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Surgery final (Sabiston) > 44 - Hernias > Flashcards

44 - Hernias Flashcards

1
Q

What is the content of the inguinal canal? (6)

A 
spermatic cord
testicular artery
ductus deference 
pampiniform plexus
genital branch of genitofemoral nerve
tunica vaginalis
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2
Q

Which nerves go through the inguinal canal? (3)

A

genital branch of genitofemoral nerve
sympathetic nerve
ilioinguinal nerve

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3
Q

The genital branch of genitofemoral nerve is part of the ___ ___ itself

A

spermatic cord

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4
Q

Ilioinguinal nerve does not enter through the ___ ring, but exist through the ___

A

deep

superficial

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5
Q

What are the 3 levels of hernia?

A

reducible
irreducible/incarcerated
strangulated

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6
Q

External hernia= classic, the sac moves with the ___ space

A

peritoneal

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7
Q

What kind of groin hernia do you know?

A

inguinal

femoral

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8
Q

Inguinal hernia may be indirect (___) or direct (___)

A

deep ring

Hesselbach triangle

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9
Q

Groin hernias make up to __% of all hernias

A

80

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10
Q

Groin hernia are __ times more common in ___. __ are direct.

A

25
men
2/3

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11
Q

Femoral hernias are __ times more common in ___.

A

10

women

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12
Q

Umbilical hernias are ___ times more common in women

A

2

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13
Q

Strangulated hernia may lead to bowel ___ and ___

A

ischemia

obstruction

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14
Q

Inguinal hernia require ___ only if symptomatic

A

surgery

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15
Q

Femoral hernia always require ___ due to high frequency of ___ (20%)

A

surgery

strangulation

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16
Q

If there is no reason to suspect ___, we can try and perform a ____ maneuver to restore the intestine

A

strangulation

manual

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17
Q

The typical imaging test for inguinal hernia is ___

A

US

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18
Q

The typical imaging test for ventral hernias is ___

A

CT

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19
Q

Name 5 DDs for a groin mass

A 
hernia (inguinal/femoral)
lymphadenopathy (reactive/infective/tumor)
cryptorchidism 
abscess
lymphoma
20
Q

Testicular tumors metastasize to the ___ lymph nodes rather than the ___ lymph nodes

A

retroperitoneal

groin

21
Q

Scrotum tumors (skin) metastasize to the ___ lymph nodes (superficial inguinal nodes)

A

gorin

22
Q

Indirect hernias are the ___ common type.

A

most

23
Q

In direct hernia, the intestine’s loop enter through the ___ __ to the ___ ___. It is a premade anatomic path.

A

deep
ring
inguinal
canal

24
Q

Complete hernia is when the loop exists through the ___ inguinal canal, into the ___ cord

A

superficial

spermatic

25
Q

Indirect inguinal hernia etiology is the patent ___ ___ that did not go through obliteration properly

A

process

vaginalis

26
Q

Indirect hernia is more common on the ___ side, due to the fact that on this side the testicle migrate last.

A

right

27
Q

Indirect hernia are more likely to cause ___.

A

strangulation

28
Q

What does hernia includes (inside->out) (7)?

A 
intestine loop
peritoneum
internal spermatic fascia
cremasteric muscle and fascia
external spermatic fascia
superficial layer
skin
29
Q

The indirect hernia passes ___ to the inferior epigastric vessels

A

latterly

30
Q

Direct inguinal hernia occurs due to ___ in the abdominal wall. Specifically of the ___ fascia.

A

weakness

transversals

31
Q

The indirect hernia does not enter through the ___ ring, but can occasionally exist through the ___ ring

A

deep

superficial

32
Q

Direct hernia is usually found in the ___ triangle area, medially to the ___ ___ vessels

A

Hesselbach

inferior epigastric

33
Q

What are the borders of the Hesselbach triangle?
inferior- ___
superior lateral- ___
medially- ___

A

inguinal ligament
inferior epigastric vessels
semilunar line of the rectus abdominis

34
Q

Femoral hernia are more common in ___, and makes up to __% of all hernias. It is more common on the ___ side.

A

women
3
right

35
Q

Femoral hernia goes through the ___ ring, found ____ to the femoral vein, ___ to the ___ ligament

A

femoral
medially
superior
cooper

36
Q 
What is the femoral ring anatomy?
superior- \_\_\_ ligament
medially- \_\_\_ ligament
inferior- \_\_\_ ligament
latterly- \_\_\_ vein
A

inguinal
lacunar
cooper
femoral

37
Q

Femoral hernia has the biggest chance (__%) to become ___, therefore we must perform ___, even if its ___

A

20
strangulated
surgery
asymptomatic

38
Q

What are the most common organs to get strangulated in femoral hernia? (2)

A

intestine

ovary

39
Q

When performing physical examination and palpating a mass ___ the inguinal ligament, ___ hernia should be highly suspected

A

under

femoral

40
Q

What is pantaloons hernia?

A

a big hernia, penetrating through the inguinal ring (indirect) and the Hesselbach triangle (direct)

41
Q

Triangle of doom: (3)

A

inguinal ligament
medial umbilical ligament
testicular vessels

42
Q

Triangle of pain: (2)

A

genitofemoral nerve

lateral femoral cutaneous nerve

43
Q

Acute incarceration/strangulation requires __ __ without trying to ___ the hernia, to avoid ___

A

emergency surgery
maneuver
perforation

44
Q

Emergency surgery is made with an ____ approach

A

open

45
Q

If the intestine is strangulated and requires surgical removal, we will not place ___, fearing from infection

A

net

46
Q

Before performing emergency surgery, we should administrate: (3)

A

fluids
ABx
NGT

47
Q

What are the 5 most common complications post hernia surgery:

A 
SSI
nerve injury- chronic pain syndrome
ischemic orchitis/ testicular atrophy 
vas deferens/viscera injury
recurrence

Surgery final (Sabiston) (54 decks)

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