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Gastrointestinal
FA complete review part 1 Embryology and Anatomy
| Question | Answer |
|---|---|
| The foregut is extended from the_________________ to the ___. | Esophagus to the Upper duodenum |
| What is covered by the Midgut? | Lower Duodenum to proximal 2/3 of transverse colon |
| What is the extent of the hindgut? | Distal 1/3 of transverse colon to anal canal above the pectinate line. |
| Esophagus -----> Upper duodenum | Foregut |
| Lower Duodenum----> Proximal 1/3 of transverse colon | Midgut |
| What structure covers the distal 1/2 of transverse colon to to anal canal above pectinate line? | Hindgut |
| In respect to the Midgut development in embryo, what occurs at the 6th week of gestation? | Physiologic midgut herniates through umbilical ring |
| What ring (structure) is used by embryological midgut to herniate during early gestational development? | Umbilical ring |
| What happens to midgut at the 10th week of development? | Midgut returns to abdominal cavity + rotates around superior mesenteric artery (SMA) total 270 degrees counterclockwise |
| Embryological midgut develops around which vessel? | Superior Mesenteric Artery (SMA) |
| What direction does the developing midgut rotate? | 270 degrees counterclockwise around the SMA |
| What are Ventral wall defects due? | Developmental defects due to failure of rostral fold closure, lateral fold closure, or caudal fold closure. |
| What are the example condition of rostral fold closure failure? | Sternal defects (ectopia cordis) |
| What is defective in embryogenesis for development of Ectopia cordis? | Failure of rostral fold closure |
| What are examples of conditions due to lateral fold closure during embryogenesis? | Omphalocele and Gastroschisis |
| Omphalocele and Gastroschisis are due to? | Failure of lateral fold closure during gestation |
| What kind of embryological developmental failure lead to bladder exstrophy? | Failure of caudal fold closure |
| Etiology of Gastroschisis | Extrusion of abdominal contents through abdominal folds (typical right of umbilicus) |
| Which ventral wall defect is characterized by abdominal contents outside of body without coverage by peritoneum or amnion? | Gastroschisis |
| What is Omphalocele etiology? | Failure of lateral walls to migrate at umbilical ring leading to persistent midline herniation of abundant contents into umbilical cord. |
| Which condition has its abdominal contents outside body and covered by peritoneum? | Omphalocele |
| Which are important associations of Omphalocele? | 1. Congenital abnormalities (trisonomies 13 and 18, Beckwith-Wiedemann syndrome) 2. Structural abnormalities (cardiac, GU, and neural tube) |
| Abdominal contents covered by peritoneum newborn. Dx? | Omphalocele |
| Which fold failed to close during GI development in Gastroschisis and Omphalocele? | Lateral fold |
| What is Congenital umbilical hernia due to? | Failure of umbilical ring to close after physiologic herniation of the intestines |
| Failure of umbilical ring to close after the intestines herniated. Dx? | Congenital umbilical hernia |
| What are the Tracheoesophageal anomalies? | 1. Esophageal atresia (EA), and, 2 Tracheoesophageal fistula (TEF) |
| What is the most common Tracheoesophageal anomaly? | EA with distal TEF |
| Esophageal atresia with distal Tracheoesophageal fistula is the | Most common Tracheoesophageal anomaly. |
| What is often presented with EA with distal TEF? | Polyhydramnios in utero. |
| What is the reason of the polyhydramnios in utero of a neonate with EA with distal TEF? | Due to inability to fetus to swallow amniotic fluid |
| What are the most common clinical signs of a neotan with a Tracheoesophageal anomalies? | Drool, choke, and vomit with first feeding. |
| Which tracheoesophageal anomaly allows for air to enter the stomach? | Tracheoesophageal fistula |
