Block 6 Anatomy Kidney Retrperitneum Umich W Expl

18 Questions | By Chachelly | Last updated: Mar 18, 2022 | Total Attempts: 120

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1.

A 57-year-old male complains of intense chest pain, but tests rule out any cardiac pathology. It was determined that the patient suffers from an esophageal (hiatal) hernia in which the stomach herniates through an enlarged esophageal hiatus. Muscle fibers from which of the following parts of the diaphragm would border directly on this hernia?
- A.
  
  Left crus
- B.
  
  Right crus
- C.
  
  Central tendon
- D.
  
  Costal fibers
- E.
  
  Sternal fibers
2.

Sympathetic fibers in the greater splanchnic nerve arise from neuron cell bodies found in the:
- A.
  
  Brainstem
- B.
  
  Celiac ganglion
- C.
  
  Chain ganglion
- D.
  
  Spinal cord
- E.
  
  Superior mesenteric ganglion
3.

After successfully performing two adrenalectomies (removal of the adrenal gland), the surgical resident was disappointed to learn that he would be merely assisting at the next one. The chief of surgery told him: "I'm doing this one, since the one on the right side may be a little too difficult for you." The difficulty he envisioned stems from the fact that the right suprarenal gland is partly overlain anteriorly by the:
- A.
  
  Aorta
- B.
  
  Inferior vena cava
- C.
  
  Left hepatic vein
- D.
  
  Right crus of the diaphragm
- E.
  
  Right renal artery
4.

During preparations to remove the left kidney from a 28-year-old female patient, the surgeon asked an observing medical student where best to ligate the renal vein. Upon hearing the reply: "as close to the inferior vena cava as possible, leaving just enough stump to ensure tight closure," the surgeon's eyebrow shot up. "Do you mean to say you're willing to compromise the venous drainage of the other structures that drain into the renal vein?" By this he meant all of the following except:
- A.
  
  Diaphragm
- B.
  
  Pancreas
- C.
  
  Ovary
- D.
  
  Suprarenal gland
5.

The celiac plexus of nerves may contain fibers derived from all of the following sources except:
- A.
  
  Posterior vagal trunk
- B.
  
  Greater thoracic splanchnic nerve
- C.
  
  Lesser thoracic splanchnic nerve
- D.
  
  Lumbar splanchnic nerves
6.

Which statement regarding the suprarenal glands is correct?
- A.
  
  Its entire arterial supply is directly from the abdominal aorta
- B.
  
  Veins from both glands drain directly into the inferior vena cava.
- C.
  
  The glands are localized in the pararenal space.
- D.
  
  Cells that secrete epinephrine and norepinephrine are innervated by preganglionic fibers from the greater thoracic splanchnic nerve.
7.

The nerve that innervates the cells of the suprarenal medulla consists of fibers of the:
- A.
  
  Greater thoracic splanchnic nerve
- B.
  
  Lesser thoracic splanchnic nerve
- C.
  
  Least thoracic splanchnic nerve
- D.
  
  Anterior vagal trunk
- E.
  
  Posterior vagal trunk
8.

Regarding the diaphragm, which, is paired INCORRECTLY?
- A.
  
  Vertebrocostal trigone - lateral arcuate ligament
- B.
  
  Esophageal hiatus - right crus
- C.
  
  Medial arcuate ligament - psoas muscle
- D.
  
  Central tendon - aortic hiatus
- E.
  
  Vena caval foramen - right phrenic nerve
9.

The nerves that end on the secretory cells of the medulla of the suprarenal glands are principally:
- A.
  
  Preganglionic fibers from the greater thoracic splanchnic nerve
- B.
  
  Postganglionic fibers from the celiac plexus
- C.
  
  Postganglionic fibers from the aorticorenal ganglia
- D.
  
  Preganglionic fibers from the lesser thoracic splanchnic nerve
- E.
  
  Postganglionic fibers from the renal plexus
10.

The vagus nerve passes into the abdomen by passing through the
- A.
  
  Aortic hiatus
- B.
  
  Esophageal hiatus
- C.
  
  Caval foramen
- D.
  
  Lateral arcuate ligament
- E.
  
  Medial arcuate ligament
11.

With one exception, preganglionic sympathetic axons synapse upon postganglionic sympathetic dendrites or cell bodies. The exception to this general rule occurs within the:
- A.
  
  Kidney cortex
- B.
  
  Kidney medulla
- C.
  
  Suprarenal medulla
- D.
  
  Suprarenal cortex
12.

The pararenal fat in the kidney bed is an elaboration of:
- A.
  
  Peritoneum
- B.
  
  Extraperitoneal connective tissue
- C.
  
  Transversalis fascia
- D.
  
  Fusion fascia
13.

The cisterna chyli accompanies which structure as it passes through the diaphragm?
- A.
  
  Inferior vena cava
- B.
  
  Esophagus
- C.
  
  Greater thoracic splanchnic nerve
- D.
  
  Aorta
14.

Blood from an injured kidney will seep through the perirenal fat until it contacts the internal surface of the renal (Gerota's) fascia. Without perforating this fascia the blood could then continue to pass in what direction?
- A.
  
  Inferiorly toward the pelvis
- B.
  
  Laterally into the body wall
- C.
  
  Medially across the midline to the other kidney
- D.
  
  Superiorly into contact with the fascia of the diaphragm
15.

A 19-year-old male suffers a tear to the psoas major muscle during the course of a football game. A scar, which formed on the medial part of the belly of the muscle, involved an adjacent nerve, immediately medial to the muscle. The nerve is called the:
- A.
  
  Femoral
- B.
  
  Genitofemoral
- C.
  
  Iliohypogastric
- D.
  
  Ilioguinal
- E.
  
  Obturator
16.

While recovering from an open abdominal hysterectomy (i.e., using a midline abdominal incision to gain entry to the pelvis), a patient realizes that she has lost sensation to the skin of her anterior thigh and cannot extend her knee. Retractors holding the incision open and pressing against the posterior abdominal wall most likely caused injury to which nerve?
- A.
  
  Femoral
- B.
  
  Genitofemoral
- C.
  
  Iliohypogastric
- D.
  
  Lateral femoral cutaneous
- E.
  
  Obturator
17.

In the lumbar region, tuberculosis may spread from the vertebrae into an adjacent muscle to produce an abscess. Pus from the abscess may travel within the fascial sheath surrounding the affected muscle. A patient presents with pus surfacing in the superomedial part of the thigh. To which muscle did the tuberculosis most likely spread?
- A.
  
  Internal oblique
- B.
  
  Obturator internus
- C.
  
  Psoas major
- D.
  
  Quadratus lumborum
- E.
  
  Rectus abdominis
18.

The nerves of the lumbar plexus are arranged around specific muscles of the posterior abdominal wall. Which of these nerves lies immediately medial to the psoas major muscle?
- A.
  
  Femoral
- B.
  
  Genitofemoral
- C.
  
  Ilioinguinal
- D.
  
  Obturator