Abdominal Wall Hernias Flashcards Preview

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Flashcards in Abdominal Wall Hernias Deck (75)
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1

Majority of all abdominal wall hernias are found in the ____

groin

2

majority of groin hernias are located in the

inguinal canal

3

What are the layer of the abdominal wall (anterior to posterior)

Skin
Camper (Superficial fatty), Scarpa (Deep Membranous),
Gallaudet (External oblique fascia)
Internal Oblique fascia
Transversus abdominis
Transversalis fascia
Properitoneal space and fat
Parietal peritoneum

4

What are the layers of the scrotum?

SkIn
Dartos
Colles
External spermatic fascia
Cremasteric fascia
Does not reach the scrotum
Internal spermatic fascia
Properitoneal space and fat
Tunica vaginalis

5

The superficial fatty layer is the ____ muscle of the scrotum

Superficial fatty (camper) : dartos

6

The colles fascia is equivalent to the _____ in the abdominal wall

Scarpas

Deep Membranous (scarpa) : Colles

7

Gallaudet fascia is also the ____ in the scrotum

external spermatic fascia

8

The tunica vaginalis is equivalent of ___ in the abdomen

parietal peritoneum

9

This layer of the abdominal wall does not reach the scrotum

transversus abdominis

10

This is equivalent of the transversalis fascia in the in the internal spermatic fascia

transversalis fascia

11

What is the length of the inguinal canal?

4-6 cm in length

12

What are the walls of the inguinal canal?

Anterior: External oblique aponeurosis

Posterior: Medial - Conjoint, Lateral - transversalis fascia and TA muscle

Lateral: Internal oblique

Medial: Conjoint tendon

Superior: arching fibers of IO and TA muscles

Inferior: Inguinal and lacunal ligamnet

13

This lies immediately above and medial to the pubic tubercle; triangular opening

superficial inguinal ring

14

located between the pubic tubercle and the anterior superior iliac spine

deep inguinal ring

15

Contents of the femoral sheath

1. Femoral artery
2. Femoral vein
3. Lymphatics

16

The inguinal ligament is also called

Poupart's ligament

17

the conjoint tendon is composed of _____

Internal Oblique
Transversus Abdominis

18

[true/false]

the spermatic cord passes through the inguinal canal

true

19

What are the contents of the spermatic cord?

3 fasciae: external, cremasteric, internal spermatic fascia
3 arteries: testicular, cremasteric, vas deferens
3 veins: pampiniform, cremasteric, deferential
3 nerve: autonomic, genital branch of genitofemoral nerve, ilioinguinal nerve
Vas deferens
Lymphatics

20

the lacunar ligament under the inguinal ligament is called

Giembernat's

21

the nerve inside the triangle of doom

Genital branch of genitofemoral nerve

22

the arteries and veinsinside the triangle of doom

iliac artery and vein
gonadal vessels

23

the medial border of the triangle of doom is

ductus deferens

24

What are the borders of the triangle of pain

Inferolateral: iliopubic
Lateral: peritoneum
Superomedial: gonadal vessels

25

What are the arteries and veins containing the triangle of pain

deep circumflex iliac artery and vein

26

What are the nerve inside the triangle of pain

Femoral nerve
Femoral branch of the genitofemoral nerve
anterior cutaneous nerve
lateral femoral cutaneous nerve

27

the circle of death is composed of these arteries

1. External iliac arteries (from common iliac)
2. Internal iliac arteries (from common iliac)
3. obturator artery
4. Aberrant artery
5. Inferior epigastric

28

[sphincter/shutter action]

Tranversalis fascia

sphincter action

29

[sphincter/shutter action]

Transversus abdominis and internal oblique muscles

shutter action

30

This forms a sling that closes the internal ring under the muscular edge of the internal oblique muscle by contraction fo the transversus abdominis muscle. This acts as a sphincter.

