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Thema 10: Het kleine bekken. Een complete samenvatting van alle tentamenstof!
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Op aanraden van mijn medestudenten verkoop ik nu mijn samenvattingen! In deze samenvatting maak ik veel gebruik van afbeeldingen, tabellen en opsommingen. Hierdoor hoef je geen lange lappen saaie en ingewikkelde tekst te lezen. In deze samenvatting staat alle stof van de boeken, colleges en leerdoe...

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  • 18 augustus 2022
  • 81
  • 2021/2022
  • Samenvatting

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Voorbeeld van de inhoud

Theme 10:


Problems in
the pelvis
Summary

,Inhoud
Week 37: Swelling of the groin and testes .............................................................................................. 5
Embryology.......................................................................................................................................... 5
Gonadal descent .............................................................................................................................. 5
Evagination of the abdominal wall .................................................................................................. 8
Further descend of the testes ......................................................................................................... 8
Abnormal descent ........................................................................................................................... 9
Anatomy ............................................................................................................................................ 13
Inguinal region ............................................................................................................................... 16
Posterior abdominal wall .............................................................................................................. 19
The pelvis ....................................................................................................................................... 21
Hernias and the groin problems ........................................................................................................ 23
Lumps in the groin ......................................................................................................................... 23
Inguinal hernia ............................................................................................................................... 24
Femoral hernia .............................................................................................................................. 24
Enlarges inguinal lymph nodes ...................................................................................................... 25
Saphena varix ................................................................................................................................ 25
Femoral artery aneurysm .............................................................................................................. 25
Psoas abscess ................................................................................................................................ 26
Chronic groin pain ......................................................................................................................... 26
Ventral hernias .............................................................................................................................. 26
Gastroschisis .................................................................................................................................. 27
Omphalocele ................................................................................................................................. 27
Umbilical hernia............................................................................................................................. 28
Disorders of the scrotal contents ...................................................................................................... 29
Male sterilisation ........................................................................................................................... 31
Disorders of the penis ....................................................................................................................... 32
Phimosis......................................................................................................................................... 32
Paraphimosis ................................................................................................................................. 33
Balanoposthitis (balanitis) ............................................................................................................. 33
Circumcision .................................................................................................................................. 34
Megaprepuce (megaforeskin) ....................................................................................................... 34
Micropenis ..................................................................................................................................... 35
Peyronie disease ............................................................................................................................ 36
Carcinoma of the penis.................................................................................................................. 36
Priapism ......................................................................................................................................... 36

, Erectile dysfunction ....................................................................................................................... 36
Hypospadias .................................................................................................................................. 36
Epispadias ...................................................................................................................................... 37
Penile duplication .......................................................................................................................... 38
Acute surgical problems in children .................................................................................................. 39
Physiological differences between infants and adults .................................................................. 39
Surgical emergencies in the neonate ............................................................................................ 39
Abdominal emergencies in infants and young children ................................................................ 39
Abdominal emergencies in older children .................................................................................... 40
Week 38: Alarming test result cervical smear ....................................................................................... 41
Benign pelvic mass ............................................................................................................................ 42
Functional cysts ............................................................................................................................. 42
Mature teratoma ........................................................................................................................... 42
Cystadenoma ................................................................................................................................. 42
Ovarian fibroma............................................................................................................................. 43
Endometrioma ............................................................................................................................... 43
Risk of malignancy index ............................................................................................................... 43
Ovarian torsion .............................................................................................................................. 44
Spontaneous rupture of an ovarian cyst ....................................................................................... 44
Ovarian cysts during pregnancy .................................................................................................... 44
Cervical premalignancies and cervical cancer ................................................................................... 45
Uterine cancer and premalignant lesions ......................................................................................... 51
Ovarian cancer................................................................................................................................... 54
Vulvar cancer and vulvar premalignancies........................................................................................ 56
Vaginal cancer ................................................................................................................................... 57
Pathology........................................................................................................................................... 58
Vulva .............................................................................................................................................. 58
Vagina ............................................................................................................................................ 58
Cervix ............................................................................................................................................. 58
Body of the uterus (myometrium) and endometrium .................................................................. 58
Ovaries ........................................................................................................................................... 59
Week 39: Incontinence and prolapse.................................................................................................... 60
Propulsion and mixing of food in the alimentary tract ..................................................................... 60
Ingestion of food ........................................................................................................................... 60
Motor functions of the stomach ................................................................................................... 60
Movements of the small intestine ................................................................................................ 60