| What is the clinical test to diagnose Tracheoesophageal anomalies? | Failure to pass nasogastric tube into stomach |
| Why is Pure TEF also called H-type? | The fistural conecting the esophagus to the trachea creates a form the remembles the letter "H" |
| What is the typical clinical presentation of Intestinal atresia? | Bilious vomiting and abdominal distension within the first 1-2 days of life. |
| Duodenal atresia is due to: | Failure to recanalize |
| What are associations of Duodenal atresia? | 1. "Double bubble" on X-ray 2. Down syndrome |
| Jejunal and ieald atresia sure due to: | Disruption of mesenteric vessels leading to ischemic necrosis and segmental resorption |
| What is another way to describe segmental resorption in Jejunal and Ileal atresia? | Bowel discontinuity or "apple peel" |
| Apple peel intestines refer to: | Jejunal and ileal atresias |
| What causes ileal and jejunal atresia to develop "apple peel" appearance? | Ischemic necrosis leading to segmental resorption |
| Hypertrophic pyloric stenosis is the MCC of: | Gastric outlet obstruction in infants |
| What are some key features of Pyloric stenosis ? | 1. Palpable olive-shaped mass in epigastric region 2. Visible peristaltic waves 3. Nonbilious projectile vomiting at ~2-6 weeks old |
| What antibiotic exposure increases the risk of developing hypertrophic pyloric stenosis? | Macrolides |
| What is the electrolyte imbalance seen in Pyloric stenosis? | Hypokalemic Hypochloremic Metabolic Alkalosis |
| Why is the reason for the Hypokalemic hypochloremic metabolic alkalosis in Pyloric stenosis? | Secondary to vomiting of gastric acid and subsequent volume contraction. |
| What are the findings of US in Pyloric stenosis? | Thickened and lengthened pylorus |
| The pancreas is derived from the _______________. | Foregut |
| What do the ventral pancreatic buds contribute for? | Uncinate process and main pancreatic duct |
| What is to become of the dorsal pancreatic bud? | Body, tail, isthmus, and accessory pancreatic duct |
| Which pancreatic bud(s) contribute to development of Pancreatic head? | Both, the ventral and dorsal buds. |
| What is Annular pancreas? | Abnormal rotation of ventral pancreatic bud forms a ring of pancreatic tissue around the second part of the duodenum. |
| What are some possible symptoms of Annular pancreas? | Duodenal narrowing and vomiting |
| What fails in order to develop Pancreas divisum? | Ventral and dorsal parts fail to fuse at 8 weeks |
| Where does the spleen arises from? | Mesentery of stomach but has foregut supply (celiac trunk --> splenic artery). |
| What is included in retroperitoneal structures? | GI structures that lack a mesentery and non-GI structures |
| Injuries to the retroperitoneal structures cause: | Blood or gas accumulation in retroperitoneal space |
| Mnemonic used to remember Retroperitoneal structures | SAD PUCKER |
| What does SAD PUCKER stand for? | Retroperitoneal structures: Suprarenal (adrenal) glands Aorta and IVC Duodenum (2nd to 4th parts) Pancreas (except tail) Ureters Colon (descending and ascending) Kidneys Esophagus (thoracic portion) Rectum (partially) |
| What part of the doudenum is in the retroperitoneal space? | 2nd to 4th parts |
| Which parts of the colon are retroperitoneal structures? | Descending and ascending colon |
| Which part of the Pancreas is NOT found in the retroperitoneal space? | Tail |
| Which glands are retroperitoneal? | Suprarrenal or Adrenal glands |
| What is connected by the Falciform ligament? | Liver to anterior abdominal wall |
| What ligament connects the liver to the anterior abdominal wall? | Falciform ligament |
| What structures are found/contained by the Falciform ligament? | 1. Ligamentum teres hepatis 2. Patent paraumbilical veins |
| Which ligament is known to be derivative of Ventral mesentery? | Falciform ligament |
| The hepatoduodenal ligament connects the: | Liver to duodenum |
| Which GI ligament is known to connect the liver and the doudenum? | Hepatoduodenal ligament |
