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UL Final Year OSCE's & Short Cases > RCSI: Hernias > Flashcards

RCSI: Hernias Flashcards

1
Q

What is a hernia?

A

An abnormal protrusion of an organ (or part of an organ) through its containing body wall.

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2
Q

List the classifications of hernias according to anatomical location.

A
  • Umbilical/periumbilical
  • Parastomal
  • Epigastric
  • Spigelian
  • Inguinal
  • Femoral
  • Obturator
  • Sciatic
  • Perineal
  • Flank
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3
Q

What are congenital hernias?

A

Defects present from birth, including persistent processus vaginalis, gastroschisis, and omphalocoele.

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4
Q

What are common risk factors for acquired hernias?

A
  • Ageing
  • Smoking
  • Steroid use
  • Pregnancy
  • Obesity
  • Chronic cough
  • Connective tissue disorders
  • Heavy lifting
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5
Q

What is the incidence of inguinal hernias?

A

Inguinal hernias account for approximately 75% of all hernias repaired.

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6
Q

What is Richter’s hernia?

A

A partial thickness of bowel trapped within the hernial sac, leading to partial bowel obstruction.

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7
Q

True or False: A sliding hernia occurs when a peritoneal covered structure slides down extra-peritoneally.

A

True

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8
Q

Define a reducible hernia.

A

Contents re-enter their containing cavity (usually the abdomen) either spontaneously or with manipulation.

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9
Q

What is a strangulated hernia?

A

Ischaemia and necrosis of hernia contents due to decreased venous/lymphatic flow.

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10
Q

What is the male to female ratio for inguinal hernias?

A

8:1

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11
Q

What anatomical structures define Hesselbach’s triangle?

A
  • Medial: rectus muscle
  • Lateral: inferior epigastric vessels
  • Inferior: inguinal ligament, pubic bone
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12
Q

Fill in the blank: Indirect hernias pass _____ the inguinal canal.

A

[in]

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13
Q

What are the three fasciae of the spermatic cord?

A
  • External spermatic fascia
  • Cremasteric fascia
  • Internal spermatic fascia
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14
Q

What are the clinical features of an inguinal hernia?

A
  • Can be incidental/asymptomatic
  • Lump +/- pain
  • Acute strangulation/obstruction
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15
Q

What is the management for strangulated hernias?

A

Surgical repair within 6–8 hours from onset to prevent bowel loss.

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16
Q

What are the contents of the inguinal canal?

A
  • Testicular artery and vein
  • Artery and vein to the vas deferens
  • Cremasteric artery and vein
  • Nerve to the cremaster
  • Sympathetic nerves
  • Ilioinguinal nerve
  • Genital branch (genitofemoral nerve)
  • Spermatic cord
  • Vas deferens
  • Lymphatics
17
Q

What is the typical presentation of a femoral hernia?

A

A lump felt inferolateral to the pubic tubercle.

18
Q

What are the surgical boundaries of the femoral triangle?

A
  • Superior: inguinal ligament
  • Lateral: medial border of sartorius muscle
  • Medial: medial border of adductor longus
  • Floor: iliacus, psoas major, pectineus, adductor longus
19
Q

What is the female to male ratio for umbilical hernias?

A

3:1

20
Q

What are the types of umbilical hernias?

A
  • True: Always congenital, through umbilical cicatrix
  • Periumbilical: Always acquired, not through umbilicus
21
Q

What are common risk factors for incisional hernias?

A
  • Post-operative wound infection
  • Abdominal obesity
22
Q

What is a Spigelian hernia?

A

A defect between the lateral border of the rectus abdominis and linea semilunaris.

23
Q

What is an obturator hernia?

A

A defect through the obturator canal that causes medial thigh pain.

24
Q

What is an obturator hernia?

A

A defect through the obturator canal from the lateral pelvis into the thigh

It involves the passage of tissue through the obturator canal.

25
Q

What does the obturator nerve supply?

A
  • Hip adductor
  • Sensation to upper medial thigh
  • Sensation to knee joint

The obturator nerve is crucial for movement and sensation in the medial thigh region.

26
Q

What is a common symptom of an obturator hernia?

A

Medial thigh pain in the cutaneous distribution of the obturator nerve

This pain can indicate the presence of an obturator hernia.

27
Q

What imaging techniques are usually required to diagnose an obturator hernia?

A
  • Ultrasound (US)
  • Computed Tomography (CT)

These imaging methods help visualize the hernia and assess its complications.

28
Q

What is the recommended treatment for an obturator hernia?

A

Direct surgical repair

Surgery is typically necessary due to the risks associated with the hernia.

29
Q

True or False: An obturator hernia has a low risk of incarceration or obstruction.

A

False

It has a high risk of incarceration/obstruction, making it a serious condition.

30
Q

Fill in the blank: An obturator hernia usually presents a __________ diagnosis.

A

very challenging

The difficulty in diagnosis often necessitates advanced imaging.

UL Final Year OSCE's & Short Cases (107 decks)

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