inguinal regions and hernias Flashcards
what is a hernia
a buldge created by a rupture of a containing structure
where are hernias most common ?
most common in abdomen
and weakend areas
what is hernia strangulation and why is it caused ?
some hernias can contain viscera
if the blood supply of this is comparised organ will necrose = strangulation
what is another way hernias might occur ?
can occur when pressure with the abdominal wall is greater then the pressure outside
what are the most common site for hernias ?
femoral
inguinal
umbilical
hiatal ( in those over 50)
what are the 2 types of umbilical hernias ?
congenital
acquired
what is an umbilical hernia an indication of after birth ?
indicated failure to close umbilical scar
where does a hiatus hernia occur ?
occurs through the oesphageal hiatus or the esophagel opening in the diaphragm
what are the 2 types of hiatus hernias ?
sliding hiatus hernia
rolling hiatus hernia
where is the femoral sheath ?
behind the inguinal ligament
what is found in the femoral canal ?
lymphatic
what is a femoral hernia ?
protrusion through the femoral canal + the saphenous opening
who are femoral hernias more common in and why ?
females
have wider hips = wider femoral canals
when do femoral hernias get strangulated ?
when they push against the lacumar ligament
why is the inguinal area weak ?
there is a gap which is created for the gonads
where is the inguinal ring ?
located laterally to inferior epigastric artery - 1.25 cm above midpoint of inguinal ligament
exit of the canal is an opening in the external obliques = superficial inguinal ring
what is the function of the inguinal canal ?
connects the spermatic cord from the testes to the pelvic cavity
what is the spermatic cord ?
refers to structures that have left the inguinal canal
what nerve lies on the surface of the spermatic cord ?
ilioinguinal nerve
what nerve is found in the wall of the spermatic cord ?
genitofemoral nerve
what are the 3 boundaries of the inguinal canal and what defines them ?
roof
wall
floor
anterior wall = external oblique aponeurosis + internal olbiques
posterior wall = transversalis fascia + conjoined tendon
floor = upturned external oblique
roof = arched fibres of conjoined tendon from internal olbique + transversus abdominis
how many layers of the inguinal canal is there ?
4
describe the deepest layer of the inguinal canal ?
is the transverse fascia
forms the deep inguinal ring and inner layer of spermatic cord
describe the 2nd deepest layer of the innguinal canal
formed from the internal oblique contributes muscle + fascia to spermatic cord
muscle is called the cremaster muscle
fascia is called cremasteric fascia
describe the 2nd most superficial layer of the inguinal canal
made up of conjoined tendon however the transverse abdominis doesnt contribute to the spermatic cord
describe the most superficial layer of the inguinal canal
formed of the external oblique
forms the superficial inguinal ring + spermatic cord
called the external spermatic fascia
where does a femoral hernia emerge from ?
from the femoral canal
where does an inguinal hernia emerge from ?
through the superficial inguinal ring
why is an inguinal hernia more common in males ?
men have wider inguinal canal dues to the spermatic cord passing through it
what hernia is more common ? inguinal or femoral ?
inguinal
how are femoral + inguinal hernias differentiated ?
by the position of their root
where is the root of a femoral hernia found ?
lies below + lateral to pubic tubercle
where is the root of an inguinal hernia ?
lies above and medial to pubic tubercle
what forms the spermatic cord ?
is formed by the descent of the testes down the abdominal wall , descent leaves a trail of neurovascular bundles = spermatic cord
where do the 3 walls of the spermatic cord come from ? what are the 3 walls called ?
3 walls comes from the obliques + the transversalis fascia
external obliques = external spermatic fascia
internal obliques = cremasteric muscle + fascia
transversalis fascia = internal spermatic fascia
what are the names of the fascia in the testes ?
campers fascia = dartos fascia
scarpas fascia = colles fascia
why is the testes covered in smooth muscle ? what is the name of this muscle ?
covered in smooth muscle so that it is kept cool. ( no fat in smooth muscle )
dartos muscle
what is the processus vaginalis ?
perfusion of the peritoneal membrane
what is hydrocele testis ?
and enlargement of the testes caused by an increased amount of fluid in the tunica vaginalis
what is an indirect inguinal hernia ?
refers to a hernia through the inguinal canal
how can you feel for an indirect inguinal hernia ?
placing finger in scrotal wall
hernia is felt emgering from superficial inguinal ring
where is a direct inguinal hernia found ?
at the inguinal triangle
what is the inguinal triangle ?
area of weakness in the lower abdominal wall
what are the boarders of the inguinal triangle and how are they formed ?
medila , lateral , inferior
medial boarder = lateral margin of rectus abdominis
lateral boarder = inferior epigastric artery
inferior = inguinal ligament
why is the lower half of the inguinal triangle at the most risk of hernias ?
only protection is the transversalis
how does the inguinal triangle try to prevent herniation ?
conjoint tendon is pulled downards during its contraction
what controls the contraction of the conjoined tendon ?
ilioinguinal nerves
