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PLE > Surgery Part 3 > Flashcards

Surgery Part 3 Flashcards

1
Q

Weight of kidney

A

150 to 160 g

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2
Q

Pain fibers of the ureter

A

T12 to L2

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3
Q

Prostate gland size

A

4 x 3 x 2 cm

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4
Q

Weight of prostate gland

A

15 to 18 grams

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5
Q

Blood supply of prostate gland

A

Inferior vesical a.
Middle hemorrhoidal a.
Internal pudental a.

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6
Q

Venous drainage of prostate

A

Pelvic plexus –> hypogastric v.

Connection with Batson’s plexus, hence brain/spine mets in prostate cancer

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7
Q

Nerve supply of prostate

A

Motor and sensory (parasympathetic): S3 to S4

Vasomotor (sympathetic): Hypogastric n.

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8
Q

Weight and covering of testes and epididymis

A

20 g, tunica albuginea

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9
Q

Blood supply of testes and epididymis

A

from aorta just below renal a.

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10
Q

Venous drainage of testes and epididymis

A

R spermatic v. directly into IVC

L spermatic v. drains into L renal v.

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11
Q

Blood supply of urinary bladder

A

Superior, middle and inferior branches of hypogastric a.

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12
Q

Autonomic nerve supply or urinary bladdder

A

sacral cord

pre-sacral and epigastric plexus

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13
Q

Process of normal micturition

A

Bladder contraction coincides with decrease in outlet resistance

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14
Q

Mitcturition center

A

Pons

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15
Q

Motor pathway to urinary bladder

A

pelvic n.

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16
Q

Erectile bodies in penis

A

corpora cavernosa (2) and corpus spongiosum (1, ventral body)

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17
Q

Somatic sensory n. of penis

A

S3 to S4 (ilioinguinal)

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18
Q

Sympathetic vasomotor n. of penis

A

hypogastric

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19
Q

Parasympathetic n. of penis

A

S2 - S4 via nervi erigentes –> cavernosal n. (impotence if injured in pelvic surgery)

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20
Q

LUTS may be caused by

A

prostatic enlargement

urethral stricture

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21
Q

Causes of erectile and ejaculatory dysfunction

A

Endocrinologic
Vasculogenic
Neurogenic

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22
Q

Significant findings in urinalysis

A

RBC > 3/hpf

WBC > 5/hpf

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23
Q

Semen analysis

A 
2-5 days sexual abstinence
Volume of 1.5 ml
15M spermatozoa per ml
10% motility
4% normal morphology
2 abnormal semen analysis for confirmation
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24
Q

Normal bladder capacity is

A

400 to 600 ml

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25
Q

Normal filling pressure

A

<15 cm water

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26
Q

First sensation of bladder filling

A

1/3 of normal capacity (200 ml?)

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27
Q

Which WINSURF (LUTS) symptoms are obstructive and which are irritative?

A

Obstructive: WISR
Irritative: NUF

Weak stream
Intermittency
Nocturia
Straining
Urgency
Retention
Frequency
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28
Q

How does Proteus cause urinary infections?

A

Urea splitting causes urinary alkalinization and precipitation of calcium
(xanthogranulomatous pyelonephritis)

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29
Q

Perinephric abscess common in diabetic patients

A

Emphysematous pyelonephritis

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30
Q

Reiter’s syndrome

A

conjunctivitis
non-gonococcal urethritis
arthritis

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31
Q

Risk factors for nephrolithiasis

A

Poor fluid intake
Hypercalcemia
Renal tubular acidosis

32
Q

pH >7 on urinalysis

A

suggest presence of urea-splitting organisms and possible struvite stones
(pH < 5: uric acid stones)

33
Q

Stones of this size rarely pass spontaneously

A

< 6 mm

34
Q

Recurrent UTI progressing to struvite stones caused by

A

Klebsiella
Proteus
Pseudomonas

35
Q

Stone-provoking medications

A
  1. Acetzolamide
  2. Cal supplements or Vit D
  3. Vit C
36
Q

What kind of stones cannot be broken down in shockwave lithotripsy?

A 
cystine stones
calcium monohydrate (variable success)
37
Q

BPH vs prostate cancer location

A

BPH: starts in periurethral/transitional zone hence LUTS symotoms
Prostate cancer: peripheral portion of gland

38
Q

Elevated PSA is elevated in ___ % of men with BPH

A

25 to 30%

39
Q

Maximal urinary flow rate

A

> 15ml/second

40
Q

TURP syndrome

A

Short-term complications: due to absorption of hypotonic irrigation fluid = hyponatremia, blood loss, urinary retention, infection

Long-term complications: Incontinence, impotence, retrograde ejaculation, bladder neck contracture, urethral strictures

41
Q

Retro or suprapubic prostatectomy

A

Prostates > 60 to 80 grams

42
Q

Second most common cancer in genitourinary system

A

Prostate cancer (95% is adenoCA)

43
Q

Common sites of mets of prostate cancer

A

bone, lung, liver, adrenals

44
Q

Renal parenchymal tumors

A

Renal cell carcinoma 85%
Wilm’s tumor/adenomyosarcoma 14%
Sarcomas of interstitial tissues 6%

45
Q

Risk factors for renal cell carcinoma

A

Male sex
Smoking
Von Hippel-Lindau syndrome
Other parenchymal tumors

46
Q

Triad of renal cell carcinoma

A

pain - stretching of renal capsule
mass - lower pole lesions
hematuria - occur in late stages, erosion of tumor into collecting system

47
Q

Why does RCC of L kidney present with new onset L varicocele?

