Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PNP1 Exam 3 > GU- Inguinal hernia > Flashcards

GU- Inguinal hernia Flashcards

1
Q

Inguinal hernia definition

A

intusion of organ through inguinal canal, usually bowel.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Indirect

A

bowel protrudes through deep inguinal ring through inguinal canal lateral to inferior epigastric artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

direct

A

bowel protrudes between interior epigastric artery and edge of rectus muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

incarcerated

A

hernia that cannot be returned or reduced by manipulation. Can become strangulated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Is this common?

A

most common surgical condition in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

_____ % are on the right side

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

____ % are on the left side

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

___ % are bilateral

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

most common type is

A

indirect (99%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

____ % present before age 1, with most seen in the first ___ months

A

50%, 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ratio boys to girsl

A

4:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

incidence

A

10-20 per 1,000 live births

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

higher incidence is seen in, higher risk

A

males

premies

positive family history

CF

undescended testes

hypospadias

congenital dislcation of hip

congenital abd wall defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where is the bulge and where does it extend to?

A

Bulge in inguinal area extending to scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

bulge is pronounced during periods of

A

crying/straining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

will have h/o

A

intermittant groin/labial/scrotal swelling

hernia spontaneously reduces when relaxing

parents usually first to notice

17
Q

questions for parents?

A

when was it noticed?

how often does it occur?

does the child appear uncomfortable?

Signs of intestinal obstruction?

18
Q

What are the signs of intestinal obstruction?

A

Vomiting, abd distention

19
Q

Where is the bulge

A

level of external/internal ring

20
Q

placing finger in inginal canal is only done

A

in adults

21
Q

how is exam performed?

A

supine position, legs and arms extended above head, wait for cry

cry will increase ABD pressure, and should demonstrate bulge ober external ring/scrotal swelling

22
Q

How is exam performed in older children?

A

Standing

23
Q

Why do we palpate testes before palpation of inguinal bulge?

A

Retractile testes which are common in infants and young children can be mistaken for hernia

24
Q

abdominal exam components

A

distension?

masses?

tenderness?

25
Q

If swelling is not noted during the exam, how is the silk sign performed?

A

To check for thickening/silkiness of the spermatic cord by palpating the spermatic cord over the pubic tubericle.

Rubbing together the area feels like silk

indicated the presence of hernia sac around cord and is reliable sign especially in unilateral

26
Q

Diagnostic testing

A

for all girls with inguinal hernia, requires rectal exam by experienced provider

may need pelvid US- can diff between hydrocele and hernia and determine if incarcerated

Dx otherwise made by H&P

27
Q

Differential dx:

A

Ing hernia: swelling vaires during day, size increases with size/straining

Incarcerated ing hernia: persistant bulge, discomfort, pos/neg abd distension,

Hydrocele: swelling does not change in size throughout day, gradually disappears in first year

28
Q

Can transillumination differenciate between hydrocele and inguinal hernia?

A

No

29
Q

Treatment:

A

surgery is usually done 1-2 weeks after diagnois

inguinal hernias do not spontaneously resolve

30
Q

Referral criteria?

A

Referral to peds surg when diagnosis made

31
Q

complications -incarcerated hernia

A

-immediate reduction under sedation

32
Q

Complications

Strangulated incarcerated hernia

A

SURGICAL EMERGENCY

blood supply is compromised

33
Q

complications

ischemia/infarction of testes

A

can occur in boys with undescended testes and inguinal hernia

34
Q

complications -

ovarian/fallopian tube infarction

A

blank

35
Q

Education:

s/s of incarcerated hernia

A

abd distension

vomiting

pain, irritablilty, erythema

persistant bulge that does not reduce

Stress importance of f/u and surg visits

operative repair in first year, increased risk of incarceration after 1 year

36
Q

immediate referral red flags

A

unable to reduce

painful, tender, hard, or red

surgery will happen within 24-48 hours

PNP1 Exam 3 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions