Anatomy-Surgery BLITZ Flashcards
(315 cards)
1
Q
Blood supply of scalp?
A
Branches of ECA
2
Q
Scalping occurs at what layer?
A
Loose areolar tissue
3
Q
Dnagerous area of the scalp
A
Loose areolar tissue
4
Q
Largest and most constant passes through the mastoid to the lateral sinus
A
Emissary vessels
5
Q
Emissary vessels are also known as
A
Cerebral veins and bridging veins
6
Q
Classification of subdural hematoma
A
Acute (up to 48 hours) blood and clot - hyperdense
Subacute (2-14days) clotted blood and fluid - hypodense
Chronic (>14 days) liquifies hematoma - hypodense
7
Q
Group of disorders that result from the abnormal obliteration if premature fusion of the cranial suture
A
Craniosynosthosis
8
Q
Complication of forceps delivery
A
Facial nerve injury
9
Q
Structure in the head that is not present at birth and develops during the first 2 years of life
A
MasTWOid process
10
Q
Cranial fossa weakest
A
Middle cranial fossa
11
Q
Thinnest part of the lateral wall of the skull
A
Pterion
12
Q
Artery affect if there’s fracture of the pterion
A
Anterior branch of the middle meningeal artery
13
Q
Hematoma that manifests LUCID INTERVAL
A
Epidural hematoma
14
Q
Basilar skull fracture affects what part of the cranium?
A
Petrous portion of temporal bone
15
Q
Part of the cranial floor that separates the middle and posterior cranial fossa
A
Petrous portion of temooral bone
16
Q
What nerve is affected if there is damage in the petrous portion of temporal bone?
A
CNVIII
17
Q
Ecchymosis of the mastoid process
A
Battle’s sign
18
Q
Hemotympanum, battle’s sign and raccoob eyes are signs seen in what cranial fracture?
A
Basilar skull fracture
19
Q
What cranial nerves are seen in the cavernous sinus?
A
CN III, IV and VI
20
Q
Mildest form of head injury that results to rotational acceleration of the head in the absence of significant injury
A
Concussion
21
Q
Most common site of hypertensive bleed
A
Putamen
22
Q
Arteries involved in hypertensive bleed
A
Lenticulostriate arteries
23
Q
Most common cause of SAH
A
Traumatic
24
Q
Most common cause of spontaneous SAH
A
Ruptured Aneurysm
25
ADPKD is associated with aneurysm. T/F
T
26
Buttresses of the face
Nasomaxillary, alveolar, zygomaticofrontal and maxillary, superior and inferior orbital, pterygomaxillary
27
Vertical buttress comprises of
Zygomaticofrontal maxillary (lateral)
Nasomaxillary (medial)
Pterygomaxillary (posterior)
28
Horizontal buttress comprises of
Supraorbital bar
Inferior orbital rim/orbital floor
Alveolus
29
Type of facial fracture according to location that involves the frontal bone, frontal sinus and supraorbital ridge
Upper third of the face
30
Type of facial fracture according to location that affects the nasal bone, orbital bones, naso-orbito-ethmoidal complex, zygoma, maxilla and alveolar process
Middle third of the face
31
Type of facial fracture that involves the alveolar process and mandible
Lower third of face
32
An opacification in the upper maxillary sinus, which represents periorbital fat and possibly an entrapped EOM in the maxillary sinus
Tear drop sinus
33
Most common fractures of the facial bone in descending order
Nasal
Zygomatic
Mandible
34
Artery contained in the cavernous sinus
ICA
35
Trecher Collins Syndrome is also known as
Mandibulofacial dysostosis
36
_____week of embryogenesis that cleft lip and palate develop
8th
37
His (classic theory)
Cleft lip and palate
Failure of fusion theory
38
Stark
Cleft lip and palate
Mesodermal penetration theory
39
Incomplete clefts affect only a portion of the lip and contain a bridge of tissue connectinf the central and lateral lip elements referred to as
Simonart’s band
40
Disorder of unknown etiology, beginning in childhood or adolescence, in which hemifacial atrophy of the skin, subcutaneous fat, muscle, bone and cartilage
Romberg’s progressive hemifacial atrophy also known as Parry-Romberg syndrome
41
Complete closure of lip and palate can be seen when?
