Arab Board Surgery Part 1 key terms

Triangular space at the top of the anterior thigh bounded by the inguinal ligament above, sartorius laterally and adductor longus medially, containing the femoral nerve, artery and vein; used for femoral access and hernia assessment.

Triangular area bounded by the cystic duct, the common hepatic duct and the inferior surface of the liver, containing the cystic artery; its careful dissection is central to safe cholecystectomy.

Branch of the vagus nerve that supplies most intrinsic muscles of the larynx; it loops beneath the right subclavian artery and the left aortic arch, so it is at risk in thyroid, parathyroid and oesophageal operations.

Vein, artery and nerve lying, in that order from above downwards, in the costal groove on the inferior border of each rib; chest drains and thoracocentesis are therefore performed just above the rib.

Between the sixth and tenth weeks the midgut herniates into the umbilical coelom, rotates about 270 degrees anticlockwise around the superior mesenteric artery and returns; failure explains malrotation and volvulus.

The opposing hydrostatic and oncotic pressures across a capillary wall that together determine net fluid movement between plasma and interstitium; imbalance produces oedema in venous obstruction, hypoproteinaemia or inflammation.

The principle that stretching cardiac muscle by greater ventricular filling increases the force of contraction, up to a point, which explains why careful volume loading raises output while over-filling causes decompensation.

The volume of oxygen transported to the tissues each minute, calculated as cardiac output multiplied by arterial oxygen content; resuscitation aims to keep delivery adequate for metabolic demand.

The part of each breath that takes no part in gas exchange, made up of airway volume plus alveoli that are ventilated but not perfused; it rises in shock and pulmonary embolism.

Cell death in which proteins denature and the tissue keeps its outline for some days, typical of ischaemia in solid organs such as heart, kidney and spleen; neutrophils later remove the debris.

Reversible replacement of one mature cell type by another, usually as an adaptation to chronic irritation, for example squamous change in the lower oesophagus with reflux; it may progress to dysplasia.

Additional cell damage that occurs when blood flow is restored to previously ischaemic tissue, driven by oxygen free radicals, calcium overload and inflammation; relevant to transplantation, revascularisation and tourniquet release.

A system describing cancer extent by primary tumour size or invasion (T), regional lymph node involvement (N) and distant metastasis (M), which together guide treatment choice and predict prognosis better than grade alone.

The three conditions that promote thrombosis - stasis of blood flow, endothelial injury and hypercoagulability - used to assess venous thromboembolism risk and select prophylaxis in surgical patients.

Infection arising within 30 days of surgery, or one year if an implant remains, involving the incision or deeper spaces; classified as superficial, deep or organ-space and largely preventable by good technique.

A structured community of bacteria attached to a surface and embedded in a self-produced polysaccharide matrix, which resists antibiotics and host defences and explains persistent infection of implants and chronic wounds.

A short course of antibiotic given before incision so that tissue levels exceed the minimum inhibitory concentration throughout the operation, preventing surgical site infection rather than treating established infection.

Life-threatening organ dysfunction caused by a dysregulated host response to infection, identified clinically by an acute rise in organ failure score; it requires urgent cultures, antibiotics and source control.

The alveolar concentration of an inhaled anaesthetic at which half of patients do not move in response to a standard surgical stimulus; it allows potency comparison and guides dosing.

Drug such as suxamethonium that binds nicotinic receptors and persistently depolarises the motor endplate, producing rapid brief paralysis; it can trigger hyperkalaemia and malignant hyperthermia.

A dose-related syndrome of perioral tingling, seizures, arrhythmia and cardiac arrest caused by local anaesthetic reaching the circulation; managed with airway support and intravenous lipid emulsion.

Combining analgesic drugs and techniques with different mechanisms, such as paracetamol, NSAIDs, local anaesthetic blocks and opioids, to improve comfort while reducing opioid dose and side effects.

The neuroendocrine and inflammatory response to trauma or surgery, with an early hypodynamic ebb phase followed by a catabolic flow phase of raised cortisol, catecholamines and cytokines causing hyperglycaemia, salt and water retention and muscle breakdown.

Potentially fatal shift of electrolytes, especially hypophosphataemia, hypokalaemia and hypomagnesaemia, when nutrition is reintroduced to a malnourished patient; it requires slow feeding and electrolyte monitoring.

The difference between nitrogen intake from protein and nitrogen lost mainly in urine and faeces; a negative balance indicates catabolism or inadequate intake and guides nutritional support.

Providing nutrients into the stomach or small bowel by tube, which maintains gut mucosal integrity and reduces infection compared with intravenous feeding; preferred whenever the gut works.

Repair of a wound left open to granulate from the base, producing more scar tissue and greater contraction than primary closure; used for contaminated or infected wounds and burns.

An overgrowth of dense scar tissue that extends beyond the original wound margins and rarely regresses, reflecting abnormal fibroblast activity; more common in darker skin and certain sites.

Crystalloids are electrolyte solutions that distribute across the whole extracellular space, whereas colloids contain large molecules retained intravascularly longer; both restore volume but neither clearly improves survival.

Absorbable sutures such as polyglactin lose tensile strength as they are broken down by hydrolysis and suit tissues that heal quickly; non-absorbable sutures such as nylon persist where prolonged support is needed.

The ABCDE approach to the injured patient - airway with cervical spine protection, breathing, circulation with haemorrhage control, disability and exposure - designed to find and treat immediately life-threatening problems first.

A four-class description of blood loss based on percentage of circulating volume, with corresponding changes in heart rate, blood pressure, pulse pressure, respiratory rate, urine output and mental state; classes three and four need transfusion.

The self-reinforcing combination of hypothermia, acidosis and coagulopathy that develops after major trauma and predicts death; management targets warming, haemorrhage control and balanced blood component transfusion.

Sustained intra-abdominal pressure above 20 mmHg with new organ dysfunction, causing reduced venous return, hypoxia and oliguria; treated by decompression, usually with a laparostomy.

A staged strategy in severely injured patients: rapid control of bleeding and contamination, temporary closure, then correction of physiology in intensive care before definitive reconstruction.

The process of giving a competent patient sufficient information about a proposed operation, its alternatives and material risks, so that they can decide freely whether to proceed.

Sensitivity is the proportion of diseased people correctly identified by a test; specificity is the proportion of healthy people correctly identified as negative; both are independent of disease prevalence.

Analysing trial participants according to the group they were originally allocated to, regardless of later deviations, which preserves randomisation and gives a realistic estimate of effectiveness.

The number of patients who must receive an intervention for one additional person to benefit, calculated as the reciprocal of the absolute risk reduction; a small value means a large effect.