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Pathology > Abdominal Wall Hernias > Flashcards

Abdominal Wall Hernias Flashcards

1
Q

Majority of all abdominal wall hernias are found in the ____

A

groin

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2
Q

majority of groin hernias are located in the

A

inguinal canal

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3
Q

What are the layer of the abdominal wall (anterior to posterior)

A 
Skin
Camper (Superficial fatty), Scarpa (Deep Membranous), 
Gallaudet (External oblique fascia)
Internal Oblique fascia
Transversus abdominis
Transversalis fascia
Properitoneal space and fat
Parietal peritoneum
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4
Q

What are the layers of the scrotum?

A 
SkIn
Dartos
Colles
External spermatic fascia
Cremasteric fascia
Does not reach the scrotum
Internal spermatic fascia
Properitoneal space and fat
Tunica vaginalis
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5
Q

The superficial fatty layer is the ____ muscle of the scrotum

A

Superficial fatty (camper) : dartos

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6
Q

The colles fascia is equivalent to the _____ in the abdominal wall

A

Scarpas

Deep Membranous (scarpa) : Colles

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7
Q

Gallaudet fascia is also the ____ in the scrotum

A

external spermatic fascia

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8
Q

The tunica vaginalis is equivalent of ___ in the abdomen

A

parietal peritoneum

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9
Q

This layer of the abdominal wall does not reach the scrotum

A

transversus abdominis

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10
Q

This is equivalent of the transversalis fascia in the in the internal spermatic fascia

A

transversalis fascia

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11
Q

What is the length of the inguinal canal?

A

4-6 cm in length

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12
Q

What are the walls of the inguinal canal?

A

Anterior: External oblique aponeurosis

Posterior: Medial - Conjoint, Lateral - transversalis fascia and TA muscle

Lateral: Internal oblique

Medial: Conjoint tendon

Superior: arching fibers of IO and TA muscles

Inferior: Inguinal and lacunal ligamnet

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13
Q

This lies immediately above and medial to the pubic tubercle; triangular opening

A

superficial inguinal ring

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14
Q

located between the pubic tubercle and the anterior superior iliac spine

A

deep inguinal ring

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15
Q

Contents of the femoral sheath

A
  1. Femoral artery
  2. Femoral vein
  3. Lymphatics
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16
Q

The inguinal ligament is also called

A

Poupart’s ligament

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17
Q

the conjoint tendon is composed of _____

A

Internal Oblique

Transversus Abdominis

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18
Q

[true/false]

the spermatic cord passes through the inguinal canal

A

true

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19
Q

What are the contents of the spermatic cord?

A

3 fasciae: external, cremasteric, internal spermatic fascia
3 arteries: testicular, cremasteric, vas deferens
3 veins: pampiniform, cremasteric, deferential
3 nerve: autonomic, genital branch of genitofemoral nerve, ilioinguinal nerve
Vas deferens
Lymphatics

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20
Q

the lacunar ligament under the inguinal ligament is called

A

Giembernat’s

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21
Q

the nerve inside the triangle of doom

A

Genital branch of genitofemoral nerve

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22
Q

the arteries and veinsinside the triangle of doom

A

iliac artery and vein

gonadal vessels

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23
Q

the medial border of the triangle of doom is

A

ductus deferens

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24
Q

What are the borders of the triangle of pain

A

Inferolateral: iliopubic
Lateral: peritoneum
Superomedial: gonadal vessels

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25
Q

What are the arteries and veins containing the triangle of pain

A

deep circumflex iliac artery and vein

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26
Q

What are the nerve inside the triangle of pain

A

Femoral nerve
Femoral branch of the genitofemoral nerve
anterior cutaneous nerve
lateral femoral cutaneous nerve

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27
Q

the circle of death is composed of these arteries

A
  1. External iliac arteries (from common iliac)
  2. Internal iliac arteries (from common iliac)
  3. obturator artery
  4. Aberrant artery
  5. Inferior epigastric
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28
Q

[sphincter/shutter action]

Tranversalis fascia

A

sphincter action

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29
Q

[sphincter/shutter action]

Transversus abdominis and internal oblique muscles

A

shutter action

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30
Q

This forms a sling that closes the internal ring under the muscular edge of the internal oblique muscle by contraction fo the transversus abdominis muscle. This acts as a sphincter.

