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Flashcards in Anorectal Disease Deck (121)
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61

Risk Factors for Inguinal Hernia

Hx of hernia or repair
Chronic cough or constipation
Abdominal wall injury
Smoking
Older age

62

What are the 2 types of inguinal hernias?

Indirect
Direct

63

Indirect Inguinal Hernia

Protrudes through internal inguinal ring
Hearnia sac located lateral to inferior epigastric artery
May protrude into the scrotum
Mor common as people age

64

Direct Inguinal Hernia

Protrude medial to inferior epigastric vessels
Result of weakness in the floor of the inguinal canal
Rarely protrude into scrotum
Almost always in older individuals

65

Boundaries of Hesselbach Triangle

Laterally: inferior epigastric artery
Medially: lateral border or rectus abdominis
Inferiorly: inguinal ligament

66

Femoral Hernia

Located inferior to the inguinal ligament & protrudes through femoral ring
More common in women
Least common type of groin hernia
High chance of strangulation

67

Clinical Presentation of an Inguinal Hernia

Painless bulge in groin or scrotum
Groin discomfort or pain
Swelling or tugging in the groin
Sudden pain (strangulated)
N/V (strangulated)

68

PE for an Inguinal Hernia

Bulge in groin
Patient standing and Valsava
Reducible vs. irreducible
Strangulation

69

Clinical Manifestation of a Strangulated Hernia

Irreducible
Painful to palpation
N/V
Appear ill with or without fever

70

Diagnosis of Inguinal Hernia

H&P
Ultrasound
CT/MRI

71

Treatment of Inguinal Hernia

Watchful waiting
TRUSS
Surgical (open or lap repair)

72

Define Umbilical Hernia

Outward bulging of the lining of the abdomen or abdominal organs around the umbilicus

73

Causes of Umbilical Hernias

Muscle through which the umbilical cord passes doesn't close completely after birth
Obesity
Multiple pregnancies
Ascites
Previous abdominal surgery

74

Clinical Presentation of an Umbilical Hernia

Soft swelling or bulge near umbilicus
Infant: noticeable when baby cries, coughs, or strains
Adults: abdominal discomfort, bulging with straining or coughing
Can become strangulated

75

PE for Umbilical Hernia

Found on exam

76

Treatment of an Umbilical Hernia

Surgery with or without mesh

77

Define Incision or Ventral Hernia

Abdominal surgery causes a flaw in the abdominal wall that must heal on its own

78

Define Epigastric Hernia

Hernia that develops int he epigastrium between the breast bone and belly button

79

Risk Factors for an Epigastric Hernia

Obesity
Pregnancy

80

Define Spigelian Hernia

Hernia through the spigelian fascia

81

Risk of Strangulation in a Spigelian Hernia

High due to small size

82

Clinical Presentation of Spigelian Hernia

Intermittent mass
Localized pain
N/V

83

Diagnostics of Spigelian Hernia

Ultrasound

84

Treatment of Spigelian Hernia

Surgery

85

Differential Diagnosis of Acute Abdominal Pain

AAA
Mesenteric ischemia
Perforation of GI tract
Acute bowel obstruction
Volvulus
Ectopic pregnancy
MI
Splenic rupture

86

Pathophysiology of an Acute Abdomen

Visceral pain
Somatic pain
Referred pain
Peritonitis

87

Visceral Pain in an Acute Abdomen

Respond to sensations of dissension & muscular contraction
Pain typically vague, dull, & nauseating

88

Somatic Pain in an Acute Abdomen

Respond to irritation from infection, chemical, & inflammatory process
Pain sharp & well localized

89

Referred Pain in an Acute Abdomen

Perceived distant from source
Results from convergence of nerve fibers at spinal cord

90

Define Peritonitis

Inflammation of the peritoneal cavity