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Anatomy (Block2) > Clinical Correlates > Flashcards

Clinical Correlates Flashcards

1
Q

Peritonitis

A

Bacterial contamination via gut trauma causing rupture of the stomach (laparotomy)

Results in infection/inflammation of the peritoneum via surgery, ruptures or ulceration

Primary = caused via infection and disease

Secondary = caused by accidental lacerations during surgery MORE COMMON

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2
Q

Peritoneal adhesions and adhesiotomy

A

Damaged peritoneal surfaces may become inflamed and sticky with fibrin

Fibrin is eventually replaced with fibrous tissue causing chronic pain.

If fibrous tissue forms, requires adhesiolysis which is surgical separation of the fibrous tissue/ adhesions

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3
Q

Ascites

A

Accumulation of ascetic fluids inside the peritoneal cavity causing abdominal distention and swelling

Caused by surgical lacerations, cirrhosis of liver or malignant cancer

  • very distended stomach and may cause respiratory issues
  • Usually pools in hepatorenal recess during supine and the rectovesical pouch when standing*
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4
Q

Abscess formation

A

Collections of purulent exudate that accumulates and causes localized infection in a peritoneal space

  • Caused usually by duodenal ulcers, ruptured gallbladder or appendix.
  • most common site is subphrenic recess
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5
Q

Internal hernia through omental foramen

A

Rare hernia that occurs via small intestine passing through omental bursa

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6
Q

Temporary control of hemorrhage from cystic artery

A

Pringle maneuver: cystic artery may be lighted or clamped and and then severed during a cholecystectomy

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7
Q

Rupture of diaphragm

A

A sudden increase in intra-abdominal pressure may rupture the diaphragm

  • can be traumatic or congenital
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8
Q

Abdominal hernias

A

Structures penetrate and pass through abdominal wall in areas of potential weakness

Areas of weakness include

  • inguinal
  • umbilical
  • epigastric regions
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9
Q

Abdominal aortic aneurism

A

Localized enlargement of the abdominal aorta.

High mortality rate when ruptured

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10
Q

Gastro-Esophageal Refulx Disorder (GERD)

A

Recurrent “heartburn” caused by regurgitation of gastric fluid into the abdominal esophagus

  • caused by failure of lower esophageal sphincter
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11
Q

Para-esophageal hiatal Hernia

A

Fundus of the stomach herniated through the esophageal hiatus without going into the esophagus itself

Cardia stays in place.

  • no regurgitation since cardinal orifice is still in normal position.
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12
Q

Sliding Hiatal Hernia

A

Esophagus, cardia, fundus all herniate through the esophageal hiatus and into the esophagus itself

Causes likely regurgitation and is more damaging than para-esophageal hernias

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13
Q

Pylorospasm

A

Spasmodic contractions of the pyloric between 2-12 weeks of age.

  • caused by smooth muscle fibers encircling the pyloric canal to be in constant spasm and failure to relax
  • results in food not passing properly to duodenum and stomach becomes overfilled, often resulting in discomfort and vomiting
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14
Q

Congenital Hypertrophic Pyloric Stenosis

A

Marked thickening of the smooth muscles along the pyloric sphincter.

  • Impairs gastric emptying into the duodenum.
  • often marked by a non-bilious projectile vomiting, dehydration and olive sized masses during palpating of the epigastric region

More common in males than females

Single-Bubble sign in radiographs*

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15
Q

Duodenal atresia

A

Congenital absence or complete closure of the duodenum at the duodenajejunal flexure.

  • often found in Downs pregnancies or overproduction of amnotic fluid during pregnancy.
  • fetus cant swallow or absorb fluid resulting in distention of the stomach and duodenum.
  • marked by bilious projectile vomiting
  • Double-Bubble* sign in radiographs
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16
Q

Paraduodenal hernias

A

2-3 inconstant folds and fossa around the duodenojejunal flexure.

