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Small Animal Surgery > Hernias I > Flashcards

Hernias I Flashcards

1
Q

Protrusion of organs through a normal abdominal opening. Examples include umbilical hernia, inguinal hernia, scrotal hernia, fremoral hernia

A

True hernia

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2
Q

Protursion of organs outside a normal abdominal opening. Seldom contained in a peritoneal sac. Example: abdominal hernia (paracostal, cranial pubic ligament)

A

False hernia

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3
Q

Protrusion of abdominal content through a debilitated area of the abdomen with intact skin.

A

Eventration

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4
Q

Protrusion of abdominal content through a debilitated area of the abdomen with non-intact skin.

A

Evisceration

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5
Q

A _____ hernia is when content can be manually reduced and is retained inside the abdomen.

A

Coercible

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6
Q

A _____ hernia is when content can be manually reduced but is not retained inside.

A

Incoercible

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7
Q

An ______ hernia is impossible to reduce into the abdominal cavity but no alteration of blood flow to the hernia contents.

A

Incarcerated

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8
Q

A ______ hernia is impossible to reduce and had vascular compromise to the protruded viscera.

A

Strangulated

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9
Q

____ abdominal hernias occur through a defect in the external wall of the abdomen, allowing protrusion of organs. Can involve the wall anywhere EXCEPT in the umbilicis, inguinal ring, femoral canal, or scrotum.

A

External

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10
Q

______ abdominal hernias occur within a ring of tissue confined within the abdomen or thorax rather than protruding through the outer wall. Examples are diaphragmatic and hiatal hernias.

A

Internal

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11
Q

The cranial pubic ligament is also called the _______ tendon.

A

Prepubic

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12
Q

Cranial abdominal hernias have been associated with ______-______ diaphgragmatic hernias.

A

peritoneal-pericardial

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13
Q

Abdominal hernias are most commonly _______. (acquired or congenital).

A

acquired

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14
Q

False hernias do not contain a _______ sac.

A

hernial

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15
Q

The two most common sites for trauamatic abdominal hernias are

A

the pre-pubic region (cranial pelvic ligament) often associated with pelvic fractures, and the flank.

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16
Q
  • Large midline umbilical and skin defect - evisceration
  • Covered by amniotic tissue - easily reuptured
  • Most neonates die or are euthanized
A

Omphaloceles

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17
Q

Umbilical hernias are usually _____ and caused by flawed ______.

A

congenital; embryogenesis

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18
Q

What three structures pass through the umbilical ring in the fetus?

A
  • the umbilical vessels
  • Vitelline duct
  • Stalk of the allantois
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19
Q

Umbilical hernias are _____ hernias. (true/false)

A

True

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20
Q

Umbilical ring closes after birth and can close up to ____ months after birth. If the umbilical ring fails to close or is too large or improperly formed, an umbilical hernia results.

A

6

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21
Q

Standard orthogonal radiographs generally are indicated in small umbilical hernias. True or False.

A

False - generally NOT indicated

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22
Q

When is it necessary for emergency surgery?

A

If actively bleeding, or obstructed itnestines or bladder in some form

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23
Q

If stable, or able to be stabilized, ______ the surgery will make suriviving anesthesia more likely, will also allow the wound to “declare” itself and make thorough debridement more possible and dehiscence and infection less likely.

A

delaying

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24
Q

In bite wounds, do not use _______ mesh, becuase it acts as a nidus for bacteria and won’t be treated by anitbiotics.

A

nonabsorbable mesh

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25
Q

Umbilical hernias may resolve ______ as late as ___ months of age.

A

Spontaneously, 6

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26
Q

Intestinal strangulation is ___ with very small or large defects.

A

rare

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27
Q

Surgery should be performed ASAP with umbilical hernias if the viscera _____

A

cannot be reduced

28
Q

Hernias can occur at insertions or attachemnts of these four muscle layers, or through the muscle bellies themselves.

A
  1. Internal abdominal oblique
  2. External abdominal oblique
  3. Rectus abdominis
  4. Transversus abdominis muscle
29
Q

The cranial public ligament (prepubic tendon) is a distinct tendon in _____ only. It attaches the ventral abdominal muscles to the _____ border of the pubis.

A

dogs; cranial

30
Q

Cats do not have a distinct prebuic tendon, and abdominal muscles attach directly to the _____

A

pelvic brim

31
Q

In correcting abdominal hernias, a _____ midline appraoch is used.

A

ventral

32
Q

For treating paracostal hernias, the appraoch depends on the hernia - either a ____ or ____ incision is made.

A

Midline, or direct (over the hernia)

33
Q

In hernias invovling the cranial pubic ligmanet, it is recommended to use a _____ suture as it retaines its tensile strenght for longer. THis is becuse muscle fascia takes about ____ weeks to regian ____ of its original strength.And up to a year to regain _____ of its tensile strength.

