Incorrect passmed incorrect again Flashcards by Nathan Edgar

Compare the parasympathetic and sympathetic innervation to the lacriminal apparatus?

Parasympathetic - via the pterygopalatine ganglion

Sympathetic - deep petrosal nerve carries post ganglionic sympathetic fibres

The sympathetic fibres do not synapse, but the parasympathetic ones synapse in pterygopalatine apparatus

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What is most commonly used to sterilize endoscopic equipment?

Glutaraldehyde

It can cause hypersensitivity reactions

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Name the 4 nerve groups found in posterior triangle of neck?

Accessory nerve
Phrenic nerve
Brachial plexus (all 3 trunks)
Cervical plexus branches (supraclavicular nerve, transverse cervical nerve, great auricular nerve, lesser occipital nerve)

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Name the 2 vessels in posterior triangle of the neck?

External jugular vein
Subclavian artery

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Which bone condition causes low calcium, low phosphate and raised ALP?

Deficiency of what causes this?

What is the name of this condition if it occurs in children?

Osteomalacia

Vit D deficiency

Rickets in children

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What mnemonic is used to remember branches of posterior cord of brachial plexus?

STAR

Subscapular (upper and lower)
Thoracodorsal
Axillary
Radial

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Which 2 types of breast cancer is Pagets disease of the nipple associated with?

DCIS or invasive carcinoma

Eczema of the nipple tends to affect the areolar region and spares the nipple, while pagets affects nipple first

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Name the 2 most common locations for an ectopic testes to occur?

Superficial inguinal pouch
Base of the penis

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Which bone of the hand do the ulnar nerve and artery lie adjacent to?

Pisiform bone

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How should emergency presentations of poorly controlled colitis not responding to medical treatment be managed?

Sub total colectomy

Panprocolectomy (excision of rectum) has much higher morbidity and shouldnt be performed in emergency setting

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At the renal hilum, what lies most anteriorly?

Renal vein

The ureter lies most posteriorly, with the artery in the middle of the two

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Which nerve roots contribute fibres to the ansa cervicalis?

C1, C2, C3

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What is the mechanism of action of atropine?

Inhibits vagal tone

Results in increased heartrate

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Resection where in the GIT is most likely to increase risk of gallstone formation?

Ileal resection

Bile salt reabsorption occurs at the ileum

Therefore, cholesterol gallstones form as a result of ileal resection

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What is a testicular mass felt seperate to the testis in a young boy most likely to be?

Rhabdomyoscarcoma

Most often arise in distal portion of spermatic cord and may invade surrounding structures

Arise from mesenchymal tissues

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Compare management for retractile testis and completely impalpable testis?

Retractile testis - close observation and reassessment

Impalpable testis - laparoscopy

Testis should hahve descended by 3 months of age

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Name the 4 substances released from Islets of Langerhan cells?

Pancreatic polypeptide (F cells)
Glucagon (alpha cells)
Somatostatin (delta cells)
Insulin (beta cells)

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Compare what fissures the optic nerve and opthalmic nerve pass through?

Optic nerve = optic canal

Ophthalmic nerve (V1) = superior orbital fissure

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Which splenic structure lies most posteriorly?

Lienorenal ligament

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Why may patients develop urinary retention following colon resections?

The parasympathetic nerves to the pelvic organs can be damaged in left sided distal colonic dissection

Parasympathetic nerves allow contraction of the detrusor muscle

Sympathetic nerves allow relaxation of the detrouser muscle

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What is the most likely lesion to occur at the cerebellopontine angle?

What cranial nerve is most likely to be affected?

Acoustic neuroma

Trigeminal nerve (CN V) most likely to be affected

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What is the correct investigation to be done in suspected lymphoma?

Excision biopsy of a lymph node

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What condition is suggested by delayed massage of meuconium?

What is first line investigation?

Hirschprung’s disease

Ix = Full thickness suction rectal biopsy

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Which vessel does the thyroidea ima arise from?

Brachiocephalic artery

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From what structure is the tunica vaginalis derived?

Peritoneum via processus vaginalis Tunica vaginalis secretes fluid that fills hydrocele cavity

What does the cephalic vein penetrate before draining into the axillary vein?

Coracoid membrane - a continuation of the clavipectoral fascia Then, the cephalic vein drains into axillary vein

Which structure is central tendon of diaphragm derived?

Septum transversum

Should right sided colonic cancers w LN involvement get radiotherapy first line?

No- radiotherapy is poorly tolerated Proceed straight to right hemicolectomy

Name the 3 hamstring muscles, from lateral to medial?

Biceps femoris Semitendinosus Semimembranosus

Which lymph node does prostate cancer spread to first?

Obturator nodes

What artery does the inferior epigastric artery originate from?

External iliac artery

Is the squamous epithelium normally lining the oesophagus keratinised or non-keratinised?

Non-keratinised !!

Describe the relations of the cervical sympathetic chain and the ansa cervicalis to the carotid sheath at C6?

Ansa cervicalis crosses carotid sheath anteriorly Cervical sympathetic chain sits posterior between sheath and prevertebral fascia

What is the mechanism of action of macrolides and tetracyclines?

Inhibits protein synthesis

Name the main structures found in the middle mediastinum?

Mostly cardiac stuff Heart, aortic root, arch of azygous vein and Main bronchi bifurcation

Name the main structures in posterior mediastinum?

Mostly vessels and nerves Aorta, vena cava, oesophagus and brachiocephalic vein Vagus, L recurrent laryngeal, phrenic nerve Thoracic duct, splanchnic nerves, sympathetic nerve trunks

Name the main structures in anterior mediastinum?

