Hernias Flashcards
Protrusion of a tissue or organ through a defect in the wall of the anatomical cavity in which it normally lies
Hernia
What is the difference of a true and false hernia?
True: anatomical hernia sac (umbilical hernia)
False: lacks hernia sac (acute traumatic abdominal hernia, only initially is this a false hernia)
What is “loss of domain”
abnormal area of organs due to hernia that has occurred
T/F: Acute hernias have a loss of domain
FALSE
Chronic hernias have a loss of domain
What is a common example of a hernia with loss of domain?
Chronic diaphragmatic hernia
T/F: perianal hernia will not have a loss of domain
TRUE
What is compartment syndrome?
Pushing contents back into place, pressure increases due to lack of space leading to organ damage
What can complicated hernias lead to?
Strangulation: blood supply compromised leading to ischemia and potential necrosis
What is the tx for hernias?
Herniorrhaphy
What suture is used during herniorrhaphy?
PDS absorbable suture
What is the difference of a closed vs. open herniorrhaphy?
Closed: invert sac and contents without opening the hernia sac
Open: hernia sac incised and removed. Freshening edges by removing hernia ring is NOT necessary and should be avoided
How does a umbilical hernia develop?
failure of fusion of rectus abdominis muscle at umbilicus
What breeds are predisposed to umbilical hernia?
Airedales, pekignese, basenji, pointers and weimaraner
What other defects should you look for if your patient has an umbilical hernia?
Cleft palate, cryptorchidism or cardiac problems
When will you observe GI signs with an umbilical hernia?
Viscera entrapped and hard/painful lesion
What is the signalment for a congenital vs. acquired inguinal hernia?
Congenital: young male dogs
Acquired: middle aged, intact female dogs
What are the breeds predisposed to heritable inguinal hernias?
Cocker spaniel and dachshund
What is the difference of direct vs. indirect inguinal hernias?
Direct: occurs through inguinal musculature
Indirect: occurs through vaginal ring (scrotal hernia)
What type of hernia is associated with blunt trauma?
Traumatic abdominal hernia
T/F: Traumatic abdominal hernia is an emergency requiring immediate sx
FALSE- most are stable- better to wait a few days to allow swelling/inflammation to decrease to decrease risk of recurrence of hernia
What suture and pattern is used on an acute abdominal hernia repair?
2/0 monofilament
Horizontal vs. vertical mattress
What is a risk factor for incisional hernias?
Inappropriate sx technique (bites or sutures incorrect)
Perineal herniation includes which organs possible of herniation?
Bladder, prostate and intestines
lateral perineal hernia involves which structure?
sacrotuberous ligament
Dorsal perineal hernia involves which structures?
Coccygeus/levator ani m.
Caudal perineal hernia involves which structures
Levator ani, external anal sphincter, internal obturator
MOST COMMON
Ventral perineal hernia involves which structures?
Bulbo/ischio cavernosus m.
What are breeds that are predisposed to perineal hernias?
Pekingese, boston terriers, corgi, boxer
Why are bob tails more prone to devloping perineal hernias?
Muscles may not develop as well allowing weakness in levator ani and coccygeus m.
T/F: excess hormones play a role in perineal hernia incidence
TRUE
What is a dx procedure for perineal hernias
Rectal palpation- finger pass through into rectal dilation and can palpate thumb
What is the tx of choice for perineal hernias?
SX
What are some management factors that can be implemented in perineal hernia patients?
stool softners, periodic fecal evaluation and high fiber/moisture diets
When does a perineal hernia become an emergency?
irreducible painful discolored swelling or bladder retroflexion
What increases chance of liquid fecal contamination in sx repair of perineal hernias?
Enemas within 24 hrs
What is the most common sx procedure for perineal hernia tx?
Internal obturator muscle transpostition
