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33 Cards in this Set
- Front
- Back
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What are the boundaries of the inguinal canal? |
Floor: Inguinal ligament Roof: Internal oblique and transversus abdominis muscles Anterior: External oblique aponeurosis and internal oblique muscle Posterior: Transversalis fascia and conjoint tendon |
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What are the payers of the inguinal canal (from superficial to deep)? |
1. External oblique aponeurosis (forms inguinal ligament) 2. Internal oblique muscle (covers deep inguinal ring anteriorly) 3. transversus abdominis muscle 4. Transversalis fascia (contains the opening for the deep inguinal ring) |
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What is the relationship between a previous appendectomy and a right sided inguinal hernia? |
The right ilioinguinal nerve (L1) may be damaged during an open appendectomy --> weakness of the shutter-effect of the arching fibres of transversus abdominis and internal oblique |
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What prevents abdominal contents herniating through the inguinal canal when intra-abdominal pressure rises? |
Lower fibres of transversus abdominis and internal oblique arch over the inguinal canal and contract when intra-abdominal pressure increases (e.g. straining) |
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What is the contents of the spermatic cord? |
Contents (rule of 3s): 3 arteries: cremasteric, deferential artery, testicular 3 nerves: genital branch of the genitofemoral nerve, autonomic, ilioinguinal 3 fascial layers: external spermatic (from EO), cremasteric (from IO), internal spermatic (from TA) 3 other structures: pampiniform plexus, vas deferens, testicular lymphatics |
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Hesselbach’s triangle is bounded by: |
1. Rectus abdominis 2. Inferior epigastric artery 3. Iinguinal ligament |
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What is the difference between a direct and an indirect hernia? |
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What is the relationship of an inguinal vs femoral hernia to the pubic tubercle? |
• An inguinal hernia is above and medial to the pubic tubercle • A femoral hernia is below and lateral to the pubic tubercle |
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Boundaries of the femoral ring are: |
the inguinal ligament (anteriorly), pectineus muscle (posteriorly), femoral vein (medially) and the lacunar ligament (laterally) |
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What is the blood supply to the adenohypophesis and neurohypophesis of the pituitary? |
ICA --> inferior hypophyseal artery --> neurohypophysis Posterior communicating artery + ICA --> Superior hypophyseal artery --> adenohypophysis |
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Describe the pathway after GHRH is released |
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What pathologies can result from disruptions to the GH secretion pathway? |
Dwarfism (insensitivity to IGF), gigantism, acromegaly |
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Which cells produce testosterone in the male and what are they stimulated by? |
GnRH --> LH --> leydig cells --> testosterone |
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Which cells produce sperm in the male and what are they stimulated by? |
Sertoli cells are stimulated by FSH and testosterone for spermatogenesis |
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What is the function of vasopressin (ADH)? |
Increase water resorption in distal tubule (allows water to move down its concentration gradient via aquaporins, from collecting duct into blood vessels) to decrease urine output, thereby increasing blood volume |
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What 3 main factors influence vasopressin (ADH) secretion, and what are they detected by? |
1. Plasma osmolarity - hypothalamic osmoreceptors 2. Blood volume - atrial stretch receptors 3. Blood pressure - carotid and aortic baroreceptors |
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What effect does puberty have on insulin? |
Transient insulin resistance secondary to increased GH |
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True of false - menarche (first mentruation) is usually anovulatory |
True |
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What is the mean age for menarche in Australia? |
12.3 years |
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What cells are effected by increased frequency and size of LH pulses from pituitary in puberty in males? |
Leydig cells stimulated to produce testosterone |
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What cells are mainly affected by increased frequency and size of FSH pulses from pituitary in males in puberty? |
Seminiferous tubules and Sertoli cells – increase in testicular size |
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What are the normal ages of onset and duration of puberty in males and females? |
› Normal range for onset 8 - 13 females › Normal range for onset 9-14 males › Duration 2 - 5 years |
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What is themost accurate tool to assess developmental age? |
Bone age - X-ray on hand/wrist |
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What is the average weight and height gained in puberty? |
› In about 2.5 years: › Boys gain 30cm and 30kg › Girls gain 20 cm and 20kg |
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What is the syndrome and chromosomal abnormality? Short stature Low set ears and hairline Ptosis Neck webbing Shield chest Increased carrying angle Partial or absent secondary sexual development Primary amenorrhoea Congenital cardiac valve lesions Absent or horseshoe kidney Conduction deafness Scoliosis Learning difficulties |
Turner syndrome - 45XO |
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What is the syndrome and chromosomal abnormality? Small testicles Tall stature Eunuchoid (long limbed) Gynaecomastia Failure to enter puberty Scoliosis Learning difficulties In less severe forms infertility may be the only symptom (azospermia) |
Kleinfelter syndrome - 47XXY |
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How can you use PICO when serching for studies on diagnostic tests? |
Population Prior test Index test Comparator Outcome or reference standard |
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Growth hormone receptors are present in most tissues of the body and their stimulation leads to production of _________. |
Insulin-like Growth Factor I (IGF-I) and the IGF binding proteins. |
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The pituitary fossa is bounded anteriorly and posteriorly by ______ and ________. |
the anterior and posterior clinoid processes, respectively |
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The roof of the pituitary fossa is formed by ______________, which has a small opening which is traversed by ___________. |
The sellar diaphragm The pituitary stalk |
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When a tumour compresses the pituitary stalk, loss of pituitary hormone secretion progresses in what order? |
1. gonadotropins, 2. growth hormone, 3. TSH and 4. ACTH. |
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Craniopharyngiomas are tumours arising from remnants of ________ which is the diverticulum at the roof of the mouth that usually gives rise to the anterior pituitary |
Rathke's pouch |
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What is the most common presentation of craniopharyngioma? |
Raised ICP |
