4LE samplex Flashcards
Which transverse planes is used in dividing the abdomen into four quadrants?
Transumbilical
Which transverse planes is midway between the manubrium sterni and the symphysis pubis?
Transpyloric
What structures attach the rectus abdominis muscle to the anterior layer of the rectus sheath producing the bulging of the muscle forward when tensed in muscular people?
Tendinous intersections
A mass in the liver may be palpable in which of the nine regions of the abdomen?
Right hypochondrium
anterior abdominal wall layer:scrotal layer pair
Internal Oblique:Cremasteric Fascia
Which of the following statements is true of the external oblique muscle
Its thickened anterolateral aponeurosis forms the inguinal ligament
Profuse bleeding may occur if a surgeon inadvertently cuts through which umbilical fold
Lateral umbilical fold (it has the inferior epigastric vessels)
The inguinal (Hesselbach’s) triangle is found in which peritoneal fossa
Middle inguinal fossa
Which structures is/are found within the rectus sheath
look for it
- Which of the following statements is true of the formation of the rectus sheath
Below the arcuate line, the anterior wall is formed by the aponeurosis of the external oblique, internal oblique, and the transversus abdominis muscle and the posterior wall is formed by the transversalis fascia
- The intricate venous plexuses in the subcutaneous tissue of the abdomen drain superiorly into which of the following vessels
Lateral thoracic veins
- Blood vessels and nerves in the anterior abdominal wall are located between
Internal oblique and transversus abdominis muscles
- An infection of the superficial anterior abdominal wall below the umbilicus may most likely affect which of the following lymph nodes
Superficial inguinal lymph nodes
- Which ligament is composed of the deepr fibers of the inguinal ligament that attach superiorly to the superior pubic ramus?
- Gimbernat
- Choose the correct wall of the inguinal canal:structure relationship
Posterior wall:Transversalis Fascia
- The herniating bowel passing through the deep inguinal canal in cases of indirect inguinal hernias will also be passing which of the following
a. Lateral to the inferior epigastric artery
- The structures that divide the mouth into vestibule and oral cavity proper is/are
Teeth and alveolar processes
- Which of the following palatal muscles is innervated by the mandibular nerve
. Tensor veli palatini
- Which esophageal constriction corresponds to the narrowest and least distensible part of the alimentary tract
Cricopharyngeal
- Which of the following statements best describes the esophagus
c. It is located between the trachea and vertebral column in the superior mediastinum
- Which of the following statements is true about the stomach
The posterior surface forms the anterior wall of the omental bursa
structures are related to the lesser curvature of the stomach
- Gastric canal - L and R gastric arteries - Anterior and posterior vagal trunks
- The major duodenal papilla is located at the posteromedial aspect of which portion of the duodenum
Descending
- A patient required emergent surgery due to intra-abdominal bleeding. One liter of blood was evacuated and a “hole” was found in the posterior wall of the stomach due to peptic ulcer. Which blood vessel would most likely have been eroded by the gastric juice
Splenic artery
- Which of the following features best describe the Jejunum
Long vasa recta
- Which flexure is held in place by the Ligament of Treitz
Duodenal-Jejunal
- Which of the following structures would be devascularized if the superior mesenteric artery is occluded
a. Ascending colon
- Which features of the large intestine cease at the recto-sigmoid junction
a. Haustra b. Omental appendices c. Taenia coli
- Choose the correct part of the large intestine characteristic relationship
a. Cecum is widest
- Clinically, a patient with internal hemorrhoids may present with
. Painless mass during digital rectal examination
- Transition of the parasympathetic innervation of the alimentary tract occurs at the
- Left colic flexure
- The terminal branches of the superior mesenteric vessels are found in the anal
a. Columns
- Which portions of the alimentary tract has/have dual blood supply coming from the celiac trunk and the superior mesenteric artery
a. Duodenum
- The submucosal venous plexuses in the abdominal esophagus drain into the portal vein via which gastric vein?
a. Left gastric vein
- Which of the following structures is crossed by the root of the mesentery
a. Horizontal part of the duodenum
- Which of the following structures is/are found in the lip?
a. Glands
- The esophageal glands are found in which of the following layers?
