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e.
4. Varicocele
a. Pampiniform plexus (testicles) becomes dilated
b. Common in adolescents
c. Mostly left side due to connection with renal vein vs. right side, which
joins with IVC
d. Could be caused by primary kidney disease
e. Presents with infertility (plexus not cooling)
5. Testicular cancer
a. Spreads upward via lumbar lymph to L1
b. Later spreads locally to superficial inguinal lymph
6. Torsion of the Testicle
a. Rotation around spermatic cord
b. Often associated with excessively large tunica vaginalis
c. Active young men and children
d.
9. Peritoneal adhesions
a. Associated with peritonitis
b. Post-surgical (gynecological and general abdominal) as well
c. Adhesion occur >90% of the patients following major abdominal surgery
and in 55-100% of the women undergoing pelvic surgery
d. Small-bowel obstruction, infertility, chronic abdominal and pelvic pain,
and difficult reoperative surgery are the most common consequences
10. Ascites and Paracentesis
a. Excessive accumulation of peritoneal fluid
b. Thin patient needs 1.5L before clinically recognizable
c. Local anesthesia, needle through abdominal wall
d. Skin, superficial fascia, deep fascia (very thin), aponeurosis or muscle of
external oblique, internal oblique muscle, transversus abdominis muscle,
fascia transversalis, extraperitoneal connective tissue (fatty), and parietal
peritoneum
e.
11. Partial gastrectomy
a. Gastric cancer
b. Gastric ulcer
i. Reduce acid by sectioning the vagus nerves (vagotomy)
ii. Else remove gastrin-bearing mucosa (antrum, gastrectomy)
b.
c. As the stomach empties its contents into the duodenum, the acid chyme is
squirted against the anterolateral wall of the first part of the duodenum
13. Appendicitis
a. Afferent pain fibers enter the spinal cord at the level of the 10th thoracic
segment, and a vague referred pain is felt in the region of the umbilicus
b. Later, the pain shifts to where the inflamed appendix irritates the parietal
peritoneum. Here the pain is precise, severe, and localized
14. Colitis
c.
15. Colectomy
a. Cancer of the large bowel
b. Minimally invasive laparoscopic surgery
c. Lymph vessels and nodes removed too
16. Ileostomy
a. Small intestine brought out to skin; collected in pouch
b. Usually done in groin on right side
c. Ulcerative colitis; Hirschprung's disease (megacolon)
17. Colonoscopy
a. Colorectal cancer is a leading cause of death in the Western world
b. Bowels washed, patient sedated, tube inserted
c.
18. Rupture of spleen
a. Associated with mononucleosis
b. Requires immediate medical and surgical attention
c. Severe blood loss (shock)