Quick Notes
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Associated Anomalies with undescended testis:

-Epididymal anomalies and patent processus vaginalis upto 90%.

-Renal Anomalies in10% cases (Renal hypoplasia, agenesis,horseshoe kidney, PUJ obstruction)

-Hypospadias.

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Remember:

Development of the Thyroid Gland:
-The thyroid gland begins to develop during the third week as an entodermal thickening in the midline of the floor of the pharynx between the tuberculum impar and the copula.

-By the seventh week, it reaches its final position in relation to the larynx and trachea.

-The thyroid gland develops from a median down growth of a column of cells from the pharyngeal floor between the first and second pharyngeal pouches (subsequently marked by the foramen caecum of the tongue).


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The right supraclavicular node is called Scalene node.

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What is the bone that has not articulation with any bone?

-The hyoid bone is a mobile single bone found in the midline of the neck below the mandible and abides the larynx.
-It does not articulate with any other bones.


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INDICATIONS OF CBD EXPLORATION:

1. History of charcot’s triad
2. USG proven stones in CBD
3. Dilated CBD (>1cm)
4. OTCshows filling deffect
5. Palpable stones in CB.

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Amount of secretions of gut.

#Medicine
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Stomas.

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Stoma examination.

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Why is indirect inguinal hernia more common in right side ?

Due to delayed descend of right testis , slower closure of a patent processus vaginalis on the right side compared to the left.

It's almost about one month difference.

#Surgery
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Coverings of Testis:

1. Skin
2. Dartos muscle
3. Colle's fascia
4. External spermatic fascia
5. Cremasteric muscle & fascia
6. lnternal spermatic fascia
7. Tunica vaginalis (parietal & visceral layers).
8. Tunica albuginea (fibrous capsule).

#Surgery
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Remember:

-Hasselbach's triangle is also called triangle of Halshted, inguinal triangle.

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Nerve Suoply of GB:

1)Autonomic:-
Parasympathetic: hepatic branch of anterior vagus.
Sympathetic: from T7-9 (pain is reffered to inferior angle of right scapula).

2)Sensory:
-By the Right phrenic C3,4,5 (the same segments as the supra-clavicular nerves ) so pain in gall bladder is referred to right shoulder).

#Surgery
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What are the types of Direct inguinal hernia?

1-Medial
2-Lateral

#Surgery
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Remember:

-The ilioinguinal nerve is a branch of the first lumbar nerve (L1)

-Innervates Skin over the root of the penis and upper part of the scrotum (male), skin covering the mons pubis and labium majus (female).

-Motor innervation of the transverse abdominus and obliques.

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Remember:

-The Adductor canal is also called Hunter's canal or Sub-sartorial canal.

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Sciatic nerve.

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Femoral triangle.

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Femoral sheath.

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Femoral canal.
F. ring and S. opening.

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Adductor canal, popliteal fossa.

#Surgery
أهم علامة تدل أن الـ Foly's catheter بمكانها الصحيح؟

-Gush of urine.