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*During cholesystectomy with laparascopic procedure you can't observe?
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*Any structure that is retroperitoneal, like Pancreas(Except tail),IVC,Aorta,Ascending or descending colon(NOT transverse, so transverse part can actually be seen),from 2nd,3rd and 4th parts of duodenum,Kidneys,Esophagus,Rectum,Suprarenal glands.
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*With Portal hypertension, Splanchic vessels dilate and thus central venous pressure decreases...what does splanchic vessels mean?
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*Basically vessels supplying viscera of the abdomen,Mainly Celiac, SMA, IMA and all their branches, NOT renal veins/arteries.
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*Patient presents with jaundice associated with a mass located in the HEAD of the panceas, placement of stent in which duct could help to relieve his jaundice?
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 *MAIN pancreatic duct(derivative of VENTRAL pancreatic bud), which is likely compressed by the mass located in the head of the pancreas(Head is derived from BOTH Ventral and dorsal pancreatic buds)... |
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Baby is born with Hiatal hernia, the region that is herniated into the diaphragm is derived from?
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*FOREgut, Hiatal hernia is due to Herniation of proximal part of Stomach herniates trough the diaphragm..Remember that Foregut gives rise to region of GI from Esophagus to the UPPER part of the duodenum(1st and 2nd portions), note that Primary supply of Foregut is derived from CELIAC Artery. ....Pain is referred in the region of EPIGASTRIUM...Hiatal hernia(usually Cardia of stomach protrued trough diaphragmatic hiatus) can compress vagal trunks and lead to HYPOsecretion of gastric acid
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Lamina propria, muscularis mucosae, submucosa, muscularis externa, adventitia/serosa and epithelial lining of the mucosa of primitive gut...Embryologic origins?
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lamina propria, muscularis mucosae, submucosa, muscularis externa, and adventitia/serosa are all derived from MESOderm while Epithelial lining of the mucosa is derived from ENDOderm...
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*Patient with Sudden onset of rebound tenderness and pain in the UMBILICAL region..Embryologic origin/supply of the organ likely involved?
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*Patient likely has Appendicitis, Appendix is derived from MIDGUT and thus referred pain often involves UMBILICAL region.(Remember during 6 th week of development PHYSIOLOGIC midgut herniates trough the umbilical ring)..MIdgut gives rise to region of GI starting from LOWER Duodenum all the way TILL distal 1/3 of the transverse colon(So it gives rise to PROXIMAL 2/3 of the transverse colon), Vessel that supplies Midgut derivatives is SUPERIOR mesenteric artery....They also want you to know that during 10 th week Midgut goes back to the abdominal cavity and this is also the time when these organs acquire "Adult Positions" and this process needs 270 degree COUNTERclockwise rotation around SUPERIOR mesenteric artery....
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*How can embryology help you know the supply of Rectum ABOVE the pectinate line?
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*Just remember that region of Rectum ABOVE pectinate line belongs to HINDgut(extends from DISTAL 1/3 of transverse colon all the way down till Pectinate line, including the region of rectum ABOVE that line), then you got to remember that all organs of Hindgut are supplied by INFEROR mesenteric artery...Note that pain from organs of Hindgut can be referred to the HYPOGASTRIUM...
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*Lowe respiratory tract is derived from?
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FOREgut...
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*Newborn baby has Heart protrudes OUTSIDE the chest...Developmental defect?
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*DEFECT in closure of ROSTRAL Folds>STERNAL DEFECTS>Ectopia Cordis, basiaclly when heart is outside the chest...MESODERM layer is involed.
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*Baby with Trisomy 18 has herniation of Abdominal contents into the Umbilical cord, are these organs likely covered by peritoneum?
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*YES, Omphalocele(Herniation of abdominal organs into the umbilical cord covered by Peritoneum) is characteristic for Edwards syndrome(trisomy 18)...rmember Omphalocele is cOvered by peritoneum while Gastroschisis is NOT....HOWEVER both conditions are due to failure of LATERAL Fold CLOSURE...
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*Abdominal contents extruted trough trough abdominal contents and are NOT covered by peritoneum, describe location of protrusion relative to Umbilicus, what is primary defect?
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*Failure of Closure of LATERAL folds can lead to Omphalocele and Gastroschisis, our patient like has Gastroschisis because contents are NOT covered by peritoneum/Amnion, Primary defect is Failure of LATERAL folds to close...
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*Protrusion of Bladder trough abdominal wall is due to?
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*Failure of CAUDAL folds to close>Bladder exstrophy...
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*Baby born with Hernia protruding from umbilicus, mechanism? prognosis?
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*INCOMPLETE closure of Umbilical ring(Umbilical scar fails to form or it is weak), they do ask prognosis about this and MOST likely it will Close on its own...
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*Polyhydramnios in utero...That baby vomits/has excessive drooling with first feeding,X-ray shows gastric air bubbles...Mechanism of polyhydramnios?Clinical test you can perform?Mechanism of Cyanosis with feeding?
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*Failure of nasogastric tube into the stomach, could hep you with confirmation of your suspicion, however more than enough data is given for you to realize that patient likely has Tracheoesophageal fistula(Esophageal atresia+DISTAL TEF, basically proximal part of esophagus ends blindly while distal part connects to the Trachea, this type is known as Type C)..To prevent REFLUX-related aspiration-DUE TO LARYNGOSPASM....*Polyhydramnios=Too much amniotic fluid in the amniotic sac, here because baby can't properly drink it, so more of it stays out...
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Different types of esophageal abnormalities?
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 *Type A- Proximal and distal esophagus are formed but there is no middle part/Constrictiont(Pure esophageal ATRESIA, / stenosis), Type B is when ONLY proximal esophagus connects to trachea,Type D is when both parts of esophagus( Proximal and distal ) connect to the trachea,this is known as PURE TEF(H-type just resembles H:)...Type C is most common and is characterized by atresia of proximal part and Communication between DISTAL esophagus and trachea... |