After 12th week
42
Mkst common cleft palate that has a trid deformities of bifid uvula, diastasis of velum (thin membrane) and palpable posterior notch
Submucous cleft palate
43
Cheiloplasty (primary cleft lip repair) rule of 10’a
At least 10 weeks age
10 lbs
Hgb 10g/dL
44
Palatoplasty
Timing of operation:
Controversial:
Timing of operation: before 1 y/o
| Controversial: early closure, improved speech, midface retrusion
45
1st step in the NB tx with a complex cleft lip and palate
Nasoalveolar molding, prosthesis in infancy, followed by stages repair
46
2-3 cm above the clavicle anteriorbto C6 transverse process, most superficial passage of brachial plexus
Erb’s point
47
Ill-fitted crutches affects what nerve?
Radial nerve
48
Muscles innervated by Radial Nerve
```
Abductor pollicis longus
Brachioradialis
Anconeus
Triceps
Extensors
Supinator
```
49
Mishaft humeral fracture and nerve in spiral groove, wristdrop
Radial nerve (C5-T1)
50
Saturday night palsy and honeymooner’s palsy
Radial nerve damage
51
Tennis elbow
Lateral epicondylitis
52
Golfer’s elbow
Medial epicondyliis
53
Nursemaid’s elbow aka as pulled elbow
Annular ligament displacement
Radial head subluxation
Indicative of child abuse
54
Fractures of the forearm
Colle’s
Smith
Galeazzi
Monteggia
55
Fracture of the distal end of the radius with the distal fragment displaced dorsally
Posterior dislocation
Dinner fork deformity
Colle’s fracture
56
Fracture of the distal end of the radius with the distal fragment displaced volarly
Anteriorly displaced
Reverse colle’s
Smith’s fracture
57
Fracture of the proximal end of the radius with dislocation of radio-ulnar joint
Galeazzi’s fractre
58
Fracture of the shaft of ulna with anterior dislocation of the radial head and rupture of annular ligament
Monteggia’s fracture
59
GRIMUS
Galleazzi - radial fracture, inferior dislocation
| Monteggia - ulnar fracture, superior dislocation
60
Weakest part of the clavicle
Junction of its middle and lateral thirds
61
Treatment of clavicular fracture
Figure of 8 splint
62
Classic history of clavicular fracture
Fall on the shoulder or outstretched hand
63
Direction of clavicular fracture
Distal fragment goes downward, medial and forward by pectoralis major
Medial end pulled upward by SCM
64
Artery that divides the clavicle
Subclavian artery
65
Scapular fractures
Result of severe trauma
Run-over accident victims, VA
Require little treatment
66
Delayed ossification of midline structures, particularly membranous bone
Partly missing/absent clavicle
Cleidocranial dysostosis
67
Muscle that divides the subclavian artery into three part
Scalenus anterior
68
3 parts of the subclavian artery divided by scalenus anterior
1. First part: vertebral artery, thyrocervical trunk and internal thoracic
2. Second part
3. Third part
69
Axillary artery is the continuation of what artery?
