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Anatomy ICOM > Clinical Correlates > Flashcards

Clinical Correlates Flashcards

1
Q

Peritonitis

A

Bacterial infection from laparotomy or traumatic penetration -> inflammation of peritoneum

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2
Q

Peritoneal adhesions

A

Damaged peritoneum -> inflamed and sticky fibrin

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3
Q

Ascites

A

Fluid accumulation in peritoneal cavity -> dissension and swelling
1. Can affect respiratory fxn

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4
Q

Abscess formation

A

Collection of purulent exudate in subphrenic recess

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5
Q

Internal hernia thru omental foramen

A

Loop in small bowel thru omental bursa

  1. Can be strangulated by foramen
  2. Rare
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6
Q

Temporary control of hemorrhage from cystic a.

A

Artery ligated and clamped -> severed during cholecystectomy

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7
Q

Diaphragm rupture

A

Inc intra-abdominal pressure -> rupture

1. Traumatic or congenital

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8
Q

Abdominal hernia

A

Structures thru wall in areas of weakness

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9
Q

Abdominal aortic aneurism

A

Localized enlargement of abdominal aorta

1. Inc mortality rate if ruptures

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10
Q

Gastro-esophageal reflux disorder (GERD)

A

Recurrent heartburn from acid regurgitation

1. Esophageal sphincter failure

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11
Q

Hiatal hernia

A
  1. Para-esophageal: cardia normal, fundus herniates-> no reflux
  2. Sliding: esophagus, cardia, and fundus herniate -> reflux
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12
Q

Pylorospasm

A

Spasms of pylorus at 2-12 weeks old, smooth muscle doesn’t relax properly -> food stuck -> discomfort and vomiting

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13
Q

Pyloric stenosis

A

Hardening and narrowing -> chyme can’t pass -> non-bilous vomiting, dehydration, and “olive” sized mass at pylorus
1. Single-bubble sign

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14
Q

Duodenal atresia

A

Congenital absence/closure at duodenojejunal flexure -> stomach distension, bilious vomiting

  1. Double-bubble sign
  2. Common w/ Down’s syndrome and pregnancies w/ xs amniotic fluid
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15
Q

Paraduodenal hernia

A

2-3 inconstant folds and fossae around duodenojejunal flexure
1. Bowel strangulation if intestinal loop stuck

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16
Q

Peptic ulcers

A

Duodenum/stomach

  1. H. Pylori
  2. Lethal hemorrhage if erode a.
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17
Q

Pancreatic cancer

A

Can obstruct IVC, bile duct, hepatopancreatic ampulla -> bile retention, inc gallbladder, and jaundice
1. Drain into lymph system -> metastasis

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18
Q

Cholelithiasis

A

Stones in gallbladder, cystic duct, or bile duct

  1. Usually asymptomatic
  2. Large -> obstruction -> ulceration -> cholecysto-enteric fistula
  3. Lodged ileocecal valve -> intestinal constriction -> bowel obstruction = gallstone ileus
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19
Q

Porcelain gallbladder

A

Inflammatory scarring and calcification of walls

1. Chronic gallstones (overweight females)

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20
Q

Subphrenic abscess

A

Pus in subphrenic recess

1. Usually drains to hepatomegaly recess

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21
Q

Cirrhosis of liver

A

Fatty/fibrous scar tissue accumulate -> dec circulation -> inc BP in partial system -> varices
1. Hobnail appearance

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22
Q

Hirschsprung’s disease (congenital megacolon)

A

Abnormal development of autonomic n. And enteric system in distal colon
A. Non-function -> accumulation prox to immobile section

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23
Q

Diverticulosis

A

Outpockets in colon wall between teniae coli

1. Infection = diverticulitis

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24
Q

Appendicitis

A

Blockage -> inflammation

  1. Nausea, vomiting, fever, dec appetite
  2. Pain vague peri-umbilicular and lumbar regions -> severe right lower quadrant
  3. Pressure at McBurney’s point -> tenderness and guarding
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25
Q

Intestinal ischemia

A

Occlusion vasa recta by emboli, thrombosis, or atherosclerotic occlusions
1. Severe -> necrosis and ileus
2. Colicky pain, abdominal distention, vomiting, fever, dehydration
3. Emboli from heart -> SMA because of acute angle from aorta
A. SM angiogram to clear obstruction

