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Y4 GI / Surgery > Hernias > Flashcards

Hernias Flashcards

1
Q

What are the contents of the inguinal canal in a female?

A

Round ligament of the uterus + ilioinguinal nerve

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2
Q

What are the contents of the inguinal canal in a mail?

A

Spermatic cord + ilioinguinal nerve

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3
Q

What are the contents of the spermatic cord?

A

3 arteries: vas, testicular, cremasteric
3 fascial layers: extenral spermatic, cremasteric, internal spermatic
3 nerves: traversing ilioinguinal, sympathetics, genitofemoral
3 other things: pampiniform plexus of veins, vas deferens, lymphatics

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4
Q

The inguinal canal is located between what 2 structures?

A

Deep inguinal ring to superficial inguinal ring

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5
Q

The opening of the inguinal canal is located laterally to what structure?

A

Inferior epigastric artery

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6
Q

What are the contents of the femoral triangle?

A 
NAVL
femoral nerve
femoral artery
femoral vein
lymphatics deep inguinal LN
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7
Q

What is the superior border, medial border and lateral border of the femoral triangle?

A

Superior border inguinal ligament
Medial border adductor longus
Lateral border sartourius

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8
Q

What is the relevance of the mid inguinal point?

A

Where are you can palpate the femoral pulse

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9
Q

What is the relevance of the midpoint of the inguinal ligament?

A

Location of deep inguinal ring

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10
Q

What is the definition of a hernia?

A

Abnormal protrusion of a body part through a wall that should normally contain it

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11
Q

What is the definition of a irreducible hernia?

A

Can’t be shoved back in

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12
Q

What is the definition of a incarcerated hernia?

A

Stuck in its sack

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13
Q

What is the definition of a strangulated hernia?

A

Blood supply cut off

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14
Q

Our inguinal hernia is more common on the right or left side?

A

Right

remember open appendectomy is a risk factor

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15
Q

Can inguinal hernia is cause obstruction of small or large bowel?

A

SBO

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16
Q

How can inguinal and femoral hernia is be differentiated on examination?

A

Femoral hernia below inguinal ligament and pubic tubercle

Inguinal hernia above pubic tubercle

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17
Q

What is an indirect inguinal hernia?

A

Goes IN the canal, through deep ring int inguinal canal, out superficial ring into scrotum

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18
Q

What is a direct inguinal hernia?

A

Through defect in abdominal wall, directly out superficial ring

19
Q

Does direct or indirect inguinal hernia have a higher risk of obstruction / strangulation

A

Indirect

20
Q

Does a direct or indirect hernia pop out on coughing?

A

Direct pops out on coughing

21
Q

If the hernia is in the scrotum, it must be a direct or indirect inguinal hernia?

A

Indirect

22
Q

Name 3 risk factors for inguinal hernia

A 
Pregnancy 
Weightlifting
Chronic cough
Ascites
Constipation
Past abdominal wall surgery
Male
Smoker
23
Q

Direct and indirect inguinal hernia is have the same management - true or false

A

True

24
Q

How are inguinal hernia is diagnosed in the non-acute setting?

A

Clinical diagnosis

25
Q

How are inguinal hernia is investigated in the emergency setting?

A

CT

26
Q

All inguinal hernias are operated on - true or false

A

False
Risk of chronic pain so only operate if hernia causes pain
If not; conservative Mx

27
Q

What is the standard type of inguinal hernia repair?

A

Lichtenstein open mesh repair

28
Q

Where are femoral hernias located in relation to the pubic tubercle?

A

Below + lateral to the pubic tubercle

29
Q

Does inguinal or femoral hernia is have a higher risk of incarceration/ strangulation?

A

Femoral

since femoral canal isn’t as stretchy as inguinal canal

30
Q

Femoral hernias are always operated on - true or false?

A

True

31
Q

How are femoral hernias investigated in the acute setting?

A

CT

32
Q

How are femoral hernia is diagnosed in the non-acute setting?

A

Clinical diagnosis

33
Q

In a inguinal hernia, can you palpate ‘get above’ the lump?

A

No

34
Q

In a femoral hernia, can you palpate ‘get above’ the lump?

A

No

35
Q

In inguinal lymphadenopathy in the scrotum, can you palpate ‘get above’ the lump?

A

No

36
Q

In a varicocele/ hydrocele, can you palpate ‘get above’ the lump?

A

Yes

37
Q

In a testicular tumour, can you palpate ‘get above’ the lump?

A

Yes

38
Q

In a epididymal cyst, can you palpate ‘get above’ the lump?

A

Yes

39
Q

Triad fever + back pain + limp =

A

Psoas abscess

40
Q

Which specialty does drainage of a psoas abscess?

A

Interventional radiology

41
Q

Define a sinus

A

Blind ended tract from an epithelial surface

one opening

42
Q

A groin sinus only occurs in what group of people?

A

PWIDs

43
Q

Give 3 causes of a groin swelling in a IVDU

A 
Abscess (groin/psoas)
Aneurysm
Infected DVT
Pseudoaneurysm
Lymphadenitis
44
Q

If you suspect a groin aneurysm, what test is done for diagnosis?

A

CT angiogram

Y4 GI / Surgery (11 decks)

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