Submucosa
- Which of the following papillae is closely related to the von Ebner’s glands?
Vallate
- Which of the following parts of the tooth contains glycosaminoglycans, Type I collagen fibers and 70% hydroxyapatite?
b. Dentin
- Which of the following features is not seen in the esophagus?
a. Brunner’s glands in the submucosa
- The lining epithelium of the stomach is best characterized as
a. Simple columnar
- Which of the following muscle layers comprise the muscularis externa of the stomach
b. Outer longitudinal, inner circular and inner oblique
- Which of the following statements best describes the pylorus histologically
Pit:gland ratio is 2:1
- Anemia (low hemoglobin levels) may occur if which of the following enteric cells is affected
c. Parietal Cells
- Among the different portions of the small intestines, which of the following structures/features is/are found only in the duodenum
d. Submucosal glands
- Which of the following layers make up a villus
a. Epithelium and lamina propria
- Which of the following features are best seen in the Jejunum?
Numerous tall and slender circular folds
- Auerbach’s plexus, a part of the enteric nervous system, is seen in which layer of the small intestines
. Muscularis Externa
- Simple columnar epithelium with goblet cells and numerous aggregated lymphatic nodules is seen in which segment of the alimentary tract
b. Appendix
- The taenia coli represent which histological layer of the muscularis externa
a. Outer longitudinal
- At the ano-rectal junction, epithelium changes from simple columnar with goblet cell to
. Stratified squamous, non-keratinizing
- Which part of the enteric nervous system is seen in the submucosa of the large intestines
. Meissner’s Plexus
- Which of the following liver organization structures emphasizes bile flow
c. Portal lobule
- Which of the following is/are the major tributary veins of the portal vein
b. Superior Mesenteric c. Splenic
- Which of the following is true regarding hepatic segmentation
b. Transverse hepatic veins subdivides 3 of the 4 primary divisions creating 6 hepatic segments
- Which of the following structures divide/s the liver into anatomical right and left lobes
b. Falciform ligament
- Blood supply to the liver comes from which of the following vessels?
Hepatic artery Portal vein
- Which of the following portocaval anastomoses is the most dangerous complication of portal hypertension
c. Esophageal varices
- A pathologist was examining a section of the liver parenchyma of a patient with congestive heart failure. He noticed a particular area which showed centrilobular necrosis. At which particular zone of the hepatic acinus was he looking
c. Zone 3
- The spiral folds which regulate the filling and emptying of the gall bladder are found in
d. Cystic duct
- Which of the following statements is true about the gall bladder
b. Its mucosa is lined by simple columnar epithelium and microvilli
- The main pancreatic duct opens into a dilatation in the wall of the duodenum called
a. Ampulla of Vater
- A first year student has difficulty locating the beginning of the portal vein. He should best be looking for it beneath which portion of the pancreas
b. Neck
- Which structures constitute the initial portion of the intercalated duct of the pancreatic acini?
a. Centroacinar cells
- Which of the following arteries supplying the head of the pancreas comes from the gastroduodenal artery?
. Superior pancreaticoduodenal
- Which of the following statements is true regarding the submaxillary gland?
b. Its duct emerges from the deep portion of the gland
- Which of the following best characterizes the histology of the sublingual gland
. Serous cells are found only in demilunes
- The left vagus nerve innervates which side/surface of the stomach after the latter has completed its rotation?
a. Anterior
- What is the direction and degree of rotation of the primary intestinal loop during its return to the abdominal cavity?