| Which ligament contains the Portal triad? | Hepatoduodenal ligament |
| What are the components of the Portal triad contained by the Hepatoduodenal ligament? | Proper hepatic artery, Portal vein, and common bile duct |
| What is the Pringle manuever? | It is when the Hepatoduodenal ligament is compressed between thumb and index finger placed in omental foramen to control bleeding. |
| Which foramen is bordered by the Hepatoduodenal ligament? | Omental foramen |
| Which is a common maneuver used to stop bleeding by pressing on the Hepatoduodenal ligament? | Pringle manuever |
| The liver to lesser curvature of stomach is connected by the: | Gastrohepatic ligament |
| Which structures are contained by the Gastrohepatic ligament? | Gastric vessels |
| What ligament separates the greater and lesser sacs of the right? | Gastrohepatic ligament |
| Which structures are connected by the Gastrocolic ligament? | Greater curvatures and transverse colon |
| Which ligament contains the Gastroepiploic arteries? | Gastrocolic ligament |
| The _________________ ligament connects the Greater curvature to the spleen. | Gastrosplenic |
| Which structures are contained by the Gastrosplenic ligament? | Short gastric, left gastroepiploic vessels |
| Which ligament connects the Spleen to the posterior abdominal wall? | Splenorenal ligament |
| What structures are contained by the Splenorenal ligament? | Splenic artery and vein, and tail of pancreas. |
| What are the 4 layers of the gut wall? | 1. Mucosa 2. Submucosa 3. Muscularis externa 4. Serosa |
| What is the deepest layer of the gut wall? | Mucosa |
| What is the outermost layer of the gut wall? | Serosa |
| Which layer of the gut wall are the Meissner plexuses? | Submucosa |
| Which layer of the gut wall secretes fluid? | Submucosa |
| What nerve plexus are found in the Muscularis externa layer of the gut wall? | Myenteric nerve plexus (Auerbach) |
| Another name for Myenteric nerve plexus? | Auerbach plexus |
| What layer of the gut wall is in charge of Motility? | Muscularis externa |
| What is the name given to the serosa if it is retroperitoneal? | Adventitia |
| If the outermost layer is referred as Adventitia, then it is safe to assume that is indicating? | Retroperitoneal structure/space |
| What is the extent of a possible ulcer in relation to the gut layers? | Submucosa, inner or outer muscular layer |
| How far (deeply) does an erosion extend in relation to gut layers? | Mucosa only |
| Which has a greater degree of extend into the layers of the gut wall, erosions or ulcers? | Ulcers |
| What are the slow waves? | Frequencies of basal electrical rhythm |
| What is the frequency of waves of the Stomach? | 3 waves/ minute |
| How many slow waves per minute are seen in the Duodenum? | 12 waves/ minute |
| Which structure has an approximate 8-9 waves/min? | Ileum |
| Which is the GI structure with the slowest basal electrical rhythm? | Stomach (3 waves/min) |
| What are the three structures that compose the Mucosa layer of the gut wall? | Epithelium, Lamina propia, and Muscularis mucosa |
| Submucosal nerve plexus = | Meissner |
| Which gut layer contains the Inner circular layer? | Muscularis |
| Myenteric nerve plexus = | Auerbach |
| Which is deeper into the gut wall, Auerbachs or Meissner? | Meissner |
| What is the outermost sublayer of the Muscularis externa layer? | Outer longitudinal layer |
| Epithelium of the esophagus? | Nonkeratinized stratified squamous epithelium |
| Is the esophagus epithelium, keratinized or nonkeratinized? | Nonkeratinized |
| Which GI structure has nonkeratinized stratified squamous epithelium? | Esophagus |
| What is the role of the Villi and microvilli of the doudenum? | Increase absorptive surface |
| Where in the GI tract are the Brunner glands found? | Duodenum |
| The doudenum is the location of which particular HCO3- secreting glands? | Brunner glands |