A

nonabsorbable; 3 weeks; 20%; 80%

34
Q

In umbilical hernias, repair the defect with ____ suture.

A

monofilament

35
Q

In irreducible or strangulated hernias, make an ____ incision to prevent damage, then incise the hernial sac and repalce contents into the abdomen.

A

eliptical

36
Q

Protrusion of organs or tissues through the inguinal canal adjacent to the vaginal process.

A

Inguinal hernia

37
Q

Defect in the inguinal ring allowing abdominal contents to protrude into the vaginal process adjacent to the spermatic cord.

A

Scrotal hernia

38
Q

Hernia that occurs via a defect in the femoral canal

A

femoral hernia

39
Q

Inguinal hernias are most commonly reported in in tact, middle aged ____.

A

females

40
Q

Inguinal hernias can occur both unilateral, and bilateral. If unilatera, it is more common on the ____ side.

A

Left

41
Q

Scrotal hernias are very rare. They are usually _____ (unilateral or bilateral), and strangulation of abdominal contents is _____ (common or uncommon).

A

Unilateral, common

42
Q

Scrotal hernais are most commonly reported in _____ breeds, like ___.

A

Chondrodystrophic breeds, Shar-peis

43
Q

It is important to not mistake _______ in obese cats for an inguinal hernia.

A

Caudal abdominal fat pad

44
Q

The inguinal canal is a sagittal slit in the caudoventral abdominal wall. What structures run tthrough the inguinal canal?

A

Genitofemoral N, A, V

External pudendal vessels

Spermatic cord in the male/Round ligament int he female

45
Q

The inguinal canal is bounded by the ___

A

Internal and external inguinal rings

46
Q

Internal inguinal ring includes:

Caudal edge of the ______

_____ medially

And ______ laterally and caudally.

A

Caudal edge of the internal abdominal oblique (cranially)

Rectus abdominis muscle medially

Inguinal ligament laterally and caudally

47
Q

The ____ inguinal ring is a slit in the external abdominal oblique aponeurosis.

A

external

48
Q

Protrusion through the normal evagination of the vaginal process.

A

Indirect inguinal hernia

49
Q

A ____inguinal hernia is a separate outpocketing from the vaginal process.

A

Direct hernia

50
Q

In female dogs, a ____ incision is preferred when correcting an inguinal hernia.

A

Midline

51
Q

In a scrotal hernia, make incision parallel to flank fold ____ or directly over the inguinal ring.

A

Lateral

52
Q

In a femoral hernia, make the skin incision ___ to the inguinal ligament, and use ______ to close defect if intact.

A

parallel; inguinal ligament

53
Q

Protrusion of the abdominal esophgaus, gastroesophageal junction or gastric fundus through the esophageal hiatus in to the mediastinum cranium to the diaphragm.

A

Hiatal hernias

54
Q

Hiatal hernias are usually caused by congenital abnormalities of the hiatus, especially invovling a lax or stretched ______ ligament, allowing the gastroesophageal junctino to move through the hiatus into the caudal mediastinum.

A

Phrenicoesophageal

55
Q

Traumatic injuries to cause hital hernias include:

A

Diaphragmatic nerve and muscle damage; upper airway obstruction; tetanus

56
Q

Upper airway obstructions may lead to _____ intrathoracic pressure during inspiration, leading to esophageal reflux and herniation.

A

reduced

57
Q

Signalment for hiatal hernia

A

Young dogs, Shar Peis and English Bulldogs; some are asymptomatic

58
Q

Most common clinical sign with hiatal hernias is:

A

regurgitation

59
Q

The esophageal hiatus contains the esophagus, vagal nerve trunks, and esophageal vessels and is surrounded by the ______ ligament.

A

Phrenicoesophageal ligament

60
Q

In hiatal hernias, contents herniate throughthe ______ hiatus.

A

Esophgaeal

61
Q

What are the three openings of the diaphragm?

A
  • esophageal hiatus
  • Caval hiatus
  • Aortic hiatus
62
Q

An _____ hiatal hernia is also called ______, and is when the gastroesophageal junction is located within the thorax, and may be intermittent.

A

Axial, sliding

63
Q

A _____ hiatal hernia is also called “rolling” and it is when the gastroesophageal junction is locate din the normal position, but hte gastric fundus or other abdominal viscera are displaced through the hiatus.

A

Paraesophageal

64
Q

When is surgery the recommended treatment for hiatal hernias?

A

Best in young symptomatic animals that do not respond to medical treatment - treat for reflux esophagitis and aspriation pneumonia first

65
Q

Hiatal herniorrhaphy:

  1. Reduce the hernia and reduce the size of the hiatus with ____ sutures.
  2. Suture esophagus to _____ aka (______)
  3. Tube or incisional ____ at the fundus
A
  1. plicating
  2. diaphgram (esophagopexy)
  3. gastropexy

Small Animal Surgery (17 decks)

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