- forms from fusion of aponeurosis of abdominal muscles, separates left and right rectus abdominis muscles, fibrous line from xiphoid process down to pubic symphysis
- becomes pigmented in pregnancy (linea nigra)
- tendinous line on lateral boundary of rectus abdominis, formed by aponeurosis of internal oblique, hernia through it is a spontaneous lateral ventral hernia
- previous attachment site of umbilical cord
- umbilical hernias: abdominal contents herniate out through umbilicus (surrounded by peritoneum), d/t open umbilicus, incr abdominal pressure d/t obesity, heavy lifting, long Hx of coughing, multiple pregnancies
Superficial Inguinal Ring:
- exit of inguinal canal, conducts spermatic cord into scrotum
- on exam, impulse felt w/ coughing for both direct & indirect hernias
- contains structures going to and from testes, suspends testes
- runs from deep inguinal ring, thru inguinal canal, out superficial inguinal ring, to scrotum and posterior testes
- vas deferens (sperm from testes) & its aa.
- pampiniform venous plexus
- testicular aa.
- cremaster aa.
- autonomics, genital branch of genitofemoral nn. (cremaster muscle)
- vasectomy: cut and ligate ends of vas deferens
- protrusion of organ or tissue thru opening
- 6 Fs: fat, food, fluid, feces, flatus, fetus (put pressure on abdominal wall)
- 75% of abdominal hernias
- lateral to inferior epigastric vessels, travels thru spermatic cord to scrotum
- more common on right side in men, assoc w/ persistent processus vaginalis, congenital
- less common
- acquired, d/t weakened abdominal wall of inguinal lig.
- medial to inferior epigastric vessels, lateral to conjoint tendon, in inguinal triangle
- rarely goes to scrotum
Pantaloon hernia (direct & indirect on same side)
Obturator hernia (through obturator foramen (opening b/w pubic bone and ischium), rare, women, assoc. w/ bowel obstruction
Femoral hernia (through wall of femoral canal, just below inguinal lig.), assoc. w/ bowel obstruction
- Median Umbilical lig.: remnant of urachus (umbilicus to bladder)
- Medial Umbilical lig.: obliterated umbilical aa.
-direct hernia is lateral to it
- Lateral Umbilical lig.: inferior epigastric aa.
- point of weakness, possible site of direct hernias
-linea semilunaris (lateral border of rectus abdominis)
-inferior epigastric aa.
area of skin supplied by one spinal cord segment (dorsal + ventral rami)
- attachment site of inguinal lig.