"Hernia & Abdominal Wall" — Practice

Question 1

A hernia emerging medial to the inferior epigastric vessels is which type?

Accepted Answer

B

Question 2

An umbilical hernia in a 1-year-old child should be managed how?

Accepted Answer

C

Question 3

A patient has a tender, irreducible lump below and lateral to the pubic tubercle with vomiting. What is the correct action?

Accepted Answer

B

Question 4

Strangulated bowel is resected during repair of an inguinal hernia. What repair should follow?

Accepted Answer

C

Question 5

Which groin swelling transilluminates brilliantly and cannot be got above?

Accepted Answer

C

Question 6

A patient with a small femoral hernia has fever, tachycardia and local tenderness but is passing flatus and stool with no distension. What is the likely diagnosis?

Accepted Answer

B

Question 7

A thin 78-year-old woman has small bowel obstruction and pain radiating down the inner thigh, with no palpable lump. What is the diagnosis?

Accepted Answer

B

Question 8

Why is the anterior wall of the inguinal canal reinforced laterally and the posterior wall medially?

Accepted Answer

Because each ring needs to be backed by strength on the opposite side of the canal. The deep ring lies laterally, so the anterior wall at that point is reinforced by the fibres of internal oblique arising from the inguinal ligament. The superficial ring lies medially, so the posterior wall at that point is reinforced by the conjoint tendon.

The result is that at no point along the canal are both walls weak simultaneously, which is one component of the mechanism preventing herniation in a normal abdominal wall. The other component is the shutter action of the arching fibres of internal oblique and transversus, which descend on straining and press the canal closed. Understanding the arrangement makes the four boundaries memorable rather than arbitrary, and it explains why a direct hernia, which arises where the posterior wall is unsupported by the deep ring mechanism, is a disease of acquired weakness in older patients.

Question 9

A paraoesophageal hiatus hernia is found incidentally in a patient with no reflux symptoms. What is the concern?

Accepted Answer

C

Practice — "Hernia & Abdominal Wall"

Sign in to save attempts to your dashboard and track your accuracy over time

Find a verified tutor

Join a live course

Browse coaching centres

About

Categories

Support

Documentation

Get Study Tips & Updates

Download Our App

Download for iOS

Download for Android

Popular Cities