L23: Hernias

Question 1

When you do a physical examination for lumps and bumps what are the things you should look at and comment on

Answer 1

Mmemonic: 5 Students and 3 Teachers around a CAMPFIRE
5 s:
Scars
Site
Size
Shape
Surface

3 Ts:
Tenderness
Transillumination
Temperature

campire:
Consistency 
Attachment
Mobility 
Pulsation
Fluctuation
Irreducibility
Regional lymph node
Edge

Question 2

What is a hernia

Answer 2

An abnormal perfusion of a tissue organ through the wall that normally contains it

Question 3

What are the types of hernias

Answer 3

Incisional hernia
Hiatus hernia
Diaphragmatic hernia
Umbiliac hernia 
Inguinal hernia

Question 4

What is a incisional hernia

Answer 4

A weakness created by cutting the tissue during operations

Question 5

What is a hiatus hernia

Answer 5

When the stomach passess throuhg the oeosphageal hiatus

Question 6

What is a diaphragmatic hernia

Answer 6

Congenital or poorly developed thoracic organs

Question 7

What is a umbilical hernia

Answer 7

Congenital or acquired due to increased abdominal pressure

Question 8

What is a inguinal hernia

Answer 8

Direct or indirect in the inguinal region

Question 9

What is the difference between direct and indirect hernia

Answer 9

Direct hernia go directly through the abdominal wall

Indirect hernia go through the inguinal ring

Question 10

Do both direct and indirect hernia pass the superficial inguinal ring

Answer 10

Yes

Question 11

Which type (direct or indirect) inguinal hernia goes through the deep inguinal ring

Answer 11

Indirect- as it passess through the inguinal canal

Question 12

How can we tell the difference between direct and indirect hernia in terms of the inferioir epigastric vessel

Answer 12

Direct: medial to the inferior epigastric vessel
Indirect: lateral to the inferior epigastric vessel.

Question 13

What is the haselbachs triangle

Answer 13

Th weakest part in the abdomen where the direct inguinal hernias go through

Question 14

What is the haselbachs triangle made of i.e what are the borders

Answer 14

Lateral border of rectus muscle
Inguinal ligament
Inferioir epigastric vein and artery

Question 15

What is the mid inguinal point

Answer 15

A theoretical line that is from the anterioir superior iliac spine (asis) to the pubic symphysis

Question 16

What does the mid inguinal point represent

Answer 16

The femoral artery

Question 17

What is the midpoint of the inguinal ligametn

Answer 17

The middle point of the inguinal ligament that runs from the asis to the pubic tubercle

Question 18

What does the midpoint of the inguinal ligament represetn

Answer 18

Location of the deep ring

Question 19

Where is the femoral canal located in relation to the inguinal ligament

Answer 19

Below

Question 20

Where is the inguinal hernia located in relation to the inguinal ligament

Answer 20

Above

Question 21

What are the risk factors for a hernia

Answer 21

males
Older age- muscles weaken
Smoking
Chronic cough
Connective tissue disorder
Pregnancy
Ascittes
Heavy lifting
Constipation

Question 22

What are the complications of hernia

Answer 22

Irreducible: stuck but not causing a problem
Obstruction: bowel contents can become stuck
Strangulation; ischaemic bowel

Question 23

What are the other differentials of a groin mass apart from hernia

Answer 23

Hydrocele: fluid in the tunica vaginalis
Undescended testis
Femoral aneurysm: pulsatile mass
Psoas abscess
Lymphadenopathy