What is the femoral triangle boundaries?
Superiorly - Inguinal ligament
Laterally - Sartorius
Medically- Adductor longus
What is the femoral sheath?
Fascial tube 3-4cm below inguinal ligament that cantains the femoral vein, artery, and deep inguinal lymph nodes but NOT femoral Nerve
What is the proper organization of the vein artery nerve in the femoral triangle?
NAVeL Lateral to Medial
Nerve,Artery,Vein,empty, Lymph
The layers of abdominal muscles superficial to deep?
External Oblique
Internal Oblique
Transversus Abdominis
Tranversalis facsia
The spermatic cord is composed of what layers of aponeurosis?
ICE tie
Internal spermatic fascia = tranversalice
Cremasteric muscle = internal oblique
External spermatic fascia = external oblique (anatomic hole passes the spermatic cord thru this structure)
What is a hernia?
A protrusion of peritoneum through an opening, usually at a site of weakness
What is at risk when you have a hernia?
incarceration = can't go back
Strangulation = ischemia
What are the four major types of hernias?
Diaphragmatic
Indirect inguinal
Direct inguinal
Femoral
What is a diaphragmatic hernia (Hiatal hernia)?
Abdominal structures enter the thorax thru weakness or congenital defect?
Which size is a diaphragmatic hernia most common?
left because liver protects the right.
What are the two subtypes of diaphragmatic hernias?
Sliding and para-esophageal
What is a sliding hernia?
Gastroesophageal junction is displaced upward
gives Hourglass stomach
What is a paraesophagel hernia?
Fundus protrudes into the thorax.
What are the locations of ingual (direct/indircet) and femoral?
Direct inguinal is medial to inf epigastic vessels
Indirect inguinal is Lateral to inf. epigastic vessels
Femoral in inferior to inguinal ligament and medial to femoral vessels
Indirect inguinal hernia enter where?
DEEP inguinal ring into scrotum (covered by same three layers as spermatic fascia)
Lateral to inf. epigastric vessels
What may causes indirect inguinal hernias in infants?
failure of processus vaginalis to close
Males>>>females
Where does a direct inguinal hernia go?
Directly thru inguinal(hesselbach) triangle.
Medial to inf. epigastric vessels
ONLY EXTERNAL part of spermatic cord
Femoral Hernias more common in men or women?
COmplications?
Women
Strangulation higher risk
What is the inguinal (Hesselbach) triangle?
Inferior Epigastric vessels
Lateral Rectus Abdominis
Inguinal Ligament