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SBA BOOK Flashcards

1
Q

Pleurae margins for lungs

A 
Both start 2.5cm above border between medial and middle third of clavicle 
Pleurae meet in the midline at 2nd CC
Left Pleura leaves midline at 4th CC
Right Pleura leaves midline at 6th CC 
Meet in mid clavicular line at 8th CC
Mid axillary line at 10th CC 
Midline in back at 12th CC
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2
Q

Where do oblique fissures start and end

A

Start at the tip of T3
Parallel to rotated medial scalpula border
End at 6TH Costochondral joint

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3
Q

Where does Horizontal fissure start and finish

A

Runs medially from oblique fissure at mid axillary line along border of 4th rib

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4
Q

What level does Aorta pass Diaphragm

What structures pass here

A

T12 Aortic Hiatus
Aorta
Thoracic duct
Azygous vein

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5
Q

Describe the course of thoracic duct, what does it lie laterally to?

A

Lies lateral to AZV
Originates from the chyle cisterns in abdomen and ascends through T12 Aortic hiatus
Drains everything but RUQ of body (this is done by Right lymphatic trunk)
Courses between aorta (lateral) and Azygous vein (medial)
Oseophagus (anterior) until T5 WHERE IT CROSSES ANTERIORLY
Drains into left subclavian

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6
Q

Location of heart valves

A

Mitral Tricuspid - 4th

Aortic pulmonary - 3RD

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7
Q

Left coronary artery branches supply

A

LAD supplies both ventricles and interventricular septum
LMA Supplies left ventricle
LCIRC Left atrium and left ventricle

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8
Q

Right coronary artery braches supply

A

RCA - RA and RV
RMA- RV AND Apex
Posterior interventricular artery - RA and RV + Interventricular septum

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9
Q

What level is sternal angle?

What happens here

A 
T4
Aortic arch is terminating 
Azygous vein enters SVC
Left recurrent laryngeal loops around ligamentum venosum 
Bifurcation of ligamentum venosum
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10
Q

Arterial supply to the oesophagus

A

Cervical portion - Inferior thyroid artery
Thoracic portion - Descending aorta
Abdominal portion - Left gastric artery (Coeliac trunk)

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11
Q

Venous drainage of oesophagus

A

Cervical portion: Inferior thyroid vein
Thoracic portion: Azygous vein
Abdominal portion: Left Gastric Vein

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12
Q

What passes through Caval hiatus (T8)

A

Right phrenic

Vena Cava

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13
Q

What passes through Oesophageal hiatus (T10)

A

Oesophagus
Left gastric artery and vein
Vagus

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14
Q

What structures form from aoric arches

A 
Six pairs Arise from truncus arteriosus 
1st and 2nd arches disappear
3rd arch becomes carotid
4th arch Right side - Brachiocephalic + Subclavian
4th arch Left - Aortic arch
5th Disappears 
6th Left and Right pulmonary arches
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15
Q

Commonest site for Bochdalek (diaphragmatic hernia)

A

Left posterior aspect

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16
Q

Most likely site for inhaled FB

A

Right lower lobe bronchus

Right main bronchus is wider, shorter and runs more vertically than left main bronchus

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17
Q

Lymphatic drainage of Oeseophagus

A

Cervical aspect - internal jugular nodes
Thoracic - Mediastinal
Abdomal - gastric and coeliac lymph nodes

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18
Q

When to use endocrine therapy in breast ca

A

Oestrogen receptor positive tumours
Downstaging primary lesions
Definitive treatment in old, infirm patients

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19
Q

When to use radiotherapy in breast ca

A

WLE

Large lesion, high grade or marked vascular invasion following mastectomy

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20
Q

When to use Chemotherapy in breast Ca

A

Downstaging advanced lesions to facilitate breast conserving surgery
Patients with grade 3 lesions or axillary nodal disease

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21
Q

Primary site Cancers likely for bone mets

A 
BReast
BRonchus
REnal (tend to be hypervascular)
Thyroid
Prostate
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22
Q

Contraindication to lung ca excision

A

Stage IIIb or IV (i.e. metastases present)
FEV1 < 1.5 litres is considered a general cut-off point
Malignant pleural effusion
Tumour near hilum
Vocal cord paralysis
SVC obstruction

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23
Q

ECG changes for thrombolysis

A

ST elevation of > 2mm (2 small squares) in 2 or more consecutive anterior leads (V1-V6) OR

ST elevation of greater than 1mm (1 small square) in greater than 2 consecutive inferior leads (II, III, avF, avL) OR