Subclavian artery
70
Axillary artery
Begins at lateral border of the first rib until lower border of teres major (brachial artery)
Related to the cords of the brachial plexus
Enclosed with them in the axillary sheath
71
Muscle that divides the axillary artery into 3 parts
Pectorialis minor
72
3 parts of the axillary artery
Screw The Lawyer Save A Patient
1st part: supreme or highest thoracic artery
2nd part: thoracocacromial, lateral thoracic
3rd part: subscapular, anterior and posterior humeral circumflex artery
73
Small branches of the axillary artery
Brachial
Radial/ulnar
Palmar arch
74
Course of brachial artery
Begins at lower border of teres major (from axillary artery)
Descends through anterior compartment of arm on brachialis muscle
Enters cubit fossa
Ends at level of neck of radius divides into radial and ulnar artery
75
Boundaries of radial pulse
Laterally: tendon of brachioradialis
Medially: tendon of FCR
76
Radial artery is ________than ulnar artery
Smaller
77
Course of ulnar artery
Descend through the anterior compartment
Enters palm in front of flexor retinaculum with the ulnar nerve
Ends by forming superficial palmar arch gives rise to superficial palmar branch of radial artery
78
Palmar arches
Radial artery -> deep palmar arch
| Ulnar artery -> superficial palmar arch
79
Allen test
Should return in 7 seconds
Prior to radial artery cannulation
Prior to heart bypass surgery
80
Most mobile yet unstable joint
Shoulder joint
81
Rotator cuff muscles
```
SITS muscle
- supraspinatus (superior)
- infraspinatus (posterior)
- teres minor (posterior)
- subscapularis (anterior)
Supports the humeral head to the glenoid fossa
Inferiorly: no support
```
82
Boundaries of quadrangular space
Superior: subscapularis
Lateral: humerus
Inferior: teres major
Medial: triceps (long head)
83
Contents of quadrangular spaces
Axillary nerve
| Posterior humeral circumflex
84
Volkmann’s ischemic contracture
Occurs in supracondylar fracture
Permanent flexion contracture of the hand and wrist (clawlike deformity)
Compressed brachial artery
85
Most common carpal bone fracture
Scaphoid
86
Most common dislocated carpal bone
Lunate
87
Artery injured in scaphoid fracture
Radial artery
88
Nerve injured in hamate fracture
Ulnar nerve
89
Froment sign is a test of what nerve?
Ulnar nerve
90
Artery traverses the anatomic snuffbox
Radial artery
91
2nd most commonly fractured carpal bone
Lunate fracture
92
Nerve compressed in lunate fracture
Median nerve
93
Boundaries of anatomic snuffbox
EPoL
APoL
EPB
94
Floor of the anatomic snuffbox
Scaphoid bone
95
No man’s land
Flexor tendon injuries at zone 2 have poor prognosis
96
Osteoarthritis
Heberden nodes
Bouchard nodes
Heberden nodes: distal
| Bouchard nodes: proximal
97
Injury to the extensor digitorum tendon
Mallet finger
98
Contracture of palmar aponeurosis seen in Uremia
Dupuytren contracture
99
Action of the lumbricals
Flex MCP and extend IP
100
Contents of the middle mediastinum
```
Heart
Roots of great vessels
Primary bronchi
Phrenic nerve
Arch of azygous
```
101
Contents of the posterior mediastinum
```
Thoracic aorta
Esophagus
Azygos and hemiazygos vein
Vagus nerve
Thoracic duct
Sympathetic trunk
```
102
Immediate management of tension pneumothorax
Needle thoracostomy (2nd ICS)
103
Definitive management of tension pneumothorax
CTT (4th or 5th ICS AAL)
| - may be done at a lower ICS but not lower than 5th rib on either side (dome of diaphragm)
104
Sternal space of Burns
It is where the deep infection in the neck and esophageal perforation affects the mediastinum causing mediadtinitis
105
Mediastinoscopy (procedure) used to obtain samples of tracheobronchial lymph nodes through thensubsternal space
Chamberlain procedure
106
Apical lung tumor that causes Horner syndrome
Pancoast tumor or superior sulcus tumor
107
Right brachiocephalic + left brachiocephalic =
SVC
108
Structure formed behind the lower border of the 1st costal cartilage
SVC
109
SA node location
Sulcus terminalis
110
Pemberton sign is seen at what disease entity?