| What are two featured histologic findings in the Duodenum? | 1. Brunner glands 2. Crypts of Lieberkühn |
| HCO3- secreting glands of the duodenal mucosa? | Brunner glands |
| What is contained in the crypts of Lieberkuhn? | Stem cells that replace enterocytes/goblet cells and Paneth cells that secrete defensins, lysozyme, and TNF. |
| Where are the Paneth cells found? | Inside the crypts of Lieberkühn of the doudenum |
| What is secreted by the Paneth cells? | Defensins, lysozyme, and TNF |
| Histological findings/features of the Jejunum | 1. Plicae circulates and, 2. crypts of Lieberkühn |
| Which part of the small intestine are the Peyer patches mostly found? | Ileum |
| What are the Peyer patches? | Lymphoid aggregates in lamina propria, and submucosa of the ileum |
| Which ileal layers contain Peyer patches? | Lamina propria and submucosa |
| What are the 3 key histological findings of the ileum? | 1. Peyer patches 2. Plicae circulares 3. Crypts of Lieberkühn |
| Which digestive tract section/structure is with Crypts of Lieberkuhn but not with villi, and with abundant goblet cells? | Colon |
| Crypts of Lieberkühn are found in: | Duodenum, Jejunum, Ileum, and colon |
| Which part of the digestive tract is abundant with goblet cells? | Colon and Ileum |
| What part of the small intestine has the largest number of Goblet cells? | Ileum |
| Which part of the digestive tract has more Goblet cells, Ileum or Colon? | Ileum |
| At what level does the abdominal aorta starts? | T12 |
| What arteries branch off the aorta at T12? | - Inferior phrenic - Superior and Middle suprarenal |
| At which level of the abdominal aorta does the Superior Mesenteric artery branches off? | At mid-L1 |
| Which imporatnt artery branches off the abodimian aorta at L3 level? | Inferior Mesenteric artery |
| At what level does the Right and Left common iliac arteries begin? | L5 |
| How do arteries that supply GI structures branch off the abdominal aorta? | These are single and branch ANTERIORLY |
| If a artery is single and branches anteriorly form abdominal aorta, it is to supply _______________ structures. | Gastrointestinal |
| Arteries supplying non-GI structures that branch from abdominal aorta. | Paired and branch LATERALLY and POSTERIORLY |
| Which are three main branches of the abdominal aorta that branch off anteriorly? | Celiac, SMA, and IMA |
| Since SMA, IMA, and Celiac arteries branch off anteriorly --> | They are single and will supply GI structures |
| What is the Superior mesenteric syndrome? | Condition in which the SMA and aorta compress transverse (third) of doudenum |
| What is the clinical features of Superior Mesenteric artery syndrome? | Intermittent intestinal obstruction symptoms (primarily postprandial) |
| Malnutrition patient complains of episodic abdominal pain, especially after eating. Dx? | Superior Mesenteric artery syndrome |
| Which areas are most susceptible to colonic ischemia? | "Watershed regions" |
| What are the two "watershed regions" of the colon? | 1. Splenic flexure 2. Rectosigmoid junction |
| What dual blood supply create the Splenic flexure? | SMA and IMA |
| The junction of the SMA and IMA | Splenic flexure |
| What arterial bodies form the Rectosigmoid junction? | Last sigmod arterial branch from the IMA and Superior rectal artery |
| At what point approximately do the Gonadal arteries branch off (laterally) from the abdominal aorta? | At the superior part of L2 |
| Which paired vessel branches off the abdominal aorta exactly at the the junction of L1 and L2? | Renal arteries |
| What artery supplies the Foregut? | Celiac |
| What artery supplies the Midgut? | SMA |
| What artery supplies the Hindgut? | IMA |
| Which embryonic gut region(s) are Parasympathetically innervated by the Vagus nerve? | Foregut and Midgut |
| The Hindgut is innervated by the _____________ nerve. | Pelvic |
| Which nerve innervates the Pharynx? | Vagus |
| What are the branches of the Celiac trunk? | 1. Common hepatic artery 2. Splenic artery 3. Left Gastric artery |
