Neurovascular anatomy

Question 1

oesophagus arterial supply

Answer 1

upper third - inferior thyroid artery
middle third - oesophageal branch of descending aorta
lower third - left gastric artery

Question 2

oesophagus venous drainage

Answer 2

upper third - inferior thyroid
middle third - azygous
lower third - left gastric (portal) and azygous (systemic)

Question 3

oesophagus LN

Answer 3

upper third - deep cervical
middle third - mediastinal
lower third - left gastric + celiac

Question 4

oesophagus innervation

Answer 4

upper half - recurrent laryngeal
lower half - oesophageal plexus

Question 5

stomach arterial supply

Answer 5

generally:

right gastric - branch of proper hepatic artery - branch of CHA
left gastric - branch of coeliac trunk
right gastro-omental - branch of gastroduodenal - branch of CHA
left gastro omental - branch of splenic - branch of coeliac trunk

Question 6

branches of CHA

Answer 6

gastroduodenal artery
proper hepatic artery

Question 7

arterial supply of lesser curvature

Answer 7

right and left gastric artery

Question 8

arterial supply of greater curvature

Answer 8

right and left gastro-omental
short gastric arteries

Question 9

stomach innervation

Answer 9

parasympathetic
sympathetic t6-t9

Question 10

stomach lymphatic drainage

Answer 10

gastric LNs
gastro-omental LNs

Question 11

L.O.S in rolling hiatus hernia

Answer 11

in place
requires surgery more than sliding HH

Question 12

duodenum arterial supply

Answer 12

proximal to major duodenal papilla - gastroduodenal artery (celiac branch)
distal to major duodenal papilla - inferior pancreaticoduodenal artery (SMA)

Question 13

duodenum lymph drainage

Answer 13

pancreaticoduodenal and superior mesenteric LNs

Question 14

jejunoileal arterial supply

Answer 14

supermesenteric arteries - vasa recta

Question 15

jejunoileal venous drainage

Answer 15

SMV

Question 16

caecum:

arterial supply
venous drainage
innervation
LNs

Answer 16

A - ileocolic artery
V - ileocolic vein
N - superior mesenteric plexus
LNs - ileocolic LNs

Question 17

jejunoileal lymph drainage

Answer 17

SM LNs

Question 18

ascending colon:

arterial supply
venous drainage
innervation
LNs

Answer 18

A - ileocolic + right colic arteries
V - ileocolic + right colic arteries
lymph nodes: superior mesenteric LNs
N: superior mesenteric plexus

Question 19

appendix:

arterial supply
venous drainage
innervation
LNs

Answer 19

A - appendicular artery
V - appendicular vein
N - superior mesenteric plexus
LNs - ileocolic LNs

Question 20

ascending colon innervation

Answer 20

superior mesenteric plexus

Question 21

midgut innervation

Answer 21

superior mesenteric plexus

Question 22

hindgut innervation

Answer 22

inferior mesenteric plexus

Question 23

inferior mesenteric plexus innervation

Answer 23

parasympathetic = pelvic splanchnic nerves
sympathetic = lumbar splanchnic nerves

Question 24

transverse colon:

arterial supply
venous drainage
innervation
LNs

Answer 24

arterial supply: right, middle and left colic arteries
venous drainage: middle colic vein
innervation: proximal 2/3 = SMP, distal 1/3 = IMP
LNs: superior mesenteric

Question 25

descending colon: arterial supply venous drainage innervation LNs

Answer 25

A - left colic V - left colic Innervation - IMP LNs - Inferior mesenteric

Question 26

SM + IM drain into....

Answer 26

cisterna chyla which drain into thoracic duct

Question 27

seperator of right atria smooth vs rough walls

Answer 27

crista terminalis

Question 28

what seperates conus arteriosus from inflow portion of RV

Answer 28

supraventricular crest

Question 29

parietal pleura: innervation arterial supply

Answer 29

innervation: phrenic + intercostal nerves arterial supply - intercostal arteries

Question 30

visceral pleura: innervation arterial supply

Answer 30

innervation - pulmonary plexus arterial supply - bronchial arteries

Question 31

calot's triangle borders

Answer 31

superior - inferior border of liver medial - common hepatic duct lateral - cystic duct

Question 32

what connects greater and lesser sacs

Answer 32

epiploic foramen (of Winslow)

Question 33

cludocentesis

Answer 33

fluid from pouch of douglas for draining pelvic abcesses

Question 34

trachea start and end point

Answer 34

c6 - t4/5

Question 35

name the pleural recesses

Answer 35

costodiaphragmatic costomediastinal

Question 36

parasympathetic effect on lungs (3)

Answer 36

bronchoconstriction vasodilation stimulate bronchial secretions

Question 37

central tendon of diaphragm derived from ___?

Answer 37

septum transversum

Question 38

each lung root contains...

Answer 38

bronchus bronchial vessels pulmonary artery pulmonary veins x2 pulmonary plexus lymphatic vessels

Question 39

cx of fasciotomy

Answer 39

rhabdomyolysis

Question 40

electrolyte disturbances causing digitalis toxicity

Answer 40

low magnesium low potassium high calcium

Question 41

causes of low magnesium

Answer 41

diuretics TPN diarrhoea hypokalaemia hypocalcaemia alcohol

Question 42

factors that decrease gastric acid production

Answer 42

secretin cholecystokinin somatostatin

Question 43

phases of gastric secretion

Answer 43

1. cephalic - 30% 2. gastric - 60% 3. intestinal - 10%

Question 44

trotter's triad

Answer 44

unilateral conductive HL ipsilateral facial pain and otalgia ipsilateral paralysis of soft palate

Question 45

g cells produce

Answer 45

gastrin

Question 46

what cells produce gastric acid

Answer 46

parietal cells

Question 47

chief cells produce

Answer 47

pepsinogen

Question 48

LP: - needle into? - where in spine?

Answer 48

into subarachnoid space around L3/L4

Question 49

csf path

Answer 49

lateral ventricles 3rd ventricle cerebral aqueduct 4th ventricles SAS

Question 50

Ormond's disease

Answer 50

fibrous proliferation of retroperitoneal structures pushes ureters medially causes HTN, kidney failure, lower back pain, DVT

Question 51

case-control study good for...

Answer 51

rarer disease done when following group WITH outcome e.g. disease odds ratio

Question 52

ix for assessing bladder reflex

Answer 52

MCUG

Question 53

causes of raised anion gap

Answer 53

MUDPILES methanol uraemia dka paraldehyde iron lactic acidosis ethylene glycol salicylates

Question 54

lacrimal gland innervation

Answer 54

opthalmic branch - lacrimal nerve greater petrosal nerve - secretomotor function

Question 55

where are pectinate muscles in heart

Answer 55

RA

Question 56

femoral canal borders

Answer 56

lateral - femoral vein medial - lacunar ligament anterior - inguinal ligament posterior - pectineal ligament

Question 57

klippel-trenauney syndrome

Answer 57

port wine stains gigantism features varicosa veins spares saphenous veins

Question 58

heart venous drainage

Answer 58

anterior cardiac veins - drain into RA coronary sinus: 1. great cardiac vein - along anterior interventricular groove 2. middle cardiac vein - along posterior interventricular groove 3. small cardiac vein - with marginal artery

Question 59

IVC origin

Answer 59

L5

Question 60

EARLY repolarisation of heart: ion responsible

Answer 60

potassium efflux

Question 61

thymus: arterial supply venous drainage

Answer 61

A - anterior intercostal + branches of internal thoracic V - left brachiocephalic vein

Question 62

breast: arterial supply venous drainage innervation

Answer 62

A: medial - internal thoracic. Lateral = mammary + lateral mammary (branches of AIC and PIC respectively) V: axillary + internal thoracic I: anterior + lateral cutaneous branches of the 4th-6th intercostal nerves

Question 63

trachea A V N

Answer 63

A - inferior thyroid V - brachiocephalic, azygous, acessory hemizaygous N = recurrent laryngeal nerve

Question 64

diaphragm A N

Answer 64

A = inferior phrenic N = phrenic n.

Question 65

SVC tributaries

Answer 65

Brachiocephalic Azygous Mediastinal Pericardial Oesophageal

Question 66

IVC tributaries

Answer 66

Hepatic Renal Lumbar Phrenic Gonadal

Question 67

bronchi nerve supply

Answer 67

pulmonary branches of CN X

Question 68

bronchioles specific cells

Answer 68

club cells - produce surfactant

Question 69

alveoli cell lining

Answer 69

simple squamous

Question 70

where do coronary arteries originate

Answer 70

aortic sinus

Question 71

3 main causes of AS

Answer 71

1. age related calcification 2. congenital defects 3. RhF

Question 72

what seperates arterial and venous vessels of heart

Answer 72

transverse pericardial sinus

Question 73

4 functions of pericardium

Answer 73

1. fixes the heart 2. lubricartion 3. prevents overfilling 4. protection from infection

Question 74

parasympathetic effect on heart

Answer 74

decrease HR

Question 75

pericardium innervation

Answer 75

somatic innervation by phrenic nerve causes referred shoulder pain in pericarditis

Question 76

tetralogy of fallot 4x

Answer 76

pulmonary stenosis (ESM) RVH VSD overriding aorta

Question 77

2 parts of RA

Answer 77

sinus venosum (posterior) atria proper (anterior) - rough walled

Question 78

level of pulmonary trunk bifurcation

Answer 78

t5/t6

Question 79

bile leak post-cholecystectomy tx

Answer 79

ERCP+ sphincterotomy + CBD stent

Question 80

cx after bypass

Answer 80

1. post-perfusion syndrome 2. MI 3. stroke 4. AKI

Question 81

barret's oesophagus causes which cancer

Answer 81

adenocarcinoma of lower 1/3 oesophagus

Question 82

zollinger ellison MEN subtype

Answer 82

type 1

Question 83

graft for CABG

Answer 83

internal mammary artery

Question 84

contents of popliteal fossa

Answer 84

popliteal artery popilteal vein common peroneal nerve tibial nerve small saph vein

Question 85

hypertrophic vs keloid scar

Answer 85

keloid scar goes beyond original wound margins

Question 86

osteomalacia bone profile

Answer 86

low calcium AND phosphate high ALP

Question 87

hernia surgery differences in adults vs kids

Answer 87

adults - herniorrhhapy - fix abdomen weakness children - herniotomy

Question 88

thoracic aorta origin and end

Answer 88

t4-t12

Question 89

whats anterior to thoracic aorta

Answer 89

oesophagus left lung root pericardium

Question 90

branches of thoracic aorta

Answer 90

bronchial posterior intercostal mediastinal oesophageal

Question 91

brown-sequard syndrome sx

Answer 91

ipsilateral loss of proprioception + UMN signs contralateral loss of pain + temp sensation

Question 92

verterbral lesions below ___ cause LMN sign

Answer 92

L1

Question 93

what articulates with tubercle of ribs

Answer 93

tranverse process of vertebra

Question 94

features of 1st rib

Answer 94

short and wider grooves due to subclavain vessels only 1 articular facet

Question 95

what muscle has a relationship with 2nd rib

Answer 95

serratus anterior

Question 96

what level do diaphragam crura arise

Answer 96

L1/L2

Question 97

caval hiatus contents

Answer 97

IVC terminal branches of right phrenic nerve

Question 98

oesophageal hiatus contents

Answer 98

oesophagus vagus nerve oesophageal branches of left gastric artery

Question 99

aortic hiatus contents

Answer 99

thoracic aorta azygous vein thoracic duct

Question 100

peripheral attachments of diaphragm

Answer 100

1. lumbar vertebrae 2. costal cartilages 7-10 3. xiphoid process

Question 101

posterior diaphragm posterior border

Answer 101

t5-t12

Question 102

phrenic nerve in relation to heart +hilum of lungs

Answer 102

anterior

Question 103

right vagus nerve travel

Answer 103

runs parallel to trachea posterior to SVC and bronchus

Question 104

left vagus nerve travel

Answer 104

anterior to aortic arch posterior to bronchus

Question 105

SAAG>1.1

Answer 105

portal HTN

Question 106

function of greater omentum

Answer 106

immunity - stops spread of infection

Question 107

function of lesser omentum

Answer 107

holds organs together hepatogastric ligament hepatoduodenal ligament

Question 108

embryology of peritoneum

Answer 108

parietal - somatic mesoderm visceral - splanchnic mesoderm

Question 109

peritoneum cell type

Answer 109

simple squamous (mesothelium)

Question 110

gubernaculum

Answer 110

fibrous cord attached to inferior portion of gonad and guides descent into scrotum or labia

Question 111

why does appendix pain start umbilical

Answer 111

visceral peritoneal pain - poorly localised. midgut structure therefore pain in umbilical region once inflammation so great it reaches parietal layer - RIF localisation

Question 112

mid inguinal point

Answer 112

halfway between PS + ASIS femoral pulse palpable here

Question 113

inguinal canal borders

Answer 113

anterior -apneurosis of external obliques + reinforced by internal obliques floor - inguinal ligament + lacunar ligament medially roof - internal oblique + transversus abdominis + transversalis fascia posterior - tranversalis fascia

Question 114

superficial ring: location formed by

Answer 114

superior to PT formed by external oblique invagination

Question 115

contents of inguinal canal

Answer 115

spermatic cord OR round ligament ilioinguinal nerve genital branch of genitofemoral nerve

Question 116

deep inguinal ring location

Answer 116

midpoint of the inguinal ligament ring created by tranversalis fascia

Question 117

lumbar vertebra features

Answer 117

largest vertebral body VB is kidney shaped foramen is triangular spinous processes are short and broad transvers processes are long and thin

Question 118

superficial fascia below skin in abdomen

Answer 118

above umbilicus - 1 layer below umbilicus - 2 layers superior - campers inferior - scarpas

Question 119

external oblique muscles origin and insertion action innervation

Answer 119

iliac crest + PT to ribs 5-12 contralateral rotation of torso thoracoabdominal nerve (t7-11), subcostal nerve (t12)

Question 120

internal oblique muscles origin and insertion action innervation

Answer 120

iliac crest + inguinal ligament to ribs 10-12 ipsilateral rotation of torso thoracoabdominal nerve (t7-11), subcostal nerve (t12), branches of lumbar plexus

Question 121

transversus abdominis origin and insertion action innervation

Answer 121

xiphoid + linea alba + costal cartilage 7-12 to inguinal ligament compression of abdominal wall thoracoabdominal nerve (t7-11), subcostal nerve (t12), branches of lumbar plexus

Question 122

rectus abdominis origin and insertion action innervation

Answer 122

innervation = TAN pubic crest to xiphoid and 5th-7th costal cartilages

Question 123

pyramidalis innervation

Answer 123

SCN

Question 124

pyramidalis insertion and origin

Answer 124

xiphoid/CC 5-7 to pubic crest

Question 125

transpyloric plane

Answer 125

L1 halfway between jugular notch and pubic symphysis

Question 126

quadratus lumborum origin and insertion action innervation

Answer 126

transverse process of L1-L4 to iliac crest extension and lateral flexion of verterbal column + fixing of 12th rib during inspiration innervation T12-l4

Question 127

psoas major origin and insertion action innervation

Answer 127

vetebral bodies of T12-l5 inserts onton lesser trochanter of femur hip flexion anterior rami of L1-L3

Question 128

psoas minor origin and insertion action innervation

Answer 128

only 60% have a psoas minor vertebral bodies of T12-L1 onto pectineal line hip flexion anterior rami of L1

Question 129

Iliacus origin and insertion action innervation

Answer 129

iliac fossa to LToF flexion of hip femoral nerve (L2-L4)

Question 130

why is psoas sign +ve in appendicitis

Answer 130

contracting iliopsoas comes into contact with inflammed appenidx

Question 131

lower leg anterior compartment: muscles actions of muscles nerve supply

Answer 131

extensor hallucis longus + extensor of toes anterior tibialis - dorsiflexor peroneus tertius - dorsiflexor extensor digitorum longus - dorsiflexor + extensor of toes deep peroneal nerve

