Surgical Terms Flashcards
The clinical presentation of a
perforated duodenal ulcer can mimic appendicitis, particularly if the perforation seals and the
spilled gastroduodenal contents gravitate down the right gutter to the cecal area.
Silent 1920s film
star Rudolph Valentino reportedly died of a perforated ulcer, although he presented with right
lower quadrant pain suggestive of acute appendicitis (since known as Valentino’s syndrome).
Perineal rectosigmoidectomy
Altemeier procedure
Appendix in hernia
Amyand‘s hernia
This anastomotic connection is also known as the marginal meandering artery
Arc of Riolan, connects the SMA and IMA.
Mutation in the ATM gene and, along with neurologic and vasculocutaneous findings, is associated with an increased risk of breast cancer, lymphoma, and leukemia
Ataxia-telangectasia
network of venous drainage that is thought to be a route for Breast ca
metastasis to the spine
Batson plexus (Batson to the back)
a novel predictor of clinical outcome in acute pancreatitis
Bedside Index for Severity in Acute Pancreatitis (BISAP). The parameters for BISAP include blood urea nitrogen (BUN) level greater than 25 mg/dL,
impaired mentation,
2 or more systemic inflammatory response syndrome (SIRS) criteria,
age greater than 65 years, and the
presence of pleural effusion.
Staging for necrotizing entercolitis (NEC)
Bell criteria:
Patients with Bell stage I (suspicious for NEC) are ruled out for NEC and kept NPO and on IV antibiotics for 3 to 7 days before enteral nutrition is reinitiated. Patients with Bell stage II (definite NEC) require close observation for 7 to 14 days. Infants with Bell stage III (advanced NEC) either have definite intestinal perforation or have not responded to nonoperative therapy, and thus require surgery. These patients have signs of peritonitis, acidosis, sepsis, and disseminated intravascular coagulation, all of which are associated with a high mortality rate.
an overgrowth disorder usually present at birth, characterized by an increased risk of childhood cancer and certain congenital features
Beckwith–Wiedemann syndrome. Associated w
Macrosomia (traditionally defined as weight and length/height >97th centile)
Macroglossia
Hemihyperplasia (asymmetric overgrowth of one or more regions of the body)
Omphalocele (also called exomphalos) or umbilical hernia
Embryonal tumor (e.g., Wilms tumor, hepatoblastoma, neuroblastoma, rhabdomyosarcoma) in childhood
Visceromegaly involving one or more intra-abdominal organs including liver, spleen, kidneys, adrenal glands, and/or pancreas
Cytomegaly of the fetal adrenal cortex (pathognomonic)
Renal abnormalities including structural abnormalities, nephromegaly, nephrocalcinosis, and/or later development of medullary sponge kidney
Anterior linear ear lobe creases and/or posterior helical ear pits
Placental mesenchymal dysplasia
Cleft palate (rare in BWS)
Cardiomyopathy (rare in BWS)
Positive family history (≥1 family members with a clinical diagnosis of BWS or a history or features suggestive of BWS)
Duodenum-preserving pancreatic head resections (3)
Beger-procedure. The pancreas is dissected on the level of the portal vein. The pancreatic head is excavated and the duodenum is preserved with a thin layer of pancreatic tissue. If the bile duct is obstructed it can be opened and a internal anastomosis with the excavated pancreatic head can be performed (not shown). The reconstruction is performed with two anastomoses, of the pancreatic tail remnant and of the excavated pancreatic head with a Roux-en-Y jejunal loop
Triad of mental status changes, petechiae, and dyspnea
Bergman’s triad, fat emboli syndrome
Gp1b receptor defect
Bernard-Soulier Syndrome
The “thyroid sheath” is a connective tissue expansion of the pretracheal fascia and envelops the thyroid, condensing posteromedially into this structure
Ligament of Berry
Suspensory ligament of the thyroid
Criteria for categorizing thyroid cytopathology for associated risk of malignancy
Bethesda Criteria:
- Non-diagnostic: repeat FNA under US
- Benign follicular lesion of undetermined significance: <1% chance of malignancy, monitor
- Atypia/follicular neoplasm of undetermined significance: 5-15% chance of malignancy, repeat FNA
- Follicular neoplasm or suspicious for follicular neoplasm: 15-30% chance of malignancy, surgical lobectomy
- Suspicion for malignancy: 60-75% chance of malignancy, Thyroid lobectomy or total thyroidectomy
Malignant: 100% chance, total thyroidectomy
Classification system which organizes cholangiocarcinoma by location
Bismuth-Corlette classification system:
