Hernias

Question 1

What is the definition of a hernia?

Answer 1

Protrusion of an organ through a defect in the wall of an anatomical cavity

Question 2

What is a true hernia?

Answer 2

1. Contents within a peritoneal sac
2. Typically at a natural opening
3. Typically congenital

Question 3

What is a false hernia?

Answer 3

1. Contents NOT within a peritoneal sac

2. Typically due to trauma

Question 4

What do you call a hernia outside the body cavity?

Answer 4

External abdominal hervia

Question 5

What do you call a hernia within the abdomen or thorax?

Answer 5

Internal abdominal hernia

Question 6

What is a reducible hernia?

Answer 6

Freely movable and easily reduced

Question 7

What is an incarcerated hernia?

Answer 7

Adhesions to surrounding tissue with hernia contents in a fixed location

Question 8

What is a strangulated hernia?

Answer 8

Obstruction of vascular supply of tissue

Question 9

What type of suture would you most commonly use to close a hernia ring?

Answer 9

Absorbable

Question 10

What are the 3 herniorrhaphy principles?

Answer 10

1. Reduce viable hernia contents
2. Remove redundant tissue of sac
3. Suture closed

Question 11

What is herniorrhaphy?

Answer 11

Surgical repair of a hernia

Question 12

Because umbilical hernias are typically a congenital defect, what other defect should you look for in a male pup with such a condition?

Answer 12

Cryptorchidism

Question 13

Umbilical hernias are thought to be heritable in some breeds. Which breeds?

Answer 13

1. Basenji
2. Weimaraner
3. Perkingese
4. Airedale
5. GS pointer

Question 14

Which is better, a large hernia or a small hernia?

Answer 14

Large hernia - avoid strangulation

Question 15

In females, would an inguinal hernia most likely be acquired or congenital?

Answer 15

Acquired

Question 16

In males, would an inguinal (scrotal) hernia most likely be acquired or congenital?

Answer 16

Congenital

Question 17

True or False: sterilization is not necessary in pups with inguinal hernias.

Answer 17

FALSE - sterilization is recommended as this is a heritable condition

Question 18

Which female dogs are most often affected by inguinal hernias?

Answer 18

Middle-aged, intact

Question 19

Which male dogs are most often affected by inguinal hernias?

Answer 19

Young male dogs (

Question 20

Which is more common, an inguinal hernia on the left or the right side?

Answer 20

LEFT

Question 21

True or False: Inguinal hernias require prompt surgical treatment.

Answer 21

TRUE - risk for incarceration and strangulation

Question 22

True or False: Males with inguinal hernias should always be castrated.

Answer 22

TRUE - risk for testicular tumors

Question 23

True or False: Inguinal hernias in the male dog are often easily reduced.

Answer 23

FALSE - often NON-REDUCIBLE in the male

Question 24

Which vessels/nerves must you preserve when surgically fixing an inguinal hernia?

Answer 24

1. Genitofemoral nerve

2. External pudendal artery and vein

Question 25

Which vessels/nerves must you preserve when surgically fixing a femoral hernia?

Answer 25

1. Femoral artery and vein 2. Saphenous nerve 3. Lymphatics

Question 26

True or False: Abdominal hernias are typically trauma related.

Answer 26

TRUE

Question 27

Because abdominal hernias are typically trauma-related, what is you first priority when one of these patients arrives?

Answer 27

Stabilize the patient

Question 28

Is emergency surgery indicated with an abdominal hernia?

Answer 28

No - stabilize the patient and wait 3-5 days before performing surgery

Question 29

When WOULD emergency abdominal hernia surgery be indicated?

Answer 29

1. Hemorrhage 2. GI strangulation 3. Urinary obstruction

Question 30

When repairing a traumatic abdominal hernia, what is a MUST?

Answer 30

Perform an abdominal exploratory

Question 31

What is the ONLY innervation to the external anal sphincter?

Answer 31

Pudendal nerve

Question 32

Which 2 muscles make up the pelvic diaphragm?

Answer 32

1. Levator ani | 2. Coccygeus

Question 33

In which dogs are perineal hernias most common?

Answer 33

Intact males

Question 34

Concerning perineal hernias, between which two muscles is the herniation most common?

Answer 34

1. Levator ani 2. External anal sphincter (some between levator ani and coccygeal muscle)

Question 35

When a diaphragmatic hernia occurs, where is it most likely to herniate?

Answer 35

In the weakest portion, within the muscle

Question 36

True or False: It is okay to wait multiple days on a diaphragmatic hernia.

Answer 36

TRUE

Question 37

What are the 2 emergency surgery indications for a diaphragmatic hernia?

Answer 37

1. Stomach herniation | 2. Inability to stabilize the respiratory system

Question 38

What is the prognosis for a diaphragmatic hernia?

Answer 38

Excellent if survive immediate post-operative period

Question 39

What is a peritoneopericardial diaphragmatic hernia (PPDH)?

Answer 39

Communication of the abdominal cavity with the pericardial sac

Question 40

Peritoneopericardial diaphragmatic hernias are always congenital or acquired?

Answer 40

Congenital - check for other congenital defects

Question 41

Do you need positive pressure ventilation for a PPDH patient?

Answer 41

No

Question 42

What are the 3 bad problems with a PPDH?

Answer 42

1. Restrict lung expansion 2. Restrict cardiac filling (cardiac tamponade) 3. Congestion/obstruction of herniated organs

Question 43

True or False: PPDH patients always require surgery.

Answer 43

FALSE - may not be necessary in older asymptomatic animals

Question 44

What is a hiatal hernia?

Answer 44

Protrusion of abdominal contents through the esophageal hiatus

Question 45

What is a sliding hiatal hernia?

Answer 45

Advancement of gastroesophageal junction into the esophageal hiatus

Question 46

What is a paraesophageal hiatal hernia?

Answer 46

Advancement of gastric fundus into the esophageal hiatus

Question 47

What is a combination hiatal hernia?

Answer 47

Advancement of both the gastroesophageal junction and the gastric fundus into the esophageal hiatus

Question 48

What is a gastroesophageal intussusception?

Answer 48

Intussusception of the gastric fundus into the lumen of the esophagus and through the esophageal hiatus

Question 49

Are hiatal hernias congenital or acquired hernias?

Answer 49

Congenital

Question 50

Which dog breed is pre-disposed to hiatal hernias?

Answer 50

Shar-pei

Question 51

What are the clinical signs associated with a hiatal hernia?

Answer 51

Similar to those of gastroesophageal reflex: esophagitis, regurgitation, aspiration pneumonia

Question 52

How would you treat a hiatal hernia medically?

Answer 52

1. Antacids | 2. Prokinetics

Question 53

How would you treat a hiatal hernia surgically?

Answer 53

1. Reduction of esophageal hiatus 2. Esophagopexy 3. Gastropexy