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Anatomy -Sarah > Blue Boxes Exam 2 (Hernias) > Flashcards

Blue Boxes Exam 2 (Hernias) Flashcards

1
Q

Liposuction

A

Surgical method for removing unwanted subcutaneous fat using a percutaneously placed suction tube and high vacuum pressure

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2
Q

The _____ is of special importance in surgery. It provides a plane that can be opened, enabling the surgeon to approach structures on or in the anterior aspect of the posterior abdominal wall, such as the ____ or ____, without entering the membranous peritoneal sac containing the ______. (The risk of contamination is minimized)

A

endoabdominal fascia,
kidneys or bodies of lumbar vertebra,
abdominal viscera

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3
Q

Space of Bogros

A

Anterolateral part of the potential space between the transversalis fascia and the parietal peritoneum used for placing prostheses when repairing inguinal hernias

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4
Q

Why is a prominent abdomen normal in infants and young children?

A

Their gastrointestinal tracts contain considerable amounts of air

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5
Q

The common causes of abdominal protrusion

A

food, fluid, fat, feces, flatus, fetus

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6
Q

Eversion of the umbilicus may be a sign of

A

increase intra-abdominal pressure, usually resulting from ascites or a large mass

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7
Q

ascites

A

abnormal accumulation of serious fluid in the peritoneal cavity

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8
Q

organomegal

A

organ enlargement

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9
Q

splenomegaly

A

enlargement of the spleen

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10
Q

(Possible) Location of abdominal hernias

A

anterolateral abdominal wall
Most hernias occur in the inguinal, umbilical, and epigastric regions
(The lines along which the fibers of the abdominal aponeuroses interlace, in the midline or in the transition from aponeurosis to rectus sheath, between the xiphoid process and the umbilicus, along the semilunar lines)

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11
Q

______ are common in neonates because the anterior abdominal wall is relatively weak in the ____, especially in low-birth-weight infants.

A

Umbilical hernias,

umbilical ring

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12
Q

Acquired umbilical hernias

A

Extraperitoneal fat and/or peritoneum protrude into the hernial sac, occurs most commonly in women and obese people.

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13
Q

Epigastric hernia

A

A hernia in the epigastric region through the linea alba, occurs in the midline between the xiphoid process and the umbilicus

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14
Q

Hernias occurring along the semilunar lines

A

Spiegelian hernias

Tends to occur in people older than 40 years and are usually associated with obesity

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15
Q

Warm hands are important when palpating the abdominal wall because cold hands make the _____ muscles ___, producing involuntary spasms of the muscles, known as ____.

A

anterolateral abdominal,
tense,
guarding

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16
Q

Guarding

A

involuntary spasms of the muscles (anterolateral abdominal muscles

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17
Q

Intense guarding is an indicator of?

A

inflammation of an organ or acute abdomen

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18
Q

Palpation of abdominal viscera is performed with the patient in the ____ position with thighs and knees semi-flexed to enable adequate relaxation of the anterolateral abdominal wall. Otherwise, the _____ pulls on the membranous layer of abdominal subcutanoeus tissue.

A

supine,

deep fascia of the thighs

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19
Q

The superficial abdominal reflex

A

elicited by quickly stroking horizontally, lateral to medial, toward the umbilicus. Contraction of the abdominal muscles is felt

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20
Q

Innervation of abdominal muscles

A

inferior thoracic spinal nerves (T7-T12), iliohypogastric, and iliolinginal nerves (L1)

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21
Q

Muscles and viscera are retracted ____ their neurovascular supply.

A

Toward

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22
Q

True or false: The rectus abdominus can be transected without causing irreversible necrosis.

A

True (from what I understood)
Transverse incisions are not made through the tendinous intersections because cutaneous nerves and branches of the superior epigastric vessels pierce these fibrous regions of the muscle.

