Hernia

Question 1

What is an hernia

Answer 1

Abnormal Protrusion of a viscus or a part of it from the cavity in which it is enclosed through an abnormal or weak opening in the wall of the cavity

Question 2

List 10 hernias

Answer 2

Inguinal
Femoral
Obturator
Umbilical
Para umbilical
Epigastric
Incisional
Lumbar
Sciatic
Spigellian

Question 3

Spigellian hernia : the hernia passes through the ___________ which is the area of __________ between the __________ and the aponeurosis of the ________, lateral to the rectus

Answer 3

Spigellian zone

Transition; muscular fibers

Transversus abdominis

Question 4

A hernia has a sac with a ____,______,______, and ______

Answer 4

Mouth, Neck , body, fundus

Question 5

Why might an hernia sac be irreducible

Answer 5

Formation of adhesions between sac and contents

Question 6

Complications of an hernia sac

List 4

Answer 6

Strangulation
Irreducible
Rupture
Fistula formation

Question 7

Inguinal Canal is about ______ long in the adult and begins in the internal inguinal ring and ends in the external inguinal ring.

Answer 7

4cm

Question 8

mid-inguinal point, i.e. a point midway between the ________________ and _____________

While midpoint of the inguinal ligament stretches from the ____________ to the ________________.

Answer 8

anterior superior iliac spine and the symphysis pubis.

anterior superior iliac spine to the pubic tubercle

Question 9

The anterior wall of the inguinal canal is formed by the _________________ and additionally in the lateral part by the _________________________

Answer 9

external oblique aponeurosis

muscular fibres of the internal oblique

Question 10

The posterior wall of the inguinal canal is formed by the ________________ reinforced superficially by aponeurotic fibres from the _____________ and buttressed in the medial half by the _______________

Answer 10

transversalis fascia

trans-versus abdominis

conjoint tendon

Question 11

Conjoint tendon

the fused common insertion of the ________ and _____________ into the pubic crest and in most people to the pectineal line as well.

Answer 11

transversus abdominis

internal oblique muscles

Question 12

The triangular part of the posterior wall of the inguinal canal , bounded laterally by the ________________ which runs upwards and medially, medially by the lateral border of the __________ , and inferiorly by the ______________ , is known as Hesselbach’s triangle.

Answer 12

inferior epigastric artery

rectus sheath

inguinal ligament

Question 13

The floor of the inguinal canal is formed by the ____________,

the roof is formed by the arched lowest muscular fibres of the ——————-.

Answer 13

inguinal ligament

internal oblique

Question 14

The part of the _______________in the inguinal canal normally becomes obliterated at or soon after birth and the part in the scrotum remains patent as the ____________ .

Answer 14

processus vaginalis

tunica vaginalis

Question 15

Obliteration of processus vaginalis ceases at _____yrs of age .

.

Answer 15

2

Question 16

Failure of obliteration of the processus vaginalis may lead
to any of the following abnormalities

List 4

Answer 16

1. Indirect inguinal hernia.
2. Encysted hydrocele of the cord.
3. Infantile hydrocele (Non-communicating).
4. Congenital hydrocele (communicating).

Question 17

Encysted hydrocele of the cord.

The ______________ parts are obliterated but the ______-portion is patent and filled with ___________. The corresponding anomaly in the female is __________________.

Answer 17

proximal and distal

mid; fluid

cyst of the canal of Nuck

Question 18

Infantile hydrocele (Non-communicating). The processus is obliterated near the ____________ but is otherwise patent and __________________________

Answer 18

internal ring

continuous with the tunica vaginalis

Question 19

Congenital hydrocele (communicating). The ______________ is patent, but the neck is ___________. It contains fluid .

Answer 19

entire processus

narrow

Question 20

Site of the internal inguinal ring?

Answer 20

1.25cm above the mid inguinal point

Question 21

Bubonocele VS funicular hernia

Answer 21

In the canal

Reaches the scrotum

Question 22

Herniotomy VS hernioraphy VS hernioplasty

Answer 22

Herniotomy: Removal of the sac only. This is the standard procedure for children, whose muscles are usually strong enough to heal without extra help.
Herniorrhaphy: Removing the sac plus stitching the muscle wall to strengthen it.
Hernioplasty: Removing the sac plus reinforcing the area with a synthetic mesh.

Question 23

Richter’s hernia

Occurs when the ________________ is involved in the hernia

Answer 23

Circumference of the loop of bowel

Question 24

Pantaloons hernia

Straddle of inferior epigastric artery due to _____________________

Answer 24

Combined direct and indirect hernia

Question 25

Littre’s hernia

Answer 25

Contains Meckel’s diverticulum

Question 26

Contents of the Inguinal canal

Answer 26

3 Arteries: Testicular, cremasteric, and the artery to the ductus deferens. 3 Fascial Layers: External spermatic, cremasteric, and internal spermatic fascia. 3nerves: genital branch of genitofemoral nerve, ilioinguinal nerve , sympathetic afferent nerve fibers 3 Other Structures: Ductus (vas) deferens, pampiniform venous plexus, and testicular lymphatics.

Question 27

Types of herniorraphy

Answer 27

Bassini McVay’s Shouldice

Question 28

Types of hernioplasty

Answer 28

Lichtenstein Nylon darning

Question 29

Pantaloon aka ?

Answer 29

Saddle-bag

Question 30

Amyand’s hernia-

Answer 30

Vermiform appendix as content of sac

Question 31

Maydl’s hernia AKA ?? Means??

Answer 31

Hernia-en-W When two loops of the bowel remain in the sac while connecting loop remains in the abdomen and becomes strangulated