Chapter 33--Part 1 (B&K) Flashcards
A _____ is the protrusion of an organ or part of an organ through a defect in the supporting structures that normally contain it.
hernia
A hernia may be _____, _____, or _____.
congenital, acquired, or traumatic
Most hernias occur in the _____ or _____ region.
inguinal or femoral (umbilical, ventral, and hiatal hernias can also occur)
A hernia is called _____ when the hernial contents can be returned to the normal cavity by manipulation.
reducible
The hernial is call _____ if the hernial contents cannot be returned to the normal cavity by manipulation.
irreducible or incarcerated
Bowel present in an incarcerated hernia not only may lack adequate blood supply but also may become obstructed, this is called _____.
a strangulated hernia
Inguinal hernias:
- often repaired with patient under local anesthesia
- oblique inguinal incision on the affected side is extended through external oblique aponeurosis
- hernia sac is emptied, ligated, and excised
- floor of the inguinal canal is reconstructed
- mesh is sometimes used
The spermatic cord is retracted with a _____ drain and _____.
Penrose
moistened with saline
A _____ hernia protrudes through a weakness in the abdominal wall in the region between the rectus abdominis and inguinal ligament and medial to the inferior epigastric artery.
direct
The region between the rectus abdominis and inguinal ligament and medial to the inferior epigastric artery is called the _____.
Hesselbach triangle
The _____ hernia is the most difficult type to repair and is more common in men.
direct
A _____ hernia often results from straining.
direct inguinal
With an _____ hernia, the peritoneal sac containing intestine protrudes through the internal inguinal ring and passes down the inguinal canal outside Hesselbach’s triangle.
indirect
An _____ hernia is more common in males, but can occur in females.
indirect inguinal
A _____ procedure may be used to repair either an indirect or direct reducible inguinal hernia using mesh behind the hernial defect.
laparoscopic
A _____ is inserted to reinforce the wall of the inguinal canal; this is stapled in place.
polypropylene mesh
A _____ involves repairing the defect in the transversalis fascia below the inguinal ligament and removing the peritoneal sac protruding through the femoral ring. (more common in women)
femoral herniorrhaphy
Repair of an _____ consists of closing the peritoneal opening and uniting the fasciae above and below the defect to reconstruct the abdominal wall surrounding the umbilicus. (most often is children/congenital, some women after childbirth)
unbilical hernia
Impaired healing of a previous surgical incision, usually a vertical abdominal incision, may cause a _____.
ventral (incisional) hernia
An _____ is sometims the aftermath of postoperative hematoma, infection, or undue strain.
incisional hernia
A _____ has a high recurrence rate when mesh is placed on the outside of a large repair.
ventral hernia
Hiatal (diaphragmatic) hernia:
- results when portion of the stomach protrudes through the hiatus of the diaphragm
- in 10% of the population
- symptoms caused by inflammation and ulceration of the adjacent esophagus, which result from the reflux of gastric juices from the herniated stomach
- symptoms include: pain, blood loss, difficulty swallowing
- diagnosis made by radiologic and endoscopic studies
- surgical approach may be thoracoabdominal (via abdomen or chest)
- abdominal method is preferred, but opening chest may provide better view
The _____ is the opening for the esophagus through the diaphragm.
hiatus
A weakening of the _____ permits violation of the muscular partition between the abdomen and the chest.
hiatus
