Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Junior Surgery- GI > Hernias > Flashcards

Hernias Flashcards

1
Q

What is a hernia?

A

A protrusion of a viscus/part of a viscus (organ) through a defect of the wall of its containing cavity into an abnormal posiiton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is meant if a hernia is irreducible?

A

Contents cannot be pushed back into place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is meant when a hernia is described as obstructed?

A

Bowel contents cannot pass - features of intestinal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is meant by a strangulated hernia?

A

A hernia that is cutting off the blood supply to the intestines and tissues in the abdomen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is meant by incarceration of a hernia?

A

Contents of the hernial sac are stuck inside by adhesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a 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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What sex do femoral hernias occur most commonly in?

A

Females - especially middle aged and elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the anterior boundary of the femoral triangle?

A

Inguinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the medial boundary of the femoral canal?

A

The lacunar ligament and pubic bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the lateral border of the femoral triangle?

A

Iliopsoas and femoral vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the contents of the femoral canal?

A
  • Fat
  • Cloquet’s node
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the differential diangosis for someone presenting with features of a femoral hernia?

A
  • Inguinal hernia
  • Saphena varix
  • Enlarged Cloquet’s node
  • Lipoma
  • Femoral aneurysm
  • Psoas Abscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How would you manage a femoral hernia?

A

Surgical repair

  • Herniotomy
  • Herniorrhaphy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where are paraumbilical hernias found?

A

Occur just above of below the umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are risk factors for paraumbilical hernias?

A
  • Obesity
  • Ascites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How would you manage a paraumbilical hernia?

A

Leave it, or repair of rectus sheath (Mayo repair)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are epigastric hernias?

A

Hernias which pass through the linea alba above the umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is an incisional hernia?

A

Following breakdown of muscle closure after surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a Spigelian hernia?

A

Occurs through the linea semilunaris at the lateral edge of the rectus sheath, below and lateral to the umbilicus

20
Q

What is an obturator hernia?

A

Occurs through the obturator canal

21
Q

Where is pain typically felt with obturator hernias?

A

Along the medial side of the thigh

22
Q

What is an indirect inguinal hernia?

A

Passess through the internal inguinal ring, and, if large, out through the external inguinal ring

23
Q

What is a direct inguinal hernia?

A

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

24
Q

What is the surface anatomy of the deep inguinal ring?

A

The mid-point of the inguinal ligament - 11/2 cm above the femoral pulse (which crosses the mid inguinal point)

25
Q

What is the surface anatomy of the superficial inguinal ring?

A

Just superior and medial to the pubic tubercle

26
Q

What is hesselbach’s triangle?

A

The space bounded by the lateral border of the rectus abdominis medially, the inguinal ligament inferiorly, and the inferior epigastric vessels laterally.

The inguinal triangle contains a depression referred to as the medial inguinal fossa, through which direct inguinal hernias protrude through the abdominal wall

27
Q

What factors predispose to the development of inguinal hernias?

A
  • Male
  • Chornic cough
  • Contipation
  • Urinary obstruction
  • Heavy lifting
  • Ascites
  • Post-abdo surgery
28
Q

How would you assess an inguinal hernia on examination?

A

Lying and standing

  • Look for previous scars
  • Feel other side
  • Examine external genitalia
  • Assess reducibility
  • Ask patient to cough - feel for impulse if not visible
29
Q

How would you clinically try to determine if a hernia was direct or indirect?

A

Reduce the hernia to deep inguinal ring and occlude the ring. Ask the patient to cough/stand - if the hernia is restrained, it is indirect; if it is not, it is direct

30
Q

In terms of the epigastric artery, where do direct hernias arise form?

A

Medial to inferior epigastric artery

31
Q

In terms of the inferior epigastric artery, where do indirect hernias arise from?

A

Lateral to inferior epigastric artery

32
Q

How could you initially manage an irreducible hernia?

A

Manually reduce - to prevent strangulation and necrosis

33
Q

What would you advise someone coming in for a hernia repair to do pre-op?

A
  • Lose weight
  • Stop smoking
34
Q

How would you repair an inguinal hernia?

A

Mesh repair - polypropylene mesh reinforces wall

35
Q

When would mesh repair be contraindicated in managing an inguinal hernia?

A
  • Strangulated hernias
  • Contamination with pus/bowel contents
36
Q

What other methods can be used to repair hernias besides mesh repair?

A

Laparoscopic repair - TAPP, TEP

37
Q

How long would you advise someone do rest following hernia surgery?

A
  • Open approach - 4 weeks - 8 weeks
  • Laparoscopic - 2 weeks
38
Q

What are the contents of the inguinal canala in a male?

A
  • External spermatic fascia
  • Cremasteric muscle
  • Internal spermatic fascia
  • Spermatic cord
    • Vas deferens
    • Lymphatics
    • Remnant of processus vaginalis
    • Arteries to the vas
    • Pampiniform plexus
    • Sympathetic nerves
    • Ilioinguinal nerve
    • Genital branch of the genitofemoral nerve
39
Q

What are the contents of the inguinal canal in females?

A
  • Round ligament of the uterus
  • Ilioinguinal nerve
  • Genital branch of genitofemoral nerve
  • Blood vessels and lymphatics
40
Q

What is the cremaster muscle an extension of?

A

Internal oblique and transversus abdominus muscle

41
Q

What is the external spermatic fascia an extension of?

A

External oblique muscle

42
Q

What is the internal spermatic fascia an extension of?

A

Transversus abdominus muscle

43
Q

What makes the floor of the inguinal canal?

A

Inguinal and lacunar ligament

44
Q

What makes the roof of the inguinal canal?

A

Fibres of transversalis and internal oblique

45
Q

What makes the posterior wall of the inguinal canal?

A

Transversalis fascia and conjoint tendon

46
Q

What makes the anterior wall of the inguinal canal?

A

External oblique aponeurosis and internal oblique for lateral 1/3rd

Junior Surgery- GI (43 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions