Module 6 - General surgery

General surgery, despite its name, is a surgical specialty that focuses on

abdominal organs, e.g., intestines including oesophagus, stomach, small bowel,
colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland
(depending on the availability of head and neck surgery specialists). General
surgeons also deal with diseases involving the skin, breast, and hernias.
Minor surgical procedures may be carried on a day-care basis with the patient
arriving and leaving on the same day. Many hospitals have a Day Surgery Unit
especially for this purpose with its own nursing, clerical and possibly secretarial
staff.
Subspecialties
Trauma surgery
Trauma surgery is a surgical specialty involved in the invasive treatment
of physical injuries, typically in an emergency setting. The trauma
surgeon is responsible for the initial resuscitation and stabilization of the
patient, as well as ongoing evaluation. The attending trauma surgeon
also leads the trauma team, which typically includes nurses, resident
physicians, and support staff.
The broad scope of their surgical critical care training enables the trauma
surgeon to address most injuries to the neck, chest, abdomen, and
extremities. In large parts of Europe trauma surgeons treat most of the
musculoskeletal trauma, whereas injuries to the central nervous system
are generally treated by neurosurgeons. In the UK skeletal injuries are
treated by trauma orthopedic surgeons. Facial injuries are often treated
by maxillofacial surgeons. There is significant variation across hospitals
in the degree to which other specialists, such as cardiothoracic surgeons,
plastic surgeons, vascular surgeons and interventional radiologists are
involved in treating trauma patients.
Laparoscopic surgery
Laparoscopic surgery also called minimally invasive surgery (MIS),
bandaid surgery; keyhole surgery is a modern surgical technique in
which operations in the abdomen are performed through small incision as
compared to larger incisions needed in traditional surgical procedures.
Keyhole surgery uses images displayed on TV monitors for magnification
of the surgical elements. Laparoscopic surgery includes operations within
the abdominal or pelvic cavities, whereas keyhole surgery performed on
the thoracic or chest cavity is called thoracoscopic surgery. Laparoscopic
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and thoracoscopic surgery belong to the broader field of endoscopy.

There are a number of advantages to the patient with laparoscopic
surgery versus an open procedure. These include reduced pain due to
smaller incisions and hemorrhaging, and shorter recovery time.
Colorectal surgery
Colorectal surgery is a field in medicine, dealing with disorders of the
rectum, anus, and colon. The field is also known as proctology, but the
term is outdated in the more traditional areas of medicine.
Physicians specialising in this field of medicine are more commonly
called colorectal surgeons, or less commonly, proctologists. Colorectal
surgeons often work closely with urologists.
Colorectal surgical disorders include:
varicosities or swelling, and inflammation of veins in the rectum
and anus (Hemorrhoids)
unnatural cracks or tears in the anus (Anal fissures)
abnormal connections or passageways between the rectum or
other anorectal area to the skin surface (Fistulas)
severe constipation conditions
fecal incontinence
protrusion of the walls of the rectum through the anus (Rectal
prolapse)
birth defects such as the imperforate anus
treatment of severe colic disorders, such as Crohn's disease
cancer of the colon and rectum (Colorectal cancer)
anal cancer (rare)
any injuries to the anus

Breast surgery
The following are some of the procedures carried out by the breast
surgeon:
Excision/biopsy of breast lump/fibroadenoma of breast
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Segmental resection or quadrantectomy

Wide local excision of lesion of breast
Repeat local excision to clear margins
Excision biopsy of breast lesion after localisation
Core biopsy of lesion of breast
Percutaneous suction core biopsy
Sampling of axillary lymph nodes
Sentinel node mapping for breast cancer with blue dye or
radioactive
probe alone
Sentinel node mapping for breast cancer with blue dye and
radioactive
Mastectomy (excluding implant / reconstruction)
Radical mastectomy including block dissection
Radical mastectomy excluding block dissection
Modified radical mastectomy including lymph node sampling
Modified radical mastectomy excluding lymph node sampling
Modified radical mastectomy including lymph node clearance
Simple mastectomy (including axillary node biopsy)
Subcutaneous mastectomy
Block dissection of axillary lymph nodes (axillary clearance) levels
1 to 3

Vascular surgery
Vascular surgery is a specialty of surgery in which diseases of the
vascular system, or arteries and veins, are managed by medical therapy,
minimally-invasive catheter procedures, and surgical reconstruction. The
specialty evolved from general and cardiac surgery.

