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?

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 ?

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
where do femoral hernias go?
down the femoral canal (not the inguinal canal)
26
how do you repair an inguinal hernia?
usually done with a mesh technique
27
what should a patient be advised before inguinal hernia repair?
lose weight and stop smoking
28
what advice should you give about returning to work after hernia repair ?
Patients can return to work, including manual labour and driving after 2 weeks if they feel comfortable.
29
repairing an inguinal hernia?
mesh technique
30
how to differentiate between direct and indirect?
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!