32 Questions
Where is the appendix attached to the caecum?
2cm below ileocaecal junction
What is the function of the mesoappendix?
To suspend the appendix
What is the approximate length range of the appendix?
7 to 11 cm
What represents McBurney’s point?
Junction of medial and lateral third of a line from umbilicus to right ASIS
What passes through the free margin of the mesoappendix?
Appendicular vessels
What guides the identification of the base of the appendix?
Taenia of caecum
What anatomical variation of the appendix is described as being least vascular and directed in various directions?
Mid-inguinal
What is the operation for the removal of the appendix called?
Appendectomy
Which of the following can lead to acute appendicitis?
Stricture of bowel
What is the classic symptom that shifts from periumbilical to right iliac fossa in appendicitis?
Periumbilical pain
Which clinical sign involves localized tenderness in the right iliac fossa?
Rebound tenderness
In which anatomical variation does the appendix pass upwards or towards the right?
Paracolic
What can occur if acute appendicitis is not managed properly?
Gangrenous appendicitis
Which sign is assessed by having the patient lift the right leg against resistance, causing friction of the psoas muscle over the inflamed appendix?
Psoas sign
Which layer of the appendix consists of lymphatic aggregations?
Submucosa
What is the canal within the narrow, tubular body of the appendix that opens into the caecum guarded by?
Mucous fold
Who first described the complete surgical removal of the gallbladder?
Langenbuch
When was the National Institutes of Health (NIH) Consensus Development Conference recognizing Laparoscopic Cholecystectomy as the new 'gold standard' for the treatment of gallstone disease?
1992
Which condition is NOT an indication for Laparoscopic Cholecystectomy according to the text?
Cholelithiasis
What was the first endoscopic cholecystectomy performed by?
Mühe
What percentage of patients have the classic anatomy of the biliary tree?
30%
Which structure forms the boundaries of Calot's triangle?
Cystic duct and cystic artery
What is the main indication for performing an intraoperative cholangiogram (IOC)?
To look for gallstones in the common bile duct
What is the risk of bile leak or biliary fistula after surgery?
0.5%
In which position should the patient be placed for the surgery?
Supine
How is the cystic duct divided during the surgery?
Simple ligature with vicryl
What is the technique used for dissection when Calot's triangle has dense adhesions?
Antegrade Cholecystectomy
What is considered for closure in complicated cases after hemostasis of gallbladder bed?
Inspection of stumps of cystic duct & cystic artery
'Kocher’s incision' or which other type of incision can be used for abdominal closure?
Midline incision
After how many hours post-operative should oral fluids be initiated for the patient?
4 hours
What is the main purpose of placing a small tube (catheter) into the cystic duct during surgery?
To inject dye to visualize the common bile duct
What is the primary goal of an intraoperative cholangiogram (IOC)?
To examine the anatomy of the biliary tree and identify any stones in the common bile duct
Test your knowledge of the anatomy of acute appendicitis with this quiz. Understand the structure and attachments of the appendix, including its suspension by the mesoappendix.
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