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Hernia and its related anatomy Under the supervision of Dr \Moheb Monier Anatomy Department

Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

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Page 1: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Hernia and its related anatomy

Under the supervision of

Dr \Moheb Monier

Anatomy Department

Page 2: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

91-Esraa Raafat Ahmed Ghanem

92-Esraa Reda Hashem Tawfik93-Esraa samy Farid Abd Elghaffar

94-Esraa Saad Abbas Hamed95-Esraa Shawky Abdelhak Abolaban

96-Esraa Sobhi Mohamed Abdelaziz97-Esraa Sabry Mohamed Ahmed Ali

98-Esraa Taher Elhossieny Farag100-Esraa Ezzat Afify Sharf

Team Members:

Page 3: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

INTENDED LEARNING OUTCOMES(ILOS):

1-Define inguinal canal 2-Know the extenet of it. 3-Enumerate the boundaries4-Enumerate the contents5-List some notes about femoral canal . 6- Define henia. 7-Explain causes of hernia 8- List the types of hernia in details.

9-Know symptoms and diagnosis of hernia in male and female. 10-Learn how to manage or treat hernia and how to avoid it

By the end of this presentatioin you will be able to:

Page 4: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

It is found within the aponeurosis of the external oblique, immediately above the crest of the pubis, 1 centimeter above and lateral to the pubic tubercle. It has medial and lateral crura. It is at the layer of the 

aponeurosis of the obliquus externus abdominis.

Definition of inguinal canal:

Page 5: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

EXTENT OF INGUINAL CANAL

1-The superficial inguinal ring (subcutaneous inguinal ring ) is an anatomical structure in the anterior wall of the human abdomen. It is a triangular opening that forms the exit of the inguinal canal. At the other end of the canal, the deep inguinal ring forms the entrance,it is found through fascia transversalis.

2-The surface marking of the deep inguinal ring is classically described as immediately above the midpoint of the inguinal ligament (midway between the anterior superior iliac spine and the pubic tubercle).

Page 6: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Boundaries of the inguinal canal Floor:

- medial ½ of upper concave surface of inguinal ligament

- the lacunar ligament at the medial end

Page 7: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Anterior wall :

- External oblique aponeurosis (along its whole length )-internal oblique ( in its lateral 1/3 )

Page 8: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Roof: - Arched fleshy fibers of the internal oblique and transversus abdominis

Page 9: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Posterior wall:

From behind forwards

-Fascia transversalis (along its whole length)

-Conjoint tendon (in its medial) ½ -Reflected part of

the inguinal ligament (in its medial ¼ )

Page 10: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

The content of inguinal canalThe structures which pass through the canal differ between males and females:in males : the spermatic cord and its coverings the ilioinguinal nerve.in females : the round ligament of the uterus the ilioinguinal nerve.

Page 11: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Note :that the ilioinguinal nerve passes through the superficial ring to descend into the scrotum in males and labia majora in females, but does not formally run through the canal.

Page 12: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Hernia is a general term used to describe a bulge or protrusion of an organ through the structure or muscle that usually contains it.

There are many different types of hernias. The most familiar type are those that occur in the abdomen, in which part of the intestines protrude through the abdominal wall. This may occur in different areas and, depending on the location, hernia is given a different name

DEFINTION OF HERNIA

Page 13: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

What Causes a Hernia?

muscle weakness strain

Page 14: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Common causes of muscle weakness

-Failure of the abdominal wall to close properly in the womb (congenital defect)

-Age -suddenly gaining weight

-Damage from injury or surgery

Page 15: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Factors that strain your body and may cause a hernia

pregnancy

constipation ascites

heavy weight lifting Chronic

coughing

(especially if your muscles are weak)

Page 16: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Am I At Risk for a Hernia?Several factors increase your risk of developing a hernia, including:

a personal or family history of hernias

overweight or obese

a chronic coughchronic

constipation

smoking

(which can trigger a chronic cough)

Page 17: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

Treatment of femoral hernia1 -Femoral hernia: If you feel sudden pain in your groin, a piece of intestine

may be stuck in the hernia .This needs treatment right away in a hospital emergency room, and you may need emergency surgery.

Types of surgery: 1- open 2-

Page 18: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

1-Laparoscopic surgery — In laparoscopic hernia repair, a surgeon makes three small incisions in the abdominal wall and then inflates the abdomen with a harmless gas. The surgeon then inserts a laparoscope through the incisions. A laparoscope is a tube-like instrument with a small video camera and surgical instruments. While viewing the internal scene on a monitor, the surgeon pushes the herniated intestine back into place and repairs the hernia opening with surgical staples.

Treatmant of inguinal hernia

Page 19: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

2-Open SurgeryGeneral anesthesia will be used, so you will not be awake during the surgery. Your surgeon might decide on a local anesthesia if the hernia is small.

The surgeon will make an incision, locate the hernia, and separate it from surrounding tissues. The herniated tissue will be pushed back into place in your abdomenStitches will be used to close up the tear or strengthen weak abdominal muscles. Sometimes mesh is attached to strengthen the abdominal tissues and reduce the risk of another hernia

Page 20: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

How to avoid hernia?1-Eat high-fiber foods with plenty of whole grains and fruits and vegetables to

prevent constipation and straining with bowel movements. Drink plenty of water. Ask a doctor about using a stool softener

Page 21: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

2-

3-

4- Avoid

Page 22: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

5-Learn how to lift heavy objects or simply do not lift them at all.

6-Exercise to strengthen the abdominal muscles.

Page 23: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad

REFERENCES:

1 -. .www webmd com.2 -. .www hopkinsmedicine org.

3 -:// . .http medind nic in

4 -. .www medscape com

5 -. . .www nicpi com

Page 24: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad
Page 25: Under the supervision of Dr \Moheb Monier. 91 - Esraa Raafat Ahmed Ghanem 92 - Esraa Reda Hashem Tawfik 93 -Esraa samy Farid Abd Elghaffar 94 -Esraa Saad