Hiatal Hernia Flashcards
hernia
= abd organ protuding through muscle or fascia (sheet of CT)
- can be through body wall or from one organ cavity to another
2 requirements for hernia
- weakened area in structure
2. inc intra-abd pressure
weakened area in structure causes
- acquired (ex. physical trauma, weak spot at Sx incision)
- congenital
- aging (tissue degenerates)
hiatal hernia
part of stomach protrudes into TC d/t hiatus weaken/enlarges + inc intra-abd pressure
hiatus
where esophagus goes through diaphragm (hole); “a gap in sequence”
2 types of hiatal hernias
- axial or sliding
2. paraesophageal or nonaxial
axial or sliding hernia
- GEJ & upper part of stomach extends into TC
- bell shape hernia
axial or sliding hernia mnfts
- chest pain
- reflux
- heartburn
why is there chest pain with axial or sliding hernia
new pressure applied to stomach + inflm
why is there reflux with axial or sliding hernia
content from stomach (acid) moves into esophagus d/t pressure exerted onto stomach from diaphragm (hiatus)
why does heartburn occur in axial or sliding hernia
d/t reflux
paraesophageal or nonaxial hernia
GEJ remains below diaphragm but non-upper part of stomach protrudes into TC
mnfts of paraesophageal or nonaxial hernia
- pain
- dyspnea
- fullness
- no reflux occurs
why does dyspnea occur with paraesophageal or nonaxial hernia
herniated portion takes space in TC and impedes left lung expansion causing difficulty breathing
why does fullness occur with paraesophageal or nonaxial hernia
- herniated portion of stomach forms “mini stomach” that gets full easily, it activates stretch receptors that signal brain stomach is full
- herniated portion fills before actual stomach
