Session 4 - Hernia And Abdominal Wall

Question 1

What is a hernia?

Answer 1

A protrusion of part of the abdominal contents beyond the normal confines of the abdominal wall.

Question 2

What is the sac of an abdominal hernia?

Answer 2

Peritoneum

Question 3

Why might someone develop a hernia?

Answer 3

Weakness in the abdominal wall.
Inguinal canal
Femoral canal
Incisional hernia

Question 4

Where does the inguinal ligament go to and from?

Answer 4

Pubic tubercle and ASIS

Question 5

What passes through the inguinal canal?

Answer 5

Males - spermatic cord to testes.

Females - round ligament to labia majora

Question 6

When do testes descend?

Answer 6

At 7-8 months of development

Question 7

What is the processus vaginalis?

Answer 7

An outpouching of the peritoneum

Question 8

What is the gubernaculum?

Answer 8

Condensed band of mesenchyme that links the inferior portion of the gonad to the labioscrotal swelling.
Acts as a guide for the gonadal descent

Question 9

What forms the anterior wall of the inguinal canal?

Answer 9

The aponeurosis of external oblique and reinforced by internal oblique laterally.

Question 10

What forms the floor of the inguinal canal?

Answer 10

The inguinal ligament; which is the rolled edge of the external oblique aponeurosis. Thickened medially by the lacunae ligament.

Question 11

The roof of the inguinal ligament?

Answer 11

Arching fibres of internal oblique and transverse abdominus

Question 12

The posterior wall of the inguinal canal?

Answer 12

Transversalis fascia

Question 13

Where is the deep ring of the inguinal canal?

Answer 13

The transversalis fascia

Question 14

Where is the superficial ring of the inguinal canal?

Answer 14

The anterior wall - the aponeurosis of external oblique

Question 15

Which vessels are an important landmark in distinguishing between direct and indirect inguinal hernias?

Answer 15

Inferior epigastric vessels

Question 16

Which inguinal hernia occurs medially to the inferior epigastric vessels?

Answer 16

Direct inguinal hernia

Question 17

Which inguinal hernia occurs laterally to the inferior epigastric vessels?

Answer 17

Indirect inguinal hernia

Question 18

What embryological remnant allows indirect inguinal hernias to occur?

Answer 18

Patent processus vaginalis

Question 19

What is the importance of Hesselbachs triangle?

Answer 19

It is an area of weakness in the abdominal wall which allows direct inguinal hernias to pass through

Question 20

The inferior border of Hesselbachs triangle?

Answer 20

Inguinal ligament

Question 21

The medial border of Hesselbachs triangle?

Answer 21

Rectus abdominus muscle

Question 22

The superior border of Hesselbachs triangle?

Answer 22

Inferior epigastric vessels

Question 23

Which sex are femoral hernias most common in?

Answer 23

Female

Question 24

Which sex are inguinal hernias more common in?

Answer 24

Male

Question 25

What is the femoral canal?

Answer 25

The empty space between the femoral vein and the lymphatics of the thigh

Question 26

Entrance to the femoral canal is called..?

Answer 26

Femoral ring

Question 27

What term refers to a hernia which is stuck? | How can you tell?

Answer 27

Incarcerated | It is not reducible

Question 28

What is the difference between an incarcerated and strangulated hernia?

Answer 28

Incarcerated is stuck. | Strnagulated is probably stuck too, but also with blood supply cut off.

Question 29

What is an omphalecele?

Answer 29

Congenital Abdominal contents herniate into the umbilical cord Has peritoneal covering

Question 30

What is an acquired infantile umbilical hernia?

Answer 30

Abdominal contents herniate through weakness in scar of umbilicus

Question 31

What is an acquired adult umbilical hernia?

Answer 31

Goes through linea alba in region of umbilicus.

Question 32

hat is an epigastric hernia?

Answer 32

Linea alba | Between xiphoid process and umbilicus

Question 33

Symptoms of hernia?

Answer 33

Achey - pain Obstruction -> vomiting Strangulation -> sepsis.

Question 34

What is the linea alba?

Answer 34

The midline fusion of the rectus abdominus.