PEDIATRICS an der Our Lady Of Fatima University | Karteikarten & Zusammenfassungen

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Both a multifactorial threshold model and autosomal __________ with incomplete penetrance and sex influence have been suggested as an explanation for this pattern of inheritance.

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dominance

-There is some genetic risk incurred for siblings of patients with inguinal hernias; the sisters of affected girls are at the highest risk, with a relative risk of 17.8. In general, the risk of brothers of a sibling is approximately 4-5, as is the risk of a sister of an affected brother. 

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TESTE DEIN WISSEN

 The PV in girls extends into the labia majora through the inguinal canal and is also known as the canal of ________? 

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Nuck.

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TRUE OR FALSE?

Androgenic hormones, adequate end-organ receptors, and mechanical factors such as increased intra-abdominal pressure influence complete descent of the testis through the inguinal canal. 


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TRUE

Involution of the left-sided PV precedes that of the right; which is  consistent with the increased incidence of indirect inguinal hernias on the right side (60%).

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TESTE DEIN WISSEN

 The ________ nerve also has an important role: It 

innervates the cremaster muscle, which develops within the gubernaculum, and experimental division or injury to both nerves in the fetus prevents testicular descent.

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TESTE DEIN WISSEN

genitofemoral

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TRUE OR FALSE?

A direct inguinal hernia originates medial to the deep inferior epigastric vessels and is external to the cremasteric fascia; the hernia sac directly through the posterior wall of the inguinal canal. 

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TESTE DEIN WISSEN

TRUE

A femoral hernia originates medial to the femoral vein and descends inferior to the inguinal ligament along the femoral canal.

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The testis passes through the inguinal canal in a few days but takes about ______ wk to migrate from the external ring to the scrotum.

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TESTE DEIN WISSEN

4  weeks

-The cord-like structures of the gubernaculum occasionally pass to ectopic locations (perineum or femoral region), resulting in ectopic testes.

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TESTE DEIN WISSEN

 In girls, the PV obliterates ______ at approximately 7 mo of gestation, and may explain why girls demonstrate a much lower incidence of inguinal hernia.

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TESTE DEIN WISSEN

earlier

 Failure of the PV to close permits fluid or abdominal viscera to escape the peritoneal cavity into the extraabdominal inguinal canal and accounts for a variety of inguinal–scrotal abnormalities seen in infancy and childhood

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TESTE DEIN WISSEN

The ovaries descend into the pelvis from the _______ but do not exit from the abdominal cavity. 

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urogenital ridge

-The cranial portion of the gubernaculum in girls differentiates into the ovarian ligament, and the inferior aspect of the gubernaculum becomes the round ligament, which passes through the internal ring and attaches to the labia majora

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TESTE DEIN WISSEN

Approximately 50% of inguinal hernias manifest clinically in the 1st yr of life, most in the 1st _______ mo.

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TESTE DEIN WISSEN

6 months  

-Premature infants have an incidence of 

inguinal hernia approaching 30%. The risk of incarceration and possible strangulation of an inguinal hernia is also greatest in the 1st yr of life (30-40%) and mandates prompt identification and operative repair to minimize morbidity and complications.


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TESTE DEIN WISSEN

Indirect inguinal hernias in infants and children are congenital and result from an __________; failure of obliteration of the PV rather than a weakness in the inguinal musculature.

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TESTE DEIN WISSEN

arrest of embryologic development 


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TESTE DEIN WISSEN

 The testes descend from the ________ in the retroperitoneum to the area of the internal ring by about 28 wk of gestation. 

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urogenital ridge 

The final descent of the testes into the scrotum occurs late in gestation between weeks 28 and 36.

 The testis is preceded in descent to the scrotum by the gubernaculum and the PV. The PV, an outpouring of peritoneum in the lower abdomen, is present in the developing fetus at 12 wk gestation that develops 

lateral to the deep inferior epigastric vessels and descends anteriorly along the spermatic cord within the cremasteric fascia through the internal inguinal ring. The testis accompanies the PV as it exits the abdomen and descends into the scrotum. 

Lösung ausblenden
TESTE DEIN WISSEN

The overwhelming majority of inguinal hernias in infants and children are congenital indirect hernias (99%) as a consequence of a patent___________ a developmental structure important in testicular descent. 

