Block 6 Anat Abdomen BRS W Expl Prt 3
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Questions and Answers
- 1.
An oncologist is reviewing a computed tomography (CT) scan of a 74-year-old man with newly diagnosed hepatocellular carcinoma. He locates the affected quadrate lobe of the liver that:
- A.
Lies between the inferior vena cava and ligamentum venosum
- B.
Receives blood from the right hepatic artery
- C.
Drains bile into the left hepatic duct
- D.
Is a medial superior segment
- E.
Is functionally a part of the right lobe
Correct Answer
C. Drains bile into the left hepatic ductExplanation
http://upload.wikimedia.org/wikipedia/commons/a/a3/Gray1087-liver.pngThe quadrate lobe of the liver drains bile into the left hepatic duct and receives blood from the left hepatic artery. It lies between the gallbladder fossa and the ligamentum teres hepatic, is a medial inferior segment, and is a part of the left lobe.Rate this question:
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- 2.
A 21-year-old young man was lifting heavy boxes while moving into his new house. During the repair of his resulting hernia, the urologist recalls that the genitofemoral nerve:
- A.
Runs in front of the quadratus lumborum
- B.
Is a branch of the femoral nerve
- C.
Supplies the testis
- D.
Passes through the deep inguinal ring
- E.
Gives rise to an anterior scrotal branch
Correct Answer
D. Passes through the deep inguinal ringExplanation
The genitofemoral nerve descends on the anterior surface of the psoas muscle and gives rise to a genital branch, which enters the inguinal canal through the deep inguinal
ring to supply the cremaster muscle, and a femoral branch, which supplies the skin of the femoral triangle. The genitofemoral nerve is not a branch of the femoral nerve but arises from the lumbar
plexus, and does not supply the testis. It is the ilioinguinal nerve that gives rise to an anterior scrotal branch.Rate this question:
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- 3.
A 6-year-old boy comes to his pediatrician with a lump in the groin near the thigh and pain in the groin. On examination, the physician makes a diagnosis of a direct inguinal hernia because the herniated tissue:
- A.
Enters the deep inguinal ring
- B.
Lies lateral to the inferior epigastric artery
- C.
Is covered by spermatic fasciae
- D.
Descends into the scrotum
- E.
Develops after birth
Correct Answer
E. Develops after birthExplanation
A direct hernia is acquired (develops after birth), whereas an indirect inguinal hernia is congenital. The direct hernia does not enter the deep inguinal ring but occurs through the posterior wall of the inguinal canal, lies medial to the inferior epigastric artery, is covered only by peritoneum, and does not descend into the scrotum.Rate this question:
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- 4.
Mrs. Jones is undergoing a routine colonoscopy for colon cancer prevention. The gastroenterologist finds a Meckel's diverticulum. Which of the following statements is true about the diverticulum?
- A.
It is found 2 feet distal to the ileocecal junction
- B.
It is located on the mesenteric side of the ileum
- C.
It occurs in about 20% of the population
- D.
It is a persistent remnant of the embryonic yolk sac
- E.
It may contain renal and suprarenal Tissues
Correct Answer
D. It is a persistent remnant of the embryonic yolk sacExplanation
The Meckel's diverticulum is a persistent remnant of the yolk stalk (vitelline duct) and located 2 feet proximal to the ileocecal junction on the antimesenteric border of the ileum. It is about 2 inches long, occurs in about 2% of the population, and contains two types of mucosal (gastric and pancreatic) tissues in its wall.Rate this question:
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- 5.
A 54-y/o man comes to an ER with abdominal pain, jaundice, loss of appetite, and weight loss. On examination of his radiograms and computed tomography (CT) scans, a physician finds a slowly growing tumor in the uncinate process of the pancreas. Which of the following structures is most likely compressed by this tumor?
- A.
Main pancreatic duct
- B.
Splenic artery
- C.
Portal vein
- D.
Superior mesenteric artery
- E.
Superior pancreaticoduodenal artery
Correct Answer
D. Superior mesenteric arteryExplanation
http://upload.wikimedia.org/wikipedia/commons/3/3b/Gray533.pngThe uncinate process of the pancreas is a projection of the lower part of the head to the left behind the superior mesenteric vessels.