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23
Q

_______ can be made along any part or the length of the linea alba from the ____ to the _____.

A

Median incisions,
Xiphoid process,
pubic symphysis

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24
Q

Longitudinal incisions

A

median and paramedian incisions, preferred for exploratory operations

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25
Q

____ incisions are often used for an appendectomy.

A

Gridiron (muscle-splitting)

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26
Q

McBurney incision

A

Made at the McBurney point, approximately 22.5 cm superomedial to the ASIS on the spino-umbilical line.

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27
Q

bikini incision

A

Suprapubic incisions, Pfannenstiel incision. Made at hairline, used for most gynecological and obstetrical operations

28
Q

_____ provide access to the gallbladder and biliary ducts on the right side and the spleen on the left.

A

Subcostal incisions

29
Q

Subcostal incisions

A

provide access to the gallbladder and biliary ducts on the right side and the spleen on the left. The incision is made parallel but at least 2.5 cm inferior to the costal margin to avoid the 7tha nd 8th thoracic spinal nerves.

30
Q

____ are preferred for exploratory operations.

A

Longitudinal incisions

31
Q

High-risk incisions

A

Pararectus and inguinal incisions. Can cut nerve supply to the rectus abdominis (pararectus). Inguinal incisions can injure ilio-inguinal nerve.

32
Q

Incisional hernia

A

Protrusion of omentum (a fold of peritoneum) or an organ through a surgical incision

33
Q

When flow in the superior or inferior vena cava is obstructed, anastomoses between the tributaries of these systemic veins, such as the ______, may provide collateral pathways by which the obstruction may be bypassed.

A

thoraco-epigastric vein

34
Q

When flow in the superior or inferior vena cava is obstructed anastamoses between the tributaries of these systemic veins. The veins become visible and the syndrome is called this.

A

Caput Medussa

35
Q

A testis has not descended or is not retractable

A

cryptorchidism

36
Q

The undescended testis usually lies somewhere along the normal path of its prenatal descent, commonly in the _____ .

A

inguinal canal

37
Q

Why would cryptorchidism be a clinical concern?

A

Developing malignancies in the undescended testis are particularly problematic because it is not palpable and is not usually detected until cancer has progressed

38
Q

External supravesical hernia

A

It leaves the peritoneal cavity through the supravesical fossa (medial to that of a direct inguinal hernia)
Repair of this type of hernia risks iliohypogastric nerve injury.

39
Q

The umbilical vein is ____ for some time after birth, and is used for _____ for exchange _____ during early infancy-for example. There are two diseases mentioned that infants might have that would require this, name them.

A

patent,
umbilical vein catheterization,
transfusion,
erythroblastosis fetalis or hemolytic disease of the newborn

40
Q

Uterine cancer cells (especially from tumors adjacent to the proximal attachment of the ___) can spread from the uterus to the ______, and from there to the superficial inguinal nodes, which receive lymph from the skin of the _____.

A

round ligament,
labium majus
perineum (including the labia)

41
Q

The majority of the abdominal hernias occur in the _____ .

A

inguinal region (75%)

42
Q

What is the difference between a direct and indirect hernia in terms of locations?

A

The skinny: Indirect hernias exit the abdominal cavity through the peritoneum of PERSISTENT processus vaginalis and exits from the anterior abdominal wall via the superficial ring WHILE INSIDE the cord (commonly passing into the scrotum or labium majus). They are LATERAL TO INFERIOR EPIGASTRIC VESSELS when they enter the deep inguinal ring. Direct hernias lie OUTSIDE the inner one or two fascial coverings of the cord when exiting the abdominal cavity and are MEDIAL TO THE INFERIOR EPIGASTRIC VESSELS (also passes through INGUINAL TRIANGLE). They are LATERAL to the spermatic cord when exiting from the anterior abdominal wall through the superficial ring. Direct hernias rarely enter the scrotum.

43
Q

What is the developmental difference between direct hernias and indirect hernias?

A

In indirect hernias, there is a patency of the processus vaginalis. In direct hernias, there is a weakness of the anterior abdominal wall in the inguinal triangle.