The vascular surgeon is trained in the diagnosis and management of

diseases affecting all parts of the vascular system except that of the
heart and brain. Cardiothoracic surgeons manage surgical disease of the
heart and its vessels. Neurosurgeons manage surgical disease of the
vessels in the brain (e.g. intracranial aneurysms).
Vascular surgical disorders include:
Arterial diseases (especially in Diabetics )
Aneurysms
Ischemia
Limb ischemia
Acute limb ischemia
Thrombectomies
Embolectomies
Anti-coagulation and Thrombolysis
Chronic limb ischemia
Intermittent claudication and peripheral artery occlusive disease
Diabetic foot ulcers
Mesenteric ischemia
Renal ischemia
Extracranial cerebrovascular disease
Carotid Endarterectomy and other carotid surgery
Surgery of the vertebral system
Venous disease
Deep Vein Thrombosis
Thrombophlebitis
Varicose Veins and Varicosities
Venous malformations
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Lymphatic disease
Lymphoedema

Vascular Medicine
Medical disorders with a significant vascular component, for example:
Raynaud's syndrome
Scleroderma
Hyperhidrosis
Endocrine surgery is a specialised surgical field where procedures are
performed on endocrine glands to achieve a hormonal or anti-hormonal
effect in the body. Almost always, this entails operating to remove a
tumour which has grown on or within an endocrine gland. The field of
endocrine surgery typically comprises surgery for the thyroid gland,
parathyroid glands, and adrenal glands.
Although not typically referred to as endocrine surgery, it could be argued
that surgery of the pituitary gland, testicles, ovaries, and pancreas are
also forms of endocrine surgery since these glands are hormone
producing glands as well. More classically, however, only thyroid,
parathyroid and adrenal surgery are thought of as "endocrine surgery"
with pituitary surgery typically thought of as a form of neurosurgery;
testicle surgery typically thought of as urologic surgery; ovary surgery
typically thought of as a form of gynecologic surgery; and pancreatic
surgery typically thought of as oncology surgery. The commonest
endocrine surgery operation is removal of the thyroid (thyroidectomy),
followed by parathyroid surgery (parathyroidectomy), followed by the rare
operation on the adrenal gland (adrenalectomy).
Endocrine surgery has developed as a sub-specialty surgical category
because of the technical nature of these operations and the associated
risks of operating in the neck.
Dermatological Surgery
The following are some of the procedures carried out by the
Dermatological Surgeon:
Excision of pressure sore excluding repair
Microscopically controlled excision of lesion of skin or
subcutaneous tissue

