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Clinical pharmacology and therapeutics > Hernias > Flashcards

Hernias Flashcards

1
Q

Risk factors for hernias

A 
Protein deficiencies
Males
Increasing age
Obesity
Chronic couging
Constipation
Lifting
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2
Q

Contents of inguinal Canal

A

Spermatic cord
Round ligament
Nerves

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3
Q

Anterior wall of inguinal canal

A

Aponeurosis of external oblique

Internal oblique

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4
Q

Floor of inguinal canal

A

Inguinal ligament

Lacunar ligament

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5
Q

Posterior wall of inguinal canal

A

Transversalis fascia

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6
Q

Roof of inguinal canal

A

Transversalis fascia
Internal oblique
Transversus abdominus

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7
Q

where does the deep inguinal ring lie

A

Just above midpoint of inguinal ligament

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8
Q

Where does inguinal canal lie in relation to inferior epigastric vessels

A

Lateral

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9
Q

Weakest wall in inguinal canal

A

Transversalis fascia

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10
Q

Where does the inguinal canal end

A

Pubic tubercle

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11
Q

Most common type of inguinal hernia

A

Indirect

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12
Q

fact file of direct inguinal hernias

A

Bowel enters inguinal canal through weakness in posterior wall (Hesselbach’s triangle)

Easily reduce and rarely strangulate

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13
Q

Fact file of indirect inguinal hernias

A

Bowel passing through the deep ring of inguinal canal due to an incomplete closure of processus vaginalis

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14
Q

Which inguinal hernias are more likely to strangulate

A

Indirect

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15
Q

Which inguinal hernia has more likely to exit superficial ring and pass into scrotum

A

Indirect

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16
Q

How to distinguish between indirect vs direct

A

Press over deep ring (just above midpoint of inguinal ligament)

Ask patient to cough

If hernia reappears it is direct

17
Q

How do we know if its direct vs indirect hernia during surgery

A

Indirect hernias are lateral to inferior epigastric vessels

Direct hernias are medial to inferior epigastric vessels

18
Q

femoral canal contents and purpose

A

Fatty tissue and lymph nodes

Lies medial to the femoral vein and allows it space for it to expand

19
Q

What are femoral hernias

A

Abdominal viscera or momentum pass through femoral ring into the potential space of the femoral canal

20
Q

Risk factors for femoral hernias

A

Female (wider pelvis)
Pregnancy
Raised intra-abdominal pressure
Age

21
Q

Problem with femoral hernias

A

High risk of strangulation so require urgent surgical intervention

22
Q

Femoral vs inguinal hernias

A

Inguinal- superiomedial to pubic tubercle

Femoral- Inferolateral

23
Q

Why do femoral hernias pose a high strangulation risk

A

Due to narrow neck of the femoral canal

24
Q

Epidemiology of direct vs indirect inguinal hernias

A

Direct- older men

Indirect- Younger men

25
Q

Cause of ubilical hernia

A

Defect in transversalis fascia or umbilical ring

26
Q

Factfile of umbilical hernia

A

More common in children

Low strangulation risk

Occur in adults due to pregnancy or gross ascites

27
Q

Cause of paraumbilical hernia

A

Weakness in linea alba

More common in 25-50yo women

Usually caused by obesity or gross ascites

High risk of strangulation

28
Q

What is an epigastric hernia caused by

A

Herniation of fat which overlies the bowel through the linea alba above the umbilicus

29
Q

Who do epigastric hernias most occur in and what are the symptoms

A

Young males

Discomfort on exercise or eating
Relieved by reclining

30
Q

What are small epigastric hernias prone to

A

Incarceration and strangulation

31
Q

What do small epigastric hernias contain

A

Extraperitoneal fat

32
Q

What do large epigastric hernias contain

A

omentum

33
Q

What is divarication of recti

A

Separation of rectus abdomens due to linea alba laxity

34
Q

Risk factors of divarication fo recti

A

Truncal obesity
Pregnancy
Repeated midline operations and chronically raised intra abdominal pressure

35
Q

How to diagnose divarication of recti

A

ultrasound

36
Q

When do you not have to intervene in incisional hernias

A

If patient is asymptomatic

Clinical pharmacology and therapeutics (16 decks)

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