TH1 ANTERIOR ABDOMINAL WALL Flashcards
DEFINE HERNIA
PROTRUSION OF VISCUS/ OTHER STRUCTURES BEYOND NORMAL COVERINGS OF CAVITY WHICH ITS CONTAINED IN
ELEMENTS OF HERNIA
SAC
CONTENT
NECK
COMPLICATION OF HERNIA
INCARCERATION
INTESTINAL OBSTRUCTION
STRANGULATION (MOST DANGEROUS)
WHAT IS TAXIS
NON OPERATIVE TX OF INTESTINAL OBSTRUCTION
MANUAL REPOSITIONING
STRANGULATED HERNIA
IRREDUCIBLE HERNIA WITH ISCHEMIC/ NECROTIC CONENTS
RECURRENT HERNIA
HERNIA THAT REOCCUR AFTER PREVIOUS HERNIA REPAIR
TYPES OF ANTERIOR ABDOMINAL WALL HERNIA?
> GROIN > INGUINAL/ FEMORAL > UMBILICAL > EPIGASTRIC > SPIGELLIAN > INCISIONAL HERNIA
ANATOMY OF INGUINAL CANAL (WALLS)?
ANTERIOR WALL
- aponeurosis of external oblique muscle
POSTERIOR WALL
- transverse fascia
SUPERIOR WALL
- arching fibres of internal oblique m. + transverse abdominis m.
INFERIOR WALL
- in rolled edge of inguinal ligament
INTERNAL RING
- round ligament / spermatic cord emerge through transverse fascia
EXTERNAL INGUINAL RING
- V-shaped opening of anterior wall immediately superior to pubic tubercle
ANATOMY OF FEMORAL CANAL
ANTERIOR WALL
- inguinal ligament
POSTERIOR WALL
- iliopectineal line
MEDIAL WALL
- lacunar part of inguinal ligament
LATERAL WALL
- femoral vein
MOST COMMON TYPE OF ANTERIOR ABDOMINAL WALL HERNIA?
INGUINAL HERNIA
80% OF CASES
TYPES OF INGUINAL HERNIA?
- DIRECT
- sac doesn’t protrude through inguinal canal - INDIRECT
- sac protrudes through inguinal canal
EPIGASTRIC HERNIA
PROTRUSION OF PREPERITONEAL FAT THROUGH FASCIAL DEFECT IN DECUSSATING FIBRES OF SUPRAUMBILICAL PORTION OF LINEA ALBA
> peritoneal sac may accompany fat through defect > containing momentum or rarely bowel
SPIGELIAN HERNIA
INTERPARIETAL HERNIA IN LINEA SEMILUNARIS
> lateral margin of rectus sheath > run from tip of 9th costal cartilage to pubic crest
INCISIONAL HERNIA
OCCURS THROUGH WOUND > CICATRIX
OF PREVIOUS OPERATIONS
> POST OPERATIVE COMPLICATION
TYPES OF ADULT UMBILICAL HERNIA
- TRUE UMBILICAL
2. PARA UMBILICAL
RICHTERS HERNIA
CONTAINS PART OF CIRCUMFERENCE OF BOWEL WALL > CAN CAUSE STRANGULATION WITHOUT OBSTRUCTION
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MAYDLES HERNIA
CONTAINS 2 ADJACENT LOOPS OF BOWEL
> SEGMENTS BETWEEN LOOPS MAY BE STRANGULATED
LITTRES HERNIA
HERNIA CONTAINS A MECKELS DIVERTICULUM
WHAT IS MECKELS DIVERITCULUM
ABNORMAL POUCH OF TISSUE ON A SMALL INTESTINE
FEMORAL VS INGUINAL HERNIA
UPPER MEDIAL BORDER OF FEMORAL HERNIA > ALWAYS BELOW + LATERAL TO PUBIC TUBERCLE
WHY SHOULD YOU NEVER TRY MANUAL REPOSITIONING OF STRANGULATED UMBILICAL HERNIA?
MANUAL REPOSITIONING = TAXIS
> shifts strangulated bowel loop from one location to another
false positive success of taxis
HERNIA WHICH GETS INCARCERATED OFTEN + SHOULD BE REPAIRED AS SOON AS DIAGNOSED?
FEMORAL HERNIA
MOST COMMON USED HERNIA REPAIR?
LICHTENSTEIN REPAIR
WHICH INTERNAL ORGAN IS FOUND IN HERNIA SAC OF INGUINAL HERNIA?
OMENTUM
SMALL INTESTINE
