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30 Cards in this Set
- Front
- Back
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What are Indirect hernias caused by?
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Patent processus vaginalis - congenital
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Where are indirect hernias wrt the inferior epigastric arteries?
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lateral
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What are indirect inguinal hernias closely associated with?
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Hydroceles
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What are direct inguinal hernias caused by?
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Wear and tear of the muscles and fascia
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Which has a hernia sac; indirect or direct hernias?
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Indirect only
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Where do direct hernias protrude?
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Medially to the inferior epigastric arteries, through hesselbach's triangle.
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Who by far has the highest incident of indirect hernias? On which side and why?
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Children - right side due to delayed descent of the R testicle
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What is the %age of direct, indirect, and femoral hernias in men?
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40/50/10
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What is the %age of direct, indirect, and femoral hernias in women?
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Rare/70/30
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What is a sliding hernia?
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One where part of the hernia sac wall is made up of a contributing organ - often the bladder or colon
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What is an incarcerated hernia?
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When bowel slips into a hernia and it becomes swollen/entrapped
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What can incarcerated hernia lead to?
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Bowel obstruction
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What is a strangulated hernia?
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one in which incarcerated bowel became ischemic and necrotic
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What is a Richter's hernia?
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One where there is incarceration or strangulation, but only of a portion of the bowel wall not the entire thickness.
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How is Richter's hernia distinguished from normal incarcerated hernia?
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No symptoms of bowel obstruction
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What is a Pantaloon hernia?
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Simultaneous occurrence of an indirect and direct hernia
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Why is it called a Pantaloon hernia?
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The two pouches bulge on either side of the inf epigastric arteries so it looks like a pantaloon.
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What is a Spigelian hernia?
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Hernia through the semilunaris line superior to the inf epigastric arteries
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What is a spigelian hernia esp at risk of?
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Incarceration
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How are uncomplicated groin hernias treated?
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With repair - the risks of incarceration and strangulation are too great
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What is the treatment for acutely incarcerated hernias?
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-Try to manually reduce w/ ice
-Observe overnite if successful -Herniorrhapy the next day |
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What is the treatment for an incarcerated hernia that cannot be manually reduced?
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Emergent repair
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What are the 4 most commonly used types of inguinal hernia repair?
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-Marcy
-McVay -Bassini -Shouldice |
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What is a Marcy repair?
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Hernias that are merely a dilated inguinal ring - snugs it up around the spermatic cord better
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What is a McVay repair for?
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Larger indirect or direct hernias
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What type of repair is a bassini repair?
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Superficial
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What is a shouldice repair?
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4 running suture lines
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What is an umbilical hernia in an infant caused by?
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Incomplete umbilical closure
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What happens to most umbilical hernias in infants?
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Spontaneously resolves
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When should umbilical hernias in children be repaired?
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If persist by age 2 or more than 1.5 cm
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