Hernia (Schwartz 11ed)

Question 1

What is the most common subtype of groin hernia in both men and women?

Answer 1

Indirect inguinal hernia

Question 2

Percentage of hernia repairs in women?

Answer 2

10%

Question 3

Percentage of hernia repairs in men?

Answer 3

90%

Question 4

Percentage of abdominal wall hernias that occur in the groin?

Answer 4

75%

Question 5

Percentage of femoral hernia repairs that occur in women?

Answer 5

70%

Question 6

Peak ages of hernia incidence in men?

Answer 6

Before 1 year old

After 40 years old

Question 7

Hernia prevalence rate in men ages 25-34 years old?

Answer 7

15%

Question 8

Hernia prevalence rate among patients over 75 years old?

Answer 8

47%

Question 9

True or false, conservative management of asymptomatic inguinal hernias is recommended.

Answer 9

True

Question 10

True or false, Elective repair of inguinal hernias can either be undertaken using laparoscopic, robotic, or open approach?

Answer 10

True

Question 11

What is the advantage of robotic assisted hernia repair?

Answer 11

Better ergonomics

Better visualization

Question 12

Does the use of prosthetic mesh improve recurrence rates, whether the repair is open or laparoscopic? Yes or no

Answer 12

Yes

Question 13

What are the 3 metrics by which hernia repair outcome are measured?

Answer 13

Recurrence
Pain
Quality of life

Question 14

Amongst the following, which one results in a tension-free repair?

Bassini
McVay
Shouldice 
Desarda 
Lichtenstein

Answer 14

Lichtenstein

All others are tissue-based repairs

Question 15

Amongst the following, which one restores the strength of the transversalis fascia?

Bassini
McVay
Shouldice 
Desarda 
Lichtenstein

Answer 15

Lichtenstein

Question 16

Advantage of laparoscopic hernia repair?

Answer 16

Reduced post-op pain

Improves recovery

Question 17

Where is the inguinal canal located?

Answer 17

Anterior portion of the pelvic basin

Question 18

How long is the inguinal canal?

Answer 18

4 - 6 cm

Question 19

What is the anterior and posterior borders of the inguinal canal?

Answer 19

Anteriorly = external oblique Aponeurosis 
Posteriorly = transversus abdominis & transversalis fascia

Question 20

What is the superior and inferior borders of the inguinal canal?

Answer 20

Superiorly = internal oblique muscle 
Inferiorly = inguinal ligament

Question 21

Where does the inguinal canal begin?

Answer 21

On the posterior abdominal wall

Question 22

Where does the inguinal canal end?

Answer 22

Superficial (external) inguinal ring

Question 23

What are the 3 ligaments that contribute to the inguinal canal?

Answer 23

Inguinal ligament
Cooper’s ligament
Lacunar ligament

Question 24

What structure traverses the inguinal canal?

Answer 24

Spermatic cord

Question 25

What are the contents of the spermatic cord?

Answer 25

``` 3 arteries 3 veins 2 nerves Pampiniform plexus Vas deferens ```

Question 26

What are the 4 other structures that surround the spermatic cord?

Answer 26

1. Ilio-pubic tract 2. Lacunar ligament 3. Cooper’s ligament 4. Conjoined tendon

Question 27

Also know as the Aponeurotic band?

Answer 27

Ilio-pubic tract

Question 28

Also known as the ligament of Gimbernat?

Answer 28

Lacunar ligament

Question 29

Also known as Cooper’s ligament

Answer 29

Pectineal ligament

Question 30

It is the fusion of the inferior fibers of the Internal oblique and transversus abdominis aponeurosis?

Answer 30

Conjoined tendon

Question 31

What aponeurotic band that helps form the deep inferior margin of the transversus abdominis muscle and transversalis fascia, as well as the inferior margin of the Internal inguinal Ring?

Answer 31

Ilio-pubic tract

Question 32

What ligament is the triangular Fanning of the inguinal ligament?

Answer 32

Lacunar Ligament

Question 33

What ligament forms the lateral portion of the lacunar ligament?

Answer 33

Cooper’s ligament

Question 34

What type of hernia that protrudes lateral to the inferior Epigastric vessels via the deep inguinal Ring?

Answer 34

Indirect inguinal hernia

Question 35

What type of hernia that protrudes medially to the inferior epigastric vessels within the Hesselbachs’s triangle?

Answer 35

Direct inguinal hernia

Question 36

What type of hernia that protrudes in a small and inflexible femoral Ring?

Answer 36

Femoral hernia

Question 37

Inferior border of the Hesselbach’s triangle?

Answer 37

Inguinal ligament

Question 38

Medial border of the Hesselbach’s triangle?

Answer 38

Lateral edge of the Rectus sheath

Question 39

Supero-lateral border of the Hesselbach’s triangle?

Answer 39

Inferior epigastric vessels

Question 40

Anterior border of the femoral Ring?

Answer 40

Ilio-pubic tract & inguinal ligament

Question 41

Posterior border of the femoral ring?

Answer 41

Cooper’s ligament

Question 42

Lateral border of the femoral ring?

Answer 42

Femoral vein

Question 43

Nyhus classification type IIIC hernia?

Answer 43

Femoral hernia

Question 44

Nyhus classification type I & II hernia?

Answer 44

Indirect Hernia

Question 45

Nyhus classification type IIIA hernia?

Answer 45

Direct hernia

Question 46

Nyhus classification type IV hernia?

Answer 46

Recurrent hernia

Question 47

Nyhus classification type IIIB hernia?

Answer 47

Sliding, Scrotal and Pantaloon hernias Hernias that encroach the posterior inguinal wall