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26
Q

Volvulus of sigmoid

A

Rotation/twisting -> lumen obstruction

1. Obstipation, ischemia, necrosis if untreated

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27
Q

Inflammatory bowel disease (IBD)

A
  1. Ulcerative colitis: chronic inflammation and ulceration of colon
  2. Crohn’s disease: patchy inflammation anywhere in GI tract -> deeper layers of intestinal wall
    A. Etiology = unknown
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28
Q

Pyloric stenosis

A

Pylorus musculature hypertrophy -> narrowing -> food obstructed

  1. Common
  2. Non-bilious projectile vomiting
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29
Q

Annular pancreas

A

Obstruction of duodenum by pancreas ring in dev

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30
Q

Mobile cecum

A

Mesentery doesn’t fuse post wall

  1. Mobile
  2. Possible volvulus
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31
Q

Omphalocele

A

Herniation thru enlarges umbilical ring

  1. Covered by amnion
  2. Failure of bowel to return into cavity
  3. Inc mortality rate
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32
Q

Gastroschisis

A

Visceral thru body wall -> amniotic cavity lateral to umbilicus

  1. Abnormal wall closure
  2. Bowel may be damaged by amniotic fluid
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33
Q

Meckel (ileal) diverticulum

A

Small portion vitelline duct persists -> outpocket ileum (40-60 cm from ileocecal valve)
1. Usually asymptomatic

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34
Q

Enterocystoma

A

Vitelline cord

  1. Ends -> fibrous
  2. Middle -> cyst
  3. Small intestine twist around strands -> volvulus
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35
Q

Umbilical fistula

A

Vitelline duct patent -> open between umbilicus and intestines
1. Feces at umbilicus

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36
Q

Rectourethral and rectovaginal fistulas

A

Abnormal formation cloaca and/or urorectal septum

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37
Q

Imperforate anus

A

Incomplete separate cloaca -> urogenital and anorectal parts

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38
Q

Non-rotation of the gut

A

Large intestines don’t surround small intestines

1. Off to left side

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39
Q

Mixed rotation and volvulus

A

Partial rotation -> volvulus of upper duodenum

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40
Q

Urethral rupture males

A
  1. Intermediate part: assoc w/ pelvic girdle fx
    A. Blood an urine -> deep perineal pouch -> (move sup) thru urogenital hiatus -> around prostate and bladder
    B. Spongy part: straddle injury
    1. Urine from bulb -> scrotum or abdominal wall
      C. Urine can’t pass into thigh (fascia lata) or posterior (superficial and deep perineal fascia)
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41
Q

Hemorrhoids

A
  1. Predisposing factors:
    A. Pregnancy
    B. Chronic constipation
    C. Disorders of venous return
  2. Anastomoses: superior, middle, and inf rectal a. Imp connection between portal and systemic venous systems
    A. Inc pressure valveless portal v. -> varices
  3. Internal (piles): prolapse anal cushions from breakdown muscularis mucosa m. Layer
    A. Thru anal canal -> strangulate and ulcerate
    B. Above pectinate line => visceral innervation => unconscious and not painful
  4. External: thromboses in external rectal venous plexus
    A. Inf pectinate line => somatic afferent => painful
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42
Q

Hypospadias

A

Common congenital abnormality of penis from failure urogenital folds to fuse on ventral surface

  1. Glandular: external urethral orifice on ventral aspect of glans
  2. Penile (body of penis)
  3. Penoscrotal/scrotal
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43
Q

Phimoses

A

Prepuce of penis fits tightly (hard to retract)

1. Smegma may accumulate -> irritation

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44
Q

Paraphimosis

A

Painful prepuce contraction over corona constricts glans inhibits blood drainage

  1. Ischemia, vascular engorgement, swelling, edema, penile gangrene
  2. Tx: circumcision
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45
Q

Impotence

A

No erection, several causes

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46
Q

Erectile dysfunction

A

CNS and endocrine related causes common

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47
Q

Greater vestibular gland infections

A

Can enlarge and partially occlude rectum

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48
Q

Weakness in female perineal m.