The superior pancreaticoduodenal artery runs between the duodenum and the head of the pancreas.
The main pancreatic runs transversely through the entire pancreas superior to the uncinate process.
The splenic artery runs along the superior border of the pancreas.
The portal vein runs behind the neck of the pancreas.Rate this question:
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- 6.
Examination of a 54-year-old man reveals an isolated tumor located at the porta hepatis. This tumor most likely compresses which of the following structures?
- A.
Cystic duct
- B.
Hepatic veins
- C.
Common hepatic artery
- D.
Left gastric artery
- E.
Branches of the portal vein
Correct Answer
E. Branches of the portal veinExplanation
The porta hepatis is the transverse fissure (doorway) in the liver and contains the hepatic ducts, hepatic arteries, and branches of the portal vein. "the other structures are not found in the porta hepatis.Rate this question:
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- 7.
A patient is rushed to the operating room for an emergent cholecystectomy (resection of a gallbladder) because of cholecystitis. While locating landmarks before surgical resection of an infected gallbladder, the surgeon recalls that one pair of veins forms a portal-caval anastomosis. Which of the following pairs of veins form a portal-caval anastomosis?
- A.
Hepatic veins and inferior vena cava
- B.
Superior and middle rectal vein
- C.
Left and right gastric veins
- D.
Inferior and superficial epigastric veins
- E.
Suprarenal and renal veins
Correct Answer
B. Superior and middle rectal veinExplanation
Portal-caval anastomoses occur between the left gastric vein and esophageal vein of the azygos, the superior rectal and middle or inferior rectal veins, paraumbilical and superficial epigastric veins, and retrocolic veins and twigs of the renal vein. The hepatic veins and the inferior vena cava are systemic or caval veins. The left and right gastric veins belong to the portal venous system. The inferior and superficial epigastric veins and the suprarenal and renal veins are systemic veins.Rate this question:
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- 8.
Before beginning a cesarean section (Csection) in a pregnant woman with a genital herpes infection, the obstetrician noted that she had an aponeurosis of the transverse abdominal muscle. This aponeurosis most likely contributes to the formation of which of the following?
- A.
Anterior layer of the rectus sheath below the arcuate line
- B.
Anterior layer of the rectus sheath above the umbilicus
- C.
Posterior layer of the rectus sheath below the arcuate line
- D.
Deep inguinal ring
- E.
Lacunar ligament
Correct Answer
A. Anterior layer of the rectus sheath below the arcuate lineExplanation
The anterior layer of the rectus sheath below the arcuate line is formed by aponeuroses of the external and internal oblique and transverse abdominal muscles, but there is no posterior layer of the rectus sheath below the arcuate line.
The anterior layer of the rectus sheath above the umbilicus is formed by aponeuroses of the external and internal oblique abdominal muscles.
The deep inguinal ring lies in the transversalis fascia.
The lacunar ligament is formed by the external oblique abdominal aponeurosis.Rate this question:
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- 9.
A 38-year-old woman with peptic ulcer disease of the stomach experiences severe abdominal pain. Which of the following nervous structures would most likely be involved?
- A.
Greater splanchnic nerve
- B.
Ventral roots of the spinal nerve
- C.
Lower intercostal nerve
- D.
Vagus nerve
- E.
Gray ramus communicans
Correct Answer
A. Greater splanchnic nerveExplanation
The greater splanchnic nerve carries pain fibers from the upper gastrointestinal (GI) tract. Neither the ventral roots of the spinal nerves nor the gray rami corn municantes
contain sensory nerve fibers. The vagus nerve contains sensory fibers associated with reflexes, but it does not contain pain fibers. The lower intercostals nerves carry general somatic afferent (GSA)
pain fibers from the diaphragm, abdominal wall, and peritoneum but not general visceral afferent (GVA) pain fibers from the GI tract.Rate this question:
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- 10.
Because of an inflammatory bowel disease (Crohn's disease) and a small bowel obstruction leading to bowel ischemia, an elderly woman requires bypass of her ileum and jejunum and is scheduled for a gastrocolostomy. The surgeon will ligate all arteries that send branches to the stomach. Which of the following arteries may be spared?
- A.
Splenic artery
- B.
Gastroduodenal artery
- C.
