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Anatomy 3 Flashcards

MRCS part A

1
Q

Sarcomas

A

Typically in extremities

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2
Q

Sarcoma of adipocytes

A

Liposarcomas

Have pseudocapsule and typically found retroperitoneum

Resistant to radiotherapy

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3
Q

Ewings sarcoma

A

Usually blood borne mets

Respond to chemo + surgery

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4
Q

Hepatocellular adenomas

A

Associated with OCP and lack fibrous capsule

Typically not concerned if under 5cm

UNLESS in males as more likely to transform

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5
Q

Clotting not produced in liver

A

Factor VIII

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6
Q

Obstruction from RECTAL cancer

A

Loop colostomy

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7
Q

Obstruction from LEFT COLON cancer

A

Resection of lesion and end colostomy (Hartmann’s)

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8
Q

T4 RECTAL cancer

A

Requires irradiation prior to resection

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9
Q

T1, 2, 3 + N0 RECTAL cancer

A

No irradiation, straight resection

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10
Q

Ligament suspending duodenojejunal flexure

A

Ligament of Trietz

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11
Q

Thoracic duct

A

On left side of neck

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12
Q

Midpoint of internal jugular

A

Crossed by ansa cervicalis

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13
Q

Atlas: internal jugular

A

Crossed by accessory nerve

All last 4 cranial nerves related at this point to it

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14
Q

Superior sagittal sinus

A

Unpaired cranial sinus

Parietal emissary veins drained into it

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15
Q

Cerebral perfusion pressure

A

MAP - intracranial pressure

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16
Q

MAP

A

Diastolic pressure + 0.33 (Systolic pressure - diastolic pressure)

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17
Q

Number of collateral venous systems

A

4 Pathways

Azygos venous system
Internal mammary venous pathway
Long Thoracic to femoral and vertebral veins (2 pathways)

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18
Q

Main rectal vessels

A

Superior rectal artery from inferior mesenteric artery (arterial supply)

Middle rectal artery from the internal iliac artery

Inferior rectal artery from the internal pudendal artery

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19
Q

Main rectal lymph drainage

A 
Mesorectal lymph nodes (superior to dentate line)
Inguinal nodes (inferior to dentate line)
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20
Q

Propofol

A

Strong anti-emetic effect

CARDIAC DEPRESSION

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21
Q

Sodium Thiopentone

A

Marked myocardial depression

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22
Q

Etomidate

A

Safe cardiac profile

Adrenal suppression

Post operative vomiting

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23
Q

Orchiplexy

A

Caudal block

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24
Q

Inguinal Canal / laparoscopic

A

TAP block

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25
Q

Major abdominal surgery

A

Epidural

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26
Q

Lingual nerve

A

Purely sensory

If muscular deficit post submandibular gland excision then hypoglossal nerve

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27
Q

Contents of popliteal fossa (medial to lateral)

A

Popliteal artery - deep
Popliteal vein
Tibial nerve - superficial + medial esp inferiorly (sural branches on inferior aspect)
Common peroneal nerve

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28
Q

Otalgia after tonsillitis

A

Glossopharyngeal nerve is tonsils and ear

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29
Q

Renal scarring

A

DMSA scan

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30
Q

Pre-existing renal impairment

A

MAG-3

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31
Q

Nasopharyngeal carcinoma triad

A

Trotter’s triad

Unilateral conductive hearing loss
Ipsilateral facial & ear pain
Ipsilateral paralysis of soft palate

Radiotherapy is first line

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32
Q

Back of tongue

A

Bilateral lymph (deep cervical) drainage

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33
Q

Bochdalek hernia

A

3 P & 3 B

1- Birth defect (congenital) 
2- Big 
3- Bad Prognosis 
4- Posterior located 
5- Pulmonary hyPoPlais is common 
6- Placement of mesh may be needed to treat
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34
Q

Rectal fascial layers

A

Denonvilliers anteriorly (bladder)

Waldeyers posteriorly (sacrum)

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35
Q

Sciatic nerve

A

Runs inferolaterally under cover of gluteus maximus midway between greater trochanter and ischial tuberosity

36
Q

Ear lymph drainage: lower half and lobule

A

Superficial cervical lymph node

37
Q

Ear lymph drainage: cranial superior half

A

Mastoid + deep cervical

38
Q

Ear lymph drainage: lateral superior half

A

Superficial parotid lymph node

39
Q

Stimulation of insulin

A 
Glucose
Amino acids
Vagal cholinergic
Secretin/Gastrin/CCK
Fatty acids
Beta adrenergic drugs (therefore BB inhibit)
40
Q

External anal sphincter nerve

A

S2,3,4 poo off the floor

41
Q

Absorption of iron

A

Duodenum and jejunum

Stored mainly in haemoglobin

42
Q

Phrenic nerve

A

Passes with the internal jugular vein across scalenus anterior
It passes deep to prevertebral fascia of deep cervical fascia
Posterior to medial aspect of first rib

