_____ and ____ hernia restore strategies use an open surgical approach - ANS-onlay and
sublay
_____ hernia repair can be accomplished open or lap - ANS-underlay/IPOM
_______ appendix is more likely to motive rectal infection, therefore free stools and urinary
symptoms from bladder inflammation - ANS-pelvic
5 approaches to lessen recurrence and continual pain after hernia surgical treatment - ANS-1.
Use huge sheet of mesh (7x15) that extends 3-4cm above Hasselbach's triangle, 2cm medial to
pubic tubercle, five-6cm lateral to internal ring
2. Go the tails of the mesh behind the spermatic twine to avoid recurrence lateral to the internal
ring
3. Maintain mesh in barely tented or free configuration to resist forward protrusion of stomach
wall muscle mass while pt stands
four. Comfortable mesh medially to conjoint tendon with 2 interrupted sutures and laterally to
inguinal ligament with 1 non-stop suture to save you folding
5. ID and shield ilioinguinal, iliohypogastric and genital nerves
ok margins and lymph nodes for colon most cancers resection? - ANS-5 cm margins, at least 12
lymph nodes
An audible snap related to a lymph-like fluid in the inguinal canal is maximum probably due to
damage of which structure? - ANS-vas deferens
anterior, posterior, medial and lateral limitations of femoral canal? - ANS-A: inguinal lig
P: coopers lig
M: lacular lig
L: femoral v
anterior, posterior, medial, lateral, superior and inferior boundaries of inguinal canal? - ANS-A:
outside oblique
P: transversalis fascia
M: superficial inguinal ring
L: deep inguinal ring
S: inferior oblique and transversus abd
I: inguinal ligament
barium swallow displaying herniation most effective of the gastroesophageal junction through
the diaphragm - ANS-sliding hiatal hernia
BEST describes the right region to manage an ilioinguinal nerve block - ANS-2cm superior and
2cm medial to the anterior advanced iliac backbone
high-quality hernia restore in girls? - ANS-laparoscopic, to rule out femoral hernias
best region to manage a neighborhood for an inguinal hernia repair - ANS-2 cm cephalad and 2
cm medial to the ASIS
Borders of the femoral canal? - ANS-iliopubic tract anteriorly, Cooper's ligament posteriorly, and
the femoral vein laterally
, can you ligate the spherical ligament in a lap hernia repair? - ANS-sure
do you notice spigelian hernias medially or laterally? - ANS-Laterally, they can't occur medially
bc of intact rectus muscle and sheath
does a health practitioner with HIV need to disclose their fame to patients or employers? -
ANS-no
all through posterior mobilization of the rectum, a medial to lateral sweep is carried out to keep
away from injuring which structures? - ANS-ureter and pelvic nerves
For which wound class is biological mesh rec in hernia repairs? And what size illness? -
ANS-contaminated and dirty, >3cm illness
grade 1 pancreatic injury and tx - ANS-Hematoma- Minor contusion without duct
damage.Laceration- Superficial laceration with out duct damage.
Tx: look at
grade 2 pancreatic harm and tx - ANS-Hematoma- Major contusion without duct harm or tissue
loss. Laceration- Major laceration with out duct damage or tissue loss.
Tx: closed suction drainage
grade three pancreatic damage and tx - ANS-Laceration- Distal transection or parenchymal
injury with duct harm.
Tx: distal pancreatectomy (splenic protection depends on hemodynamic stability of pt)
grade 4 pancreatic injury and tx - ANS-Laceration- Proximal (proper of advanced mesenteric
vein) transection or parenchymal injury.
Tx: Wide drainage or Roux-en-Y jejunal limb to distal segment and oversew proximal phase.
Grade 5 pancreatic harm and tx - ANS-Laceration- Massive disruption of the pancreatic head.
Tx: damage manipulate, trauma whipple
Hannington-Kiff sign - ANS-loss of the thigh adductor reflex within the presence of a high quality
patellar reflex; due to obturator nerve compression
Heavyweight polypropelene mesh has a ______ rate of hernia recurrence than lightweight mesh
however an extended risk of________ due to its microporous design - ANS-decrease
contamination
Hernia recurrance charge in primary restore vs restore w mesh - ANS-primary: 30-60%
w mesh: 10%
hernia repair wherein mesh is placed above fascia - ANS-overlay
hernia restore wherein mesh is located underneath peritoneum - ANS-underlay, IPOM
hernia repair where mesh is located between fascial edges - ANS-inlay
hernia restore where mesh is placed between the rectus muscle groups and
peritoneum/posterior rectus sheath - ANS-sublay
how do you take a look at for the adductor reflex? - ANS-adductor reflex may be elicited by way
of percussion on the adductor tendon 5 cm above the medial femoral condyle with the index
finger placed across the adductors. A loss of adductor reflex is evidenced by using mild or no
muscle contraction as compared with the contralateral side
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