gsafsaf's version from 2016-01-09 20:07

Basic Hernia Questions

Question Answer
What is a hernia?Protrusion of a peritoneal sac through a musculoaponeurotic barrier; a fascial defect
The majority of hernias are of what subtype?Indirect
Why should hernias be repaired?To avoid complications of incarceration/strangulation; bowel necrosis; SBO; pain
What are the precipitating factors of hernias?Increased intra-abdominal pressure

Types of Hernias

Question Answer
Sliding herniaHernia sac partially formed by the wall
Littre's herniaHernia involving Meckel's diverticulum
Spigelian herniaHernia through the linea semilunaris; aka spontanous lateral ventral hernia
Internal herniaHernia into or involving intra-abdominal structure
Petersen's herniaSeen after bariatric gastric bypassinternal herniation of small bowel through the mesenteric defect from the Roux limb
Obturator herniaMore common in females > males
Petit's herniaRare hernia thru inferior lumbar triangle
Grynfeltt's herniaHernia thru superior lumbar triangle
Pantaloon herniaBoth direct and indirect hernia straddling the inferior epigastric vessels
Parastomal herniaHernia adjacent to an ostomy
Richter's herniaIncarcerated or strangulated hernia involving only one sidewall of the bowel
Epigastric herniaHernia thru the linea alba above the umbilicus
Hesselbach's herniaUnder inguinal ligament lateral to femoral vessels
Bochdalek's herniaHernia thru posterior diaphragm
Morgagni's herniaAnterior parasternal diaphragmatic hernia
Cooper's herniahernia thru the femoral canal and tracking into the scrotum or labia majus
Amyand's herniaHernia sac containing a ruptured appendix

Hernia Intraoperative Questions

Question Answer
What is the first identifiable subcutaneous layerScarpa's fascia (thin in adults)
What is the name of the subcutaneous vein that is ligated?Superficial epigastric vein
What happens if you cut the ilioinguinal nerve?Numbness of inner thigh or lateral scrotum; usually goes away in 6 mo.
From what abdominal muscle layer is the cremaster muscle derived?Internal oblique muscle
From what abdominal muscle layer is the inguinal ligament derived?External oblique muscle aponeurosis
To what does the inguinal ligament attach?Anterior superior iliac spine to the pubis tubercle
Which nerve travels on top of the spermatic cord?Ilioinguinal nerve
Which nerve travels within the spermatic cord?Genital branch of the genitofemoral nerve
What is a direct hernia sac made of?Peritoneum
What is an indirect hernia sac made of?patent processus vaginalis
What attaches the testicle to the scrotum?Gubernaculum
What is the MC organ in an inguinal hernia in men?Small intestine
What is the MC organ in an inguinal hernia in women?Ovary/fallopian tube
What is the medial border of Hesselbach's triangle?Lateral border of the rectus muscle
What is the superior border of Hesselbach's triangle?Epigastric vessels
What is the inferior border of Hesselbach's triangle?Inguinal ligament
What lies in the inguinal canal in females instead of the vas deferens?Round ligament
What is a conjoint tendon?Aponeurotic attachments of the internal oblique and transversus abdominis to the pubic tubercle