OB Flashcards
Percent included in 1/2/3 SD?
1 SD = 68%
2 SD = 96%
3 SD = 99%
Sensitivity and specificity
Sens - ability to correctly dx a disease
SN = TP / TP + FN
Spec - ability to correctly exclude a disease
SP = TN / TN + FP
PPV and NPV
PPV = TP/ TP + FP (is a + result really positive?)
NPV = TN / TN + FN (probability that a - result is correct)
Incidence/prevalence
Incidence = number of new cases over a period of time
Prevalence = number of cases at a given point in time
ABD wall and Arcuate line
Superficial –> deep
External obl > internal obl > transverse abdominis
Above Arcuate line - aponeuroses splits
Below - all superficial to rectus
Ovary artery/vein
Arteries directly from aorta
Left ovarian vein –> left renal vein
Right ov vein –> IVC
Branches of posterior division internal iliac (hypogastric)
Iliolumbar
lateral sacral
superior gluteal
Branches of anterior division
Umbilical (medial umbilical ligament)
Obturator
Middle rectal
Internal pudendal
inferior gluteal
Uterine –> vaginal
superior vesicle
Anterior abdominal wall folds
midline
- Urachus = median umbilical ligament
- Obliterated umbilical arteries = medial umbilical ligaments
- Inferior epigastric arteries
lateral
Dermatomes
- Nipple
- Xiphoid
- Umbilicus
- Pubis
Nipple - T4
Xiphoid - T7
Umbilicus - T10
Pubis - L 1-2
Course of pudendal nerve
From S 2,3,4 > exits pelvis through greater sciatic notch > lateral to ischial spine > enters ishiorectal fossa through lesser sciatic notch > Alcock’s canal > innervates perineum, anus and dorsal nerve of clitoris
Nerve palsies
- iliohypogastric
- ilioinguinal
IH: T12-L1, suture entrapment with Pfanny –> sensory loss of skin overlying syphysis down to labia majora
II: T12-L1, also entrapment –> medial aspect of labia majora
Nerve palsies
- Femoral
- Lateral peroneal
- Sciatic
- F: L2-4, self retaining retractor blades, exaggerated hip flexion –> anterior/medial leg/thigh numb, weak quads
- LP: L4-S2, lateral displacement of the knee without support –> foot drop and inversion
- Sciatic: L4-S3, sacroiliac fossa procedures –> weak hamstrings
How long to heal nerve injury?
Compression: heals spontaneously in 6-12 wks
Brachial nerve palsies
- Erb’s
- Klumpke’s
Erb’s: C5-6, waiters tip, grasp reflex intact
Klumpke’s: C8-T1, hand and wrist paralysis, reflex lost