07 Hernia

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• inhale, diaphragm moves down and closes structures/bowels, herniation

3 locations

• diaphragm where esophagus pokes through
• umbilicus
• inguinal

Femoral Structure

• inguinal ligament between superior iliac spine and pubic symphysis
• find femoral artery by feeling for pulsation. Medial is vein. Lateral is nerve

• look down from top
• femoral ring contained in vein that carry lymphatics
• femoral sheath contain vein, artery, ring

Inguinal Canal

• on top of inguinal ligament

Hernia

Indirect

• testes form within process
• opening should seal

• develop in adulthood with years of bearing down

Direct

• indirect in spermatic cord, fascia
• direct outside spermatic fascia

• transversalis fascia weak and breaks down

Femoral

Ventral Hernia

Hiatal Hernia

• obesity: stomach forced up

• GE junction slides up

• phrenoesophageal membrane in diaphragm not sealed
• gurgling in stomach heard in abdomen

Diaphragmatic Hernia