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TESTE DEIN WISSEN

 processus vaginalis (PV);

-The incidence of inguinal hernia in children is up to 

10 times higher in boys than in girls. Two other types of inguinal hernia are direct (acquired) hernia (0.5-1.0%) and femoral hernia (<0.5%). 

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Q:

Both a multifactorial threshold model and autosomal __________ with incomplete penetrance and sex influence have been suggested as an explanation for this pattern of inheritance.

A:

dominance

-There is some genetic risk incurred for siblings of patients with inguinal hernias; the sisters of affected girls are at the highest risk, with a relative risk of 17.8. In general, the risk of brothers of a sibling is approximately 4-5, as is the risk of a sister of an affected brother. 

Q:

 The PV in girls extends into the labia majora through the inguinal canal and is also known as the canal of ________? 

A:

Nuck.

Q:

TRUE OR FALSE?

Androgenic hormones, adequate end-organ receptors, and mechanical factors such as increased intra-abdominal pressure influence complete descent of the testis through the inguinal canal. 


A:

TRUE

Involution of the left-sided PV precedes that of the right; which is  consistent with the increased incidence of indirect inguinal hernias on the right side (60%).

Q:

 The ________ nerve also has an important role: It 

innervates the cremaster muscle, which develops within the gubernaculum, and experimental division or injury to both nerves in the fetus prevents testicular descent.

A:

genitofemoral

Q:

TRUE OR FALSE?

A direct inguinal hernia originates medial to the deep inferior epigastric vessels and is external to the cremasteric fascia; the hernia sac directly through the posterior wall of the inguinal canal. 

A:

TRUE

A femoral hernia originates medial to the femoral vein and descends inferior to the inguinal ligament along the femoral canal.

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Q:

The testis passes through the inguinal canal in a few days but takes about ______ wk to migrate from the external ring to the scrotum.

A:

4  weeks

-The cord-like structures of the gubernaculum occasionally pass to ectopic locations (perineum or femoral region), resulting in ectopic testes.

Q:

 In girls, the PV obliterates ______ at approximately 7 mo of gestation, and may explain why girls demonstrate a much lower incidence of inguinal hernia.

A:

earlier

 Failure of the PV to close permits fluid or abdominal viscera to escape the peritoneal cavity into the extraabdominal inguinal canal and accounts for a variety of inguinal–scrotal abnormalities seen in infancy and childhood

Q:

The ovaries descend into the pelvis from the _______ but do not exit from the abdominal cavity. 

A:

urogenital ridge

-The cranial portion of the gubernaculum in girls differentiates into the ovarian ligament, and the inferior aspect of the gubernaculum becomes the round ligament, which passes through the internal ring and attaches to the labia majora

Q:

Approximately 50% of inguinal hernias manifest clinically in the 1st yr of life, most in the 1st _______ mo.

A:

6 months  

-Premature infants have an incidence of 

inguinal hernia approaching 30%. The risk of incarceration and possible strangulation of an inguinal hernia is also greatest in the 1st yr of life (30-40%) and mandates prompt identification and operative repair to minimize morbidity and complications.


Q:

Indirect inguinal hernias in infants and children are congenital and result from an __________; failure of obliteration of the PV rather than a weakness in the inguinal musculature.

A:

arrest of embryologic development 


Q:

 The testes descend from the ________ in the retroperitoneum to the area of the internal ring by about 28 wk of gestation. 

A:

urogenital ridge 

The final descent of the testes into the scrotum occurs late in gestation between weeks 28 and 36.

 The testis is preceded in descent to the scrotum by the gubernaculum and the PV. The PV, an outpouring of peritoneum in the lower abdomen, is present in the developing fetus at 12 wk gestation that develops 

lateral to the deep inferior epigastric vessels and descends anteriorly along the spermatic cord within the cremasteric fascia through the internal inguinal ring. The testis accompanies the PV as it exits the abdomen and descends into the scrotum. 

Q:

The overwhelming majority of inguinal hernias in infants and children are congenital indirect hernias (99%) as a consequence of a patent___________ a developmental structure important in testicular descent. 

A:

 processus vaginalis (PV);

-The incidence of inguinal hernia in children is up to 

10 times higher in boys than in girls. Two other types of inguinal hernia are direct (acquired) hernia (0.5-1.0%) and femoral hernia (<0.5%). 

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