Type I: occurs below the confluence of the L & R hepatic duct
Type II: occurs at the juncture of the L & R hepatic ducts
Type III: involves either the Right (type IIIa) or left (type IIIb) hepatic duct
Type IV: involves secondary and tertiary extensions of either the L or R hepatic ducts
a palpable nodule on rectal examination suggesting a
drop metastasis
Blumer shelf
Procedure for repair of long-segment urethras defects
Boari flap:
Useful for 8-12 cm defects
Rectangular pedicled flap of bladder dome closed transversely to create tube conduit. EEA w/ distal ureter
Posterolateral congenital diaphragmatic hernia
Bochdalek hernia
Triad of sudden onset of severe upper abdominal
pain, recurrent retching without vomitus, and an inability to pass a nasogastric tube
Borchardt’s triad, gastric volvulus
squamous cell carcinoma in situ (not invasive) of the perianal margin and
most commonly caused by HPV-16 and 18
Bowen dz
Hepatic venous thrombosis
Budd-Chiari syndrome
imaginary division of the liver used when performing hepatectomies. The division divides the liver into two planes, extending from the Middle Hepatic Vein to the middle of the gallbladder
Cantlie’s line
Separates L and R
Separates 4 from 5-8
Cephalon fold defects result in this syndrome
pentalogy of Cantrell: cardiac defect (most commonly VSD), sternal cleft, anterior diaphragmatic hernia, omphalocele, and ectopia cordis. Omphalocele of the most common variety is a result of failure of the lateral folds to form correctly. Caudal fold defects result in cloacal exstrophy, and right umbilical vein obliteration is associated with gastroschisis.
Mobilization of the ascending colon to the midline
Cattel maneuver
Intrahepatic duct cysts
Caroli dz. (Type V choledochal cyst)
a linear erosion or ulceration of the mucosal folds lining the stomach where it is constricted by the thoracic diaphragm in persons with large hiatal hernias.
Cameron’s ulcer
For advanced cases of lymphedema that do not respond to conservative management, this procedure has been performed, which involves complete and circumferential excision of the skin, subcutaneous tissues, and deep fascia of the leg and dorsum of the foot. The exposed muscle is then grafted with a full- or split-thickness skin graft.
Charles procedure
Types of perforating veins of the lower extremity
The Cockett perforators drain the lower part of the leg
medially, whereas the Boyd perforators connect the greater saphenous vein to the deep vein higher
up in the medial lower leg, approximately 10 cm below the knee.
Adrenaloma causing hyperaldosteronism
Conn syndrome
Mutation in PTEN. Characterized by multiple hamartomatous lesions as well as cancer of the breast, endometrium, kidney, and thyroid. Hamartomas are made up of all three germ layers
Cowden syndrome
congenital malformation in the stomach (typically on the lesser
curvature) characterized by a submucosal artery that is abnormally large and tortuous. As a result
of its relatively superficial location, it may erode through the mucosa and become exposed to
gastric secretions, leading to massive upper GI hemorrhage. On endoscopy, the mucosa of the
stomach appears normal, and the only finding is a pinpoint area of mucosal defect with brisk
arterial bleeding. The lesion may easily be missed if the bleeding is not active.
Dieulafoy lesion
mid-diastolic rumble that is associated with rheumatic fever
Carey Coombs murmur
Quantify dysphagia sx
DeMeester Score
Dysphagia 0 - None 1 - Occasional transient episodes 2 - Require liquids to clear 3 - Impaction requiring medical attention
Heartburn 0 - None 1 - Occasional brief episodes 2 - Frequent episodes requiring medical tx 3 - Interference w/ daily activities
Regurgitation 0 - None 1 - Occasional episodes 2 - Predictable by posture 3 - Interference w/ daily activities
difficulty in swallowing due to
compression of the esophagus by an aberrant right subclavian artery
Dysphagia lusoria (dysphagia by a freak of nature)
fluoroscopic examination of the small bowel using liquid contrast
Enteroclysis
Procedure used for the mobilization of undescended testicles
Fowler Stevens
In the first stage, the testicular vessels are clipped laparoscopically. In addition to the testicular arteries, the testicles receive collateral blood from the cremasteric artery, a branch of the inferior epigastric artery, and the artery to the vas, a branch of the superior vesical artery. The orchiopexy is then performed through the groin approximately 6 months later, after which time collateral flow has increased.