A

Left gonadal v. drains into the left renal v.

48
Q

Stauffer’s syndrome

A

Renal cell carcinoma + hepatic cell dysfunction

49
Q

Sites of metastasis of renal cell carcinoma

A

lungs, liver, brain, bone, inferior vena cava/heart

50
Q

Classification of open fractures

A

Gustilo and Anderson

  • size of wound
  • amount of contamination
  • severity of fracture
51
Q

Fracture of distal radius with the fragment displaced dorsally, “silver fork”, FOOSH

A

Colles’ fracture

52
Q

Fracture of the distal radius with the fragment displaced volarly, “reverse silver fork”

A

Smith’s fracture (Reverse Colles’)

53
Q

Hutchinson’s/Chauffeur’s fracture

A

Fracture of the radial styloid or scaphoid

54
Q

Monteggia’s fracture

A

Fracture of the ulna with dislocation of the radial head

55
Q

Galeazzi’s fracture

A

Fracture of the distal radius with dislocation of DRUJ

56
Q

Piedmont’s fracture

A

Fracture of the radial shaft at the junction of the middle and distal thirds without an associated fracture of the ulna (Galleazi without ulna)

57
Q

Hard signs of peripheral arterial injury (operation mandatory)

A

pulsatile hemorrhage
absent pulses
acute ischemia

58
Q

Soft signs of peripheral arterial injury (further evaluation indicated)

A

proximity to vasculature
significant hematoma
associated nerve injury (A-A index of < 0.9)
thrill or bruit

59
Q

Most commonly dislocated joint

A

glenohumeral joint (anterior > posterior)

closed reduction: Stimson/Hippocratic technique

60
Q

Bankart lesion

A

tear in glenoid labrum

61
Q

Hill-Sach’s lesion

A

compression fracture of the humeral head

62
Q

Trendelenburg sign

A

DDH

Patient stands bearing weight on the affected hip, the pelvis is tilted downward on the normal side

63
Q

Galeazzi sign

A

DDH

With the knees and hips flexed, there is shortening of the dislocated side

64
Q

Barlow’s test

A

click! (adduction)

65
Q

Ortolani test

A

sensation of hip reducing back into acetabulum (abduction)

66
Q

Management of DDH

A 
Up to 6 months: Pavlik harness
6 months to 15 months: Spica cast
15 months to 2 years: femoral osteotomy
2 years and more: Synovial joint types and examples:
acetabular and/or femoral osteotomies
67
Q

Another name for Legg-Calve-Perthes disease

A

Coxa Plana
(LCPD)

Avascular necrosis of the frmoral head
M >F
Age: 4 to 10 years old
Trendelenburg gait

68
Q

Adolescent hip disorder, displaced femoral head on the femoral neck

A

Slipped Capital Femoral Epiphysis (SCFE)

painful limp located in the thigh or knee with loss of abduction and internal rotation of the hip

69
Q

Trethowan’s sign

A

SCFE
Klein’s line does not intersect the lateral part of the superior femoral epiphysis on AP xray of pelvis
Tx: percutaneous pinning or screw fixation through the growth plate

70
Q

Osgood-Schlatter disease

A

Ossification in the distal patellar tendon at the point of its tibial insertion, tendon fragments due to chronic tensile stress in athletes

71
Q

Salter-Harris

A

pediatric fracture of growth plate

Type I to VI
Type I to V: SALT ER
I - straight across
II - above
III - lower/beLow
IV - two/through
V - erasure of growth plate/cRush
VI - bone bridge across growth plate (healing)
72
Q

Difference between Finkelstein’s and Eichhoff’s test

A

Finkelstein’s: examiner grasps thumb
Eichhoff’s: patient flexes thumb, clench fist over it
Both: the examiner ulnar deviates

73
Q

Tendons involved in De Quervain/Stenosing tenosynovitis

A

EPB - extensor pollicis brevis
APL - abductor pollicis longus
Surgical release: partial resection of extensor retinaculum

74
Q

Tests for bicipital tendonitis (long head of biceps tendon)

A

Speed test
Yergason test
Palm-Up test

Surgical repair: arthroscopic decompression, acromioplasty, anterior acromionectomy

75
Q

Fixed or flexible deformity of the DIP joint of the toe

A

Mallet toe

76
Q

Flexion deformity of the PIP joint of the toe, hyperextension of the MTP and DIP joints

A

Hammer toe

77
Q

Degenerative changes in the musculotendinous cuff

A

Supraspinatus tendinitis or Subacromial bursitis

PLE (14 decks)

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