USMLE Step 1 Review 02 11 Anatomy Hernias

USMLE Step 1 Review 02 11 Anatomy Hernias


On these “Gold Standard Step 1 Facts” pages you will find Free:

  • USMLE Audio Review files from our “Gold Standard USMLE Reviews”
  • Transcriptions of those files
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  • Following along with the transcription
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Let’s continue our USMLE Review with Anatomy from the Gold Standard USMLE Step 1 Audio Review program.

Play USMLE Audio MP3 02 11 Anatomy Hernias Below


Begin 02 11 Anatomy Hernias Transcription

What makes up 25% of all hernias?

  • Direct inguinal hernia.

What makes up 75% of hernias?

  • Indirect inguinal hernia.

Why is a direct inguinal hernia called direct?

  • Because it bulges directly through the anterior abdominal wall.

What weakened fascia allows it to burst through?

  • The transversalis fascia of the posterior wall of the superficial inguinal ring.

Where does the direct inguinal hernia come through?

  • The medial part of Hesselbach’s triangle.

What are the boundaries of Hesselbach’s triangle?

  • The medial border is the lateral edge of the rectus abdominus muscle, the superior border is the inferior epigastric artery, and the inferior border is the inguinal ligament.

The indirect inguinal hernia pokes through what structures?

  • It herniates indirectly through the inguinal canal into the scrotum.

What is the defect in this case that allows this to happen?

  • Failure of processus vaginalis to close.

When the indirect inguinal hernia enters the inguinal canal, it does so in what relation to what structure?

  • Lateral to the inferior epigastric artery.

Under what two conditions can indirect inguinal hernias can appear?

  • They can be congenital upon birth or be acquired later because of a congenital problem with processus vaginalis.



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