, Movements of the colon ............................................................................................................... 60
Normal micturition ............................................................................................................................ 62
Functional anatomy ....................................................................................................................... 62
Urinary incontinence, bladder- and pelvic floor disorders ............................................................... 66
Urinary incontinence ..................................................................................................................... 66
Bladder dysfunction ...................................................................................................................... 66
Pelvic floor disorders ..................................................................................................................... 67
Pelvic organ prolapse ........................................................................................................................ 68
Functional anatomy ....................................................................................................................... 68
Presentation .................................................................................................................................. 69
Classification .................................................................................................................................. 69
Normal defecation............................................................................................................................. 73
Anatomy ........................................................................................................................................ 73
Abnormal defaecation ....................................................................................................................... 75
Constipation .................................................................................................................................. 75
Obstructed defaecation................................................................................................................. 75
Faecal incontinence ....................................................................................................................... 75
Relation other pelvic organs.......................................................................................................... 76
Anal and perianal disorders............................................................................................................... 77
Haemorrhoids ................................................................................................................................ 77
Perianal abcess .............................................................................................................................. 77
Perianal fistula ............................................................................................................................... 78
Anal fissure .................................................................................................................................... 79
Sinus pilonidalis.............................................................................................................................. 80
External rectal prolapse................................................................................................................. 80
Anal carcinoma .............................................................................................................................. 80
Proctalgia fugax ............................................................................................................................. 81
Pruritis Ani ..................................................................................................................................... 81
Treating function: do’s and don’t .................................................................................................. 81

,Week 37: Swelling of the groin and testes
Embryology
Gonadal descent
- Testes = intraperitoneal
- Gonads develop in the posterior abdominal wall: superior lumbar region = pelvic
region
- Inguinal canal acts as a passage for the testes to descend into the scrotum =
entrance: fascia transversalis and exit: external oblique muscle
- Gubernaculum attaches to inferior pole of the gonads and helps guide their descent
into the scrotum/pelvis
- Formation of processes vaginalis: an outpouching of the peritoneum through the
anterior abdominal musculature
➔ Takes layers of the abdominal wall with it = creation of the inguinal canal

,Males:

• Gubernaculum projects through the peritoneal cavity between the abdominal
wall musculature into the labioscrotal swellings
• The pathway formed guides the descent of the gonads
• Testes descend between the processes vaginalis and the muscular layers of the
anterior abdominal wall into the scrotal sac
Females:

• Descent of the gonads is considerably less
• Gubernaculum attaches to the primordial ovaries and the future labia majora
• Finally, the ovaries lie just below the rim of the pelvis laterally within the pelvic cavity
• Gubernaculum forms the round ligament, extending into the labia majora →
protrusion of the peritoneum: Canal of Nuck

,
, Evagination of the abdominal wall
The gubernaculum is accompanied by an extension of the parietal cavity caller the process
vaginalis → will become the tunica vaginalis layers that cover the testes




Further descend of the testes
- Transversalis fascia is stretched and pushed ahead of the process vaginalis towards
the labia scrotal swellings → outpouching of the transversalis fascia will create the
deep inguinal ring
- Internal abdominal oblique: also be drawn toward the labioscrotal swellings →
cremasteric muscle
- External abdominal oblique: will form the superficial ring

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