SVC syndrome
111
Sign used to denote flushing of head when hands are raised
Pemberton sign
112
Branches of the arch of the aorta
Brachiocephalic trunk
Left common carotid
Left subclavian
113
2 branches of the pulmonary trunk
Right and left pulmonary artery
114
Most sensitive CXR finding suggesting tear of the aorta
Widened mediastinum
115
Best screening test for aortic tear
Dynamic spiral CT
116
Definitive test for aortic tear
Aortography
117
Aortic tear or disruption is caused by
Deceleration injury
118
Location of injury in aortic tear
Distal to subclavian artery at level of ligamentum arteriosum
119
CXR finding of aortic tear
Widened mediastinum
Pleural capping
1st and 2nd rib fracture
Loss of aortic knob
120
Atypical rib that is the broadest, shortest, most sharply curved, groove for subclavian artery
Rib 1
121
Site of intercostal nerve block
Lower border of the robins
122
Site of needle thoracentesis
2nd or 3rd ICS MCL, upper border of rib
123
Weakest part of the rib where most fractures occur
Anterior to the angle usually rib 5-10
124
Paradoxical chest movement caused by Two separates fractures in >3 contiguous ribs ( junction and angle)
Flail chest
125
Major cause of respiratory compromise
Pulmonary contusion
126
Cervical prominence
C7
127
Causes of thoracic outlet syndrome
Cervical rib, physical injuries and muscle enlargement
128
Thoracic outlet syndrome causes compression of the NV bundle namely
Subclavian vessels and brachial plexus
129
Lining epithelium of esophagus
Stratified squamous
130
Muscle of the upper 1/3 of the esophagus
Striated muscle
131
Muscle of the lower 1/3 of the esophagus
Smooth muscle
132
Level of esophagus
C6 to cardiac
133
Length of esophagus
10in
134
Constriction of esophagus
Cervical constriction
Bronchoaortic constriction
Diaphragmatic constriction
135
Blood supply
Cervical esophagus
Thoracic esophagus
Abdominal esophagus
Cervical esophagus: inferior thyroid artery
Thoracic esophagus: bronchial arteries and aorta
Abdominal esophagus: left gastric artery and inferior phrenic artery
136
Triad of achalasia
Hypertensive LES
Aperistalsis of esophageal body
Failure of LES to relax
137
Surgical treatment for achalasia
Heller’s myotomy with or without Partial fundoplication
138
Gold standard in diagnosis of GERD
24 hour pH monitoring
139
Most effective surgical treatment for GERD
Nissen fundoplication
140
Hallmark of intestinal metaplasia
Presence of jntestinal goblet cells
141
Most common location of esophageal adenocarcinoma
Middle 3rd
142
Linear laceration of esophagus which is common in alcoholics with history of forceful retching or vomiting
Mallory weiss tear
143
Most common location of Mallory weiss tear
GEJ
144
Thin submucosal ring in the lower esophagus presenting with dysphagia
Schatzki’s ring
145
Plummer Vinson is characterized as
Esophageal webs
Atrophic glossitis
IDA
146
CA predisposed by Plummer Vinson syndrome
Squamous cell CA
147
Spontaneous pressure rupture of esophagus
Boerhaave’s syndrome
148
Location of Boerhaave’s syndrome
Left pleural cavity or just above the GEJ
149
Most common benign tumor of the esophagus and stomach
Leiomyoma
150
Most common presenting symptom of esophageal CA
Dysphagia (60% of esophageal lumen is infiltrated)
151
Ivor-Lewis procedure
Trans-thoracic esophagectomy
| Wider lymphadenopathy
152
Orringer’s procedure
Trans-hiatal procedure
Avoids thoracotomy
Less morbidity
153
Most common site of Zenker’s diverticulum
Killian’s triangle
154
Most common site of esophageal perforation
Killian’s triangle
155
Weaknspit between inferior constrictor and cricopharyngeus muscles
Killian’s triangle
156
Most common type of esophageal diverticula
Pharyngoesophageal (Zenker’s diverticula) thru Killian’s triangle usually left
157
Contents of the inguinal canal
Ilioinguinal nerve
Spermatic cord (male)
Round ligament of uterus (female)
158
Structure that guides the descent of testis
Gubernaculum
159
Caused by poor gubernacular fixation leading to torsion of testes
Bell clapper deformity
160
Other name of inguinal, lacunar ligament and Cooper’s ligament?