Question 132

lower leg peroneal compartment: muscles actions of muscles nerve supply

Answer 132

peroneus longus - everts foot + plantarflexor peroneus brevis - plantarflexor superficial peroneal nerve

Question 133

lower leg posterior superficial compartment: muscles actions of muscles nerve supply

Answer 133

gastrocnemius - plantar flexor + may also flex the knee soleus - plantarflexor tibial nerve

Question 134

lower leg posterior deep compartment: muscles actions of muscles nerve supply

Answer 134

flexor hallucis longus - flex toes flexor digitorum longus - flex toes tibialis posterior - plantarflexor + foot inverter tibial nerve

Question 135

palmar interossei function

Answer 135

adductors of fingers

Question 136

dorsal interossei function

Answer 136

abduction of fingers

Question 137

lumbricals function

Answer 137

flex @ MCPJ extend @ IPJ

Question 138

lumbricals innervation

Answer 138

1+2 = median 3+4 = ulnar

Question 139

thenar eminence muscles

Answer 139

opponens policis abductor policis brevis flexor policis brevis

Question 140

hypothenar eminence muscles

Answer 140

opponens digiti minimi flexor digiti minimi abductor digiti minimi

Question 141

most common organism of Nec Fasc

Answer 141

streptococcus

Question 142

most common causative organism for fourniers gangrene

Answer 142

e.coli + bacteriodes

Question 143

extravasation injuries = tx

Answer 143

doxorubicin - cold compress TPN - hyaluronidase

Question 144

fissure in ano 1st line tx

Answer 144

gtn or diltiazem cream

Question 145

internal haemorrhoids 1st line tx

Answer 145

ligation > sclerotherapy

Question 146

ankle joint ligaments

Answer 146

medial - deltoid ligaments lateral - anterior talofibular, posterior talofibular, calcaneofibular

Question 147

ankle fracture mx based on weber

Answer 147

A - boot B - boot or surgery - depends on talar shift C - fixation

Question 148

lauge-hansen classification

Answer 148

supination adduction supination external rotation pronation abduction pronation external rotation

Question 149

syndesmosis made of

Answer 149

interosseus membrane anterior tibiofibular ligament posterior tibiofibular ligament transverse tibiofibular ligament

Question 150

heparin affects which clotting factors

Answer 150

2,7,9, 10, 11

Question 151

bevacuzimab has a role in which cancers

Answer 151

colorectal renal glioblastoma

Question 152

undisplaced intracapsular fracture tx

Answer 152

internal fixation hemiarthroplasty if unfit

Question 153

stable intertrochanteric fracture tx

Answer 153

DHS

Question 154

abdominal aorta branches

Answer 154

inferior phrenic t12 coeliac trunk t12 superior mesenteric l1 suprarenal l1 renal l1 testicular l2 lumbar l1-l2 inferior mesenteric l3 medial sacral l4

Question 155

le fort 2 vs le fort 3 difference

Answer 155

more likely csf leak in le fort 3

Question 156

ileum resection cx

Answer 156

diarrhoea risk of gallstones due to malabsorption of bile salts tx with oral cholestyramine

Question 157

klumpke features

Answer 157

claw hand - mcpj extension, iph flexion horners loss of sensation over medial forearm and hand loss of wrist flexors

Question 158

oesophagus constricts at 4 points

Answer 158

aortic arch left main bronchus cricoid cartilage diaphragmatic hiatus

Question 159

layers of oesophagus

Answer 159

adventitia muscle layer submucosa mucosa

Question 160

oesophagus vertebral level start and end

Answer 160

c6 to t11

Question 161

difference between upper oesophageal and lower oesophageal sphincter

Answer 161

upper is muscular - cricopharyngeus muscle lower is physiological

Question 162

organs anterior to stomach

Answer 162

liver gall bladder

Question 163

superior duodenum level

Answer 163

L1

Question 164

descending duodenum level

Answer 164

L1-L3

Question 165

inferior duodenum level

Answer 165

lateralises left L3

Question 166

ascending duodenum level

Answer 166

L3-L2

Question 167

superior duodenum special facts (3)

Answer 167

1. connected to liver by hepatoduodenal ligament 2. most common site of duodenal ulceration 3. only intraperitoneal portion of duodenum

Question 168

causes of appendicitis

Answer 168

<30 years old - lymphatic tissue >30 years old - faecolith

Question 169

features of large colon

Answer 169

taenia coli omental appendices wider than small intestine

Question 170

rectum begins at which vertebral level

Answer 170

s3

Question 171

2 main flexures in rectum

Answer 171

sacral flecure anorectal flexure - formed by puborectalis muscle

Question 172

site in rectum that temporarily stores faeces

Answer 172

ampulla

Question 173

is the rectum covered by peritoneum

Answer 173

partially upper third is middle third is covered anteriorly lower third is not

Question 174

rectal arterial supply

Answer 174

superior rectal artery - inferior mesenteric artery middle rectal artery - internal iliac artery inferior rectal artery - internal pudenal artery

Question 175

rectal veins

Answer 175

superior rectal vein - into portal circulation middle and inferior rectal veins - into systemic circulation anastomosis in wall of anal canal between both circulations

Question 176

rectal innervation

Answer 176

sympathetic 1. lumbar splanchnic n 2. superior hypogastric plexus 3. inferior hypogastric plexus parasympathetic 1. s2-s4 via pelvic splanchnic n

Question 177

rectal lymph node drainage

Answer 177

upper rectum - pararectal LNs lower rectum - internal iliac LNs

Question 178

anal canal sphincters

Answer 178

internal sphincter - surrounds upper 2/3 involuntary smooth muscle external sphincter - surrounds lower 2/3 voluntary

Question 179

junction between rectum and anal canal

Answer 179

anorectal ring

Question 180

anorectal ring formed of

Answer 180

fusion between internal and external anal sphincters and puborectalis muscle

Question 181

dentate line formed by

Answer 181

anal canals

Question 182

cell differences above and below dentate

Answer 182

above - columnar below - non-keratinised stratified squamous once at the intersphincteric groove - becomes keratinised stratified squamous

Question 183

above dentate line arterial supply venous drainage innervation lymph

Answer 183

A - superior rectal artery + branches of middle rectal artery V: superior rectal vein (portal) N: inferior hypogastric lymph: internal iliac nodes

Question 184

below dentate line arterial supply venous drainage innervation lymph

Answer 184

A: inferior rectal artery + branches of middle rectal V: inferior rectal vein N: inferior rectal nerve LN: superficial inguinal

Question 185

shape of each adrenal gland

Answer 185

right - pyramidal left - semilunar

Question 186

adrenal arterial supply

Answer 186

1. superior adrenal - branch of internal phrenic 2. middle adrenal 3. inferior adrenal - branch of renal arteries

Question 187

adrenal venous drainage

Answer 187

right adrenal vein drains straight into IVC left adrenal vein drains into left renal vein then into IVC

Question 188

adrenal innervation

Answer 188

coeliac plexus greater splanchnic nerves

Question 189

adrenal lymphatic drainage

Answer 189

lumbar LNs

Question 190

parotid tumours only affect facial nerve if

Answer 190

malignant

Question 191

most common bilateral tumour of parotids

Answer 191

warthins

Question 192

cord of brachial plexus related to

Answer 192

axillary artery

Question 193

dose of protamine before vascular bypass surgeries

Answer 193

around 3000 U given 3-5 mins before clamping of vessel

Question 194

dose of protamine before cardiac bypass surgeries

Answer 194

30000 U

Question 195

macrolide MOA

Answer 195

inhibit protein synthesis by binding to 50S

Question 196

aminoglycoside MOA

Answer 196

inhibit protein synthesis

Question 197

most common biliary disease in HIV patients

Answer 197

sclerosing cholangitis

Question 198

where is ampulla of vater

Answer 198

medial aspect in the 2nd part of duodenum

Question 199

ligament of treitz significance

Answer 199

AKA suspensory muscle of duodenum differentiates Upper vs Lower GI bleed

Question 200

ejection systolic murmur causes

Answer 200

AS Aortic sclerosis pulmonary stenosis ToF HOCM ASD

Question 201

mid diastolic murmur causes

Answer 201

mitral stenosis austin flint (severe AR)

Question 202

late systolic murmur causes

Answer 202

mitral valve prolapse coarctation of aorta

Question 203

decreased global uptake on technetium scan

Answer 203

Subacute thyroiditis

Question 204

trigeminal nerve originates from ___

Answer 204

pons

Question 205

muscles innervated by mandibular nerve

Answer 205

maasseter temporalis tensor tympani mylohyoid pterygoid anterior belly of digastric

Question 206

gingiva innervated by which nerve

Answer 206

lingual nerve

Question 207

periosteum layers

Answer 207

outer fibrous layer inner cambium layer - contains progenitor cells

Question 208

pharyngeal arches: 1st

Answer 208

external carotid mandibular n

Question 209

pharyngeal arches: 2nd

Answer 209

facial nerve

Question 210

pharyngeal arches: 3rd

Answer 210

common carotid internal carotid glossopharyngeal inferior parathyroids thymus

Question 211

pharyngeal arches: 4th

Answer 211

right subclavian aortic arch vagus superior parathyroid

Question 212

pharyngeal arches 6th

Answer 212

pulmonary arteries vagus + RLN ductus arteriosus

Question 213

hashimotos histology

Answer 213

lymphocytic infiltration + fibrosis

Question 214

penile fractures pathophysiology

Answer 214

break in the tunica albunginea

Question 215

ansa cervicalis nerve roots

Answer 215

c1-c3

Question 216

thoracic cord lesion symptoms

Answer 216

ACUTE: spinal shock causes arreflexia + flaccid paralysis AFTER WEEKS: - spastic paralysis - sensory ataxia - urinary incontinence - hyperreflexia - extensor plantars

Question 217

forearm flexor muscles

Answer 217

flexor carpi radialis - median nerve flexor carpi ulnaris - ulnar palmaris longus - median flexor digitorum superificialis - median flexor digitorum profundus - ulnar (medial) + anterior interosseus (lateral)

Question 218

flexor carpi radialis functions

Answer 218

wrist flexor carpal abductor part flexor of elbow part pronater of forearm

Question 219

flexto carpi ulnaris functions

Answer 219

wrist flexor carpal adductor

Question 220

breast surgery cx

Answer 220

intercostobrachial nerve injury - paraesthesia of armpit long thoracic nerve injury serosa

Question 221

kidneys anatomical position wrt vertebra

Answer 221

T12-L3

Question 222

order of encapsulating layers of kidneys

Answer 222

outer to inner pararenal fat renal fascia perirenal fat renal capsule

Question 223

function of calyx in kidneys

Answer 223

store urine

Question 224

what can be used to show differing arterial supply to parts of kidney

Answer 224

Line of Brodel

Question 225

describe pathway: renal artery to efferent arterioles

Answer 225

renal artery TO anterior or posterior renal artery TO 5x segmental arteries each TO interlobar arteries TO arcuate arteries TO interlobular arteries TO afferent arterioles TO glomerulus TO efferent arterioles

Question 226

what type of vessels make up glomerulus

Answer 226

capillaries

Question 227

kidney lymphatic drainage

Answer 227

para-aortic nodes

Question 228

horseshoe kidney

Answer 228

fusing of both kidneys fuse at the isthmus (lower pole)

Question 229

why can renal cancers often be treated with partial nephrectomies

Answer 229

segmental blood supply

Question 230

how is spleen connected to other organs

Answer 230

greater ommentum gastrosplenic ligament splenorenal ligament

Question 231

spleen anterior to...

Answer 231

left ribs left diaphragm left lung

Question 232

spleen arterial supply

Answer 232

splenic artery

Question 233

spleen venous drainage: portal or systemic?

Answer 233

splenic vein > SMA > hepatic portal vein

Question 234

spleen innervation

Answer 234

coeliac plexus

Question 235

spleen LN

Answer 235

pancreaticosplenic LNs

Question 236

vertebral level of pancreas

Answer 236

L1

Question 237

pancreas relationship to duodenum

Answer 237

2nd part of duodenum wraps around pancreatic head

Question 238

what is posterior to head of pancreas

Answer 238

aorta IVC

Question 239

which part of the pancreas is intraperitoneal

Answer 239

tail - in the splenorenal ligament

Question 240

pancreas blood supply

Answer 240

pancreatic branches of splenic artery pancreatic head: + superior pancreaticoduodenal artery (coeliac)+ inferior pancreaticoduodenal artery (SMA)

Question 241

pancreas LN

Answer 241

pancreaticoduodenal LN

Question 242

pancreas venous drainage

Answer 242

head - SMV rest - pancreatic veins of splenic vein

Question 243

pancreatitis causes

Answer 243

GET SMASHED gallstones ethanol trauma scorpion mumps autoimmune steriods high calcium, high triglycerides, high PTH ERCP drugs e.g. sodium valproate, azathioprine

Question 244

what stimulates relase of bile from gall bladder

Answer 244

cholecystokinin

Question 245

Hartmann's pouch

Answer 245

mucosal folds at neck of the gall bladder - commonest entrapment of gallstones

Question 246

common hepatic duct runs ____ in relation to pancreas head + 1st part of duodenum

Answer 246

posterior

Question 247

cystic artery is a branch of

Answer 247

right hepatic artery

Question 248

gall bladder venous drainage

Answer 248

neck - into cystic vein body + fundus - directly into hepatic sinusoids

Question 249

gall bladder innervation

Answer 249

sympathetic - coeliac plexus parasympathetic - vagus

Question 250

parasympathetic innervation effect on gall bladder

Answer 250

stimulate contractions

Question 251

lymph nodes of gall bladder

Answer 251

hepatic lymph nodes

Question 252

where do hepatic lymph nodes drain into

Answer 252

coeliac lymph nodes

Question 253

ligaments of liver

Answer 253

1. falciform ligament - straps liver to anterior abdomen wall 2. ligamentum teres - in free edge of falciform ligament 3. coronary ligament - attach bare edge of liver to diaphragm 4. triangular ligament - liver to diaphragm + LESSER OMENTUM (hepatogastric + hepatoduodenal ligaments)

Question 254

Morison's pouch: 1. what is it 2. clinical relevancee

Answer 254

1. potential space between liver and right kidney. deepest part of peritoneal cavity when lying flat 2. ascites more likely to accumulate here in bed-ridden patient

Question 255

liver is covered by a fibrous layer named?

