Wednesday, June 26, 2013

Of Hernias and Outings

We had Long Case session with Prof.Azmi this morning, on the topic of Reducible Inguinal Hernia. He asked us a lot of questions, but we only managed to answer a few. 

My mind went blank during the second half of the session, because I was trying hard to recall and imagine the diagrams of inguinal ring and the associated structures. I was totally lost in thought! And I hate it. I felt stupid. Very.

So after the session ended, we all decided to revise back on the chapter. We spent the evening reading and memorizing.

1. Classifications of hernia: Reducible, Irreducible, Strangulated, Obstructed and Incarcerated

2. Types of hernia (common): Inguinal, Femoral, Paraumbilical, Spigelian and Epigastric  

3. Difference between direct and indirect inguinal hernia?
Direct: It pushes directly forward through posterior wall of inguinal canal ito abdominal wall defect (Hasselbach triangle)
Indirect: It passes through internal inguinal ring, if large may involve external ring as well

4. Which is more common, direct or indirect inguinal hernia?
80% are indirect with risk of strangulation

5. Relations of inguinal canal:
Floor: Ligaments (inguinal and lacunar)
Roof: Muscles (internal oblique and transversalis fibres)
Anterior: Aponeurosis (external oblique) and internal oblique for lat 1/3
Posterior: Transversalis fascia (lat) and conjoint tendon (med)

6. Contents of inguinal canal in male:
+ Fascias (external spermatic fascia, cremasteric fascia and internal spermatic fascia)
+ Ilioinguinal nerve
+ Spermatic cord (vas deferens, obliterated processus vaginalis, lymphatics, arteries and veins to vas, cremaster and testis, pampiniform plexus and genital branch of genitofemoral nerve and sympathetic nerve)

7. In female?
Round ligament of uterus is present 

Okay so that's a bit about Inguinal Hernia! :D 

Me and my friend went back early in the evening because we wanted to register (re-register!) our Wifi at ITD. So by 4pm, I dropped my friend off at UIA, went back home to get my laptop, and then went back to UIA. The registration finished at about 5.30pm.

I went back home, took shower and dressed up for an outing with my girlfriend. She was fasting today, so I agreed to take her out for break fast. By 7pm, I reached UIA and we went to East Coat Mall for PIZZA!

Initially, our plan was to watch Monsters University 3D after dinner. But my Mom didnt allow me to go inside a cinema. So I had to be grateful for just a dinner. It was still fun though!

My Mom wouldnt know if I secretly go and watch the movie, right? Heck, I can even go out with a guy if I want to. It's a date!

But of course, I wont do that. I am a good girl!

Am i NOT? ;)

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