wk 8 8 Hernias

Question 1

define a hernia

Answer 1

protrusion of an organ through a wall which is designed to contain it

Question 2

t/f inguinal hernias more common in females

Answer 2

false

males due to natural weakness from testicles

Question 3

femorals more common in females?

Answer 3

yes

femoral=female

Question 4

what is the inguinal canal

Answer 4

oblique intermuscular slit, allows passage of spermatic cord

Question 5

spermatic cord contains

Answer 5

rule of 3
3 arteries - testicular, cremasteric, artery to vas
3 nerves -
3 other things - vas, pampiniform plexus, lymphatic

Question 6

risk factors for hernia

Answer 6

fat
age
chronic cough
collagen disorder

Question 7

inguinal hernia can be either direct or indirect, outline each

Answer 7

indirect - through deep inguinal ring

direct = through anterior surface (ligaments)

Question 8

indirect hernia would be medial to inferior epigastric vessels

Answer 8

false
medial = direct
lateral = indirect

Question 9

which hernia, indirect or direct, would disappear on palpitation

Answer 9

indirect

Question 10

t/f all hernias will require surgery

Answer 10

false
most likely to frail for surgery
30% postop develop chronic pain

Question 11

complications of inguinal hernias

Answer 11

urinary retention
bleeding / haematoma (clot in tissue) 
chronic pain 
numbnes
testicular atrophy 
wound infection

Question 12

which hernia is usually an emergency

Answer 12

femoral

Question 13

borders of femoral canal

Answer 13

anteior - inguinal ligament
posteior - superior pubic ramus
laterally - femoral vein
medially - lateral border of lacunar ligament

Question 14

borders of inguinal canal

Answer 14

anterior - internal oblique/ apponeurosis of external oblique
posteior -transversalis fascia and conjoint tendon
superior - internal oblique and transveruss abdominis
inferior - inguinal and lacunar ligament

Question 15

inguinal hernias originate _____ and ____ to pubic tubercle

femoral hernias originate ________ and _____ to pubic tubercle

Answer 15

above and medial

below and lateral

Question 16

epigastric hernias arise due to a defect in ___ ___

Answer 16

linea alba

Question 17

2 types of epigastric hernias

Answer 17

paraumbilical (just beside umbilicus)

incisional - at site of incision

Question 18

incisional hernias are due to big chunk of the ab wall missing, what are the risks for incisional hernia

Answer 18

older
smoker
on steroids
poorly closed wounds

Question 19

most comomon pediatric hernia

Answer 19

umbilical hernia - usually resolves by age 4

Question 20

boys born prematurely can develop ____ _____

Answer 20

inguinal hernias

silk sign - inguinal area rubbed superiorly - inferiorly, feels like silk

Question 21

obturator hernias are uncommon, however can occur in small bowel obstruction in elderly females, what happens and where

Answer 21

bowel squeezes between pubic symphisis