Answer 255

Glisson's capsule

Question 256

lobes of liver

Answer 256

right left caudate quadrate

Question 257

what seperates caudate and quadrate lobes of liver

Answer 257

porta hepatis

Question 258

portal triad

Answer 258

hepatic artery portal vein hepatic bile duct

Question 259

liver blood supply

Answer 259

hepatic artery proper - 25% portal vein - 75%

Question 260

liver innervation

Answer 260

sympathetic - hepatic plexus parasympathetic - vagus

Question 261

liver lymph drainage

Answer 261

anterior - hepatic LNs posterior - phrenic + posterior mediastinal LNs

Question 262

thoracic aorta branches UPDATED

Answer 262

bronchial mediastinal pericardial oesophageal intercostal superior phrenic

Question 263

how can aortic aneurysm affect voice

Answer 263

irritates recurrent laryngeal nerve causing hoarse voice

Question 264

watershed zone

Answer 264

splenic flexure

Question 265

coeliac trunk compression by

Answer 265

median arcuate ligament

Question 266

most common type of visceral aneurysm

Answer 266

splenic aneurysm

Question 267

disc herniation pathophysiology

Answer 267

jelly nucleus pulposus herniates through annulus fibrosus

Question 268

cervical vertebrae features

Answer 268

7x bifid spinous processes triangular vertebral foramine have transverse foramina

Question 269

thoracic verterbrae features

Answer 269

12x circular foramine vertebral bodies have 2x demifacets transverse processes have costal facets spinous processes are inferiorly orientated

Question 270

lumbar vertebra features

Answer 270

5x largest vertebral bodies kidney shaped VB triangular vertebral foramina SP short and wide TP long and thin

Question 271

sacrum features

Answer 271

5x fused vertebrae inverted triangle shaped have lateral facets for ilium

Question 272

coccyx features

Answer 272

4x fused verterbrae no vertebral arches

Question 273

lumbarisation

Answer 273

S1 seperation from sacrum

Question 274

sacralisation

Answer 274

L5 fused to sacrum

Question 275

trochlear nerve supplies this ocular muscle

Answer 275

superior oblique

Question 276

corneal reflex innervation

Answer 276

afferent - nasociliary branch of ophthalmic (V1) efferent - facial nerve via oribicularis oculi muscle

Question 277

where does trigeminal nerve originate

Answer 277

pons

Question 278

where does facial nerve originate

Answer 278

between pons and medulla

Question 279

where does vestibulocochlear nerve originate

Answer 279

pons

Question 280

where does glossopharyngeal nerve originate

Answer 280

pons

Question 281

where does vagus nerve originate

Answer 281

medulla

Question 282

where does hypoglossal nerve originate

Answer 282

medulla

Question 283

which tongue muscle does hypoglossal nerve not innervate

Answer 283

palatoglossus

Question 284

course of facial nerve

Answer 284

leave between pons and medulla passes temporal bone and enters internal auditory meatus then passes through facial canal and exits at the stylomastoid foramen

Question 285

what cranial nerve supplies parotid

Answer 285

glossopharyngeal

Question 286

richter's hernia

Answer 286

wall of small bowel (usually anti-mesenteric layer) is strangulated - but as luminal patency maintained there is no obstruction

Question 287

bochdalek hernia

Answer 287

congenital hernia nearly always associated with left hemidiaphragm causes lung hypoplasia more common in males

Question 288

jenkins rule

Answer 288

aim to minimis incisional hernias in midline laparotomy incisions suture length 4x incision length sutures at 1cm intervals sutures 1cm from wound edge

Question 289

morgagni hernia

Answer 289

rare diaphgramatic hernia hernia through foramen of morgagni

Question 290

umbilicus hernia tx

Answer 290

surgery after 3rd birthday

Question 291

paraumbilical hernias more common in ?

Answer 291

adult females

Question 292

technique for paraumbilical hernia repair

Answer 292

mayo's repair - overlapping vertical edges

Question 293

spigelian hernias

Answer 293

lateral to rectus abdominis where arcuate line meets semilunaris line

Question 294

middle meningeal artery is a branch of

Answer 294

maxillary artery which is a branch of external carotid artery

Question 295

HLA types asx with mismatch

Answer 295

A B C DR

Question 296

septic arthritis most common causative organism

Answer 296

staph aureus

Question 297

basilic vein medial or lateral? superficial or deep?

Answer 297

medial superficial until mid upper arm

Question 298

middle meningeal artery exits through which cranial foramen

Answer 298

foramen spinosum

Question 299

basilic vein + ____ vein > _____ vein

Answer 299

medial brachial vein axillary vein

Question 300

potent vasodilators in acute inflammation

Answer 300

prostaglandins nitric oxide histamine complement 5a and 3a lysosomal compounds

Question 301

serotonin - vasodilator or vasoconstrictor?

Answer 301

depends on vessel state - in healthy vessels it is a vessel dilator

Question 302

malignancy histology

Answer 302

angiogenesis increased mitoses de-differentiation invasion of basement membrane - this differentiates it to in situ tumours

Question 303

types of gastritis

Answer 303

type A - autoimmune type B - antral (infective erosive - NSAIDs and alcohol stress - mucosal ischaemia reflux - bile refluxes into stomach. prokinetics can help

Question 304

type A gastritis pathophysiology

Answer 304

autoimmune antibodies to parietal cells causing decrease HCl and decreased intrinsic factor decrease in HCl also stimulates gastrin release and stimulates enterochromaffin cells leading to adenoma production

Question 305

causes of lymphodema

Answer 305

primary - congenital - milroys secondary - infection e.g. filariasis - DVT - thrombophlebitis - radiation to LNs - LN clearance - lymphatic malignancy

Question 306

indications for lymphoedema surgery

Answer 306

marked disability and/or deformity incompetent proximal lymphatics

Question 307

lymphoedema procedures

Answer 307

Homans - reduction procedure with preservation of overlying skin Charles - all skin and subcutaneous tissue removed + split skin grafts placed over surgical sites lymphovenous anastomosis - when proximal lymph obstruction with normal distal lymphatics

Question 308

stored blood has more or less affinity for oxygen

Answer 308

more affinity less 2,3-DPG

Question 309

haldane effect of haemoglobin

Answer 309

LEFT SHIFT haem has greater affinity for oxygen

Question 310

what causes haldane effect

Answer 310

low co2 low 2,3-DPG HbF carboxyhaemoglobin low temperature

Question 311

bohr effect of haemoglobin

Answer 311

RIGHT SHIFT haem has lower affinity for oxygen oxygen more readily available/deliverable

Question 312

what causes bohr effect

Answer 312

acidosis high co2 high temperature high 2,3-DPG

Question 313

suxamethonium features

Answer 313

depolarising muscular blocker rapid onset produces muscular contractions before paralysis

Question 314

side effects of suxamethonium

Answer 314

hyperkalaemia malignant hyperthermis

Question 315

atracurium reversing agent

Answer 315

neostigmine

Question 316

diagnostic OGD prep

Answer 316

NBM >6hrs

Question 317

flexi sigmoidoscopy prep

Answer 317

phosphate enema 30 mins before

Question 318

femoral triangle borders

Answer 318

medial - adductor longus lateral - sartorius superior - inguinal ligament

Question 319

brachial embolectomy can damage which nerve

Answer 319

median @ ACF

Question 320

malignant mesothelioma rough tx

Answer 320

receptive to combination chemotherapy - usually cisplatin based relatively resistant to radiotherapy - best given pre-operatively

Question 321

fem-pop surgery

Answer 321

for proximal occlusions use own vein if sufficient if not, can use PTFE + Miller cuff e.g. in varicose veins

Question 322

propofol features

Answer 322

rapid onset pain on injection anti-emetic properties

Question 323

sodium thiopentane features

Answer 323

very rapid onset marked myocardial depression

Question 324

etomidate

Answer 324

can cause adrenal suppression

Question 325

Laplace law

Answer 325

wall tension proportional to pressure x radius - explains why its harder to blow up a balloon at the start

Question 326

how does Laplace law explain why aneurysms don't ordinarily explode

Answer 326

pressure is inversely proportional to radius as balloon inflates, pressure decreases

Question 327

bainbridge reflex

Answer 327

reflexive increase in heart rate when baroreceptors in atria are stimulated this decreases SVC pressure, creating a pressure gradient between venous system and right atria - meaning no pooling of blood in venous system can occur in rapid blood transfusions

Question 328

sympathetic effect on ventricles

Answer 328

increase contracrility via increase of intracellular calcium

Question 329

what increases functional residudal capacity

Answer 329

standing up right asthma emphysema

Question 330

what decreases FRC

Answer 330

abdo swelling pulmonary oedema decreased diaphragm tone

Question 331

cavernous sinus lateral wall contents

Answer 331

oculomotor trochlear ophthalmic maxillary

Question 332

cavernous sinus contents

Answer 332

ICA (medially) abducens (laterally)

Question 333

insulinoma ix and tx

Answer 333

ix - endoscopic USS tx - benign = enucleation, malignant = whipples

Question 334

superficial back muscles

Answer 334

lats traps rhomboid minor rhomboid major levator scapula

Question 335

traps: origin and insertion innervation

Answer 335

origin: skull + spinous process C7-T12 insertion: clavicle, acromion, scapula spine

Question 336

lats: origin and insertion innervation

Answer 336

origin: spinous process of T6-T12 insertion: intertubercular sulcus of humerus innervation: thoracodorsal nerve

Question 337

function of lats

Answer 337

extends, adducts and medially rotates upper arm

Question 338

levator scapula: origin and insertion innervation

Answer 338

transverse process of C1-C4 insertion: medial border of scapula dorsal scapular nerve

Question 339

function of levator scapula

Answer 339

elevate scapula

Question 340

rhomboid major: origin and insertion innervation

Answer 340

spinous process of T2-T5 medial border of scapula dorsal scapular nerve

Question 341

rhomboid minor origin and insertion innervation

Answer 341

spinour process of C7-T1 medial border of scapula dorsal scapular nerve

Question 342

intermediate muscles of the back

Answer 342

serratus posterior superior serratus posterior inferior

Question 343

serratus posterior superior origin and insertion innervation

Answer 343

C7-T3 to anterior ribs 2-5 intercostal nerve

Question 344

serratus posterior superior action

Answer 344

elevate the ribs 2-5

Question 345

superficial muscles of the deep back muscles

Answer 345

the SPINOTRANSVERSALIS muscles splenius capitis splenius cervicis

Question 346

splenic capitis innervation

Answer 346

posterior rami of c3-c4

Question 347

splenic capitis funciton

Answer 347

rotate + extend head

Question 348

intermediate muscles of the deep back muscles

Answer 348

erector spinae muscles longissimus iliocostalis spinalis

Question 349

function of erector spinae muscles

Answer 349

unilateral contraction = lateral flex bilateral contraction = extension

Question 350

innervation of erector spinae muscles

Answer 350

posterior rami of the spinal nerves

Question 351

deep muscles of the deep back

Answer 351

transversospinales muscle group semispinalis - extends head multifidius rotatores

Question 352

conus medullaris

Answer 352

tapering of spinal cord @ L1/L2

Question 353

spinal cord enlarges where

Answer 353

cervical and lumbosacral regions

Question 354

2 depressions of spinal cord

Answer 354

anterior median fissure posterior median sulcus

Question 355

filum terminales

Answer 355

meninges ending at bottom of spinal cord

Question 356

epineurium

Answer 356

dura mater surrounding the peripheral nerves when they leave spinal cord

Question 357

spinal cord vasculature

Answer 357

anterior spinal artery - branch of vertebral arteries posterior spinal artery - branch of vertebral artery or PICA

Question 358

artery of Adamkiewicz

Answer 358

main artery that supplies blood to the lower third of the spinal cord

Question 359

venous drainage of spinal cord

Answer 359

3x anterior spinal veins 3x posterior spinal veins

Question 360

where does subscapularis attach on scapula

Answer 360

subscapular fossa on costal surface of scapula

Question 361

where do supraspinatus and infraspinatus originate

Answer 361

posterior side of scapula supraspinatus fossa infraspinatus fossa

Question 362

where does long head of biceps brachii attach

Answer 362

supraglenoid tubercle

Question 363

where does long head of triceps brachii attach

Answer 363

infraglenoid tubercle

Question 364

most common part of clavicel that is fractured

Answer 364

middle

Question 365

muscles inserting onto greater tuberosity of humerus

Answer 365

supraspinatus infraspinatus teres minor

Question 366

muscles inserting onto lesser tuberosity of humerus

Answer 366

subscapularis

Question 367

muscles attaching onto intertubercular sulcus of humerus

Answer 367

lats pec major teres major

Question 368

what tendon runs along intertubercular sulcus

Answer 368

long head of biceps brachii

Question 369

what neurovascular vessels are related to surgical neck of humerus

Answer 369

axillary nerve circumflex humeral vessels

Question 370

axillary nerve injury paralyses which muscle

Answer 370

deltoid teres minor ABDCUTORS

Question 371

what muscles attach onto humeral shaft

Answer 371

coracobrachialis deltoid (tuberosity) brachialis brachoradialis medial and lateral tricep heads

Question 372

mid shaft humeral fracture affects which nerves

Answer 372

radial nerve - wrist drop

Question 373

lateral epicondyle is associated with which attachment site of humerus

Answer 373

trochlea

Question 374

medial epicondyle is associated with which attachment site of humerus

Answer 374

capitulum

Question 375

what makes up trochlear notch of ulnar

Answer 375

olecranon + coronoid fossa

Question 376

which artery is at risk in supracondylar humeral fractures

Answer 376

brachial artery

Question 377

volkmann's contracture

Answer 377

ischaemic contracture as a result of brachial artery damage causing fibrosis and shortening of flexors of hand and wrist

Question 378

how do you test function of anterior interosseoss nerve

Answer 378

OK sign assessing flexor pollicis longus

Question 379

ulnar shaft shape

Answer 379

triangular shape

Question 380

monteggia fracture

Answer 380

proximal ulnar fracture with radial head dislocation at elbow

Question 381

galeazzi fracture

Answer 381

distal radial fracture with distal RUJ dislocation

Question 382

what muscle inserts on to radial tuberosity

Answer 382

biceps brachii

Question 383

proximal carpal bones (lateral to medial)

Answer 383

scaphoid,lunate, triquetrum, pisiform

Question 384

distal carpal bones (lateral to medial)

Answer 384

trapezium, trapezioid, capitate, hamate

Question 385

bennetts fracture

Answer 385

base of 1st metacarpal fracture

Question 386

tx of fibroadenoma

Answer 386

<3cm - observation >4xm - cone biopsy to exclude phyllodes

Question 387

as well as resection, what are colon cancer patients with high chance of recurrence offered

Answer 387

chemotherapy - 5FU + oxaliplatin combination

Question 388

rectal cancer: anterior resection or APER?

Answer 388

APER is sphincters involved or lower tumours (anal verge)

Question 389

difference between tx of rectal cancers and colon cancers

Answer 389

rectum is retroperitoneal therefore neoadjuvant radiotherapy can be used

Question 390

which colon cancers need chemotherapy

Answer 390

high risk recurrence lymph node involvement

Question 391

transverse colon cancer tx

Answer 391

extended RHC + ileocolic anastomosis

Question 392

left colon cancer tx

Answer 392

LHC + colon-colon anastomosis

Question 393

sigmoid cancer tx

Answer 393

high anterior resection with colo-rectal anastomosis

Question 394

upper rectum tx

Answer 394

anterior resection (TME) with colo-rectal anastomosis

Question 395

low rectum tx

Answer 395

anterior resection (low TME) with colo-rectal anastomosis +/- defunctioning stoma

Question 396

why do rectal cancers usually need defunctioning stoma

Answer 396

to reduce the risk of anastomotic leakage and reoperation rates

Question 397

most common type of rotator cuff tear

Answer 397

supraspinatus

Question 398

gastric cancer tx

Answer 398

if >5-10cm from GOJ = subtotal resection if <5cm from GOJ = total gastrectomy + Roux en Y bypass will need lymphadenectomy and most patients get pre- or post-op chemo

Question 399

investigation for suspected lymphoma presenting with lymphadenopathy

Answer 399

excision biopsy

Question 400

axillary artery branches

Answer 400

Highest thoracic Thoraco-abdominal Lateral thoracic Subscapular - circumflex scapula artery is a branch of this Posterior circumflex humeral artery Anterior circumflex humeral artery he took love so pain awaits

Question 401

how does cholestatic jaundice cause vit k deficiency

Answer 401

less bile into circulation vit K cannot be absorbed as well

Question 402

what muscle flexes DIP joints

Answer 402

flexor digitorum profundus

Question 403

TPN SEs

Answer 403

phlebitic can cause deranged LFTs long term

Question 404

testicular cancer tx

Answer 404

orchidectomy via inguinal approach

Question 405

gardners syndrome facts

Answer 405

Autosomal dominant can cause malignant tumours of colon APC gene association to desmoid tumours

Question 406

cervical ribs usually arise from which vertebra

Answer 406

C7

Question 407

layers of spermatic cord

Answer 407

inner - transversalis fascia outer - external oblique

Question 408

contents of spermatic cord

Answer 408

vas deferens vas deferens artery testicular artery genital branch of genitofemoral nerve cremasteric artery pampiniform plexus SNS fibres lymphatic vessels

Question 409

which cancer surgeries need bowel prep

Answer 409

left sided colon

Question 410

in surgeries with radiated tissue - how do you close wounds

Answer 410

using flaps

Question 411

which heparin for bypass

Answer 411

unfractioned - shorter HL, more controllable

Question 412

c fibres trasmit ...

