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MED2100 & MED2200 - Foundations of medical practice & principles of medicine 2 - Clayton - FY 2025

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During further dissection of the lung hilum, there is an injury to structure corresponding to label “B”, necessitating its ligation. Following injury to structure B, venous drainage of the majority of the bony thorax will then occur via the:

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SOURCE:  Rohen, J. W., Yokochi, Chihiro, & Lütjen-Drecoll, Elke. (2011). Color atlas of anatomy : a photographic study of the human body (7th ed.). Wolters Kluwer Health/Lippincott Williams & Wilkins ; Schattauer.

During a thoracoscopy for a lung tumour, a surgical registrar encounters a structure that corresponds to label A on the prosection image shown. Potential consequences of injury to this structure may include:

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Pain from the myocardium may be transmitted by:

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Which of the following arteries branch from the ascending aorta?

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What type of pain would be more typical of a myocardial infarction?

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A-76 year old patient presents to the emergency department with sudden onset, tearing chest pain. Which of the following symptoms or signs are more suggestive that pathology of the ascending aorta is implicated in the patient’s symptoms?

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Samples from this patient are taken from the lower oesophagus demonstrating changes consistent with “Barrett’s Oesophagus” with superior translocation of the gastroesophageal junction, due to changes in the mucosa present. What type of epithelium may then be found in this abnormal lower oesophagus?

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In instances of severe reflux, surgical treatment can include the “Nissen Fundoplication''. In this procedure, the fundus of the stomach is wrapped around the lower oesophagus and fixed with sutures to prevent sliding, while the right crus of the diaphragm is also tightened with sutures to reinforce the lower oesophageal sphincter. Based on the description of the Nissen Fundoplication, which structures may be at risk in this operation, particularly as the oesophagus passes through its hiatus in the diaphragm?

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A 56-year old patient undergoes a gastroscopy for persistent symptoms of gastro-oesophageal reflux. On this gastroscopy it is noted that the patient has a “sliding-type hiatus hernia of a moderate size”. Which of the following parts of the stomach would be the MOST LIKELY to herniate through the diaphragm? (More than one answer may be selected).

 

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What long-term effects are most likely for this patient if this nerve is stretched or damaged?

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