44
Q

Cremasteric reflex is shown by

A

the rapid elevation of the testis on the same side (contraction is elicited by lightly stroking the skin on the medial aspect of the superior part of the thigh)

45
Q

Hyperactive cremasteric reflexes may simulate _____.

A

undescended testes

46
Q

Canal of Nuck

A

If the processus vaginalis persists in females, it forms a small peritoneal pouch

47
Q

A bulge in the anterior part of the labium majus in a female infant might be produced by a cyst in the ____ and has the potential to develop into an ______.

A

canal of Nuck,

indirect inguinal hernia

48
Q

The presence of excess fluid in a persistent processus vaginalis

A

hydrocele

49
Q

hydrocele

A

the presence of excess fluid in a persisten processus vaginalis

50
Q

hydrocele of the testis

A

confined to the scrotum and distends the tunica vainalis

51
Q

hydrocele of the spermatic cord

A

confined to the spermatic cord and distends the persistent part of the stalk of the processus vaginalis

52
Q

transillumination

What is a possible finding of this test?

A

a procedure during which a bright light is applied to the side of the scrotal enlargement in a darkened room. A red glow = serous fluid in the scrotum. (Blood does not transilluminate)

53
Q

hematocoele of testis

A

collection of blood in the tunica vaginalis that results, for example, from rupture of branches of the testicular artery by trauma to the testis

54
Q

results from effusion of blood into the scrotal tissues

A

scrotal hematocoele

55
Q

True or false: Torsion of the spermatic cord is a surgical emergency

A

True

56
Q

Torsion of the spermatic cord obstructs _____ and results in ___ and ___ and ____.

A

venous drainage,

edema, hemorrhage, and arterial obstruction

57
Q

What nerve fibers supply the scrotum?

A

The anterolateral surface of the scrotum is supplied by the lumbar plexus (primarily L1 via the illioinguinal nerve) and the postero-inferior aspect is supplied by the sacral plexus (primarily S3 fibers via the pudendal nerve)

58
Q

Retention cyst in the epididymis

A

spermatocele (usually occurs near the head of the epididymis)

59
Q

True or False: Spermatoceles are generally asymptomatic.

A

True

60
Q

True or false: Torsion of the spermatic cord is generally asymptomatic.

A

False

61
Q

The appendix of the testis is a vesicular remnant of the _____ end of the ______, the embryonic genital duct that in the female forms half of the _____.

A

crainial,
paramesonephric (mullerian) duct,
uterus

62
Q

The appendices of the epididymis are remnants of the ____ end of the ____, the embryonic genital duct that in the male forms part of the _____.

A

cranial,
mesonephric (wolffian) duct,
ductus deferens

63
Q

varicocele

A

The vine-like pampiniform plexus of veins may become dilated (varicose) and tortuous, producing a varicocele, which is usually visible only when the man is standing or straining.

64
Q

Varicoceles may result from defective ____ in the ____ vein, but kidney or ____ vein problems can also result in distention of the pampiniform veins. Varicocele occurs predominantly on the ____ side, probably because the acute angle at which the right vein enters the ___ is more favorable to flow than the nearly 90 degree angle at which the left ____ enters the left ___ vein, making it more susceptible to obstruction or reversal of flow.

A 
valves,
testicular, renal,
left,
IVC (inferior vena cava),
testicular vein, renal vein
65
Q

Cancer of the testis metastasizes initially to the retroperitoneal _______, which lie just ____ to the renal veins. Subsequent spread may be to _____ and ____ nodes.

A

lumbar lymph nodes,
inferior,
mediastinal,
supraclavicular

66
Q

Cancer of the scrotum metastasizes to the _____ which lie in the subcutaneous tissue inferior to the _____ and along the terminal part of the great ____ vein.

A

superficial inguinal lymph nodes,
inguinal ligament,
saphenous

Anatomy -Sarah (12 decks)

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