A

Inc risk urinary incontinence and post-partum prolapse

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49
Q

Hydrocele

A

Fluid in tunica vaginalis of testes or along spermatic cord
1. Infection or injury -> partial occlusion processes vaginalis
2. Hematocele: blood
3. Varicocele: enlargement pampiniform venous plexus or spermatic cord
A. “Bag of worms” in scrotum

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50
Q

Injury to pelvic floor (childbirth)

A
  1. Dec support for vagina, uterus, bladder, and rectum
  2. Pubococcygeus and puborectalis tear
  3. Urinary stress incontinence
  4. Pelvic organ prolapse
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51
Q

Cystocele

A

Herniation of female urinary bladder
1. Weakened muscles and CT between bladder and ant wall vagina -> vagina bulges and herniates into vaginal lumen
2. Causes
A. Pelvic floor rupture during childbirth
B. Lesion of nerves supplying m.
C. Rupture of fascial support

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52
Q

Uretrocele

A

Female urethra displaced -> dec passive compression of urethra -> “leakage” w/ inc intra-abdominal pressure

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53
Q

Tubal sterilization

A

Surgical resection uterine tubes

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54
Q

Deferenectomy

A

Male sterilization

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55
Q

Disposition of uterus

A

Disposition of normally anteverted and anteflexed uterus, which passively supports the uterus

56
Q

Hysterectomy

A

Surgical resection uterus

57
Q

Benign hypertrophy of prostate (BHP)

A

Enlargement
1. May project into bladder, compress urethra, obstruct internal urethral orifice
2. Lead to
A. Nocturnal
B. Dysuria
C. Urgency
3. Assoc w/ bladder infections and kidney damage

58
Q

Prostate cancer

A

Feels hard and irregular of digital rectal exam

1. Transurethral resection of prostate (TRUP) to remove hypertrophied region

59
Q

Regional analgesia/anesthesia for childbirth

A
  1. Regional analgesia: conscious of contractions and can bear down
  2. Regional anesthesia: complete block pain
    A. Epidural: L3-L4, entire birth canal anesthetized, limbs not affected
    1. Uterine pain (sup pelvic line) still felt => conscious uterine contraction
60
Q

Spinal anesthesia

A

Subarachnoid space L3-L4 -> complete anesthesia inf to waist
1. Circulates subarachnoid space -> “spinal headache”

61
Q

Pudendal n. Block

A

S2-S4 dermatologist and inf 1/4 vagina

1. Contractions felt

62
Q

Ilio-inguinal n. Block

A

Abolish sensation from ant part perineum

63
Q

Accessory ureters

A

Division of ureteric bud

64
Q

Renal agenesis

A
  1. Unilateral: one kidney forms
  2. Bilateral: no kidneys
    A. Potter sequence
    1. Oligohydramnios
    2. Anuria
    3. Cardinal anomalies
    4. Tracheal and duodenal atresias
    5. Cleft lip/palate
    6. Brain abnormalities
    7. Flat face
    8. Clubbed feet
65
Q

Malrotated kidney

A

Rotated wrong direction or not at all

1. Possible vasculature probs

66
Q

Ectopic kidneys

A

Stays ant to sacrum

  1. Supply: aortic bifurcation or common iliac a.
  2. Can be confused as tumor
  3. Damaged during childbirth
67
Q

Horseshoe kidney

A

Inf poles fuse before ascension

1. Ureter obstruction possible

68
Q

Cystic kidney disease

A 
Numerous cysts
1. Autosomal recessive
  A. Progressive
  B. Renal failure infancy/childhood
2. Autosomal dominant
  A. More common
  B. Less progressive
  C. Renal failure adulthood
69
Q

Urachal fistula

A

Urine from umbilicus

70
Q

Urachal cyst

A

Local area allantois persists -> cystic dilation

71
Q

Urachal sinus

A

Lumen in upper part of allantois persists

  1. May open to bladder
  2. Asymptomatic unless infected
72
Q

Exstrophy of bladder

A

Mucosa exposed in ventral body wall

73
Q

Exstrophy of cloaca

A

More severe version of bladder exstrophy

  1. Dev. Urorectal septum altered -> anal canal malformations and imperforate anus
  2. External genitalia defects
74
Q

Hypostadias

A

Incomplete fusion of urethral folds in males

  1. Glandular: urethra on ventral surface of glans
  2. Shaft
  3. Scrotal
75
Q

Epispadias

A

Urethral opening on dorsal side of penis

1. Assoc w/ exstrophy of bladder

76
Q

Duplications of uterus

A

Lack of paramesonephric duct fusion

  1. Uterus didelphys: entirely double
  2. Uterus arcuatus: slight indentation in middle
  3. Uterus bicornis: 2 horns entering one vagina
77
Q