Poupart’s, Gimbernat and Pectineal Ligament
161
Conjoint tendon (Cinta) aka Falc Inguinalis are formed by what 2 structures?
1. Transverse Abdominis
| 2. Internal oblique
162
Boundaries of Hesselbach triangle
Medially, rectus abdominis
Inferiorly, inguinal ligament
Laterally, inferior epistric vessel
163
Contents of spermatic cord
Vas deferens, testicular artery and vein pampiniform plexus), genital branch of genitofemoral nerv
Cremaster artery, artery of the vas
164
Triangle of Doom affected vessels
Iliac vessels, genital brach of genitofemoral nerve, ductus deferens
165
Triangle of pain boundaries
Inferolateral border: iliopubic tract
Superomedial border: gonadal vessels
Lateral border: reflected peritoneum
166
Triangle of pain affected vessels
Iliopubic tract
Lateral and anterior femoral cutaneous nerve
Iliac vessels
167
Circle of death or corona mortis affected vessels
Aberant artery
Obturator artery
Internal iliac artery
168
Femoral triangle
| From lateral to medial
NAVEL
| Nerve, artery, vein, empty, lymphatics
169
Boundaries of femoral triangle
Superiorly: inguinal ligament
Laterally: sartorius muscle
Medially: adductor longus muscle
170
Floor of femoral triangle
Iliopsoas, pectineus, adductor longus
171
Hernia that is most common in both gender described as the neck of the hernia is LATERAL to the inferior epigastric vessels
Inguinal hernia
172
Hernia that is MEDIAL to the inferior epigastric vessels
Direct hernia
173
Superior lumbar triangle is what type of hernia?
Grynfeltt’s hernia
174
Inferior lumbar triangle is what type of hernia
Petit’s hernia
175
Hernia repair consisting of tightening an enlarged deep ring only (simple ring closure)
Hernioplasty of choice for women with IIH
Marcy
176
Hernial repair involving TO, TA, TF approximated to iliopubic tract and the shelving edge of inguinal ligament with interrupted sutures
Non anatomic
May cause tension, hence recurrence
Bassini
177
Same aponeurotic layers in Bassini are approximated by precise layered imbrication with continuous suture
Non-anatomic
May cause tension, hence recurrence of hernia
Shouldice
178
```
Hernia repair that is
Longer duration
More extensive dissection
More pain
More suturing
More dissection
```
Shouldice repair
179
Hernia repair wherein the transverse aponeurotic arch is sutured to Cooper’s ligament medially and to the femoral sheath laterally
Anatomic basis: a strong posterior inguinal wall is the best protection againstnangroin hernia in an adult
McVay-Lotheissen
180
Hernia repair that bridges the decect without tension along with tissue through the internstices of a prosthetic marerial (MESH) to reinfore the repair
Mesh is sutured circumferentially to IO, rectus sheath and shelving edge of inguinal ligament
Lichtenstein
181
The line of Cantle represents location of what hepatic vein?
Middle hepatic vein
182
Functional segments of the lover
1
2-4
5-8
1 caudate lobe
2-4 left hemiliver
5-8 right hemiliver
183
Divides the liver anatomically
Falciform ligament
184
Postero-inferior surface of the piver, in between the quadrate and caudate lobe
Within the hepatoduodenal ligament
Porta hepatis/hilum of liver
185
Boundaries of porta hepatis
Anteriomedial: heptic artery
Antero-lateral: CBD
Posterior: portal vein
186
Maneuver used to clamp the prota hepatis
Pringle’s maneuver
187
Union of SMV and splenic vein
Portal vein
188
Vein that drains venous blood from lower 3rd of esophagus doen to half of anal canal
Opens into porta hepatis and divides into left and right branches
Portal vein
189
Major blood supply of the liver comes from the portal vein (____%) then the hepatic artery (______%)
portal vein (70%) then the hepatic artery (30%)
190
Esophageal varices comes from what vessels?