Located in front of the heart - not much there... Fat, lymph nodes, thymic remnants

Name the cardiac specific contents of the superior mediastinum ?

Arch of aorta Superior vena cava

Which compartment of the mediastinum is the thymus located?

Anterior, extending into superior mediastinum

Compare the muscles that are most closely associated to the pudendal canal and sciatic foramen?

Pudendal canal = Obturator internus Sciatic foramen = Piriformis

In which hereditary condition are abnormally shaped RBCs prone to splenic sequestration and destruction? What may be seen on blood film?

Herediatry spherocytosis Blood film shows elliptical cells - may require splenectomy

Which part of the nephron is responsible for the most sodium reabsorption?

Proximal convoluted tubule is where most sodium reabsorption occurs

Which cytokine is responsible for inducing fever in inflammation?

IL 6 Released by macrophages which stimulates hypothalamus to induce fever

Name 2 classes of antibiotics that inhibit bacterial cell wall synthesis?

Penicillins Cephalosporins (ceftriaxone)

Which foramen does the facial nerve leave through?

Stylomastoid foramen

Which structure is most likely to be encountered during axillary dissection during axillary node clearance for breast cancer?

Thoracodorsal trunk It runs through the nodes in the axilla and if injured, may compromise the function and blood supply to lat dorsi

How should lesions below the peritoneal reflection that are causing obstruction generally be treated?

Loop colostomy A low anterior resection during the acute phase would likely end up with an anastamotic leak, so this should be delayed to a later date

Deficiency of which vitamin is seen in rickets?

Vit D

What ligament does Pringles manouvre clamp?

Hepatoduodenal ligament (contains portal vein, hepatic artery and CBD)

What is the name of the syndrome where gallstone becomes lodged in hartmas pouch, causing recurrent inflammation and compression of the bile duct ?

Mirizzi syndrome Calots triangle is usually completely obliterated Fitz hugh curtis syndrome occurs secondary to PID

Why is a loop ileostomy preferred to a loop colostomy in a patient with rectal cancer?

Loop ileostomy is away from the segment being operated on and also easier than a loop colostomy to reverse

Which structure separates the intervertebral discs from the spinal cord?

Posterior longitudinal ligament

What inflammatory mediator is involved in graft versus host disease?

Lymphocytic proliferation

Which structure is the tunica vaginalis derived from?

Peritoneum

Which brachial plexus cord gives rise to the axillary and radial nerve?

Posterior cord of brachial plexus

How are most patients who have bile leaks following cholecystectomy managed?

ERCP, sphincterotomy and stenting

Compare the drainage of the right and left adrenal glands?

Right adrenal - drains right into IVC Left adrenal - drains into left renal

What is the most common cause of osteolytic bone mets in children?

Neuroblastoma They have strong tendancy to develop widespead lytic mets

Innervation of long head of biceps femoris muscle?

Tibial division of the sciatic nerve The short head of biceps muscle is innervated by the common peroneal branch of sciatic nerve

Which part of the posterior rectus sheath is formed from internal oblique aponeurosis?

Posterior rectus sheath above arcuate line Posterior rectus sheath below the arcuate line contains only peritoneum and transversalis fascia - a weak wall prone to herniation

Which vessels are most closely related to the axillary nerve within the quadrangular space?

Posterior circumflex humeral vessels They are branches of the axillary artery

Compare the innervations of abductor pollicis longus and abductor pollicis brevis?

Abductor Pollicis Longus = radial nerve (via posterior interosseous branch) Abductor Pollicis Brevis = median nerve

What makes up posterior border of femoral canal?

Pectineal ligament Lacunar ligament makes up medial border

What is the longest part of the male urethra and which LN does it drain to?

Spongy urethra is the longest It drains to the deep inguinal LNs

Name the parts of the male urethra that drain to the internal iliac LNs and the parts that drain to the deep inguinal?

Deep inguinal LNs = spongy (longest) and glans penis Internal iliac = prostatic and membranous urethra

What part of the mediastinum houses the azygous vein?

Posterior mediastinum

Structure most likely to be damaged during needle thoracocentesis?

Intercostal nerve Neurovascular bundle lies posterior to rib, in VAN formation from superior to inferior

What 2 features are often associated with intestinal malrotation in neonates?

Congenital diaphragmatic hernia Exomphalos Tx of malrotaiton with Ladds procedure (laparotomy and division of adhesional bands)

Compare the cell types involved in acute and chronic inflammation?

Acute - neutrophils predominant Chronic- Macrophages, lymphocytes and plasma cells

Thyroid cancer associated with autoimmune thyroiditis?

Lymphoma AI thyroidits is the same as Hashimoto's thyroiditis Commonest sequale of thyroiditis is hypothyroidism

How does subacute thyroiditis affect the thyroid compared to AI thyroiditis?

Subacute thyroiditis = hyperthyroid Autoimmune thyroiditis = hypothyroid

What medication should be given in acute rises of ICP?

IV Mannitol Nimodipine is given to precent vasospasm in SAH

Describe the histology seen in hashimotos thyroidits?

Intense lymphocytic infiltrate with acinar destruction and fibrosis Lymphoma usually only presents with dense lymphatic tissue

Compare which amino acids are present in collagen and adrenaline?

Collagen = glycine Adrenaline = tyrosine

Most radiodense renal stone on XR?

Calcium phosphate Uric acid radiolucent

Which genetic syndrome is most likely to cause right sided colonic tumours that are poorly differentiated and mucinous?

Lynch syndrome

Incorrect passmed incorrect again Flashcards

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