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Quiz of Hernia Section

1.  Imaging of hernias is best achieved by:

A. Upper GI study then small bowel follow through.
B. CT, ultrasound, or herniography, since either technique is equally effective.
C. Depends on the clinical scenario, with each imaging modality providing different strengths.
D. CT, ultrasound, then MRI.

2. Which of the following is NOT true regarding hiatal hernias:

A. The majority of hiatal hernias (99%) are sliding hiatal hernias. 1% are paraesophageal hernias.
B. Paraesophageal hernias are benign and usually not treated.
C. Upper GI barium series is the preferred study for fully evaluating hernias.
D. Sliding hernias occurs when the gastroesophageal junction, along with a portion of the stomach, prolapses into the mediastinum.

3. The following image demonstrates what type of hernia?


A. Morgagni hernia.
B. Petit hernia.
C. Grynfeltt hernia.
D. Bochdalek hernia.

4. Morgagni hernias are classically located:

A. Medially, in a retrosternal or parasternal location, more frequently on the right.
B. Posteriorly to the left of the diaphragm.
C. Through a defect in the anterior or lateral abdominal wall.
D. At the site of a previous surgery.

5. Which is NOT true about the following type of hernia:


A. It may be an incisional hernia if it is at the site of previous surgery.
B. Small aperture hernias of this type are less dangerous than large aperture hernias of this type.
C. Repair is usually on an elective basis, but may be urgent if bowel strangulation occurs.

6. The following image demonstrates what type of hernia? (R=rectus abdominus)


A. Bochdalek hernia.
B. Spigelian hernia.
C. Femoral hernia.
D. Direct inguinal hernia.

7.Umbilical hernias may resolve spontaneously if they are less than 1.5 cm. Thus, surgery is not considered until the defect persists after 4 years of age.


8.Indirect inguinal hernias:

A. Occur as a result of a patent processus vaginalis.
B. Are located medial to the the inferior epigastric vessels, through the floor of Hasselbach's triangle.
C. Cannot migrate into the scrotum.

9. What type of hernia is demonstrated below?


A. Indirect inguinal hernia.
B. Obturator hernia.
C. Direct inguinal hernia.
D. None of the above.

10. Which of the following is NOT true regarding Grynfeltt and Petit hernias?

A. Grynfeltt hernias occur through the superior lumbar triangle.
B. Petit hernias occur through the inferior lumbar triangle.
C. Are common in occurrance and are typically seen on the right side.
D. They may consist of bowel, omentum, kidney, spleen, or stomach.

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