Inguinal Region and Hernias

Question 1

Hernias

Answer 1

Protrusion of peritoneum through abdominal walls, abdominal roof or pelvic floor
Can just be a protrusion of parietal peritoneum or maintain intestinal vescera

Question 2

Locations of common occurence

Answer 2

At linea alba at umbilicus, epigastric region
Umbilical hernias, common in babies, intestines grow too fast but normally return to abdominal cavity
Inguinal and femoral regions

Question 3

Inguinal hernias

Answer 3

Inguinal canal between deep and external inguinal ring allows spermatic cord/round ligament/vessels/ilioinguinal nerves through
Lies above pubic tubercle
Forms a weak spot, more likely to occur in males

Danger, lacunar ligament, v tough, can cut into hernia => strangulation

Question 4

Inguinal canal

Answer 4

Transversalis fascia forms deep ring, covers spermatic cord
Internal oblique, transversus abdominal form roof of canal above spermatic cord, forms conjoint tendon which meets at pubic crest

Question 5

Descent of testes

Answer 5

Tissue that will form gonads guided down gubernaculum
Inguinal canal, pathway by which testes leave abdominal cavity
Same in females, stays in pelvis, gubernaculum forms round ligament

Question 6

Formation of spermatic cord

Answer 6

Testes between peritoneum and transversals fascia

Descends down and out

Question 7

Structure of inguinal region

Answer 7

Peritoneum = visceral and parietal tunica vaginalis
Transversalis fascia = internal spermatic fascia
Internal oblique = Cremaster muscle
External oblique = external spermatic fascia
Scarpers fascia = dartos

Internal ring = peritoneum and transversals fascia region
Superficial ring = external and internal oblique, peritoneum, transversalis fascia

Peritoneal fluid found surrounding testes
No Campers fascia, no insulation
If patent processus vaginalis present, peritoneal fluid accumulates, forms hydrocele

Question 8

Inguinal triangle

Answer 8

Epigastric vessels
Side of rectus abdominis
Inguinal ligament

Area of weakness

Question 9

Why is the superficial ring weak and what is done to reduce the likelihood of a hernia forming

Answer 9

Only supported by thin layer of transversalis fascia

When muscles contract, conjoint tendon moves down, decreases space for inguinal hernia formation in traingle

Question 10

What is a direct hernia

Answer 10

Pass through superficial ring

Question 11

What is an indirect hernia

Answer 11

Pass through superficial and deep ring