isurg

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Parasagittal meningioma Tumour: Parasagittal meningioma Typical presentation Gradually progressive contralateral lower limb weakness Focal seizures in the leg UMN signs Why Compression of the Paracentral lobule (leg area of the Primary motor cortex). Exam clue Progressive leg weakness + seizures → parasagittal meningioma. Acoustic neuroma (vestibular schwannoma) Tumour: Vestibular schwannoma Typical presentation Unilateral hearing loss Tinnitus Balance problems Later: Facial numbness Facial weakness Why Compression of: Vestibulocochlear nerve (CN VIII) Facial nerve (CN VII) Exam clue Progressive unilateral deafness. Pituitary adenoma Tumour: Pituitary adenoma Typical presentation Bitemporal hemianopia Why Compression of the Optic chiasm. Other clues: Hormonal symptoms (galactorrhoea, acromegaly, Cushing's). Exam clue Loss of temporal visual fields. Cerebellopontine angle tumour Often a Vestibular schwannoma. Symptoms Hearing loss Facial numbness Ataxia Structures involved: Trigeminal nerve Facial nerve Vestibulocochlear nerve Exam clue Multiple cranial nerve deficits in the cerebellopontine angle. Frontal lobe tumour Commonly a Glioma. Typical presentation Personality change Disinhibition Poor judgement Sometimes urinary incontinence Structure affected: Frontal lobe Exam clue Behavioural change before neurological deficit. ✅ Very high-yield MRCS pattern Symptom Likely tumour Leg weakness Parasagittal meningioma Unilateral deafness Vestibular schwannoma Bitemporal hemianopia Pituitary adenoma Behaviour change Frontal lobe tumour Multiple cranial nerve palsies CPA tumour

You are the SHO in the orthopaedic department. A 35-year-old man, Mr. James Carter, sustained a knee injury following a sports accident three months ago and was diagnosed with a post-traumatic meniscal tear. He was listed for an arthroscopic meniscectomy, but his operation has been cancelled twice before due to emergency cases. Unfortunately, his surgery has been postponed again today for the same reason. Your task is to update Mr Carter and address his concerns.

You are a core surgical trainee in the outpatient clinic. A 52-year-old man is referred by his GP with recurrent upper abdominal pain and weight loss. He has a background of heavy alcohol use. Site of pain (epigastric, radiating to back) Onset and duration (acute vs chronic, recurrent episodes) Character of pain (deep, boring, constant) Radiation (especially straight through to the back) Severity and impact on daily activities Timing and relation to meals (worse after eating) Relieving/exacerbating factors (leaning forward, alcohol, food) Associated nausea and vomiting Weight loss and anorexia Steatorrhoea (pale, greasy, foul-smelling stools) Symptoms of diabetes mellitus (polyuria, polydipsia) History of alcohol intake (quantity, duration) Previous episodes of acute pancreatitis Gallstone history or biliary symptoms (jaundice, colic) Drug history (e.g. steroids, azathioprine) Family history of pancreatic disease or malignancy

1: "Adductor longus", 2: "Arterial branch of vastus medialis", 3: "Corona of glans penis", 4: "External oblique aponeurosis", 5: "Fascia lata (cut edge)", 6: "Femoral artery", 7: "Femoral nerve", 8: "Femoral vein", 9: "Grachis", 10: "Great saphenous vein", 11: "Iliopsoas", 12: "Ilioitibal tract", 13: "Inguinal ligament", 14: "Nerve to vastus medialis", 15: "Pectineus", 16: "Perforating branch of profunda femoris artery", 17: "Rectus femoris", 18: "Saphenous nerve", 19: "Sartorius", 20: "Subartorial fascia (thickened aponeurosis)", 21: "Spermatic cord", 22: "Superficial circumflex iliac vein", 23: "Superficial epigastric vein", 24: "Superficial external pudendal vein", 25: "Superficial inguinal ring", 26: "Tensor fasciae latae deep to fascia lata", 27: "Valvular bulge lie in vein", 28: "Vastus lateralis", 29: "Vastus medialis",

@florianecaffart @Photosaurus hi hi merci !

Vagus nerve course in thorax & abdomen? Thorax: Left vagus nerve SpoilerCrosses in front of the left subclavian artery. Enters the thorax between the left common carotid and subclavian arteries. Descends on the left side of the aortic arch. Travels behind the phrenic nerve. Courses behind the root of the left lung. Deviates medially and downwards to reach the esophagus and form the esophageal plexus with the right vagus nerve. Right vagus nerve SpoilerCrosses in front of the first part of the subclavian artery. Travels behind the innominate vessels. Reaches the thorax on the right side of the trachea. Inclines behind the hilum of the right lung. Courses medially towards the esophagus to form the esophageal plexus with the left vagus nerve. Abdomen: SpoilerThe oesophageal plexus, formed by the union of the right and left vagus nerves, The vagus nerve enters the abdomen through the oesophageal hiatus at the level of the tenth thoracic vertebra (T10). It divides into the anterior and posterior vagal trunks, which innervate the stomach, small intestine, liver, gallbladder, pancreas, and spleen. Nerves in oesophageal hiatus? SpoilerAnt & post vagal trunks. What do they supply? SpoilerStomach, duodenum, jejunum, ileum, cecum, ascending colon, medial 2/3 of transverse colon, spleen, pancreas, gall bladder Muscle dissected to see thyroid? SpoilerSternohyoid muscle