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23 Cards in this Set
- Front
- Back
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GI causes of finger clubbing
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1. Inflammatory bowel disease
2. Primary biliary cirrhosis 3.Liver cirrhosis 4.Achalasia 5.Peptic ulceration of the oesophagus |
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Stages of Finger Clubbing
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1. Increased fluctuation of the nail bed
2. Loss of normal angle between nail bed and cuticle 3. Increased longitudinal curvature of nail 4. Thickening of whole distal finger (drumbsticking) 5. Shiney and striated appearance of nail and skin |
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Signs of Peritonitis
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TRAPPED...
tenderness reflex guarding --> rigidity absent bowel sounds pyrexia percussion pain extremely unwell distant-local sign (e.g. Rovsing's sign) |
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What is Virchow's node?
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lymph node in left supraclavicular fossa which takes it's supply from the lymph vessels in the abdominal cavity.
First lymph node for abdominal cancer to spread to (sentinel node) especially gastric cancer. |
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What is Troisier's sign?
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A hard, enlarged lymph node in the left supraclavicular fossa (virchow's node) which is strongly indicative of cancer in the abdominal cavity.
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Causes of parotid swelling
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a) Bilateral (tends to be non-inflammatory)
* mumps *sarcoiditis *parotitis * alcoholic liver cirrhosis b) unilateral (more likely to be inflammatory) * tumour *salivary calculus |
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What are the differences between ileostomies and and colostomies?
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SITE, SPOUT AND WHAT COMES OUT
location - ileostomy RIF. colostomy LIF. appearance - ileostomy spout, colostomy flush in the bag - ileostomy liquid faeces, colostomy solid faces, ileal conduit urine, mucous fistula - mucus opening - most stomas one, loop stoma - two |
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What are the causes of abdominal distention?
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Fat (obesity)
Fluid (ascites) Faeces (constipation) Flatus (obstruction/ileus) Fetus (pregnancy) |
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Signs of abdominal obstruction
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tender
distended tinkling bowel sounds visible peristalsis |
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How can you distinguish a kidney from a spleen?
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You can get above a kidney, it is rounded with no notch, moves inferiorly on inspiration, resonant to percussion and it's ballottable.
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How can you distinguish a spleen from a kidney?
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It has an edge and a notch, can't get above it, moves towards RIF on inspiration and it's dull to percussion.
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What is the difference between voluntary guarding and involuntary guarding?
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Voluntary guarding is the contraction of the abdominal muscles when palpation provokes pain.
Involuntary guarding is the REFLEX contraction of the abdominal muscles when there is inflammation of the parietal peritoneum. |
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How can you differentiate between an intra-abdominal mass and an abdominal wall mass?
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Ask the patient to tense abdominal wall muscles.
- an intra-abdominal mass will disappear -an abdominal wall mass will still be present |
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What are some causes of hepatomegaly?
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Chronic parenchymal liver disease
- alcoholic liver disease -hepatic steatosis -hepatitis (viral, autoimmune) -primary biliary cirrhosis Malignancy -primary hepatocellular carcinoma -secondary metastatic cancer (colonic) Right Heart Failure Haematological disorders -lymphoma -leukaemia -myelofirbrosis -polycythaemia |
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What are some causes of splenomegaly?
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Haematological disoders
- lymphoma -lymphatic leukaemias -myeloproliferative disease -haemolytic anaemias Portal Hypertension Infections -glandular fever -TB -bacterial endocarditis -malaria Rheumatological conditions - RA and felty's syndrome -SLE |
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What is the anatomical relations of the mid-inguinal point and the midpoint of the inguinal ligament?
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mid-inguinal point - ASIS to pubic symphysis (where femoral artery lies)
midpoint of inguinal ligament - ASIS to pubic tubercle (where deep ring lies) |
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What's the definition of an abdominal hernia?
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An abnormal protrusion of bowel and/or omentum from the abdominal cavity.
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What are some potential complications of hernias?
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Incarceration: irreducibility, sometimes with loss of cough impulse
Obstruction: constriction of loops of bowel Strangulation: arterial occulsion, infarction, peritonitis, groin abcesses |
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What is Richter's hernia?
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This is when only part of the wall of the bowel herniates. It allows strangulation without obstruction.
It is more common with femoral hernias. |
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How can hernias be repaired?
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1. Hernitomy - excision of sac and tying of neck.
2.Herniorrhaphy - strengthening or repair procedure to prevent recurrence (can be done with Lichtenstein's mesh) |
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What are the contents of the spermatic cord?
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3 arteries: cremasteric artery, deferential artery, testicular artery.
3 nerves: genital branch of the genitofemoral nerve (L1/2), autonomic and visceral afferent fibres. ilioinguinal nerve (N.B. outside spermatic cord but travels next to it) 3 fascial layers: external spermatic, cremasteric, and internal spermatic fascia. 3 other structures: pampiniform plexus, vas deferens (ductus deferens), testicular lymphatics. |
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What are the contents of the inguinal canal?
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Spermatic cord in men and the round ligament in women.
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What are the borders of the inguinal canal?
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anterior wall: external oblique aponeurosis medially (internal oblique laterally)
posterior wall: transversalis fascia roof: arching lower fibres of internal oblique floor: inguinal ligament |