| What arterial bodies constitute the main blood supply to of the stomach? | The branches of the Celiac trunk |
| At the Celiac trunk and stomach levels, which are some strong anastomoses that exist? | 1. Left and right gastroepiploic 2. Left and right gastrics |
| What artery is penetrated by posterior duodenal ulcers? | Gastroduodenal artery |
| Which artery is perforated by anterior duodenal ulcers? | Anterior abdominal cavity, potentially leading to pneumoperitoneum |
| Antrum of stomach is mostly irrigated by _________________. | Common hepatic artery |
| Which vessels form the anastomosis in the esophagus? | Left gastric <---> Azygos |
| Caput medusae appears at the region of the _______________. | Umbilicus |
| What arterial and venous bodies create the anastomosis that lead to Caput medusae? | Paraumbilical <---> Small epigastric veins the anterior abdominal wall. |
| Which type of varices are seen in Portal hypertension? | Esophageal varices, Caput medusae, and anorectal varices. |
| What is a common invasive treatment for Portal hypertension? | TIPS |
| TIPS can precipitate _________. | Hepatic encephalopathy |
| What is TIPS? | Treatment with a transjugular intrahepatic portosystemic shunt (TIPS) between the portal vein and hepatic vein relieves portal hypertension by shunting blood to the sytemic circuation bypassin the liver. |
| Where is the Pectinate line? | Formed where endoderm (hindgut) meets ectoderm |
| What is another name for Pectinate? | Dentate |
| Innervation above the pectinate line? | Visceral innervation |
| Arterial supply above the pectinate line? | Superior Rectal artery (branch of IMA) |
| Where does lymph form above the pectinate line drains into? | Internal iliac lymph node |
| What type of hemorrhoids are developed above the pectinate line? | Internal hemorrhoids |
| What type of malignancy is associated with tissue above the pectinate line? | Adenocarcinoma |
| Not painful hemorrhoids | Internal hemorrhoids |
| Non-painful hemorrhoids must be _____________ pectinate line. | Above |
| External hemorrhoids appear ________ the pectinate line. | Below |
| What are some pathologies/malignancies that are seen below the pectinate line? | 1. External hemorrhoids 2. Anal fissures 3. Squamous cell carcinoma |
| Painful hemorrhoids appear ________________ the dentate line. | Below |
| What is an anal fissure? | Tear in the anal mucosa below the Pectinate line. |
| What are associated conditions that accompany anal fissures? | Low-fiber diets and constipation |
| Why do anal fissures tend to appear posteriorly? | It is a poorly perfused area |
| Which type of hemorrhoids receive Somatic innervation? | External hemorrhoids |
| Which artery supplies below the pectinate line? | Inferior rectal artery (branch of the Internal Pudendal artery) |
| Where does lymph below the pectinate line drain to? | Superficial inguinal Lymph node |
| The inferior rectal artery is a branch of the: | Internal pudendal artery |
| Inferior rectal vein --> internal pudendal vein --> internal iliac vein --> Common iliac vein -----> IVC | Venous drainage below the pectinate line |
| Superior rectal vein ---> Inferior mesenteric vein ---> Splenic vein ---> portal vein | Venous drainage above the pectinate line |
| Venous blood below the pectinate line ultimately drains into what major venous body? | IVC |
| Which is the vein that receives venous blood from areas above the pectinate line? | Portal vein |
| Description of liver architecture | Hexagonally arranged lobules surrounding the central vein with portal triads on edges . |
| What are the portal triads in liver architecture, composed of? | Portal vein, Hepatic artery, bile ducts, as well lymphatics |
| Which surface of the hepatocytes faces the canaliculi? | Apical surface |
| The basolateral surface of the hepatocytes faces the ______________________. | Sinusoids |
| What are Kupffer cells? | Specialized macrophages of the liver, located ate the sinusoids. |
