Hernia Surgery Lecture Powerpoint

Question 1

Associated factors with inguinal herniation (5)

Answer 1

• family history
• straining of stool
• obesity
• connective tissue disorder
• ascites

Question 2

Scarpa’s fascia

Answer 2

Most superficial layer of the anterior lower abdominal wall seen initially during hernia repair

Question 3

2 nerves that run thru the inguinal canal

Answer 3

• Ilioinguinal nerve

- Genitofemoral nerve

Question 4

The ___ runs thru the male inguinal canal, the ___ runs thru the female

Answer 4

spermatic cord, round ligament

Question 5

Hesselbach’s triangle components

Answer 5

Lateral - inferior epigastric vessels
Medial - lateral border of rectus abdominus
Inferior - inguinal ligament
Floor - internal oblique and transversus abdominus

Question 6

Inguinal hernia signs and symptoms (3)

Answer 6

• vague discomfort
• pain
• bulge

Question 7

During palpation of a hernia, indirect (abdomoinal contents going thru inguinal canal) is felt on the ___ of the finger while direct (abdominal contents going thru abdominal wall) is felt on the ___, often done while the patient valsalvas (turn head and cough)

Answer 7

tip, side

Question 8

Inguinal hernia complications (4)

Answer 8

• Incarcerations (trapped herniated tissue but not ischemic)
• strangulation (ischemia - elevated wbc, nausea, acutely ill)
• bowel obstruction
• recurrence of hernia

Question 9

Inguinal hernia therapy

Answer 9

Surgery - elective is less risk in all cases than emergency!

Question 10

Bassini vs Lichtenstein operative types for inguinal hernia

Answer 10

Bassini is baseline repair of hernia, lichtenstein uses mech

Question 11

Inguinal hernia surgical complications (5)

Answer 11

• bleeding
• loss of testicle
• ileoinguinal nerve entrapment syndrome
• hematoma/seroma
• vas deferens injury

Question 12

NAVEL acronym in the femoral triangle (lateral to medial)

Answer 12

Nerve artery vein lymphatics

Question 13

Spigelian hernia

Answer 13

Located at the junction of the semilunar line and the semicircular line at the lateral border of the rectus muscle just below the umbilicus

Question 14

Diastasis recti vs epigastric hernia

Answer 14

Easily mistaken for each other, diastasis recti is widening of abdomen muscles (thinning linea alba) often after pregnancy but preservation of the fascia while epigastric hernia will often continue to grow in size and has the potential to strangulate