Hernias Flashcards

1
Q

Hernia definition

A

protrusion of a viscus or part of a viscus through a defect of the walls of its containing cavity into an abnormal position

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2
Q

Irreducible

A

if a bowel hernia can’t be pushed back into the right space

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3
Q

Incarcertaion

A

contents of the hernia sac are stuck inside by adhesions

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4
Q

Obstructed

A

if bowel contents cannot pass through them

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5
Q

strangulated

A

if ischamia occurs

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6
Q

whats the most common type of hernia?

A

inguinal

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7
Q

indirect inguinal hernias

A

pass through the internal (deep) inguinal ring, and, if large, out through the external (superficial) ring

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8
Q

direct inguinal hernias

A

push their way directly forward through the posterior wall of the inguinal canal, into a defect in the abd wall

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9
Q

predisposing conditions to an inguinal hernia

A

male, chronic cough, constipation, urinary obstruction, heavy lifting, ascites, past abd surgery

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10
Q

relations of the inguinal canal

A

floor: inguinal ligament
roof: fibres of transversalis, internal oblique
anterior: external oblique aponeurosis + internal oblique
posterior: laterally, transversals fascia. medially, conjoint tendon

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11
Q

gold standard for determining the type of inguinal hernia?

A

at surgery:

  • (80%) direct hernias arise lateral to inferior epigastric vessels
  • indirect hernias are medial
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12
Q

which hernias frequently strangulate and are frequently irreducible

A

femoral

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13
Q

femoral hernia

A

bowel enters the femoral canal, presenting as a mass in the upper medial thigh or above the inguinal ligament where it points down the leg

likely to be irreducible and to strangulate

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14
Q

RF for femoral hernia

A

female, elderly

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15
Q

boundaries of the femoral canal

A

anteriorly: inguinal ligament
medially: lacunar ligament (and pubic bone)
laterally: femoral vein
posteriorly: pectineal ligament + pectineus

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16
Q

treatment for femoral hernia

A

surgical repair

herniotomy - ligation + excision of the sac
herniorrhaphy - repair of hernial defect

17
Q

incisional hernia

A

follow breakdown of muscle closure after surgery

repair isn’t easy if obese

18
Q

hiatus hernia

A

part of the stomach herniates through the oesophageal hiatus of the diaphram

19
Q

whats a sliding hiatus hernia?

symptoms?

A

accounts for more than 95% of cases
GO junction slides through hiatus + lies above diaphragm

no symptoms unless associated reflux

20
Q

other type of hiatus hernia aside from sliding?

A

para-oesophageal hernia dangerous!!

gastric funds rolls up through the hiatus alongside oesophagus, GO junction remaining below the diaphragm

21
Q

hernia repair

A

mesh techniques

advise to diet and stop smoking pre-op