ABSITE ch 38 hernias, abdomen, surgical

technology.
1. Structure that forms external oblique fascia and shelving edge

External abdominal oblique

2. Structure that forms cremasteric muscles

Internal abdominal oblique

3. Structure that forms inguinal canal floor

Transversalis muscle

4. Structure extending from external abdominal oblique, running from ASIS to pubis

Inguinal ligament

5. Where the inguinal ligament splays out to insert in the pubis

Lacunar ligament

6. Structure that originates from transversalis, running from ASIS to pubis below
inguinal ligament

Ileopubic tract

7. Pectineal ligament

Cooper�s ligament

8. Aponeurosis of internal oblique and transversus abdominus muscles

Conjoined tendon

9. Structure that runs parallel and just medial to cord structures

Vas deferens

10. Borders of Hesselbach�s triangle

 Rectus muscle, inferior inguinal ligament, inferior epigastrics

11. Hernia medial to epigastric vessels

Direct

12. Hernia superior/lateral to epigastric vessels

Indirect

13. Risk factors for inguinal hernias (9)

Age, obesity, heavy lifting, COPD, constipation, straining, ascites, pregnancy,

peritoneal dialysis

14. Hernia from persistently patent processus vaginalis

Indirect

15. Hernia with higher recurrence rate (between direct and indirect)

Direct

16. Hernia with both direct and indirect components

Pantaloon hernia

17. Most common structures in sliding hernias (male and female)

Female: ovaries, fallopian tubes. Male: cecum, sigmoid

18. Female with an ovary in hernia canal: what do you do?

Ligate round ligament, return ovary to abdomen, biopsy if abnormal

19. Open mesh repair that minimizes tissue tension

Lichtenstein repair

20. Approximation of conjoined tendon and transversalis fascia superiorly to free edge
of inguinal ligament inferiorly

Bassini repair
21. Approximation of conjoined tendon and transversalis fascia to Cooper�s
ligament. Uses a relaxing incision in external oblique fascia

McVay (Cooper�s ligament repair)

22. Indications for lap hernia repair

Bilateral or recurrent

23. Most common early complication after hernia repair

Urinary retention

24. Morbidity associated with vessel disruption and thrombosis of spermatic cord
veins during hernia repair

Testicular atrophy

25. Nerve commonly injured following open hernia repair

Ilioinguinal nerve

26. Consequences of ilioinguinal nerve damage

Loss of cremasteric reflex, numbness of ipsilateral penis, scrotum and thigh

27. Nerve commonly injured following laparoscopic hernia repair

Genitofemoral nerve

28. Treatment of cord lipoma

Removal

29. Femoral hernia: seen more often in men or women?

Men

30. Location of femoral hernia

Medial to femoral vein

31. Hernia with characteristic bulge on anterior-medial thigh below inguinal ligament
 Femoral

32. Hernia along lateral border of rectus muscle, through linea semilunaris

Spigelian hernia

33. Hernia with noncircumferential incarceration of bowel wall (knuckle of bowel)

Richter�s hernia

34. Hernia with incarcerated Meckel�s

Littre�s hernia

35. Inferior lumbar hernia

Petit�s hernia

36. Superior lumbar hernia

Grynfelt�s hernia

37. Borders of Petit/inferior lumbar hernia (3)

External oblique, lat, iliac crest

38. Borders of Grynfelt/superior lumbar hernia (3)

Internal oblique, lumbodorsal aponeurosis, 12th rib

39. Inner thigh pain with internal rotation, secondary to obturator hernia

Howship-Romberg sign

40. Hernia most likely to recur (among all types)

Incisional

41. Morbidity associated with damage to epigastric vessel

Rectus sheath hematoma

42. Painless masses, typically found in women, associated with Gardner�s syndrome
 Desmoid tumors

43. Malignant tumors of mesentery (2)

Liposarcoma, leiomyosarcoma

44. Location of malignant mesenteric tumors

Near root of mesentery

45. Location of benign mesenteric tumors

Peripheral

46. Most common malignant retroperitoneal tumors (2)

Lymphoma, liposarcoma

47. 5-year survival after resection of retroperitoneal sarcoma

10%

48. most common site of metastasis of sarcoma

lungs

49. most common omental solid tumor

metastatic disease

50. immediate treatment after CO2 embolus

position patient head down turned to left

51. first symptom of CO2 embolus

rise in ETCO2, hypotension

52. surgical instrument that disrupts H-bonds, causing coagulation

Harmonic

53. Surgical instrument with superficial coagulation, and depth of necrosis related to
power setting; good for hemostasis of liver and spleen
 Argon beam

54. Surgical instrument that returns electrons to ground state for energy release as
heat; this heat used to coagulate and vaporize

Laser

55. Artificial material that allows fibroblast ingrowth

Dacron

56. Incidence of vascular or bowel injury with Veress needle or trocar

0.1%