A Trivia Quiz On Abdominal Wall & Inguinal Canal!

1. A patient presents to you with a protrusion through the deep inguinal ring that is entering the inguinal canal and extending into the scrotum. The protrusion is lateral to the inferior epigastric blood vessels. Which of the following is most likely type of hernal?

Direct Inguinal Hernia

Indirect Inguinal Hernia

The patient's presentation of a protrusion through the deep inguinal ring that extends into the scrotum indicates an inguinal hernia. The fact that the protrusion is lateral to the inferior epigastric blood vessels suggests that it is an indirect inguinal hernia. In an indirect inguinal hernia, the hernia sac follows the pathway of the spermatic cord, entering the inguinal canal through the deep inguinal ring and extending into the scrotum. Direct inguinal hernias, on the other hand, protrude medially to the inferior epigastric blood vessels. Therefore, the most likely type of hernia in this case is an indirect inguinal hernia.

Explanation

The patient's presentation of a protrusion through the deep inguinal ring that extends into the scrotum indicates an inguinal hernia. The fact that the protrusion is lateral to the inferior epigastric blood vessels suggests that it is an indirect inguinal hernia. In an indirect inguinal hernia, the hernia sac follows the pathway of the spermatic cord, entering the inguinal canal through the deep inguinal ring and extending into the scrotum. Direct inguinal hernias, on the other hand, protrude medially to the inferior epigastric blood vessels. Therefore, the most likely type of hernia in this case is an indirect inguinal hernia.

2. A patient presents to you with a protrusion in Hesselbach's triangle. You suspect that the patient has a direct inguinal hernia. Which of the following is not a boundary of Hesselbach's Triangle?

Inferior Epigastric blood vessels

Inguinal Ligament

Rectus Abdominis

Linea Alba

The Linea Alba is the center line of the rectus abdominis. The Medical border of Hesselbach's Triangle the lateral border of the Rectus Abdominis.

Explanation

The Linea Alba is the center line of the rectus abdominis. The Medical border of Hesselbach's Triangle the lateral border of the Rectus Abdominis.

3. Which of the following is not a content of the inguinal canal in males?

Spermatic Cord

Inferior Epigastric Artery

Genital Branch of the Genitofemoral Nerve and Vessels

Ilioinguinal Nerve

The inguinal canal in males contains the spermatic cord, which includes the vas deferens, testicular artery, and pampiniform plexus. It also contains the genital branch of the genitofemoral nerve and vessels, which innervate the cremaster muscle and supply blood to the scrotum. The ilioinguinal nerve is also present in the inguinal canal, providing sensory innervation to the skin of the scrotum and medial thigh. However, the inferior epigastric artery is not a content of the inguinal canal in males. It is a branch of the external iliac artery and runs superiorly to supply blood to the anterior abdominal wall.

Explanation

The inguinal canal in males contains the spermatic cord, which includes the vas deferens, testicular artery, and pampiniform plexus. It also contains the genital branch of the genitofemoral nerve and vessels, which innervate the cremaster muscle and supply blood to the scrotum. The ilioinguinal nerve is also present in the inguinal canal, providing sensory innervation to the skin of the scrotum and medial thigh. However, the inferior epigastric artery is not a content of the inguinal canal in males. It is a branch of the external iliac artery and runs superiorly to supply blood to the anterior abdominal wall.

4. While dissecting, you found that most of the major nerves and vessels of the abdominal wall run between which layers?

Internal Abdominal Oblique and Transversus Abdominis

External Abdominal Oblique and Internal Abdominal Obliqe

External Abdominal Oblique and Scarpa's Fascia

Most of the major nerves and vessels of the abdominal wall run between the Internal Abdominal Oblique and Transversus Abdominis layers.

Explanation

Most of the major nerves and vessels of the abdominal wall run between the Internal Abdominal Oblique and Transversus Abdominis layers.

5. You are on a rotation with a colorectal surgeon. You are about to go into surgery to remove a cancerous tumer in the middle of the ascending colon. When he asks you in which region he will be working in, you say the:

Epigastric Region

Hypogastric Region

Right Flank

Left Flank

The correct answer is "Right Flank". The right flank region is located on the right side of the abdomen, between the lower ribs and the pelvis. In this case, the surgeon will be operating in the middle of the ascending colon, which is located in the right flank region. This region is commonly associated with the right side of the body and is the appropriate choice for the surgery described in the question.

