USMLE Step 1 Web Prep Abdomen, Pelvis, and Perineum: Part I

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Abdomen, Pelvis, and Perineum

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Fascias of S erma!ic "ord S erma!ic fascia - an abdominal wall derivative E#!ernal s erma!ic fascia - external abdominal oblique fa !ia "remas!eric fascia - internal abdominal oblique fa !ia In!ernal s erma!ic fascia - tran ver ali fa !ia

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Descen! of !$e %es!es "#e tuni!a va$inali i a remnant of %arietal %eritoneum &'i$ure 111-3-5(:

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"linical "orrela!e )ot# direc! and indirec! in$uinal #ernia %a t#rou$# t#e su erficial in$uinal rin$* +nl, indirec! in$uinal #ernia %a t#rou$# t#e dee% in$uinal rin$* -ire!t in$uinal #ernia u uall, %a t#rou$# t#e in$uinal trian$le: .ateral border: inferior /%i$a tri! ve el 0edial border: re!tu femori 1nferior border: in$uinal li$ament

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1n$uinal #ernia %a

"linical "orrela!e above t#e in$uinal li$ament*

'emoral #ernia %a

belo( t#e in$uinal li$ament*

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Adul! S!ruc!ures Derived from Eac$ of !$e %$ree Divisions of !$e Primi!ive *u! %ube Fore+u! ,"eliac /id+u! ,Su erior /esen!eric 1ind+u! ,Inferior /esen!eric %run-. Ar!er0. Ar!er0. / o%#a$u 3toma!# -uodenum 1 t %art .iver "able 111-3-1*
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-uodenum 2nd2 3rd 2 4t# %art 4e5unum 1leum 6e!um

"ran ver e !olon &di tal t#ird( -e !endin$ !olon 3i$moid !olon 7e!tum

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Adul! S!ruc!ures Derived from Eac$ of !$e %$ree Divisions of !$e Primi!ive *u! %ube Fore+u! ,"eliac /id+u! ,Su erior /esen!eric 1ind+u! ,Inferior /esen!eric %run-. Ar!er0. Ar!er0. 8an!rea )iliar, a%%aratu :all bladder "able 111-3-1*
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9%%endix 9 !endin$ !olon "ran ver e !olon &%roximal two t#ird (

9nal !anal &u%%er %art(

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Annular Pancreas +!!ur w#en t#e ventral and dor al %an!reati! bud form a rin$ around t#e duodenum2 t#ereb, !au in$ an ob tru!tion of t#e duodenum* Duodenal A!resia +!!ur w#en t#e lumen of t#e duodenum i o!!luded owin$ to failed re!anali;ation* "#i !ondition i a o!iated wit# %ol,#,dramnio 2 bile-!ontainin$ vomitu 2 and a di tended toma!#*
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3m $alocele +!!ur w#en t#e mid$ut loo% fail to return to t#e abdominal !avit,2 formin$ a li$#t $ra, #in, a! at t#e ba e of t#e umbili!al !ord filled wit# loo% of mall inte tine*
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Ileal ,/ec-el. Diver!iculum +!!ur w#en a remnant of t#e vitelline du!t %er i t 2 t#ereb, formin$ a blind %ou!# on t#e antime enteri! border of t#e ileum* "#i !ondition i often a ,m%tomati! but o!!a ionall, be!ome inflamed if it !ontain e!to%i! $a tri!2 %an!reati!2 or endometrial ti ue2 w#i!# ma, %rodu!e ul!eration*
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4i!elline Fis!ula +!!ur w#en t#e vitelline du!t %er i t 2 t#ereb, formin$ a dire!t !onne!tion between t#e inte tinal lumen and t#e out ide of t#e bod, at t#e umbili!u * "#i !ondition i a o!iated wit# draina$e of me!onium from t#e umbili!u *
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/alro!a!ion of /id+u! +!!ur w#en t#e mid$ut under$oe onl, %artial rotation and re ult in abnormal %o ition of abdominal vi !era* "#i !ondition ma, be a o!iated wit# volvulu &twi tin$ of inte tine (*
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"olonic A+an+lionosis ,1irsc$s run+ Disease. 7e ult from t#e failure of neural !re t !ell to form t#e m,enteri! %lexu in t#e i$moid !olon and re!tum* "#i !ondition i a o!iated wit# lo of %eri tal i 2 fe!al retention2 and abdominal di tention*
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/a6or Peri!oneal 3r+ans

In A 5u!s$ell /a6or Secondar0 7e!ro eri!oneal 3r+ans 0o t of duodenum 0o t of %an!rea 9 !endin$ !olon -e !endin$ !olon <%%er re!tum

3toma!# .iver and $allbladder 3%leen )e$innin$ of duodenum "ail of %an!rea 4e5unum 1leum 9%%endix "ran ver e !olon 3i$moid !olon

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In A 5u!s$ell /a6or Primar0 7e!ro eri!oneal 3r+ans

=idne, 9drenal $land <reter 9orta 1nferior vena !ava .ower re!tum 9nal !anal
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