Double vagina

A

Sinovaginal bulbs don’t fuse

78
Q

Vaginal atresia

A

Sinovaginal bulbs don’t develop

1. Vaginal pouch surrounds cervix

79
Q

Micropenis

A

Low androgen

  1. Primarily hypogonadism
  2. Hypothalamic/pituitary dysfunction
  3. 2.5 SD below mean length
80
Q

Bifid/double penis

A

Genital tubercle splits

81
Q

Ambiguous genitalia

A

Large clitoris or small penis

1. Hermaphrodites

82
Q

Ovotesties

A

Ovarian and testicular tissue

83
Q

Androgen insensitivity syndrome (AIS)

A

Lack androgen receptors => no male parts

1. No female internal genitalia

84
Q

Gonadal dysgenesis

A

No oocytes

  1. Ovaries appear as streak gonads
  2. Female phenotype
85
Q

Measuring obstetric conjugate

A
  1. Measure diagonal conjugate
  2. Subtract 1.5-2.0 cm
  3. Normal > or = 10 cm
86
Q

Bituberous measurement

A

Pelvic outlet measurement

1. Measure distance between ischiotuberosities (find w/ thumbs from outside)

87
Q

McDonald’s rule

A

OB
20-32 wks
Cm=week number

88
Q

Ankle sprains

A

Torn ligament

  1. Mostly inversion injury: weak lateral tendons
  2. Can -> tibia/fibula fx
89
Q

Pott’s fx

A

Eversion ankle sprain

  1. Torn deltoid and posterior tibiofibular ligaments
  2. Distal fibula fx
90
Q

Maisonneuve fx

A

Eversion ankle sprain

  1. Torn anterior tibiofibular, deltoid lig, and interosseous membrane
  2. Posterior medial malleolus fx
  3. Spiral fx proximal fibula
91
Q

Genu varum

A

Bow-legged

1. Small Q-angle

92
Q

Genu valgum

A

Knock-kneed

1. Large Q-angle

93
Q

Abnormal Q-angle

A

Leads to arthritis and menisci degeneration

94
Q

Unhappy triad

A

Torn:

  1. MCL
  2. ACL
  3. Medial meniscus
95
Q

Baker’s cyst

A

Abnormal fluid-filled sac in popliteal region

1. Usually between semimembranosus tendon and medial head gastrocnemius

96
Q

Fabellar syndrome

A

Sesamoid bone irritates lateral aspect popliteal fossa

1. Lateral head gastrocnemius

97
Q

Hallux valgus

A

Lateral deviation of hallux

  1. From tight shoes or degenerative joint disease
  2. Can -> corns or bunions at MTP joint of hallux
98
Q

Hammer toe

A

Proximal phalanx permanently dorsiflexed at MTP jt

  1. Middle phalanx plantarflexed PIP joint
  2. DIP hyperextended
  3. Usually 2nd digit
  4. Weak lumbrical or interosseous membrane
99
Q

Claw toe

A
  1. Hyperextension MTP
  2. Flexion DIP
  3. Usually lateral 4 digits
  4. Can -> callouses or corns
100
Q

Pens planus

A 
Flat feet
1. Flexible: normal when not wt bearing
2. Rigid: always flat
  A. Congenital: bone fusion
  B. Acquired
    1. Dysfunction dynamic arch support
    2. Trauma
    3. Degeneration
    4. Denervation
101
Q

Epidural hematoma

A

Blood between dura and calvaria

102
Q

Subdural hematoma

A

Between dura and arachnoid

103
Q

Subarachnoid hematoma

A

Between arachnoid and pia

104
Q

Intraparenchymal hematoma

A

Within brain tissue

105
Q

Le Fort fx I, II, III

A

Facial fx along thinning areas and suture lines

1. Common

106
Q

Positional plagiocephaly “flat head syndrome”

A

Malformation from repetitive positioning in early development
1. Often oblique slant sagittal plane

107
Q

Craniosynostosis

A

Premature suture fusion

108
Q

Scaphocephaly

A

Premature fusion sagittal suture (40-60%)

109
Q

Brachycephaly

A

Premature fusion coronal suture (20-30%)

110
Q

Plagiocephaly

A

Premature fusion one side either coronal or lamboidal sutures or both (<4%)

111
Q

Trigonocephaly

A

Premature fusion metopic suture (<10%)

