MRCS June 4/52

Question 1

what is the embryological origin of the processus vaginalis

Answer 1

parietal peritoneum

Question 2

what kind of inguinal hernia is more common in children

Answer 2

indirect inguinal hernia

Question 3

some risk factors for indirect inguinal hernias

Answer 3

male, younger age, premature/twins, right testes, africans, increased abdominal pressures e.g. ascites.

Question 4

femoral nerve lies within the femoral sheath, true or false?

Answer 4

false

Question 5

what are the contents of the femoral sheath

Answer 5

femoral artery
femoral vein
lymphatics (within femoral canal)
femoral branch of genitofemoral nerve (L1)

Question 6

how far below does the femoral sheath go on fo

Answer 6

2.5cm below inguinal canal

Question 7

what are the abdominal fascia continuous with the femoral sheath anteriorly and posteriorly

Answer 7

anterior: transversalis fascia
posterior: fascia of illiacus and psoas

Question 8

what lies within the femoral canal

Answer 8

lymphatics

Question 9

why is a femoral hernia more prone to strangulation?

Answer 9

3 of 4 boundaries of the femoral ring are rigid

Question 10

what are the boundaries of the femoral ring

Answer 10

anterior: inguinal ligament
posterior: pectineal ligament/sup pubic ramus
medially: lacunar ligament
Laterally: femoral vein

Question 11

most common type of thyroid malignancy

Answer 11

papillary adenocarcinoma

Question 12

what is Hartmann’s pouch?

Answer 12

a congenital abnormality causing a diverticulum at the neck of the gallbladder, potentially causing mirrizi’s syndrome if a stone is lodged in there

Question 13

what is Boas’ sign

Answer 13

hypersensitivity of right inferior scapula - can be caused by cholecystitis

Question 14

inferior border of epiploiec foramen

Answer 14

1st part of duodenum

Question 15

superior border of epiploiec foramen

Answer 15

caudate lobe of liver

Question 16

what is contained within the free border of the lesser omentum?

Answer 16

cystic duct, hepatic artery and portal vein

Question 17

lymph drainage for cancer near dentate line of rectum?

Answer 17

internal iliac nodes

Question 18

what vessel is within the lienorenal ligament?

Answer 18

splenic artery and vein

Question 19

what grade of injury is ‘renal laceration through corticomedullary layers and into the collecting system’

Answer 19

grade IV

Question 20

what type of collagen is seen first during wound healing, followed by what?

Answer 20

type 3 -> type 1

Question 21

muscles of the larynx

Answer 21

cricothyroid
cricoarytenoid 
thyroarytenoid
transverse arytenoid 
aryepiglottic muscle

Question 22

action of cricothyroid muscle

Answer 22

tilts cricoid cartilage upwards at the front and downwards at the back
lengthens vocal folds and tightens

Question 23

action of cricoarytenoid muscle

Answer 23

posterior - outward rotation of arytenoid, opens vocal fold

anterior - pulls arytenoids forward and laterally, narrows vocal fold

Question 24

action of thyroarytenoid

Answer 24

pulls arytenoid forward: shortens and slackens vocal ligament and opening

Question 25

action of transverse arytenoid

Answer 25

pulls back of arytenoids closer together, closes posterior opening of vocal fold

Question 26

what are the dura extensions in the cranium

Answer 26

falx cerebrii tentorium cerebrii falx cerebelli

Question 27

describe the nerve supply of the larynx

Answer 27

sensation above vocal cord: internal laryngeal N cricothyroid: external laryngeal N sensation below vocal cord: recurrent laryngeal N all other laryngeal muscles: recurrent laryngeal N

Question 28

where does the recurrent laryngeal nerve branch off?

Answer 28

Right side: at subclavian artery and goes behind | Left side: aortic arch

Question 29

what supplies infrahyoid muscles?

Answer 29

ansa cervicalis (c1-3)

Question 30

what gives sensation to anterior part of ear

Answer 30

greater auricular nerve (c2-3)

Question 31

what supplies platysma muscle?

Answer 31

cervical branch of facial nerve

Question 32

describe the levels of axillary clearance and its anatomical borders

Answer 32

lvl 1: up to lateral edge of pectoralis minor lvl 2: lvl 1 + posterior of pect minor lvl 3: superior and medial to pect minor

Question 33

what kind of bacteria is commonly seen a/w staghorn calculi

Answer 33

urease producing bacteria e.g. klebsiella, proteus, enterobacter, pseudomonas

Question 34

what kind of skin infection is a/w green discharge and foul smelling

Answer 34

pseudomonas A

Question 35

high altitude does what to pulmonary vascular resistance?

Answer 35

increases resistance by constriction of arterioles - this shunts blood to better ventilated lung areas

Question 36

what is the supply and course of the middle meningeal artery

Answer 36

ECA -> maxillary -> MMA within infratemporal fossa -> F spinosum -> dura/skull

Question 37

where does the left brachiocephalic vein lie in relation to the aortic arch?

Answer 37

lies over it (anterior), travels obliquely