Answer 412

mechanicothermal stimuli

Question 413

A beta fibres transmit

Answer 413

touch and pressure stimuli

Question 414

B fibres transmit

Answer 414

autonomic stimuli

Question 415

CSF contains ???

Answer 415

no RBC less glucose than plasma

Question 416

hyatid cysts associated with which infection

Answer 416

echnicoccus infection

Question 417

USS shows daughter cysts with septa and thick walls in liver??

Answer 417

hyatid cysts

Question 418

how does pagets disease cause high output heart failure

Answer 418

angiogenesis

Question 419

path of subclavian artery and vein

Answer 419

both pass OVER (anterior) 1st rib but POSTERIOR to clavicle SCA passes posterior to scalenus anterior SCV passes anterior to scalenus anterior

Question 420

trunks of brachial plexus relationship to SCA

Answer 420

brachial plexus passes posterior to SCA at 1st rib

Question 421

3 types of nerve injury

Answer 421

neuropraxia axonotmesis neurotmesis

Question 422

neuropraxia features

Answer 422

nerve intact problem with conduction wallerian degeneration not present

Question 423

axonotmesis features

Answer 423

axon damaged but connective tissue intact wallerian degeneration occurs

Question 424

wallerian degeneration

Answer 424

distal axonal injury

Question 425

neurotmesis features

Answer 425

degeneration of axon and myeline sheath wallerian degeneration occurs

Question 426

ulnar nerve path in forearm

Answer 426

medial forearm passes inferiorly to flexor carpi ulnaris

Question 427

scrotal cancer drains into which lymph nodes

Answer 427

inguinal LNs

Question 428

access point for right middle lobe

Answer 428

6th ICS in mid axillary line

Question 429

quadrangular space borders

Answer 429

superior - inferior border of teres minor inferior - superior border of teres major medial - lateral border of triceps brachii lateral - surgical neck of humerus

Question 430

quadrangular space contents

Answer 430

axillary nerve posterior circumflex humeral artery

Question 431

triangular space borders

Answer 431

superior - inferior border of teres minor inferior - superior aspect of teres major lateral - medial margin of long head of triceps brachii

Question 432

triangular space contents

Answer 432

circumflex scapular artery

Question 433

triangular interval borders

Answer 433

superior border - inferior border of teres major lateral - lateral head of triceps medial - long head of triceps trachi

Question 434

triangular interval contents

Answer 434

radial nerve profunda brachii artery

Question 435

axilla borders

Answer 435

anterior - pec major + minor posterior - scapula, teres major, + lats medial - serratus anterior + thoracic wall lateral - intertubercular sulcus

Question 436

what affects axilla size

Answer 436

arm abduction - decreases it

Question 437

apex of the axilla

Answer 437

lateral border of 1st rib posterior border of clavicle superior border of scapula

Question 438

contents of axilla

Answer 438

axillary artery axillary vein brachial plexus axillary lymph nodes biceps brachii short head

Question 439

cubital fossa borders

Answer 439

superior - epicondylar line medial - lateral border of pronator teres lateral - medial border of brachoradialis

Question 440

cubital fossa contents (5)

Answer 440

radial nerve median nerve brachial artery biceps tendon median cubital vein

Question 441

carpal tunnel contents

Answer 441

median nerve 1x flexor pollicis longus tendon 4x flexor digitorum supericialis 4x flexor digitorum profundus

Question 442

median nerve branches

Answer 442

splits in carpal tunnel recurrent branch - thenar muscles palmar digital nerve - innervates lateral lumbricals + sensation

Question 443

anatomical snuffbox contents (3)

Answer 443

radial artery superficial branch of radial nerve cephalic vein

Question 444

anatomical snuffbox borders

Answer 444

medial - extensor hallucis longus lateral - extensor pollicis brevis proximal border = styloid process of radius

Question 445

extensor compartment 1 of wrist contents

Answer 445

Extensor pollicis breivs abductor pollicis longus

Question 446

extensor compartment 2 of wrist contents

Answer 446

extensor carpi radialis longus extensor carpi radialis brevis

Question 447

extensor compartment 3 of wrist contents

Answer 447

extensor policis longus

Question 448

what seperates extensory compartment 2 and 3 of the wrist

Answer 448

Lister's tubercle of radius

Question 449

ulnar's canal contents

Answer 449

ulnar nerve ulnar artery venae comitantes of ulnar artery lymphatic vessels

Question 450

dysphagia lusoria is dysphagia caused by what

Answer 450

oesophageal compression from vascular abnormality

Question 451

dysphagia lusoria dx ix

Answer 451

CT angio

Question 452

sural nerve supplies sensation to which area

Answer 452

lateral aspect of foot

Question 453

dorsum of foot sensation nerve

Answer 453

superficial peroneal nerve

Question 454

1st web space of foot sensation nerve

Answer 454

deep peroneal nerve

Question 455

cell saver devices what is it contraindications

Answer 455

collect patient blood during surgery and reinfuse CI: malignancy and infection

Question 456

Lynch disease cancer associations

Answer 456

colorectal endometrial

Question 457

Lynch disease gene

Answer 457

mismatch repair gene mutation

Question 458

ESWL contraindications

Answer 458

pregnancy patients with severe calcification of vessels

Question 459

uteroscopy method

Answer 459

scope through urethra and bladder into ureters laser of pneumatic fragmentation a stent can be left in situ

Question 460

RENAL stone tx

Answer 460

0-5mm + asx = observation <10 = ESWL 10-20 = ESWL or ureteroscopy >20 = PC NL

Question 461

URETERIC stone tx

Answer 461

0-5mm = observation 5-10mm = ESWL 10-20mm = ureteroscopy

Question 462

oesophageal cancer tx

Answer 462

largely resction based no resection if patient has mets or N2+ disease lower or middle third - Ivor lewis oesophagectomy upper third - Mckeowans (total) very distal tumours - can have transhiatal procedures

Question 463

ivor lewis incisions

Answer 463

laparotomy + RHS thoractomy (Mckeowan = + neck incision)

Question 464

how can delayed gastric emptying be avoided in oesophagectomies

Answer 464

pyloroplasty - widening of canal

Question 465

anal fissures associations

Answer 465

STDs IBD leukaemia TB previous surgery

Question 466

catecholamines derived from ....

Answer 466

tyrosine (--> dopamine --> NA -->A)

Question 467

which clotting factors are most sensitive to temperature

Answer 467

FACTOR 5 AND 8 this is why FFP needs to be frozen ASAP

Question 468

gluteus maximus innervation

Answer 468

inferior gluteal nerve

Question 469

bartons fracture

Answer 469

distal radial fracture + radiocarpal dislocation

Question 470

holstein lewis fracture

Answer 470

distal 1/3 humerus fracture causing entrapped radial nerve

Question 471

varicose veins tx

Answer 471

1. endothermal ablation 2. foam sclerotherapy 3. trendelnberg surgery

Question 472

cowden disease what is it mutation ?

Answer 472

PTEN mutation harmatomal growths of colon also associated with breast cancer

Question 473

boerhaave syndrome ix

Answer 473

CT contrast

Question 474

boerhaave syndrome tx

Answer 474

<12hours since sx onset = surgery >12 hours = controlled fistula with T tube

Question 475

positive iontropes

Answer 475

adrenaline/noradrenaline dopamine glucagon dobutamine theophylline

Question 476

alpha 1 receptors MOA

Answer 476

vasoconstriction

Question 477

alpha 2 receptors MOA

Answer 477

vasoconstriction

Question 478

beta 1 receptors MOA

Answer 478

increase heart rate and contractility

Question 479

beta 2 receptors MOA

Answer 479

vasodilation

Question 480

adrenaline MOA

Answer 480

alpha 1, alpha 2, beta 1, beta 2 stimulation

Question 481

noradrenaline MOA

Answer 481

alpha 1 stimulation

Question 482

dobutamine MOA

Answer 482

beta 1 stim (increase contractility + heart rate)

Question 483

omphalitis definition, organism + tx

Answer 483

infection of umbilicius staph aureus topical + systemic abx

Question 484

umbilical granuloma

Answer 484

cherry red lesions

Question 485

patent urachus - definition and symptoms

Answer 485

patent connection between umbilicus and bladder sx - urine leaks through umbilicus

Question 486

biers block

Answer 486

double torniquet applied prilocaine injected into vein

Question 487

which local anaesthetic is very cardiotoxic

Answer 487

bupivicaine

Question 488

why is adrenaline sometimes added to local anaesthetic

Answer 488

potentiates duration of action

Question 489

penile erection physiology

Answer 489

1. autonomic innervation: - SNS from T11-L2 and PSNS from S2-S4 - PSNS - causes erection - SNS - causes ejaculation 2. somatic - dorsal penile nerve - pudendal nerve

Question 490

ulnar nerve and artery association

Answer 490

nerve lies on ulnar side of artery

Question 491

2 nerves involved in voice production

Answer 491

superior laryngeal nerve recurrent laryngeal nerve

Question 492

superior laryngeal nerve innervates ... ?

Answer 492

cricothyroid muscle - tenses vocal cords

Question 493

paralysis of superior laryngeal nerve causes

Answer 493

pitch abnormalities

Question 494

specificity =

Answer 494

true negative / true negative + false positives

Question 495

laryngeal muscles and their function (4)

Answer 495

posterior cricoarytenoid - abduct vocal folds lateral cricoartyenoid - adduct vocal folds thyroarytenoid - relaxes vocal cords vocalis - relaxes posterior fold, tenses anterior folds

Question 496

laryngeal muscles supplied by

Answer 496

laryngeal arteries branch of superior/inferior thyroid arteries branch of ECA

Question 497

cranial nerve for external ear sensation

Answer 497

auriculotemporal nerve branch of mandibular nerve

Question 498

which nerve runs next to middle meningeal artery

Answer 498

auriculotemporal nerve

Question 499

allograft

Answer 499

same species

Question 500

pec majo function

Answer 500

adduct and medially rotate upper arm

Question 501

pec major innervation

Answer 501

medial and lateral pectoral nerves

Question 502

what is the added function of clavicular head of pec major

Answer 502

flex upper limb

Question 503

pec major insertions

Answer 503

clavicular head: medial clavicle sternal head: sternum + 1-6th CC both attach on intertubercular sulcus of the humerus

Question 504

pec minor function

Answer 504

stabilise scapula

Question 505

pec minor innervation

Answer 505

medial pectoral nerve

Question 506

pec minor insertions

Answer 506

ribs 3-5 onto coracoid process of scapula

Question 507

serratus anterior function

Answer 507

rotates scapula allowing for shoulder flexing >90 degrees

Question 508

serratus anterior insertions

Answer 508

lateral aspect of ribs 1-8 and insert onto scapula

Question 509

subclavius action innervation

Answer 509

depress clavicle nerve to subclavius

Question 510

biceps brachii origin and insertion

Answer 510

long head - supraglenoid tubercle short head - coracoid process insert onto radial tuberosity

Question 511

what artery supplies anterior compartment of upper arm

Answer 511

brachial artery

Question 512

coracobrachialis insertions

Answer 512

coracoid process to medial shaft humerus

Question 513

coracobrachialis function

Answer 513

shoulder flexion

Question 514

brachialis insertions

Answer 514

humeral shaft to unlar tuberosity

Question 515

triceps supplied by which blood vessel

Answer 515

profunda brachii

Question 516

where do triceps insert onto

Answer 516

olecranon

Question 517

deltoid insertions

Answer 517

lateral 1/3 clavicle onto deltoid tuberosity

Question 518

front delt function

Answer 518

flexion and internal rotation

Question 519

rear delt fx

Answer 519

extension and external rotation

Question 520

teres major function

Answer 520

adduct and axternally rotate shoulder

Question 521

teres major innervation

Answer 521

lower subscapular nerve

Question 522

supraspinatus fx

Answer 522

0-15degrees abduction

Question 523

where do rotator cuffs insert

Answer 523

supraspinatus, infraspinatus and teres minor - insert onto greater tubercle of humerus subscapularis inserts onto lesser tubercle of humerus

Question 524

nerve supply to rotator cuffs

Answer 524

supraspinatus - suprascapular nerve infraspinatus - suprascapular nerve subscapularis - upper and lower subscapular nerve teres minor - axillary nerve

Question 525

subscapularis fx

Answer 525

internal rotation

Question 526

anterior forearm ALL muscles

Answer 526

superior: flexor carpi radialis flexor carpi ulnaris palmaris longus pronator teres intermediate: flexor digitorum superficialis deep: flexor digitorum profundus pronator quadratus flexor pollicis longus

Question 527

superficial muscles of the anterior forearm all originate from

Answer 527

medial epicondyle

Question 528

flexor carpi ulnaris

Question 529

muscles of the anterior forearm all innervated by? expect for?

Answer 529

median nerve not FCU - ulnar n medial half of FDP - ulnar n deep muscles innervated by anterior interrosseous branch of median nerve

Question 530

FCU: fx insertion

Answer 530

flex and adduct wrist inserts onto pisiform, HoH and base of 5th metacarpal

Question 531

palmaris longus: fx insertion

Answer 531

flex wrist inserts onto flexor retinaculum

Question 532

flexor carpi radialis: fx insertion

Answer 532

flex and abduct wrist inserts onto 2nd and 3rd metacarpal

Question 533

pronator teres: originS insertion fx

Answer 533

head 1 - medial epicondyle head 2 - coronoid process of ulnar insert onto midshaft radius fx - pronation

Question 534

FDS what lies between 2 heads?

Answer 534

ulnar artery and median nerve

Question 535

FDS origins insertion fx

Answer 535

medial epicondyle and radius --> 4 tendons at wrist which attach to base of middle phalanx flex wrist, flex MCPJ and proximal IPJ

Question 536

FDP action

Answer 536

flex Distal IPJ and MCPJ and wrist

Question 537

FPL fx

Answer 537

flex all joints of thumb

Question 538

FPL insertions

Answer 538

attach onto base of distal phalanx of thumb

Question 539

pronator quadratus insertions

Answer 539

anterior ulnar to anterior radius

Question 540

muscles in posterior forearm

Answer 540

superficial brachoradialis extensor carpi radialis longus extensor carpi radialis brevis extensor carpi ulnaris extensor digitorum communis extensor digit minimi aconeus deep supinator extensor pollucis longus extensor pollicis brevis abductor pollicis longus extensor indicis propius

Question 541

superficial muscles of posterior forearm

Answer 541

brachoradialis extensor carpi radialis longus + brevis extensor carpi ulnaris extensor digitorum communis extensor digit minimi aconeus

Question 542

deep muscles of posterior forearm

Answer 542

extensor pollicis longus extensor policis brevis abductor poliicis longus extensor indicis propius supinator

Question 543

muscles in posterior forearm innervated by?

Answer 543

radial nerve

Question 544

what is special about brachoradialis

Answer 544

paradoxical muscle origin and innervation suggest extensor, but is a flexor

Question 545

brachoradialis origin, insertion, fx

Answer 545

lateral humerus onto distal radius flex at elbow and supination at proximal RUJ

Question 546

extensor carpi radialis longus and brevis insertions

Answer 546

longus: supracondylar ridge to MC II and III brevis: lateral epicondyle to MC II and III

Question 547

extensor carpi radialis fx

Answer 547

extend and abduct wrist

Question 548

extensor digitorum communis fx insertions

Answer 548

main flexor of fingers lateral epicondyle --> extensor hood of each fingers

Question 549

extensor digiti minimi insertions and fx

Answer 549

lateral epicondyle to extensor hood of 5th finger fx - extend all little finger joints

Question 550

extensor carpi ulnaris fx and insertions

Answer 550

extend and adduct wrist lateral epicondyle to MC V

Question 551

aconeus fx

Answer 551

extend and stablise elbow

Question 552

supinator makes up what part of cubital fossa

Answer 552

floor

Question 553

deep muscles of the posterior forearm are innervated by?

