S4.2 Hernias Flashcards
What is a hernia?
A protrusion of part of the abdominal wall beyond the confines of its containing cavity.
What causes a hernia?
Weakening in the abdominal wall, commonly in the inguinal canal, femoral canal and umbilicus
What are the attachments of the inguinal canal?
ASIS to pubic tubercle
What is the function of the inguinal canal in male development?
Male gonad forms in the abdomen then relocates to the perineum through the inguinal canal.
The processus vaginalis leads the way then closes up, if it doesn’t close this can cause and inguinal or scrotal hernia.
What are the borders of the inguinal canal?
Roof: int oblique, T abdominus
Floor: inguinal ligament
Anterior: aponeurosis of ext oblique
Posterior: T fascia
What are the openings of the inguinal canal?
Deep inguinal ring: posterior wall entrance
Superficial inguinal ring: anterior wall exit
What are the two inguinal hernias?
Indirect (50%, Males) or direct (25%).
Where do hernias pass in relation to the inferior epigastric vessels?
Indirect inguinal hernia occurs lateral to the inferior epigastric vessels
Direct inguinal hernia occurs medial to the IEVs
IL DM you
What is hasselbachs triangle and its borders?
An area of weakness for direct hernias
Lateral: inferior epigastric vessels
Medial: rectum abdominus
Inferior: inguinal ligament
What is the path of an indirect inguinal hernia?
Enters through deep ring, then inguinal canal, then exits through superficial ring.
Then depending on where the Processus Vaginalis was obliterated can potentially descend into the scrotum.
What is the path of a direct inguinal hernia?
Bulges through Hesselbach’s triangle in vicinity of superficial ring. Acquired due to weakened abdominal musculature.
How might a femoral hernia present and what gender is it more common in?
A lump situated inferolaterally to the pubic tubercle. More common in women as wider bony pelvis, femoral ring broader.
The hernia is non-reducible – can’t push it back in.
There are 3 types of umbilical hernias, describe a congenital omphalocoele
Contents herniated into umbilical cord due to persistence of physiological herniation.
There are 3 types of umbilical hernias, describe an acquired infant hernia
Contents herniates through weakness in scar of umbilicus
There are 3 types of umbilical hernias, describe and acquired adult hernia
Contents herniates through linea alba in the region of the umbilicus.
More common in females and due to obesity
