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MET 3A > Hernias > Flashcards

Hernias Flashcards

1
Q

What is a femoral hernia

A

Protrusion of the peritoneal sac through the femoral ring and into the femoral canal

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2
Q

Describe the relation of a femoral hernia to the inguinal ligament

A

Posterior inferior

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3
Q

What does the lump in a femoral hernia feel like? Does this change when it becomes strangulated?

A
  • Small- 2cm

- Hard and tender when strangulated

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4
Q

Are femoral hernias suitable for truss

A

No

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5
Q

During femoral hernia repair, between which 2 ligaments is the closure made

A

Inguinal and pectineal

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6
Q

Risk factors for femoral hernia (4)``

A

Female
Increased age
Pregnancy
Increased intra-abdominal pressure

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7
Q

How can you tell apart a femoral hernia and an inguinal hernia using the pubic tubercule

A

Femoral- infero-lateral

Inguinal-Superomedial

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8
Q

Define hernia

A

The abnormal protrusion of viscus through its normal coverings

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9
Q

What is a reducible hernia

A

A hernia that can be pushed back through the skin with minimal force

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10
Q

What is an incarcerated hernia

A

A hernia that becomes ‘trapped’- it will be irreducible but the contents still viable

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11
Q

How may an incarcertaed hernia appear

A

Red, painful, tender

Sometimes symptoms of bowel obstruction

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12
Q

What is a strangulated hernia

A

The blood supply is cut off to the intestines and organs

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13
Q

What is a hiatus hernia

A

When contents of the abdomen protrude into the thorax via the oesophageal hiatus

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14
Q

What is an inguinal hernia

A

Protubences of the peritoneal contens through the abdominal wall where it is weakened by the presence of the inguinal canal

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15
Q

What path do indirect inguinal hernias follow

A

The spermatic cord or the round ligament down the inguinal canal

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16
Q

What is the origin of indirect hernias in relation to the inferior epigastric artery

A

Lateral

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17
Q

Where is the weakness that leads to direct inguinal hernias

A

Posterior wall of the inguinal canal

18
Q

What is the origin of direct hernias in relation to the inferior epigastric artery

A

Medial

19
Q

A weakness in which muscle causes umbilical hernias

A

Linear alba

20
Q

Are epigastric hernias superior or inferior to umbilical hernias

A

Superior

21
Q

What is contained in the sac in an umbilical hernia

A

Omentum and bowel

22
Q

When are epigastric hernias particularly painful

A

On exercise

23
Q

Define incisional hernia

A

Breakdown of muscle closure at the site pf a previous abdominal wound

24
Q

What is a pantaloon hernia and why is it so named

A

When a direct and indirect hernia develop of the same side of the groin
So named because the epigastric vessels separate the 2 hernia making them look like trousers

25
Q

What conservative management can be offered for indirect hernias

A

A truss

26
Q

What imaging can be used for hernias, and when

A

Ultrasound

Suggestive symptoms but no lump found (eg hiatus)

27
Q

Do indirect or direct hernias protrude into scrotum usually

A

Indirect

28
Q

Describe 3 features which can usually distinguish inguinal/ femoral hernias from other causes of lumps in the groin

A
  • Can’t get above the lump
  • Bowel sounds over lump
  • Reducibility
29
Q

What can cause umbilical hernia in adults

A

Ascites

30
Q

What kind of hernia is a surgical emergency

A

Strangulated

31
Q

Is mesh or suture repair more common

A

Mesh

32
Q

What is the commonest cause of small bowel obstruction

A

Herniae

33
Q

What are some signs of a strangulated hernia

A

Tachycardia
Pyrexia
WCC raised

34
Q

In congenital indirect inguinal hernias what does the hernia pass through and what does it follow path of

A
  • Patent Processus Vaginalis

- Path of the testes

35
Q

What forms the hernia sac in direct inguinal hernias

A

Transversalis fascia

36
Q

Describe the Lichtenstein procedure

A
  • hernial sac reduced or excised

- mesh inserted to reinforce posterior inguinal canal

37
Q

When is laparoscopic repair recommended for inguinal hernia

A

Recurrent and bilateral herniae

38
Q

Describe the surgery for femoral herniae

A

Dissection of the sac
Reduction of contents
Ligation of sac
Closure between ligaments

39
Q

Describe the surgery for strangulated herniae

A

Reduction of hernia, remove damaged tissue, use of synthetic mesh

40
Q

Give some differentials of lumps in the groin

A 
Hernia
Soft tissue lumps
Femoral artery aneurysm
Saphena Varix
Enlarged lymph node
Undescended testes

MET 3A (15 decks)

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