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19 Cards in this Set
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- 3rd side (hint)
GILBERT classification |
1- indirect with small internal ring
2- indirect with moderately dilated internal ring 3-indirect with large internal ring (>2 fingerbreadth) 4-direct with entire floor disruption 5-direct with only small diverticular opening |
First 3- Indirect
Next 2- Direct |
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What are rutkow Robbins addition to Gilbert classification
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type 6- Pantaloon hernia ( means both direct and indirect component)
type 7- Femoral hernia |
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Nyhus classification
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type 4-recurrent hernia
type 3a -direct hernia 3b -indirect hernia -enroaching on posterior wall -reaching till scrotum - sliding hernia -pantaloon hernia 3c- Femoral hernia |
has 4 types
with 3 subtypes of type 3 |
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nyhus classification
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type 1- Indirect inguinal hernia with normal internal ring
type 2 - indirect inguinal hernia with dilated ring ( but no features of 3b) |
type 1 and 2 of nyhus resemble Gilbert classification
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Hassebachs triangle
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laterally inferior epigastric vessels
medially lateral border of rectus sheath inferiorly inguinal ligament |
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schumpelick classification
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another classification
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Myopectineal orifice of fruchaud bpundaries
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Superiorly - arching fibres of internal oblique and transversus abdominis
Medially -lateral border of rectus abdominis Laterally -iliopsoas Inferiorly -cooper's ligament |
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Triangle of pain contents
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1. Femoral nerve
2.Lateral cutaneous femoral nerve 3. Femoral branch of genitofemoral nerve |
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Boundaries of triangle of pain
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superolaterally - iliopubic tract
inferomedially - gonadal vessels |
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Contents of triangle of doom
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1.Ext iliac vessels
2.Deep circumflex iliac vessels 3.Femoral nerve 4.Genital branch of genitofemoral nerve |
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ilioinguinal nerve sensory supply
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1.Root of penis
2.anterior 1/3 of scrotum 3.small area of thigh below medial end of inguinal ligament xtraa'''in females since no scrotum so labia majus |
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iliohypogastric nerve supply
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1. skin over suprapubic region
2.skin over posterlateral gluteal region note ....so iliohypogastric provides afferent and efferent for abdominal reflex |
hypogastric refers to suprapubic region
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Genitofemoral nerve
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femoral branch of genitofemoral nerve
Skin over femoral triangle ( anteromedial thigh) so it is afferent for cremastric reflex |
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Genitofemoral nerve
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Genital branch of genitofemoral nerve
1. cremastric muscle (so efferent of cremastric reflex) 2. spermatic fascia and tunica vaginalis of testis |
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Meralgia parasthetica
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injury to lateral femoral cutaneous nerve
it supplies upper lateral thigh causes pain and numbness in this area |
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arteries in spermatic cord
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Testicular art -br of aorta
Art to vas. -br of inferior vesical Cremastric art - be of inferior epigastric art |
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vessels encountered in subcutaneous plane while doing repair by open method |
Superficial Ext pudendal Superficial epigastric Superficial circumflex iliac ( med to lat ) |
2 S.E.P S.C.I |
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Triangle of doom
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medially -vas deferens
laterally gonadal vessels |
mnemonic VG
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veins cut in skin in inguinal hernia
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media to lateral
superficial ext pudendal superficial epigastric superficial circumflex iliac |
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