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Fiser Absite > 38 - Hernias, Abd, Surg Tech > Flashcards

38 - Hernias, Abd, Surg Tech Flashcards

1
Q

Forms the shelving edge and roof of the inguinal ligament at inferior portion of inguinal canal

A

External oblique fascia

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2
Q

Forms cremasteric muscles

A

Internal oblique

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3
Q

Forms inguinal canal floor, along with conjoined tendon

A

Transversalis Muscle

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4
Q

Composed of the aponeurosis of the internal oblique and transversalis fascia

A

Conjoined tendon

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5
Q

Originates from external oblique fascia, runs from anterior superior iliac spine to pubis; anterior to femoral vessels

A

Inguinal ligament

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6
Q

Where inguinal ligament splays out to insert on pubis

A

Lacunar ligament

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7
Q

Pectineal ligament; posterior to femoral vessels, lays on bone

A

Cooper’s ligament

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8
Q

Runs medial to cord structures

A

Vas deferens

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9
Q

Components of Hesselbach’s triangle

A

rectus muscle, inferior inguinal ligament, inferior epigastrics

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10
Q

Hernia inferior/medial to epigastric vessels

A

Direct hernia

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11
Q

Hernia superior/lateral to epigastric vessels

A

Indirect hernia

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12
Q

Indirect hernia forms from _

A

Patent processus vaginalis

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13
Q

Direct and indirect hernia components

A

Pantaloon hernia

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14
Q

Can lead to bowel strangulation, should be repaired emergently

A

Incarcerated hernia

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15
Q

When retroperitoneal organ makes up part of the hernia sac

A

Sliding hernia

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16
Q

Most common organ involvement in sliding hernias for males and females

A

Males - sigmoid, cecum

Female - Ovaries, fallopian tube

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17
Q

Hernia repair type with mesh hernia repair type with mesh

A

Lichtenstein repair

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18
Q

Approximation of the conjoined tendon to the free edge of inguinal ligament repair type

A

Bassini repair

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19
Q

Approximation of the conjoined tendon to Cooper’s ligament repair type

A

Cooper’s ligament repair

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20
Q

Indicated for bilateral or recurrent inguinal hernia

A

Laparoscopic hernia repair

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21
Q

Often used for femoral hernia repair

A

Cooper’s ligament repair

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22
Q

Most common early complication following hernia repair

A

Urinary retention

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23
Q

Hernia recurrence rate

A

2%

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24
Q

Complication often occurring secondary to dissection of the distal component of the hernia sac causing vessel disruption

A

Testicular atrophy

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25
Q

Testicular atrophy can result from thrombosis of

A

spermatic cord veins

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26
Q

Pain after hernia usually results from

A

Compression of ilioinguinal nerve

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27
Q

Ilioinguinal nerve injury can results in (2)

A

Loss of cremasteric reflex

Numbness on ipsilateral penis, scrotum and thigh

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28
Q

Ilioinginal nerve injury runs _ to spermatic cord

A

Anterior

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29
Q

Usually injured with laparoscopic hernia repiar

A

Genitofemoral nerve injury

30
Q

Genital branch of genitofemoral nerve innervation

A

Cremaster (motor), Scrotum (sensory)

31
Q

Femoral branch of genitofemoral nerve innervation

A

Upper lateral thigh

32
Q

Femoral canal boundaries

A 
Cooper's ligament (posterior)
Inguinal ligament (anterior)
Femoral vein (lateral)
Lacunar ligament (medial)
33
Q

Location of femoral hernia

A

Medial to femoral vein, lateral to lymphatics

34
Q

May require division to reduce bowel in incarcerated femoral hernia

A

Inguinal ligament

35
Q

Characteristic presentation of femoral hernia

A

Anterior-medial thigh bulge

36
Q

Age to delay repair of umbilical hernia

A

5 yrs old

37
Q

Location of Spigelian hernia

A

Lateral to rectus muscle, along linea semilunares

38
Q

Can present as tender medial thigh mass or SBO

A

Obturator hernia (anterior pelvis)

39
Q

Howship-romberg sign

A

inner thigh pain with internal rotation

40
Q

Posterior pelvis hernia

A

Sciatic hernia

41
Q

Sciatic hernias herniate through

A

Greater sciatic foramen

42
Q

Type of hernia most likely to recur

A

Incisional hernia

43
Q

Posterior rectus sheath is absent below

A

Semicircularis/umbilicus

44
Q

Fothergrill’s sign

A

Rectus hematoma sign of more prominent and painful mass with flexion of rectus muscle

45
Q

Medical tx of desmoid tumor

A

Sulindac and tamoxifen

46
Q

Can occur with hypersensitivity to methysergide

A

Retroperitoneal fibrosis

47
Q

Most sensitive test for retroperitoneal fibrosis

A

IVP (intravenous pyelogram)

48
Q

Tx of retroperitoneal fibrosis

A

Steroids

49
Q

Typical location of malignant mesenteric tumors

A

Root of mesentery

50
Q

Typical location of benign mesenteric tumors

A

Periphery of mesentery

51
Q

1 malignant mesenteric tumor

A

Liposarcoma

52
Q

Most common malignant retroperitoneal tumor

A

Lymphoma

53
Q

Retroperitoneal sarcomas metastasizes to _

A

Lung

54
Q

Most common omental solid tumor is _

A

Metastatic disease

55
Q

Removed with peritoneal dialysis (4)

A

Lead
NH3
Fe
Ca

56
Q

Increased with CO2 pneumoperitoneum (5)

A 
Mean arterial pressure
Pulmonary artery pressure
Mean airway pressure
HR
Systemic vascular resistance
CVP
Peak inspiratory pressure
57
Q

Decreased with CO2 pneumoperitoneum (4)

A

pH
Venous return (IVC compression)
Cardiac output
Renal flow (2/2 decreased CO)

58
Q

CO2 embolus signs

A

Sudden increase in end tidal CO2 -> drop with hypotension

59
Q

Tx of CO2 embolus

A

Head down, turn pt to left, aspirate through central line

60
Q

Cost effective tool for medium vessels

A

Harmonic scalpel

61
Q

Ultrasound most commonly used mode, assesses relative density of structures

A

B-mode

62
Q

Dark area on US posterior to object indicating mass

A

Shadowing

63
Q

Brighter area on US posterior to object indicating fluid filled cyst

A

Enhancement

64
Q

Deep structures on US are seen on _ frequency

A

Lower

65
Q

Superficial structures on US are seen on _ frequency

A

Higher

66
Q

Adds doppler on US, color visual description of blood flow

A

Duplex

67
Q

Argon beam acts by causing _

A

Superficial necrosis

68
Q

Acts by coagulation and vaporizing

A

Laser

69
Q

Good for deep tissue penetration and bronchial lesions

A

Nd:YAG laser

70
Q

Graft which you cannot get fibroblast ingrowth

A

PTFE (gore-tex)

71
Q

Graft which allows for fibroblast ingrowth

A

Dacron

72
Q

Incidence of bowel/vascular injury with Veress needle

A

0.1%

Fiser Absite (14 decks)

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