Small Animal Surgery > Hernias > Flashcards

Hernias Flashcards

(45 cards)

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1
Q

What is a hernia?

A

protrusion of contents through a defect in the wall of the cavity in which it normally lies

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2
Q

What is the difference between a true hernia and a false hernia?

A

a true hernia has a peritoneal covering or sac

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3
Q

Define reducible in respect to a hernia

A

contents are readily manipulated back into the cavity

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4
Q

Define incarcerated in respect to a hernia

A

contents are fixed into abnormal locations

- cannot be reduced

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5
Q

What is the problem when a hernia is strangulated?

A

incarceration obstructs vascular supply

- usually a surgical emergency

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6
Q

What are the principles of herniorrhaphy?

A
  • ensure tissue viability
  • return viable contents
  • obliterate redundant tissue in the sac
  • secure closure of defect without tension
  • use the patient’s own tissue when possible
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7
Q

What is the most common type of abdominal hernia?

A

umbilical hernias

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8
Q

Describe the clinical signs/presentation of an umbilical hernia

A
  • soft, round mass at the umbilical scar
  • often reducible
  • if the viscera is trapped, may be hard and painful
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9
Q

How is an umbilical hernia usually managed?

A
  • conservative management
  • may close spontaneously in patients < 6 months
  • repair during elective period/neuter
  • if incarcerated, enlarge ring and dissect sac free
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10
Q

Describe the indirect form of inguinal hernias

A
  • passes through the vaginal process

- called a scrotal hernia in males

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11
Q

Describe the direct form of inguinal hernias

A
  • passes through inguinal musculature

- less common

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12
Q

Describe the congenital form of inguinal hernias

A
  • more common in males

- delayed inguinal ring narrowing from late testicular descent

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13
Q

Describe the acquired form of inguinal hernias

A
  • more common in intact females
  • shorter and larger inguinal canal
  • estrogen/estrus predisposes
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14
Q

What are the clinical signs/presentation of an inguinal hernia?

A
  • painless mass in inguinal area

- can be unilateral or bilateral

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15
Q

How is an inguinal hernia diagnosed?

A
  • ability to reduce

- if unable to reduce, use imaging

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16
Q

Describe the traditional repair of an inguinal hernia

A
  • incision over the lateral aspect of the swelling
  • reduce contents, extend ring if necessary
  • close the ring
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17
Q

Which vessels should be avoided in traditional repair of inguinal hernias?

A
  • pudendal artery

- genitofemoral nerve

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18
Q

Describe the features of the ventral midline approach to correcting inguinal hernias

A
  • commonly done in females
  • can inspect both sides
  • avoids mammary tissue
  • perform one layer closure over ring
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19
Q

What is a scrotal hernia?

Study These Flashcards
A

an indirect inguinal hernia in a male

20
Q

What are the clinical features of a scrotal hernia?

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A
  • painful swelling

- usually unilateral

21
Q

How is a scrotal hernia usually managed?

Study These Flashcards
A
  • incision over ring, reduce contents, and close ring

- castrate to decrease risk of recurrence

22
Q

What are the clinical signs of acute traumatic abdominal hernia?

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A
  • bulging mass
  • asymmetric abdomen
  • reducible contents
  • palpable ring
23
Q

How is an acute abdominal hernia repaired?

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A
  • ventral midline approach
  • explore abdomen and repair any organ injury
  • use tension relieving pattern
24
Q

What approach is usually used for a chronic abdominal hernia repair?

Study These Flashcards
A

approach over the hernia

25
How is a patient usually positioned when they have a prepubic tendon rupture?
truncal flexion | rear legs forward
26
What is an incisional hernia?
acquired hernia from disruption of surgically closed cavity (iatrogenic)
27
When does an incisional hernia usually occur?
< 7 days post operation
28
What are the predisposing factors for an incisional hernia?
- intra-abdominal pressure (obesity, effusion, pregnancy) - fat trapped in closure - inappropriate suture - infection - steroids - poor post-op care
29
How is an incisional hernia diagnosed?
- exaggerated swelling - serosanguinous discharge - reducible - radiographs, ultrasound
30
What are the differentials for incisional hernias?
- hematoma/seroma | - abscess
31
How does a perineal hernia occur/develop?
- weakness and separation of the pelvic diaphragm components - allows dilation and rectal deviation - stretching of rectal tissue
32
What is the anatomical location of a lateral perineal hernia?
between coccygeus muscle and sarcotuberous ligament
33
What is the anatomical location of a dorsal perineal hernia?
between the coccygeus muscle and levator ani muscle
34
What is the anatomical location of a caudal perineal hernia?
between the levator ani, external anal sphincter, and internal obturator muscle
35
What is the anatomical location of a ventral perineal hernia?
between the bulbocavernosus, ischiocavernosis, and ischiourethralis muscles
36
Which type of perineal hernia is most common?
caudal perineal hernia
37
What are the predisposing factors for perineal hernias?
- hormonal influence - prostatic disease - relaxin - neurogenic atrophy - chronic straining
38
What are the clinical signs/presentation of a perineal hernia?
- can be asymptomatic - tenesmus, constipation, perineal swelling - a firm, non-reducible mass indicates strangulation - possible bladder retroflexion
39
How are perineal hernias diagnosed?
- rectal palpation - radiographs - ultrasound
40
When is medical management used for a perineal hernia?
only with patients whose health status prevents general anesthesia
41
What is the medical management for perineal hernias?
- promote regular defecation - stool softeners - periodic fecal evacuation - high fiber/high moisture diets
42
When is a perineal hernia considered an emergency?
- irreducible painful discolored swelling | - bladder retroflexion
43
What are the surgical options for correcting a perineal hernia?
- traditional herniorrhaphy - internal obturator muscle transposition - superficial gluteal muscle transposition - semitendinosis muscle transposition
44
What are complications associated with perineal hernia surgery?
- infection/abscess - fecal incontinence - sciatic injury - urinary dysfunction - tenesmus
45
What predisposes cats to perineal hernias?
- megacolon - perineal masses - colitis
Small Animal Surgery
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