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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. 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. 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. 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. 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. 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