Hernia 1

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ABSITE

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Quizzes Created: 3 | Total Attempts: 5,434

Questions: 5 | Attempts: 2,464 | Updated: Mar 22, 2023

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Questions and Answers

1.

A long-standing scrotal hernia becomes incarcerated and is reduced with difficulty 4 hrs later in the ER. 24 hours later the patient presents with signs of sepsis and an area of localized tenderness in the LLQ and no hernia. The likely cause is:
- A.
  
  Diverticulitis
- B.
  
  Appendicitis
- C.
  
  Mesenteric thrombosis
- D.
  
  "reduction in masse" with infarction
Correct Answer
D. "reduction in masse" with infarction

Explanation
The likely cause for the patient's presentation with signs of sepsis and localized tenderness in the LLQ, after a long-standing scrotal hernia is reduced with difficulty, is "reduction in masse" with infarction. This refers to the hernia being reduced back into the abdominal cavity, causing a decrease in blood supply to the herniated tissue. This compromised blood flow can lead to tissue death (infarction), resulting in infection and sepsis. Diverticulitis, appendicitis, and mesenteric thrombosis are less likely causes in this scenario.

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2.

The most likely etiology of a small bowel obstruction in a 45 yo morbidly obese femal with no previous abdominal operation is:
- A.
  
  Incarcerated groin hernia
- B.
  
  Internal paraduodenal hernia
- C.
  
  Adhesions
- D.
  
  Meckel's diverticulum
Correct Answer
A. Incarcerated groin hernia

Explanation
Incarcerated groin hernia is the most likely etiology of a small bowel obstruction in a 45-year-old morbidly obese female with no previous abdominal operation. This is because obesity increases the risk of developing hernias, and the presence of a groin hernia can lead to the obstruction of the small bowel. Adhesions are also a common cause of small bowel obstruction, but since the patient has no previous abdominal operation, it is less likely to be the cause in this case. Internal paraduodenal hernia and Meckel's diverticulum are less common causes of small bowel obstruction compared to incarcerated groin hernia.

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3.

Gastroschisis is:
- A.
  
  A genetic defect resulting in an abdominal wall defect
- B.
  
  The result of an intrauterine umbilical cord rupture
- C.
  
  Presence of a peritoneal sac
- D.
  
  Associated with multiple congenital anomalies
Correct Answer
B. The result of an intrauterine umbilical cord rupture

Explanation
Gastroschisis is a condition that occurs during fetal development where there is a rupture in the abdominal wall, specifically near the umbilical cord. This rupture leads to the intestines and sometimes other organs protruding outside the body, without the protection of a peritoneal sac. It is not a genetic defect but rather a result of the intrauterine umbilical cord rupture. While gastroschisis can be associated with other congenital anomalies, it is primarily characterized by the abdominal wall defect caused by the umbilical cord rupture.

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4.

The nerve most commonly injured in a laparoscopic preperitoneal inguinal hernia repair is:
- A.
  
  Obturator
- B.
  
  Genitofemoral
- C.
  
  Ilioinguinal
- D.
  
  Iliohypogastric
Correct Answer
B. Genitofemoral

Explanation
The genitofemoral nerve is the most commonly injured nerve in a laparoscopic preperitoneal inguinal hernia repair. This nerve runs along the inguinal canal and supplies sensation to the groin and upper thigh. During the surgery, the nerve can be accidentally damaged or compressed, leading to symptoms such as pain, numbness, or weakness in the affected area.

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5.

A characteristic of a spigelian hernia is:
- A.
  
  They occur anywhere along the semilunar line
- B.
  
  These hernias are readily identified
- C.
  
  Interparietal location
- D.
  
  Do not have a peritoneal sac
Correct Answer
C. Interparietal location

Explanation
A spigelian hernia is characterized by its interparietal location. This means that the hernia occurs between the layers of the abdominal wall, specifically through the spigelian fascia. Unlike other types of hernias, spigelian hernias do not have a peritoneal sac, which makes them more difficult to diagnose. However, they can be identified through careful examination and imaging techniques.

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Hernia 1

A long-standing scrotal hernia becomes incarcerated and is reduced with difficulty 4 hrs later in the ER. 24 hours later the patient presents with signs of sepsis and an area of localized tenderness in the LLQ and no hernia. The likely cause is:

The most likely etiology of a small bowel obstruction in a 45 yo morbidly obese femal with no previous abdominal operation is:

Gastroschisis is:

The nerve most commonly injured in a laparoscopic preperitoneal inguinal hernia repair is:

A characteristic of a spigelian hernia is: