Session 4 - Hernia And Abdominal Wall Flashcards
What is a hernia?
A protrusion of part of the abdominal contents beyond the normal confines of the abdominal wall.
What is the sac of an abdominal hernia?
Peritoneum
Why might someone develop a hernia?
Weakness in the abdominal wall.
Inguinal canal
Femoral canal
Incisional hernia
Where does the inguinal ligament go to and from?
Pubic tubercle and ASIS
What passes through the inguinal canal?
Males - spermatic cord to testes.
Females - round ligament to labia majora
When do testes descend?
At 7-8 months of development
What is the processus vaginalis?
An outpouching of the peritoneum
What is the gubernaculum?
Condensed band of mesenchyme that links the inferior portion of the gonad to the labioscrotal swelling.
Acts as a guide for the gonadal descent
What forms the anterior wall of the inguinal canal?
The aponeurosis of external oblique and reinforced by internal oblique laterally.
What forms the floor of the inguinal canal?
The inguinal ligament; which is the rolled edge of the external oblique aponeurosis. Thickened medially by the lacunae ligament.
The roof of the inguinal ligament?
Arching fibres of internal oblique and transverse abdominus
The posterior wall of the inguinal canal?
Transversalis fascia
Where is the deep ring of the inguinal canal?
The transversalis fascia
Where is the superficial ring of the inguinal canal?
The anterior wall - the aponeurosis of external oblique
Which vessels are an important landmark in distinguishing between direct and indirect inguinal hernias?
Inferior epigastric vessels
Which inguinal hernia occurs medially to the inferior epigastric vessels?
Direct inguinal hernia
Which inguinal hernia occurs laterally to the inferior epigastric vessels?
Indirect inguinal hernia
What embryological remnant allows indirect inguinal hernias to occur?
Patent processus vaginalis
What is the importance of Hesselbachs triangle?
It is an area of weakness in the abdominal wall which allows direct inguinal hernias to pass through
The inferior border of Hesselbachs triangle?
Inguinal ligament
The medial border of Hesselbachs triangle?
Rectus abdominus muscle
The superior border of Hesselbachs triangle?
Inferior epigastric vessels
Which sex are femoral hernias most common in?
Female
Which sex are inguinal hernias more common in?
Male
What is the femoral canal?
The empty space between the femoral vein and the lymphatics of the thigh
Entrance to the femoral canal is called..?
Femoral ring
What term refers to a hernia which is stuck?
How can you tell?
Incarcerated
It is not reducible
What is the difference between an incarcerated and strangulated hernia?
Incarcerated is stuck.
Strnagulated is probably stuck too, but also with blood supply cut off.
What is an omphalecele?
Congenital
Abdominal contents herniate into the umbilical cord
Has peritoneal covering
What is an acquired infantile umbilical hernia?
Abdominal contents herniate through weakness in scar of umbilicus
What is an acquired adult umbilical hernia?
Goes through linea alba in region of umbilicus.
hat is an epigastric hernia?
Linea alba
Between xiphoid process and umbilicus
Symptoms of hernia?
Achey - pain
Obstruction -> vomiting
Strangulation -> sepsis.
What is the linea alba?
The midline fusion of the rectus abdominus.
