WBR0807: Difference between revisions
Jump to navigation
Jump to search
Rim Halaby (talk | contribs) No edit summary |
Sergekorjian (talk | contribs) No edit summary |
||
| Line 1: | Line 1: | ||
{{WBRQuestion | {{WBRQuestion | ||
|QuestionAuthor={{ | |QuestionAuthor={{YD}} (Reviewed by Serge Korjian) | ||
|ExamType=USMLE Step 1 | |ExamType=USMLE Step 1 | ||
|MainCategory=Histology | |MainCategory=Histology | ||
| Line 8: | Line 8: | ||
|MainCategory=Histology | |MainCategory=Histology | ||
|SubCategory=Gastrointestinal | |SubCategory=Gastrointestinal | ||
|MainCategory=Histology | |||
|MainCategory=Histology | |MainCategory=Histology | ||
|MainCategory=Histology | |MainCategory=Histology | ||
| Line 20: | Line 21: | ||
|MainCategory=Histology | |MainCategory=Histology | ||
|SubCategory=Gastrointestinal | |SubCategory=Gastrointestinal | ||
|Prompt=A 52 year old construction worker with no significant past medical history presents to the physician's office | |Prompt=A 52-year-old construction worker with no significant past medical history presents to the physician's office with complaints of right inguinal pain. The patient reports that his pain gradually worsens during the day and is worst at night. It is relieved almost completely when he lies down. Physical examination is remarkable for a bulge in the right inguinal region. The patient is diagnosed with a direct inguinal hernia bulging from the Hasselbach's triangle. Which anatomic structure most likely defines the medial aspect of the patient's hernia? | ||
|Explanation=The patient presents with symptoms typical of direct inguinal hernia. Direct hernias bulge through the external superficial inguinal ring and occur secondary to abdominal wall weakness that occurs at old age. DIrect hernias are most commonly present in the Hasselbach's triangle, a unique region that lies low in the posterior aspect of the anterior abdomen lined medially by the rectus abdominis muscle, inferiorly by the inguinal ligament, and laterally by the inferior epigastric vein and artery. | |Explanation=The patient presents with symptoms typical of direct inguinal hernia. Direct hernias bulge through the external superficial inguinal ring and occur secondary to abdominal wall weakness that occurs at old age. DIrect hernias are most commonly present in the Hasselbach's triangle, a unique region that lies low in the posterior aspect of the anterior abdomen lined medially by the rectus abdominis muscle, inferiorly by the inguinal ligament, and laterally by the inferior epigastric vein and artery. In contrast, indirect inguinal hernias are common at young age; they occur due to the persistence of the processus vaginalis. Patients present with a bulge protruding from the internal deep inguinal ring. | ||
In contrast, indirect inguinal hernias are common at young age; they occur due to the persistence of the processus vaginalis. Patients present with a bulge protruding from the internal deep inguinal ring. | |||
|AnswerA=Inguinal ligament | |AnswerA=Inguinal ligament | ||
|AnswerAExp=The inguinal ligament occupies the inferior aspect of the Hasselbach's triangle. | |AnswerAExp=The inguinal ligament occupies the inferior aspect of the Hasselbach's triangle. | ||
| Line 35: | Line 34: | ||
|AnswerEExp=The femoral vein occupies the lateral aspect of the femoral canal, a unique anatomic landmark that contains the femoral ring where femoral hernias are usually present. | |AnswerEExp=The femoral vein occupies the lateral aspect of the femoral canal, a unique anatomic landmark that contains the femoral ring where femoral hernias are usually present. | ||
|RightAnswer=B | |RightAnswer=B | ||
|WBRKeyword= | |WBRKeyword=Direct inguinal hernia, Hasselbach triangle, Indirect hernia, Hernia, Femoral, Rectus abdominis, Femoral vein, | ||
|Approved= | |Approved=Yes | ||
}} | }} | ||
Revision as of 19:47, 4 March 2015
| Author | [[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Serge Korjian)]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Histology |
| Sub Category | SubCategory::Gastrointestinal |
| Prompt | [[Prompt::A 52-year-old construction worker with no significant past medical history presents to the physician's office with complaints of right inguinal pain. The patient reports that his pain gradually worsens during the day and is worst at night. It is relieved almost completely when he lies down. Physical examination is remarkable for a bulge in the right inguinal region. The patient is diagnosed with a direct inguinal hernia bulging from the Hasselbach's triangle. Which anatomic structure most likely defines the medial aspect of the patient's hernia?]] |
| Answer A | AnswerA::Inguinal ligament |
| Answer A Explanation | AnswerAExp::The inguinal ligament occupies the inferior aspect of the Hasselbach's triangle. |
| Answer B | AnswerB::Rectus abdominis muscle |
| Answer B Explanation | AnswerBExp::The rectus abdominis muscle occupies the medial aspect of the Hasselbach's triangle. |
| Answer C | AnswerC::Inferior epigastric artery |
| Answer C Explanation | AnswerCExp::The inferior epigastric vessels occupy the lateral aspect of the Hasselbach's triangle. |
| Answer D | AnswerD::Inferior epigastric vein |
| Answer D Explanation | AnswerDExp::The inferior epigastric vessels occupy the lateral aspect of the Hasselbach's triangle. |
| Answer E | AnswerE::Femoral vein |
| Answer E Explanation | AnswerEExp::The femoral vein occupies the lateral aspect of the femoral canal, a unique anatomic landmark that contains the femoral ring where femoral hernias are usually present. |
| Right Answer | RightAnswer::B |
| Explanation | [[Explanation::The patient presents with symptoms typical of direct inguinal hernia. Direct hernias bulge through the external superficial inguinal ring and occur secondary to abdominal wall weakness that occurs at old age. DIrect hernias are most commonly present in the Hasselbach's triangle, a unique region that lies low in the posterior aspect of the anterior abdomen lined medially by the rectus abdominis muscle, inferiorly by the inguinal ligament, and laterally by the inferior epigastric vein and artery. In contrast, indirect inguinal hernias are common at young age; they occur due to the persistence of the processus vaginalis. Patients present with a bulge protruding from the internal deep inguinal ring. Educational Objective: |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::Direct inguinal hernia, WBRKeyword::Hasselbach triangle, WBRKeyword::Indirect hernia, WBRKeyword::Hernia, WBRKeyword::Femoral, WBRKeyword::Rectus abdominis, WBRKeyword::Femoral vein |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |