Inguinal Canal and Hernias Flashcards Preview

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Flashcards in Inguinal Canal and Hernias Deck (27)
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0
Q

What is the congential thing that can lead to an inguinal hernia?

A

During development, canal is flanked by an outpocket of the peritoneum - the processus vaginalis
This normally degenerates
Failure to do so can result in a hernia

1
Q

Where is relation to the inguinal ligament is the inguinal canal?

A

Superior to the ligament

2
Q

Which type of hernia is due to a congential abnormality?

A

Indirect

3
Q

What is the mid-inguinal point?

A

Halfway between the pubic symphysis and the ASIS

Where the femoral artery crosses into the lower limb

4
Q

Where is the midpoint of the inguinal ligament?

A

As it says
Inguinal ligament runs between the pubic tubercle to the ASIS so halfway between these two
Opening of the inguinal canal is just above it

5
Q

Boundaries of the inguinal canal?

A

Anterior wall - aponeurosis of the external oblique, reinforced by the internal oblique muscle laterally

Posterior wall - transversalis fascia

Roof - transversalis fascia, internal oblique and transversus abdominis

Floor - inguinal ligament, thickened medially by the lacunar ligament

6
Q

What is the inguinal ligament?

A

A rolled up portion of the external oblique aponeurosis

7
Q

During increased intra-abdominal pressure, how are abdominal viscera prevented from herniation?

A

Muscles of the anterior and posterior abdominal wall contract and clamp down on the canal

8
Q

Where is the deep (internal) ring of the inguinal canal found?

A

Above the midpoint of the inguinal ligament, lateral to epigastric vessels

9
Q

What is the deep inguinal ring created by?

A

Invagination of the transversalis fascia

Forms a covering of the contents of the inguinal canal

10
Q

Where is the superficial ring of the inguinal canal found?

A

Just superior to the pubic tubercle

11
Q

What passes through the inguinal canal?

A

Men - Spermatic cord which supplies and drains the testes

Women - Round ligament of the uterus

12
Q

Which rings does an indirect hernia pass through?

A

Enters via the deep inguinal ring and can then go as far as the superficial ring

13
Q

What rings does a direct inguinal hernia involve?

A

Not the deep ring

Protrudes through the posterior wall of inguinal canal

14
Q

Why does a direct hernia occur?

A

Weakening of the abdominal musculature

15
Q

Which is the most common type of inguinal hernia?

A

Indirect hernia

16
Q

How to distinguish between a direct and indirect hernia?

A

Place hand over superficial inguinal ring
Ask patient to cough
If it still pushes through, it is a direct hernia

17
Q

Where is an epigastric hernia?

A

Hernia of the epigastric region through the linea alba

Occurs in midline between xiphoid process and umbilicus

18
Q

Risk factors for an epigastric hernia?

A

Obesity

Pregnancy

19
Q

Why is an umbilical hernia common in neonates?

A

May have weakness/incomplete closure of their abdominal wall after litigation of the umbilical cord at birth

20
Q

Risk factors for umbilical hernias in adults?

A

Women

Obesity

21
Q

What is a femoral hernia?

A

Protrusion of abdominal viscera into the femoral canal through the femoral ring

22
Q

Where does a femoral hernia appear?

A

In the femoral triangle

23
Q

What are femoral hernias bounded by?

A

Femoral vein laterally

Lacunar ligament medially

24
Q

Who are femoral hernias more common in?

A

Females

25
Q

Complications of hernias and their definition?

A

Strangulation - constriction of blood vessels

Incarceration - hernia can’t be reduced or pushed back into place easily

26
Q

Why can a femoral hernia easily become strangulated?

A

Sharp rigid boundaries of femoral ring