Hiatal Hernia

Question 1

What are the structures in the esophageal hiatus

Answer 1

esophagus, anterior and posterior branches of the vagal nerve, esophageal branches of the left gastric artery and vein

Question 2

what is a hiatal hernia ?

Answer 2

a fascial defect that causes a portion of the stomach to protrude through the diaphragm into the thorax

Question 3

if a hiatal hernia is congenital it is a defect in?

Answer 3

the pleuroperitoneal membrane

Question 4

risk factors for a hiatal hernia

Answer 4

smoking (loss of elastin fibers in the diaphragm)

obesity (widening of the hiatus)

aging ( weakened phrenoesophageal ligament)

Question 5

what level is the esophageal hiatus

Answer 5

T10

Question 6

what are the parts of the esophageal hiatus

Answer 6

Right and Left Cruz

Arcuate Ligament

Question 7

Aortic Hiatus Level

Answer 7

T12

Question 8

IVC hiatus level

Answer 8

T8

Question 9

what does the phrenoesophageal ligament do

Answer 9

maintains intraabdominal pressure

connects the GEJ and esophagus to the diaphragm

closes the esophageal hiatus

Question 10

sliding hiatal hernia vs. paraesophageal hiatal hernia

Answer 10

sliding: both the GEJ and the cardia herniate up

Paraesophagel: the funds herniates up

Mixed: both

Question 11

side effects of sliding vs paraesophageal hernia

Answer 11

sliding: Gerd

paraesophageal: dysphagia, ulcer, bleeding, volvulus

Question 12

what is a volvulus?

Answer 12

abnormal rotation of the stomach

Question 13

level of the cardia

Answer 13

T11

Question 14

the greater curvature of the stomach is supplied by?

Answer 14

left and right gastroepiploic

short gastric

Question 15

the lesser curvature of the stomach is supplied by?

Answer 15

the left and right gastric arteries

Question 16

the right gastric artery is a branch of the ?

Answer 16

hepatic artery

Question 17

branches of the celiac artery

Answer 17

Left gastric

Hepatic Artery (common)

Splenic Arteries

Question 18

right gastric artery comes from

Answer 18

proper hepatic artery which comes from the common hepatic artery

Question 19

left gastric comes from?

Answer 19

straight from the celiac trunk

Question 20

left gastroepiploic comes from

Answer 20

the splenic artery which comes from the celiac

Question 21

the right gastroepiploic comes from

Answer 21

the gastroduodenal artery which goes from the common hepatic artery

Question 22

common hepatic artery branches

Answer 22

gastroduodenal –> right gastroepiploic

proper hepatic –> right gastric

Question 23

spleen blood supply

Answer 23

splenic artery and splenic vein

Question 24

branches of the splenic artery

Answer 24

splenic branches, pancreatic branches, short gastric , left gastroepiploic

Question 25

branches of the left gastric artery

Answer 25

gastric branches, esophageal branches

Question 26

surgical treatment of a sliding hernia and what does it entail?

Answer 26

laparoscopic nissen fundolopication

-wrap the funds around the LEX and suture it in place