DEFINITIONS AND ANATOMY

Question 1

DEFINE ABDOMINAL CORE

Answer 1

The circumferential soft tissue of the diaphragm superiorly , pelvic floor inferiorly , abdominal wall and flanks anterolaterally , excluding the abdominal viscera

Question 2

hernia word meaning

Answer 2

latin worf meaning RUPTURE

Question 3

DEFINE HERNIA

Answer 3

An abnormal protrusion of an organ or tissue through a defect in its surrounding wall

Question 4

where does hernia occur in abdominal wall

Answer 4

at sites where the fascia and aponeurosis are not covered by striated muscle

Question 5

pelvic hernias

Answer 5

obturator , sciatic , perineal

Question 6

incidence of abdominal wall hernia

Answer 6

5%

Question 7

proportion of groin hernia in abd wall hernias

Answer 7

75%

Question 8

proportion of femoral hernias in groin hernias

Answer 8

3%

Question 9

most common hernia in female

Answer 9

indirect

Question 10

why right side femoral hernia common

Answer 10

tamponading effect of sigmoid colon on left femoral canal

Question 11

why indirect inguinal hernias are common in right

Answer 11

slower descent of right testes and hence the delayed trophy

Question 12

incidence of strangulation in groin hernias

Answer 12

1-3%

Question 13

incidence of strangulation in femoral hernias

Answer 13

15-20%

Question 14

lacunar ligament

Answer 14

fan shaped medial expansion of inguinal ligament , attaching to pubis

Question 15

conjoint tendon is present only in

Answer 15

5-10%

Question 16

iliopubic tract

Answer 16

an aponeurotic band formed by transversalis fascia , transverse abdominis aponeurosis and fascia

lies posterior to inguinal ligament
inner lip of ilium to ASIS

Question 17

endoabdominal fascia

Answer 17

aka transversalis fascia

Question 18

shutter mechanism

Answer 18

deep ring
superior crus - transverse abdominis aponeurotic arch
inferior crus- iliopubic tract

Question 19

coopers ligament

Answer 19

formed by periosteum and aponeurotic tissues along superior pubic rami

Question 20

corona mortis

Answer 20

in 75% , a branch of obturator artery may cross through the lateral border of cooper ligament

Question 21

inguinal ligament length

Answer 21

4cm

Question 22

spermatic cord is composed of

Answer 22

testicular artery , cremastric fibres , vas deferens , pampiniform plexus , genitall branch of genitofemoral nerve , lymphatics , processus vaginalis , cremasteric vessels

Question 23

inguinal canal is bounded by

Answer 23

superficially - external oblique aponeurosis
cephalad - io +ta
inferior - inguinal ligament & lacunar ligament
posterior/floor - ta + transversalis fascia

Question 24

preperitoneal space contents

Answer 24

adipose tissue , lymphatics , blood vessels , nerves

lateral femoral cutaneous nerve of thigh
genitofemoral nerve

inferior epigastric artery ,
deep circumflex iliac artery

vas deferens

Question 25

boundaries and contents of femoral canal

Answer 25

anteriorly - iliopubic tract
posteriorly - coopers ligament
laterally - femoral vein
apex - pubic tubercle

contents - connective tissue and lymphatics

Question 26

european hernia society hernia classification

Answer 26

M, L , F
1- <1.5 cm
2- 1.5-3cm
3->3 cm

Question 27

NYHUS CLASSIFICATION OF GROIN HERNIAS

Answer 27

I - indirect
II - indirect with diltaed inguinal ring
III - posterior wall defect
A - DIRECT
B - INDIRECT
C - FEMORAL

IV -RECURRENT HERNIA
DIRECT , INDIRECT , FEMORAL , COMBINED