Answer 553

posterior interosseous branch of radial nerve

Question 554

difference in fx between EPL and EPB

Answer 554

longus extends all thumb joints INCLUDING IPJ brevis only extends MCPJ and CMCJ

Question 555

thenar muscles are innervated by

Answer 555

recurrent branch of median nerve

Question 556

opponens policis insertions and fx

Answer 556

tubercle of trapezium onto lateral margin of MC I fx - medial rotation and flexion at CMCJ

Question 557

abductor policis brevis insertions

Answer 557

tubercle of scaphoid and trapezium onto lateral side of proximal phalanx

Question 558

opponens digit minimi origin

Answer 558

hook of hamate

Question 559

abductor digiti minimi origin

Answer 559

pisiform

Question 560

flexor digiti minimi brevis origin

Answer 560

hook of hamate

Question 561

lumbricals fx

Answer 561

flex and MCPJ and extend at IPJ

Question 562

palmaris brevis fx and innervation

Answer 562

wrinkles skin in hypothenar region and ulnar n

Question 563

adductor policis innervation

Answer 563

ulnar n

Question 564

cranial nerves carrying parasympathetic fibres

Answer 564

3, 7, 9, 10

Question 565

fasciola hepatica definition

Answer 565

common liver fluke from parasitic infection by trematode

Question 566

fasciola hepatica symptoms

Answer 566

acute - abdo pain, fever chronic - bile duct infection - jaundice

Question 567

dx of fasciola hepatica

Answer 567

stool sample +/- serology

Question 568

tx of fasciola hepatica

Answer 568

triclabendazole +/- ERCP

Question 569

inflammatory breast carcinomas risk factors

Answer 569

pregnancy lactation

Question 570

branchial cyst excision - nerves at risk of injury

Answer 570

mandibular nerve greater auricular nerve accessory nerve

Question 571

cryptochidism causes

Answer 571

idiopathic patent processus vaginalis cerebral palsy wilms tumour developmental delay

Question 572

differentials for cryptochidism

Answer 572

could be retractile testes could be absent testes ix - try to locate testes and move into scrotum. if it stays immediately after --> probably retractile

Question 573

reasons to correct cryptochidism

Answer 573

infertility increased risk of seminoma (40x) risk of torsion cosmetic

Question 574

cryptochidism tx

Answer 574

orchidopexy at 6m-18m if identified later - orchidectomy (sertoli cells already degraded)

Question 575

episiotomy usually requires which nerve block

Answer 575

pudendal nerve

Question 576

pudendal nerve innervates

Answer 576

anal sphincters and external urethral sphincters

Question 577

acute inflammation general phases

Answer 577

1. vascular phase 2. cellular phase

Question 578

vascular phase of inflammation

Answer 578

1. vasodilation of arterioles and capillaries which increases blood flow to area (calor and rubor) 2. increased vascular permeability 3. this allows protein, cells and fluids to leave the blood vessel to form exudate

Question 579

exudate formation

Answer 579

made by starling forces 1. hydrostatic forces - force exerted by fluid which forces fluid out 2. oncotic pressure - force exerted by colloids to draw fluid in

Question 580

neutrophil role in acute inflammation

Answer 580

1. margination 2. rolling 3. adhesion 4. emigration - into blood vessel wall

Question 581

sign of chronic infection

Answer 581

granuloma formation

Question 582

AA vs AL amyloidosis

Answer 582

AA secondary to chronic inflammatory conditions e.g. IBD or RhA

Question 583

complications of renal transplantation

Answer 583

common - blocked catheter or hypovolaemia vascular - renal artery thrombosis SUDDEN UO CESSATION or renal artery stenosis immunological - graft rejection urological -obsturction

Question 584

vascular cx of renal transplant

Answer 584

<1% typically results in graft loss usually due to technical problem sudden cessation of UO

Question 585

salter harris types

Answer 585

SALTER S straight (T1) through GP A above (T2) through GP and into metaphysis L lower (T3) through GP and into epiphysis T through (T4) through GP, epiphysis and metaphysis E everything (T5) - crush T2 MOST COMMON

Question 586

brachial plexus definition

Answer 586

anterior rami of c5-t1

Question 587

brachial plexus 5 parts

Answer 587

roots trunks division cords branches

Question 588

brachial plexus roots relationship to scalene muscles

Answer 588

pass between anterior and medial scalene muscles

Question 589

roots to trunks brachial plexus

Answer 589

roots converge to form 3 trunks at base of neck: 1. superior trunk - c5+c6 2. middle trunk - c7 3. inferior trunk - c8 +t1

Question 590

trunks to divisions brachial plexus

Answer 590

each trunk forms an anterior and posterior division leaves 3x anterior and 3x posterior divisions (anterior superior trunk division, posterior superior trunk division etc)

Question 591

divisions to cords brachial plexus

Answer 591

3 cords named accordingly to position to axillary artery lateral cord - anterior division of superior trunk and middle trunk posterior cord - all posterior divisions (superior, middle and inferior) medial cord - anterior division of inferior trunk

Question 592

which nerves are posterior to axillary artery

Answer 592

axillary nerve radial nerve

Question 593

ulnar nerve in relation to axillary artery

Answer 593

medial to axillary artery

Question 594

musculocutaneous nerve in relation to axillary artery

Answer 594

lateral to axillary artery

Question 595

axillary nerve sensory branch

Answer 595

superior lateral cutaneous nerve

Question 596

median nerve roots

Answer 596

c6-t1 (c5 in some individuals)

Question 597

radial nerve roots

Answer 597

c5-t1

Question 598

axillary nerve roots

Answer 598

c5,c6

Question 599

ulnar nerve roots

Answer 599

c8-t1

Question 600

musculocutaneous nerve roots

Answer 600

c5-c7

Question 601

sensory branches of median nerve

Answer 601

palmar cutaneous branch - lateral palm sensation digital cutaneous branch - lateral 3.5 fingers

Question 602

minor branches of brachial plexus

Answer 602

roots - dorsal scapular nerve, long thoracic nerve trunks - suprascapular nerve & nerve to subclavius lateral cord - lateral pectoral nerve medial cord - medial pectoral nerve posterior cord - upper and lower subscapular nerve

Question 603

MCN anatomical course

Answer 603

pierces coracobrachialis passes deep to bicep passes superior to brachialis emergees lateral to biceps tendon where it gives off lateral cutaneous branch (sensation of lateral forearm)

Question 604

radial nerve - as it passes down humerus, accompanied by which artery

Answer 604

brachial artery

Question 605

how does radial nerve enter forearm

Answer 605

anteriorly to lateral epicondyle

Question 606

radial nerve branches in ACF:

Answer 606

1. deep - motor of posterior forearm 2. superficial - sensory

Question 607

axillary nerve passes ____ to surgical neck of humerus

Answer 607

medial

Question 608

3 branches of axillary nerve

Answer 608

posterior terminal branch - teres minor + rear delt anterior terminal branch - supply front delt articular branch - supply GHJ

Question 609

median nerve descends down humerus, ____ to brachial artery

Answer 609

laterally then crosses medially halfway down humerus

Question 610

branches of median nerve

Answer 610

in forearm: 1. anterior interosseous --> deep anterior forearm muscles 2. palmar cutaneous nerve --> lateral palm sensation in carpal tunnel: 1. recurrent --> thenar 2. palmar digital nerves --> lateral lumbrical (motor) and lateral finger sensation

Question 611

why is there preserved lateral palm sensation in carpal tunnel syndrome

Answer 611

palmar cutaneous nerve does not pass through carpal tunnel

Question 612

supracondylar fractures damage which nerve

Answer 612

initially - anterior interosseous nerve (median) most common post-op - ulnar nerve is most common (by k-wire)

Question 613

hand branches of ulnar nerve

Answer 613

deep branch - supplies hypothenar superficial branch - medial 1.5 fingers

Question 614

ulnar nerve in relation to axillary artery and vein

Answer 614

ulnar nerve is medial to axillary artery ulnar nerve is lateral to axillary vein

Question 615

ulnar nerve entering forearm

Answer 615

passes posterior to medial epicondyle

Question 616

froment's sign

Answer 616

ulnar nerve palsy test tests adductor policis hold paper between thumb and index finger lack of thumb adduction and compensation by flexing IPJ is positive

Question 617

froment's sign tests which muscle

Answer 617

adductor policis

Question 618

hypochonium of nail

Answer 618

area distal to nail bed, under the free edge of nail plate

Question 619

eponychium

Answer 619

stratum corneum layer at base of nail

Question 620

germinal matrix of nail

Answer 620

cells that become keratinized to become nail plate

Question 621

3 possible outcomes of peripancreatic fluid collection post-pancreatitis

Answer 621

1. resolution 2. pseudocyst 3. abscess

Question 622

psuedocyst of pancreas features

Answer 622

high amylase in 75% most are retrogastric PRESENT >4 WEEKS AFTER ACUTE PANCREATITIS

Question 623

tx of pseudocyst

Answer 623

endoscopic or surgical cystogastrostomy or aspiration

Question 624

father can consent if....

Answer 624

1. married to biological mother OR 2. on birth certificate

Question 625

renal cell carcinoma tx

Answer 625

t1 = partial nephrectomy t2 = radical nephrectomy no need for neoadjuvant chemo if resection is complete

Question 626

nerve repair growth rate

Answer 626

1mm/day

Question 627

lobular carcinoma in situ - distinct features

Answer 627

low malignancy risk can observe need MRI

Question 628

risk factor for lobular carcinoma in situ

Answer 628

previous contralateral breast cancer

Question 629

risks of aortic aneurysm over 5 years

Answer 629

5-5.9 cm = 25% 6-6.9 cm = 35% >7.0 cm = 75%

Question 630

anything over ____ cm on USS for aortic aneurysm needs a CT scan

Answer 630

5 cm

Question 631

CEA also high in

Answer 631

colitis (IBD) cirrhosis

Question 632

osteomyelitis of spine predilects to which part of spine

Answer 632

cervical

Question 633

TB of spine predilects to which part of spine

Answer 633

thoracic

Question 634

carcinoid ix

Answer 634

24hr urine collection of 5-hydroxindoleacetic acid CT

Question 635

carcinoid tx

Answer 635

if <1.2cm and limited to appendix - DISCHARGE if >2cm need isotope scan --> if mets --> right hemicolectomy octreotide often given

Question 636

charcot foot definition

Answer 636

occurs in patients with peripheral neuropathy where trauma occurs to neuropathic extremities leading to bone and soft tissue/joint damage

Question 637

what nervous system predominates post-op

Answer 637

sympathetic

Question 638

body responses to surgery (4)

Answer 638

1. NA and A facilitated sympathetic drive resulting in bronchodilation, increased glucagon, decreased cortisol, increased HR, increased contractility 2. increased APP 3. increased nitric oxide from vessels 4. endocrine --> increased cortisol

Question 639

tunnelled vs non-tunnelled lines

Answer 639

tunnelled lines have a different exit point (not same as entry point) - they are inserted under skin - have a cuff to anchor to skin - are for longer term infusions e.g. dialysis and chemotherapy examples include groshong and hickmans

Question 640

groshong vs hickmanns

Answer 640

groshong has 3 way valve

Question 641

omphacele vs gastroschisis

Answer 641

omphacele - abdominal contents covered in peritoneum gastroschisis - abdominal contents not covered by peritoneum

Question 642

ligament anterior to spleen

Answer 642

gastrosplenic ligament (part of greater ommentum)

Question 643

ligament posterior to spleen

Answer 643

leinosplenal ligament

Question 644

indications for pre-operative enteral feeding

Answer 644

patients having major abdominal surgery who are: malnourised, have an unsafe swallow or inadequate oral intake but have functional GIT

Question 645

ITU patient feeding

Answer 645

continuous enteral feeding 16-24 hours

Question 646

enteral feeding options

Answer 646

gastric feeding unless upper GI problem - then duodenal or jejunal feeding

Question 647

PEG can be used when after insertion

Answer 647

after 4 hours post-insertion

Question 648

best sterilising method for tubercle bacili

Answer 648

autoclaving

Question 649

what is autoclaving

Answer 649

air removed & high pressure steam used

Question 650

pulmonary artery occlusion pressure is an indirect monitor of

Answer 650

left atrial pressure / filling of left side of heart

Question 651

PAOP interpretation

Answer 651

normal = 8-12 low <5 = hypovolaemia low w/ pulmonary oedema <5 = ARDS high >18 overload

Question 652

what can be damaged in anterior resection

Answer 652

left ureter (near upper rectum/sigmoid)

Question 653

dorsalis pedis is a branch of

Answer 653

anterior tibial artery

Question 654

what structures can be damaged in caecum operations

Answer 654

right ureter + gonadal arteries

Question 655

which adenoma in colon has highest malignancy risk

Answer 655

villous adenoma

Question 656

colorectal cancer follow up after resection

Answer 656

colonoscopy 1year post op

Question 657

high risk features found on baseline colonsocopy - how to follow up

Answer 657

3 year colonoscopy

Question 658

branches of facial nerve

Answer 658

when it passes through IAM - has 3 branches: 1. greater petrosal nerve 2. nerve to stapedius 3. chorda tympani then passes through SMF and has 2 branches: 1. posterior auricular 2. branch of posterior digastric belly then passes through parotid and has 5 branches: Temporal nerve Zygomatic nerve Buccal nerve Marginal Mandibular Cervical nerve

Question 659

diagnosis of transitional cell carcinoma

Answer 659

CT IVU

Question 660

most renal tumours are what colour?

Answer 660

yellow or brown

Question 661

pathology - colour of TCC

Answer 661

pink fleshy

Question 662

nephroblastoma tx

Answer 662

surgical resection combined with chemotherapy (usually vincristine, actinomycin D and doxorubicin)

Question 663

neuroblastoma definition

Answer 663

nerve cell cancer

Question 664

neuroblastoma tx

Answer 664

surgical resection, radiotherapy and chemotherapy

Question 665

most common extracranial tumour of childhood

Answer 665

neuroblastoma

Question 666

angiomyolipoma associated neurological condition

Answer 666

tuberous sclerosis

Question 667

radial head fracture

Answer 667

proximal forearm tenderness pain on pronation and supination

Question 668

An upper GI endoscopy is performed and an ulcer is seen at the greater curvature of the stomach that is actively bleeding. What vessel is most likely to be involved?

Answer 668

gastroepiploic artery.