  • intestinal loop can enter these fossa and cause bowl strangulations

Can affect inferior mesenteric artery/vein and/or the left colic artery due to close proximity

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17
Q

Peptic Ulcers

A

Infection of Helicobacter pylori in the duodenum or stomach

H. Pylori erodes the mucous lining of the stomach and inflaming the mucosa, making it vulnerable to effects of gastric acid and enzymes.

  • if unchecked, can erode the wall of the organ and subsequent arteries causing lethal hemorrhage.
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18
Q

Pancreatic cancer

A

Drains to lymph nodes that’s re relatively inaccessible and metastasize quickly making mortality rates high.

Often obstructs IVC, Bile duct or hepatopancreatic ampulla.

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19
Q

Hirschsprung’s disease (congenital megacolon)

A

Failure of neural crest cells to migrate to the distal colon during embryogenesis

Causes abnormal development of the autonomic nerves and the enteric system in the distal large intestine.

Ultimately results in non-functional distal colon and accumulation of colon contents in proximal colon.

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20
Q

Diverticulosis

A

Rupture of Multiple outpockets of the wall of the colon at weak points between teniae coli.

Causes infection and peritonitis

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21
Q

Appendicitis

A

Blocked appendix causes acute inflammation in the appendix.

Clinical signs = vomiting, nausea, fever, pain and lack of appetite

  • Pain is usually in the peri-umbilical region, lumbar region and McBurney’s point.
  • contains fecaliths or hyperplasia lymphatic vesicles
  • if untreated can cause ischemia and peritonitis (when ruptured)
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22
Q

Ischemia of the intestine

A

Occlusion of vasa recta by emboli originating in heart or atherosclerotic occlusions results in ischemia.

Severe cases cause necrosis and paralysis.

Clinical signs = colicky pain, abdominal distention, vomiting, fever, dehydration.

Most common site is Superior mesenteric artery (SMA) due to more obtuse angle.

Requires SMA angiogram to clear obstruction.

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23
Q

Volvulus of sigmoid colon

A

Rotation and twisting of mobile loop of sigmoid colon

Results in obstruction of lumen of the colon proximal to the twisted segment

Progressively results in ischemia, necrosis and obstipation (inability to pass stool) if left untreated.

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24
Q

Inflammatory bowel disease (IBD)

A

Includes ulcerative colitis and Crohn’s disease

Inflammation of the intestines in various ways.

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25
Q

Ulcerative colitis

A

Chronic inflammation and ulceration of the innermost mucosal lining of the large intestine.

  • forms pseudopolyps
  • increase risk of colorectal cancer
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26
Q

Crohn’s disease

A

Patch inflammation anywhere in the GI tract extending to deeper layers of intestinal wall.

most common in small intestine

Etiology is unknown

  • increases risk of colorectal cancer
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27
Q

Most common flow and site of ascites or peritonitis pooling

A

Uses the parabolic gutters to flow the ascetic fluid and infections through out the peritoneal cavity.

hepatorenal recess when supine and pelvic floor when standing

Draining requires patents to sit at >45degrees

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28
Q

Esophageal varices

A

Inferior esophageal veins markedly enlarge and form a portal-caval anastomoses when the hepatic portal vein is blocked (portal hypertension).

These varices can rupture and cause internal hemorrhage.

very common in alcoholic cirrhosis in the liver

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29
Q

Displacement of the stomach

A

Pancreatic pseudocysts, pancreatitis and abscesses in the omental bursa can cause the stomach to displace

Pancreatitis = posterior displacement

Pancreatic pseudocysts and omental abscesses = anterior displacement

can cause adhesion of the stomach to the pancreas

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30
Q

Visceral referred pain in the stomach

A

Stomach pain caused by multiple reasons can cause skin pain along the T7-T8 dermatome

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31
Q

Duodenal ulcers

A

Inflammatory erosions of the duodenal mucosa w/ the majority of ulcers occurring in the posterior wall of the superior duodenum.

Ulcers can perforate the wall causing peritonitis.

Ulcers can also adhere the liver, gallbladder or pancreas to the duodenum via chronic inflammation.

