hernia management Flashcards

1
Q

hernia superior and medial to the pubic tubercle?

A

inguinal

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2
Q

who gets inguinal hernias?

A

men - minguinal

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3
Q

risk factors for inguinal hernias?

A

obesity, heavy lifting, constipation, pregnancy

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4
Q

Direct and indirect inguinal hernia?

A

Direct is less common
weakness in abdominal wall
medial to epigastric artery

Indirect is more common
Lindirect - lateral to epigastric artery
if scrotal mass that you can’t get above - its an indirect hernia

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5
Q

two types of inguinal hernia?

A

direct and indirect

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6
Q

which inguinal is reduceable and restrainable ?

A

indirect

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7
Q

which hernia is more likely to strangulate? direct or indirect?

A

indirect (in the scrotum)

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8
Q

why do you get indirect inguinal hernias?

A

failure of the deep inguinal ring to close

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9
Q

femoral hernias more common in males or females?

A

females

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10
Q

paediatric hernias more common in boys or girls?

A

boys

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11
Q

If under one year old, management of paediatric inguinal hernia?

A

urgent surgery (risk of strangulation)

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12
Q

epigastric hernia due to defect in ?

A

linea alba

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13
Q

midline mass above the umbilicus

A

epigastric

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14
Q

who are epigastric hernias most common in ?

A

teenage boys

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15
Q

occurs in newborns due to defect in trasnversalis fascia?

A

umbilical

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16
Q

most umbilical hernias will resolve by age?

A

3

17
Q

para umbilical hernia is strongly assocaited with ?

A

obesity and ascites

18
Q

where would you find a para umbilical hernia?

A

mass above or below the umbilicus

19
Q

hernia at lateral edge of rectus sheath ?

A

spigelian

20
Q

where does a spigelian hernia appear ?

A

inferior and lateral to umbilicus

21
Q

hernia at site of previous surgery ?

A

incisional

22
Q

what sort of stuff is around inguinal hernia (pneumonic)

A
NAVEL 
nerve
artery 
vein 
empty space 
lymphatics
23
Q

where could an indirect hernia strangulate?

A

at the deep inguinal ring

24
Q

what do you do with femoral hernia?

A

repair is recommended

25
Q

where do femoral hernias go?

A

down the femoral canal (not the inguinal canal)

26
Q

how do you repair an inguinal hernia?

A

usually done with a mesh technique

27
Q

what should a patient be advised before inguinal hernia repair?

A

lose weight and stop smoking

28
Q

what advice should you give about returning to work after hernia repair ?

A

Patients can return to work, including manual labour and driving after 2 weeks if they feel comfortable.

29
Q

repairing an inguinal hernia?

A

mesh technique

30
Q

how to differentiate between direct and indirect?

A

you should reduce the hernia, then occlude the internal inguinal canal with 2 fingers. Ask the patient to cough. If it pops out, then is direct, if it stays in then its indirect!