Session 3 - Hernias Flashcards

1
Q

Give three sites of potential weakness in the abdominal wall?

A

• Inguinal canal, femoral ring and umbilicus

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2
Q

What is the inguinal canal?

A

• The canal through which structures leave and enter the abdomiopelvic cavity

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3
Q

In which direction does the inguinal canal travel?

A

• Downward and medial direction

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4
Q

Where does the inguinal canal begin and end

A
  • Starts at the deep inguinal ring
    • Continues 4cm

Ends at superficial inguinal ring

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5
Q

Where does the inguinal canal lie?

A

• In between the muscles of the anterior abdominal wall and runs parallel and superior to the medial half of the inguinal ligament

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6
Q

What runs through the inguinal canal in men?

A
  • The spermatic cord

* The ilioinguinal nerve

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7
Q

What runs through the inguinal canal in women?

A
  • The round ligament of the uterus

* The iliolinguinal nerve

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8
Q

What is a hernia?

A

• A protrusion of part of the abdominal viscus through a defect in the abdominal wall

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9
Q

What is a hernial sac usually covered in?

A
  • Skin
    • Subcutaneous tissue
    • Layers of the abdominal wall
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10
Q

Give three common locations of hernias

A
  • Inguinal
    • Umbilical
    • Epigastric
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11
Q

What is a direct inguinal hernia?

A

• Gut protrudes into the inguinal canal through a weakened area in the transversalis fascia near the medial inguinal fossa within an anatomical region know as Hesselbach’s triangle

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12
Q

What are the borders of Hesselbachs triangle?

A
  • Inferiorly - Medial half of the inguinal ligament
    • Medially - Lower lateral border of rectus abdominis
    • Laterally - Inferior epigastric artery
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13
Q

What is an indirect inguinal hernia?

A

• Protrudes throught he deep inguinal ring

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14
Q

Why do indirect inguinal hernias often occur?

A

• Result of the failure of embryonic closure of the deep inguinal ring after the testicle has passed through

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15
Q

What is an epigastric hernia?

A

• Hernia which occurs in the epigstric region in the midline between the xiphoid process and the umbilicus, through the linea alba

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16
Q

What are the two primary risk factors?

A

• Primary risk factors are obesity and pregnancy

17
Q

What is an umbilical hernia?

A

• Occur through the umbilical ring

18
Q

Why do umbilical hernias occur?

A

• As a result of a increased intra-abdominal pressure in the presence of weakness and incomplete closure of the anterior abdominal wall after ligation of the umbilical cord at birth

19
Q

What causes an acquired umbilical hernia?

A

• Pregnant women

Obese people

20
Q

Where do femoral hernias occur?

A

Occur through femoral ring into femoral canal

21
Q

What are femoral hernias bounded by laterally and medially?

A

• Femoral vein laterally

Lacunar ligament mediall

22
Q

What can femoral hernia do?

A

• Compresses the contents of the femoral canal and distends the wall

23
Q

How are femorl hernias enlarged?

A

• By passing through saphenous opening into subcutaneous tissue of the thigh

24
Q

Why are femoral hernias more common in female?

A

• Wider pelvis

25
Why does strangulation of femoral hernias occur?
• Sharp, rigid boundaries of femoral ring
26
What are two main complications of hernia?
* Strangulation | * Incarceration
27
What is strangulation?
• The constriction of blood vessels, preventing flow of blood to tissue
28
What is incarceration?
Hernia cannot be reduced, or pushed back into place.
29
What is the commonest hernia in females?
• Indirect Hernia
30
What is a divarication hernia?
• Weakness of lina alba
31
What is a richter's hernia?
• Part of bowel strangulates through hernia No bowel obstruction
32
What is a spigelian hernia?
• Area of weakness in linea semilunaris
33
Why operate on hernias?
• Strangulation can cause ischaemia
34
What is an incisional hernia?
• Post-surgical weakness in muscle wall