Primary excision of malignant lesion Head & Neck

Primary excision of malignant lesion Trunk & Limbs
Secondary excision of malignant lesion Head & Neck
Secondary excision of malignant lesion Trunk & Limbs
Photodynamic therapy to malignant lesion of skin
Excision of lesion of skin or subcutaneous tissue
Laser destruction of lesion(s) of skin
Skin photodynamic therapy (PDT)
Curettage/cryotherapy of lesion of skin including cauterisation
Shave biopsy of lesion of skin
Biopsy of skin or subcutaneous tissue
Needle/tru-cut biopsy of muscle
Removal of foreign body in deeper tissue
Drainage of lesion of skin including abscess
Drainage of large subcutaneous abscess/haematoma
Skin resurfacing (laser/dermabrasion)
Excision of nail bed (Zadeks)
Wedge excision or avulsion of nail including chemical ablation of
nail bed
Conditions treated by the general surgeon
The following list of diseases or medical conditions are some of the medical
problems that may be treated by the general surgeon:
Anal fissure - or rectal fissure is a break or tear in the skin of the anal
canal. Anal fissures may be noticed by bright red anal bleeding on toilet
paper, sometimes in the toilet. If acute they may cause pain after
defecation but with chronic fissures pain intensity is often less
Anal fistula - or fistula-in-ano, is an abnormal connection between the
epithelialised surface of the anal canal and the perianal skin. Anal fistulae
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originate from the anal glands, which are located between the two layers
of the anal sphincters and which drain into the anal canal
Appendicectomy - Appendectomy is the surgical removal of the
appendix. The appendix is a worm-shaped hollow pouch attached to the
cecum, the beginning of the large intestine.
Breast lump excision - Breast lump removal, called lumpectomy, is
surgery to remove a breast cancer or other lump in the breast, along with
some surrounding tissue from the breast.
Breast Lump Wide Excision & Axillary Sampling - is a surgical
procedure to remove a small area of diseased or problematic tissue with
a margin of normal tissue. This procedure is commonly performed on the
breast and to skin lesions, but can be used on any area of the body. The
tissue removed is examined under a microscope to confirm the type of
lesion and to grade malignant tumours. This examination also determines
if all of the lesion has been removed without leaving any behind
Cholecystectomy - is the surgical removal of the gallbladder. The two
basic types of this procedure are open cholecystectomy and the
laparoscopic approach. It is estimated that the laparoscopic procedure is
currently used for approximately 80% of cases.
Colonoscopy - is a test that allows your doctor to look at the inner lining
of your large intestine (rectum and colon). He or she uses a thin, flexible
tube called a colonoscope to look at the colon
Gastrectomy - is the surgical removal of all or part of the stomach.
Gastroscopy - Looking into the stomach with a flexible viewing
instrument called a gastroscope.
Haemorrhoidectomy - Surgical removal of hemorrhoids (enlarged and
dilated veins in and around the anus). Hemorrhoidectomy is usually
reserved for severe hemorrhoids if more conservative treatment
measures fail to alleviate the symptoms (burning, itching, swelling,
protrusion, bleeding, and pain).
Inguinal hernia repair - laparoscopic and open - An inguinal hernia
occurs when soft tissue usually part of the membrane lining the
abdominal cavity (omentum) or part of the intestine protrudes through
a weak point in the abdominal muscles. The resulting bulge can be
painful, especially when you cough, bend over or lift a heavy object.
An inguinal hernia isn't necessarily dangerous by itself. It doesn't get
better or go away on its own, however, and it can lead to life-threatening
complications. For this reason, your doctor is likely to recommend
surgery to fix an inguinal hernia that's painful or becoming larger. Inguinal
hernia repair is a common surgical procedure.
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Laparoscopic hernia repair is similar to other laparoscopic procedures.

General anaesthesia is given, and a small cut (incision) is made in or
just below the navel. The abdomen is inflated with air so that the
surgeon can see the abdominal (belly) organs.
A thin, lighted scope called a laparoscope is inserted through the
incision. The instruments to
repair the hernia are inserted
through other small incisions in the lower abdomen. Mesh is then placed
over the defect to reinforce the belly wall.
There are many things to think about when deciding if you should have
inguinal hernia repair surgery, such as whether your hernia is
incarcerated or strangulated and whether you have other conditions that
need to be addressed before hernia repair surgery is appropriate.
Large bowel resection Large bowel resection is surgery to remove all
or part of your large bowel. This surgery is also called colectomy. The
large bowel is also called the large intestine or colon.
Removal of the entire colon and the rectum is called a proctocolectomy.
Removal of part or all of the colon but not the rectum is called subtotal
colectomy.
The large bowel connects the small intestine to the anus. Normally, stool
passes through the large bowel before leaving the body through the
anus.
Mastectomy - Surgical removal of all or part of a breast, sometimes
including excision of the underlying pectoral muscles and regional lymph
nodes, usually performed as a treatment for cancer.
Sigmoidoscopy - is a test that provides an inside look at your rectum
and the lower part of you colon. A doctor uses a flexible tube (called a
sigmoidoscope) that has the ability to snip off polyps.
Small bowel resection - A small bowel resection is the removal of part
of the small intestine. The small intestine includes the duodenum,
jejunum, and ileum. The surgery can be done through an open incision or
using smaller incisions using a laproscope
Thyroidectomy - Surgery to remove part or all of the thyroid gland.
Thyroidectomy might be done to remove a tumor or to treat
hyperthyroidism or goiter (enlarged thyroid gland). Complications of the
surgery can include vocal cord paralysis and accidental removal of the
parathyroid glands, which are located behind the thyroid gland. Because
the parathyroid glands regulate calcium metabolism, their removal can
result in low calcium levels.