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32
Q

Spleen rupture

A

Rupturing of the spleen occurs by disruption of its soft pulp. Always results in intraperitoneal hemorrhage and shock.

spleen is most commonly injured abdominal organ

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33
Q

Splenectomy

A

Removal of the spleen when ruptured due to incapability of healing.

Usually partial is preformed when possible.

Results in greater susceptibility to encapsulated bacterial infections

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34
Q

Splenomegaly

A

Enlargement of the spleen by roughly 10x due to a diseased spleen or hypertension.

If the lower edge of the spleen is palpable always means splenomegaly.

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35
Q

Pyloric stenosis

A

Extreme narrowing of the pyloric lumen and sphincter obstructing passage of food.

Results in severe projectile vomiting

Can also result in atretic pyloric (complete closure of the pyloric lumen).

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36
Q

Annular pancreas

A

Obstruction of the duodenum via fashion of the dorsal pancreatic bud with an abnormal bifid vental pancreatic bud.

Results in a “ring” appearance.

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37
Q

Mobile cecum

A

Failure of the mesentary attached to the ascending colon to fuse with the abdominal wall.

Allows for abnormal movement of the cecum and ascending colon and sometime Volvulus (looping in itself causing a herniation) of the cecum and colon.

  • can also result in retrocolic portions behind the colon allowing additional sites of herniation and pooling.
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38
Q

Omphalocele

A

Herniation of abdominal viscera through the umbilical ring of the fetus in the womb.

Caused by failure of the bowel to return to body cavity during development.

High mortality and chromosomal abnormalities.

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39
Q

Gastroschisis

A

Protrusion of abdominal contents through the body wall directly into amniotic cavity lateral to umbilicus in the womb.

Caused by abnormal closure around the connecting stalk

Results in bowel damage and exposure to amnotic fluid.

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40
Q

Meckel diverticulum

A

Small portion of Vitelli need duct persists resulting in an abnormal outpocket in the ileum close to the ileocecal valve

Asymptomatic baring extreme increases of pressure (results in rupture)

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41
Q

Enterocystoma

A

Both ends of vitelline duct transforms into fibrous cords and forms a large cyst in the middle of the duct.

Fibrous cords can cause volvulus or strangulation of the intestines.

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42
Q

Umbilical fistula

A

Vitelline duct does not devolve over its entire length causing a direct communication between the umbilicus and intestines.

Can result in fecal discharge at the umbilicus

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43
Q

Rectourethral/ rectovaginal fistulas

A

Failure to form the cloaca and urorectal septum

Asymptomatic

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44
Q

Imperforate anus

A

Incomplete seperation of the cloaca into urogential and anorectal portions.

No urorectal septum

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45
Q

Congenital megacolon (Hirschsprungs disease)

A

Dilation of distal colon (descending or sigmoid usually) due to lack of autonomic ganglia in myenteric plexus distal to the segment dilated.

Prevents movement along that part of the colon resulting in fecal build up and distended stomach.

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46
Q

Pancreatic pseudocysts

A

Pancreatic fluid pooling in the omental bursa

Caused by inflamed, ruptured or lacerated pancreas

Often pushes the stomach anteriorly and if pancreatitis is present, can form a direct adhesion between posterior omental bursa and stomach

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47
Q

Pyrosis

A

“Heart burn”

Most common cause of esophageal discomfort and Sub-sternal pain

GERD is most common form but can also be associated with hiatal hernias

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48
Q

Caput Medusae

A

Type of varices caused by portal obstruction and subsequent portal-caval anastomoses.

  • caused when peri-umbilical veins become enlarged due to this process and can rupture.
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49
Q

Hemorrhoids

A

Caused by enlarged superior and inferior rectal veins due to portal-caval anastomoses.

