Abdominal: In-Class Q's

Question 1

Choose all that apply to a Direct Inguinal Hernia;

1. Occurs in Old age
2. Can reach the Scrotum
3. Does not enter the deep inguinal ring
4. The herniating sac is lateral to the inferior epigastric vessels
5. Originates in the inguinal triangle
6. Pass through the inguinal canal.

Answer 1

Direct Inguinal Hernias:

1. Occurs in old age
2. Does not reach the Deep inguinal ring
3. Originates in the Inguinal (hasselbachs) triangle.

Question 2

A 19-yo gang member was shot with a 9mm bullet in his RLQ.

The bullet entered and traversed the anterolateral abdominal wall.

The following structures form the layers of this wall:

1. Internal Abdominal Oblique m.
2. Transversalis Fascia
3. Transversus Abdominis m.
4. Campers Fascia
5. Scarpas Fascia
6. External Abdominal Oblique m.

Put them in the correct order of the structure in which the bullet traversed.

Answer 2

4-5-6-1-3-2

Question 3

A 45-yo man is admitted to the hospital with a massive hernia that passes through the inguinal (Hasselbachs) triangle.

Which of the following structures is used as a landmark to distinguish a direct inguinal hernia from an indirect inguinal hernia?

A. Femoral Ring

B. Inguinal Ligament

C. Lateral Border of the Rectus Abdominis m.

D. Inferior Epigastric Vessels

E. Medial Umbilical Fold

F. Median Umbilical fold

Answer 3

D. Inferior Epigastric vessles;

Indirect hernias occur LATERAL to the Inferior Epigastric Vessles, while Direct Hernias occur MEDIALLY.

Question 4

During Laparoscopic procedure, you observe the inferior epigastric vessels ascending on the posterior surface of the Rectus Abdominis m.

They Suddenly disappear from view by passing superior to the..

A. Linea Alba

B. Linea Semilunaris

C. Transversalis Fascia

D. Medial Umbilical Ligament

E. Arcuate Line

Answer 4

E. Arcuate Line

Question 5

A surgeon entering the abdominal cavity through the abdominal wall will take care to avoid injury to the vessels and nerves within the wall.

The majority of these vessels and nerves will be found immediately deep to the…

A. Skin

B. Superficial Fascia

C. External Abdominal Oblique m.

D. Internal Abdominal Oblique m.

E. Transversus Abdominis m.

Answer 5

D. Internal Abdominal Oblique m.

Vessels & nerves travel between the IAO & TA muscles.

Question 6

A patient receives a general anesthetic in preparation for a cholecystectomy.

A right subcotstal incision is made, which begins near the xiphoid process, runs along the and immediately beneath the costal margin to the anterior axillary line, and transects the rectus abdominis muscle and rectus sheath.

At the level of the subcostal plane, the anterior lamina of the rectus sheath receives contributions from the…

A. Aponeurosis of the Internal & External oblique muscles

B. Aponeuroses of the transverse abdomens and internal oblique muscles

C. Aponeuroses of the transverse abdominis and internal oblique muscles

D. Transversalis Fascia

E. Transversalis Fascia & Aponeuroses of the transverse abdominis muscle

Answer 6

A. Aponeurosis of the Internal & External oblique muscles

Question 7

Dr. Thompson noted that he is getting a “beer belly” and has decided to undergo a slimming “Tummy Tuck” (Abdominoplasty) procedure.

Which of the following layers of the abdominal wall would be structurally strong enough to hold the suture?

A. Campers Fascia

B. Transversalis Fascia

C. Extraperitoneal Tissue

D. Scarpas Fascia

E. Fatty Layer of the Superficial Fascia

Answer 7

D. Scarpas Fascia

Question 8

Which of the following landmarks is most often used to located the inferior end of the posterior lamina (wall) of the rectus sheath?

A. Intercristal Line

B. Linea Alba

C. Linea Semilunaris

D. Tendinous Intersections

E. Arcuate Line

Answer 8

E. Arcuate Line