| What is the name of liver macrophages? | Kupffer cells |
| Where in the liver architecture are the Kupffer cells located? | Sinusoids |
| What is the abbreviation used for Hepatic stellate cells? | Ito |
| Where are the Hepatic stellate (Ito) cells located? | Space of Disse |
| What do Hepatic stellate cells store? | Vitamin A |
| What do hepatic stellate cells produce when activated? | Extracellular matrix |
| Which cells are responsible for hepatic fibrosis? | Ito cells (hepatic stellate cells) |
| What is the name of the Liver Zone 1? | Periportal zone |
| Which zone of the liver is first affected by viral hepatitis? | Zone I |
| Ingested toxins such as cocaine affect which zone of the liver? | Zone I |
| Name of Zone II of the liver? | Intermediate zone |
| Which is the known pathology to affect zone II of the liver? | Yellow fever |
| Yellow fever will cause liver damage by affecting the Zone _____. | II |
| Different forms to refer to Zone III of the liver? | - Pericentral vein zone or, - Centrilobular zone |
| Which zone of the liver is 1st affected by ischemia? | Zone III |
| Which zone, I, II, or III, has the highest cytochrome P-450 concentration in the liver? | Zone III |
| Which is the site of alcoholic hepatitis? | Zone III |
| Which zone of the liver is the most sensitive to metabolic toxins? | Zone III |
| What are some common metabolic toxins that affect the zone III of liver? | Ethanol. CCl4, halothane, and rifampin |
| Which cells in the liver store vitamin A? | Stellate cells in space of Disse |
| Gallstones that get lodged in the ampulla of Vater cause: | - Blockage of both: 1. Common bile duct ----> Cholangitis 2. Pancreatic ducts ----> Pancreatitis |
| What is the most common type of tumor seen at the head of the pancreas? | Ductal adenocarcinoma |
| What is the Courvoisier sign? | Enlarged bladder with painless jaundice |
| What is a consequence of a tumor at the head of the pancreas? | Obstruction of common bile duct ---> enlarged bladder with painless jaundice |
| How do a cholangiography help to visualize gallbladder problems? | Shows filling defects in gallbladder and cystic duct |
| What is the organization of the femoral region in respect of structures passing through? | Arranged for lateral to medial: Nerve-Artery-Vein-Lymphatics |
| Which is the most lateral structure of the femoral region? | Nerve |
| Mnemonic used to describe the order and organization of structures in the femoral region | NAVeL |
| What structures are contained by the Femoral triangle? | Femoral nerve, artery, and vein |
| What structures are contained by the Femoral sheath? | Femoral artery, vein, and canal, but NOT the femoral nerve |
| Facial tube 3-4 cm below inguinal ligament? | Femoral sheath |
| What is in the canal covered by the Femoral sheath? | Deep inguinal lymph nodes |
| Where is the site of protrusion of a direct inguinal hernia? | Abdominal wall |
| What is the site of protrusion of an indirect inguinal hernia? | Deep (internal) inguinal ring |
| What is a hernia? | Protrusion of peritoneum through an opening, usually at site of weakness. |
| What are two significant concerns or complications of all hernias? | 1. Incarceration (not reducible back into abdomen/pelvis) 2. Strangulation( ischemia and necrosis) |
| When a hernia is said be incarcerated, it means? | Hernia cannot be reducible back into the abdomen or pelvis |
| Complicated hernias present with: | Tenderness, erythema, and fever |
| Abdominal structures enter the thorax. Dx? | Diaphragmatic hernia |
| Which side is more prone to develop a diaphragmatic hernia? | Left side due to relative protection of right hemidiaphragm by liver. |
| Which is the most common type of diaphragmatic hernia? | Hiatal hernia |
| What is a hiatal hernia? | Stomach herniates upward through the esophageal hiatus of the diaphragm |
| Stomach protrudes upward through the diaphragm | Hiatal hernia |
