__________ is the herniation of abdominal viscera through the abdominal wall at the point of junction of umbilical cord and abdomen.?

Appeared in: AIIMS BHOPAL NO- 2018( Shift-2nd)

Explanation

Omphalocele is defined as the herniation of abdominal contents into the base of the umbilical cord.
The herniated organs are covered by a sac composed of peritoneum and amnion.
The defect occurs at the umbilical ring, where the umbilical cord meets the abdomen.
This condition is distinct from other neural tube defects and other abdominal wall defects like gastroschisis.

Option A: Meningocele is a neural tube defect, not an abdominal wall defect. It involves the protrusion of the meninges (membranes covering the spinal cord) through an opening in the spine.
Option B: Myelomeningocele is the most severe form of spina bifida. It involves the protrusion of both the meninges and the spinal cord through an opening in the spine. It is a defect of the vertebral column, not the abdomen.
Option D: Spina bifida is a broad term for a range of birth defects affecting the spinal column. The options meningocele and myelomeningocele are specific types of spina bifida. It does not involve herniation of abdominal contents.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Congenital abdominal wall defects as background academic context rather than a clinical decision trigger.
Immediate nursing priority for a newborn with omphalocele is to protect the sac from injury, drying, and infection by covering it with a sterile, saline-soaked dressing.
Nurses must closely monitor the infant for signs of hypothermia, dehydration, and infection, as the exposed sac can lead to significant heat and fluid loss.
What if? If the sac ruptures before or during delivery, the risk of infection and damage to the organs increases dramatically. The infant would require immediate sterile wrapping of the exposed organs and urgent surgical intervention.

How to Approach the Question

First, analyze the keywords in the question: 'herniation,' 'abdominal viscera,' 'abdominal wall,' and 'junction of umbilical cord.'
These keywords point to a defect at the navel involving the intestines or other abdominal organs.
Next, evaluate the options. Recognize that 'Meningocele,' 'Myelomeningocele,' and 'Spina bifida' all relate to defects of the spine (neural tube defects).
Eliminate the options related to the spine, as the question clearly specifies an abdominal wall defect at the umbilicus.
This process of elimination leaves 'Omphalocele,' which correctly describes the herniation of abdominal contents into the base of the umbilical cord.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1142-1144

Practise the full AIIMS BHOPAL NO- 2018( Shift-2nd)

Attempt every question from this paper in a timed mock, then review the full solution for each one.