Ventral/Epigastric/Random Hernias Flashcards
Which of the following is NOT categorised as a ventral hernia, which is a herniation in the anterior abdominal wall.
1 - paraumbilicial/umbilical hernia
2 - direct inguinal hernia
3 - epigastric hernia
4 - incisional hernia
2 - direct inguinal hernia
- these are the most common forms of ventral hernias
Where does a paraumbilicial/umbilical hernia occur?
1 - defect in deep inguinal ring
2 - linea semilunaris
3 - midline defect in linea alba
4 - rectus abdominus
3 - midline defect in linea alba
- close to umbilicus
What % of the adult population will experience a ventral hernia?
1 - 0.2-0.5%
2 - 2-5%
3 - 20-50%
4 - >60%
2 - 2-5%
Which of the following is NOT a common risk factor for a paraumbilical/umbilical hernia?
1 - increased abdominal pressure (pregnancy/ascites)
2 - male gender
3 - obesity
2 - male gender
- 3:1 more common in females
Are congenital or acquired paraumbilical/umbilical hernias more common?
- 10% are congenital
- 90% are acquired
- involution of umbilical vessels is most common cause of congenital hernia
Which of the following is NOT a common presentation of an paraumbilical/umbilical hernias?
1 - pain
2 - palpable/visible lump
3 - tenderness
4 - respiratory distress
4 - respiratory distress
When is a paraumbilical/umbilical hernia a medical emergency?
1 - incarcerated
2 - pain
3 - change in bowel habits
4 - strangulated
1 - incarcerated
- can be chronic or asymptomatic
- normally involves abdominal wall fat
4 - strangulated
- can involve large bowel
- cause a bowel obstruction
Malignancy of which lymph node is commonly linked with being a differential diagnosis for an paraumbilical/umbilical hernia?
1 - popliteal node
2 - virchows lymph node
3 - sister josephs node
4 - cloquet node
3 - sister josephs node
- 50% are GI malignancy
- 25% are gynaecological cancer
In addition to the sister mary joseph lymph node as a differential for paraumbilical/umbilical hernia is divarication of the rectus muscles. What is this?
1 - linea alba becomes stiff and ruptures
2 - abdominal muscles do not form in development
3 - stretched and weakened linea alba
3 - stretched and weakened linea alba
- distance between rectus abdominus becomes larger
- also referred to as diastasis
In patient who have divarication of the rectus, also known as diastasis which is a seperating of the linea alba is not typically treated surgically due to poor results. Which of the following is typically NOT a risk factor for diastasis?
1 - increasing age
2 - obesity
3 - increased abdominal pressure
4 - gender
4 - gender
Paraumbilical/umbilical hernias are commonly treated only when the patient becomes symptomatic or the opening enlarges. What size are Paraumbilical/umbilical hernias commonly?
1 - <0.1cm
2 - <1cm
3 - <2cm
4 - <4cm
2 - <1cm
- generally repaired laparoscopically
- either mesh or just repair
- always a risk of infection and/or chronic pain
What is the definition of an epigastric hernia?
1 - defect in linea alba between pubic symphysis and xiphoid process
2 - defect in linea alba between
arcuate line and xiphoid process
3 - defect in linea alba between umbilicus and xiphoid process
3 - defect in linea alba between umbilicus and xiphoid process
What % of hernias in adults are accounted for by epigastric hernias?
1 - 0.2-0.3%
2 - 2-3%
3 - 22-33%
4 - >50%
2 - 2-3%
- relatively rare
Which of the following is NOT typically a risk factor for an epigastric hernia?
1 - gender
2 - obesity
3 - pregnancy
4 - older age
1 - gender
Are epigastric hernias more common in men or women?
- men are 4 times more likely