MRCS Part A: Essential Revision Notes: Book 2 by Catherine; Chalmers, Claire Ritchie Parchment Smith

By Catherine; Chalmers, Claire Ritchie Parchment Smith

Presents the main up to date fabric, matching the MRCS syllabus, to help education for the MRCS A examinations. The booklet covers each significant topic within the MRCS syllabus; works systematically via each basic surgical subject more likely to seem within the examination; highlights very important rules of surgical procedure; includes vital lists and important issues; is obviously laid out with illustrations to help realizing.

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Extra info for MRCS Part A: Essential Revision Notes: Book 2

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11) Linea alba: symphysis pubis to xiphoid process midline. (12) Linea semilunaris: lateral edge of rectus crosses costal margin at ninth costal cartilage (tip of gall bladder palpable here). Relatively avascular. May cause bladder damage. (2) Subumbilical incision: used for repair of paraumbilical hernias and laparoscopic port. Other hazards: tendinous intersections must be dissected off; need to divide falciform ligament above umbilicus on the right; if rectus is split more than 1 cm from medial border, intercostal nerves are disrupted leading to denervation of medial rectus (avoid by retracting rectus without splitting).

Cannot be extended caudally. Used for radical pancreatic and gastric surgery and bilateral adrenalectomy. Beware of intercostal nerves. Beware: scarring if not horizontal; iliohypogastric and ilioinguinal nerves; deep circumflex artery. (8a) Rutherford–Morrison incision: gridiron can be extended cephalad and laterally, obliquely splitting the external oblique to afford good access to caecum, appendix and right colon. Tends to divide iliohypogastric and ilioinguinal nerves, leading to denervation of inguinal canal mechanism (can increase risk of inguinal hernia).

The swelling and oedema increase the strangulation, which normally starts with venous obstruction, leading to oedema, arterial obstruction and finally ischaemia. 6 Pathophysiology of bowel strangulation The longer the strangulated length of bowel, the more the consequent systemic morbidity. The more distal the bowel is strangulated, the more toxicity and morbidity. The constricting agent is usually the neck of the peritoneal sac, which is often fibrosed and rigid where it crosses the parietal defect.

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