Appendicitis Flashcards
What is appendicitis?
1 - inflammation of the veriform appendix
2 - inflammation of the ovaries
3 - inflammation of the mesoappendix
4 - inflammation of the ileocaecal valve
1 - inflammation of the veriform appendix
The mesentery is a fold of membrane that attaches the intestine to the abdominal wall and holds it in place. Which mesentery anchors the appendix to the ileum?
1 - mesovarium
2 - lesser omentum
3 - mesoappendix
4 - greater omentum
3 - mesoappendix
What is the blood vessel supplying the appendix?
1 - superior mesenteric artery
2 - ileocolic artery
3 - appendicular artery
4 - posterior caecal artery
3 - appendicular artery
- appendicular vein drains the appendix
What is the incidence appendicitis?
1 - 1 / 100000 a year
2 - 10 / 100000 a year
3 - 100 / 100000 a year
4 - 1000 / 100000 a year
3 - 100 / 100000 a year
At what age is appendicitis most likely to occur?
1 - 1st decade
2 - 2nd decade
3 - 3rd decade
4 - 4th decade
3 - 3rd decade
- approximately ages 18 to 30
- rare in <9 y/o
What is the most common cause for appendicities?
1 - appendiceal obstruction
2 - idiopathic
3 - acute inflammation
4 - trauma
1 - appendiceal obstruction
Appendiceal obstruction is the most common cause for appendicities. What is the most common cause of this blockage?
1 - colorectal neoplasia (polyp or cancer)
2 - faecolith (mass of hard stool)
3 - Lymphoid tissue hyperplasia
4 - abscess
2 - faecolith (mass of hard stool)
- higher incidence in patients with lower dietary fibre
Appendiceal obstruction is the most common cause for appendicities caused by faecolith (mass of hard stool). If the appendix is not removed it can lead to complications. Which of the following is NOT a common complication?
1 - gangrene with perforation
2 - localised abscess
3 - generalised peritonitis
4 - small bowel distension
4 - small bowel distension
Patients with an acute appendicitis can have a variety of symptoms. Where does pain generally start?
1 - right iliac fossa
2 - left iliac fossa
3 - epigastric region
4 - umbilical region
4 - umbilical region
- central/non-specific pain from involvement of visceral peritoneum (visceral/autonomic innervation)
- pain moves due to embryology as appendix was once part of midgut
Patients with acute appendicitis start with a generalised pain in the umbilical region of the abdomen. From here the pain becomes more specific to where?
1 - right iliac fossa
2 - left iliac fossa
3 - epigastric region
4 - left lumbar region
1 - right iliac fossa
- RIF pain when parietal peritoneum involved (somatic nervous system)
Pain in the right iliac fossa is the most common presentation in appendicitis. Which of the following is NOT a common symptom of appendicitis?
1 - anorexia (not wanting to eat)
2 - nausea and vomiting
3 - dysuria (from serosal irritation of the bladder)
4 - small bowel distension
5 - mild temperature
4 - small bowel distension
- dysuria is pain when urinating
- serosa is outer lining of organs
Why are children <10 y/o at a greater risk of infection and complications?
1 - immune system not full developed
2 - caecum not able to protect appendix
3 - greater omentum not full developed
4 - GIT walls are more fragile
3 - greater omentum not full developed
- in adults greater omentum protects other organs
There are a number of clinical signs of an acute appendicitis. One of these is tenderness at McBurneys point. What is this location?
ASIS = anterior superior iliac spine
AIIS = anterior inferior iliac spine
1 - half way between umbillicus and ASIS
2 - 2/3 between umbilicus and ASIS
3 - 2/3 between umbilicus and AIIS
4 - halfway between ASIS and coccyx
2 - 2/3 between umbilicus and ASIS
There are a number of clinical signs of an acute appendicitis. One of these is Rovsings sign, which is pain felt in RIF when pressing on the LIF. Why is this?
1 - nerves for RIF are on the LIF
2 - contents of LIF push into RIF distending RIF parietal peritoneum
3 - serratus muscle crosses pelvic here
2 - contents of LIF push into RIF distending RIF parietal peritoneum
There are a number of clinical signs of an acute appendicitis. One of these is psoas sign. What is this?
1 - pain on right hip extension when laying on left side
2 - pain on left hip extension when laying on right side
3 - pain on right hip extension when laying on right side
4 - pain on left hip extension when laying on left side
1 - pain on right hip extension when laying on left side