Flashcards in Week 3 - Anterior abdominal wall and hernias Deck (16):
What is the inguinal canal? Where is it?
-An oblique passage between the deep and superficial inguinal rings
-Lies between external oblique and internal oblique and directly above the inguinal ligament
Where is the inguinal ligament?
-Inferior border of aponeurosis of external oblique
-Runs from ASIS to pubic tubercle
What are the normal contents of the inguinal canal?
-Spermatic cord in men
-Round ligament of uterus in women
-Ilioinguinal nerve (partially)
What are the two potential sites of weakness in anterior abdominal wall which lead to inguinal hernias?
-Deep inguinal ring
What is a hernia?
-Protrusion of part of an abdominal organ through the abdominal wall
What is a hernial sac covered by?
-structures through which it passes
eg skin, SCT
Describe an indirect inguinal hernia
-Bowel pushes through deep inguinal ring travels down the inguinal canal and pushes through superficial inguinal ring to appear in scrotum or labia majora
Who is indirect inguinal hernia most common in?
Describe hesselbachs triangle
-Weak area of anterior abdominal wall defined by:
Medial border -> lateral margin of rectus sheath/linea semulunaris
Superiolateral border -> Inferior epigastric vessels
Inferior border -> Inguinal ligament
Describe a direct inguinal hernia
-Bowel pushes through an area in hesselbachs triangle and extends down and out of the superficial inguinal ring to appear in scrotum or labia majora
Describe a femoral hernia
-Bowel protrudes through femoral ring of femoral canal
-More common in females due to wider pelvis (but overall still less common than inguinal)
Describe an umbilical hernia
-In children it is protrusion through umbilical scar
-in adults it is protrusion through linea alba anywhere between xiphersternum and umbilicus (includes epigastric and paraumbilical hernias
Describe a diaphragmatic hernia
-Caused by developmental defects of the diaphragm which allows the intestine to herniate into the chest
Describe a hiatus hernia
-Special diagphragmatic hernia
-Can be sliding whereby gastro-oesophageal junction slides through diaphragm into chest
-Can be rolling where fundus of stomach passes into chest alongside oesophagus
What is an incisional hernia?
-Surgical scar breakdown due to obesity or poor abdominal musculature