Hernias

Question 1

Which of the following hernias is not matched to its appropriate etiology?
•	Umbilical - congenital 
•	Substernal - traumatic 
•	Prepubic and femoral - traumatic 
•	Scrotal and inguinal - congenital

Answer 1

B (false, congenital)

Question 2

What is an often life-threatening sequela of repairing abdominal hernias?

Answer 2

• Loss of domain

Question 3

True or false: strangulation and incarceration are the same when dealing with hernias?

Answer 3

• False, incarceration is when the contents are through the hernia ring and function is compromised. Strangulation is when devitalization occurs due to circulation being cut off

Question 4

What does each hernia usually contain?
•	Umbilical 
•	Inguinal 
•	Femoral 
•	prepubic hernias

Answer 4

• Umbilical - falciform/omentum
• Inguinal - uterus
• Femoral - prostatic fat
• prepubic hernias - urinary bladder

Question 5

What are the main goals of hernia repair?

4

Answer 5

• (1) ensure the viability of entrapped hernia contents
• (2) release and return viable hernia contents into their normal location within abdominal cavity
• (3) obliterate redundant hernia sac tissue;
• (4) provide a tension-free and secure primary closure of the defect using strong, healthy surrounding tissue.

Question 6

where does the external abdominal oblique originate?

Answer 6

4 or 5th -12th rib, 13th rib, thoracodorsal fascia

Question 7

Where does the internal abdominal oblique originate/

Answer 7

Thoracolumbar fascia caudal to last rib and from tuber coxae

Question 8

Name congenital hernias (4)

Answer 8

umbilical, substernal, scrotal, inguinal

Question 9

Name often traumatic hernias (4)

Answer 9

paracostal defects, dorsal lateral, prepubic, femoral

Question 10

What are indications for sx repair of a hernia? (3)

Answer 10

Symptoms such as abdominal discomfort, local tissue discoloration, signs organ obstruction
Protrusion affects QOL
risk for hollow organ obstruction

Question 11

What is the difference between a true and a false hernia?

Answer 11

true = ring confined within a normal aperture
False = trauma or iatrogenic defect

Question 12

Define peritonealization (in regards to hernia)

Answer 12

a peritoneal sac may form over contents of a chronic traumatic or incisional hernia (congenital hernias already have a mesothelial membrane/sac)