Abdominal Hernia

Spigelian hernias, also known as lateral  , are a type of
abdominal hernia along the  , resulting in herniation
between the muscles of the abdominal wall

The inguinal region is area of the  

The  represents an area of weakness in the anterior abdominal
wall, especially in males, owing to the prenatal penetration of the wall
by the and  .

The superficial inguinal ring is triangular in shape with its base located
at and formed by the , and its apex is  .

• The sides of the ring are formed by the   and 
(“legs”) of the superficial ring.

• The  inserts on the pubic tubercle
• The  inserts on the pubic symphysis

In the superifical inguinal ring
-  in the male
-  in the female
-  nerve

Ilioinguinal nerve [L1] (male and female) transits
through the ring to supply the skin over the
 . Also the skin of the
 ,  ,  , or
 .

Boundaires of the inguinal canal

The  = slit-like opening in the fascia transversalis

The   = a triangular opening in the EOM aponeurosis

Indirect inguinal hernia leave the abdominal cavity  to the  , traverse the deep inguinal ring, inguinal
canal, and superficial inguinal ring.

In indirect inguinal hernias, hernial sac is contained within the 
because they follow the route taken by the testis, and it is
covered by the 3 layers ( ,
  and  ) of the spermatic
cord.

Direct inguinal hernias protrude  through the posterior wall of inguinal cavity and leave the abdominal cavity   to inferior epigastric vessels

Direct inguinal hernias pass through the  

The hernial sac in direct hernias parallels the  

The inguinal canal is an oblique passage measuring approximately 4-5 cm in the adult,
through the   of the   wall

Boundaires of the superifical inguinal ring
•  (inferior)
•   (lateral)
•   (medial)

TEST QUESTION
  = slit-like opening in the fascia transversalis
  = a triangular opening in the EOM aponeurosis

Indirect Inguinal Hernias are congenital or aquired?

Direct Inguinal Hernias are congenital or aquire ?

Indirect hernias can be palpated lateral to the  

Direct hernia goes through the   by entering on the side and out the  . Indirect will travel   from deep ring to superifical.

Direct Inguinal Hernia: Hernating bowel passes   to the inferior epigastric vessels and push through the peritoneum and transversalis fascia in the inguina triangle to eneter canal.

Indirect Inguinal Hernia: Hernating bowel passes   to inferior epigastric vessels to enter inguinal ring.

The  forms the cremaster muscle

What is NOT a content of the spermatic cord?

The   vein drainage is more likely to be backed up

Left testicular drains into   at 90 angle the right testicular drians into the  

Testicular veins = they begin in the testes as an extensive
venous plexus (pampiniform plexus)
•The right testicular vein leaves the plexus as a single vein and
drains directly into the 
•The left testicular vein leaves the plexus as a single vein and
drains into the  

The   is a content of the inguinal canal BUT NOT a content of the
spermatic cord.

The cremasteric reflex is a superficial reflex that when absent indicates  

The   arm of the reflex is the ilioinguinal nerve (L1) that
supplies the anterosuperior skin of the thigh.

The   arm is the genital branch of the genitofemoral nerve
(L1-L2) through the superficial inguinal ring.

The   of the
genitofemoral nerve supplies the cremaster muscle.

Abdominal reflex is stimulated by scraping the
  to or towards the  .