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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.
****END OF TRANSCRIPTION****
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