inguinal regions and hernias

Question 1

what is a hernia

Answer 1

a buldge created by a rupture of a containing structure

Question 2

where are hernias most common ?

Answer 2

most common in abdomen

and weakend areas

Question 3

what is hernia strangulation and why is it caused ?

Answer 3

some hernias can contain viscera

if the blood supply of this is comparised organ will necrose = strangulation

Question 4

what is another way hernias might occur ?

Answer 4

can occur when pressure with the abdominal wall is greater then the pressure outside

Question 5

what are the most common site for hernias ?

Answer 5

femoral
inguinal
umbilical
hiatal ( in those over 50)

Question 6

what are the 2 types of umbilical hernias ?

Answer 6

congenital

acquired

Question 7

what is an umbilical hernia an indication of after birth ?

Answer 7

indicated failure to close umbilical scar

Question 8

where does a hiatus hernia occur ?

Answer 8

occurs through the oesphageal hiatus or the esophagel opening in the diaphragm

Question 9

what are the 2 types of hiatus hernias ?

Answer 9

sliding hiatus hernia

rolling hiatus hernia

Question 10

where is the femoral sheath ?

Answer 10

behind the inguinal ligament

Question 11

what is found in the femoral canal ?

Answer 11

lymphatic

Question 12

what is a femoral hernia ?

Answer 12

protrusion through the femoral canal + the saphenous opening

Question 13

who are femoral hernias more common in and why ?

Answer 13

females

have wider hips = wider femoral canals

Question 14

when do femoral hernias get strangulated ?

Answer 14

when they push against the lacumar ligament

Question 15

why is the inguinal area weak ?

Answer 15

there is a gap which is created for the gonads

Question 16

where is the inguinal ring ?

Answer 16

located laterally to inferior epigastric artery - 1.25 cm above midpoint of inguinal ligament
exit of the canal is an opening in the external obliques = superficial inguinal ring

Question 17

what is the function of the inguinal canal ?

Answer 17

connects the spermatic cord from the testes to the pelvic cavity

Question 18

what is the spermatic cord ?

Answer 18

refers to structures that have left the inguinal canal

Question 19

what nerve lies on the surface of the spermatic cord ?

Answer 19

ilioinguinal nerve

Question 20

what nerve is found in the wall of the spermatic cord ?

Answer 20

genitofemoral nerve

Question 21

what are the 3 boundaries of the inguinal canal and what defines them ?

Answer 21

roof
wall
floor

anterior wall = external oblique aponeurosis + internal olbiques
posterior wall = transversalis fascia + conjoined tendon
floor = upturned external oblique
roof = arched fibres of conjoined tendon from internal olbique + transversus abdominis

Question 22

how many layers of the inguinal canal is there ?

Answer 22

4

Question 23

describe the deepest layer of the inguinal canal ?

Answer 23

is the transverse fascia

forms the deep inguinal ring and inner layer of spermatic cord

Question 24

describe the 2nd deepest layer of the innguinal canal

Answer 24

formed from the internal oblique contributes muscle + fascia to spermatic cord
muscle is called the cremaster muscle
fascia is called cremasteric fascia

Question 25

describe the 2nd most superficial layer of the inguinal canal

Answer 25

made up of conjoined tendon however the transverse abdominis doesnt contribute to the spermatic cord

Question 26

describe the most superficial layer of the inguinal canal

Answer 26

formed of the external oblique forms the superficial inguinal ring + spermatic cord called the external spermatic fascia

Question 27

where does a femoral hernia emerge from ?

Answer 27

from the femoral canal

Question 28

where does an inguinal hernia emerge from ?

Answer 28

through the superficial inguinal ring

Question 29

why is an inguinal hernia more common in males ?

Answer 29

men have wider inguinal canal dues to the spermatic cord passing through it

Question 30

what hernia is more common ? inguinal or femoral ?

Answer 30

inguinal

Question 31

how are femoral + inguinal hernias differentiated ?

Answer 31

by the position of their root

Question 32

where is the root of a femoral hernia found ?

Answer 32

lies below + lateral to pubic tubercle

Question 33

where is the root of an inguinal hernia ?

Answer 33

lies above and medial to pubic tubercle

Question 34

what forms the spermatic cord ?

Answer 34

is formed by the descent of the testes down the abdominal wall , descent leaves a trail of neurovascular bundles = spermatic cord

Question 35

where do the 3 walls of the spermatic cord come from ? what are the 3 walls called ?

Answer 35

3 walls comes from the obliques + the transversalis fascia external obliques = external spermatic fascia internal obliques = cremasteric muscle + fascia transversalis fascia = internal spermatic fascia

Question 36

what are the names of the fascia in the testes ?

Answer 36

campers fascia = dartos fascia | scarpas fascia = colles fascia

Question 37

why is the testes covered in smooth muscle ? what is the name of this muscle ?

Answer 37

covered in smooth muscle so that it is kept cool. ( no fat in smooth muscle ) dartos muscle

Question 38

what is the processus vaginalis ?

Answer 38

perfusion of the peritoneal membrane

Question 39

what is hydrocele testis ?

Answer 39

and enlargement of the testes caused by an increased amount of fluid in the tunica vaginalis

Question 40

what is an indirect inguinal hernia ?

Answer 40

refers to a hernia through the inguinal canal

Question 41

how can you feel for an indirect inguinal hernia ?

Answer 41

placing finger in scrotal wall | hernia is felt emgering from superficial inguinal ring

Question 42

where is a direct inguinal hernia found ?

Answer 42

at the inguinal triangle

Question 43

what is the inguinal triangle ?

Answer 43

area of weakness in the lower abdominal wall

Question 44

what are the boarders of the inguinal triangle and how are they formed ?

Answer 44

medila , lateral , inferior medial boarder = lateral margin of rectus abdominis lateral boarder = inferior epigastric artery inferior = inguinal ligament

Question 45

why is the lower half of the inguinal triangle at the most risk of hernias ?

Answer 45

only protection is the transversalis

Question 46

how does the inguinal triangle try to prevent herniation ?

Answer 46

conjoint tendon is pulled downards during its contraction

Question 47

what controls the contraction of the conjoined tendon ?

Answer 47

ilioinguinal nerves