Hernia Overview and Types

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Questions and Answers

Which of the following best describes a reducible hernia?

  • A hernia that requires surgical intervention to return to the abdominal cavity.
  • A hernia that is always a medical emergency.
  • A hernia that cannot be manually returned to the abdominal cavity.
  • A hernia that can spontaneously return or be manually returned to the abdominal cavity. (correct)

What is a primary risk factor that contributes to the development of a ventral or incisional hernia?

  • A history of multiple antibiotic treatments.
  • A previous diagnosis of an umbilical hernia.
  • A prior surgical incision with impaired healing. (correct)
  • A diet low in essential nutrients.

What is a key characteristic of a strangulated hernia that differentiates it from an incarcerated hernia?

  • Significant reduction in blood supply to the trapped contents. (correct)
  • It presents without pain or discomfort.
  • The hernia only occurs along the inguinal ligament.
  • The ability to be easily reduced manually.

What specific anatomical feature contributes to the increased risk of strangulation in femoral hernias?

<p>Their protrusion through the femoral ring into the canal. (C)</p> Signup and view all the answers

Which diagnostic method is LEAST likely to help directly visualize the contents of a hernia?

<p>Physical assessment. (A)</p> Signup and view all the answers

What is the primary method by which a herniorrhaphy enhances the integrity of the abdominal wall?

<p>By reinforcing weakened areas with materials like mesh. (A)</p> Signup and view all the answers

Which symptom is a late indicator when a hernia is strangulated?

<p>Severe pain accompanied by symptoms of bowel obstruction. (C)</p> Signup and view all the answers

An umbilical hernia occurs due to:

<p>Weakening of rectus muscle or failure of umbilical closure after birth. (B)</p> Signup and view all the answers

An inguinal hernia is characterized by its occurrence:

<p>At the point the spermatic cord (men) or round ligament (women) emerges. (A)</p> Signup and view all the answers

Which activity will most likely exacerbate the discomfort of a hernia?

<p>Activities increasing intra-abdominal pressure. (C)</p> Signup and view all the answers

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Flashcards

Hernia

A protrusion of tissue through an abnormal opening in a cavity wall.

Reducible Hernia

A hernia that can return to the abdominal cavity easily.

Irreducible Hernia

A hernia where contents are trapped and cannot be returned.

Strangulation

Occurs when blood supply to an irreducible hernia is compromised.

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Acute Bowel Obstruction

A blockage in the intestines that can result from strangulated hernia.

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Inguinal Hernia

The most common type of hernia; occurs in the abdominal wall where muscles are weak.

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Umbilical Hernia

Occurs when the umbilical opening does not close after birth or muscle weakness.

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Ventral Hernia

A hernia at a previous incision site due to weakness.

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Herniorrhaphy

Surgical repair of a hernia, typically an outpatient procedure.

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Hernioplasty

Reinforcement of the weakened area with materials like mesh.

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Study Notes

Hernia Overview

  • A hernia is a protrusion of tissue (like intestines) through a weakened area in the abdominal cavity wall.
  • Can occur anywhere, but most commonly in the abdominal cavity.
  • Reducible hernias can be manually or spontaneously pushed back into the cavity.
  • Irreducible (incarcerated) hernias cannot be returned and have trapped abdominal contents.
  • Strangulation occurs when blood supply to trapped contents is compromised (resulting in acute bowel obstruction, gangrene, necrosis).

Types of Hernia

  • Umbilical hernia: Weak rectus muscle or failure of umbilical closure after birth.
  • Femoral hernia: Protrusion through the femoral ring into the femoral canal(below inguinal ligament), prone to strangulation.
  • Inguinal hernia: Most common, occurs at the abdominal wall weakness where spermatic cord (men) or round ligament (women) emerges.
  • Ventral/incisional hernia: Weakness of abdominal wall at a previous incision site (common in obese, multiple surgeries, poor wound healing).
  • Peristomal hernia: A ventral hernia at the stoma site.

Clinical Manifestations

  • Pain: worsens with increased abdominal pressure (lifting, coughing, straining).
  • Visible bulge: Especially noticeable when abdominal muscles are tensed.
  • Strangulated hernia: Severe pain, symptoms of bowel obstruction (vomiting, cramping, abdominal pain, distention).

Diagnosis and Treatment

  • Diagnosis typically based on history and physical examination.
  • Imaging (ultrasound, CT, MRI) assists in diagnosis and content identification.
  • Treatment: Laparoscopic surgery (herniorrhaphy) is the standard approach.
  • Hernioplasty: Reinforcing weakened area with wire, fascia, or mesh.
  • Strangulated/inflamed hernias require emergency surgery; includes possible sectioning and temporary colostomy.

Post-Operative Care

  • Voiding issues: Monitor intake & output, observe bladder distension.
  • Scrotal edema (inguinal hernia repair): Apply ice pack, elevate scrotum, use scrotal support.
  • Coughing/sneezing: Avoid forceful coughing, instruct patients to splint incision and keep mouth open.
  • Activity restrictions: Avoid heavy lifting (>10 lb) for 6-8 weeks.

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