Abdomen Flashcards

1
Q

Which one of the following organs is classified as being entirely retroperitoneal?

A. Pancreas

B. Duodenum

C. Spleen

D. Liver

E. Rectum

F. Kidneys

G. Ileum

A

F

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2
Q

Which one of the following organs is classified as being intraperitoneal?

A.

Sigmoid colon

B.

Aorta

C.

Proximal 1/3rd of the rectum

D.

Distal 2/3rds of the rectum

E.

2nd part of the duodenum

F. 4th part of the duodenum

G.

Proximal esophagus

H.

Urinary bladder

A

A

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3
Q

The majority of the organ in the accompanying image is best described as being which of the following?

A.

Intraperitoneal

B.

Primary (1°) retroperitoneal

C.

Secondary (2°) retroperitoneal

D.

Infraperitoneal

A

C

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4
Q

The hepatoduodenal ligament is defined as the thick, free edge of the lesser omentum. Which of the following statements is true in relation to

this ligament?

A.

It connects the liver to the anterior abdominal wall

B.

It connects the liver to the posterior abdominal wall

C.

It forms the anterior boundary of the omental (epiploic) foramen

D.

It forms the superior boundary of the omental (epiploic) foramen

E.

It contains the left gastric artery

F.

It contains the Inferior vena cava (IVC)

A

C

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5
Q

An 8 year old girl presents to her physician with well localized, sharp stabbing pains in her left lower abdominal quadrant (LLQ). The patient’s father is concerned as he witnessed the patient fall off of their farm’s quad bike at high speed when she was trying to help round up cattle.

After examination, the physician diagnoses that the patient has likely perforated her descending colon. The sharp, well localized pain is most likely a result of the exudate inflaming which abdominal layer?

A.

Parietal peritoneum

B.

Visceral peritoneum

C.

Rectus sheath

D.

Camper’s fascia

E.

Scarpa’s fascia

A

A

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6
Q

A 19 year old woman presents to the emergency department with fever, nausea and severe abdominal pain in the right lower quadrant (RLQ)

of her abdomen 1/3rd of the distance from the anterior superior iliac spine towards the umbilicus. A ruptured appendix is suspected and the

physicians decide to surgically perform an appendectomy. In order to cut

off the arterial supply to the appendix during this surgical procedure,where will the appendicular artery be located?

A.

Branching from the middle colic artery

B.

Travelling in the mesentery proper

C.

Branching from the inferior mesenteric artery (IMA)

D.

Traveling in the mesoappendix

E.

Branching from the intestinal branches (of the SMA)

F.

Travelling in the gastrocolic ligament

A

D

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7
Q

A 67 year old man presents to his physician with severe abdominal swelling and distension caused by ascites (extra peritoneal fluid) which is leaving him short of breath, particularly when he lies in a supine position. The physician determines that the action of the diaphragm is being affected by the build up of abdominal pressure due to the ascites. Other than advising the patient to remain in an inclined position, what is the name of the surgical procedure that is typically performed to drain the ascitic fluid?

A.

Pringle maneuver

B.

Paracentesis

C.

Dialysis

D.

Fasciectomy

E.

Adhesiotomy

A

B

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8
Q

A 48 year man has suffered trauma to his liver following a motor vehicle accident. The physician is attempting to control an internal hemorrhage and the accompanying image illustrates the technique which was used during the patient’s surgery. Which of the following anatomical structures is indicated by the tip of the yellow arrow?

A.

Left lobe of the liver

B.

Celiac trunk

C.

Hepatoduodenal ligament

D.

Common bile duct

E.

Hepatic portal vein

F.

Hepatogastric ligament

G.

Hepatic artery proper

A

F

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9
Q

Medical imaging is performed in a 61 year woman who has malignant ascites. The asterisk in the accompanying CT scan denotes fluid which is

present in the patient’s lesser sac (omental bursa) and has been causing her discomfort. The diagram beside the CT scan shows the relationship

of the splenic artery and vein (as indicated by the tips of the yellow arrows) and the tail of the pancreas being contained within which peritoneal ligament?

A.

Gastrophrenic

B.

Hepatogastric

C.

Hepatoduodenal

D.

Splenorenal

(lienorenal)

E.

Gastrosplenic (gastrolienal)

A

D

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10
Q

In the accompanying image, which one of the following arrow tips is pointing to the common bile duct?

A.

Choice A

B.

Choice B

C.

Choice C

D.

Choice D

E.

Choice E

A

E

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11
Q

Which two arteries are commonly involved in providing an arterial anastomosis to form a connection between the celiac trunk and the

superior mesenteric artery (SMA)?

A.

Superior and Inferior pancreaticoduodenal arteries

B.

Left and Right gastric arteries

C.

Left and Right gastro-omental arteries

D.

