Hernias

Question 1

Relative frequencies of inguinal hernias?

Answer 1

Direct (20%)

Indirect (80%)

Question 2

Location of an inguinal hernia relative to the pubic tubercle?

Answer 2

Superomedial

Question 3

Location of a femoral hernia relative to the pubic tubercle?

Answer 3

Inferolateral

Question 4

How (theoretically) can direct vs indirect inguinal hernias be distinguished?

Answer 4

If the reduced hernia can be controlled by pressure over the deep inguinal ring, this suggests indirect inguinal hernia

Question 5

Management of inguinal hernia?

Answer 5

Any patient with symptomatic hernia should be offered surgery; if any evidence of strangulation this needs urgent surgical exploration

Question 6

Small irreducible mass lateral to the rectus muscle at the level of the ASIS

Answer 6

Spigelian hernia

Question 7

Why do femoral hernias need to repaired promptly?

Answer 7

High risk of strangulation

Question 8

Which group of patients are most commonly affected by femoral hernias?

Answer 8

Middle aged multiparous women

Question 9

Groin lump with expansile cough impulse + fluid thrill

Answer 9

Saphena varix

Question 10

Course of the inguinal ligament?

Answer 10

ASIS to pubic tubercle

Question 11

Pathophysiology of inguinal hernia?

Answer 11

Protuberance of bowel through the abdominal wall where is it is weakened by the presence of the inguinal canal

Question 12

If an inguinal hernia extends out through the external inguinal ring, where will it emerge?

Answer 12

Into the scrotum/vulva