Hernias Flashcards
What is the definition of a hernia?
Protrusion of an organ through a defect in the wall of an anatomical cavity
What is a true hernia?
- Contents within a peritoneal sac
- Typically at a natural opening
- Typically congenital
What is a false hernia?
- Contents NOT within a peritoneal sac
2. Typically due to trauma
What do you call a hernia outside the body cavity?
External abdominal hervia
What do you call a hernia within the abdomen or thorax?
Internal abdominal hernia
What is a reducible hernia?
Freely movable and easily reduced
What is an incarcerated hernia?
Adhesions to surrounding tissue with hernia contents in a fixed location
What is a strangulated hernia?
Obstruction of vascular supply of tissue
What type of suture would you most commonly use to close a hernia ring?
Absorbable
What are the 3 herniorrhaphy principles?
- Reduce viable hernia contents
- Remove redundant tissue of sac
- Suture closed
What is herniorrhaphy?
Surgical repair of a hernia
Because umbilical hernias are typically a congenital defect, what other defect should you look for in a male pup with such a condition?
Cryptorchidism
Umbilical hernias are thought to be heritable in some breeds. Which breeds?
- Basenji
- Weimaraner
- Perkingese
- Airedale
- GS pointer
Which is better, a large hernia or a small hernia?
Large hernia - avoid strangulation
In females, would an inguinal hernia most likely be acquired or congenital?
Acquired
In males, would an inguinal (scrotal) hernia most likely be acquired or congenital?
Congenital
True or False: sterilization is not necessary in pups with inguinal hernias.
FALSE - sterilization is recommended as this is a heritable condition
Which female dogs are most often affected by inguinal hernias?
Middle-aged, intact
Which male dogs are most often affected by inguinal hernias?
Young male dogs (
Which is more common, an inguinal hernia on the left or the right side?
LEFT
True or False: Inguinal hernias require prompt surgical treatment.
TRUE - risk for incarceration and strangulation
True or False: Males with inguinal hernias should always be castrated.
TRUE - risk for testicular tumors
True or False: Inguinal hernias in the male dog are often easily reduced.
FALSE - often NON-REDUCIBLE in the male
Which vessels/nerves must you preserve when surgically fixing an inguinal hernia?
- Genitofemoral nerve
2. External pudendal artery and vein
Which vessels/nerves must you preserve when surgically fixing a femoral hernia?
- Femoral artery and vein
- Saphenous nerve
- Lymphatics
True or False: Abdominal hernias are typically trauma related.
TRUE
Because abdominal hernias are typically trauma-related, what is you first priority when one of these patients arrives?
Stabilize the patient
Is emergency surgery indicated with an abdominal hernia?
No - stabilize the patient and wait 3-5 days before performing surgery
When WOULD emergency abdominal hernia surgery be indicated?
- Hemorrhage
- GI strangulation
- Urinary obstruction
When repairing a traumatic abdominal hernia, what is a MUST?
Perform an abdominal exploratory
What is the ONLY innervation to the external anal sphincter?
Pudendal nerve
Which 2 muscles make up the pelvic diaphragm?
- Levator ani
2. Coccygeus
In which dogs are perineal hernias most common?
Intact males
Concerning perineal hernias, between which two muscles is the herniation most common?
- Levator ani
- External anal sphincter
(some between levator ani and coccygeal muscle)
When a diaphragmatic hernia occurs, where is it most likely to herniate?
In the weakest portion, within the muscle
True or False: It is okay to wait multiple days on a diaphragmatic hernia.
TRUE
What are the 2 emergency surgery indications for a diaphragmatic hernia?
- Stomach herniation
2. Inability to stabilize the respiratory system
What is the prognosis for a diaphragmatic hernia?
Excellent if survive immediate post-operative period
What is a peritoneopericardial diaphragmatic hernia (PPDH)?
Communication of the abdominal cavity with the pericardial sac
Peritoneopericardial diaphragmatic hernias are always congenital or acquired?
Congenital - check for other congenital defects
Do you need positive pressure ventilation for a PPDH patient?
No
What are the 3 bad problems with a PPDH?
- Restrict lung expansion
- Restrict cardiac filling (cardiac tamponade)
- Congestion/obstruction of herniated organs
True or False: PPDH patients always require surgery.
FALSE - may not be necessary in older asymptomatic animals
What is a hiatal hernia?
Protrusion of abdominal contents through the esophageal hiatus
What is a sliding hiatal hernia?
Advancement of gastroesophageal junction into the esophageal hiatus
What is a paraesophageal hiatal hernia?
Advancement of gastric fundus into the esophageal hiatus
What is a combination hiatal hernia?
Advancement of both the gastroesophageal junction and the gastric fundus into the esophageal hiatus
What is a gastroesophageal intussusception?
Intussusception of the gastric fundus into the lumen of the esophagus and through the esophageal hiatus
Are hiatal hernias congenital or acquired hernias?
Congenital
Which dog breed is pre-disposed to hiatal hernias?
Shar-pei
What are the clinical signs associated with a hiatal hernia?
Similar to those of gastroesophageal reflex: esophagitis, regurgitation, aspiration pneumonia
How would you treat a hiatal hernia medically?
- Antacids
2. Prokinetics
How would you treat a hiatal hernia surgically?
- Reduction of esophageal hiatus
- Esophagopexy
- Gastropexy