Left and Right hepatic arteries

E.

Supraduodenal and short gastric arteries

F.

Esophageal and gastroduodenal arteries

A

A

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12
Q

In the accompanying image, the tip of the yellow arrow is indicating

which of the following structures?

A.

Esophagus

B.

1st part of the duodenum

C.

Pyloric sphincter

D.

Gastric rugae

E.

Circular folds

F.

Ileocecal valve

G.

Angular notch

H.

Cardinal notch

A

C

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13
Q

Which two veins commonly unite to form the hepatic portal vein?

A.

Inferior mesenteric vein (IMV) and Superior mesenteric vein (SMV)

B.

Inferior mesenteric vein (IMV) and Splenic vein

C.

Inferior mesenteric vein (IMV) and Left hepatic vein

D.

Superior mesenteric vein (SMV) and Splenic vein

E.

Superior mesenteric vein (SMV) and Left hepatic vein

F.

Superior mesenteric vein (SMV) and Inferior vena cava (IVC)

A

D

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14
Q

In the accompanying image, the tip of the yellow arrow is pointing to which anatomical structure?

A.

Superior mesenteric vein (SMV)

B.

Right hepatic vein

C.

Central vein

D.

Middle hepatic vein

E.

Hepatic portal vein

F.

Inferior vena cava (IVC)

A

F

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15
Q

A 27 year old man is admitted to the emergency department following a motorcycle accident. Physical examinations reveal that the patient has

many fractured ribs and the physicians are concerned that the spleen has ruptured.

Typically, the spleen has a close posterolateral anatomical relationship to (i) which of the following ribs and (ii) what other structure?

A.

Ribs 7-9 and the left part of the diaphragm

B.

Ribs 9-11 and the left part of the diaphragm

C.

Ribs 11-12 and the left part of the diaphragm

D.

Ribs 7-9 and the right part of the diaphragm

E.

Ribs 9-11 and the right part of the diaphragm

F.

Ribs 11-12 and the right part of the diaphragm

A

B

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16
Q

A 72 year old woman presents with jaundice (yellowing of the skin and sclera of the eyes) and pain in her right upper quadrant (RUQ). Medical

imaging reveals a particularly large gallstone is

completely obstructing her hepatopancreatic ampulla (Ampulla of Vater). Although bile is

unable to be released into the second part of her duodenum, pancreatic juices are still able to be released via an alternative opening. Which duct opens via the minor duodenal papilla?

A.

Main pancreatic duct

B.

Common bile duct

C.

Accessory pancreatic duct

D.

Cystic duct

E.

Common hepatic duct

A

C

17
Q

A 53 year old man has regularly been administering large quantities of aspirin and presents to his physician with nausea, epigastric pain and hematesmesis (blood in his vomit). Endoscopy reveals a large gastric

ulcer has eroded the mucosa on the lesser curvature of his stomach.

Which one of the following arteries has most likely been eroded as a result of the gastric acid being released out of the patient’s stomach?

A.

Right gastric

B.

Left gastro-omental

C.

Splenic

D.

Supraduodenal

E.

Posterior inferior pancreaticoduodenal

A

A

18
Q

Lymphatic drainage of the superior part of the lesser curvature of the stomach will initially drain towards the gastric lymph nodes. Which

group of lymph nodes will the lymph most likely drain to next?

A.

Parasternal

B.

Superior mesenteric

C.

Inferior mesenteric

D.

Celiac

E.

Lumbar (para-aortic)

F.

Superficial inguinal

A

D

19
Q

A 29-year-old man presents to the emergency department vomiting blood. Medical records reveal that the patient has a rare eating disorder

and medical imaging reveals a large quantity of metal objects have been ingested as shown in the accompanying radiograph. The physicians are

concerned that the sharp items may perforate the gastrointestinal tract so perform surgery to remove the 227 objects. If the artery supplying the distal (inferior) portion of the greater

curvature of his stomach was cut by one of the sharp metal objects, (i)

which artery would most likely be at risk of laceration and (ii) from

which branch of the celiac trunk would this artery most commonly branch?

A.

Left gastro-omental–Splenic

B.

Right gastro-omental–Gastroduodenal

C.

Left gastric–Splenic

D.

Right gastric–Hepatic artery proper

E.

Left gastro-omental–Hepatic artery proper

F.

Right gastro-omental–Splenic

G.

Left gastric–Gastroduodenal

H.

Right gastric–Common hepatic

A

B

20
Q
A

D

21
Q
A

F

22
Q
A

D

23
Q
A

C

24
Q

A 20-year-old man is experiencing the on-set of appendicitis. In this case the appendix has become inflamed without irritating the surrounding parietal peritoneum. Which abdominal region would the

patient most likely experience referred pain if General Visceral Afferent (GVA) axons carried pain sensation?

A

F