triad of rheumatoid arthritis, splenomegaly, and neutropenia
Felty syndrome
Classify bleeding gastric ulcer
Forrest classification 1a brisk bleeding 1b oozing 2a visible vessel 2b adherent clot 2c flat pigmentation 3 clean base
Classification of hyatid cyst
(Gharbi types): a simple cyst (type I), a cyst with free-floating hyperechogenic material called hydatid sand (type II), a cyst with a rosette appearance suggesting a daughter cyst (type III), and a cyst with a diffuse hyperechoic solid pattern (type IV)
GpIIb/IIIa receptor defect
Glanzmann thrombasthenia
a surgical technique used in the treatment of chronic pancreatitis in which the diseased portions of the pancreas head are cored out. A lateral pancreaticojejunostomy (LRLPJ) is then performed
Frey procedure
A layer of connective tissue surrounding the liver and ensheathing the hepatic artery, portal vein, and bile ducts within the liver.
Glisson’s capsule
“Valves” within the cystic duct
Heister valves (spiral shaped with no true valvular function)
Hernia through the superior lumbar triangle, and its boundaries
Grynfeltt hernia. Bounded by the quadratus lumborum muscle, the 12th rib, and the internal oblique
Splenic watershed area
Griffith’s point
Subtype of follicular thyroid cancer. They differ from follicular cell carcinomas in that they are often multifocal and bilateral, are more likely to metastasize to local nodes and distant sites, and are associated with a higher mortality rate
Hürthle cell carcinoma
A metastatic left axillary lymph node from gastric cancer
Irish node
These cells are responsible for liver fibrosis and are characterized by the presence of lipid droplets because they store vitamin A
Ito cells
Thrombocytopenia secondary to consumptive coagulopathy in the setting of AV shunting
Kasabach-Merritt syndrome
Perihilar Cholangiocarcinoma
Klatskin Tumors.
Classified by location with the Bismuth-Corlette Classification system:
Type I: occurs below the confluence of the L & R hepatic duct
Type II: occurs at the juncture of the L & R hepatic ducts
Type III: involves either the Right (type IIIa) or left (type IIIb) hepatic duct
Type IV: involves secondary and tertiary extensions of either the L or R hepatic ducts
A 2-month-old infant has persistent jaundice. Ultrasonography fails to demonstrate a gallbladder. Technetium-99m iminodiacetic acid scanning with phenobarbital pretreatment reveals uptake in the liver but not in the intestine. α1-Antitrypsin and cystic fibrosis determination is normal. The most appropriate surgical management would be:
Kasai operation (hepatoportoenterostomy). The procedure involves anastomosing an isolated limb of jejunum to the transected ducts at the portal plate of the liver. The likelihood of surgical success is increased if the procedure is performed before the infant reaches the age of 2 months. If the patient remains symptomatic after the Kasai operation, he or she will require liver transplantation
the dissection of the lateral peritoneal attachments of the duodenum to allow inspection of the duodenum, pancreas, and other retroperitoneal structures over to the great vessels
Kocher maneuver
Perihilar cholangiocarcinomas
Klatskin tumor
Anatomical space formed by the inferior fibers of the inferior constrictor muscle and the
superior border of the cricopharyngeus muscle.
Killian triangle. Site of zenker’s
An ovarian mass from a gastric metastasis
Krukenberg tumor
Metastatic adenocarcinoma to the ovary
Krukenberg tumor is metastatic adenocarcinoma to the ovary. Stomach is the most common primary site accounting for 70% of cases. Colon, appendix, and breast are the next most common primary sites. Retrograde lymphatic spread is the most likely route of metastasis. Krukenberg tumors are bilateral in more than 80% of the reported cases.
DVT in an iliac vein due to compression by iliac artery. Identify laterality and name of syndrome
L iliac vein commonly compressed by R iliac artery. May-Thurner syndrome
Nerves that innervate the proximal stomach, and are divided during highly selective vagotomy
anterior and posterior Latarjet nerves. Also, the nerve of Grassi, which is a branch off the posterior trunk of the vagus
Management of type I choledochal cyst, the posterior aspect of which invades the portal vein
Lilly procedure: resection of the anterior portion of the cyst, leaving the posterior portion in situ, and fulgrating it
p53 mutation assoc. w/ breast ca, sarcomas, glioblastoma, adrenocortical cancers
Li-Fraumeni syndrome
rare, autosomal dominant, hereditary disorder that pre-disposes carriers to cancer development. This syndrome is also known as the sarcoma, breast, leukaemia and adrenal gland (SBLA) syndrome.
