Learning MRCS part A - applied surgery

  1. Fracture mx - bony injury -> # may arise from
    • - trauma (excessive forces applied to bone)
    • - stress related (repetitive low velocity injury)
    • - pathological (abnormal bone, # during normal use / minimal trauma)
  2. # Mx - diagnosis involves
    • - assessing fracture - site, type
    • - associated injuries 
    • - distal NV deficit
    • (so o/e +/- imaging)
  3. Most common classification system for open #
    • Gustilo and Anderson classification 
    • - Grade 1: low energy wound <1cm
    • - Grade 2: >1cm wound with moderate soft tissue damage
    • - Grade 3: >10cm with extensive soft tissue damage
    • + 3A: adequate soft tissue coverage
    • + 3B: inadequate soft tissue coverage
    • + 3C: associated artery injury
  4. Spinal disorders - dorsal column lesion
    • Loss vibration and proprioception
    • Tabes dorsalis, SACD

    (Post-terrier picmonic, propeller + vibration fork, also pressure)
  5. Spinal disorders - Spinothalamic tract lesion
    Loss of pain, temperature (lateral), crude touch and pressure (anterior)

    - Contralateral anaesthesia

    (Thor Picmonic - ladder temp thermometer, pain bolt, then anterior - ant-eater - touch crude oil, pressure)
  6. Spinal disorders - central cord lesion
    Flaccid paralysis of the upper limbs
  7. Spinal disorders - infarction spinal cord
    Dorsal column signs (loss of proprioception and fine discrimination) (jQuery112408195846008499672_1614906298310 not vibration, yes, just not written here) (fine discrimination - deep touch)
  8. Spinal disorders - cord compression
    • UMN signs
    • Malignancy
    • Haematoma
    • Fracture
  9. Spinal disorders - osteomyelitis progress, common microbes
    • - Normally progressive
    • - What
    • + Staph aureus in IVDU, normally cervical region affected
    • + Fungal infections in immunocompromised
    • + Thoracic region affected in TB
  10. Spinal disorder - Brown-sequard syndrome
    • Hemisection of the spinal cord
    • Ipsilateral paralysis
    • Ipsilateral loss of proprioception and fine discrimination
    • Contralateral loss of pain and temperature
  11. Syringomyelia - what, most common variant
    • - cystic cavity forms within spinal cord
    • - commonest variant: Arnold - Chiari malformation (cavity connects with a congenital malformation affecting cerebellum)
    • - acquired: from prev meningitis, surgery, tumours
  12. Syringomyelia - neurological manifestations - classical
    • - spares dorsal columns and medial lemnicus
    • - affecting only spinothalamic tract (loss of pain and temp sensation)
Author
trincam2008
ID
354779
Card Set
Learning MRCS part A - applied surgery
Description
Applied surgery - topics
Updated