112
Q

Kleeblattschadel (clover leaf)

A

Premature fusion coronal, lamboid, and sagittal sutures

1. Extremely rare

113
Q

Microcephaly

A

Premature fusion of all sutures and fontanelles

1. Severe cognitive dysfxn

114
Q

Hydrocephaly

A

Inability to absorb CSF -> inc pressure -> inc calvaria growth
1. Usually fixed w/ shunt to venous system

115
Q

Cauliflower ear

A

Fibrous build-up external ear from repeated trauma and auricular hematoma

116
Q

Otitis externa

A

“Swimmer’s ear”

1. Infection external auditory meatus

117
Q

Ear wax compaction

A

Most common ear problem

118
Q

Otitis media

A

Infected middle ear

1. Often associated w/ upper respiratory infections

119
Q

Infection of mastoid air cells

A

Similar to sinus infection

1. Usually diagnosed when spreads -> middle ear

120
Q

Vertigo/Ménière’s disease

A

Membranous labyrinth bursts

121
Q

Tinnitus

A

Ringing in ears

1. Usually associated w/ decreased hearing from prolonged exposure to loud noises

122
Q

Meningitis (leptomeningitis)

A

Inflammation leptomeminges from microorganisms

1. Entry: subarachnoid space via blood or compound cranial fracture

123
Q

Subarachnoid hemorrhage

A
  1. Causes
    A. Rupture saccular aneurysm (cerebral a.)
    B. Trauma
124
Q

Meningiomas

A 
Tumors from arachnoid cells
1. Compress brain tissue
2. Most common:
  A. parasagittal regions cerebral hemisphere
  B. Olfactory groove
  C. Sphenoid wings
125
Q

Septic thrombosis cavernous sinus

A

Usually from infections in orbit, paranasal sinuses, or face

  1. May affect CN VI as traverses cavernous sinus
  2. Nerves embedded in sinus (CN III, IV, V1 and V2)
126
Q

Cerebrovascular accidents (strokes)

A 
No blood flow to brain -> cell death
1. Most common in adults in US
2. Neurological symptoms
3. Types
  A. Ischemic
  B. Hemorrhagic
127
Q

Cerebral herniation

A 
Lesions -> brain shift between compartments
1. Most common
   A. Subfalcine
   B. Tentorial
   C. Tonsillitis
128
Q

Concussion

A

Mild TBI: temporary loss of brain fxn (lasts months 15% pts)

  1. +/- unconsciousness
  2. Transient confusion
  3. Memory impairment
  4. Incoordination
  5. Headache
  6. Fatigue
  7. Irritability
  8. Dizziness
  9. Nausea
  10. Blurred vision
129
Q

Cerebral contusion

A

Brain bruising from head trauma

  1. Initial unconsciousness
  2. Edema -> fluctuating consciousness
  3. Seizures
  4. Focal neuronal signs
  5. Contusions = permanent
  6. Damaged tissue phagocytosed -> astrocyte prolfieration -> scarring
  7. Pts monitored closely
130
Q

Hydrocephalus

A

Ventricular system dilation from collection of CSF

  1. Non-communicating
  2. Communicating
131
Q

Non-communicating (obstructive) hydrocephalus

A

CSF obstructed in ventricular system

  1. Common: cerebral aqueduct and interventricular foramen
  2. Uncommon: ventricular system -> subarachnoid space
  3. Dilation above obstruction
132
Q

Communicating hydrocephalus

A

Flow CSF blocked outside ventricular system

  1. Usually dec CSF reabsorption in arachnoid granulations
  2. Obstruction in subarachnoid space
  3. XS CSF production
133
Q

Leakage of CSF

A

Fx of middle cranial fossa -> leakage from external acoustic meatus if meninges sup middle ear torn and tympanic membrane rupture

  1. If fx anterior to cranial fossa involve cribiform plate -> CSF thru nose
  2. Pts inc risk meningitis
134
Q

Pharyngeal arch syndrome

A

Arch derivative dev patterns fail

1. Congenital abnormalities eyes, ears, mandible, and palate

135
Q

Treacher-Collins syndrome

A

Underdeveloped zygomatic bones -> abnormalities external, middle, and inner ear

136
Q

Pierre Robin sequence

A

Underdeveloped mandible, cleft palate, defects of eye and ear

Anatomy ICOM (34 decks)

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