Groin Hernias

Question 1

This type of hernia protrudes medial to the inferior epigastric blood vessels

Answer 1

Direct inguinal hernia

Question 2

Most common type of hernia

Answer 2

Indirect inguinal

Question 3

Initial diagnostic test of choice in groin hernias

Answer 3

Ultrasound

(CT if US is unclear)

Question 4

Common anatomical location of direct hernias

Answer 4

Hesselbach’s triangle

Question 5

Most common side of the body for indirect inguinal hernias

Answer 5

Right

(males and females)

Question 6

Peak ages for groin hernias

Answer 6

0-5 for males (pathway for testicle descension open)

75-80 males and females (collagen breakdown with age)

Question 7

This groin hernia is most common in elderly women

Answer 7

Femoral hernia

Question 8

Most common symptom of all types of groin hernias

Answer 8

Heaviness or dull discomfort in the groin/pelvic region

(most pronounced when intra-abdominal pressure is increased)

Question 9

This hernia is more common in young males and is lateral to the inferior epigastric vessels

Answer 9

Indirect inguinal hernia

Question 10

Indirect inguinal hernias are typically discovered at this age

Answer 10

Before first birthday

Question 11

Which groin hernias are more common in males and females?

Answer 11

Male = inguinal (direct or indirect)

Female = Femoral

Question 12

Moderate to severe pain in a patient with a groin hernia might suggest this

Answer 12

Incarceration and/or strangulation

(pain is not normal in uncomplicated hernias)

Question 13

History of this surgical procedure increases risk of groin hernias by 4x

Answer 13

Prostatectomy

(or any large abdominal incision, scar tissue never as strong as original skin)

Question 14

A patent processus vaginalis leads to this type of hernia

Answer 14

Indirect inguinal

Question 15

Which, femoral or inguinal hernias, typically occurs later in life?

Answer 15

Femoral

Question 16

At what times is the discomfort from all types of groin hernia most pronounced

Answer 16

End of the day or after prolonged standing

Question 17

In females, groin hernias can be hard to palpate. What imaging method can be used to help locate them?

Answer 17

Ultrasound

Question 18

Strangulated hernias may manifest with these symptoms (other than local tenderness/pain)

Answer 18

Symptoms of bowel obstruction including nausea, vomiting, abdominal pain, and bloating.

May also be febrile

Question 19

Which groin hernia is most lateral?

Answer 19

Femoral hernia

Question 20

Anatomical landmark used to differentiate direct from indirect inguinal hernias

Answer 20

Inferior epigastric vessels

Question 21

Which groin hernia is closest to midline?

Answer 21

Direct inguinal hernia

Question 22

This hernia is more common in elderly males and is medial to the inferior epigastric vessels

Answer 22

Direct inguinal hernia