INGNL HRNIA NTMY

Question 1

What percentage of abdominal wall hernias occur in the groin?

Answer 1

75%

Question 2

of inguinal repairs, what percentage is done on men?

Answer 2

90%

Question 3

What is a man’s lifetime risk of developing inguinal hernia?

Answer 3

27%

Question 4

What is a woman’s lifetime risk of developing inguinal hernia?

Answer 4

3%

Question 5

At what age/s do inguinal hernia incidence peak in men?

Answer 5

before 1st year of age

after age 40

Question 6

Lifetime prevalence rate of age 25-34?

Answer 6

15%

Question 7

Lifetime prevalence rate of age 75 years and over?

Answer 7

47%

Question 8

What percentage of femoral hernia repairs are done in women?

Answer 8

70%; thus femoral hernia are more common in women

Question 9

What is the most common type of inguinal hernia?

Answer 9

indirect inguinal hernia

Question 10

What is the most common type of inguinal hernia in women?

Answer 10

indirect inguinal hernia

Question 11

What is the length of the inguinal canal?

Answer 11

4-6 cm

Question 12

The deep inguinal ring passes through a hiatus at this fascia. What is this fascia?

Answer 12

Transversalis fascia

Question 13

True about the anatomy of the inguinal canal

a. the superficial ring is where the spermatic cord passes through the hiatus in the transversalis fascia
b. the deep inguinal ring is the point at which the spermatic cord crosses a defect in the external oblique aponeurosis
c. The inguinal canal is bounded by the internal oblique muscle laterally
d. the spermatic cord contains three arteries, three nerves and two arteries, three layers of spermatic fascia

Answer 13

C.

A. deep ring is where the spermatic cord crosses the transversalis fascia
B. the superficial ring is where the spermatic cord crosses a defect in the external oblique aponeurosis
D. the spermatic cord contains three arteries three veins and two nerves, three layers of spermatic fascia

Question 14

What are the boundaries of the inguinal canal?

Anteriorly: _________

Answer 14

External oblique aponeurosis

Question 15

What are the boundaries of the inguinal canal?

laterally : _________

Answer 15

internal oblique muscle

Question 16

What are the boundaries of the inguinal canal?

posteriorly : _________

Answer 16

transversalis fascia and transversus abdominis

Question 17

What are the boundaries of the inguinal canal?

superiorly : _________

Answer 17

internal oblique and transversus abdominis

Question 18

What are the boundaries of the inguinal canal?

inferiorly : _________

Answer 18

inguinal (Poupart’s) ligament

Question 19

An aponeurotic band that begins at the ASIS and inserts into Cooper’s ligament

Answer 19

Iliopubic tract

Question 20

This ligament is the traingular fanning of the inguinal ligament as it joins the pubic tubercle.

Answer 20

Lacunar ligament

Question 21

lateral portion of the lacunar ligament that is fused to the periosteum of the pubic tubercle

Answer 21

Cooper’s ligament

Question 22

This structure is described as the fusion of the inferior fibers of the internal oblique and transversus abdominis aponeurosis at the point where they insert on the pubic tubercle

Answer 22

Conjoined tendon

Question 23

True about inguinal hernias

a. direct hernias protrude lateral to the inferior epigastric vessels
b. indirect hernias protrude at the Hesselbach’s triangle
c. direct hernias protrude at the deep inguinal ring
d. The Hesselbach’s triangle is medial to the inferior epigastrc vessels

Answer 23

D.

Direct inguinal hernias protrude medial to the I.E.V. at Hesselbach’s triangle

Indirect inguinal hernias…lateral…deep inguinal ring

Question 24

Borders of Hesselbach’s triangle

SuperoLateral : _____

Answer 24

Inferior epigastric vessels

Question 25

Borders of Hesselbach's triangle | Medial: _____

Answer 25

Rectus abdominis

Question 26

Borders of Hesselbach's triangle | Inferior: _____

Answer 26

Inguinal ligament

Question 27

Borders of the femoral ring | Anterior: ________

Answer 27

ilipubic tract and inguinal ligament

Question 28

Borders of the femoral ring | Posterior: _________

Answer 28

Cooper's ligament

Question 29

Borders of the femoral ring | Medially: _________

Answer 29

Lacunar ligament

Question 30

Borders of the femoral ring | Laterally: _________

Answer 30

Femoral vein

Question 31

Intraperitoneal points of references in laparoscopic inguinal hernia

Answer 31

5 pertoneal folds bladder inferior epigastric vessels psoas muscle

Question 32

Two potential spaces within the preperitoneum a. Bogros and Retzius b. Mitz and Boom c. Scarpa and Camper d. Cooper and Gimbernat

