Lecture 8-Abdominal Wall and Hernias Flashcards
(27 cards)
Define hernia
Protrusion of part of the abdominal contents beyond the confines of its containing cavity
What are the 3 parts of a hernia?
- sac = pouch of peritoneum
- contents of the sac = structures within the abdominal cavity
- coverings of the sac = layers of abdominal wall through which hernia has passed
What are areas of potential weakness in the abdominal wall?
- inguinal canal
- femoral canal
- umbilicus
- previous incisions
The inguinal canal is halfway between which structures?
Pubic tubercle and ASIS
What forms the anterior wall of the inguinal canal?
Aponeurosis of external oblique muscle
What forms the floor of the inguinal canal?
Inguinal ligament and lacunar ligament medially
What forms the roof of the inguinal canal?
Arching fibres of internal oblique and transversus abdominus
What forms the posterior wall of the inguinal canal?
Transversalis fascia and conjoint tendon (internal oblique and transversus abdominus)
When do the testes descend in males?
7/8th month
What does the processus vaginalis form when it is obliterated?
Tunica vaginalis
What happens if the processus vaginalis doesn’t obliterate?
There will be a connection between the scrotum and peritoneal cavity -> inguinal or scrotal hernia
What do indirect inguinal hernias pass through?
Through deep inguinal ring -> canal -> superficial inguinal ring (could descend into scrotum if processus vaginalis not obliterated)
Anatomically, what is the difference between indirect and direct inguinal hernias?
Indirect - lateral to inferior epigastric vessels
Direct - medial to inferior epigastric vessels
What do direct inguinal hernias pass through?
Hesselbach’s triangle (near superficial inguinal ring)
What forms the medial border of Hesselbach’s triangle?
Rectus abdominus
What forms the superior border of Hesselbach’s triangle?
Inferior epigastric vessels
What forms the inferior border of Hesselbach’s triangle?
Inguinal ligament
Why are femoral hernias more common in females?
Females have a wider femoral ring (entrance to femoral canal)
What is medial to the femoral ring?
Lacunar ligament
What is lateral to the femoral ring?
Femoral vein
What happens if a hernia gets strangulated?
Blood supply gets compromised -> necrosis -> sepsis
What happens if a hernia is incarcerated?
Irreducible (can’t be pushed back into abdomen)
What is a congenital umbilical hernia?
Omphalocoele = persistence of physiological herniation of midgut, contents herniate into umbilical cord and have a peritoneal covering
What is an acquired infantile umbilical hernia?
Contents herniate through weakness in scar of umbilicus, has skin covering
