Inguinal Hernia

Front 1

GILBERT classification

Back 1

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

Hint 1

First 3- Indirect
Next 2- Direct

Front 2

What are rutkow Robbins addition to Gilbert classification

Back 2

type 6- Pantaloon hernia ( means both direct and indirect component)
type 7- Femoral hernia

Front 3

Nyhus classification

Back 3

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

Hint 3

has 4 types
with 3 subtypes of type 3

Front 4

nyhus classification

Back 4

type 1- Indirect inguinal hernia with normal internal ring
type 2 - indirect inguinal hernia with dilated ring ( but no features of 3b)

Hint 4

type 1 and 2 of nyhus resemble Gilbert classification

Front 5

Hassebachs triangle

Back 5

laterally inferior epigastric vessels
medially lateral border of rectus sheath
inferiorly inguinal ligament

Front 6

schumpelick classification

Back 6

another classification

Front 7

Myopectineal orifice of fruchaud bpundaries

Back 7

Superiorly - arching fibres of internal oblique and transversus abdominis
Medially -lateral border of rectus abdominis
Laterally -iliopsoas
Inferiorly -cooper's ligament

Front 8

Triangle of pain contents

Back 8

1. Femoral nerve
2.Lateral cutaneous femoral nerve
3. Femoral branch of genitofemoral nerve

Front 9

Boundaries of triangle of pain

Back 9

superolaterally - iliopubic tract
inferomedially - gonadal vessels

Front 10

Contents of triangle of doom

Back 10

1.Ext iliac vessels
2.Deep circumflex iliac vessels

3.Femoral nerve
4.Genital branch of genitofemoral nerve

Front 11

ilioinguinal nerve sensory supply

Back 11

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

Front 12

iliohypogastric nerve supply

Back 12

1. skin over suprapubic region
2.skin over posterlateral gluteal region
note ....so iliohypogastric provides afferent and efferent for abdominal reflex

Hint 12

hypogastric refers to suprapubic region

Front 13

Genitofemoral nerve

Back 13

femoral branch of genitofemoral nerve
Skin over femoral triangle ( anteromedial thigh)
so it is afferent for cremastric reflex

Front 14

Genitofemoral nerve

Back 14

Genital branch of genitofemoral nerve
1. cremastric muscle (so efferent of cremastric reflex)
2. spermatic fascia and tunica vaginalis of testis

Front 15

Meralgia parasthetica

Back 15

injury to lateral femoral cutaneous nerve
it supplies upper lateral thigh

causes pain and numbness in this area

Front 16

arteries in spermatic cord

Back 16

Testicular art -br of aorta
Art to vas. -br of inferior vesical
Cremastric art - be of inferior epigastric art

Front 17

vessels encountered in subcutaneous plane while doing repair by open method

Back 17

Superficial Ext pudendal

Superficial epigastric

Superficial circumflex iliac

( med to lat )

Hint 17

2 S.E.P

S.C.I

Front 18

Triangle of doom

Back 18

medially -vas deferens
laterally gonadal vessels

Hint 18

mnemonic VG

Front 19

veins cut in skin in inguinal hernia

Back 19

media to lateral
superficial ext pudendal
superficial epigastric
superficial circumflex iliac