Hernias

Question 1

Boundaries of inguinal canal

Answer 1

• Anterior wall
• *- Ext oblique aponeurosis**
• Floor
• *- Inguinal ligament**
• Roof
• *- Int oblique aponeurosis**
• *- Transversus abdominus**
• Posterior wall
• *- Transversalis fascia**
• *-** Reinforced by conjoint tendon

Question 2

The inguinal canal contains:

Answer 2

• Spermatic cord
• Vas deferens
• Testicular artery
• Pampinaform plexus veins
• Lymphatics
• Nerve
• Ilioinguinal nerve

Question 3

Deep + superfical inguinal ring

Answer 3

Deep:

• Opening in transversalis fascia
• Located at midpoint of inguinal ring
• Just lateral to inferior epigastric vessels

Superficial:

• Opening in external oblique aponeurosis

Question 4

Subinguinal space contains:

Answer 4

• Psoas major muscle
• Iliacus muscle
• Femoral nerve, artery + vein
• Lateral cutaneous nerve

Question 5

Hesselbach’s triangle

Answer 5

= area of weakness in abdominal wall

• Direct inguinal hernia location

Borders:

• *- Lateral rectus abdominis** (medial)
• *- Inferior epigastric vessels** (lateral)
• *- Inguinal ligament** (inferior)

Question 6

Indirect hernia

Answer 6

Herniation of bowel through deep ring

• Deep ring → inguinal canal → superfical ring → scrotum
• Lateral to inferior epigastric artery

Question 7

Direct hernia

Answer 7

Herniation of bowel through inguinal (‘Hesselbach’s’) triangle

• Medial to inferior epigastric artery