Term
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Definition
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Term
|
Definition
Int abd oblique + Tversalis fascia
= FLOOR |
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Term
| what ligaments do fem vessels pass thru? |
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Definition
| between inguinal and pectineal |
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Term
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Definition
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Term
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Definition
rectus
inguinal lig
inf epigastrics |
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Term
| direct vs indirect anatomy |
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Definition
w/in triangle..2/2 floor weakness
indirect = lateral to epigastrics = MC type
2/2 persistently patent processus vag |
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Term
direct vs indirect..
-MC type
-Higher recurrence risk
-higher incarceration risk |
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Definition
MC type = indirect
MC reucrrence = direct (MEN>WOMEN)
MC incarceration = indirect |
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Term
sliding hernia
-def
-MC type |
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Definition
-sac made up of visceral peritoneum from retroP structure
-cecum or sig @ men (MC gender)
-ovaries or fallopians @ female |
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Term
mgmt
-sliding hernia w/ovary |
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Definition
| -ligate the round ligament, then reduce ovary back to peritoneum |
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Term
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Definition
| medial to cord structures |
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Term
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Definition
conjoined/transversalis to ing-lig
= floor reconstruction |
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Term
|
Definition
Coopers lig repair
-Conjoined/transversalis to coopers
*make relaxing incision in ext abd oblique* |
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Term
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Definition
mesh between conjoined and inguinal lig
-dec recurrence |
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Term
| recurrence rate after lap inguinal hernia? |
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Definition
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Term
| MCC recurrence after lap ing. hernia ? |
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Definition
medial separation of mesh from fascia @ inguinal ligament
*mesh is too small or failed to attach it medially* |
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Term
inguinal hernia in elderly
-pre op considerations? |
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Definition
| make sure no straining from colon CA etc or BPH |
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Term
Severe COPD pt needing inguinal repair
-approach? |
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Definition
| under local w/ilioinguinal nerve block |
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Term
can't reduce inguinal hernia contents @ time of repair
-mgmt? |
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Definition
1. divide ing. lig @ internal ringt
2. incise into abd wall muscles staying extra-peritoneal (better for direct)
3. laparotomy |
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Term
@ time of inguinal repair, find a femoral hernia that you cant reduce
-mgmt |
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Definition
| cut through inguinal ligament and floor of canal..?then do a McVay? |
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Term
Inguinal hernia Cx
1. MC early cx
2. wound infxn rate
3. recurrence rate |
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Definition
1. urinary retention
2. 1%
3. 1% (lower w/mesh) |
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Term
Inguinal hernia repair
-pphys testicular atrophy |
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Definition
2/2 dissection of distal hernia sac ==>vessel disruption and spermatic cord vein thrombosis
*MC after indirect repair* |
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Term
| MC inguinal hernia nerve injury |
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Definition
ilioinguinal nerve
-MC @ external ring
??loss of cremasteric reflex, ispilat penis/scrotum/thigh numbness?? |
|
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Term
| relative location of ilioinguinal nerve |
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Definition
| anterior to cord structure |
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Term
| MC nerve injury w/lap inguinal hernia? |
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Definition
genitofemoral nerve
-genital br = cremaster and scrotum sensation
-femoral br = lateral thigh sensation (runs lateral to iliacs) |
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Term
|
Definition
Sup = ing lig
medial = lacunar lig
inf = pectineal lig
lateral = fem vein |
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Term
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Definition
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Term
| First port location vs ventral hernia |
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Definition
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Term
|
Definition
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Term
| type of mesh/sutures for lap ventral hernia? |
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Definition
dual mesh (PTFE inside)
prolene sutures to hold it up, then tacks |
|
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Term
| % recurrence w/primary ventral hernia repair? |
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Definition
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Term
| MCC ventral hernia recurrence after repair? |
|
Definition
5%
-separation of mesh from posterior fascia |
|
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Term
| MC cx after ventral hernia repair |
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Definition
|
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Term
| age for umbo repair in kids? |
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Definition
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Term
spigelian hernia
-location
-MC side |
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Definition
-lat border rectus (thru linea semi-lunaris)
inf to semi-curcularis (below umbo, no post sheath)
-in the int abd oblique aponeurosis
*usually no bulge, MC right side
*high incarceration risk |
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Term
Sciatic hernia
-pres/location |
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Definition
-painful mass in gluteal area
-herniation thru greater sciatic foramen
*high strangulation rate* |
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Term
Obturator hernia
-pres/rf |
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Definition
-thru obturator canal. bowel gas below sup pubic ramus. Howship romberg sign
-RF elderly women, multiparous |
|
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Term
|
Definition
inner thigh pain w/int rotation
-2/2 obturator hernia |
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Term
|
Definition
operative reduction w/mesh
-check other side
-dx usually @ time of operation for bowel obstruction |
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Term
Richters hernia =
-definition
-unique pres |
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Definition
non-circumferential incarceration of non-mesenteric bowel wall
-can cause strangulation and perf w/ou obstruction |
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Term
Petit's hernia
-definition
-borders |
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Definition
inferior lumbar triangle hernia
-borders =
1. external abd oblique
2. lat dorsi
3. iliac crest |
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Term
|
Definition
| incarcerated Meckle's divertic |
|
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Term
| MC type of hernia to recur = |
|
Definition
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Term
Parastomal hernia
-type with inc incidence-->tx? |
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Definition
| -colostomies (50% @ 5 year)-->only tx if sxs |
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Term
|
Definition
-best = relocation of ostomy
1. true hernia: remove/replace in rectus m
2. pseudohernia: 2/2 to being placed in oblique
3. prolapse: don't relocate..fix mesentery |
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Term
| anatomic point where posterior sheath stops |
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Definition
semicircularis
-below umbo |
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Term
|
Definition
pain w/rectus muscle flexion
-rectus sheath hematoma |
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