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MRCS > SBA BOOK > Flashcards

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
Q

How to test for CSF in suspected base of skull ffracture

A

Beta 2 transferrin

26
Q

Where does uterine artery originate and what else does it supply

A

Internal iliac artery
Found medial to levator ani
Branch is given off to ureter 2cm above the cervix ureter

27
Q

Location of spleen

A

9-12 LEFT RIBS

28
Q

Muscles of pelvic diaphragm

A

Puborectalis
Pubococcygeus
Iliococcygeous
Coccygrous

29
Q

Four abnormalities of TOF

A

Overriding Aorta
Pulmonary stenosis
RVH
VSD

30
Q

Three Cranial Nerves most likely to be injured during submandibular gland surgery

A 
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
Q

Lung hila structures

A

Pulmonary artery - superior
Pulmonary vein - inferior
Bronchus - posterior

32
Q

Papillary carcinoma

A 
papillary projections and pale empty nuclei
Seldom encapsulated
Lymph node metastasis predominate
Haematogenous metastasis rare
Account for 60% of thyroid cancers
33
Q

Course of Brachial Plexus

A

Ventral rami, the roots of the plexus, lie between scalenus medius and anterior. (C5-T1)
Pass between Scalene anterior and medius

34
Q

Nerves from Roots of Brachial Plexus

A

C5,6,7 Long thoracic nerve

35
Q

Nerves from Trunks of Brachial plexus

A

Upper trunk - 2USS
Suprascapular (C5-6)
Subclavius (C5-6)

36
Q

Nerves from Lateral cord of Brachial Plexus

A

Lateral Pectoral

Evenually gives musculocutateonus (C-5-7) branches

37
Q

Nerves from Medial cord

A 
Medial arm stuff
Medial Pec
Medial cut FARM
Medial cut ARM
Continues to give ulnar nerve CT T1
38
Q

Nerves from Postreior cord

A 
ULNAR
U upper scapular
L ower scapular
Nerve to lat dorsi (thoracodorsal)
Axillary (c5-6)
Radial (C5-8)
39
Q

Nerves involved in Erbs palsy

A 
C5,6 
MASS affect 
Muculocutaneous
Axillary 
Suprascapular
Subclavius
Limp upper limp, Medially rotated, pronated
Waiters tip
40
Q

Nerves involved in Klumpkes

A

C8-T1
Ulnar and Median most affected
ie) Intrinsic muscles of the hand
Claw hand

41
Q

Ulnar nerve damage at elbow

A

FDP ulnar aspect not at all supplied
So no DIP flexion
Less severe clawing

42
Q

Ulnar never damage at wrist

A

FDP is working
So DIP is flexed
Clawing more obvious

43
Q

Upper limb myotomes

A 
Elbow flexors/Biceps	C5
Wrist extensors	C6
Elbow extensors/Triceps	C7
Long finger flexors	C8
Small finger abductors	T1
44
Q

Lower limb Myotomes

A 
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
Q

Inguinal canal boundaries

A

Anterior wall: External Oblique Aponeurosis
Floor: EO, Lacunar ligament, inguinal ligament
Roof:Internal oblique Transversus abdominis
Posterior: Transversalis fascia
Conjoint tendon

46
Q

Spermatic cord coverings and origins

A

External spermatic - external oblique
Cremasteric - Internal oblique
Internal sperm - TF

47
Q

Adductor canal borders

A

Posteriorly Adductor longus, adductor magnus
Laterally Vastus medialis muscle
Roof Sartorius

48
Q

Adductor canal contents

A

Saphenous Nerve

Superficial Femoral Artery and Vein

49
Q

Structures passing through Parotid

A

Facial nerve (Mnemonic: The Zebra Buggered My Cat; Temporal Zygomatic, Buccal, Mandibular, Cervical)
External carotid artery
Retromandibular vein
Auriculotemporal nerve

50
Q

Relations of parotid

A

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
Q

Nerve stimulation of parotid causes?

A

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
Q

Galeazzi fracture

A

Radial shaft fracture with associated dislocation of the distal radioulnar joint

디스털레이어스로가자

53
Q

Monteggia Fracture

A

Dislocation of the proximal radioulnar joint in association with an ulna fracture

54
Q

Osteomalacia picture

A

low: calcium, phosphate
raised: alkaline phosphatase

55
Q

Perthes disease aetiology and radiological grading

A

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
Q

Salter Harris

A

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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