
Medially = an opening in the external oblique muscle SUPERIOR and MEDIAL to the pubic tubercle called the SUPERFICIAL (EXTERNAL) INGUINAL RING
Through which structure do inguinal hernias protrude from?
What are the X2 types of inguinal hernia and what are the differences between these?
The superficial (external) inguinal ring.
There are:
(1) Direct inguinal hernias - these directly exit via the superficial (external) inguinal ring
(2) Indirect inguinal hernias - these actually enter the inguinal canal via the deep (internal) inguinal ring before exiting through the superficial (external) inguinal ring
In what structure will inguinal hernias end up protruding into?
The groin/scrotum.
Through which structure do femoral hernias protrude from?
Where is this structure located?
The femoral ring.
It is located LATERAL to the pubic tubercle and INFERIOR to the inguinal ligament.
Which feature of the inguinal canal prevents abdominal contents from protruding when abdominal pressure increases?
The obliqueness (staggering) of the superficial and deep rings.
What is the deepest layer of the inguinal canal created by the descent of the testes?
What type of fascia is this renamed as, as the innermost layer of the spermatic cord?
Transversalis fascia.
This is the layer which forms the deep (internal) inguinal ring.
This is renamed as internal spermatic fascia in the spermatic cord.
What is the name of the tendon formed by the aponeurosis of transversalis and internal oblique as they arch over the inguinal canal?
How does this tendon work when the abdominal muscles contract to avoid contents of the abdominal cavity protruding into the inguinal canal?
The conjoint tendon.
It pulls down like a shutter as a reflex action in response to increased abdominal pressure.
