Inguinal Hernias Review Questions Flashcards

1
Q

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

A

An indirect inguinal hernia

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2
Q

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

A

Umbilical hernia

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3
Q

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

A

superior: grynfeltt hernia
inferior: petit hernia

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

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4
Q

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

A

Direct Inguinal Hernia

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5
Q

What are the borders of the Hesselbach triangle?

A
  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
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6
Q

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

A

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)

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7
Q

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?

A

Indirect inguinal hernia

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8
Q

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

A

Side of Digit

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9
Q

What vessels pass through the deep inguinal ring?

A

Ductus deferens and testicular vessels.

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

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10
Q

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

A

Indirect hernias are most common types of hernia in women.

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11
Q

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

A

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

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12
Q

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

A

A direct inguinal hernia

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13
Q

The anterior wall of the inguinal canal is made of:

A

aponeurosis of external and internal oblique muscles and

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14
Q

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

A

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

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15
Q

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:

A

Indirect Inguinal hernia

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16
Q

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

A

True

17
Q

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

A

Internal Spermatic fascia

18
Q

Tissue over the spermatic cord is:

A

The external spermatic fascia

19
Q

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

A

The end of the inguinal canal

20
Q

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

A

Cremasteric fascia which contains the cremasteric muscle.

21
Q

Spermatic cord has what three layers of fascia surrounding it?

A

internal fascia
cremasteric fascia
external fascia

22
Q

The spermatic cord is made of:

A

ductus deferens and its arteries

testicular vessels

lymphatics

remnants of processus vaginalis

genital branch of genitofemoral nerve

23
Q

What is a congenital hydrocele?

A

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

24
Q

When does ectopic testes occur?

A

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

25
Q

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?

A

process vaginilis (extraperitoneal fascia)

26
Q

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

A

Canal of Nuck

27
Q

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

A

Ilioinguinal nerve which comes from L1

28
Q

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

A

Ilioiguinal nerve

29
Q

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

A

Lateral cutaneous nerve of thigh

30
Q

What is the most common type of hernia?

A

Indirect inguinal hernia

31
Q

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

A

The gluteal and pubic regions.

32
Q

What nerve of the lumbar plexus supplies the anterior thigh?

A

Femoral nerve

33
Q

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

A

Iliohypogastric

34
Q

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

A

Tunica vaginalis

35
Q

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

A

fluid-filled hydrocele

36
Q

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

A

pathway for congenital indirect inguinal hernia

37
Q

What is the inferior epigastric artery a branch of?

A

External iliac artery

38
Q

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

A

The internal iliac artery

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