Appendicitis Flashcards Preview

Gastroenterology > Appendicitis > Flashcards

Flashcards in Appendicitis Deck (7)
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1
Q

Describe the anatomy of the appendix.

A

The appendix is a blind ending tube from 2-20cm in length (avg 9cm).
Arises from posteromedial wall of caecum.

2
Q

How may the appendix position vary anatomically?

A

Varies:

  • retrocaecal (65%)
  • pelvic (projects down) (31%)
  • subcaecal (immediately below caecum) (2%)
  • pre-ileal (front of terminal ileum) (1%)
  • post-ileal (behind ileum) (0.4%)
3
Q

How is the appendix supplied (vasculature)?

A
Appendicular artery (branch of ileocolic). 
Runs behind terminal ileum to reach base of appendix; extends to tip in mesoappendix.
4
Q

Describe the histology of the appendix.

A
  • Mucosa similar to colon: columnar with crypts and mucous secreting glands
  • Extensive lymphoid tissue in lamina propria (lymphocytes forming lymphoid follicles, eosinophils, macrophages).
  • Outer layers formed from inner (circular) and outer (longitudinal) smooth muscle of caecum. Covered by series.
5
Q

What is the patholophysiology of appendicitis?

A

obstruction of appendicular lumen (faecolith or oedema). Bacteria multiply distally increasing pressure. Blood supply compromised -> gangrene. May rupture OR be walled off by omentum and form an abscess.

6
Q

Describe the symptoms of appendicitis.

A

-Initial: visceral central abdominal pain; + anorexia, N/V
-Later: continued peritoneal irritation causes parietal pain in RIF.
May also have urinary symptoms if inflamed appendix is near to bladder/ureter.

7
Q

What are the examination features of appendicitis?

A

-Coated tongue and foul breath with mild pyrexia (classic but not always)
-Tenderness and guarding at McBurney’s point
(for appendix medial to caecum)