5th year Course Book/Thoracic & Cardiovascular Surgery


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5th year Course Book/Thoracic & Cardiovascular Surgery

  1. 1. UNIVERSITY OF SULAIMANI COLLEGE OF MEDICINE DEPARTMENT OF SURGERY UNIT OF THORACIC AND CARDIOVASCULAR SURGERY COURSE BOOK FOR ACADEMIC YEAR 2010-2011 FOURTH YEAR TEACHING STAFF: 1. Dr. Abdulsalam Y Taha FICMS (CTVS). Professor E mail: salamyt_1963@hotmail.com Mobile phone: 07701 51 0420 2. Dr. Ahmed Ibraheem Abbass FICMS (CTVS); Lecturer E mail: alazzawi_69@yahoo.com Mobile phone: 07702163557 3. Dr. Aram Baram Mohammed MD, AFSCTCVS, MRCSEd ; Lecturer e-mail: baram_aram@yahoo.com Mobile phone: 009647702217248 SURGICAL OBJECTIVES Glossary of Terms:
  2. 2. OBJECTIVE: What is hoped that the student will be able to demonstrate as learned knowledge. SKILL: A technical ability. RECALL: Rememberance of what has been learned from other disciplines which are applicable to present course. DESCRIBE: Detailed explanation of facts. OUTLINE: Usually a brief explanation of principles. DISCUSS: Be able to explain and argue about studied facts or problems. LIST: Place, usually in order of priority or importance a number of causes, details or modes of treatment. IDENTIFY: Present in argument based on historical and clinical features. CLINICAL FEATURES: Signs and symptoms of disease. TREATMENT: Medical or surgical therapy. MANAGEMENT: Whole care of a patient and his disease from initial presentation, clinical and diagnostic features to treatment and final outcome. COURSE OVERVIEW: The unit of Thoracic and Cardiovascular Surgery is involved in theoretical teaching of Fourth Year students as follows: FOURTH YEAR: Oesophagus, hiatal hernia and diaphragm- 5 lectures; given by Dr. Aram Baram Muhammad.
  3. 3. Symptoms and signs of vascular surgical disorders 1 lecture; given by Dr. Ahmed Ibraheem Al Azzawi Acute Arterial Disorders: 2 lectures; given by Dr. Ahmed Ibraheem Al Azzawi. Chronic Arterial Disorders: 1 lecture; given by Dr. Ahmed Ibraheem Al Azzawi. Symptoms and signs of cardiothoracic surgical disorders 1 lecture; given by Dr. Abdulsalam Y Taha. Venous Disorders: 2 lectures; given by Dr. Abdulsalam Y Taha Lymphatic Disorders: 1 lecture; given by Dr. Abdulsalam Y Taha Total: 13 lectures. SURGICAL OBJECTIVES: OESOPHAGUS: 1. Recall the surgical anatomy of the oesophagus and the physiological process of peristalsis and upper and lower sphincter action. 2. Recall the disturbances of oesophageal hypermotility (oesophageal spasm) and of hypomotility (Achalasia). 3. Outline the clinical tests performed in the study of oesophageal motility and their diagnostic significance. 4. Recall the pathogenesis of oesophageal diverticula. 5. List the types of oesophageal hiatal hernia. 6. Describe the clinical features of reflux oesophagitis and outline its causes, diagnostic tests and principles of medical and surgical management.
  4. 4. 7. Outline the emergency management following ingestion of corrosives and acids. 8. Outline the emergency management of ingestion of foreign bodies. 9. Outline the causes and clinical features of rupture of the oesophagus. 10. Describe the clinical features of carcinoma of the oesophagus and give a differential diagnosis and investigations that would confirm the diagnosis. 11.Outline the methods of treatment of oesophageal cancer at various levels. 12.List causes of dysphagia and describe the diagnostic workup of a patient with this symptom. DIAPHRAGM 1. Recall the surgical anatomy and function of the diaphragm. 2. Describe the clinical features, diagnostic methods and surgical treatments of congenital diaphragmatic hernias. 3. Describe the aetiology and management of acute and chronic rupture of the diaphragm. PERIPHERAL ARTERIAL DISEASE 1. Recall the surgical anatomy of the major arteries. 2. List the common causes of occlusive arterial disease. 3. Outline the patho-physiological changes resulting from occlusive disease in the subclavian-axillary, aorto-iliac, femoro-popliteal, renal, superior mesenteric, carotid, vertebral regions and pulmonary region.
  5. 5. 4. Describe how should assess for possible vascular injury in extremity trauma. 5. Outline the consequences of untreated vascular injury. 6. List the cardinal manifestations of acute arterial occlusion. 7. Describe the clinical features of Aortic aneurysms and their complications. 8. Describe the causes, patho-physiology and local as well as general effects of arterio-venous fistulae. 9. Outline current methods of investigations of flow in peripheral vascular disease. 10.Describe the non-operative treatment of intermittent claudication. 11.List the clinical features, diagnosis and role of surgery in the management of chronic arterial obstruction. 12.Outline the causes, and pathophysiology, clinical features of arterial embolism. 13. Define (Reynaud’s phenomenon); list its causes and methods of management. 14.Discuss the role of diabetis, hyperlipidemia, smoking, exercise and drugs in the causation and effects on therapy of peripheral arterial disease. VENOUS DISEASE: 1. Recall the surgical anatomy of the venous system of the lower limb and the normal method of venous return to the heart. 2. Describe the clinical features, pathophysiology and role of surgery in chronic venous varicosities of the lower limb.
  6. 6. 3. Recall the classification of ulcers of the lower limb and describe their diagnosis and surgical management. 4. Outline methods of deep venous thrombosis prevention. 5. Recall the clinical features of deep venous thrombosis and outline its diagnosis and management. 6. Describe the pathophysiology, clinical features and management of post-thrombotic syndrome. THE LYMPHATIC SYSTEM 1. Recall the surgical anatomy and physiology of the lymphatic vessels and system. 2. Describe the diagnostic methods of lymphoedema particularly lymphangiography. 3. Recall the pathology of lymphoedema and describe its clinical features and non-operative management. 4. Describe surgical treatment of lymphoedema. 5. Recall the pathogenesis of chylus effusion in the thorax and abdomen. READING LIST: 1. Bailey & Love’s SHORT PRACTICE OF SURGERY. 25TH EDITION. 2. PHYSICAL SIGNS. Hamilton Bailey’s Demonstrations of Physical Signs in Clinical Surgery. 3. NMS-Surgery 4th Edition. Edited by Bruce E. Jarrell and R. Anthony Carabasi, III