Name and identify the affected gene
Li-Fraumeni syndrome. Germaine mutation of the TP53 tumor suppressor gene which normally produces the p53 protein
Hernia containing a Meckel’s
Littre hernia
In a 48-year-old man who presents with an ulcerated wound in the middle of a grafted site, evaluate the lesion
Ulcerated growth with rolled-up edges
Marjolin ulcer
likely diagnosis of squamous cell carcinoma.
Clinical features of a Marjolin ulcer include:
Ulcerated growth with rolled-up edges
Aggressive but slow-growing lesion
Well-differentiated growth
No lymphatic spreading because of destruction of lymph channels
Mobilization of the descending colon to the midline to expose the abdominal aorta
Mattox maneuver
Syndrome of vaginal agenesis
Mayer-Rokitansky-Küster-Hauser syndrome
murmur sounds similar to a pericardial rub and may be heard in patients with
hyperthyroidism
Means-Lerman scratch murmur
Aspiration pneumonitis
Mendelson’s syndrome
familial version of congenital lymphedema
Milroy dz
an acquired disease with no family
predisposition (D). The etiology is unknown, but it is associated with an increase in transforming
growth factor alpha. Giant rugal folds, particularly in the fundus and body, and a loss of parietal
cells develop. Thus, patients have hypo- or achlorhydria.
Ménétrier disease
Types of choledochal compression/fistula
Mirizzi syndrome. Types:
I. External compression of CHD/CBD by stone in GB/cystic duct
II. Fistula involving < 1/3 circumference of CBD
III. Fistula involving 1/3 - 2/3 circumference of CBD
IV. Destruction of the entire wall of CBD
V. Cholecystoenteric fistula
Criteria for liver transplantation in HCC
Milan Criteria
Single tumor ≤ 5cm or 2-3 tumors, none exceeding 3 cm, and no lymphovascular invasion or extrahepatic spread
UCSF criteria
Single tumor ≤ 6.5cm or 2-3 tumors, none exceeding 4.5 cm, with total tumor diameter ≤ 8cm, and no lymphovascular invasion or extrahepatic spread
a rare but aggressive skin cancer of neuroendocrine origin
arising from specialized touch receptor cells in the epidermis of the skin. It occurs in elderly, light-
skinned patients and those with a history of sun exposure or immunosuppression, particularly
CLL. The clinical features can be remembered by the mnemonic “AEIOU:” Asymptomatic,
Expanding rapidly, Immunosuppression, Older than 50 years old, and UV-exposed area. It often
first appears as a pink nodule and progresses to a violaceous blue color with or without ulceration.
Merkel cell carcinoma
Loud churning murmur associated w/ air embolus
“Millwheel” murmur
Gallstone in neck that erodes cystic duct
Mirizzi syndrome
Type I – No fistula present
Type IA – Presence of the cystic duct
Type IB – Obliteration of the cystic duct
Types II–IV – Fistula present
Type II – Defect smaller than 33% of the CHD diameter
Type III – Defect 33–66% of the CHD diameter
Type IV – Defect larger than 66% of the CHD diameter
an asymptomatic radiographic finding in patients with a preexisting cavitary lung disease such as sarcoidosis. A soft-tissue mass within a cavity that is surrounded by a crescent of air is diagnostic
Monad sign, aspergilloma
rare disease presenting with localized pain with a tender, palpable subcutaneous cord or linear dimpling. The cause is most often superficial thrombophlebitis of the lateral thoracic vein. It is a self-resolving disease that is often treated with NSAIDs for pain relief.
Mondor dz
Resection of perineal hernia and closure of the cul-de-sac
Moschcowitz procedure
Anteromedial congenital diaphragmatic hernia
Morgagni hernia
Thrombophlebitis involving one or more of the superficial anterior chest wall veins (lateral thoracic vein, thoracoepigastric vein, superficial epigastric vein)
Mondor dz
spontaneous
thrombosis of the axillary-subclavian vein
Paget-Schroetter syndrome. It is thought to be, in most instances, a manifestation of thoracic outlet syndrome, whereby a hypertrophied or aberrant muscle compresses the axillary-subclavian vein as it passes between the first rib and the clavicle.
Calculate fluids based on PSA burn
Parkland formula:
4ml x TBSA (%) x body weight (kg); 50% given in first eight hours; 50% given in next 16 hours.
area defined by the junction of the cystic duct
and common bile duct, the second and third portions of the duodenum, and the neck and body of the pancreas.