Answer 32

A

Question 33

Two potential spaces exist within the peritoneum. Between the peritoneum and the posterior lamina of the transversalis fascia is the preperitoneal space a.k.a

Answer 33

Bogros's space

Question 34

Two potential spaces exist within the peritoneum. The most medial aspect of the preperitoneal space that which lies superior to the bladder is known as the

Answer 34

Space of Retzius

Question 35

This orifice is a relatively weak portion of the abdominal wall that is divided by the inguinal ligament.

Answer 35

Orifice of Fruchaud

Question 36

This structure is situated between the posterior and anterior laminae of the transversalis fascia and it houses the inferior epigastric bessels.

Answer 36

Vascular space

Question 37

What supplies the rectus abdominis?

Answer 37

inferior epigastric artery

Question 38

The inferior epigastric artery is derived from this artery

Answer 38

external iliac artery

Question 39

The inferior epigastric artery anastomoses with this artery which is a continuation of the internal thoracic artery

Answer 39

superior epigastric artery

Question 40

What are the 4 nerves of interest in the inguinal region?

Answer 40

Ilioinguinal iliohypogastric genitofemoral lateral femoral cutaneous nerves

Question 41

From which nerve root does ilioinginal and iliohypogastric nerves arise?

Answer 41

L1

Question 42

This nerve emerges from the lateral border of the psoas major and passes obliquely across the quadratus lumborum

Answer 42

Ilioinguinal nerve

Question 43

Function of ilioinguinal nerve (general)

Answer 43

somatic sensation to skin of upper and medial thigh; in males, innervates base of penis and upper scrotum; females mons pubis

Question 44

Function of ilioinguinal nerve (males)

Answer 44

base of penis and scrotum

Question 45

Function of ilioinguinal nerve (females)

Answer 45

mons pubis and labium majus

Question 46

Nerve root of ilihypogastric nerve

Answer 46

T12-L1

Question 47

Muscles supplied by iliohypogastric nerve

Answer 47

internal oblique and transverus abdominis

Question 48

Nerve root of genitofemoral nerve

Answer 48

L1 and L2

Question 49

Nerve root of lateral femoral cutaneous nerve?

Answer 49

L2-3

Question 50

What nerve supplies the cremasteric muscle?

Answer 50

genital branch of the Genitofemoral nerve

Question 51

What is the function of the genital branch of the genitofemoral nerve in females?

Answer 51

supplies ipsilateral mons pubis and labium majus

Question 52

Which nerve courses along the retroperitoneum and emerges on the anterior aspect of the psoas?

Answer 52

Genitofemoral nerve

Question 53

Which nerve pierces the transverus and internal oblique muscles to enter the inguinal canal and exit through the superficial inguinal ring?

Answer 53

Ilioinguinal nerve

Question 54

Which nerve pierces the deep abdominal wall, courses between the internal oblique and transversus abdominis,.

Answer 54

Iliohypogastric nerve

Question 55

Which nerve emerges lateral to the psoas muscle at the level of L4 and crosses the iliacus muscle obliquely toward the ASIS?

Answer 55

Lateral femoral cutaneous nerve

Question 56

Borders of the triangle of doom | Medial:________

Answer 56

vas deferens

Question 57

Borders of the triangle of doom | Lateral:________

Answer 57

vessels of the spermatic cord

Question 58

What are the contents of the triangle of doom?

Answer 58

``` D Ex GF External iliac vessels Deep Circumflex iliac vein Femoral nerve Genital Branch of the genitofemoral nerve ```

Question 59

Triangle of pain | Inferolateral border: ______

Answer 59

iliopubic tract

Question 60

Triangle of pain | superomedial border: ______

Answer 60

gonadal vessels

Question 61

Triangle of pain | Lateral border: ______

Answer 61

reflected peritoneum

Question 62

Contents of triangle of pain (nerves)

Answer 62

``` 4Fs Femoral nerve Femoral branch of genitomeral nerve Anterior femoral cutaneous nerve Lateral femoral cutaneous nerve ```

Question 63

What makes up the circle of death (5)

Answer 63

Interesting Info Ob Ex Con ``` Internal Iliac Inferior epigastric Obturator artery External Iliac Corona mortis (retropubic obturator branch) ```