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SRGRY3 > SRGR RCL HRN > Flashcards

SRGR RCL HRN Flashcards

1
Q

What is it?
Hernia within the floor of Hesselbach’s triangle, that is, the hernia sac does not
traverse the internal r

A

Direct inguinal hernia

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2
Q

What is the cause of direct inguinal hernia?

A

Acquired defect from mechanical breakdown over the years

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3
Q

What nerve runs with the spermatic cord in the inguinal canal?

A

Ilioinguinal nerve

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4
Q

Cause of indirect inguinal hernia

A

PPV

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5
Q

Incidence of direct inguinal hernia

A

1% of men

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6
Q

Incidence of indirect inguinal hernia

A

5% of all men

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7
Q

most common inguinal hernia

A

indirect inguinal hernia

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8
Q

How is an inguinal hernia diagnosed?

A

mainly on hx and pe

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9
Q

What is the risk of strangulation?

a. higher with indirect hernia than femoral hernia
b. highest in femoral hernias
c. higher in direct than indirect hernia
d. NOTA

A

Higher with indirect than direct inguinal hernia, but highest in femoral hernias

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10
Q

Sutures approximate reflection of inguinal ligament (Poupart’s) to the transversus abdominis aponeurosis/conjoint tendon

a. Bassini
b. McVay
c. Lechenstein
d. plug and patch

A

A

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11
Q 
Cooper’s ligament sutured to transversus abdominis aponeurosis/conjoint
tendon
a. Bassini
b. McVay
c. Lechenstein
d. plug and patch
A

B

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12
Q

“Tension-free repair” using mesh

A

Lichtenstein

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13
Q

Placing a plug of mesh in hernia defect and then overlaying a patch of mesh
over inguinal floor (requires few if any sutures in mesh!)

A

plug and patch

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14
Q

Ligation and transection of indirect hernia sac without repair of inguinal floor
(used only in children)

A

High ligation

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15
Q

What are the indications for laparoscopic inguinal hernia repair?

A
  1. Bilateral inguinal hernias
  2. Recurring hernia
  3. Need to resume full activity as soon as possible
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16
Q

What is the first identifiable subcutaneous named layer?

A

Scarpa’s fascia (thin in adults)

17
Q

What is the name of the subcutaneous vein that is ligated?

A

Superficial epigastric vein

18
Q

What happens if you cut the ilioinguinal nerve?

A

Numbness of inner thigh or lateral scrotum; usually goes away in 6 months

19
Q

From what abdominal muscle layer is the cremaster muscle

derived?

A

Internal oblique muscle

20
Q

From what abdominal muscle layer is the inguinal ligament (a.k.a.
“Poupart’s ligament”) derived?

A

External oblique muscle aponeurosis

21
Q

To what does the inguinal (Poupart’s) ligament attach?

A

Anterior-superior iliac spine to the pubic tubercle

22
Q

Which nerve travels on the spermatic cord?

A

Ilioinguinal nerve

23
Q

Why do some surgeons deliberately cut the ilioinguinal nerve?

A

remove the risk of

entrapment and postoperative pain

24
Q

What is the hernia sac made of?

A

Peritoneum (direct) or a patent processus vaginalis (indirect)

25
Q

What attaches the testicle to the scrotum?

A

Gubernaculum

26
Q

What is the most common organ in an inguinal hernia sac in men?

A

Small intestine

27
Q

What is the most common organ in an inguinal hernia sac in

women?

A

Ovary/fallopian tube

28
Q

What lies in the inguinal canal in females instead of the VAS?

A

Round ligament

29
Q

Where in the inguinal canal does the hernia sac lie in relation to the
other structures?

A

Anteromedially

30
Q

Preperitoneal fat on the cord structures (pushed in by the hernia sac); not a real
lipoma; remove surgically, if feasible

A

cord lipoma

31
Q

What is a small outpouching of testicular tissue off the testicle?

A

Testicular appendage

32
Q

What nerve is found on top of the spermatic cord?

A

Ilioinguinal nerve

33
Q

What nerve travels within the spermatic cord?

A

Genital branch of the genitofemoral nerve

34
Q

What are the borders of Hesselbach’s triangle?

A
  1. Epigastric vessels
  2. Inguinal ligament
  3. Lateral border of the rectus
35
Q

What type of hernia goes through Hesselbach’s triangle?

A

Direct hernia due to a weak abdominal floor

36
Q

What is a “relaxing incision”?

A

Incision(s) in the rectus sheath to relax the conjoint tendon so that it can be
approximated to the reflection of the inguinal ligament without tension

37
Q

Aponeurotic attachments of the of the internal oblique and

transversus abdominis to the pubic tubercle

A

conjoint tendon

SRGRY3 (44 decks)

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