The primary cause is portal hypertension to some degree, causing a need for the rectal veins to anastomoses

Two types: internal and external

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50
Q

Pancreatic cancer

A

Often obstruct IVC, bile duct or hepatopancreatic ampulla resulting in bile blockage, jaundice and enlarged gallbladders

-metastasis quickly and often

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51
Q

Gallstones (cholelithiasis)

A

Concentrations of crystals in the gallbladder, cystic duct or bile duct

  • usually asymptomatic unless lots are present. High numbers can cause obstruction, cholecystitis (inflammation of gallbladder).
  • left untreated can cause cholecysto-enteric fistulas
  • illieocecal valvue is a very common site of obstruction*
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52
Q

Porcelain gallbladder

A

Inflammatory scarring and calcification of the gallbladder usually caused by cholelithiasis.

-very common in overweight females

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53
Q

Subphrenic abscess

A

Collections of pus within the subphrenic recess.

When patient is supine drains to the hepatorenal recess.

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54
Q

Cirrhosis of the liver

A

Fatty or fibrous scar tissue accumulation within the liver.

Causes firm liver and impedes circulation of blood through portal venous system which causes portal hypertension and variable varices pending on where portal-caval anastomoses occurs.

  • looks hobnail-like*
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55
Q

Cholecysto-enteric fistula

A

Large gallstones can cause inflammation of the gallbladder

Adhesions with gallbladder and intestinal viscera occur during intense inflammation and subsequent ulceration of this adhesion.

Gallstones now move throughout intestines instead of remaining in gallbladder.

56
Q

Colorectal carcinoma

A

Malignant tumors of colon and rectum that often metastasis to the liver or lungs

  • metastasis to liver is more common due to superior rectal vein draining directly into portal system
  • metastasis in lungs occurs through drainage by middle and inferior rectal veins which skip the portal system initially.

clinical signs = loss of appetite, diarrhea, weight loss and blood in stool.

57
Q

Esophageal atresia

A

Caused by deviation of the tracheoesophageal septum in the posterior direction, causing incomplete separation or sometimes complete failure of esophageal recanalization

Causes the proximal esophagus to blindly end where as the distal esophagus attaches to the trachea via fistula

  • results in polyhydramnios (accumulation of amniotic fluid in fetus(
58
Q

Tracheo-esophageal fistula

A

Failure of recanalization of the tracheoesophageal septum causing incomplete Division of the esophagus and trachea at various points

59
Q

Esophageal stenosis

A

Narrowing of the esophageal lumen at various locations (usually distal 1/3rd)

Caused by incomplete recanalization of esophagus during week 8

60
Q

Abnormal shapes in female pelvis

A

Platypelloid: wider but shorter
- “platypus beak”

Android: heart/funnel shaped

Anthropoid: longer but narrower

All can result in complications for birth through vaginal delivery

61
Q

Pelvic fractures

A

Almost always are segmented fractures

Common types of pelvic injuries and the sites of common associated fractures

Crush accidents = anywhere

Heavy object falling onto pelvis = pubic rami

Falls from high heights directly onto feet = acetabulum

62
Q

Latrogenic injury of ureters

A

When uterine, ovarian or testicular arteries need to be ligated for a procedure, the ureters are at risk for being injured

63
Q

Injury to pelvic nerves

A

Obturator nerve is most likely to be hurt during surgery or childbirth

  • injury is marked by painful spasms of the adductor thigh muscles and loss of sensation to the medial thigh
64
Q

Ureteric calculi

A

Dilated ureters and kidneys are seen in CT/MRIs if kidney stones block the ureter

  • causes severe pain if large
  • treatment is surgery, passing manually or lithotripsy (shock waves break up stones)
65
Q

Cystocele

A

Herniation of the urinary bladder through the anterior wall (usually in females so vaginal wall)

66
Q

Rupture of the bladder

A

Results in urine pooling based on how it was ruptured.

