Chapter 12: Repair of Hernias

Alexanders Care Of the Patient in Surgery 14th Edition Rothrock

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Chapter 12: Repair of Hernias

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. Identify the triad of anatomic sites of abdominal wall weakness with a potential for hernias.
a. Groin, ventral line, umbilicus
b. Inguinal rings, femoral canal, incision
c. Inguinal canal, femoral rings, umbilicus
d. Ventral line, aponeurosis, inguinal canal

 

 

ANS:  C

The weak places or intervals in the abdominal aponeurosis are (1) the inguinal canal, (2) the femoral rings, and (3) the umbilicus.

 

REF:   Page 396

 

  1. What composes the lining of a herniated abdominal sac?
a. Fascia
b. Peritoneum
c. Muscularis
d. Rectus abdominis muscle

 

 

ANS:  B

A hernia is a sac lined by peritoneum that protrudes through a defect in the layers of the abdominal wall. Hernias can occur in several places in the abdominal wall, with protrusion of a portion of the parietal peritoneum and often a part of the intestine. Generally, the hernia mass is composed of covering tissues, a peritoneal sac, and any contained viscera.

 

REF:   Page 396

 

  1. Select the triad of the boundaries of the Hesselbach triangle.
a. Inguinal ligament, rectus abdominis muscle, deep epigastric vessels
b. Rectus abdominis muscle, Cooper ligament, aponeurosis
c. Scarpa’s fascia, deep epigastric vessels, external oblique muscle
d. Inguinal ligament, inguinal canal, Cooper ligament

 

 

ANS:  A

The boundaries of the Hesselbach triangle are deep epigastric vessels laterally, inguinal ligament inferiorly, and rectus abdominis muscle medially.

 

REF:   Page 399

 

  1. Select the most common hernia that occurs in both males and females and name the side on which it would most likely occur.
a. Direct femoral hernia on the left
b. Indirect inguinal hernia on the right
c. Indirect femoral hernia on the left
d. Direct inguinal hernia on the right

 

 

ANS:  B

Although hernias occur most often in males, the most common hernia in both males and females is the indirect inguinal hernia. Hernias occur more commonly on the right side than on the left.

 

REF:   Page 396

 

  1. Contributing factors to hernia formation include age, gender, previous surgery, obesity, nutritional status, and pulmonary and cardiac disease. The formation of the hernia at a site of weakness is due to any number of conditions that cause:
a. impaired healing and defective collagen formation.
b. thinning and stretching of muscle fibers.
c. increased pressure within the abdomen.
d. loss of tissue elasticity.

 

 

ANS:  C

Any number of conditions causing increased pressure within the abdomen can contribute to the formation of a hernia. Loss of tissue turgor occurs with aging and from chronic debilitating diseases. Current evidence suggests that adult male inguinal hernias are likely associated with impaired collagen metabolism and weakening of the fibroconnective tissue of the groin. Smoking has also been noted as a contributing factor to hernia formation.

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