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SURG 7500 > Hernias > Flashcards

Hernias Flashcards

1
Q

Most common type of hernia after age 50

A

Direct

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2
Q

External hernia

A

Sac protrudes completely through abdominal wall

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3
Q

Intraparietal hernia

A

Sac is contained within the abdominal wall

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4
Q

Internal hernia

A

Sac is within the visceral cavity (ex. diaphragmatic hernia)

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5
Q

Protruding viscus can be returned to abdomen

A

Reducible hernia

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6
Q

Strangulated hernia

A

Vascularity of the viscus is compromised. Surgical emergency!

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7
Q

Anterior wall of inguinal canal

A

External oblique aponeurosis

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8
Q

Posterior wall of inguinal canal

A

Transverse abdominal muscle aponeurosis

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9
Q

Innervates cremaster muscle, skin of the side of the scrotum and labia

A

Genital nerve (L1-L2)

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10
Q

Site of direct inguinal hernia

A

Hesselbach’s triangle

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11
Q

Why are females more predisposed to femoral hernias than men?

A

Increased diameter of true pelvis…proportionally widens the femoral canal

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12
Q

DDX for inguinal hernia

A 
Abdominal wall mass
Desmoids
Neoplasm
Adenopathy
Rectus sheath hematoma
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13
Q

Bassini’s repair

A

Suturing of conjoint tendon to the incurved part of the inguinal ligament

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14
Q

Benefits of laparoscopic repair

A

Decreased post-op pain

Decreased wound infection

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15
Q

How do you handle a hernia in a patient with ascites?

A

Repair the hernia AFTER the ascites is controlled

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16
Q

Complications of hernia surgery

A

Ischemic orchitis with testicular atrophy

Residual neuralgia

17
Q

Recurrence is more common with which type of hernia?

A

Direct

18
Q

Hernia more common in smokers

A

Direct: due to weakened connective tissue

19
Q

Where is pain referred in a direct inguinal hernia?

A

Testis

20
Q

Congenital indirect hernia is associated with a patent what?

A

Processus vaginalis

21
Q

Which side is a hernia more common on in the first decade of life? Why?

A

Right: because of the late descent of right testis

22
Q

Symptoms of obstructed femoral hernia?

A

vomiting, constipation

23
Q

DDX femoral hernia

A 
Inguinal hernia
Saphenous varix
Enlarged femoral lymph node
Lipoma
Femoral artery aneurysm
Psoas abscess
24
Q

Associated factors with umbilical hernias?

A

Ascites
Pregnancy
Obesity

25
Q

Cause of pediatric umbilical hernia

A

Failure of timely closure of umbilical ring…central defect in linea alba

26
Q

Type I esophageal hiatal hernia

A

Sliding type: cardia of stomach upwardly dislocates in the posterior mediastinum

*Most common type

27
Q

Type II hiatal hernia

A

Upward dislocation of the gastric fundus alongside a normally positioned cardia

*No disruption of GE junction

28
Q

Type III hiatal hernia

A

Upward dislocation of both the cardia and the gastric fundus

29
Q

Sliding hiatal hernia predisposes patient to what?

A

Barretts esophagus

30
Q

Which type of hiatal hernia warrants prompt surgical correction?

A

Type II (paraesophageal)–high frequency of complications (obstruction, strangulation, hemorrhage)

31
Q

Richter’s hernia

A

Only part of the intestinal wall circumfrence is in the hernia. May strangulate without obstruction.

32
Q

Littre’s hernia

A

Hernial sac containes Meckel’s diverticulum

33
Q

Garengoff’s hernia

A

Hernial sac has the appendix

34
Q

Pantaloon hernia

A

combo of direct and indirect inguinal hernia

35
Q

Cooper’s hernia

A

Hernia that involves the femoral canal and tracts to the labia majora in females and to the scrotum in males

36
Q

Hernias associated with obesity

A

Direct inguinal
Paraumbilical
Hiatal hernia

37
Q

Incisional hernia

A

Result as surgical complication: associated with obesity, diabetes, and infection

SURG 7500 (8 decks)

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