Explanation

The correct answer is "Right Flank". The right flank region is located on the right side of the abdomen, between the lower ribs and the pelvis. In this case, the surgeon will be operating in the middle of the ascending colon, which is located in the right flank region. This region is commonly associated with the right side of the body and is the appropriate choice for the surgery described in the question.

6. Which of the following muscles contribute to the Cremaster Muscle of the Spermatic Cord?

External Abdominal Oblique

Internal Abdominal Oblique

Transversus Abdominis

Transversalis Fascia

o External oblique contributes to external spermatic fascia
o Internal oblique contributes to cremaster muscle/fascia
o Transversalis fascia contributes to internal spermatic fascia
o Transversus abdominis m DOES NOT contribute to the coverings of the spermatic cord

Explanation

o External oblique contributes to external spermatic fascia
o Internal oblique contributes to cremaster muscle/fascia
o Transversalis fascia contributes to internal spermatic fascia
o Transversus abdominis m DOES NOT contribute to the coverings of the spermatic cord

7. A surgeon needs to access the pancreas for a surgery. Which region holds the pancreas?

Epigastric Region

Umbilical Region

Hypogastric Region

Right Hypochondrium

the epigastric region holds the following contents:

1. duodenum
2. liver (part)
3. pancreas
4. stomach (part)

Explanation

the epigastric region holds the following contents:

1. duodenum
2. liver (part)
3. pancreas
4. stomach (part)

8. Which of the following is a branch of the internal thoracic artery?

Musculophrenic A.

Superficial Epigastric A.

Inferior Epigastric A.

Superficial Circumflex Iliac A.

The two branches of the Internal Thoracic Artery that supply blood to the superior portion of the abdomin are the:

1. Musculophrenic A.
2. Superior Epigastric A.

Explanation

The two branches of the Internal Thoracic Artery that supply blood to the superior portion of the abdomin are the:

1. Musculophrenic A.
2. Superior Epigastric A.

9. A patient presents to you with a penile injury. All of the following would indicate perforation of the urethrea with penetration of bucks fascia EXCEPT:

Urine collects in the scrotum deep to Dartos Fascia

Urine collects in the penis between buck's fascia and dartos fascia.

Urine collects between camper's fascia and scarpa's fascia

Urine collects between buck's fascia and scarpa's fascia

Scarpa's Fascia is continuous with Dartos Fascia, so when urine collects deep to Dartos Fascia, it can also collect deep to Scarpa's Fascia.

Camper's Fascia is superficial to Scarpa's Fascia and the question never gave any indication that the urine penetrated scarpa's or darto's fascia.

Explanation

Scarpa's Fascia is continuous with Dartos Fascia, so when urine collects deep to Dartos Fascia, it can also collect deep to Scarpa's Fascia.

Camper's Fascia is superficial to Scarpa's Fascia and the question never gave any indication that the urine penetrated scarpa's or darto's fascia.

10. Which of the following when contracted with turn the anterior abdomen to the right side?

Rectus Abdominis

Left Internal Abdominal Oblique

Left External Abdominal Oblique

Right External Abdominal Oblique

Flexion of one external abdominal oblique turns the anterior abdomin to the opposite side.

Flexion of one internal abdominal oblique turns the anterior abdomin to the same side.

Explanation

Flexion of one external abdominal oblique turns the anterior abdomin to the opposite side.

Flexion of one internal abdominal oblique turns the anterior abdomin to the same side.

11. A patient present to your ER with a knife wound in the 6-pack region above the arcurate line. Which of the following shows the order or layers the knife would have penetrated?

Skin, Camper's Fascia, Scarpa's Fascia, Rectus Sheath, Rectus Abdominis, Rectus Sheath, Extraperitoneal Fascia, Peritoneum

Skin, Scarpa's Fascia, Camper's Fascia, Rectus Sheath, Rectus Abdominis, Rectus Sheath, Extraperitoneal Fascia, Peritoneum

Skin, Camper's Fascia, Rectus Sheath, Rectus Abdominis, Scarpa's Fascia, Extraperitoneal Fascia, Peritoneum

Skin, Camper's Fascia, Scarpa's Fascia, Rectus Sheath, Rectus Abdominis, Extraperitoneal Fascia, Peritoneum

The Superficial Fascia is made up of Camper's Fascia and Scarpa's Fascia.

Camp out, Scarp In

Also, above the arcurate line is rectus sheath behind the rectus abdominis, but not below.

Explanation

The Superficial Fascia is made up of Camper's Fascia and Scarpa's Fascia.

Camp out, Scarp In

Also, above the arcurate line is rectus sheath behind the rectus abdominis, but not below.