Distal 3rd, esophageal branches of left gastric vein (portal)
191
Hemorrhoids come from what vessel?
Superior rectal vein (portal)
192
Caput medusae comes from what vessels?
Paraumbilical vein (superficial veins of anterior abdominal wall)
193
Next Surgical management for recurrent esophageal varices despite medical management and esophageal sclerotherapy
TIPS for Child’s B and C
| Surgical shunt for Child’s A
194
Shunt that has the least incidence of hepatic encephalopahty
Distal splenorenal shunt (Waren shunt)
195
Bilirubin is detectable at what level?
>2.5 mg/dL
196
During liver biopsy, the needle is inserted into what ICS?
Right 10th ICS MAL in full expiration
197
Congestive hepatopathy characterized by obstruction to hepatic venous outflow
Budd-Chiari Syndrome
198
Definitive study for Budd-Chiari Syndrome
Heptic venography
199
Pyogenic abscess, as caused by E.coli in 2/3, affects what lobe in the liver?
Right lobe
200
Organism involved in hepatic abscess more common in the 3rd world countries and has a characteristic finding of anchovy paste (necrotic central portion containing reddish brown pus-like material)
Amebic
201
Most common form of liver abscess worldwide
Amebic abscess
202
Commonly affects the antero-inferior or postero-inferior portions of the right lobe characterized by dull RUQ pain or abdominal distention, allergic or anaphylactic reaction with cyst rupture
Hydatid disease
203
Water-lily sign?
Hydatid disease
204
Most common primary hepatic tumor in children
Hepatoblastoma
205
Most common benign hepatic tumor
Hemangioma
206
Most common metastatic site of colon CA
Liver
207
Most common primary liver malignancy
HCC
208
Triad of hemobilia (or Quincke’s)
RUQ pain, UGIB and jaundice
209
Part of the pancreas that has projection to left behind SMA
Uncinate process
210
Most common and clinically significant congenital anomaly of the pancreas
Functional obstruction of duct of Santorini
Pancreas divisum
211
2nd part of the duodenum surrounded by a rim of pancreatic tissue
Annular pancreas
212
Treatment of annular pancreas
Duodenoduodenostomy
213
Signs of hemorrhagic pancreatitis
```
Grey Turner sign
Cullen sign (blood dissects up to the falciform ligament and create periumbilical ecchymosis)
```
214
Acute pancreatitis radiologic finding
Calcification, lesser sac fas, blurred psoas, COLON CUT-OFF SIGN, reverse or inverted 3 sign
215
Pancreatic head mass radiologic finding?
Double duct sign
216
Chronic pancreatitis radiologic finding?
Chain of lakes
217
Most common cause of chronic pancreatitis?
Alcohol consumption and abuse
218
Most common primary malignancy of the pancreas
Ductal adenocarcinoma
219
Most common site of pancreatic CA
Pancreatic head
220
Most frequent altered oncogene in pancreatic CA
Kras (also colon CA)
221
The current diagnostic and staging test of choice for pancreatic CA?
Spiral CT with contrast
222
Etiology for the severe pain experienced by patients with pancreatic CA
Invasion of retroperitoneal nerve
223
Drug used for palliative treatment of advanced pancreatic CA
Gemcitabine
224
Tumor linked with whipple’s triad
Insulinoma
225
Syndrome of watery diarrhea, hypokalemia and achlorhydia?