Superior ruptures = intraperitoneal/ extravasation pooling

Posterior ruptures = Extraperitoneal pooling

67
Q

Abscesses in seminal glands

A

Collections of pus in seminal glands usually a result of gonococci (gonorrhea pathogens) infections

  • palpable seminal glands are usually an indication of abscesses in seminal glands
68
Q

Hypertrophy of prostate

A

Common occurrence when aging.
- most common in the middle lobule

Causes urethral obstruction if big enough and causes dysuria and urgency

Can also increase bladder and kidney infections (cystitis)

69
Q

Ectopic tubal pregnancy

A

Most common type of ectopic gestation/ pregnancy. (1/250)

  • implantation in the uterine tube instead of uterus.
70
Q

Hysterectomy

A

Surgical excision of the uterus

Can be done through the anterior abdominal wall (transabdominal)
Or through the vagina (transvaginal)

Ligation of arteries are done as distal to the vaginal artery as possible (heals quicker)

71
Q

Vaginal fistulae

A

Abnormal passages between the vaginal lumen and the bladder, urethra, bowel, or rectum.

Vesicovaginal, ureterovaginal, and urethrovaginal fistulas result in urine pooling

72
Q

Pelvic organ prolapse

A

Stretching or tearing of the levator ani or pelvic fascia

Often occurs during child birth, extreme trauma, inflammation and infection

Can result in a vaginal fistula

73
Q

Types of vaginal prolapse

Urethrocele, cystocele, uterovaginal, rectocele, enterocele

A

Urethrocele: prolapse of lower vaginal wall with urethra

Cystocele: prolapse of anterior vaginal wall with bladder

Uterovaginal prolapse: prolapse of uterus, cervix or superior vagina

Rectocele: prolapse of the lower posterior vaginal wall into rectum

Enterocele: prolapse of the upper posterior vaginal wall involving rectovaginal pouch.

74
Q

Pelvic organ prolapse quantification (POP-Q)

A

Four degrees of prolapse

  • 1st degree: prolapse of organ halfway to the hymen
  • 2nd degree: prolapse of organ to hymen
  • 3rd degree: prolapse of organ past hymen
  • 4th degree: complete descent of organ out or normal position
75
Q

Internal hemorrhoids

A

Prolapses of rectal mucosa containing dilated rectal veins.

Result from muscularis mucosa breakdown and are only treated if they prolapse or ulcerated

Can ulcerated and impede blood flow if they prolapse into anal canal

When bleed, blood is bright red

Are not painful since they are above the pelvic painline

76
Q

External hemorrhoids

A

Result of thrombosis in external rectal plexus veins

Can result from pregnancy, chronic constipation, and anything that impedes venous return and increases intra-abdominal pressure.

Often result from portal hypertension which produces anastomoses between superior, middle and inferior rectal veins.

Are painful since they are below the pelvic pain line

77
Q

Possible reasons for distention of scrotum

A

Indirect inguinal hernias

Inflammation of testies

Mumps or other inflections (especially parasitic infections)

Bleeding or chronic lymph obstruction

78
Q

Hypospadias

A

Most common congenital anomaly of the penis

Changes in positioning of the external urethral

Types:

Glandular = ventral surface of penis
Penile = Body of the penis
Scrotal =. Perineum

79
Q

Phimosis and paraphimosis

A

Phimosis:
Tight fit of the prepuce over the glans of the penis and cannot be easily retracted
- often produces smegma and irritation

Paraphimosis: retraction of prepuce over the glans penis causes construction of blood vessels in the penis

Both are most commonly treated with circumcision

80
Q

Impotence and erectile dysfunction

A

Inability to obtain erection due to two primary causes

  • lesions of the prostatic plexus or cavernosium nerves/ blood vessels
  • CNS or endocrine disorders (specifically hypothalamus testicular and pituitary)
81
Q

Bartholinitis

A

Infection of the greater vestibular glands and impinge onto the rectum.

  • can produce gland cysts
82
Q

Pudendal nerve block

A

Very common procedure used to release perineal pain during childbirth or surgery

Only does anterior perineum/ posterior vagina , posterior cutaneous nerve of the thigh does posterior perineum.

