Hernias

Question 1

Strangulation define

Answer 1

Strangulation develops as a consequence of incarceration and implies impairment of blood flow (arterial, venous, or both).

A strangulated hernia presents as severe, exquisite pain at the hernia site, often with signs and symptoms of intestinal obstruction, toxic appearance, and, possibly, skin changes overlying the hernia sac.

A strangulated hernia is an acute surgical emergency.

Question 2

hernia is called reducible when

Answer 2

the hernia sac itself is soft and easy to replace back through the hernia neck defect.

Question 3

hernia is incarcerated

Answer 3

when it is firm, often painful, and nonreducible by direct manual pressure.

Question 4

most common form of hernia

Answer 4

INGUINALHERNIA

Question 5

most common hernias in women

Answer 5

inguinal hernias

Question 6

True or false

100% sensitivity and 100% specificity of bedside emergency US for the diagnosis of groin hernia

Answer 6

True

Question 7

Hesselbach triangle

Answer 7

Lateral border : inferior epigastric arteries
Medial border : rectus sheath
Inferior border : inguinal ligament

Question 8

direct inguinal hernia

Answer 8

passes directly through a weakness in the transversalis fascia in the Hesselbach triangle

Question 9

indirect inguinal hernia

Answer 9

passes from the internal to the external inguinal ring through the patent process vagina- lis, and then to the scrotum

Question 10

develop as a result of a defect in the anterior abdominal wall and can be either spontaneous or acquired. They are typically characterized by their anatomic location as epigastric, umbilical, incisional, or hypogastric

Answer 10

Ventral hernias

Question 11

account for up to 20% of all abdominal wall hernias. They are often the result of excess wall tension or inadequate wound healing. They are also associated with surgical wound infections.

Answer 11

Incisional hernias

Question 12

hernia sac protrudes through the femoral canal and produces a mass that is typically below the inguinal ring

Answer 12

Femoral hernia

Question 13

Arises at the lateral edge of the rectus muscle and the arcuate (semilunar) line.

Nearly always acquired conditions due to comorbidities that increase intra-abdominal pressure

Answer 13

Spigelian hernia also known as a lateral ventral hernia

Question 14

classic presentation is abdominal pain associated with an anterior lateral abdominal wall mass or bulge

Answer 14

Spigelian hernia, also known as a lateral ventral hernia

Question 15

True or false

CT scan remains the best imaging for diagnosis

Answer 15

True

Question 16

bowel herniation through the obturator canal and nearly always presents as either a partial or complete bowel obstruction

Answer 16

Obturator hernia

Question 17

typical patient is an elderly frail female with signs and symptoms of intestinal obstruction

Answer 17

Obturator hernia

Question 18

pain in medial portion of the thigh due to obturator nerve compression

Answer 18

Howship-Romberg sign

Question 19

involves only the antimesenteric border of the intestine and involves only a portion of the wall circumference

Answer 19

Richter hernia

Question 20

presents differentially from a traditional incarcerated/strangulated hernia

presents without vomiting or intestinal obstruction due to the incomplete involvement of the circumference of the intestine

leads to strangulation and gangrene than other more standard hernias. Surgical repair is indicated

Answer 20

Richter hernia

Question 21

reduction en mass

Answer 21

incarcerated hernia is reduced back into the peritoneal cavity but a loop of bowel remains inside the hernia sac even after reduction, so that the retained bowel remains incarcerated