Inferior pancreaticoduodenal artery
- D.
Left gastroepiploic artery
- E.
Proper hepatic artery
Correct Answer
C. Inferior pancreaticoduodenal arteryExplanation
The inferior pancreaticoduodenal artery does not supply the stomach. All of the other arteries supply the stomach. Gastrocolostomy is used to establish a communication between the stomach and colon, bypassing the small inte st tne when the patient has Crohn's disease (inflammation disease) and small bowel obstruction.Rate this question:
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- 11.
A 19-year-old man with ruptured appendix is sent to the emergency department for surgery. To cut off the blood supply to the appendix (if collateral circulation is discounted), a surgeon should ligate which of the following arteries?
- A.
Middle colic artery
- B.
Right colic artery
- C.
Ileocolic colic artery
- D.
Inferior mesenteric artery
- E.
Common iliac artery
Correct Answer
C. Ileocolic colic arteryExplanation
The appendicular artery is a branch of the ileocolic artery. The other arteries do not supply the appendix. The middle colic and right colic arteries are branches of the superior
mesenteric artery. The Inferior mesenteric artery passes to the left behind the peritoneum and distributes to the descending and sigmoid colons and the upper portion of the rectum. The common
iliac arteries are bifurcations from the aorta.Rate this question:
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- 12.
Which structure runs along the superior border of the pancreas and enters the lienorenal ligament?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
D. DExplanation
The splenic artery is a branch of the celiac trunk, follows a tortuous course along the superior border of the pancreas, and divides into several branches that run through the
lienorenal ligament.Rate this question:
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- 13.
Which structure is divided into the proper hepatic and gastroduodenal arteries?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
A. AExplanation
The common hepatic artery is divided into the proper hepatic and gastroduodenal arteries.Rate this question:
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- 14.
Which structure provides an attachment of the suspensory muscle of the duodenum (ligament of Treitz)?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
B. BExplanation
The duodenojejunal flexure is supported by a fibromuscular band called the suspensory ligament of the duodenum (ligament of Treitz), which is attached to the right crus of the diaphragm.Rate this question:
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- 15.
Which structure is retroperitoneal in position and receives blood from the splenic artery?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
C. CExplanation
The pancreas is an endocrine and exocrine gland; is retroperitoneal in position; arid receives blood from the splenic, gastroduodenal, and superior mesenteric arteries.Rate this question:
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- 16.
Which structure is a direct branch of the aorta and supplies blood to the ascending and transverse colons?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
D. DExplanation
The superior mesenteric artery, a direct branch of the aorta, supplies blood to the ascending and transverse colons.Rate this question:
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- 17.
Which structure receives bile, concentrates it by absorbing water and salt, and stores it?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
A. AExplanation
The gallbladder receives bile, concentrates it by absorbing water and salt, and stores it.Rate this question:
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- 18.
Which structure runs behind the inferior vena cava?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
B. BExplanation
The right renal artery arises from the aorta, is longer than the left one, and runs behind the inferior vena cava and the right renal vein.Rate this question:
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- 19.
Which structure receives blood from the left gonad and suprarenal gland?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
E. EExplanation
The left renal vein runs anterior to the aorta but posterior to the superior mesenteric artery and receives blood from the gonad and suprarenal gland. and the right renal vein.Rate this question:
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- 20.
Which structure receives blood from the liver and kidney and enters the thorax by piercing the central tendon of the diaphragm?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
B. BExplanation
The inferior vena cava, which receives blood from the liver, kidneys, and other abdominal structures, enters the thorax through the vena caval foramen to empty into the right atrium.Rate this question:
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.JPG "Which structure is divided into the proper hepatic and gastroduodenal arteries?")
.JPG "Which structure provides an attachment of the suspensory muscle of the duodenum (ligament of Treitz)?")
.JPG "Which structure is retroperitoneal in position and receives blood from the splenic artery?")
.JPG "Which structure is a direct branch of the aorta and supplies blood to the ascending and transverse colons?")
.JPG "Which structure receives bile, concentrates it by absorbing water and salt, and stores it?")
.JPG "Which structure runs behind the inferior vena cava?")
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Mar 22, 2023Quiz Edited by
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Feb 21, 2012Quiz Created by
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