Extra (2) Flashcards
What is testicular torsion caused by?
Twisted spermatic cord leading to ischaemia of the testis, which is a medical emergency.
When is testicular torsion common?
In young boys, usually just after birth and during puberty.
What are the signs of testicular torsion?
Ret and hot swollen testis sitting high in the scrotum.
What is hydrocele?
Accumulation of fluids around the testicle that is often caused by fluid secreted from a remnant piece fo peritoneum wrapped around the testicle.
How is hydrocele treated?
It often resolves spontaneously and does not require treatment.
Do testicular cancers metastasise and where too?
Not very common but can to the lung.
What structures can be felt in a digital rectal exam in a healthy male?
- Prostate
- Rectum
- Full bladder
- Seminal vesicles
- Bilbo-Urethral glands
- Membranous urethra when catheterised
Which is the narrowest part of the urethra?
External urethral orifice.
How does anal venous drainage change?
Below the pectinate line the inferior rectal vein drains blood into the internal pudendal vein (systemic) whereas above the pectinate line, the superior rectal vein drains into the inferior mesenteric artery (portal).
What is the pectinate line?
The line that represents the hindgut-proctodeum junction and divides the upper two thirds and the lower third of the anal canal.
What are haemorrhoids?
Also known as piles. They are swellings of the interior muscular tube which connects the anus and the rectum, occurring in the cushions. Can be internal or external (difference marked by pectinate line).
What can the broad ligament be broken down into?
Three specific ligaments:
- Mesovarium (associated with ovary)
- Mesosalpinx (associated with fallopian tube)
- Mesometrium (associated with uterus)
What is the role of the cervix during pregnancy?
Establishment of effective barrier through retaining a sufficient length of closed cervix within which the mucus plug prevent entry of microbes from lower genital tract.
What are the boundaries of the perineum?
- Ishciopubic ramus
- Pubic symphysis
- Coccyx
- Sacrotuberous ligament
- Ischial tuberosity
What are complications of damage to the perineal body during childbirth?
- Urinary incontinence
- Uterus prolapse
What are the three superficial landmarks of the female perineum?
Pubic symphysis, ischial tuberosity and coccyx.
Which vessels anastomose with the vaginal arteries to form the blood supply to the lower third of the vagina?
Uterine artery
What is the ovary attached to?
Broad ligament by a sleeve of peritoneum (mesovarium).
What is an abdominal x-ray used for?
Used to investigate:
- Kidney and bladder stones
- Gall stones
- Intestinal blockage or perforation
- Ingested foreign objects
What is a CT scan use for?
Used to investigate: - Infection - Inflammation - Cancer - Injury - Kidney and bladder stones - Abdominal aortic aneurysms Great to answer acute questions as it provides greater detail than x-rays, especially soft tissue and vessels.
What are MRIs used for?
Used to investigate: - Tumours - Liver cirrhosis - Inflammation - Vessel malformation Provides detailed soft tissue imagine however it is time consuming and expensive.
What are ultrasounds used for?
Used to investigate: - Pain and distension - Abnormal organ function - Kidney and gall stones - Abdominal aortic aneurysm - Blood flow through vessels (Doppler) - Monitor the foetus in pregnancy Not useful for air-filled organs or large patient with fat as this weakens the imagine. Not as good detail as CT/MRI but it is cheap, quick and real-time.
What is angiography used for?
Used to investigate: - AAA - Aortic or renal artery stenosis - Blockages Can also be used in interventions.
What is urography used for?
Used to investigate:
- Haematuria
- Kidney and bladder stones (first line)
- Cancer
What is a colonoscopy typically used for?
To investigate lower GI bleeding, common in the diagnosis of colon cancer or IBD. It can also be used to investigate further about acute or chronic diarrhoea.
What is a UGI endoscopy?
Esophagogastroduodenoscopy
What is a UGI endoscopy used for?
- Upper GI bleed
- Persistent dyspepsia
- Heart burn and chronic acid reflux
- Dysphagia
- IBD (can be therapeutic)
What is dyspepsia?
Indigestion
In a digital rectal examination, what structure needs to be palpated to carry out a pudendal nerve block?
Ischial spine
Testicular cancer most commonly metastases to which organ?
Lungs
Right posterolateral herniation of the L2 vertebra will cause pain in what region?
Right thigh
Which structure creates the roof of the inguinal canal?
Overarching fibres of the internal oblique.
The blood supply of the vulva is derived from which artery?
Deep external pudendal artery.
Which structure is used to assess the width of the true pelvic during childbirth?
Distance between sacral promontory to superior side of pubic symphysis.
A 40 year old man has abdominal pain and blood in the stool, what is the most appropriate test to carry out?
Colonoscopy
Describe the position of a femoral hernia relative to the pubic tubercle.
Below and lateral to the pubic tubercle.
What are the four portosystemic anastomoses?
- Oesophageal vein (syst) and left gastric vein (port)
- Inferior rectal vein (syst) and superior rectal vein (port)
- Epigastric vein (syst) and paraumbilical vein (port)
- Retroperitoneal vein (syst) and visceral vein (port)
Posterior herniation of lumbar vertebrae causes pain where?
Local pain near the spine.
Where does posterolateral herniation of lumbar vertebrae cause pain?
In the dermatome of the corresponding spinal root.