Passaro (gastronoma) triangle
Congenital absence of pectoralis +/- ipsilateral breast / ribs
Poland syndrome
Hernia through the inferior lumbar triangle (and its boundaries)
Petit hernia, bounded by the external oblique, latissimus dorsi, and iliac crest
Folded gallbladder find us
Phrygian cap
This potential space results from herniation of
intestinal loops through a defect in the mesentery and between small bowel limbs, transverse
mesocolon, and the retroperitoneum
(Petersen’s space hernia
sporadic congenital disorder that classically affects the unilateral breast, chest wall, and upper extremity. It is present in at least 1 in 100,000 individuals, occurs more commonly on the right than left (2:1 to 3:1), and affects men more often than women (3:1). Underdevelopment or absence of the pectoralis, serratus, and latissimus dorsi muscles, symbrachydactyly (fused, missing, and/or shortened digits), shortened forearm, dextrocardia, rib abnormalities, absent axillary hair, athelia, diminished subcutaneous fat localized over the
ipsilateral chest wall, and renal agenesis or hypoplasia (rare) have all been described as
characteristics. The cause is thought to be due to interruption in the vascular supply to the affected chest wall and upper extremity in utero resulting in hypoplasia of the chest wall muscles
Poland’s syndrome
an autosomal dominant genetic disorder characterized by the development of benign hamartomatous polyps in the gastrointestinal tract and hyperpigmented macules on the lips and oral mucosa (melanosis).
Peutz-Jeghers
Mutation in STK11 gene and classically associated with the presence of hyperpigmented mucocutaneous spots, bowel hamartomas, and cancers of the GI tract, pancreas, liver, breast, endometrium, and ovary
Peutz-Jeghers syndrome
Primary pneumatosis intestinalis synonym
pneumatosis cystoides intestinalis
Clamping of the hepatoduodenal ligament, interrupting the blood flow of the hepatic artery and portal vein to control bleeding from the liver
Pringle maneuver
Rectal prolapse synonym
Procidentia
calcified deposits representing clumps of sloughed cells on FNA for thyroid ca
Psammoma bodies
procedure involves cutting open the length of the main pancreatic duct and anastomosing a Roux
limb of jejunum to the duct but requires a dilated duct (>6 mm).
Puestow
Air on both sides of the bowel wall
Rigler sign. Indicative of pneumoperitoneum
Findings of gallstone ileus
Rigler’s triad: SBO, gallstone outside GB, and pneumobilia
Tx of choice for children with portal vein thrombosis and refractory UGI bleeding
Rex Shunt:
superior mesenteric vein–to–
left portal vein bypass at the Rex recessus
placement of a prosthetic mesh around the mobilized rectum with attachment of the mesh to the presacral fascia below the sacral promontory.
Ripstein repair. The procedure involves mobilizing the rectum on both sides and posteriorly down to the levator ani muscle plate. After mobilization of the rectum, a 5-cm band of rectangular mesh is placed around its anterior aspect at the level of the peritoneal reflection, and both sides of the mesh are sutured with nonabsorbable suture to the presacral fascia, approximately 1 cm from the midline. Sutures are used to secure the mesh to the rectum anteriorly and the rectum is pulled upward and posteriorly. A significant complication of this operation is the incidence of new-onset or worsened constipation.
Atrophy of GB mucosa as a result of chronic cholecystitis
Rokitansky-Aschoff sinuses
interpectoral
(between the pectoralis major and minor muscles) and are technically level II nodes
Rotter nodes
Classification of arterial insufficiency
The Rutherford Classification grades the severity of chronic arterial insufficiency based on clinical presentation. Categories range from 0 to 6: 0 = asymptomatic; 1 = mild claudication; 2 = moderate claudication; 3 = severe claudication; 4 = ischemic rest pain; 5 = minor tissue loss; and 6 = major tissue loss. Alternative classification systems include the Fontaine Classification, SVS WIfI (wound, ischemia, and foot infection), and others. TASC II uses strictly anatomic distribution of disease for its classification.
Criteria used to dx antiphospholipid syndrome
Sapporo criteria (Sydney criteria)
Clinical – The presence of either vascular thrombosis or pregnancy morbidity, defined as follows:
Vascular thrombosis is defined as one or more episodes of venous, arterial, or small vessel thrombosis, with unequivocal imaging or histologic evidence of thrombosis in any tissue or organ. Superficial venous thrombosis does not satisfy the criteria for thrombosis for APS.