Question 669

non surgical treatment of keloid scars

Answer 669

triamcinolone

Question 670

giant cell tumour of the bone (osteoclastoma) xray appearance

Answer 670

soap bubble appearance - multiple lytic and lucent appearances

Question 671

bones usually affected by osteoid osteoma

Answer 671

femur and tibia

Question 672

commonest benign tumour of the bone

Answer 672

osteoid osteoma

Question 673

Mirel Scoring system use

Answer 673

stratify the risk of spontaneous fracture for bone metastasis of varying types and thus identify those that need prophylactic fixation

Question 674

Boerhaaves syndrome definition

Answer 674

spontaneous rupture of the oesophagus that occurs as a result of repeated episodes of vomiting

Question 675

where is the rupture typically located in boerhaave's syndrome

Answer 675

left sided and distal

Question 676

why do you ventilate head injured patients

Answer 676

prevents hypercapnia prevents vasodilation, reducing blood flow to brain and therefore ICP

Question 677

tranexemic acid MOA

Answer 677

prevents plasminogen to plasmin prevents clot from being broken down

Question 678

pseudomyxoma peritonei: definition where do they arise

Answer 678

rare mucinous tumour most commonly arising from appendix but also bladder and ovaries

Question 680

risk factors for pseudogout

Answer 680

hyperPTH hypothyroidism haemochromatosis

Question 681

why is haemochromatosis a RF for pseudogout

Answer 681

iron causes overstimulation of osteoclasts

Question 682

causes of hydronephrosis

Answer 682

UNILATERAL: PACT Pelvic-ureteric obstruction Aberrant blood vessels Calculi Tumours BILATERAL: SUPER Stenosis of urethra Urethral valve Prostatic enlargement Extensive bladder tumour Retro-peritoneal fibrosis

Question 683

lymphatic drainage from inferior to dentate line

Answer 683

inguinal nodes

Question 684

why can hypocalcaemia occur in hyperventilation

Answer 684

hyperventilation --> respiratory ALKALOSIS --> bound hydrogen ions dissociate from albumin leaving more albumin to bine to ionized calcium

Question 685

prostate cancer tx

Answer 685

1. if old, multiple co-morbidities or low gleason score - WATCH AND WAIT 2. external beam radiotherapy - both palliative and curative therapy possible. radiation proctitis and rectal malignancy are later problems 3. radical prostatectomy - for localised disease or young patients. Erectile dysfunction common SE 4. Hormonal therapy - anti androgen or LHRH analgoues. Testosterone stimulates prostate tissue

Question 686

A 35 year old man falls and sustains a fracture to the medial third of his clavicle. Which vessel is at greatest risk of injury?

Answer 686

subclavian vein

Question 687

common organisms causing maxillary sinusitis

Answer 687

haemophilus influenzae strep pneumoniae

Question 688

malignancies of the nose and paranasal sinuses

Answer 688

adenoid cystic carcinoma squamous cell carcinoma adenocarcinoma

Question 689

adenocarcinoma of the paranasal sinus and nasopharynx linked to what exposure

Answer 689

hard wood dust

Question 690

ameloblastomas definition

Answer 690

rare tumours of odontogenic epithelium they have a rim of periosteum that when palpated gives rise to crepitus

Question 691

in normal distribution data - what percentage of values lies between: 1 SD of mean 2 SD of mean 3 SD of mean

Answer 691

68.27% 95.54% 99.73%

Question 692

what stimulates prolactin release

Answer 692

TRH (dopamine inhibits)

Question 693

superficial partial thickness burns characteristics:

Answer 693

- form vesicles and bullae - preservation of hair follicles - healing by re-epithelialisation

Question 694

plasma typically accounts for what percentage of body weight

Answer 694

4-6%

Question 695

what % of body water is intracellular

Answer 695

65%

Question 696

what % of body weight is intracellular

Answer 696

40%

Question 697

which dermatome requires blockade in local anaethetic open inguinal hernia repair

Answer 697

T12

Question 698

Which nerve wraps around Wharton's duct (submandibular duct)

Answer 698

lingual nerve

Question 699

flail chest with sats<90% mx

Answer 699

intubation and ventilation

Question 700

full spine immobilisation if:

Answer 700

GCS<15 neck pain/tenderness paraesthesia extremities focal neurological deficit suspected c-spine injury

Question 701

cspine injury: Xray or CT

Answer 701

CT if: - intubated - GCS <13 - normal Xray - any focal neurology - a CT head is being performed - Xray is abnormal

Question 702

what 2 cranial nerves may be non-functioning in hyperacusis?

Answer 702

facial nerve - impaired innervation to stapedius trigeminal nerve - increased tensor tympani innervation

Question 703

porta hepatis transmits what structures

Answer 703

common hepatic duct hepatic artery portal vein SNS and PSNS fibres lymphatic drainage of the liver

Question 704

papillary thyroid spread

Answer 704

lymphatic

Question 705

follicular thyroid cancer spread

Answer 705

haematogenous

Question 706

berrys sign

Answer 706

absence of carotid pulse due to malignant thyromegaly

Question 707

friebergs disease

Answer 707

anterior metatarsalgia affecting the head of the second metatarsal usually associated to pubertal growth spurt

Question 708

use of alginate dressing

Answer 708

for abscess or highly exudating wounds used after incision and drainage alginate is a calcium compound acting as a haemostat

Question 709

fissure in ano tx

Answer 709

stool softerners + topical diltiazem or GTN if topical fail -> botulinum toxin injection if botulinum toxin fails --> sphincterotomy

Question 711

osteopetrosis definition

Answer 711

osteoclast function problem bones become overly dense --> brittle --> fracture

Question 712

rectal cancer staging

Answer 712

MRI rectum + CT CAP

Question 713

colon cancer staging

Answer 713

CT CAP

Question 714

which menisci is usually affected in injury? and why do most sympatomatic tears need treatment?

Answer 714

medial menisci have no nerve or blood supply to heal poorly

Question 715

urethral injury triad of sx

Answer 715

urinary retention perineal haematoma blood at the meatus

Question 716

dieulafoy lesion

Answer 716

large tortuous artery most commonly in the stomach wall that erodes and bleeds

Question 717

A 23 year old man is readmitted following a difficult appendicectomy. His wound is erythematous and, on incision, foul smelling pus is drained. Which of the organisms listed below is responsible?

Answer 717

bacteroides fragilis

Question 718

septic shock precise meaning

Answer 718

refers to refractory systemic arterial hypotension in spite of fluid resuscitation

Question 719

vasopressors vs ionotropes

Answer 719

vasopressors increase blood pressure by constricting blood vessels which increases the amount of blood that can flow to organs ionotropes increase the heart's ability to contract, which imrpoves cardiac output and help maintain BP

Question 720

phrenic nerve - which triangle of the neck

Answer 720

posterior

Question 721

Rectal cancers with threatened resection margins management

Answer 721

radiotherapy and chemotherapy

Question 722

frank haematuria + high RBC?

Answer 722

renal cell carcinoma (not bladder) because RCC cause polycythaemia

Question 723

angiotensinogen to angiotensin 1. which enzyme

Answer 723

renin

Question 724

cerebral perfusion pressure =

Answer 724

mean arterial pressure - ICP

Question 725

mean arterial pressure =

Answer 725

diastolic +0.33(SBP - DBP)

Question 726

phases of wound healing

Answer 726

1. haemostasis 2. inflammation - neutrophils, fibroblasts and macrophages 3. regeneration - fibroblasts, endothelial cells and macrophages 4. myofibroblasts

Question 727

tracheomalacia

Answer 727

collapse of airway due to cartilage degeneration (collapses in expiration) can occur after removal of very large thyroids/goitre

Question 728

femoral nerve (L2-L4) palsy sx

Answer 728

weak hip flexion weak knee extension impaired quadriceps reflex sensory deficit in anteromedial aspect of the thigh

Question 729

what muscles do femoral nerve innervate

Answer 729

pectineus sartorius quadriceps muscles

Question 730

branches of the femoral nerve

Answer 730

medial cutaneous nerve of thigh saphenous nerve intermediate cutaneous nerve of thigh

Question 731

which gut hormone is dependent of vagal stimuli

Answer 731

gastrin

Question 732

what autosomal dominant neurological condition causes discrepancies in limb length

Answer 732

neurofibromatosis type 1

Question 733

The inferior aspect of the vagina drains to which of the following lymph node groups?

Answer 733

superficial inguinal nodes

Question 734

superior aspect of the vagina lymph node drainage

Answer 734

internal and external iliac nodes

Question 735

which muscles attach onto greater trochanter

Answer 735

piriformis obturator internus gemelli obturator externus

Question 736

anal cancer tx

Answer 736

chemoradiotherapy (different from rectal cancer)

Question 737

medications causing pseudohaematuria

Answer 737

rifampicin phenytoin levodopa methyldopa quinine

Question 738

DIC dx

Answer 738

fibrin degredation products are raised

Question 739

DIC definition

Answer 739

dyregulation between coagulation and fibrinolysis - mediated by the abnormal exposure of TF in the circulation

Question 740

Via which structure does cerebrospinal fluid enter the subarachnoid space?

Answer 740

Laterally: foramen of Luschka (from 4th ventricle) Medially: foramen of Magendie (from 4th ventricle)

Question 741

stable bleeding peptic ulcer tx

Answer 741

adrenaline injection + endoscopic clipping/heat therapy

Question 742

cushings triad

Answer 742

HYPERTENSION bradycardia respiratory depression

Question 743

pancreatic cancer with mets tx

Answer 743

ERCP and stent and palliation

Question 744

head of pancreas cancer tx

Answer 744

Whipple's + adjuvent chemo newer techqiues include pylorus preservation and SMA/SMV resection

Question 745

carcinoma of pancreas body and tail

Answer 745

distal pancreatectomy + adjuvant chemo

Question 746

vertebral level of left main bronchus

Answer 746

T6

Question 747

inferior border of both lungs

Answer 747

6th rib MCL 8th rib MAL 10th rib posteriorly

Question 748

popliteal fossa contents (medial to lateral)

Answer 748

popilteal artery popliteal vein tibial nerve common peroneal nerve

Question 749

thoracic aorta rupture CXR

Answer 749

widened mediastinum trachea/oesophagus to right depression of left main stem bronchus widened paraspinal interfaces

Question 750

DALM lesions tx

Answer 750

seen in longstanding ulcerative colitis panproctocolectomy

Question 751

homonymous hemianopia with macula sparing lesion location

Answer 751

occipital cortex

Question 752

which finger has no attachment of the palmar interosseous

Answer 752

middle finger

Question 753

how do catecholamines work as ionotropes

Answer 753

increase cAMP levels by adenylate cyclase stimulation this increases intracellular calcium ion mobilisation and thus the force of contraction

Question 754

adrenaline receptor preference

Answer 754

alpha agonist at lower doses beta agonist at higher doses

Question 755

tranexamic acid MOA

Answer 755

competitively inhibits conversion of plasminogen to plasmin

Question 756

unilateral isolated cleft lip cause

Answer 756

incomplete fusion of the nasolabial muscle rings

Question 757

Contents of carotid sheath:

Answer 757

Common carotid artery Internal carotid artery Internal jugular vein Vagus nerve

Question 758

post-transplant viral complications

Answer 758

CMV - 4weeks-6m EBV >6m (post-transplant lymphoproliferative disorder)

Question 759

most gastric malignancies are....

Answer 759

adenocarcinoma

Question 760

the tunica vaginalis is derived from -----

Answer 760

peritoneum

Question 761

vein mapping investigation

Answer 761

venous duplex > venous doppler

Question 762

coarctation of aorta tx

Answer 762

angioplasty

Question 763

tumours of the posterior tongue metastasize to

Answer 763

bilateral deep cervical nodes

Question 764

lymphatic drainage from the tip of the tongue

Answer 764

submental nodes

Question 765

lymphatics from the medial mid portion of the tongue drain into

Answer 765

submandibular nodes? bilateral deep cervical nodes

Question 766

lymphatics from the lateral mid portion of the tongue drain into

Answer 766

ipsilateral deep cervical nodes

Question 767

rome IV criteria for IBS

Answer 767

recurrent abdo pain or discomfort at 3 days/ month for >3months associated with: 1. improvement with defecation 2. onset associated with a change in the frequency of stool 3. onset associated with a change in the form of the stool

Question 768

which thyroid cancer linked to non-therapeutic irradiation

Answer 768

papillary thyroid

Question 769

main pancreatic duct embryological origin

Answer 769

ventral outgrowth of the duodenum

Question 770

which bacteria implicated in cholangitis infections

Answer 770

e.coli

Question 771

Paneth cells - what are they and where are they located

Answer 771

Secretory cells that contribute to the gut micobiome Crypt of lieberkuhn

Question 772

where do the 3 adrenal arteries arise from

Answer 772

superior - inferior phrenic middle - aorta lower adrenal vessels - renal vessels

Question 773

femoral canal borders

Answer 773

lateral - femoral vein medial - lacunar ligament anteriorly - inguinal ligament posteriorly - pectineal ligament

Question 774

how is tamoxifen a RF for endometrial cancer

Answer 774

is an ER antagonist in breast BUT agonist in endometrial tissue

Question 775

Patients being monitored for HCC: if they have rise in AFP + USS show nodule -> diagnostic scan?

Answer 775

Liver MRI

Question 776

saphena varix O/E

Answer 776

blue discolaration enlarge during coughing disappear on lying down

Question 777

what nerve lies medially to lobes of thyroid and is betewen thr oesophagus and trachea

Answer 777

recurrent laryngeal nerve

Question 778

phrenic nerve: does it pass anteriorly or posteriorly to the following structure: Subclavian vein Subclavian artery Lung roots

Answer 778

SCV - travels posterior to SCV SCA - travels anterior to SCA lung roots - travels anteriorly to lung roots

Question 779

vagus nerve leaves cranium via

Answer 779

jugular foraemne

Question 780

right vagus nerve anatomical course in the neck

Answer 780

passes anterior to the subclavian artery

Question 781

left vagus nerve anatomical course in the neck

Answer 781

passes between the left common carotid and left subclavian artery

Question 782

hyperplasia vs hypertrophy

Answer 782

hyperplasia - increase in number of cells hypertrophy - increase in size of cells

Question 783

what happens when catheter enters prostatic urethra

Answer 783

resistance decreases (as it is much wider)

Question 784

arterial supply of prostate

Answer 784

inferior vesical artery (branch of internal iliac)

Question 785

prostate lymph drainage

Answer 785

internal iliac

Question 786

prostate innervation

Answer 786

inferior hypogastric plexus

Question 787

where do most prostate cancers occur in prostate

Answer 787

peripheral zones

Question 788

what causes high amylase

Answer 788

acute pancreatitis acute cholecystitis DKA mesenteric infarct

Question 789

what hormones are decreased in stress response

Answer 789

insulin testosterone oestrogen thyroxine

Question 790

hormonal affects on pancreatic secretions

Answer 790

SECRETIN - causes secretion of water and electrolytes CCK - causes enzyme secretion Somatostatin - decreases volume of secretion

Question 791

loop diuretic MOA

Answer 791

inhibit Na/K/Cl transporter in ascending limb of Henle reduces absorption of NaCl

Question 792

Thiazide site of action

Answer 792

distal tubule

Question 793

if colonoscopy is indicated but cannot be tolerated - which scan is next

Answer 793

CT colonography

Question 794

stridor after thyroid surgery management

Answer 794

re-open neck wound by removal of skin clips ON THE WARD

Question 795

drugs that can cause parotid enlargement

Answer 795

high oestrogen dose contraceptives thiouracil isoprenaline

Question 796

permanent sutures

Answer 796

polypropylene polyester

Question 797

when should clopidegrel be stopped before surgery

Answer 797

5-7d before reduces ADP induced platelet aggregation for 120hours after final dose

Question 798

heterotropia

Answer 798

tissue found in abnormal location that is present from birth e.g. Meckels (gastric mucosa)

Question 799

most common extra-colonic lesion in FAP?

Answer 799

duodenal polyps

Question 800

external jugular vein relation to sternocleidomastoid

Answer 800

lateral / superficial

Question 801

right recurrent laryngeal nerve anatomical course

Answer 801

branches off right vagus nerve more proximal than T4 it arches posteriorly around the subclavian artery

Question 802

lady having splenectomy for ITP - when to give platelet transfusion?

