Inguinal Hernias Review Questions

Question 1

If a surgeon notes that there is a loop of intestines passing through the deep inguinal ring, what type of hernia will it be?

Answer 1

An indirect inguinal hernia

Question 2

What type of hernia exit through the umbilicus and not the deep inguinal ring?

Answer 2

Umbilical hernia

Question 3

If a lumbar hernia penetrates superiorly, what kind of hernia is it? And inferiorly?

Answer 3

superior: grynfeltt hernia
inferior: petit hernia

“superior means GRand”
“inferior means small/or PEtite ppl”

Question 4

What type of hernia passes through the inguinal triangle (of Hesselbach) ?

Answer 4

Direct Inguinal Hernia

Question 5

What are the borders of the Hesselbach triangle?

Answer 5

1. Inferior border:: is the illiopubic tract of the inguinal ligament
2. ) Lateral border:: is the inferior epigastric vessels
3. )Medial border: is the lateral edge of the rectus abdominis

Question 6

Which feature is more common of the indirect inguinal hernia but does not happen with the direct inguinal hernia?

Answer 6

It passes through the deep ring of the inguinal canal and often passes through the superficial ring into the labium or scrotum. (less common in direct)

Question 7

If the tip of the examiner’s little finger is inserted into the superficial ring and the patient is asked to couch, what hernia can be felt hitting the very tip of the finger?

Answer 7

Indirect inguinal hernia

Question 8

A direct inguinal hernia will be felt on what part of the finger?

Answer 8

Side of Digit

Question 9

What vessels pass through the deep inguinal ring?

Answer 9

Ductus deferens and testicular vessels.

So if intestines are found passing along the ductus deferens and testicular vessels it is an inguinal ring.

Question 10

What is the most common type of hernia in a female patient?

Answer 10

Indirect hernias are most common types of hernia in women.

Question 11

The transversus abdomnis aponeurosis (of rectus abdominis) and transversalis fascia forms a significant portion of what structures?

Answer 11

posterior wall of the inguinal canal and lower part of the inguinal triangle (of Hesselbach).

Question 12

Gradual weakness or attrition of tissues in posterior wall of inguinal canal will cause what kind of hernia to arise?

Answer 12

A direct inguinal hernia

Question 13

The anterior wall of the inguinal canal is made of:

Answer 13

aponeurosis of external and internal oblique muscles and

Question 14

The posterior wall of the wall/floor of the inguinal canal is made of which layers:

Answer 14

transversalis fascia and conjoint tendon (transversus abdominis plus internal oblique muscle)

Question 15

A patent process vaginalis at the deep inguinal ring or expansion of the deep inguinal ring with stretching the transversalis fascia can contribute to the formation of:

Answer 15

Indirect Inguinal hernia

Question 16

Deep ring is referred to as a defect in transversalis fascia. True or False

Answer 16

True

Question 17

What fascia forms the round ligament of the uterus or the spermatic cord in men?

Answer 17

Internal Spermatic fascia

Question 18

Tissue over the spermatic cord is:

Answer 18

The external spermatic fascia

Question 19

What part of the cana is the superficial inguinal ring located?

Answer 19

The end of the inguinal canal

Question 20

The internal oblique muscle gives rise to what fascia and muscle of the inguinal canal?

Answer 20

Cremasteric fascia which contains the cremasteric muscle.

Question 21

Spermatic cord has what three layers of fascia surrounding it?

Answer 21

internal fascia
cremasteric fascia
external fascia

Question 22

The spermatic cord is made of:

Answer 22

ductus deferens and its arteries

testicular vessels

lymphatics

remnants of processus vaginalis

genital branch of genitofemoral nerve

Question 23

What is a congenital hydrocele?

Answer 23

A patent segment of processus vaginalis filled with fluid. Can cause swelling of labium majus.

Question 24

When does ectopic testes occur?

Answer 24

When the gubernaculum does not migrate correctly during development and testis does not reach the scrotum

Question 25

What is formed as the parietal peritoneum layer of the abdominal wall (inguinal reigon) and eveginates through the deep inguinal ring and continues through the superficial inguinal ring?

Answer 25

process vaginilis (extraperitoneal fascia)

Question 26

If the process vaginalis is not obliterated during development, it will form a cyst know as what?

Answer 26

Canal of Nuck

Question 27

What nerve accompanies the spermatic cord through the superficial inguinal ring and is responsible for pain sensation in the groin area?

Answer 27

Ilioinguinal nerve which comes from L1

Question 28

What nerve innervates the skin of the upper and medial parts of the thigh, root of penis and scrotum and labia majus in women?

Answer 28

Ilioiguinal nerve

Question 29

What nerve of the lumbar plexus supply innervates the skin on the lateral part of the thigh?

Answer 29

Lateral cutaneous nerve of thigh

Question 30

What is the most common type of hernia?

Answer 30

Indirect inguinal hernia

Question 31

What region of the lower body does the iliohypogastric nerve supplies?

Answer 31

The gluteal and pubic regions.

Question 32

What nerve of the lumbar plexus supplies the anterior thigh?

Answer 32

Femoral nerve

Question 33

What nerve of the lumbar plexus crosses over the quadratus lumborum?

Answer 33

Iliohypogastric

Question 34

The portion of the processus vaginalis that is normally retained is called the ____.

Answer 34

Tunica vaginalis

Question 35

If the intermediate part of the processus vaginalis is retained, then what will occur?

Answer 35

fluid-filled hydrocele

Question 36

If the proximal part of the processus vaginalis is retained, what will occur?

Answer 36

pathway for congenital indirect inguinal hernia

Question 37

What is the inferior epigastric artery a branch of?

Answer 37

External iliac artery

Question 38

The umbilical artery originates from what artery? And it gives rise to what?

Answer 38

The internal iliac artery

The umbilical artery gives rise to medial umbilical artery and superior vesical arteries of the urinary bladder.