# Spleen 👩‍⚕️ The spleen is a frequent MRCS Part A topic because almost every fact about it doubles as a clinical scenario. Know the two ligaments and their contents, the danger zones during splenectomy, the post-splenectomy blood film, and OPSI prophylaxis. Almost every spleen SBA tests one of these four

# Biliary System The biliary tree drains bile from hepatocytes to the duodenum, with the gallbladder acting as a side-pocket reservoir. It is the most cholecystectomised and examined region of the upper abdomen — punishing candidates who confuse Calot's triangle borders with the Pringle manoeuvre, or biliary colic with

# LIVER The liver is the largest solid organ in the body (≈1.5 kg) and the only one with a dual blood supply. It sits in the right upper quadrant, tucked under the diaphragm, and acts as the metabolic factory, detoxifier and synthetic powerhouse of the body. For MRCS Part

# PANCREAS The pancreas is a retroperitoneal gland that performs two unrelated jobs in the same organ: it secretes digestive enzymes into the duodenum (exocrine) and hormones into the bloodstream (endocrine). For MRCS Part A, examiners test it from every angle — embryology (divisum, annular), surgical anatomy (relation to SMV and portal

# PEPTIC ULCER DISEASE What is a peptic ulcer? A peptic ulcer is a focal breach of the mucosa that penetrates through the muscularis mucosae into the submucosa or deeper. This is the histological feature that distinguishes a true ulcer from an erosion, which is confined to the mucosa. The depth

# 45 FEEDING METHODS Surgical patients are catabolic. Trauma, sepsis, major surgery and burns drive a stress response that breaks down lean muscle and depletes protein stores within days. Malnutrition delays wound healing, weakens the immune response, prolongs ileus and roughly doubles postoperative mortality in those affected. Choosing the right feeding

# 44 OESOPHAGUS Detailed notes The oesophagus is a 25 cm muscular tube that conducts food from the pharynx to the stomach. It begins at the cricopharyngeus (C6) as the continuation of the laryngopharynx and ends at the cardia of the stomach (T11) after piercing the diaphragm at T10. It is

# Aortic Disease The aorta carries the entire cardiac output, so when it dilates, dissects or ruptures the consequences are catastrophic. Aortic disease is high-yield in MRCS Part A because the same anatomical landmarks, embryological origins and pathological mechanisms reappear across vascular, anatomy and pathology SBAs. 👩‍⚕️ Anchor concept: AAA = loss

# Endocrinology Endocrine pathology underlies many "atypical" surgical patients. MRCS Part A rarely volunteers the diagnosis — recognise the hormonal pattern. Detailed notes The pituitary gland Sits in the sella turcica beneath the optic chiasm, flanked by the cavernous sinuses (CN III, IV, V1, V2, VI). Two embryologically distinct lobes.

# Heart 👩‍⚕️ Examiners hammer the same themes: which chambers form which surface, the coronary arteries and their territories, conduction anatomy, valve auscultation areas, the four classic murmurs, and the haemodynamic patterns of tamponade and pump failure. If you remember one thing: aortic stenosis is the most dangerous valvular lesion intraoperatively because