Toenail Excision -is the most common surgical procedure performed on

the nail unit. It is the excision of the body of the nail plate from its primary
attachments, the nail bed ventrally and the PNF dorsally.
Umbilical hernia repair - Umbilical hernia repair is a surgery performed
to fix an umbilical hernia. An umbilical hernia is a bulge or pouch that
forms in the abdomen. This bulge occurs when a section of the lining of
your abdominal cavity pushes through the abdominal wall around where
the belly button is located
Varicose vein stripping Surgery - The surgical removal of a varicose
vein of the leg by ligating iteg, the great saphenous vein and its
tributaries at the junction with the common femoral vein in the groin, then
yanking it, which pops off the collaterals, 'stripping' it out in its entirety
Indications VS is indicated for 2 varicosities with deep venous
insufficiency; 90% of Pts treated by VS have satisfactory functional and
cosmetic results; in 10%, varicosities recur.

Module 6 - Procedures/Treatments
Abdominal surgery - Any operative procedure in which the abdominal cavity is
opened, and a surgeon excises or repairs damaged, redundant or malignant
tissue.
Bariatric/Gastric Bypass Surgery - Gastric bypass is surgery that helps you
lose weight by changing how your stomach and small intestine handle the food
you eat.
After the surgery, your stomach will be smaller. You will feel full with less food.
The food you eat will no longer go into some parts of your stomach and small
intestine that break down food. Because of this, your body will not absorb all of
the calories from the food you eat.
Cancer surgery an operation to repair or remove part of your body to
diagnose or treat cancer remains the foundation of cancer treatment. Your
doctor may use cancer surgery to achieve any number of goals, from
diagnosing and treating your cancer to relieving the symptoms it causes.
Cancer surgery may be your only treatment, or it may be supplemented with
other treatments, such as radiation, chemotherapy, hormone therapy and
biological therapy.
Cryotherapy - is a technique that uses an extremely cold liquid or instrument
to freeze and destroy abnormal skin cells that require removal. The technique
has been in use since the turn of the century, but modern techniques have
made it widely available to dermatologists and primary care doctors. The
technique is also called cryosurgery.
Laparoscopic appendectomy, cholecystectomy and hernia repair Laparoscopy is a type of surgical procedure in which a small incision is made,
usually in the navel, through which a viewing tube (laparoscope) is inserted.
The viewing tube has a small camera on the eyepiece. This allows the doctor to
examine the abdominal and pelvic organs on a video monitor connected to the
tube. Other small incisions can be made to insert instruments to perform
procedures. Laparoscopy can be done to diagnose conditions or to perform
certain types of operations. It is less invasive than regular open abdominal
surgery (laparotomy).
Robot-Assisted Surgery - computer-assisted surgery, and robotically-assisted
surgery are terms for technological developments that use robotic systems to
aid in surgical procedures. Robotically-assisted surgery was developed to
overcome the limitations of minimally-invasive surgery and to enhance the
capabilities of surgeons performing open surgery
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General Robotic Surgery - Robotic surgery is a method to perform surgery

using very small tools attached to a robotic arm. The surgeon controls the
robotic arm with a computer.
Urologic Robotic Surgery - also known as genitourinary surgery, is the
branch of medicine that focuses on the surgical and medical diseases of the
male and female urinary tract system and the male reproductive organs. The
organs under the domain of urology include the kidneys, adrenal glands,
ureters, urinary bladder, urethra, and the male reproductive organs (testes,
epididymis, vas deferens, seminal vesicles, prostate and penis).
Gynecological Robotic Surgery - The most common minimally invasive
surgery is laparoscopy. Instead of a large open incision, surgery is done through
a few small incisions using a tiny camera and long, thin surgical instruments.
The camera takes images inside your body and those images are sent to a
video monitor in the operating room which guides surgeons as they operate.
Thyroid Surgery - is the removal of all or part of your thyroid gland. Your
thyroid is a butterfly-shaped gland located at the base of your neck. It produces
hormones that regulate every aspect of your metabolism, from your heart rate to
how quickly you burn calories.
Thyroidectomy is used to treat thyroid disorders, such as cancer, noncancerous
enlargement of the thyroid (goiter) and overactive thyroid (hyperthyroidism).
Vascular Surgery - is a specialty of surgery in which diseases of the vascular
system, or arteries and veins, are managed by medical therapy, minimallyinvasive catheter procedures, and surgical reconstruction.
Day Surgery Unit - Day surgery is best defined as the admission of selected
patients to hospital for a planned surgical procedure, returning home on the
same day. True day surgery patients, are day case patients who require full
operating theatre facilities and/or a general anaesthetic, and any day cases not
included as outpatient or endoscopy'.
More and more surgery is carried out as day case in the Day Surgery Unit, with
the patient treated and discharged home in the same day. This is good for the
patient and it also makes a significant contribution to reducing NHS waiting
times.