Provides parasthesia of S2-S4 dermatomes

83
Q

Vaginismus

A

Involuntary muscle spasms that occur in the vagina often during sexual inter pours easily

Is caused by distended perineal muscles and almost always realists in dyspareunia and prevents vaginal entry

84
Q

Rupture of the urethra in males

A

Intermediate part of urethra:

  • often caused by pelvic girdle fractures
  • commonly associated with hematocele and urine build up
  • build up is found in deep perineal pouch

Spongy part:
common through straddle injury and results in extravastion of urine into scrotum or superior abdominal wall

85
Q

Hydrocele

A

Accumulation of fluid into the tunica vaginalis of the testis or along the spermatic cord.

Often due to infection or occlusion of processes vaginalis.

86
Q

Varicocele

A

Enlargement of panpiniform plexus via black age upstream.

Appears bag of worms-like

Usually caused by blockage to the left renal vein, causing downstream blockage of the left panpiniform plexus

87
Q

Ilioinguinal nerve block

A

Applies parasthesia over the anterior part of the perineum.

Often applied in conjunction with pudendal nerve block to complete desensitize vagina during birth.

88
Q

Nutcracker syndrome

A

Compression of the left renal vein between the SMA and the abdominal aorta.

Blocks the left testicular vein and can often cause a varicocele

89
Q

Superior mesenteric artery syndrome

A

Compression of the duodenum between the SMA and abdominal aorta.

Often caused due to a lack of peritoneal fat

90
Q

Fabellar syndrome

A

Painful irritation of the lateral popliteal fossa

Due to presence of fabella Desmond bone that did not degenerate

91
Q

Potts (Dupuytren) fracture

A

Hyper Eversion ankle sprain

Results in the flowing:

torn anterior and posterior tibiofibular ligament

Torn deltoid ligaments

Interosseous membrane tears

Fracture of medial malleolus

Spiral fracture of proximal fibula

92
Q

Bakers cyst

A

Abnormal fluid-filled synovial sac between semimembrouns tendon and medial head of gastrocnemius

93
Q

Hallux valgus

A

Lateral deviation of hallux often caused by degenerative joint disease of chronic pressure from footwear

  • can result in corns or bunions
94
Q

Claw toe

A

Hyperextension of metatarophalangeal joints and flexion of DIP foot joints

Develop callouses and corns

95
Q

Hammer toe

A

Proximal phalanx is permanently dorsiflexion and middle phalanx is permanently plantarflexed

Unknown caused by theorized weak lumbaricals or interosseous Muscles

96
Q

Maisonneuve fracture

A

Eversion ankle injury

Tear:

  • Tibiofibula ligaments
  • deltoid ligaments
  • Interosseous membranes

Fractures:

  • posterior medial malleus
  • spiral fracture of fibula
97
Q

Hydronephrosis

A

Obstruction of the Ureter caused by an accessory artery to the inferior pole of the kidney that does not degenerate while the kidneys ascend.

Causes enlarged urinary bladder that can be seen in imaging

98
Q

Unilateral renal agenesis

A

one kidney (usually the left one) does not form. Caused by failure of the ureteric buds to penetrate the metanephrogenic blastema or complete absence of ureteric bud.

  • Usually asymptomatic until puberty and causes hypertrophy of the remaining kidney
  • 1/1000 neonates w/ males more likely affected
  • should be suspected if an infant only has a single umbilical artery
99
Q

Bilateral renal agenesis

A

Both kidneys do not form. Usually caused by failure of both ureteric buds to penetrate both metanephrogenic blastema or complete absence of both ureteric buds.

  • causes oligohydramnios (low amniotic fluid levels), anuria, hypoplastic lungs
  • Also associated with Potter syndrome (20%) and polycystic kidneys.
  • Usually results in infant death shortly after birth
100
Q

Polycystic kidney disease

A

Genetic disorder where renal tubules don’t develop properly and result in multiple cysts in kidneys

101
Q

Ectopic kidneys

A

Abnormal positioning of kidneys usually caused by failure to rotate during development.