Answer 802

AFTER ligation of the splenic artery before surgery - platelets would be sequestered by spleen

Question 803

differences in procedure of splenectomy in emergency vs elective

Answer 803

most elective are laparoscopic

Question 804

cx of splenectomy

Answer 804

haemorrhage pancreatic fistula thrombocytosis encapsulated bacteria infection

Question 805

CKK effects on rate of gastric emptying

Answer 805

reduce rate

Question 806

factors increasing gastric acid production

Answer 806

vagal nerve stimulation gastrin release histamine release

Question 807

factors decreasing gastric acid production

Answer 807

somatostatin CKK secretin

Question 808

dercums disease

Answer 808

multiple lipomas + generalized obesity

Question 809

statistical power definition

Answer 809

probability of a test that it will reject the null hypothesis when it is false (thereby avoiding type 2 error)

Question 810

normal statistical power desired

Answer 810

0.8

Question 811

type 1 error

Answer 811

a test rejects a TRUE null hypothesis (false positive). it equates to the significance of a test

Question 812

type 2 error

Answer 812

a test fails to reject a false null hypothesis related to statistical power

Question 813

components needed for power calculations

Answer 813

size of effect significance level sample size desired power

Question 814

where do vertebral arteries unite to form basilar artery

Answer 814

base of the pons

Question 815

branches of the vertebral arteries

Answer 815

PICA anterior spinal artery posterior spinal artery

Question 816

basilar artery branches

Answer 816

pontine arterie AICA superior cerebellar artery posterior cerebral artery

Question 817

what passes posterior to the medial malleolus

Answer 817

tibialis posterior tendon flexor hallucis longus tendon flexor digitorum longus tendon tibial nerve posterior tibial artery

Question 818

locations of accessory spleens (8)

Answer 818

tail of pancreas splenic vessels gastrosplenic ligament splenrenal ligament walls of the stomach and intestines greater omentum mesentery gonads

Question 819

adrenal masses of what size need to be removed

Answer 819

>4cm

Question 820

most significant event to contribute to wound healing immediately following injury

Answer 820

platelet degranulation

Question 821

fistula in ano cell type

Answer 821

squamous

Question 822

respiratory centres

Answer 822

1. medulla respiratory centre 2. apneustic centre 3. pneumotaxic centre

Question 823

apneustic vs pneumotaxic centre

Answer 823

pneumotaxic centre in upper pons apneustic centre in lower pons pneumotaxic centre overrides apneustic cntre and can inhibit inspiration

Question 824

where are respiratory chemoreceptors

Answer 824

central - medulla peripheral - carotid and arch of aorta

Question 825

central chemoreceptors in medulla respond to

Answer 825

H+ in brain interstital fluid

Question 826

obstructing renal cancer stoma

Answer 826

loop colostomy - to defuntion distal segment of colon

Question 827

loop ileostomy indications

Answer 827

defunction distal bowel in low anterior resection

Question 828

spongy urethra and glans penis lymphatic drainage

Answer 828

deep inguinal nodes

Question 829

additional antibiotics to consider for MRSA (in addition to glycopeptide)

Answer 829

rifampicin macrolides tetracyclines

Question 830

bone mets that are hypervascular primary source?

Answer 830

renal cancer

Question 831

prilocaine antidote

Answer 831

methylene blue reverts ferric type to ferrous type Hb

Question 832

scrotal sensation

Answer 832

ilioinguinal nerve - anterior pudendal - posterior skin

Question 833

SOMATOSTATIN FUNCTIONS

Answer 833

1. inhibit GH 2. delays gastric emptying 3. reduces gastric acid production 4. reduces pancreatic exocrine secretions

Question 834

suspicious melanoma lesions should undergo which ix

Answer 834

excision biopsy

Question 835

long head of biceps femoris innervation

Answer 835

tibial division of sciatic nerve

Question 836

short head of biceps femoris innervation

Answer 836

common peroneal nerve

Question 837

hydrocele tx

Answer 837

children - transinguinal ligation of the patent processus vaginalis adults - Lords of Jabouley procedure

Question 838

lord vs jabouley procedure of hydrocele

Answer 838

Lord - plication of sac Jabouley - sac drained, everted and sutured behind testes Jabouley for larger hydrocele; lower risk of recurrence but higher risk of haematoma

Question 839

comedo vs cribiform DCIS

Answer 839

comedo - microcalficications cribiform - multifocal

Question 840

hyoid vertebral level

Answer 840

C3

Question 841

notch of the thyroid cartilage vertebral level

Answer 841

c4

Question 842

cricoid cartilage vertebral level

Answer 842

c6

Question 843

what landmarks are at C6

Answer 843

junction of larynx with trachea junction of pharynx with oesophagus inferior thyroid artery enters thyroid middle cervical ganglion level

Question 844

open fractures >6 hours ago mx

Answer 844

amputation

Question 845

hartmans procedure risk of wound infection

Answer 845

35%

Question 846

preparation for endoscopy

Answer 846

colonoscopy = oral purgatives day before sigmoidoscopy = eneme 30 mins before OGD = NBM for 6 hours

Question 847

where does apneuorsis end

Answer 847

below arcuate line

Question 848

high output fistula management

Answer 848

octreotide - limit pancreatic secretions nutritional complications nutritional support is common - TPN

Question 849

perianal fistulae secondary to Chrons mx

Answer 849

seton

Question 850

nephroblastoma vs neuroblastoma

Answer 850

nephroblastoma are non-calcified neuroblastoma are usually calcified

Question 851

drug causing goitre

Answer 851

lithium

Question 852

when do callus become visible on radiographs after fracture

Answer 852

3 weeks

Question 853

which cell type relies on Cori cycle alone for energy needs

Answer 853

erythrocytes - lack mitochondria

Question 854

parenteral nutrition - what needs to be monitored

Answer 854

zinc folate b12 copper iron ferritin magnesium vitamin d bone density

Question 855

intra-op arterial bleeding mx

Answer 855

ligation

Question 856

proximal humerus fractures mx

Answer 856

impacted fractures - collar and cuff for 3 weeks displaced - ORIF

Question 857

drugs reducing renin secretion

Answer 857

beta blockers NSAIDs

Question 858

which scaphoid fractures need surgery

Answer 858

1. displaced 2. all proximal pole fractures

Question 859

splenic vein thrombosis: dx cx tx

Answer 859

dx - CT angio cx - varices tx - splenectomy

Question 860

During an Ivor Lewis Oesophagectomy for carcinoma of the lower third of the oesophagus which structure is divided to allow mobilisation of the oesophagus?

Answer 860

azygous vein

Question 861

gritti stokes amputation

Answer 861

remove part of femur. connect remaining femur to patella

Question 862

skew flaps benefits

Answer 862

less bulky easier to attach prosthesis to

Question 863

late sign of compartment

Answer 863

lossof pulses

Question 864

pelvic fracture and lwoer abdominal peritonism ....?

Answer 864

bladder rupture

Question 865

large bowel obstruction with visible fluid level cause

Answer 865

sigmoid volvulus

Question 866

what aspect of RAAS causes vasoconstriction

Answer 866

angiotensin II

Question 867

burns + bad ventilation in patient who already intubated

Answer 867

escharotomy

Question 868

colonic pseudoobstruction mx

Answer 868

supportive - electrolyte replacement sometimes neostigmine required to stimulate peristalsis

Question 869

suture for securing drains

Answer 869

2/0 silk

Question 870

what type of smooth muscle propels food through the oesophagus

Answer 870

longitudinal smooth muscle

Question 871

how long does it take food to get from oesophagus into the stomach

Answer 871

9 seconds (primary peristalsis)

Question 872

three main types of peristaltic activity in the colon

Answer 872

1. segmentation contractions - localised contractions in which the bolus is subjected to local forces to maximise mucosal absorption 2. anti-peristaltic contractions - reverse peristaltic waves to slow entry into colon and maximise absorption 3. mass movements

Question 873

discitis organisms in children

Answer 873

0-6m = staph aureus 6m-4y = kingella kingae

Question 874

cluster RCT vs normal RCTs

Answer 874

randomize GROUPS vs individuals more prone to error they require increased recruitment to achieve the same level of statistical power

Question 875

what ligament seperates vertebral column vs spinal cord

Answer 875

posterior longitudinal ligament

Question 876

what blood vessel is divided in lateral approach for hip arthroplasty

Answer 876

transverse branch of the lateral circumflex artery

Question 877

brisk haematuria in pregnancy

Answer 877

placenta PERCRETA - invades mymometrium and can extend into bladder

Question 878

hashimoto's can lead to which cancer

Answer 878

thyroid lymphoma (MALT)

Question 879

most posterior structure at the hilum of the kidney

Answer 879

ureter

Question 880

body of uterus drains into which lymph node

Answer 880

iliac lymph nodes

Question 881

ovaries drain into which lymph node

Answer 881

para-aortic lymph nodes

Question 882

MEN IIB

Answer 882

medullary thyroid phaeochromocytoma mucosal neruroma marfanoid features

Question 883

MEN I

Answer 883

pancreatic/ZES parathyroid pituitary

Question 884

MEN IIA

Answer 884

Phaeochromocytoma Medullary thyroid HyperPTH

Question 885

difficult viewing during cholecystectomy - how to manage

Answer 885

cholecystostomy - drainage of gall bladder

Question 886

sarcomas spread how? and where commonly

Answer 886

haematogenous lung common site

Question 887

parotid gland secretions account for what percentage of secretions to saliva

Answer 887

25%

Question 888

PTH half life

Answer 888

10 mins

Question 889

which parasitic infection affects gut and lungs

Answer 889

ascariasis

Question 890

duct ectasia tx

Answer 890

multiple ducts = hadfields procedure single duct = microdochectomy

Question 891

stroke volume range

Answer 891

55-100ml

Question 892

coronary arteries have which adrenergic receptors

Answer 892

Beta2

Question 893

most common cause of bacterial infective diarrhoea

Answer 893

campylobacter jej

Question 894

causes of hyperuricaemia

Answer 894

severe psoriasis lesch-nyhan syndrome DKA alcohol

Question 895

which 2 arteries run near SFJ

Answer 895

deep external pudendal artery superficial external pudendal artery

Question 896

contents of greater sciatic foramen

Answer 896

sciatic nerve pudendal nerve superior and inferior gluteal nerves nerve to quadratus femoris nerve to obturator internus superior gluteal artery and vein inferior gluteal artery and vein internal pudendal artery and vein

Question 897

hypokalaemia is associated to which pH imbalance

Answer 897

alkalosis

Question 898

posterior urethral valve tx

Answer 898

endoscopic valvotomy

Question 899

Which substance is released from the sympathetic nervous system to stimulate the adrenal medulla?

Answer 899

acetyl choline

Question 900

worm infection of anus most common

Answer 900

enterobius vermicularis

Question 901

5 FU MOA

Answer 901

antimetabolite

Question 902

doxorubicin MOA

Answer 902

Anthracycline - inhibit DNA and RNA synthesis by intercalating base pairs

Question 903

cisplatin MOA

Answer 903

crosslinks DNA to induce apoptosis

Question 904

cyclophosphomide MOA

Answer 904

alkylating agent

Question 905

actinomycosis

Answer 905

chornic progressive granulomatosis disease caused by filamentous gram positive anaerobic bacteria

Question 906

proximal SCC oesophageal cancer tx

Answer 906

chemoradiotherapy

Question 907

lateral medullary syndrome sx

Answer 907

ipsilateral ataxia ipsilateral nystagmus ipsilateral facial nerve dysphagia contralateral hemisensory loss

Question 908

saphenous nerve is related to which vein

Answer 908

long saphenous vein below the knee

Question 909

long saphenous vein course

Answer 909

travels anterior to medial malleolus at the knee runs over the posterior border of the medial epicondyle of the femur bone

Question 910

short saphenous vein course

Answer 910

posterior to the lateral malleolus passes between the heads of the gastrocnemius muscle

Question 911

CNS tumour with sigificant necrosis

Answer 911

glioblastomas

Question 912

most common paediatric CNS tumours

Answer 912

astrocytomas

Question 913

cranial venous sinuses eventually drain into...

Answer 913

internal jugular vein

Question 914

what is the single most important prognostic factor in breast cancer

Answer 914

nodal disease

Question 915

Kocher criteria

Answer 915

WIFE WCC >12 Inability to weight bear Fever ESR . 40

Question 916

lacunar infarct presentation

Answer 916

isolated hemiparesis isolated hemisensory or hemiparesis with limb ataxia

Question 917

lesion affecting lobule in ear - drain into...

Answer 917

superficial cervical LNs

Question 918

sartorius nerve supply

Answer 918

femoral nerve

Question 919

the foramen marking the termination of the adductor canal is located in ...?

Answer 919

adductor magnus

Question 920

papillary thyroid cancer tx

Answer 920

total thyroidectomy and central compartment nodal dissection

Question 921

GIT surgery - what surgeries have lower rates of anastomotic leak

Answer 921

small intestine oesophageal and rectal have highest

Question 922

follicular thyroid cancer tx

Answer 922

total thyroidectomy

Question 923

anaplastic thyroid cancer tx

Answer 923

palliative radiotherapy

Question 924

medullary thyroid cancer tx

Answer 924

total thyroidectomy

Question 925

Which of the following nerves is responsible for the cremasteric reflex?

Answer 925

genitofemoral nerve

Question 926

dupuytrens contracture tx

Answer 926

fasiectomy

Question 927

what is the pathological size of the caecum

Answer 927

9+cm

Question 928

drugs inhibiting secretion of insulin

Answer 928

alpha adrenergic drugs beta blockers sympathetic nerves

Question 930

where are oxyphil cells found

Answer 930

parathyroid glands and follicular thyroid

Question 931

GIST derived from

Answer 931

cells of Cajal

Question 932

what nerve innervates perineum

Answer 932

pudendal n

Question 933

CSF: lateral ventricles to 3rd ventricle foramen

Answer 933

foramen of Munro

Question 934

CSF: 3rd to 4th ventricle foramen

Answer 934

aqueduct of sylvius

Question 935

neurological signs + acute abdo =

Answer 935

acute intermittent porphyria or lead posioning

Question 936

the activation of which clotting factor is when both intrinsic and extrinsic factors meet

Answer 936

factor 10

Question 937

heparin inhibits which clotting factors

Answer 937

2,9,10,11

Question 938

which is the main pathway of coagulation

Answer 938

extrinsinc

Question 939

what starts extrinsic pathway

Answer 939

tissue factor

Question 940

which structure is at risk of injury following a fracture dislocation of femoral epicondyles

Answer 940

popliteal artery

Question 941

symptom difference between maxillary and ethmoidal sinusitis

Answer 941

altered sense of smell a feature of maxillary sinusitis

Question 942

what causes a risk in TLCO

Answer 942

asthma haemorrhage LtoR shunts polycythaemia

Question 943

parotid gland PSNS fibres originate from

Answer 943

Otic ganglion

Question 944

saliva secretion by parotid gland nerve involvement

Answer 944

PREGANGLIONIC: tympanic nerve (branch of CN IX) to lessor petrosal nerve to OTIC GANGLION POSTGANGLIONIC fibres travel as part of auriculotemporal nerve (branch ofV3)

Question 945

The parasympathetic fibres to the lacrimal apparatus transit via which ganglion

Answer 945

pterygopalatine

Question 946

which ligament keeps radial head connected to radial notch of ulnar

Answer 946

annular ligament

Question 947

Which of the following nerves is most often permanently damaged during a superficial parotidectomy

Answer 947

GREATER AURICULAR

Question 948

Which structures pass through both greater and lesser sciatic foramina

Answer 948

pudendal nerve internal pudendal artery nerve to obturator internus

Question 949

cholangitis tx

Answer 949

ERCP and stent

Question 950

where is most iron absorbed?

Answer 950

duodenum

Question 951

ileitis common organism

Answer 951

yersinia enterocolitica

Question 952

external urethral sphincter nerve roots

Answer 952

s2-s4 (pudendal)

Question 953

COCP linked to what liver disease

Answer 953

liver cell adenoma

Question 954

which of the following would still be digested normally in a patient with pancreatic insufficiency? 1. Fat 2. Protein 3. Folic Acid 4. Vitamin B12

Answer 954

3. Folic Acid 4. Vitamin B12

Question 955

during a splenectomy - what needs to be divided

Answer 955

short gastric vessels within the gastrosplenic ligament

Question 956

WARTHIN TUMOUR CHARACTERISTICS

Answer 956

male elderly smokers bilateral in 10%

Question 957

younger patient with PROXIMAL lymphoedema management ?

