Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Hernias
| Question | Answer |
|---|---|
| Define inguinal hernia | Opening in the myofascial plane of the oblique and tranversalis muscles allowing intraabdominal or extraperitoneal organs |
| What are the 3 types of inguinal hernias? | Direct, indirect, femoral |
| What is a direct inguinal hernia? | Medial to inferior epigastrics, directly thru Hesselbach’s triangle |
| What is an indirect inguinal hernia? | Lateral to inferior epigastrics, contains the spermatic cord in men, round ligament in women |
| What is a femoral hernia? | Through the femoral canal, medial to the femoral vein |
| What nerves can be damaged during inguinal hernia repair? | Iliohypogastric, ilioinguinal, genitofemoral nerves |
| Complications of inguinal hernia repair? | Seroma, hematoma, hemorrhage (near femoral vessels), SSI, urinary retention, ischemic orchitis (caused by thrombosis of the testicular vein), vas deferns injury, chronic pain |
| When should a mesh be used in ventral hernia repair? | When hernia is 1cm or greater |
| What is an onlay approach to ventral hernias? | Mesh is placed over the anterior abdominal fascia after primary closure of the fascial defect. Abdominal forces push this away from repair making recurrence likely. |
| What factor impacts hernia recurrence most? | Infection and tension-free repair |
| What are spigelian hernias? | Hernias that occur through the aponeurotic layers between the rectus muscle and the semilunar line. Usually at the arcuate ligament. |
| How do you manage spigelian hernias? | They are so narrow-necked they have a large risk of incarceration and must be repaired |
| What is a conjoint tendon? | Where the aponeurosis of the internal oblique meets the aponeurosis of the transversus muscle, attached to the pubic crest and pecten pubis |
| What is the other name for Cooper’s ligament? | Pectineal ligament |
| What is the roof of the inguinal canal? | Lacunar ligament |
| Cooper’s ligament is an extension of what ligament fibers? | Lacunar ligament |
| What side are inguinal hernias more likely on? | R side: in normal development the R side testes is slower to descend thus the processus vaginalis has delayed atrophy |
| What type of inguinal hernia is highest risk of strangulation? | Femoral hernia |
| What forms the anterior rectus sheath? | External oblique, int oblique and transversus aponeurosis |
| What forms the inguinal ligament? | Ext oblique aponeurosis |
| What makes up the inguinal floor? | Transversalis fascia and transversus abdominis muscle |
| What forms the iliopubic tract? | Aponeurosis of transversus abdominis muscle and the transversalis fascia |
| Where is the iliopubic tract found? | Posterior to inguinal ligament |
| Importance of iliopubis tract in inguinal hernia repair? | Must be the inferior border for staples and tacks— otherwise risk of injuring femoral, lateral cutaneous and genitofemoral nerves |
| What forms Cooper ligament? | Periosteum and aponeurosis running along the superior ramus of the pelvis |
| A branch of what artery cross Cooper ligament? | Branch of obturator artery |
| What forms the superior wall of the inguinal canal? | Aponeurosis of the int oblique and transverus abdominis (or the conjoint tendon) |
| Anterior wall of the inguinal canal? | Ext oblique aponeurosis |
| What is the inferior border of the inguinal canal? | Inguinal ligament and lacunar ligament |
| What is the floor of the inguinal canal? | Transversalis fascia and aponeurosis of transversus abd muscle |
| What does the iliohypogastric innervate? | Upper lateral buttock and skin above the pubic symphysis |
| Ilioinguinal provided sensation? | To skin along inguinal ligament |
| Genitofemoral nerve provides sensation to? | Anterior thigh and skin of scrotum or labia majora |
| Origin of inferior epigastrics? | External iliac vessels |
| How are groin hernias classified? | Nyhus classification |
| When is a mesh repair contraindicated? | Contamination (eg. bowel perforation or bowel resection) |
| Why do spigelian hernias occur below the umbilicus? | Below the arcuate line lacks posterior rectus shesth |
Created by:
cdcaplan