Step 2 Surgery 1 11-29-2015 abdominal hernia

ruhland1's version from 2015-11-29 20:26

Section 1

Question Answer
herniaprotusion of peritoneal sac through a muscluloaponeurotic layer
50%indirect h
25%direct h
hernia priskstraining, obese, preg, Cough, COPD
patent processus vaginalisup indirect
small defectworse than large, up strangulate
incanceratedirreducible h
complete hhernia sac and contents protrude all the way through the defect
incomplete hdefect present without sac/contecnt protruding completly through it
sliding hlike hiatal hernia
spigelian hthrough semilunaris fascia
obturator canalin pelvis, up obturator h
lumbar herniapetits h
grynfeltts hlumbar h
petits hthrough petits triangle
grynfeltts hthrough superior lumbar triangle
sup lumbar triangle medialquadratus lumborum
sup lumbar triangle sup12th rib
sup lumbar triangle latinternal oblique m

Section 2

Question Answer
internal hinvolving intrabdominal structure
pantaloon herniaboth direct and indirect (2 bulges)
pantaloon herniaindirect and direct separated by inferior epigastric muscles
wound infectionup incisional hernia
sciatic herniathrough sciatic foramen
ricthersstrangulated involving only ONE sidewall of bowel
gangrenous bowel and perforation wo signs of obstructionrichter's hernia
epigastric hthrough linea alba above umbilicus
femoral hunder inguinal ligmanet
hesselbachs hunder inguinal ligament LATERAL to femoral vessels
lateral to hessel triangleindirect h
within hessel triangledirect h
Amyands hcontaining ruptured Appendix

Section 3

Question Answer
hesselbachsinferior epigastric vessels
hesselbachsinguinal lig
hesselbachslateral border of rectus sheath
hesselbachs floorinternal oblique and transversus abdominis
below arcuate lineno posterior rectus sheath
layersskin camper scarp EO IO transversus abd transversialis fascia preperitoneal fat peritoneum
mass in healed C-section incisionendometrioma
groin massLAD, hematoma, seroma, abscess
groin masshydrocele, femoral artery aneurysm, undescned testicle
groin masssacrcoma, hernia, testicular torsion
runs with spermatic cord in inguinal canalilioinguinal nerve
patent processus vaginalisup indirect h
risk strangulationfemoral > indirect > direct
herniorrhaphysurgical repair of hernia

Section 4

Question Answer
first ID'd subcut layerSarpas
1st vein ligatedsuperficial epigastric vein
cut ilioiguinal nerveinner thigh/ lateral scrotum, goes away in 6 mo
cremaster m.derives from IO m.
inguinal ligderived from external oblique muscle aponeurosis
inguinal ligattaches from ASIS to pubic tubercle
travels through spermatic cordilioinguinal n
why cut ilioinguinal nerveavoid entrapment/ post-op pain
in spermatic cord cremaster
in spermatic cordvas def
in spermatic cordtesticular a
in spermatic cordtesticular pampiniform plexus

Section 5

Question Answer
hernia sacmade of peritoneum or patent processus vaginalis if indirect
attaches testicle to scrotumgubernaculum
hernia sacin men = sm intestine, women=ovary/fallopian tube
vas def in female= round ligament
cord lipomapreperitoneal fat pushed in by hernia sac
on top of spermatic cordilioinguinal n
within spermatic cordgenital branch of genitofemoral nerve
conjoint tendontendon of IO m
forms medial part of inguinal canalconjoint tendon
weak conojoint tup direct h
inguinal canal medialconjoint tendon
inguinal canal antinguinal lig
inguinal canal posteriortransversus aponeurosis
femoral herniaMedial to femoral vessels

Section 6

Question Answer
femoral canal border posteriorcooper lig
femoral canal border anterioringuinal lig
femoral canal border lateralfemoral vein
femoral canal border mediallacunar lig
85%of femoral hernias are femal
femoral h1/3 incarcerate
Howship Signpain of proximal medial thigh due to obturator hernia