WDHA syndrome/ VIPoma/ Verner-Morrison syndrome
226
Pancreatic disease in the presence of migratory erythema
Glucagonoma
227
Characteristics of glucagonoma
Serum glucagon >500pg/mL
Usually at body and tail
Metastatic at time of diagnosis
Debulking at treatment
228
Blood supply of lesser curvature
Right and left gastric
229
Blood supply of greater curvature
Right and left gastroepiploic
230
Blood supply of fundus of the stomach
Short gastric (from splenic artery)
231
Most abundant of gastric cell
Chief cell
232
Gastric cell responsible for carcinoid tumor
Enterochromaffin like cell
233
Main innervation of the stomach
Left and right vagal trunk
234
Location of left vagal trunk
Anterior surface, gives hepatic branch and nerve of Latarjet
235
Location of right vagal trunk
Posterior surface, gives rise to celiac branch, gives rise to criminal nerve of Grassi
236
Nerve often missed during vagotomy and is then responsible for recurrence of PUD
Criminal nerve of Grassi
237
Posterior nerve of the lesser curvature is a branch of the posterior vagal trunk which supplies the pylorus
Nerve of Latarjet
238
Removal of Nerve of Latarjet will predispose the patient to what gastric condition
Dumping syndrome
239
Nerve of Latarjet was left intact in what procedure
Highly selective vagotomy
240
Other name of the nerve of Latarjet
Crow’s foot
241
Ulcer treatment associated with the least recurrence and highest mortality
Antrectomy + bilateral truncal vagotomy
242
Hormones that will induce gastric acid secretion
Ach, Histamine, Gastrin
243
Hormone that will inhibit acid secretion
Somatostatin
244
Most potent physiologic stimulus for pepsinogen release
Food
245
Most potent inhibitor of gastrin release
Luminal acid
246
Most common type of gastric ulcer
Antral lesser curvature
247
Define type II gastric ulcer
Type 1 plus duodenal ulcer
248
Define type III gastric ulcer
Pre-pyloric ulcer
249
Define type IV gastric ulcer
High in the lesser curvature
250
Type of gastric associated with NSAID use
Type V
251
Length of duodenum
25cm
252
Most common site of duodenal ulcer
1st part of the duodenum
253
Artery that lies directly behind the first portion of the duodenum
Gastroduodenal artery
254
Horizontal folds of mucuous membrane, around orifice of ileum
Ileocecal valve
255
Hormone controls the ileocecal sphincter
Gastrin
256
Sphincter that controls flow of contents from ileum into colon
Ileocecal sphincter
257
Most common surgical disorder of the small interstines
Mechanical small bowl obstruction (75% adhesions)
258
Hernia in a meckel’s diverticulum
Littre’s hernia
259
Most common cause of mesenteric ischemia
Arterial embolus
260
Arterial embolus, causing Mesenteric Ischemia, is usually found in ____% with cardiac disease, from left atrial thrombi, lodges to SMA distal to middle colic
95%
261
Complication of mesenteric ischemia
Full-thickness infarction within 6 hours
262
Classic history of mesenteric ischemia
Physical examination finding is not compatible
263
Most common site of bowel ischemia
Griffith’s point (watershed area of SMA and IMA)
264
Artery that forms an umportant anastomosis beween SMA and IMA, and forms a continuous arterial circle or arcade along the inner border of the colon
Marginal artery of Drummond
265
Another anastomosis present kn the colonic mesentery that connecta the proximal middle colic artery with the left colic artery
Arc of Riolan
266
Blood vessel that is compressed in Nutcracker syndrome
Renal vein
267
Most common site of aneurysm
Infrarenal
268
Most common risk factor
Atherosclerosis
269
Weight of prostate gland
20-25gms
270
Medication that relaxes the prostate and provide larger urethral opening
Terazosin
271
Medication that shrinks the prostate
Finasteride
272
Prostate adenocarcinoma is often asymptomatic and ____% nodule on DRE
70%
273
Most common grading system of prostate CA
Gleason system
274
Calcium stones that is associated with distal RTA
Calcium phosphate stone
-described as balck, grey or white small smooth or spiky, dense
275
Renal stone that is caused by repeated UTI with urease producing bacteria
Struvite stone or Magnesium Aluminum Phosphate
276
Level of PSA that is considered micrometastatic
>20pg/mL
277
Most common solid renal tumor
Renal cell tumor
278
Classic triad of renal cell CA (10-15%)
Flank pain, hematuria and palpable mass
279
Most common solid renal tumor of childhood
Wilms tumor
280
What fascia is included in radical !nephrectomy?
