Chapter 33--Part 1 (B&K)

Question 1

A _____ is the protrusion of an organ or part of an organ through a defect in the supporting structures that normally contain it.

Answer 1

hernia

Question 2

A hernia may be _____, _____, or _____.

Answer 2

congenital, acquired, or traumatic

Question 3

Most hernias occur in the _____ or _____ region.

Answer 3

inguinal or femoral (umbilical, ventral, and hiatal hernias can also occur)

Question 4

A hernia is called _____ when the hernial contents can be returned to the normal cavity by manipulation.

Answer 4

reducible

Question 5

The hernial is call _____ if the hernial contents cannot be returned to the normal cavity by manipulation.

Answer 5

irreducible or incarcerated

Question 6

Bowel present in an incarcerated hernia not only may lack adequate blood supply but also may become obstructed, this is called _____.

Answer 6

a strangulated hernia

Question 7

Inguinal hernias:

Answer 7

1. often repaired with patient under local anesthesia
2. oblique inguinal incision on the affected side is extended through external oblique aponeurosis
3. hernia sac is emptied, ligated, and excised
4. floor of the inguinal canal is reconstructed
5. mesh is sometimes used

Question 8

The spermatic cord is retracted with a _____ drain and _____.

Answer 8

Penrose

moistened with saline

Question 9

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.

Answer 9

direct

Question 10

The region between the rectus abdominis and inguinal ligament and medial to the inferior epigastric artery is called the _____.

Answer 10

Hesselbach triangle

Question 11

The _____ hernia is the most difficult type to repair and is more common in men.

Answer 11

direct

Question 12

A _____ hernia often results from straining.

Answer 12

direct inguinal

Question 13

With an _____ hernia, the peritoneal sac containing intestine protrudes through the internal inguinal ring and passes down the inguinal canal outside Hesselbach’s triangle.

Answer 13

indirect

Question 14

An _____ hernia is more common in males, but can occur in females.

Answer 14

indirect inguinal

Question 15

A _____ procedure may be used to repair either an indirect or direct reducible inguinal hernia using mesh behind the hernial defect.

Answer 15

laparoscopic

Question 16

A _____ is inserted to reinforce the wall of the inguinal canal; this is stapled in place.

Answer 16

polypropylene mesh

Question 17

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)

Answer 17

femoral herniorrhaphy

Question 18

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)

Answer 18

unbilical hernia

Question 19

Impaired healing of a previous surgical incision, usually a vertical abdominal incision, may cause a _____.

Answer 19

ventral (incisional) hernia

Question 20

An _____ is sometims the aftermath of postoperative hematoma, infection, or undue strain.

Answer 20

incisional hernia

Question 21

A _____ has a high recurrence rate when mesh is placed on the outside of a large repair.

Answer 21

ventral hernia

Question 22

Hiatal (diaphragmatic) hernia:

Answer 22

1. results when portion of the stomach protrudes through the hiatus of the diaphragm
2. in 10% of the population
3. symptoms caused by inflammation and ulceration of the adjacent esophagus, which result from the reflux of gastric juices from the herniated stomach
4. symptoms include: pain, blood loss, difficulty swallowing
5. diagnosis made by radiologic and endoscopic studies
6. surgical approach may be thoracoabdominal (via abdomen or chest)
7. abdominal method is preferred, but opening chest may provide better view

Question 23

The _____ is the opening for the esophagus through the diaphragm.

Answer 23

hiatus

Question 24

A weakening of the _____ permits violation of the muscular partition between the abdomen and the chest.

Answer 24

hiatus