Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
12 Cards in this Set
- Front
- Back
|
Define Herniations
|
organ protrusion through retaining structure
|
|
|
where do herniations usually occur?
|
abdominal cavity
|
|
|
Etiology (2)
|
Weakening of body structure (d/t age, obesity, pregnancy)
& inc. abdominal pressure = protrusion of organ through weakened structure |
|
|
2 types of hernias
|
1) Hiatal Hernia
2) Inguinal Hernia |
|
|
Pathology - Hiatal Hernia (2)
|
Body structure weakens
-weakened muscle allows aperture to widen & inc. Intra-abdominal pressure (d/t age obesity, pregnancy) -part of stomach passes through aperture into thoracic cavity |
|
|
2 types of Hiatal Hernias (explain each)
|
1) Sliding (95%) - Gastroesophageal Juncture (upper part of stomach) slides up through hiatus and into thoracic cavity
2) Rolling (Paraesophageal) (5%) - Greater curvature of stomach rolls through hiatus into thoracic cavity (gastroesophageal juncture remains below diaphragm in abdominal cavity) |
|
|
Manifestations - Sliding Hiatal Hernia (4)
|
-50% asymptomatic
-heartburn -reflux (HCL in Gastroesphageal acid moves into esophagus and burns b/c has no protective lining) -chest pain (not to be confused with cardiac pain) |
|
|
Manifestations - Rolling Hiatal Hernia (3)
|
-chest pain
-fullness after meals -dyspnea (d/t left side congestion = difficult lung expansion) |
|
|
Why isn't reflux a manifestation of Rolling Hiatal Hernias?
|
In sliding, the stomach is constricted & pressure pushes against the sphincter; whereas in rolling the hiatus does not constrict below the sphincter
|
|
|
Pathology - Inguinal Hernia
|
-Abdominal organs protrude through inguinal ring (opening for perfusion and testes)
-Peritoneum forms hernial sac (usually containing intestine & omentum |
|
|
2 types of Inguinal Hernias (define/ explain)
|
1) Direct hernia - (WOMEN) organ goes directly through supporting structure
2) Indirect hernia - (MEN) organ goes through an opening in the supporting structure |
|
|
Treatment
|
-behaviour/ lifestyle (don't bend in ways that inc. pressure, avoid meals max 2hrs before bed, elevate head of bed
-Surgery (~15%) - fundoplication (wrap funds of stomach around gastroesophageal juncture to strengthen the sphincter and pull back into place) DRUGS for reflux -antacids (to neutralize acids; reflux still occurs but dec. pain) -Proton Pump Inhibitors (PPIs) (protons are the acid component of HCL) -H2 Receptor Antagonists (H2RA) (stop reception of H+) |
