WEEK 3

Question 1

Location of abdominal mass

Answer 1

skin, subcutan, fascia, otot (rectus hematoma, lipoma, tumor), hernia

Question 2

Intra/retroperitoneal mass

Answer 2

intra = jejunum, ileum
retro = duodenum, pancreas, ascending colon, dll

Question 3

Onset of mass

Answer 3

Suddenly = mekanis, obstruksi (bladder, galbladder, intusseption), hemorrhage (rupture or into tumor)
several days = inflamatory
slowly develops = secondary degeneration, chronic inflamation, tumor

Question 4

Mobility of mass

Answer 4

organ-bound = usually not very mobile

diaphragm bound = change during respiration (liver, spleen, kidney)

Question 5

Ganas atau bukan? Massa

Answer 5

pulsation = pem.darah (aortic aneurysm, vascular tumors, adjacent to main arteries)
tenderness = inflammatory
Enduration = hard/firm, rubbery, change in shape, red
surface = nodule/rough/smooth
Usia = ..
Gender = uterus (women), colon, abdominal aorta (men)

Question 6

RUQ

Answer 6

liver, gallbladder, duodenum, right kidney, hepatic flexure of
colon

Question 7

RLQ

Answer 7

Cecum,
appendix
in case of female, right ovary & tube

Question 8

LLQ

Answer 8

• Small intestine
• Omentum
• Descending Colon
• Sigmoid colon
• Mesentery
• in case of female, left ovary & tube
• Retroperitoneal masses
• Fecalom

Question 9

LUQ

Answer 9

• Stomach,
• spleen,
• left kidney,
• pancreas (tail),
• splenic flexure of colon

Question 10

Epigastric region

Answer 10

• Stomach,
• pancreas (head and body),
• aorta

Question 11

Suprapubic

Answer 11

Bladder
Uterus
Small intestine , colon , ovary, omentum

Question 12

general abdominal swelling

Answer 12

Bowel obstruction
Ascites
Big cysts of ovary

Question 13

Hernia

Answer 13

An abnormal protrusion of a viscous from the body cavity of its origin into another cavity of the body

Question 14

External Hernia

Answer 14

• Protrusion of viscus
• From peritoneal cavity
• Through weak part of abdominal wall inguinal, femoral umbilical, incisional etc

Question 15

Internal Hernia

Answer 15

Obturatoria, diaphragmatic, for. Winslowi, lig. treitz

Question 16

Predisposing hernia factor

Answer 16

a. Congenital - Persistent proc. Vaginalis, Persistent canalis inguinalis, Non obliterated umbilicus
b. Acquisita
- Operation wound
- Gravidity
- Malnutrition
- Ageing
- Nerve disturbance

Question 17

Hernia exit through

Answer 17

• Via natural orifices
• Via natural ‘weaknesses’
• Via iatrogenic orifices
• Via iatrogenic ‘weaknesses

Question 18

condition of hernia

Answer 18

1. Reducible (Reponibilis) = baru muncul jika di strain
2. Irreducible (Irreponibilis)
3. Incarcerated
4. Strangulated

Question 19

Hernia can cause…

Answer 19

• Nothing
• Lump
• Pain
• Incarcerate = get stuck
• Obstruct = gets stuck and blocks
• Strangulate = gets stuck and loses its blood supply

Question 20

test for hernia?

Answer 20

Valsava test –> can cause the hernia to show in physical test

Question 21

Inguinal hernia

Answer 21

• Site; – Inguinal canal – Right/Left groin
• Types; – Direct – Indirect
• Causes; – Congenital – Raised intra-abdominal
pressure

Question 22

gejala klinia inguinal hernia

Answer 22

– Lump
– Pain
– Bowel obstruction
– Scrotal symptoms

Question 23

indirect vs direct inguinal hernia

Answer 23

indirect = Exit abdomen via deep ring– Through whole inguinal canal –Exit superficial ring– May enter scrotum
direct = Exit abdomen via Hesselbach’s Triangle– Exit superficial ring – Do not enter scrotum

Question 24

treatment hernia inguinal

Answer 24

Treatment; 
• Conservative (e.g. Truss) 
– Surgery : 
• Open
• Laparoscopic