transversalis fascia

31

____ hernia that does not traverse the internal ring; traverses through abdominal wall

direct inguinal hernia

32

____ hernia that passes through the internal inguinal ring and down the inguinal canal

indirect inguinal hernia

33

___ hernia

medial or inferior to the inferior epigastric vessels

direct inguinal hernia

MAD LICE

34

____ hernia is lateral or superior to the inferior epigastric vessels

indirect inguinal hernia

MAD LICE

35

[NYHUS classification]

indirect, normal sized internal ring

Type I

36

[NYHUS classification]

indirect, does not extend into scrotum, internal ring enlarged

Type II

37

[NYHUS classification]

Direct hernia

Type III-A

38

[NYHUS classification]

Indirect hernia, large that it enroaches the posterior inguinal wall

Type III-B

39

[NYHUS classification]

indirect hernia, indirect sliding, scrotal, pantaloon hernias

Type III-B

40

[NYHUS classification]


femoral hernia

Type III-C

41

[NYHUS classification]

Recurrent direct hernia

Type IV-A

42

[NYHUS classification]

Recurrent indirect hernia

Type IV-B

43

[NYHUS classification]

Recurrent femoral hernia

Type IV-C

44

[NYHUS classification]

Recurrent hernia, combination

Type IV-D

45

[Physical Examination]

in the Zieman Technique, the index finger is placed at the ____

deep inguinal ring

46

[Physical Examination]

in the Zieman Technique, the middle finger is placed at the ____

superficial inguinal ring

47

[Physical Examination]

in the Zieman Technique, the ring finger is placed at the ____

saphenous opening

48

[Physical Examination]

in the Zieman Technique, the impulse is felt at the index finger, the hernia is ___

indirect

index finger: deep inguinal

49

[Physical Examination]

in the Zieman Technique, the impulse is felt at the middle finger, the hernia is ___

direct

middle finger: superficial ring

direct: middle: superficial

50

[Physical Examination]

in the Zieman Technique, the impulse is felt at the ring finger, the hernia is ___

femoral

ring finger: saphenous opening

51

[management]

symptomatic hernia

elective surgery

52

[management]

strangulated hernia

urgent surgery

53

[management]

In a symptomatic, primary unilateral hernia. The type of surgery is?

Lichtenstein or endoscopic

54

[management]

In a symptomatic, primary bilateral hernia. The type of surgery is?

Endoscopic or lichtenstein

55

What are the structures lateral to the femoral hernia

Femoral: NAV (lateral to medial)

56

the surgical technique in treating femoral hernia

Mcvay

57

Bassini procedure includes closure of these layers

3 layers

TF, TA, IO

58

Shouldice repair includes repair of how many layers?

4 layers

59

[what nerve is damaged]

severe burning pain radiating down the lateral side of the ipsilateral thigh

lateral femoral cutaneous nerve

60

this nerve innervates the inguinal and gluteal region

Iliohypogastric

61

This nerve innervates the anterior surface of the scrotum, labia majora, root of penis, mons pubis, small portion of the upper anteromedial thigh

Ilioinguinal nerve

62

This innervates the spermatic cord/round ligament

genitofemoral nerve

63

this nerve innervates the anterior thigh and anteromedial aspect of the leg

femoral nerve

64

[Name that hernia]

superior lumbar triangle hernia

Grynfeltt's hernia

65

[Name that hernia]

inferior lumbar triangle

Petit's hernia

66

[Name that hernia]

only antimesenteric part of the bowel

richter

67

[Name that hernia]

meckel diverticulum

littre hernia

68

[Name that hernia]

direct + indirect hernia

pantaloon

69

[Name that hernia]

2 loops in same ring

W shaped

Madyl

70

[Name that hernia]

appendix

amyand

71

[Name that hernia]

anterior diaphragm

morgagni

72

[Name that hernia]

posterior diaphragm

bochdalek

73

[Name that hernia]

lateral to rectus muscle

spigelian

74

[Name that hernia]

due to defective midline fusion of lateral abdominal wall;

located in the midline between the xiphoid process and the umbilicus

epigastric hernias

75

[diagnose]

clinically evident separation of the rectus abdominis muscle pillars resulting to a characteristic bulgin og the abdominal wall in the epigastrium

rectus abdominis diastasis