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Module 6 - Glossary of terms used in

surgery
ABG abbreviation for arterial blood gas, a small sample of blood removed
from an artery and analyzed in the lab. Provides information on the amount of
oxygen in the blood and how well the lungs and kidneys are working.
adhesions scar tissue that forms between loops of bowel after surgery
performed in the abdominal cavity.
adenocarcinoma a type of malignancy where the cancerous cell is columnar
in shape.
a fib slang for atrial fibrillation, an irregular beating of the top chambers of
the heart or atria.
appendectomy surgical removal of the appendix.
atrium one of two chambers in the heart that receives blood.
atrophy wasting away or shrinkage of a body part or tissue.
bariatric surgery area of surgery that describes procedures performed to
cause weight loss
bifid this means a body part or tissue has cleft into two parts or branches.
blepharoplasty surgery on the eyelids; usual meaning is for a cosmetic
improvement.
bradycardia a slow heartbeat. In adults this means a rate of less than 60
beats per minute.
bursa sac-like structure filled with thick fluid that prevents certain tissues from
rubbing against each other.
c diff abbreviation for Clostridium difficile infection, a serious and potentially
life-threatening overgrowth of bacteria in the colon, usually caused by antibiotic
use.
carcinoma cancer.
cardiac relating to the heart.
cecum the very last two inches of the small bowel
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cholecystectomy surgical removal of the gallbladder.

Colectomy surgical removal of all or a part of the colon.
colon the large bowel.
craniotomy surgical opening made in the skull to allow access to the brain.
cretonne a waste product made by the body and passed out of the body in
the urine. The normal value is less than 1.0.
distal describes position of body part that is farther from the centre.
duodenum the first part of the small bowel.
erythrocyte another word for red blood cell.
ET tube abbreviation for end tracheal tube, or the proverbial breathing tube
actuate removal of the hollow breathing tube from the mouth or nose and
windpipe. Usually means the patient is capable of breathing on their own.
femur the large bone running from the knee to the hip. Also called the thigh
bone.
fibrosis scar tissue.
fibula the smaller outside bone of the two bones of the lower leg. It runs
from just under the knee to the ankle.
Foley catheter - hollow plastic tube placed into the bladder to drain urine.
forceps large, tweezers-like surgical instruments used for grasping tissue.
gastric another word for stomach.
genicular relating to the knee.
hepatic another term for liver.
IM abbreviation for intramuscular; some medications are given IM via a
needle and syringe.
IV abbreviation for intravenous; medications and fluids are typically given this
way to inpatients.
IVC abbreviation for inferior vena cava.
JP abbreviation Jackson Pratt drain; used to remove fluid or blood after
surgery; has a suction bulb that can be emptied by the patient or nursing staff.
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MRSA abbreviation for methicillin resistant Staphylococcus aureus.

OT abbreviation for occupational therapy.
preoperative the time just before and/or just after surgery.
po abbreviation for per os, meaning by mouth.
renal another term for kidney.
Swan used as either a noun or a verb. As a noun it refers to a Swan-Ganz
catheter which is a long plastic catheter placed through the subclavian or
jugular vein into the right atrium, into the right ventricle, and out the pulmonary
artery into the lung vasculature. As a verb it means to place the Swan-Ganz
catheter.
trach slang for tracheostomy or a breathing tube placed surgically into the
trachea that exits the skin of the neck.
VAP abbreviation for ventilator associated pneumonia
vtach ventricular tachycardia, a life-threatening heart rhythm where the
ventricles (lower heart chambers) contract without stimulus from the atria (upper
heart chambers).
VRE abbreviation for vancomycin resistant enterococcus.