A

transversalis fascia

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31
Q

____ hernia that does not traverse the internal ring; traverses through abdominal wall

A

direct inguinal hernia

32
Q

____ hernia that passes through the internal inguinal ring and down the inguinal canal

A

indirect inguinal hernia

33
Q

___ hernia

medial or inferior to the inferior epigastric vessels

A

direct inguinal hernia

MAD LICE

34
Q

____ hernia is lateral or superior to the inferior epigastric vessels

A

indirect inguinal hernia

MAD LICE

35
Q

[NYHUS classification]

indirect, normal sized internal ring

A

Type I

36
Q

[NYHUS classification]

indirect, does not extend into scrotum, internal ring enlarged

A

Type II

37
Q

[NYHUS classification]

Direct hernia

A

Type III-A

38
Q

[NYHUS classification]

Indirect hernia, large that it enroaches the posterior inguinal wall

A

Type III-B

39
Q

[NYHUS classification]

indirect hernia, indirect sliding, scrotal, pantaloon hernias

A

Type III-B

40
Q

[NYHUS classification]

femoral hernia

A

Type III-C

41
Q

[NYHUS classification]

Recurrent direct hernia

A

Type IV-A

42
Q

[NYHUS classification]

Recurrent indirect hernia

A

Type IV-B

43
Q

[NYHUS classification]

Recurrent femoral hernia

A

Type IV-C

44
Q

[NYHUS classification]

Recurrent hernia, combination

A

Type IV-D

45
Q

[Physical Examination]

in the Zieman Technique, the index finger is placed at the ____

A

deep inguinal ring

46
Q

[Physical Examination]

in the Zieman Technique, the middle finger is placed at the ____

A

superficial inguinal ring

47
Q

[Physical Examination]

in the Zieman Technique, the ring finger is placed at the ____

A

saphenous opening

48
Q

[Physical Examination]

in the Zieman Technique, the impulse is felt at the index finger, the hernia is ___

A

indirect

index finger: deep inguinal

49
Q

[Physical Examination]

in the Zieman Technique, the impulse is felt at the middle finger, the hernia is ___

A

direct

middle finger: superficial ring

direct: middle: superficial

50
Q

[Physical Examination]

in the Zieman Technique, the impulse is felt at the ring finger, the hernia is ___

A

femoral

ring finger: saphenous opening

51
Q

[management]

symptomatic hernia

A

elective surgery

52
Q

[management]

strangulated hernia

A

urgent surgery

53
Q

[management]

In a symptomatic, primary unilateral hernia. The type of surgery is?

A

Lichtenstein or endoscopic

54
Q

[management]

In a symptomatic, primary bilateral hernia. The type of surgery is?

A

Endoscopic or lichtenstein

55
Q

What are the structures lateral to the femoral hernia

A

Femoral: NAV (lateral to medial)

56
Q

the surgical technique in treating femoral hernia

A

Mcvay

57
Q

Bassini procedure includes closure of these layers

A

3 layers

TF, TA, IO

58
Q

Shouldice repair includes repair of how many layers?

A

4 layers

59
Q

[what nerve is damaged]

severe burning pain radiating down the lateral side of the ipsilateral thigh

A

lateral femoral cutaneous nerve

60
Q

this nerve innervates the inguinal and gluteal region

A

Iliohypogastric

61
Q

This nerve innervates the anterior surface of the scrotum, labia majora, root of penis, mons pubis, small portion of the upper anteromedial thigh

A

Ilioinguinal nerve

62
Q

This innervates the spermatic cord/round ligament

A

genitofemoral nerve

63
Q

this nerve innervates the anterior thigh and anteromedial aspect of the leg

A

femoral nerve

64
Q

[Name that hernia]

superior lumbar triangle hernia

A

Grynfeltt’s hernia

65
Q

[Name that hernia]

inferior lumbar triangle

A

Petit’s hernia

66
Q

[Name that hernia]

only antimesenteric part of the bowel

A

richter

67
Q

[Name that hernia]

meckel diverticulum

A

littre hernia

68
Q

[Name that hernia]

direct + indirect hernia

A

pantaloon

69
Q

[Name that hernia]

2 loops in same ring

W shaped

A

Madyl

70
Q

[Name that hernia]

appendix

A

amyand

71
Q

[Name that hernia]

anterior diaphragm

A

morgagni

72
Q

[Name that hernia]

posterior diaphragm

A

bochdalek

73
Q

[Name that hernia]

lateral to rectus muscle

A

spigelian

74
Q

[Name that hernia]

due to defective midline fusion of lateral abdominal wall;

located in the midline between the xiphoid process and the umbilicus

A

epigastric hernias

75
Q

[diagnose]

clinically evident separation of the rectus abdominis muscle pillars resulting to a characteristic bulgin og the abdominal wall in the epigastrium

A

rectus abdominis diastasis

Pathology (36 decks)

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