| What are the two most common types of hiatal hernias? | 1. Sliding hiatal hernia 2. Paraesophageal hiatal hernia |
| Gastroesophageal junction is displaced upward as gastric cardia slides into hiatus | Sliding hiatal hernia |
| Which condition is described with "hourglass stomach" | Sliding hiatal hernia |
| Which is the MC type of hiatal hernia? | Sliding hiatal hernia |
| What is a Paraesophageal hiatal hernia? | Gastroesophageal junction is usually normal but gastric fundus protudes into thorax. |
| Which part of the stomach is protruded/herniated upward in a Sliding hiatal hernia? | Gastric cardia |
| Which hiatal hernia has the gastric fundus protrading/herniating upward into the thorax? | Paraesophageal hiatal hernia |
| Which type of inguinal hernia goes THROUGH the internal (deep) inguinal ring? | Indirect inguinal hernia |
| Which inguinal hernia goes into the scrotum? | Indirect inguinal hernia |
| Protrusion of peritoneum goes through the deep inguinal ring --> external inguinal ring, and finally into scrotum. Dx? | Indirect inguinal hernia |
| Anatomically, how does an indirect inguinal hernia enter the internal inguinal ring? | Lateral to inferior epigastric vessels |
| What is the cause of Internal inguinal hernias? | Failure of processus vaginalis to close |
| What is developed in a person that suffered of failure of processus vaginalis to close? | Indirect inguinal hernia |
| Besides an indirect inguinal hernia, what other condition may be developed due to failure of processus vaginalis to close? | Hydrocele |
| Which population is seen with Indirect inguinal hernias most commonly? | Infants; especially males |
| What path is followed by an indirect inguinal hernia? | Path of descent of testes; covered by all 3 layers of spermatic fascia. |
| During a hernia repair, the surgeon notices the hernia is covered by all 3 layer of the spermatic fascia. Dx? | Indirect inguinal hernia |
| What is the featured structure by which a direct inguinal hernia goes through? | Hesselbach triangle |
| Bulges directly through parietal peritoneum medial to the inferior epigastric vessels but lateral to the rectus abdominis. | Direct inguinal hernia |
| Which type of inguinal hernia is only covered by the external spermatic fascia? | Direct inguinal hernia |
| What type of inguinal hernia is mostly seen in older men? | Direct inguinal hernia |
| Weakness in the transversalis fascia leads to the development of: | Direct inguinal hernia |
| Hesselbach triangle is associated with: | Direct inguinal hernia |
| Medial to inferior epigastric vessels ---> | Direct inguinal hernia |
| Lateral to the Inferior Epigastric vessels------> | Indirect inguinal hernia |
| Which population is more affected by Direct inguinal hernia development? | Older men |
| Through which ring does a Direct inguinal hernia passes? | External (superficial) inguinal ring only |
| If the inguinal hernia only passes through one inguinal ring. Dx? | Direct inguinal hernia |
| Femoral hernia pathogenesis: | Protrudes below inguinal ligament through femoral canal below and lateral to pubic tubercle |
| What gender is most commonly affected by Femoral hernias? | Female |
| Which type of hernia, inguinal or femoral, are more prone to present with incarceration or strangulation? | Femoral hernia |
| Which hernia is found to protrude below the inguinal ligament? | Femoral hernia |
| If the hernia is said to be lateral to pubic tubercle. Most likely Dx? | Femoral hernia |
| What are the bordering structures of the Hesselbach triangle? | - Inferior Epigastric vessels - Lateral border of rectus abdominis - Inguinal ligament |
| What is the INFERIOR border of the Hesselbach triangle? | Inguinal ligament |
| What is the MEDIAL border of the Hesselbach triangle? | Lateral border of the Rectus abdominis |
| What is the SUPEROLATERAL border of the Hesselbach triangle? | Inferior epigastric vessels |
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