HERNIAS

Question 1

Pertinent Anatomy of a patient with Hernia.

Answer 1

(1) Abdomen
(2) Inguinal Canal
(a) Processus vaginalis

Question 2

the protrusion of any viscus from its natural cavity

Answer 2

hernia

Question 3

The protrusion may be_______and in a wide range of locations

Answer 3

internal or external

Question 4

Abdominal wall hernias may be subdivided further into

Answer 4

(a) groin (inguinal or femoral),
(b) umbilical,
(c) anterior abdominal,
(d) pelvic,
(e) lumbar locations.
(3) All inguinal hernias occur more commonly in males than in females.

Question 5

What is the etiology for all indirect
inguinal hernias.
( indirect inguinal hernias)

Answer 5

congenitally persistent processus vaginalis

Question 6

Passage of contents through this patent processus vaginalis

indirect inguinal hernias

Answer 6

indirect inguinal hernia.

Question 7

The origin of the hernia sac is located where

indirect inguinal hernias

Answer 7

lateral to the inferior epigastric artery.

Question 8

inguinal hernia in males is more common on the right side
due to what
( indirect inguinal hernias)

Answer 8

later passage of the right testis.

Question 9

(g) A shutter mechanism, which is postulated to close the internal inguinal ring
to a slit, may be dysfunctional in patients with a patent processus vaginalis.
(h) Increases in intra-abdominal pressure in association with reduced muscle
tone or other connective tissue abnormalities can then force abdominal
contents through the widened internal ring into the inguinal canal, resulting in
a clinically detectable hernia.
(i) Indirect inguinal hernias frequently incarcerate and strangulate, particularly
in the first year of life and in females.
(j) These hernias are called “indirect” because the term ‘indirect’ refers to the
fact that the bowel and peritoneal protrusion do not herniate directly through
a weakness in the abdominal musculature. Instead, the bowel and peritoneal
fluid move through a patent processus vaginalis into the scrotum.
(k) Direct inguinal hernias, on the other hand, occur due to weakness in the
bottom of the inguinal canal.
( indirect inguinal hernias)

Answer 9

BREAK THIS CARD UP.

Question 10

These hernias are protrusions directly through the transversalis fascia and the
external inguinal ring, medial to the inferior epigastric vessels.

Answer 10

Direct Inguinal Hernia

Question 11

T/F:Recurrence after repair is more frequent than for an indirect inguinal hernia.
(Direct Inguinal Hernia)

Answer 11

True

Question 12

In utero contraction of the umbilical cord insertion forms a fibromuscular
umbilical ring

Answer 12

Umbilical Hernia

Question 13

Patients with_____frequently will no longer reduce on presentation.

Answer 13

incarceration

Question 14

S/S of incarceration

Answer 14

pain may develop suddenly.
(b) Incarceration may be accompanied by nausea and vomiting if bowel
obstruction has occurred.
(c) Incarcerated hernias are a leading cause of small bowel obstruction, second
only to postoperative adhesions.

Question 15

S/S of strangulation

Answer 15

the patient may be toxic
may result in perforation, abscess formation,
peritonitis, or septic shock.