Hernias

Question 1

(L. rupture) Protrusion of a peritoneal sac through a musculoaponeurotic barrier

Answer 1

Hernia

Question 2

Incidence of Hernia

Answer 2

5-10% lifetime
50% indirect inguinal
25% direct inguinal
=5% are femoral

Question 3

Precipitating factors of hernias

Answer 3

Increased intraabdominal pressure
straining at defecation or urination
COPD

Question 4

Why should hernias be repaired?

Answer 4

To avoid complications of INCARCERATIONS/Strangulation, bowel necrosis, SBO, pain

Question 5

What is more dangrerous: a large or small hernia defect?

Answer 5

SMALL: tight defect is more likely to strangulate if incarcerated

Question 6

Ability to return the displaced organ or tissue/hernia contents to their usual anatomic site

Answer 6

Reducible

Question 7

Swollen or fixed within the hernial sac

Answer 7

Incarceated

Question 8

Strangulated

Answer 8

Incarcerated with resulting ischemia

Question 9

Hernia sac and its contents protrude all the way through the defect

Answer 9

Complete

Question 10

Defect present without sac

Answer 10

Incomplete

Question 11

Hernia sac partially formed by the wall of a viscus

Answer 11

Sliding hernia

Question 12

Hernia involving a Mecke’s diverticulum

Answer 12

Littre’s henria

Thing alphabetically = LM

Question 13

Hernia through the linea semilunaris

Answer 13

Spigelian

Question 14

Hernia into or involving intraabdominal structure

Answer 14

Internal Hernia

Question 15

after bariatric gastric bypass

Answer 15

Peterson’s hernia

Question 16

Petit’s hernia or Grynfeltt’s hernia

Answer 16

Lumbar hernia

Question 17

Both a direct and indirect

Answer 17

Pantaloon hernia

Question 18

Incisional hernia in the ventral abdominal wall

Answer 18

Ventral

Question 19

Hernia adjacent to an ostomy

Answer 19

Paratomal hernia

Question 20

Only one sidewall of the bowel involved

Answer 20

Richter’s hernia

Question 21

Abdominal contents migrate between the layers of the abdominal wall

Answer 21

Intraparietal hernia

Question 22

Hernia MEDIAL to femoral vessels

Answer 22

Femoral hernia

Question 23

Hernia UNDER the inguinal LIGAMENT, LATERAL to femoral vessels

Answer 23

Hesselbach’s hernia

Question 24

Hernia THROUGH the femoral canal tracking into the scrotum or labia majus

Answer 24

COPPER’s

Question 25

Hernia LATERAL to the Hesselbach's triangle

Answer 25

Indirect inguinal

Question 26

Inguinial Hernia WITHING the HESSELBACH' triangle

Answer 26

Direct

Question 27

hernia containing a ruptured appendix

Answer 27

Amyand's

Question 28

The bounderies of the HESSELBACH's triangle

Answer 28

Inferior epigastric levels Inguinal ligament (Pourparts) Lateral border of the rectus sheath

Question 29

What are the LAYERS of the abdominal wall?

Answer 29

``` Skin Subcutaneous fat Scarpa's Fascia External oblique Internal oblique Transversus abdominis Transversalis fascia Peritoneal fat Peritoneum ```

Question 30

Hernia within the floor of HESSELBACH's triangle

Answer 30

Direct inguinal

Question 31

Cause of direct inguinal hernia

Answer 31

Anatomical breakfown over the years

Question 32

Hernia through the internal ring of the inguinal canal, traveling down toward the external ring

Answer 32

Indirect inguinal hernia

Question 33

What is the cause of INDIRECT inguinal hernia

Answer 33

Patent processus vaginalis

Question 34

How do you diagnose indirect inguinal herna

Answer 34

Hx and PE | examination with index finger invaginated into the external ring and palpation of hernia

Question 35

Treatment for Indirect inguinal hernia

Answer 35

Emergent herniorrhaphy - Strangulated

Question 36

Hernia traveling BENEATH the inguinal ligamant down the femoral canal medial to the femoral vessels

Answer 36

Femoral Hernia

Question 37

Factors associated with femoral hernias

Answer 37

women pregnancy exertion

Question 38

% of all femoral hernias

Answer 38

5%

Question 39

% of all female femoral hernas

Answer 39

85%!

Question 40

Complications of femoral hernia

Answer 40

1/3 incarcerate

Question 41

Most common hernia in women

Answer 41

indirect inguinal hernia

Question 42

What is the repair of a femoral hernia

Answer 42

McVay (cooper's ligament repair) | Mesh plug repair

Question 43

Which comes first? | Elective TURP or Elective hernioraphy?

Answer 43

TURP

Question 44

What must you do before leaving the OR after and inguinal hernia repair?

Answer 44

Pull the testicle back down the scrotum