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Hernia Flashcards

1
Q

Hernia is the commonest condition encountered in surgical practice, T/F?

A

True

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2
Q

Hernia may account for up to 75% of cases of intestinal obstruction in developing countries, T/F?/

A

True

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3
Q

All hernia protrudes through the abdominal wall, T/F?

A

False.

Only External hernia.

Internal hernia do not.

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4
Q

Mention the 10 types of hernia you should know (excluding diaphragmatic hernia)

A
  1. Inguinal
  2. Femoral
  3. Umbilical
  4. Paraumbilical
  5. Epigastric
  6. Incisional
  7. Spigelian (lines semilunaris)
  8. Lumbar
  9. Obturator
  10. Sciatic
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5
Q

What are the 2 main factors in the causation of a hernia?

A
  1. A defect or weakness in the wall of the abdominal cavity (predisposes)
  2. Repeated increase intra-abdominal pressure (precipitates)
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6
Q

A gridiron incision can be complicated by an inguinal herb is, T/F?

A

True.

If there is an injury to the nerve of the muscle during a gridiron incision

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7
Q

All hernia has a sac, T/F?

A

False.
All except in some cases of incisional and epigastric hernia

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8
Q

List the possible content of a hernial sac

A
  1. Usually Omentum, small intestine, parts of the colon
  2. Appendix
  3. Occasionally uterine adnexa and part of the bladder
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9
Q

If the content of a hernia does not return completely to the abdominal cavity, it is called _____ hernia

A

Irreducible hernia

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10
Q

A hernia in which the viscus forms part of the sac is called

A

Sliding hernia

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11
Q

Causes of irreducible hernia

(Hint: 3)

A
  1. Adhesion (b/w the sac and the content )
  2. Content distension to form a mass too bulky to return
  3. Sliding hernia
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12
Q

The strangulation of a part of the circumference of the wall of the bowel is called _____ type of strangulation

A

Richter type of strangulation

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13
Q

Complications of hernia

(Hint: 4)

A
  1. Irreducibility
  2. Strangulation
  3. Fistula formation
  4. Rupture of hernial sac
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14
Q

Content of the inguinal canal canal in male

A

A spermatic cord with testicular vessels, ilioinguinal nerve, and the genital branch of the genito-femoral nerve

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15
Q

Embryologically, the inguinal canal is formed by the passage of _______

A

Gubernaculum testis and Processus vaginalis

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16
Q

The length of the inguinal canal in adult

A

About 4cm

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17
Q

The opening of the internal inguinal ring is directed upwards and inwards? T/F?

A

False.

Upwards and outwards

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18
Q

Describe the natural mechanism that occurs during an increase in intra-abdominal pressure to close the internal inguinal ring and prevent peritoneal herniation

A

Via the lateral and upward contraction of the transverse, which pulls the attached internal ring upwards and outwards behind the transverse, thus, closing the ring around the cord

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19
Q

In the repair of an indirect inguinal hernia, narrowing and tightening of the internal ring are not important, T/F?

A

False.
It is important, b/c without narrowing & tightening, it becomes a weak site and recurrence is then high

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20
Q

Location of the internal inguinal ring

A

Lies about 1.25cm above and perpendicular to the mid-inguinal point

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21
Q

The external inguinal ring, situated above and lateral to the public tubercle, is an opening in the ______

A

External oblique aponeurosis

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22
Q

The anterior wall of the inguinal canal is formed by

A

External oblique aponeurosis and additionally in the lateral part by the muscular fibers of the internal oblique

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23
Q

The posterior wall of the inguinal canal is formed by

A

The transversalis fascia, reinforced superficially by the aponeurotic fibers from the transverse abdominis and buttressed in the medial half by the conjoint tendon

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24
Q

Boundaries of Hesselbach’s triangle

A

Laterally: Inferior epigastric artery
Medially: lateral border of the rectus sheath
Inferior my: inguinal ligament