180o CCW
- The distal end of the foregut lies at or just below the level of
Liver bud
- The peritoneal covering of the liver arises from
Septum Transversum
- A 24-hour old newborn infant has not passed stool since birth. Examination revealed imperferate anus. Which of the following could have caused this abnormality?
b. Failure of rupture of the anal membrane
- An infant was taken to the ER after being delivered at home. Examination revealed herniated loops of bowel covered by membrane. Which of the following congenital abnormalities does the patient most likely have
c. Omphalocele
- Which of the statements is true regarding gastroschisis?
c. Protusion of the abdominal contents directly into the amniotic cavity
- A 6-month old infant presented with an enlarged abdomen, mucoid stools and vomiting. Plane abdominal xray revealed dilated colon. What could have caused this condition?
a. Absence of the parasympathetic ganglie in the bowel wall
During a game, a 23-year old football player was hit from behind just below the ribs on his left side and was pinned to the ground. After being hit, he complained of severe pain on the left flank and was immediately taken to the hospital. Urinalysis showed blood in his urine. Radiologic imaging revealed no fractures but hemorrhage confined to the area around the medial aspect of the left kidney. He was brought to surgery for suspected kidney laceration. Upon which posterior abdominal wall muscle does the medial side of the kidney lie? What structure would confine the hemorrhage to the area around the kidney?
Psoas muscle Renal Fascia of Gerota
- A distinguishing feature of the proximal convoluted tubule is the presence of:
a. Brush border
- Which of the following best describes podocytes
a. Glomerular endothelial cells
- What arteries arise directly from the interlobar arteries
a. Arcuate
- Which of the following statements best describe the juxtaglomerular cells
They are modified smooth muscles of the afferent arteriole
- Which of the following structures is/are found in the renal cortex
d. Medullary rays
- Which of the following statements is true regarding the prostatic urethra
b. It is the widest and most dilatable portion of the urethra
- Renal calculi would most likely be arrested on its descent along the ureter in which of the following locations?
c. At the junction of the ureter and the renal pelvis
- The metanephros appears in what week of intrauterine development?
d. 5th week
- The left testicular vein drains directly into the:
. Left renal vein
- Which of the following best describes the general arrangement of the following structures from anterior to posterior at the renal hilum?
b. Renal Vein – Renal Artery – Ureter
- Referred pain from a ureteric stone on the ipsilateral lower quadrant of the anterior abdominal wall in the inguinal area is transmitted via what spinal cord segments?
. T11-L2
- Which of the following nerves inhibits the detrussor muscle from contracting and increases the urethral sphincter tone?
a. Hypogastric plexus
- Which of the following statements is true regarding the suprarenal glands?
b. It is highly vascularized
- Which anterior abdominal wall layer provides the greates structural strength and therefore would require proper suturing during wound closure in a right lower quadrant appendectomy?
. External oblique aponeurosis
- During a classic open appendectomy via RLQ incision, the structure best used to locate the appendix is the:
c. Taenia coli
- When the left colic artery becomes compromised for whatever reason, viability of the descending colon is primarily maintained by the
. Marginal artery of Drummond
- In laparoscopic cholecystectomy, the surgical clips are applied close to the gall bladder to avoid ligating which of the following structures?
a. Common bile duct
- Rebound tenderness on the examination of a patient with acute abdomen is suggestive of
d. Peritoneal irritation
- Which of the following abdominal structures is intraperitoneal in location?
Transverse colon
- Upper GI series shows intrinsic compression of the medial second part of the duodenum with widening of the duodenal C-loop. Which of the following is most likely affected?
a. Pancreas
- A patient with progressive epigastric pain shows pneumoperitoneum (free air in the peritoneal cavity on plane abdominal xray). Perforation of which of the following hollow organs would be most likely considered?
Sigmoid colon
- The following locations should be evaluated when suspecting the presence of hemoperitoneum (blood in the peritoneal cavity) EXCEPT
a. Bare area of the liver
- The ureter is seen as a series of discontinuous opacities in the normal intravenous pylography because of
b. Peristalsis of the ureter