hernias Flashcards
What are the boundaries of
Hesselbach’s triangle?
- Inferior epigastric vessels
- Inguinal ligament (Poupart’s)
- Lateral border of the rectus sheath
Floor consists of internal oblique and the
transversus abdominis muscle
what is a direct hernia
Hernia within the floor of Hesselbach’s
triangle, i.e., the hernia sac does not
traverse the internal ring (think directly
through the abdominal wall)
cause of direct hernia
Acquired defect from mechanical
breakdown over the years
what is an indirect hernia
Hernia through the internal ring of the
inguinal canal, traveling down toward the
external ring; it may enter the scrotum
upon exiting the external ring (i.e., if
complete); think of the hernia sac traveling
indirectly through the abdominal wall
from the internal ring to the external ring
cause of indirect hernia
Patent processus vaginalis (i.e., congenital)
What is the first identifiable
subcutaneous named layer?
Scarpa’s fascia (thin in adults)
What is the name of the subcutaneous
vein that is ligated?
Superficial epigastric vein
What happens if you cut the
ilioinguinal nerve?
Numbness of inner thigh or lateral
scrotum; usually goes away in 6 months
From what abdominal
muscle layer is the cremaster
muscle derived?
Internal oblique muscle
From what abdominal
muscle layer is the inguinal
ligament (a.k.a. Poupart’s
ligament) derived?
External oblique muscle aponeurosis
To what does the inguinal
(Poupart’s) ligament attach?
Anterior superior iliac spine to the pubic
tubercle
Which nerve travels on the
spermatic cord?
Ilioinguinal nerve
What is in the spermatic
cord (6)?
- Cremasteric muscle fibers
- Vas deferens
- Testicular artery
- Testicular pampiniform venous plexus
- +/- hernia sac
- Genital branch of the genitofemoral
nerve
What is the hernia sac
made of?
Peritoneum (direct) or a patent processus
vaginalis (indirect)
What attaches the testicle to
the scrotum?
Gubernaculum