43
Q

Left phrenic nerve

A

Left crosses anterior to 1st part of subclavian artery

44
Q

Right phrenic nerve

A

Anterior to scalenus anterior. Crosses anterior to 2nd part of subclavian artery
Passes over right atrium

45
Q

Paget’s disease of nipple

A

Areolar region spared initially

46
Q

Attachment of greater trochanter

A

POGO

Piriformis
Obturator internus
Gemelli
Obturator externus

47
Q

Parathyroid relations

A

Lateral - common carotid
Medial - recurrent laryngeal nerve
Anterior - thyroid
Posterior - pretracheal fascia

48
Q

1st web space sensation

A

Deep peroneal nerve

49
Q

Lateral sensation

A

Sural nerve

50
Q

Dorsum sensation

A

Superficial peroneal

51
Q

Proximal plantar sensation

A

Tibial nerve

52
Q

Medial plantar sensation

A

Medial plantar nerve

53
Q

Epiploic foramen

A

Superior is caudate process of liver

Inferior is 1st part of duodenum

54
Q

Hyperhidrosis resection Rx

A

T2 and T3 symphatetic ganglia

55
Q

Spondylolisthesis

A

Stress fracture of back (in young athletes)

Scotty dog appearance on X-ray

56
Q

Spondylolysis

A

Congenital or acquired deficiency of the pars interarticularis of the neural arch of a particular vertebral body, usually affects L4/ L5
Usually asymptomatic

57
Q

Branches of subclavian artery

A

VIT CD

V ertebral artery
I nternal thoracic
T hyrocervical trunk

C ostalcervical trunk
D orsal scapular

58
Q

Phrenic nerve

A

C3,4,5 diaphragm alive

59
Q

Isthmus location

A

Rings 2, 3, 4 make the isthmus floor

Attached ligament of berry

60
Q

Rockall score

A

ABCDE

A: Age 
B: Blood pressure drop (Shock) 
C: Co-morbidity 
D: Diagnosis 
E: Evidence of bleeding
61
Q

Kocher’s septic knee criteria

A

WIFE

WCC >12 
Inability to weight bear 
Fever 
ESR >40
= >90 chance of septic arthritis
62
Q

Posterior cord of brachial plexus

A

STAR

S ubscapular (upper and lower)
T horacodorsal
A xillary
R adial

63
Q

Lateral cord

A

Musculocutaneous is branch

64
Q

Long thoracic

A

C5,6,7 at root (first branch of plexus)

65
Q

Suprascapular

A

Drunk Superior (lateral) trunk

66
Q

Lateral hip rotators

A

P - GO - Q

Piriformis
Gemellus superior
Obturator internus
Gemellus inferior
Obturator externus
Quadratus femoris
67
Q

Mets to bone

A

BBRTP

Breast - lytic
Bronchus
Renal
Thyroid - follicular
Prostate - sclerotic
68
Q

Down’s sydrome

A

Duodenal atresia

69
Q

Appendicular artery branch of:

A

Ileo-colic artery

70
Q

Tough ligamentous structure lying anterior to the spinous processes

A

Ligamentum flavum

71
Q

Most common type of fistula in ano

A

Intersphincteric

72
Q

Saphenous vein stripped to

A

level of knee/upper calf.

NB increased risk of saphenous neuralgia if stripped more distally

73
Q

Coeliac autonomic plexus

A

Anterolateral to the aorta

74
Q

Glioblastoma

A

Originate from astrocytes

75
Q

SIADH causes

A

ABCD

A nalgesics: opioids, NSAIDs
B arbiturates
C yclophosphamide/ Chlorpromazine/ Carbamazepine
D iuretic (thiazides)

76
Q

Ureter retroperitoneal at

A

L2-L5 transverse processes

77
Q

Anal fissures causes

A 
STI
IBD
Leukaemia
TB
Previous anal surgery
78
Q

Structures passing behind the medial malleolus (ant to post)

A 
Tibialis posterior
Flexor digitorum longus
Posterior tibial vein
Posterior tibial artery
Saphenous nerve
Flexor hallucis longus
79
Q

Delormes operation

A

Avoids haemorrhoid resection (safest) but high recurrence

80
Q

Altmeirs operation

A

More effective than Delormes as resects sigmoid colon and rectum, but high anastomotic leak

81
Q

Rectopexy

A

Well tolerated in young healthy. Lowest complication rate

82
Q

Insertion at anteromedial proximal tibia

A

Sartorius, gracilis, semitendinous

83
Q

Platelets

A

High risk of grame +ve infections

84
Q

RCC

A

High risk of gram -ve infections

85
Q

Doxorubicin

A

Cold compress

86
Q

Hyaluronidase

A

Given for contrast extravasation, TPN and alkaloid

Finals PACES (12 decks)

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