New Left bundle branch block

24
Q

GCS Parameters

A 
Eye opening
4 Spontaneous
3 To speech
2 To pain
1 None

 Verbal response
5 Orientated
4Confused
3 Words
2 Sounds
1 None

Motor response
6Obeys commands
5Localises to pain
4Withdraws from pain
3Abnormal flexion to pain (decorticate posture)
2Extending to pain
1 None
25
How to test for CSF in suspected base of skull ffracture
Beta 2 transferrin
26
Where does uterine artery originate and what else does it supply
Internal iliac artery Found medial to levator ani Branch is given off to ureter 2cm above the cervix ureter
27
Location of spleen
9-12 LEFT RIBS
28
Muscles of pelvic diaphragm
Puborectalis Pubococcygeus Iliococcygeous Coccygrous
29
Four abnormalities of TOF
Overriding Aorta Pulmonary stenosis RVH VSD
30
Three Cranial Nerves most likely to be injured during submandibular gland surgery
``` Marginal Mandibular (lower lip muscles - orbicularis oris etc - so drooling/pooling of saliva) Lingual (Sensory deficit anterior 2/3- Remember NOT taste) Hypoglossal (Motor - Ipsilateral tongue paralysis) ```
31
Lung hila structures
Pulmonary artery - superior Pulmonary vein - inferior Bronchus - posterior
32
Papillary carcinoma
``` papillary projections and pale empty nuclei Seldom encapsulated Lymph node metastasis predominate Haematogenous metastasis rare Account for 60% of thyroid cancers ```
33
Course of Brachial Plexus
Ventral rami, the roots of the plexus, lie between scalenus medius and anterior. (C5-T1) Pass between Scalene anterior and medius
34
Nerves from Roots of Brachial Plexus
C5,6,7 Long thoracic nerve
35
Nerves from Trunks of Brachial plexus
Upper trunk - 2USS Suprascapular (C5-6) Subclavius (C5-6)
36
Nerves from Lateral cord of Brachial Plexus
Lateral Pectoral | Evenually gives musculocutateonus (C-5-7) branches
37
Nerves from Medial cord
``` Medial arm stuff Medial Pec Medial cut FARM Medial cut ARM Continues to give ulnar nerve CT T1 ```
38
Nerves from Postreior cord
``` ULNAR U upper scapular L ower scapular Nerve to lat dorsi (thoracodorsal) Axillary (c5-6) Radial (C5-8) ```
39
Nerves involved in Erbs palsy
``` C5,6 MASS affect Muculocutaneous Axillary Suprascapular Subclavius Limp upper limp, Medially rotated, pronated Waiters tip ```
40
Nerves involved in Klumpkes
C8-T1 Ulnar and Median most affected ie) Intrinsic muscles of the hand Claw hand
41
Ulnar nerve damage at elbow
FDP ulnar aspect not at all supplied So no DIP flexion Less severe clawing
42
Ulnar never damage at wrist
FDP is working So DIP is flexed Clawing more obvious
43
Upper limb myotomes
``` Elbow flexors/Biceps C5 Wrist extensors C6 Elbow extensors/Triceps C7 Long finger flexors C8 Small finger abductors T1 ```
44
Lower limb Myotomes
``` Hip flexors (psoas) L1 and L2 Knee extensors (quadriceps) L3 Ankle dorsiflexors (tibialis anterior) L4 and L5 Toe extensors (hallucis longus) L 5 Ankle plantar flexors (gastrocnemius) S1 2 ```
45
Inguinal canal boundaries
Anterior wall: External Oblique Aponeurosis Floor: EO, Lacunar ligament, inguinal ligament Roof:Internal oblique Transversus abdominis Posterior: Transversalis fascia Conjoint tendon
46
Spermatic cord coverings and origins
External spermatic - external oblique Cremasteric - Internal oblique Internal sperm - TF
47
Adductor canal borders
Posteriorly Adductor longus, adductor magnus Laterally Vastus medialis muscle Roof Sartorius
48
Adductor canal contents
Saphenous Nerve | Superficial Femoral Artery and Vein
49
Structures passing through Parotid
Facial nerve (Mnemonic: The Zebra Buggered My Cat; Temporal Zygomatic, Buccal, Mandibular, Cervical) External carotid artery Retromandibular vein Auriculotemporal nerve
50
Relations of parotid
Anterior: masseter, medial pterygoid, superficial temporal and maxillary artery, facial nerve, stylomandibular ligament Posterior: posterior belly digastric muscle, sternocleidomastoid, stylohyoid, internal carotid artery, mastoid process, styloid process Lymph drainage- deep cervical
51
Nerve stimulation of parotid causes?
Parasympathetic stimulation produces a water rich, serous saliva. - ready to eat Sympathetic stimulation leads to the production of a low volume, enzyme-rich saliva.
52
Galeazzi fracture
Radial shaft fracture with associated dislocation of the distal radioulnar joint 디스털레이어스로가자
53
Monteggia Fracture
Dislocation of the proximal radioulnar joint in association with an ulna fracture
54
Osteomalacia picture
low: calcium, phosphate raised: alkaline phosphatase
55
Perthes disease aetiology and radiological grading
Boys 2-12 Half a dozen half a head Catterall staging Stage Features Stage 1 Clinical and histological features only Stage 2 Sclerosis with or without cystic changes and preservation of the articular surface Stage 3 Loss of structural integrity of the femoral head Stage 4 Loss of acetabular integrity
56
Salter Harris
S (Type 1): Straight through the growth plate A (Type 2): Above - through growth plate and Above involving the metaphysis L (Type 3): Lower -through growth plate and beLow involving the epiphysis T (Type 4):Through - Through both metaphysis, epiphysis and growth plate E (Type 5): Everything - Crush / compression injury R (Type 5): Ruined

MRCS (14 decks)

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