  • most common sites are pelvis and inferior abdominal wall
  • pelvic kidneys usually fuse together and form a “pancake kidney
102
Q

Crossed renal ectopia

A

One kidney becomes ectopic and moves over to the same side as the normal kidney when ascending.

  • Almost always results in fusion
103
Q

Horseshoe kidney

A

Unilateral fused kidney that fuse at the inferior poles just at the beginning of ascension.

  • usually found in the pubic region right under the inferior mesenteric artery
  • usually asymptomatic unless blockage occurs, then deadly.
104
Q

Bifid ureter

A

Results from partial early division of a ureteric bud before penetrating the metanephrogenic blastoma

  • results in one proximal ureter, but has two distal ends in the kidney
105
Q

Potter sequence

A

Abnormal appearance during birth causes incompatibility with life.

Presents with the following

  • Low-set eyes
  • Beaked nose
  • Prominent epicanthic
  • Downward slanted eyes with eyelids folded over.

-Often presented with bilateral renal agenesis

106
Q

Autosomal recessive polycystic kidney disease (ARPKD)

A

Progressive disorder where cysts form in the collecting ducts causing extreme hypertrophy of the cystic kidney.

  • renal failure at infancy/childhood
  • Occurs in 1/5000 (much more rare)
  • genes affected are PKD1/2 and PKHD1
107
Q

Autosomal dominant polycystic kidney disease (ADPKD)

A

Progressive disorder where cysts form in the nephrons causing extreme hypertrophy of the cystic kidney.

  • renal failure in adulthood
  • occurs in 1/500 - 1/1000 (more common)
  • genes are affected PKD1/2 and PKHD1
108
Q

Double ureter

A

Results from complete early division of a ureteric bud before penetrating the metanephrogenic blastoma

  • results in two separate Ureteral that go to the same kidney (usually)
  • can result in an ectopic ureter
109
Q

Common locations for ectopic ureter and its definition

A

Ectopic ureter: double ureter where one ureter does not enter the urinary bladder

Females:

  • Vagina
  • Urethra
  • Vestibule

Males:

  • neck of bladder
  • prostatic portion of urethra
  • ductus deferens
  • prostatic utricle
  • seminal gland
110
Q

Urachal fistula

A

Entire Allantois does not degenerate and persists

  • causes urine to drain from umbilicus (pee out your belly button)
111
Q

Urachal cyst

A

Local area of allantois persists and urachus forms. Generates a fixed cyst that gradually fills

  • usually forms in median umbilical ligament and causes pain when it is full
  • connects to the umbilicus and urinary bladder and is tender at touch
112
Q

Urachal sinus

A

Upper part of allantois persists and the urachus does not seal. Forms a Blind-ended sac that can be a sight for infection

  • if not infected, is asymptomatic
113
Q

Exstrophy of the bladder

A

Ventral wall of the bladder does not develop. Caused by later staged failure of lateral body wall folds to fuse in the midline.

  • causes bladder to be exposed but is present
  • occurs 1/5000 (rare)
114
Q

Exstrophy of the cloaca

A

Ventral body wall defect where the lateral body wall folds don’t initiate or are disrupted early when initiating closure. This results in no bladder being formed at all

  • occurs in 1/30,000 (very rare)
  • also disrupts urorectal septum and usually results in imperforate anus
115
Q

XX Testicular DSD

A

A rare disorder that produces a chromatin-positive nuclei that results in a 46 XX chromosome

  • SRY gene is translocated to the X chromsome
  • results in male external genitalia with small testes and hypospadias
116
Q

XY Gonadal Dysgenesis

A

Disorder that produces chromatin negative nuclei and a 46 XY chromosome.

  • causes by inadequate testosterone ant anti-mullarian Hormone in testies
  • results in external and internal female appearing genitalia and under devolped gonads
  • do not produce secondary sexual characteristics at puberty
117
Q

Ovotesticular DSD

A

Disorder that has chromatin positive nuclei and has a variety of chromosomal constitution (usually 46 XX)

  • can result in 46 XX/ 46XY mosaicism.
  • produce nonfunctional testicular and ovarian tissues in the gonads since medulla and cortex both develop.
  • always produces ambiguous genitalia in both males or females
118
Q

Androgen insensitivity syndrome

A

Male with 46 XY chromosomal that has female external genitalia and breasts. Caused by resistance to testosterone of the genital tubercle, labioscrotal and urethra folds.

