INGL HRNIA PTHPHS Flashcards
True about the pathophysiology of inguinal hernia EXCEPT
a. most adult inguinal hernias are considered acquired defects in the abdominal wall.
b. The most likely risk factor for inguinal hernia is weakness in the abdominal wall musculature
c. There is no known hereditary association for inguinal hernia as all cases are sporadic.
d. congenital hernias are considered a developmental defect.
C. There is a known hereditary association that is not well understood.
The descent of the testes from the intra abdominal space into the scrotum is guided by the ____
Gubernaculum
Evagination of the pertioneum which protrudes through the inguinal canal becomes the
Processus vaginalis
The processus vaginalis closes and eliminates the peritoneal opening at the internal inguinal ring at this weeks AOG
36-40wks AOG
True about congenital inguinal hernia EXCEPT
a. failure of peritoneum to close results in a patent processus vaginalis
b. In preterm babies, indirect inguinal hernias as a result of PPV is very high
c. Overall, the risk of developing symptomatic hernia during childhood in the presence of a known PPV is high.
d. NOTA
C. It’s low.
The ff predispose to inguinal hernia EXCEPT
a. COPD
b. BPH
c. Obesity
d. Connective Tissue disease
e. NOTA
E; Obesity has a protective effect. however this may be due to increased difficulty in detecting inguinal hernias in obese individuals; it is shown in table 37-3 as presumed cause of groin herniation
The following statements about collagen is true.
A. Type III collagen does not contribute to wound tensile strength as significantly as type I
B. Decreased ratios of Type I to type III collagen increases risk of developing inguinal hernia.
C. Collagen disorders such as Ehlers-Danlos syndrome are also associated with an increased incidence if hernia formation
D. AOTA
D
The ff. causes of groin herniation EXCEPT
a. Coughing
b. Constipation
c. Prostatism
d. Pregnancy
e. NOTA
E
Presumed causes of groin herniation: Give 5
Coughing COPD Constipation Prostatism Pregnancy Birthweight <1500g Family history of hernia Valsalva's Maneuver Ascites Upright position Congenital connective tissue disorders Defective collagen synthesis Previous R lower quadrant incision Arterial aneurysms Cigarette smoking Heavy lifting Physical exertion
What is the most common symptom of inguinal hernia?
Groin mass that protrudes while standing, coughing, or straining, reducible while lying down
Referred pain of inguinal hernia may involve (3)
STI
Scrotum
Testes
Inner thigh
3 important parts of the history that should prompt the surgeon to perform a thorough workup to rule out any underlying malignancy?
Chronic constipation
Cough
Urinary retention
What is the goal of inspection in evaluating inguinal hernia?
identify an abnormal bulge along the groin or within the scrotum
True about the inguinal occlusion test
a. impulse palpated on the dorsum of the finger implies a direct hernia
b. A controlled impulse suggests direct hernia
c. A persistent herniation suggests an indirect hernia
d. Transmission of the cough impulse to the tip of the finger implies a diret hernia
e. This entails the examiner blocking the internal inguinal ring with a finger as the patient is instructed to cough.
E
True about femoral hernia
a. it can be palpated above the inguinal ligament medial to the pubic tubercle
b. Prominent inguinal fat pad in a think patient may prompt erroneus diagnosis of femoral hernia
c. both
d. neither
B.
