MRCS

Question 1

Diaphragm openings levels and contents

Answer 1

T8: IVC, R phrenic n.

T10: Eso, L gastric a/v.

T12: Aorta, thoracic duct, azygos v.

Question 2

Most common site of arterial emboli causing acute limb ischemia

Answer 2

Common femoral a.

Question 3

Types of hernia

Answer 3

Littre’s: Meckel’s diverticulum

Para-umbilical: More in F, obesity/preg, high risk of strangulation

Femoral: Lateral + below inguinal ligament

Inguinal: Medial + above inguinal ligament

Lumbar: through lumbar triangle of Petit (iliac cest, posterior external oblique, anterior latissimus dorsi)

Spigelian: through linea semilunaris at lateral border of rectus sheath

Richter: no IO caused, dangerous, only anti-mesentertic border trapped

Amyand: perforated appendix within inguinal hernia

Maydl: loops of SB, W-shaped

Question 4

Content of carpal tunnel

Answer 4

1. Median n.
2. FDS
3. FDP (digitorum profundus)
4. FPL (pollicis longus)
5. FCR (carpi radialis)

Question 5

Content of extensor compartment wrist

Answer 5

1: APL, EPB
2. ECR
3. EPL
4. E digitorum, indicis
5. E digiti minimi
6. ECU

Question 6

Quadrilateral space

Answer 6

Sup: Subscapularis
Inf: Teres major
Medial: Long head of triceps
Lat: medial shaft of humerus

Contains: Axillary n., post circumflex humeral a/v

Question 7

Median n. innervate which hand muscles

Answer 7

LOAF

Lateral 2 lumbricals
Opponens pollicis
APB
FPB

Question 8

Axilla boundary

Answer 8

Ant: Pec major/minor
Post: Subscapularis, Lat dorsi, Teres major
Medial: Serratus anterior, ribs

Floor; Axillary fascia

Apex: 1st rib, clavicle, scapula