OnlineMedEd: Surgery: General - "Small Bowel"

Question 1

Anyone with peritoneal signs needs to go to the OR immediately. What are peritoneal signs?

Answer 1

• Rebound tenderness
• Pressing down on an area that doesn’t hurt and getting referred pain to the area that does
• Pain with movement (like shaking the bed)
• Rigidity

Question 2

Small bowel obstructions typically result from what two pathologies?

Answer 2

• Hernias

* Adhesions

Question 3

What is obstipation?

Answer 3

Severe constipation

Question 4

Before the bowel sounds stop, you can hear ____________ in SBO.

Answer 4

borborygmi

This is a high-pitched, crescendo-decrescendo sound of peristalsis passing the obstruction.

Question 5

Before the person with SBO develops obstipation, they can ______________.

Answer 5

pass the flatus and stool that is distal to the obstruction

Question 6

How do you diagnose SBO?

Answer 6

1) KUB

2) CT with PO contrast

Question 7

CT with PO contrast can show complete or incomplete obstruction. What should you do in each case?

Answer 7

• Complete: OR to relieve the obstruction

* Incomplete: watch and reevaluate; if no improvement in 3 days, then OR

Question 8

Which muscle does bowel protrude through in a direct inguinal hernia?

Answer 8

Transversalis

Question 9

Inguinal hernias are seen in ________________.

Answer 9

infant males

Question 10

Femoral hernias are more often seen in ____________.

Answer 10

women (“FEMorAL in FEMALes!”)

Question 11

What landmark differentiates inguinal from femoral hernias?

Answer 11

The inguinal ligament: above is inguinal, below is femoral

Question 12

Ventral hernias are typically caused by ______________.

Answer 12

surgery

Question 13

___________ hernias are irreducible.

Answer 13

Incarcerated

Question 14

What is the difference between an incarcerated and a strangulated hernia?

Answer 14

Strangulated is an ischemic incarcerated hernia.

Question 15

Describe the classic presentation of appendicitis.

Answer 15

• Periumbilical pain that migrates to McBurney’s point
• Fever
• Nausea
• Vomiting
• Anoxeria

Question 16

Officially, ___________ is not needed to diagnose appendicitis.

Answer 16

CT

Question 17

The triad of carcinoid syndrome is ______________.

Answer 17

flushing, wheezing, and diarrhea

Right-sided fibrosis of the valves can also occur.