25
The Hesselbach's triangle is part of the posterior surface of the inguinal canal. Why is it a weak area?
B/c the transversalis fascia here is not supported by the conjoint tendon and aponeurotic fibers of the transversus abdominis, unlike the other parts of the posterior wall
26
Direct inguinal hernia is via ______
Hesselbach's triangle
27
The floor of the inguinal canal is formed by ____
Inguinal ligament
28
The roof of the inguinal canal is formed by _______
The arched lowest muscular fibers of the internal oblique
29
Boundaries of the Femoral triangle: Superiorly- Medially- Laterally- Floor- Anterior wall (roof)-
Superiorly: Inguinal ligament Medially: Adductor longus Laterally: Sartorius Floor: Iliopsoas (lateral) and Pectineus (medial) Anterior wall: Skin, superficial fascia, deep fascia (fascia lata)
30
Which muscle separates the content of the femoral triangle from the hip joint and obturator foramen
Pectineus
31
Mention the contents of the femoral triangle from medial to lateral: + something else (Hint: 4 + 1)
Femoral canal, femoral vein, femoral artery, femoral nerve. + Lymph nodes
32
Content of the femoral canal (Hint: 2)
Lymph node (node of Cloquet) Fat
33
The width of the femoral ring depends on _____
The extent of the insertion of the conjoint tendon to the pectineal line
34
Boundaries of the Femoral ring: Anterior: Posterior: Lateral: Medial:
Anterior: inguinal ligament Posteriorly: pubic bone & the fascia covering the pectineus( forming the pectineal ligament) Laterally: Femoral vein Medially: Fascia from iliopubic tract and lacunar ligament
35
The femoral ring is a weak area in the abdominal wall, T/F?
True
36
The testes descend into the scrotum in what month inutero?
9th Month
37
The testis begins descending from the iliac fossa into the inguinal canal in which month, inutero?
7th Month
38
The right testis usually descends earlier than the left, T/F?
False. The right testis usually descends later than the left
39
Which of the testis accounts for the higher incidence of abnormalities?
Right. B/c of its later discernment into the scrotum
40
What part of the processus vaginalis normally becomes obliterated at or soon after birth?
The part in the inguinal canal.
41
Tunica vaginalis is derived from ____
The part of the processus vaginalis in the scrotum that remains patent
42
Obliteration of the processus vaginalis ceases at ____ age
At 2years of age.
43
The failure of obliteration of the processus vaginalis may lead to Hint: 4
1. Indirect inguinal hernia 2. Infantile hydrocele of the cord 3. Congenital hydrocele or Complete indirect inguinal hernia 4. Encysted hydrocele of the cord
44
The commonest hernia in both sexes is
Inguinal hernia
45
The incidence of direct inguinal hernia increases with age, T/F?
True
46
The indirect inguinal hernia occurs in age groups but especially from age ____ to ____
20yrs - 49yrs
47
The direct inguinal hernia is usually seen after ___yrs of age
30yrs
48
The main symptoms of inguinal hernia are ____ & _____
Swelling and Pain
49
Severe pain in the swelling associated with abdominal pain indicates strangulation, T/F?
True
50
The neck of the sac is below the inguinal ligament, T/F?
False. It's above
51
An inguinal hernia that enters the scrotum or labium majus is called ____
Complete inguinal hernia
52
A hernia limited to the inguinal canal is referred to as _____ OR ______
Incomplete inguinal hernia OR bubonocele
53
An inguinal hernia that is out of the external inguinal ring and lies just above the pubic tubercle is called as
Funicular hernia
54
A complete inguinal hernia is nearly always direct in type, T/F?
False. Nearly always Indirect in type
55
Very rarely does a direct hernia enter the scrotum, T/F?
True.
56
The coexistence of an indirect and a direct inguinal hernia is called ____
Pantaloon hernia
57
Spigelian hernia is also called ___
Lateral Ventral Hernia
58
Describe the Spigelian zone

General Surgery (2 decks)

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