Anatomy of Acute Appendicitis
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Questions and Answers

Where is the appendix attached to the caecum?

  • 3cm below ileocaecal junction
  • 2cm above ileocaecal junction
  • 2cm below ileocaecal junction (correct)
  • At the ileocaecal junction

What is the function of the mesoappendix?

  • To aid in digestion
  • To regulate blood flow to the appendix
  • To guide the length of the appendix
  • To suspend the appendix (correct)

What is the approximate length range of the appendix?

  • 2 to 5 cm
  • 5 to 10 cm
  • 11 to 15 cm
  • 7 to 11 cm (correct)

What represents McBurney’s point?

<p>Junction of medial and lateral third of a line from umbilicus to right ASIS (C)</p> Signup and view all the answers

What passes through the free margin of the mesoappendix?

<p>Appendicular vessels (C)</p> Signup and view all the answers

What guides the identification of the base of the appendix?

<p>Taenia of caecum (D)</p> Signup and view all the answers

What anatomical variation of the appendix is described as being least vascular and directed in various directions?

<p>Mid-inguinal (B)</p> Signup and view all the answers

What is the operation for the removal of the appendix called?

<p>Appendectomy (C)</p> Signup and view all the answers

Which of the following can lead to acute appendicitis?

<p>Stricture of bowel (A)</p> Signup and view all the answers

What is the classic symptom that shifts from periumbilical to right iliac fossa in appendicitis?

<p>Periumbilical pain (C)</p> Signup and view all the answers

Which clinical sign involves localized tenderness in the right iliac fossa?

<p>Rebound tenderness (A)</p> Signup and view all the answers

In which anatomical variation does the appendix pass upwards or towards the right?

<p>Paracolic (B)</p> Signup and view all the answers

What can occur if acute appendicitis is not managed properly?

<p>Gangrenous appendicitis (A)</p> Signup and view all the answers

Which sign is assessed by having the patient lift the right leg against resistance, causing friction of the psoas muscle over the inflamed appendix?

<p>Psoas sign (B)</p> Signup and view all the answers

Which layer of the appendix consists of lymphatic aggregations?

<p>Submucosa (D)</p> Signup and view all the answers

What is the canal within the narrow, tubular body of the appendix that opens into the caecum guarded by?

<p>Mucous fold (D)</p> Signup and view all the answers

Who first described the complete surgical removal of the gallbladder?

<p>Langenbuch (A)</p> Signup and view all the answers

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?

<p>1992 (D)</p> Signup and view all the answers

Which condition is NOT an indication for Laparoscopic Cholecystectomy according to the text?

<p>Cholelithiasis (C)</p> Signup and view all the answers

What was the first endoscopic cholecystectomy performed by?

<p>Mühe (C)</p> Signup and view all the answers

What percentage of patients have the classic anatomy of the biliary tree?

<p>30% (A)</p> Signup and view all the answers

Which structure forms the boundaries of Calot's triangle?

<p>Cystic duct and cystic artery (A)</p> Signup and view all the answers

What is the main indication for performing an intraoperative cholangiogram (IOC)?

<p>To look for gallstones in the common bile duct (C)</p> Signup and view all the answers

What is the risk of bile leak or biliary fistula after surgery?

<p>0.5% (A)</p> Signup and view all the answers

In which position should the patient be placed for the surgery?

<p>Supine (A)</p> Signup and view all the answers

How is the cystic duct divided during the surgery?

<p>Simple ligature with vicryl (A)</p> Signup and view all the answers

What is the technique used for dissection when Calot's triangle has dense adhesions?

<p>Antegrade Cholecystectomy (D)</p> Signup and view all the answers

What is considered for closure in complicated cases after hemostasis of gallbladder bed?

<p>Inspection of stumps of cystic duct &amp; cystic artery (A)</p> Signup and view all the answers

'Kocher’s incision' or which other type of incision can be used for abdominal closure?

<p>Midline incision (D)</p> Signup and view all the answers

After how many hours post-operative should oral fluids be initiated for the patient?

<p>4 hours (D)</p> Signup and view all the answers

What is the main purpose of placing a small tube (catheter) into the cystic duct during surgery?

<p>To inject dye to visualize the common bile duct (C)</p> Signup and view all the answers

What is the primary goal of an intraoperative cholangiogram (IOC)?

<p>To examine the anatomy of the biliary tree and identify any stones in the common bile duct (C)</p> Signup and view all the answers

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