Answer 957

1. lymphovenous anastomosis

Question 958

clinical differences between FAP and Lynch

Answer 958

FAP - usually 100s of polyps Lynch associated with more RHS cancers

Question 959

axillary artery branches

Answer 959

FIRST SEGMENT of the axillary artery: 1. superior thoracic artery SECOND SEGMENT of the axillary artery: 1. thoracoacromial 2. lateral thoracic artery THIRD SEGMENT of the axillary artery: 1. subscapular artery 2. anterior circumflex humeral artery 3. posterior circumflex humeral artery

Question 960

Which of the following laboratory tests would most accurately identify whether CSF is present or not?

Answer 960

beta-2 transferrin assay

Question 961

Which structures are linked by the ductus arteriosus?

Answer 961

PA and (descending) aorta

Question 962

persistent PDA tx

Answer 962

NSAIDs

Question 963

ductus venosus connects what 2 structures

Answer 963

umbilical vein to IVC (to bypass the liver)

Question 964

burns affect on potassium levels

Answer 964

HYPERKALAEMIA

Question 965

JVP waveform detailing

Answer 965

A wave - right atria contracts X descent - RELAXATION of the right atrium causing drop in pressure C wave - tricuspid wave closes and right ventricle contract causing bulging of TV which transiently increases pressure in RA therefore JVP X descent - complete RV contraction allowing atria to expand - pressure drops V wave - atrial filling with bloods (against a closed tricuspid valve) Y wave - tricuspid valve opens again (JVP pressure drops)

Question 966

tricuspid regurgitation affevct on JVP

Answer 966

large V waves

Question 967

first radiological change in Perthes disease

Answer 967

stage II Caterall disease: Sclerosis of femoral head

Question 968

secondary haemorrhage after tonsillectomy usual time frame

Answer 968

5-10 days (anything over 24hours is technically secondary haemorrhage however)

Question 969

autonomic vs voluntary control of bladder function

Answer 969

autonomic - hypogastric plexuses voluntary control of urethral sphincter - pudendal nerve

Question 970

desmoid tumours: what are they? and where do they tend to arise?

Answer 970

fibrous neoplasms usually arise from musculoaponeurotic structures

Question 971

INDUCTION AGENT (SEDATIVE) BEFORE PARALYTIC AGENTS (RELAXANTS)

Answer 971

.

Question 972

GOODSALLS rule

Answer 972

anterior fistula - tract straight posterior fistula - curvature traction only applies to fistulae within 3cm radius of anus

Question 973

what skin rash is associated to necrolytic migratory erythema

Answer 973

glucagonoma

Question 974

What type of epithelium is present on the external aspect of the tympanic membrane?

Answer 974

stratified squamous

Question 975

adductor longus innervation

Answer 975

anterior division of obturator nerve (L2-L4

Question 976

Which substance is commonly used to sterilize endoscopic and laparoscopic equipment?

Answer 976

glutaraldehyde

Question 977

abdo + neurological symptoms niche cosiderations

Answer 977

think acute intermittent porphyrias think lead posioning

Question 978

most radioopaque kidney stone

Answer 978

calcium phosphate

Question 979

sensory innervation of axilla

Answer 979

intercostobrachial plexus

Question 980

laboratory features of dehydration

Answer 980

rising haemotocrit hypernatraemia metabolic acidosis rising lactate urinary sodium<20

Question 981

posteriorn digastric innervation

Answer 981

facial nerve

Question 982

posterior approach hip replacement - which artery is at risk

Answer 982

inferior gluteal artery

Question 983

popcorn cells seen in ...

Answer 983

nodular lymphocyte predominant HL

Question 984

beta-napthalamine is associated with which cancer

Answer 984

bladder cancer

Question 985

important structures posterior to right colon

Answer 985

gonadal vessels right ureter

Question 986

distal third clavicle fracture - which artery at risk of injury

Answer 986

thoracoacromial artery

Question 987

squamous cell carcinoma of skin excision margins

Answer 987

lesions <20mm need 4mm margin excision lesions >20mm need 6mm margin excisions

Question 988

metastatic bone fractures - which cancers are more likely to have bone mets that fracture

Answer 988

breast cancer bone mets are usually lytic (prostate cancers are sclerotic)

Question 990

which bone mets site is at greatest risk of fracture

Answer 990

peritrochanteric fracture

Question 991

typical GFR

Answer 991

125ml

Question 992

left sided SVC congenital abnormality - how does blood enter right atrium

Answer 992

enlarged coronary sinus

Question 993

somatostatin effects

Answer 993

decrease acid and pepsin secretion decrease gastrin secretion decreases pancreatic enzyme secretion decreases insulin and glucagon secretion

Question 994

waldeyer's fascia

Answer 994

posterior ano-rectum

Question 995

sibsons fascia

Answer 995

apex of lung

Question 996

bucks fascia

Answer 996

base of penis

Question 997

gerotas fascia

Answer 997

surrounding kidney

Question 998

denonvilliers fascia

Answer 998

between rectum and prostate

Question 999

discitis in children organisms

Answer 999

<6m = staph aureus 6m-4y = kigella kingae

Question 1000

which enzyme deficiency causes steatorrhoea

Answer 1000

lipase

Question 1001

why is tranfusion with platelets most likely to cause gram +ve infection out of all transfusion types

Answer 1001

platelets stored at room temperature

Question 1002

hypovolaemic shock features

Answer 1002

decreased CO decreased BO increased HR increased SVR

Question 1003

parathyroid embryological origin

Answer 1003

superior parathyroids - fourth pharyngeal pouch inferior parathyroids - inferior pharyngeal pouch

Question 1004

parathyroid relation to thyroid

Answer 1004

parathyroid is POSTERIOR

Question 1005

epiploic foramen contents

Answer 1005

portal vein hepatic artery common bile duct

Question 1006

how is the pituitary gland attached to the hypothalamus

Answer 1006

by the infundibulum

Question 1007

what can cause high 5-HIAA

Answer 1007

drugs: naproxen and MAOi food: spinach, cheese, wine, caffeine, tomatoes

Question 1008

hassall's corpuscles found in ...

Answer 1008

medulla of the thyroid

Question 1009

middle ear innervated by ....

Answer 1009

glossopharyngeal nerve

Question 1010

aptt is a measure of

Answer 1010

intrinsic pathway

Question 1011

instrinsic patheay of coagulation

Answer 1011

F12> F11>F9>F10

Question 1012

PT measure of

Answer 1012

extrinsic pathway (TF+F7)

Question 1013

tip of tongue lymphatic drainage

Answer 1013

submental nodes (then to deep cervical nodes)

Question 1014

mid portion of tongue lymphatic drainage

Answer 1014

submandibular drainage or if lateral then ipsilateral deep cervical nodes

Question 1015

what muscles do ansa cervicalis innervate

Answer 1015

sternohyoid sternothyroid omohyoid

Question 1016

From which embryological structure is the ureter derived?

Answer 1016

mesonephric duct

Question 1017

metallic heart valve patient needs operation - when to stop heparin

Answer 1017

6 hours pre-op

Question 1018

mid inguinal point

Answer 1018

midway between the ASIS and the pubic symphysis

Question 1019

stoma earliest complication vs most common

Answer 1019

earliest = necrosis most common = dermatitis

Question 1020

electrical burns fluid resus

Answer 1020

4ml hartmanns x kg x %TBSA

Question 1021

flame burns fluid resus

Answer 1021

2ml hartmanns x kg x %TBSA

Question 1022

scrotal layers

Answer 1022

1. skin 2. dartos fascia and muscle 3. external spermatic fascia 4. cremasteric muscle and fascia 5. internal speramtic fasscia 6. parietal layer of the tunica vaginalis

Question 1023

physiologyical insulin after surgery

Answer 1023

reduced (so is testosterone and oestrogen)

Question 1024

nerve most closely related to bladder

Answer 1024

obturator bladder

Question 1025

hormones increased after surgery

Answer 1025

GH cortisol renin ACTH aldosterone prolactin ADH glucagon

Question 1026

where does neonate spinal cord end

Answer 1026

L3

Question 1027

What increases physiological dead space

Answer 1027

PE COPD hypotension

Question 1028

ileo-ileal intususcception mx

Answer 1028

rarer subtype requires laparotomy

Question 1029

DMSA vs MAG 3 uses

Answer 1029

DMSA best for scarring (not necessary if CT-proven) MAG-3 best for assessment of renal function in damaged kidneys

Question 1030

renal vein in relation to renal hilum

Answer 1030

vein is anterior

Question 1031

ureter in relation to renal hilum

Answer 1031

posterior to hilum

Question 1032

transported kidney anastomised to which blood supply

Answer 1032

external iliac artery

Question 1033

haemangioma on ultrasound

Answer 1033

hyperechoic

Question 1034

pancreatic secretions volume a day

Answer 1034

1L-1.5L

Question 1035

What is the lymphatic drainage of the female urethra?

Answer 1035

internal iliac nodes

Question 1036

what type of suture is prolene

Answer 1036

permanent monofilament

Question 1037

vicryl type of suture

Answer 1037

braided absorbable

Question 1038

what type of suture is polyester

Answer 1038

braided permanent

Question 1039

PDS type of suture

Answer 1039

monofilament

Question 1040

high output stoma causes acidosis or alkalosis

Answer 1040

acidosis

Question 1041

superior adrenal artery is a branch of

Answer 1041

inferior phrenic artery

Question 1042

suxamethonium can lead to which electrolyte imbalance

Answer 1042

hyperkalaemia

Question 1043

structures passing through the parotid gland

Answer 1043

facial nerve and branches external carotid artery retromanidbular vein auriculotemporal nerve

Question 1044

which artery runs under the long saphenous vein

Answer 1044

deep external pudendal artery

Question 1045

what does inferior mesenteric vein drain into

Answer 1045

splenic vein

Question 1046

which steroid doesnt affect cortisol levels

Answer 1046

dexamethasone

Question 1047

incision for malrotation

Answer 1047

transvere supra umbilical abdominal incision

Question 1048

rectal prolapse surgery types

Answer 1048

perineal 1. Delormes 2. Altmeirs - more effective but carries higher risk of anastomotic leak abdominal 1. rectopexy - low recurrrence rates

Question 1049

atracurium produces what on hydrolysis

Answer 1049

histamine

Question 1050

What is the most important urinary acid base buffer?

Answer 1050

phosphate

Question 1051

toxic megacolon mx

Answer 1051

sub total colectomy and end ileostomy

Question 1052

brocas area is supplied. by

Answer 1052

middle cerebral artery

Question 1053

posterior belly of diagastric muscle supplied by

Answer 1053

facial nerve

Question 1054

which vessels most likely to bleed in tonsils removal

Answer 1054

external palatine vein

Question 1055

asteroid bodies found in which condition

Answer 1055

sarcoidosis

Question 1056

Administration of which of the following may facilitate the identification of parathyroid glands intra operatively?

Answer 1056

methylene blue

Question 1058

median nerve course relative to the brachial artery

Answer 1058

lateral>anterior>medial

Question 1059

adductor longus innervation

Answer 1059

obturator nerve

Question 1060

which thyroid cancer spreads haematogenously and commonly mets to bones

Answer 1060

follicular

Question 1061

incision for whipples procedure

Answer 1061

rooftopv

Question 1062

lateral to medial: foramina of skull

Answer 1062

spinosum > ovale > rotundum SOR

Question 1063

hydrocele mx

Answer 1063

children - ligation of patent processus vaginalis via inguinal approach adult - jabuloay or lords via scrotal approach

Question 1064

exposure of which fascia exposes the ansa cervicales

Answer 1064

pretracheal fascia

Question 1065

ansa cervicales lies _____ to carotid sheath

Answer 1065

anterior

Question 1066

obstructing splenic flexure cancer tx

Answer 1066

EXTENDED RIGHT HEMICOLECTOMY IF NOT OBSTRUCTING THEN LEFT HEMICOLECTOMY

Question 1067

MIDDLE MENINGEAL ARTERY IS A BRANCH OF....

Answer 1067

maxillary artery

Question 1068

What is the most important structure involved in supporting the uterus?

Answer 1068

central perineal tendon

Question 1069

which coagulation factor likely to be normal in liver failure

Answer 1069

factor 8

Question 1070

What is the level of the hyoid bone?

Answer 1070

c3

Question 1071

What is the commonest type of fistula in ano?

Answer 1071

intersphincteric

Question 1072

parasympathetic nerve supply to bladder does what

Answer 1072

contraction of detrusor muscles

Question 1073

What is the main component of colloid in the thyroid gland?

Answer 1073

thyroglobulin

Question 1074

anterior vs posterior duodenal ulcers

Answer 1074

anterior - more likely to perforate causing peritonitis posterior - more likely to bleed

Question 1075

Sudden onset of abdominal pain followed by forceful evacuation of bowels - think of...

Answer 1075

acute mesenteric infarction

Question 1077

which breast cancer patients need post-op chemo

Answer 1077

patients with grade 3 lesions or axillary node disease

Question 1078

tenia coli converge where?

Answer 1078

base of appendix

Question 1079

diaphragm disease: 1. what is it 2. what causes it

Answer 1079

rare condition that causes multiple strictures in the small bowel caused by NSAID overuse

Question 1080

Infection with which of the following micro-organisms may result in a clinical picture resembling achalasia of the oesphagus?

Answer 1080

TRYPANOSOMA CRUZI (Chagas)

Question 1081

upper pole of kidney corresponds with which rib

Answer 1081

11th

Question 1082

colonic villous adenomas can cause which electrolyte disturbance

Answer 1082

hypokalaemia

Question 1083

what blood product most cocmmonly causes urticaria

Answer 1083

FFP

Question 1084

how can you confirm enterocutaneous fistula as appose to wound infection?

Answer 1084

methylene blue found in the drain = fistula

Question 1085

DIC consumes which clotting factors first

Answer 1085

5&8 then platelets

Question 1086

what cell type responsible for contractile nature of scar

Answer 1086

myofibroblasts

Question 1087

which hormone will secreted in decreased quantities after distal gastrectomy

Answer 1087

gastrin - released from gastric antrum

Question 1088

structures that pass posterior to lateral malleolus

Answer 1088

peroneus brevis tendon peroneus longus tendon short saphenous vein sural nerve

Question 1089

What is the half life of insulin in the circulation of a normal healthy adult?

Answer 1089

less than 30 mins

Question 1090

parasympathetic affect on HR

Answer 1090

tachycardia atropine (antiPSNS causes brady)

Question 1091

What is the anatomical level of the transpyloric plane?

Answer 1091

L1

Question 1092

A 34 year old lady is due to undergo a laparoscopic cholecystectomy. Which of the following intrabdominal pressures should typically be set on the gas insufflation system?

Answer 1092

10mmhg

Question 1092

what proportion of fissures are anterior

Answer 1092

10%

Question 1093

Into which of these veins does the middle thyroid vein drain?

Answer 1093

internal jugular vein

Question 1094

thyroid arterial supply

Answer 1094

superior thyroid - ECA inferior thyroid - branch of thyrocervical - branch of subclavian thyroidea ima

Question 1095

thyroid venous drainage

Answer 1095

superior and middle thyroid veins - drain into IJV inferior thyroid vein - into brachiocephalic

Question 1096

sigmoid sinus drains into...

Answer 1096

internal jugular vein

Question 1097

radial nerve position to humerus at distal third

Answer 1097

anterolateral

Question 1098

one RCT is which level of evidence

Answer 1098

II

Question 1099

dura terminates at which spinal level

Answer 1099

S2

Question 1100

JUGULAR FORAEMEN PART OF WHICH BONE

Answer 1100

temporal

Question 1101

foramen magnum part of which bone

Answer 1101

occipital bone

Question 1102

suspected breast implant complication - which imaging

Answer 1102

MRI