Hernia

Question 1

what is a hernia?

Answer 1

abnormal protrusion of a cavity’s contents through a weakness in the wall of the cavity

Question 2

types of hernias

Answer 2

reducible
incarcerated
strangulated

Question 3

presentation

Answer 3

sudden onset pain
presence of a lump
vomiting

Question 4

diagnosis

Answer 4

indirect lump will not reappear

assess size of neck to assess for strangulation/ reducible

Question 5

management

Answer 5

surgical correction

Question 6

what is a Maydl’s hernia?

Answer 6

two different loops of bowel are contained within the hernia

Question 7

what is a Spigelian hernia?

Answer 7

between rectus abdominus and linea semilunaris (spigelian fascia)

Question 8

what is diastasis recti?

Answer 8

widening of the linea alba

Question 9

management of hernias in children?

Answer 9

leave alone until 3-4

unless inguinal needs immediate surgery

Question 10

most common hernia in kids?

Answer 10

umbilical

adults more likely to get paraumbilical

Question 11

most common hernia in females?

Answer 11

femoral

Question 12

most common hernia in males?

Answer 12

inguinal

Question 13

which hernia can be direct or indirect?

Answer 13

inguinal hernia

Question 14

four types of hiatus hernias

Answer 14

1. sliding
2. rolling
3. combination
4. large with additional abdominal organs

Question 15

what is a sliding hiatus hernia?

Answer 15

gastro-oesphageal junction slides up into the chest

Question 16

what is a rolling hiatus hernia?

Answer 16

bulge of the stomach herniates up

Question 17

why do femoral hernias always require surgical repair?

Answer 17

prone to obstruction and strangulation against sharp lacunar ligament

Question 18

do femoral hernias need surgical repair?

Answer 18

yes

Question 19

which nerve does the inguinal canal contain?

Answer 19

ilioinguinal

Question 20

where is the internal/ deep ring?

Answer 20

midpoint of the inguinal canal (ASIS and pubic tubercle), lateral to inferior epigastric vessels

Question 21

where is the external ring (superficial)

Answer 21

two crura of the external oblique above and medial to the pubic tubercle

Question 22

where do indirect hernias enter?

Answer 22

via the internal/ deep ring

Question 23

where do direct hernias eneter

Answer 23

defect in the wall medial to the deep/ internal ring