Hernia Repair

Question 1

What are the layers of the abd wall

Answer 1

skin, fascia, muscle, fascia transversalis, peritoneum

Question 2

What is Camper’s fascia

Answer 2

fatty superficial layer

Question 3

What is Sacrpa’s fascia

Answer 3

deep fibrous layer

Question 4

what are the muscles of the abd wall

Answer 4

Rectus abdominis, external oblique, internal oblique, transverse abdominal

Question 5

What is a reducible hernia

Answer 5

Contents of hernai return to the abdomen spontaneously or with manual pressure when the patient is lying down

Question 6

What is an incarcerated hernia

Answer 6

Hernia whose content cannot return back to the abdomen usually do being trapped by a narrow neck or content edema

Question 7

What is an obstructed hernia

Answer 7

Fecal content cannot pass through the lumen of segment of bowel trapped in a hernia sac

Question 8

what is stragulated hernia

Answer 8

Compromise to the blood supply of the content of the sac (eg. omentum or intestine)

Question 9

What is a Richter hernia

Answer 9

only part of the circumference of the bowel becomes strangulated in the fascial defect

Question 10

What is the MCC of indirect hernia

Answer 10

mainly in utero; results from failure of obliteration of the prossessus vaginalis

Question 11

What is the definition of the indirect hernia

Answer 11

hernia sac through the internal inguinal ring

Question 12

What is a sliding inguinal hernia

Answer 12

type of indirect hernia; occurs when an organ drags along part of the peritoneum

Question 13

What is Pantaloon hernia

Answer 13

A combined direct and indirect hernia, when the hernia sac protrudes on either side of the inferior epigastric vessels

Question 14

What is the cause of a direct hernia

Answer 14

Hesselbach’s triangle

Question 15

What is Hesselbach’s triangle

Answer 15

inguinal ligament, inferior epigastric, lateral border of the rectus muscle

Question 16

What is the cause of femoral hernia

Answer 16

Small empty space between lacunar ligament medially and femoral vein laterally; Passes through the inguinal ring into the upper thigh; More common in women; highest risk of incarceration

Question 17

What is Cooper’s hernia

Answer 17

a femoral hernia with two sacs

Question 18

What is Hesselbach’s hernia

Answer 18

femoral hernia with a pouch through the cribiform fascia

Question 19

What is Bochdalek hernia

Answer 19

Congenital Posterio-lateral herniation through the diaphragm usually on the left side; abd contents protrudes through the diaphragm

Question 20

What is Morgagni hernia

Answer 20

congenital herniation through the foramini of Morgagni which is located immediately adjacent to the xiphoid process and the sternum

Question 21

What is a Hiatal hernia

Answer 21

acquired; Part of the stomach herniates through the musculature opening where the esophagus passes through the diaphragm

Question 22

What are the sx of Hiatal hernia

Answer 22

heartburn relieved by drinking or taking antacids, often worse lying down, regurgitation, pain can be similar to angina, N/V in infants, anemia, pulmonary symptoms, dysphagia

Question 23

What are the complications of Hiatal hernia

Answer 23

esophagitis d/t reflux, Barrett’s esophagitis, aspiration

Question 24

What are the risk factors of Hiatal hernia

Answer 24

obesity, aging, weakening of musculofascial structures

Question 25

What is the surgical treatment of hiatal hernia

Answer 25

Nissen Fundiplication

Question 26

What is paraesophageal hernia

Answer 26

All or part of the stomach herniates into the thorax immediately adjacent and to the left of a displaced or nondisplaced gastroesphogeal junction

Question 27

What are the sx of paraesophageal hernia

Answer 27

dysphagia, incarceration, stasis gastric ulcer

Question 28

what are the complications of paraesophageal hernia

Answer 28

hemorrhage, incarceration, obstruction, strangulation

Question 29

When will an umbilical hernia occur

Answer 29

after the closure of the umbilical ring

Question 30

What are the risk factors of umbilical hernias

Answer 30

mulitple pregnancies with prolonged labor, ascites, obesity, large intra-abdominal tumors

Question 31

what is an epigastric hernia

Answer 31

Hernia that protrudes through the linea alba above the umbilicus; Develop through one of the foramens of egress of small nerves & vessels or through congenital weakness; M>W; Often between the ages of 20-50

Question 32

What is Littre's hernia

Answer 32

Hernia that contains a Meckel diverticulum in the hernia sac

Question 33

What side is a Littre's hernia most common

Answer 33

Right

Question 34

What is a Spigelian hernia

Answer 34

A rare hernia through spigelian fascia, which is the aponeurotic later between the rectus abdominis muscle medially, and the semilunar line lateraly; develop at or below the linea arcuata

Question 35

What is a lumbar/dorsal hernia

Answer 35

herniations through the posterior wall of the abd wall, "lump in the flank"

Question 36

What is Grynfeltt's triangle

Answer 36

quadratus lumborum muscle, twelfth rib, and internal oblique muscle

Question 37

What is Petit's triangle

Answer 37

formed medially by the latissimus dorsi muscle; laterally by the external abdominal oblique muscle; and inferiorly by the iliac crest

Question 38

What is an obturator hernia

Answer 38

A herniation through the obturator canal; elderly hernia