Gerota’s fascia
281
Bladder CA is highly associated with what risk factor?
Smoking (2-naphthylamine 4-aminobiphenyl)
282
Most common urothelial carcinoma subtype in developing countries and caused by schistosoma haematobium
Squamous cell carcinoma
283
Most common complication of thyroglossal duct cyst
Infection
284
Surgical procedure for thyroglossal duct cyst
Sistrunk operation
285
Most common branchial cleft anomaly gound in te opening between middle and lower third of SCM
2nd branchial cleft anomaly
286
Surgical procedure for branchial cleft anomaly
“Stepladder” incision to remove entire tract
287
Most common site of cystic hygroma
Neck
288
Lymphatic malformation as a result of a maldeveloped localized lymphatic network, which fails to connect or drain into the venous system (lymphangioma)
Cystic hygroma
289
Treatment of choice for cystic hygroma
Surgical excision
290
Sclerosing agent for cystic hygroma
OK-432 (or Picibanil) or bleomycin
291
Bleomycin is notorious for causing what complication?
Pulmonary fibrosis
292
Congenital Diaphragmatic Hernia
a. Bochdalek’e hernia
b. Morgagni’s hernia
a. Bochdalek’e hernia: posterilateral
| b. Morgagni’s hernia: anterior
293
UGIS finding in pyloric stenosis
String sign orbdouble railroad sign
294
Surgical management of pyloric stenosis
Fredet-Ramstedt pyloromyotomy
295
Location of 85% cases of duodenal atresia
Ampulla of vater
296
Meconium ileus is associated with what condition?
Cystic fibrosis (>95%)
297
Soap bubble seen in meconium ileus is known as what sign?
Neuhaser’s sign (meconium mixes with air and appeara like ground glass)
298
Most common GI emergency in neonatal period
Necrotizing enterocolitis
299
Single most important risk factor for the development of NEC
Prematurity
300
Pneumatosis intestinalis is seen in what condition?
NEC
301
Surgical indication of NEC
Pneumatosis or free abdominal air
302
Most common ectopic tissue fron Meckel’s diverticulum
Gastric mucosa (85%)
303
Complications of Meckel’s Diverticulum
Hemorrhage (50%)
Obstruction (25%)
Inflammation (20%)
304
Most common cause of colon obstruction
Hirschprung’s disease
305
Diagnosis of a pediatric patient with failure of passage of meconium in 24 hours
Hirschprung’s disease
306
Mutation of what gene is Hirschprung’s disease associated with?
Ret protooncogene
307
Most common presentation of Hirschprung’s disease
Constipation, abdominal distention and failure to thrive
308
Definitive surgical management of Hirschprung’s disease
Pull-through
309
Diagnostic of Hirschprung’s disease
Barium enema: transition zone
| Deep rectal or suction biopsy
310
2 types of imperforate anus
High type: rectum ends above levator muscle, usually had fistula into membranous urethra in M or vagina in F
Low type: rectum descends into levator muscle, fistula in perineum found in median raphe of scrotum in M or at posterior fourchette in F
311
Surgical management for imperforate anus
High: colostomy (newborn) and pull-through procedure at 2 months
Low: anoplasty
312
Pentalogy of Cantrell
```
D COPS
Diaphragmatic defect
Cardiac abnormality
Omphalocele
Pericardium malformation
Sternal cleft
```
313
Defect of the abdominal wall; extruded viscera not covered by sac, defect lateral to umbilicus (R>L)
Gastrochisis
314
Uncommon anomaly in gastrochisis comprising of 10-15% of cases
Intestinal atresia
315
Swenson, Duhamel and Soave are procedure of what congenital gastrointestinal tract?
Hirschprung’s disease