  • possesses testies in inguinal canal or abdomen usually.
  • female genitalia is a blind end pouch with no uterus or uterine tubes
  • usually caused by point mutations in androgen receptors and is X-linked recessive inheritance.
119
Q

Glandular hypospadias

A
  • Most common type of hypospadias*

- external urethral orifice is on the ventral surface of the Glans penis.

120
Q

Penile hypospadias

A

External urethral orifice is on the ventral surface of the penis body.

121
Q

Penoscrotal hypospadias

A

External urethral orifice is between the unfused half’s of the scrotum

  • caused by failure of the labioscrotal folds to fuse
122
Q

What is the cause of all hypospadias?

A

Inadequate production of androgens by fetal testies and/or inadequate receptors

123
Q

Epispadias

A

External urethral orifice is on the dorsal surface of penis

  • results from improper location of genital tubercle. Produces urogenital membrane rupture and the sinus opens on the dorsal surface.
  • urine is expelled at the roof of the penis in the superficial perineal pouch.
  • often associated with exstrophy of the bladder
124
Q

Agenesis of external genitalia

A

Results from genital tubercle to devolve and the urethra as a result opens into the perineum near the anus

125
Q

Diphallia or bifid penis

A

Double penis

  • results from two genital tubercles being developed
  • often associated with exstrophy of the bladder
126
Q

Micropenis

A

Results from failure of the fetal testies to form properly and also hypopituitarism

127
Q

Double uterus (uterus didelphys)

A

Distal (inferior) parts of both paramesonephric ducts fail to fuse

  • double uterus, usually double cervix and single vagina
128
Q

Unicornuate uterus

A

One paramesonephric duct forms properly however the other does not develops at all or very rudimentary

  • single cervix and a single vagina
129
Q

Bicornuate uterus

A

Occurs when the superior-inferior portion of the paramesonephric ducts do not fuse but the inferior-most portions do (uterus portion).

  • two uterus, one cervix and one vagina present
130
Q

Septate uterus

A

Both paramesonephric ducts fuse however the partition/septum between them remains, producing a septum

  • One uterus, two cervix and one vagina usually
  • can result in two cervix and two vaginas pending on how complete the patent septum is
  • almost always produces miscarriage unless fixed
131
Q

Absence of vagina

A

Failure of the sinovaginal bulbs to develop and form the vaginal plate.

  • usually is accompanied with an absent uterus as well since the uterus induces the formation of the sinovaginal bulbs.
132
Q

Atresia of the vagina

A

Blockage of the vaginal opening caused by a failure of canalization

133
Q

Double vagina

A

Distal paramesonephric ducts dont fuse and both contact the urogenital sinus. Produces two sinus tubercles that dont fuse together.

  • double uterus, cervix and vaginal canals
134
Q

Rudimentary horn uterus

A

One paramesonephric duct forms properly, whereas the other begins to form and then arrests suddenly idiopathically.

  • usually forms a unicornate uterus with the other uterus engorging with uterine lining and unable to get rid of it. In this case would have to be surgically removed
  • one uterus, 1 cervix and 1 vagina
135
Q

Cervical atresia

A

No cervix forms due to the paramesonephric ducts fusing together, but not penetrating the urogential sinus properly and deteriorating.

  • one uterus, no cervix and one vagina
136
Q

Vagina atresia

A

Caused by the sinovaginal bulbs not forming once the paramesonephric ducts contact the urogential sinus.

One uterus, one cervix, no vagina

137
Q

Scrotal hypospadias

A

Labioscrotal folds dont form causing urethra opening to form on the scrotum

Anatomy (Block2) (12 decks)

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