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Gastrointestinal > Hernia > Flashcards

Hernia Flashcards

1
Q

what is a hernia

A

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

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2
Q

causes of a hernia

A

anatomical
inherited collagen disorders
sites where surgical incisions are made

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3
Q

example of anatomical causes of a hernia

A

sites where structures exit through an opening in the cavity

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4
Q

types of hernia

A 
epigastric
spigelian
femoral
inguinal 
incisional
umbilical
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5
Q

classification of hernia

A

reducible
incarcerated or irreducible
strangulated

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6
Q

describe reducible hernia

A

hernia can be easily pushed back into abdomen

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7
Q

describe incarcerated or irreducible hernia

A

hernia cannot be manipulated back to abdomen

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8
Q

describe strangulated hernia

A

vascular supply to contents contained within hernia is compromised, resulting in ischaemic and gangrenous tissue

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9
Q

treatment of hernias

A

conservative/non-surgical management

surgical

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10
Q

define epigastric hernia

A

fascial defect in the linea alba betune the xiphoid process and the umbilicus

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11
Q

clinical features of epigastric hernia

A

midline lump
asymptomatic - may present with pain
+incarcerated or strangulated = symptoms dependent on organ involved

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12
Q

epidemiology of paraumbilical hernia

A

occurs in all age group

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13
Q

aetiology of paraumbilical hernia

A

stretching of abdominal wall by obesity
multiple pregnancy
ascites

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14
Q

clinical features of paraumbilical hernia

A

pain

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15
Q

complications of paraumbilical hernia

A

do not resolve spontaneously

high incidence of incarceration and strangulation

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16
Q

treatment of paraumbilicial hernia

A

always surgical

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17
Q

aetiology of adult umbilical hernia

A

persistent elevation of intra-abdominal pressure

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18
Q

clinical features of adult umbilical hernia

A

pain

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19
Q

treatment of adult umbilical hernia

A

always surgical

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20
Q

complications of adult umbilical hernia

A

do not resolve spontaneously

high incidence of incarceration and strangulation

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21
Q

length of the inguinal canal

A

4cm

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22
Q

describe the pathway the inguinal canal

A

stars at deep inguinal ring and ends in superficial inguinal ring

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23
Q

boundaries of inguinal canal - anterior

A

external oblique and internal oblique muscle

24
Q

boundaries of inguinal canal - floor

A

ligament

25
Q

boundaries of inguinal canal - roof

A

transversals fascia

internal oblique and transverses abdominis

26
Q

boundaries of inguinal canal - posterior

A

transversals fascia and conjoint tendon

27
Q

function of inguinal canal - male

A

transmits the spermatic cord and ilioinguinal nerve

28
Q

function of inguinal canal - female

A

transmits the round ligament of the uterus and ilioinguinal nerve

29
Q

where does spermatic cord enter inguinal canal

A

through the deep inguinal ring in posterior wall

30
Q

where does spermatic cord exit inguinal canal

A

through superficial inguinal ring on the anterior wall

31
Q

contents of spermatic cord

A

3 coverings

6 contents

32
Q

coverings of spermatic crd

A

internal spermatic fascia
cremasteric fascia
external spermatic fascia

33
Q

contents of spermatic cord

A 
vas deferens
3 arteries 
pampiniform plexus (veins)
lymphatics 
nerves 
remains of processes vaginalis
34
Q

arteries of spermatic cord

A

testicular artery
artery to Vas
cremasteric

35
Q

nerves of spermatic cord

A

genital branch of genitofemoral nerve

sympathetic twigs

36
Q

lateral edge of hesselbach triangle

A

inferior epigastric artery

37
Q

medial edge of hesselbach triangle

A

lateral border of rectus muscle

38
Q

inferior edge of hesselbach triangle

A

inguinal ligament

39
Q

types of inguinal hernia

A

direct inguinal hernia
indirect inguinal hernia - most common
right sided hernias more common

40
Q

describe direct inguinal hernia

A

bowel pushes through weak area in floor of inguinal canal - the hesselbach triangle

41
Q

describe indirect inguinal hernia

A

bowel inters the inguinal canal via the deep inguinal ring and pushes out through the superficial inguinal ring

42
Q

epidemiology of inguinal hernia

A

males

43
Q

pathology of inguinal hernia

A

multifactorial - patent processus vaginalis and pathological change in connective tissue

44
Q

clinical presentation of inguinal hernia

A

groin swelling that disappears when lying down, located above and medial to pubic tubercle
palpable cough impulse

45
Q

tests of inguinal hernia

A

ultrasound - if in doubt about diagnosis

46
Q

treatment of inguinal hernia

A

non surgical

surgical - open or laparoscopic

47
Q

epidemiology of femoral hernia

A

older age
20% of hernias in woman
5% of hernias in men

48
Q

clinical presentation of femoral hernia

A

strangulation in 40% of hernias

49
Q

borders of femoral ring - anterior

A

inguinal ligament

50
Q

borders of femoral ring - posterior

A

iliopectineal ligament

51
Q

borders of femoral ring - medial

A

lacunar ligament

52
Q

borders of femoral ring - lateral

A

femoral vein

53
Q

treatment of femoral hernia

A

surgical

54
Q

aetiology of incisional hernia

A

iatrogenic - most common complication of laparotomy

55
Q

predisposing factors of incisional hernia

A 
wound complications 
inherited collagen abnormlaites 
advanced age 
smoking 
morbid obesity 
malignancy 
surgical technique
56
Q

management if incisional hernia

A

conservative or surgical

Gastrointestinal (71 decks)

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