40 Questions
Which muscle, along with the conjoined tendon, forms the floor of the inguinal canal?
Transversalis muscle
What structures are part of the spermatic cord?
Testicular artery, pampiniform plexus, cremasteric muscle, vas deferens
Where is the vas deferens located in relation to the spermatic cord structures?
Medial to cord structures
What forms the inguinal ligament, which runs from the anterior superior iliac spine to the pubis?
External abdominal oblique
Where are direct hernias located in relation to the epigastric vessels?
Inferior and medial
Which ligament is an extension of the lacunar ligament and lies against the bone?
Pectineal ligament
In children, at what age is it recommended to delay repair of an umbilical hernia?
5 years
Which type of hernia has the highest recurrence rate?
Incisional/ventral hernia
What is the primary cause of inadequate closure in incisional/ventral hernias?
Smoking
Which technique involves separating the layers of the abdominal wall to reduce tension when closing large ventral hernias?
Anterior technique
Where is the rectus sheath absent below?
The arcuate line
What is the most common tumor of the retroperitoneum?
Lymphoma
What are the most common components removed through peritoneal dialysis?
$NH_3$ and Ca
What can occur with hypertonic intraperitoneal saline load?
$CO_2$ pneumoperitoneum
What is the most sensitive test for retroperitoneal fibrosis?
$IVP$ (intravenous pyelogram)
What are the common symptoms associated with retroperitoneal sarcomas?
Vague abdominal and back pain
Which hormone is used to control bleeding in desmoid tumors?
Sulindac
What is the main blood supply to the rectus sheath?
Superior and inferior epigastric arteries
What is the most cost-effective method for managing medium vessels, such as short gastrics?
Harmonic scalpel
Which energy source disrupts protein hydrogen bonds and causes coagulation?
Harmonic scalpel
In ultrasound imaging, what does shadowing indicate?
Relative density of structures
What is the primary function of the B-mode in ultrasound imaging?
Assessing relative density of structures
Which energy source is good for hemostasis of the liver and spleen and is smokeless?
Laser
What is the primary function of duplex ultrasound imaging?
Visual description of blood flow
Which type of laser is good for deep tissue penetration and bronchial lesions?
Nd:YAG laser
Which material allows fibroblast ingrowth and is associated with vascular or bowel injury incidence of 0.1% with Veress needle or trocar?
Dacron (polypropylene)
Which method can be tried to aspirate a CO2 embolus through a central line?
Head down position
What happens to the ETCO2 levels in response to a CO2 embolus?
Sudden transient rise followed by a drop
Which type of hernia is most common and congenital?
Indirect hernia
Which hernia type has a lower risk of incarceration but a higher risk of recurrence in females?
Direct hernia
What is the rarest type of hernia in females?
Femoral hernia
What is the main goal of inguinal hernia repair?
Tension-free repair
Which nerve injury can result in numbness on the ipsilateral penis, scrotum, and thigh following an open inguinal hernia repair?
Ilioinguinal nerve injury
Which blood vessel runs along the abdominal wall and can be injured with abdominal wall tacks during hernia repair?
Inferior epigastric artery
What is the characteristic bulge location for a femoral hernia?
Anterior–medial thigh below the inguinal ligament
Which ligament forms the inferior boundary of the femoral canal?
Cooper’s ligament
What is the most common early complication following hernia repair?
Urinary retention
What is the most common cause of hernia recurrence?
Inadequate closure in incisional/ventral hernias
What is the main purpose of using mesh in inguinal hernia repair?
To cover indirect, direct, and femoral areas
What is the primary risk associated with femoral hernias?
High risk of incarceration
This quiz covers the characteristics and care of umbilical hernias, including its prevalence in African Americans, risk of incarceration in adults, and appropriate treatment for children and adults. It also touches upon the considerations for pregnant women with umbilical hernias.
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