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Module 6 - Genetics
Genetics is a discipline of biology, is the science of genes, heredity, and
variation in living organisms. Genetics departments are only found in the larger
teaching hospital. These departments offer a full diagnostic, genetic counseling
and genetic testing service to individuals and families affected with genetic
disorders. As these departments are few and far between, this chapter presents
only a short summary of the conditions treated.
Conditions
Multidisciplinary and Specialist clinics within the Clinical Genetics department:
Cardiac

Endocrine Neoplasia (EN)

Fetal Medicine

Huntingtons Disease

Myotonic Dystrophy

Neurogenetics

Ophthalmic

Paediatric Neurology

Peripheral genetics clinics

Pre-implantation Genetic Diagnosis

(PGD)

Skin disorders

Tay Sachs

Von Hippel Lindau (VHL)

General Information
Hereditary diseases are often rare and affected families require specialist
advice and services. In some families there is a known genetic disorder which
affects family planning decisions or other plans for the future. In other families a
genetic disorder is diagnosed for the first time during a pregnancy or after the
birth of a child, and this brings up questions and worries for many members of
the family. Geneticists also work closely with a wide variety of medical
specialities to provide joint clinics and specialist services for particular genetic
disorders.
Glossary of terms used in Genetics
Allele: Another word for gene. Each chromosome has a copy of this allele, thus
a gene-pair.

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Crossing over: exchange of genetic material between non-sister chromatids

from homologous chromosome during prophase I of meiosis; results in new
allele combinations.
Chromosome: A long threadlike association of genes in the nucleus of all
eukaryotic cells which are visible during meiosis and mitosis. A chromosome
consists out of DNA and proteins. An organism always has 2n chromosomes,
which means that all chromosomes are paired.
Diploid: Cell with two of each kind of chromosome; is said to contain a diploid,
or 2n, number of chromosomes
DNA: Deoxyribonucleic acid, the heritable material of an organism.
Dominant gene: In a heterozygote, this allele (gene) is fully expressed in the
phenotype. In genetic schemes, these genes are always depicted with a capital
letter. Egg haploid female sex cell produced by meiosis
Fertilisation: Fusion of male and female gametes
Gamete: Male and female sex cells, sperm and eggs
Gene: The units of inheritance that transmit information from parents to
offspring.
Genotype: This is the genetic makeup of an organism: the genes
Haploid: Cell with one of each kind of chromosome; is said to contain a haploid
or n, number of chromosomes.
Heredity: Passing on of characteristics from parents to offspring
Heterozygous: This term indicates that an organism has two different copies of
a gene on each chromosome.
Homozygous: This term indicates that an organism has two identical alleles at
a single place on a chromosome. This results in an organism that breeds true
for only one trait.
Hybrid: Offspring formed by parents having different forms of a specific trait.
Law of independent assortment: Mendelian principal stating that genes for
different traits are inherited independently of each other.
Law of segregation: Mendelian principal explaining that because each plant
has two different alleles, it can produce two different types of gametes. During
fertilization, male and female gametes randomly pair to produce four
combinations of alleles

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Meiosis: Type of cell division where one body cell produces for gametes, each
containing half the number of chromosomes in a parents body.
Nondisjunction: Failure of homologous chromosomes to separate properly
during meiosis; results in gametes with too many or too few chromosomes
Phenotype: The physical and physiological traits of an organism. These are
influenced by genetic makeup (genes) and surrounding.
Recessive gene: In a heterozygote, this allele (gene) is completely masked in
the phenotype. In genetic schemes, these genes are always depicted with a
lower case letter.
Sexual reproduction: Pattern of reproduction that involves the production of
subsequent fusion of haploid cells.
Sperm: Haploid male sex cells produced by meiosis
Trai: Characteristic that is inherited; can be either dominant or recessive
Zygote: Diploid cell formed when a sperm fertilizes an egg.

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Module 6 - Assignment
Welcome to your Module 6 Assignment.
Please note that all your work for this assignment should be saved in one document and it
should follow the following title requirements:
Medical Secretary_ Module 6_Your Name
For this assignment you are required to research the conditions described in your Genetics
module as well as the impact of Day Surgery as opposed to Inpatient surgery on patients
and staff.

Please read below before submitting your assignment:

1. You must ensure that you have COMPLETED the assignment and all the requirements before
submitting your work.
2. In order to successfully complete your module you are required to achieve a minimum pass
mark of 75%.
3. By submitting your assignment you indicate that you have understood the following statements:
This assignment is my own original work, except where I have appropriately cited the original
source ( References for text or images used )
This assignment has not previously been submitted for assessment in this or any other subject.
If it is deemed that my assignment includes unoriginal work that is not referenced, my assignment
will be failed with no option to resubmit.

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