Pregnancy morbidity is defined as otherwise unexplained fetal death at ≥10 weeks gestation of a morphologically normal fetus, or one or more premature births before 34 weeks of gestation because of eclampsia, preeclampsia, or placental insufficiency, or three or more embryonic (<10 weeks gestation) pregnancy losses unexplained by maternal or paternal chromosomal abnormalities or by maternal anatomic or hormonal causes.
Laboratory – The presence of antiphospholipid antibodies on two or more occasions at least 12 weeks apart and no more than five years prior to clinical manifestations, as demonstrated by one or more of the following:
IgG and/or IgM anticardiolipin antibodies in moderate or high titer (>40 GPL or MPL units or >99th percentile for the testing laboratory)
Antibodies to beta2-glycoprotein (GP) I of IgG or IgM isotype at a titer >99th percentile for the testing laboratory when tested according to recommended procedures
Lupus anticoagulant (LA) activity detected according to published guidelines.
Criteria does NOT include presence of SLE9
network of
lymphatics that drains the subareolar region
called Sappey, and it is important because this is
the principle behind subareolar injection of blue dye and radiocolloid for sentinel lymph node
mapping (sappey for the mappey)
Test in which oral radiolabeled vit B12 is administered along with parenteral unlabeled vitamin B
12. The unlabeled B12 saturates liver receptors. Thus, if the oral radiolabeled vitamin B12 is properly absorbed and liver receptors are saturated, the radiolabeled vitamin B12 will be excreted in high concentrations in the urine. With pernicious anemia and blind loop syndrome, oral absorption will be low, and thus urinary excretion of radiolabeled vitamin B12 will be low. When the test is repeated after the administration of intrinsic factor, vit B12 excretion will increase, whereas with blind loop syndrome it will not
Schilling test
An umbilical nodule that suggests carcinomatosis.
Sister Mary Joseph node
Removal of a thyroglossal duct cyst or sinus tract, involving a neck incision with dissection up to the hyoid bone.
Sistrunk procedure
associated with a small ventral septal defect and is described as a vibratory systolic ejection rumble
Still’s murmur
Hernia through the aponeurotic layer between the recuts muscle and the semilunar line
Spigelian hernia
Purple nodular lesions occurring on an arm with long-standing lymphedema present is
angiosarcoma, or lymphangiosarcoma, otherwise referred to as
Stewart-Treves syndrome
Name three procedures used for the treatment of Hirschsprung’s disease
Soave - ileal pull through method with ganglionic ileum inside aganglionic rectum. Can be performed trans anal or open, with trans anal being associated with shoulder hospital stays
Swenson - End to end ileoanal anastomosis. Associated with higher rates of sexual dysfunction And enterocolitis
Duhamel - End to side ileoanal anastomosis. Associated with higher rates of incontinence.
H. Pylori Eradication protocols
Triple therapy:
PPI, clarithromycin, and amoxicillin
Quadruple therapy:
PPI, bismuth, tetracycline, and flagyl
rectosigmoid junction
Sudeck’s critical point. Watershed between IMA and superior rectal a.
Anal encirclement procedure name
Thiersch anal encirclement
Position used in the case of air embolus
Trendelenburg position with left side
down (Durant’s maneuver)
Superficial migratory thrombophlebitis
Trousseau’s sign
Synonyms for VIPoma
WDHA (watery diarrhea,
hypokalemia, and achlorhydria) and Verner-Morrison syndrome
A metastatic left supraclavicular lymph node
Virchow node (Troisier sign)
Presacral fascia synonym, and location.
Waldeyer fascia. Separates the rectum from the presacral venous plexus and the pelvic nerves.
Three risk fx for DVT
Virchow’s triad:
Venous stasis
Hypercoagulability
Endothelial injury
Nephroblastoma associated with hemihypertrophy and aniridia
Wilms tumor
Anastomotic connection between the subclavian and the femoral vessels
(pathway of) Winslow: subclavians → internal thoracic artery, superior epigastric,inferior epigastric artery, external iliac artery
Final location of testis during orchipexy
Dartos Pouch
Orchipexy steps:
- Complete mobilization of the spermatic cord and testis
- Ligation of the patent processus vaginalis and skeletonization of the cord
- Formation of dartos pouch usually with a small separate skin incision. Dartos fascia is thin subcutaneous fascia of the scrotum and penis
- Put the testicle in the pouch and narrow the fascia behind it to secure it
