Questions Flashcards
If one were to make an incision parallel to and 2 inches above the inguinal ligament, one would find the inferior epigastric vessels between which layers of the abdominal wall?
Camper’s and Scarpa’s fascias
External abdominal oblique and internal abdominal oblique muscles
Internal abdominal oblique and transversus abdominis muscles
Skin and deep fascia of the abdominal wall
Tranversus abdominis muscle and peritoneum
Transversus Abdominus & peritoneum
loop of bowel protrudes through the abdominal wall to form a direct inguinal hernia; viewed from the abdominal side, the hernial sac would be found in which region? Deep inguinal ring Lateral inguinal fossa Medial inguinal fossa Superficial inguinal ring Supravesical fossa
Medial Inguinal Fossa
While performing a routine digital examination of the inguinal region in a healthy teen-aged male, the physician felt a walnut-sized lump protruding from the superficial inguinal ring. She correctly concluded that it was :
definitely an indirect inguinal hernia
possibly an unusual femoral hernia
definitely a direct inguinal hernia
possibly an enlarged superficial inguinal lymph node
either a direct or an indirect inguinal hernia
Either a direct or indirect hernia
Where is the deep inguinal ring found?
The deep inguinal ring is found near the midpoint of the inguinal ligament, below the anterior superior iliac spine. This ring is lateral to the inferior epigastric artery. The superficial inguinal ring is found above the pubic tubercle. Remember–the supravesical fossa is the space between the median and medial umbilical folds.
An elderly patient with a large indirect inguinal hernia came to your clinic complaining of pain in the scrotum. You conclude that the hernial sac is compressing the following nerve: Femoral branch of the genitofemoral Femoral Iliohypogastric Ilioinguinal Subcostal
Ilioinguinal
A 45-year-old porter develops a direct inguinal hernia. If the hernia extended through the superficial inguinal ring, it would be surrounded by all of the abdominal wall layers EXCEPT the:
External spermatic fascia
Internal spermatic fascia
Peritoneum and extraperitoneal connective tissue
Weak fascia of the transversus abdominis muscle lateral to the falx
Internal Spermatic Fascia
Which organ becomes retroperitoneal during rotation of the gut tube? Duodenum Kidney Spleen Stomach Transverse Colon
Duodenum
During a cholecystectomy (removal of the gall bladder), the surgical resident accidentally jabbed a sharp instrument into the area immediately posterior to the epiploic foramen (its posterior boundary). He was horrified to see the surgical field immediately fill with blood, the source which he knew was the: aorta inferior vena cava portal vein right renal artery superior mesenteric vein
IVC
Portal Vein is anterior to epiploic foramen
The division between the true right and left lobes (internal lobes) of the liver may be visualized on the outside of the liver as a plane passing through the:
gallbladder fossa and round ligament of liver
falciform ligament and ligamentum venosum
gallbladder fossa and inferior vena cava
falciform ligament and right hepatic vein
gallbladder fossa and right triangular ligament
Gall bladder Fossa & IVC
A 50-year-old female patient with severe jaundice was diagnosed with pancreatic cancer. You suspect that the tumor is located in which portion of the pancreas? Head Neck Body Tail Uncinate process
HEAD
- obstructing the COMMON BILE DUCT
A medical student was asked to identify a small specimen taken for pathological examination from a surgically removed duodenum. The student noted that the specimen revealed a thin wall and no circular folds. The specimen is from which segment? Superior Descending Horizontal Ascending
Superior Part
Upon endoscopic examination of a 65-year-old man who had a history of a chronic duodenal ulcer, it was found that the ulcer had been eroding the posterior wall of the first part of the duodenum. If erosion perforates the wall, the gastric expellant of high acidity would endanger the structures in its vicinity. Which is least likely to be endangered? Common bile duct Gastroduodenal artery Main pancreatic duct Portal vein
Main Pancreatic DUct
A 58-year-old patient was diagnosed with a severe case of portal hypertension due to alcoholic cirrhosis of the liver. It was determined that a bypass between the vessels of the portal and caval systems was necessary. The plan most likely to be successful is:
Coronary vein to right gastro-omental vein
Left colic vein to sigmoidal vein
Inferior mesenteric vein to splenic vein
Splenic vein to left renal vein
Superior rectal vein to inferior rectal vein
Splenic Vein to Left Renal Vein
The splenic vein is a major vein of the portal system, while the left renal vein is a major vein of the caval system.
An ulcer near the pyloroduodenal junction perforated and eroded a large artery immediately posterior to the duodenum. The ligation of the eroded vessel at its origin would LEAST affect the arterial supply to the: First part of the duodenum Second part of the duodenum Greater curvature of the stomach Head of the pancreas Tail of the pancreas
Tail of the pancreas
A surgeon needs to construct a bypass between the veins of the portal and caval systems to circumvent insufficient drainage through the natural portacaval anastomoses. Which plan is likely to be successful?
Coronary vein to right gastroepiploic vein
Inferior mesenteric vein to splenic vein
Left colic vein to middle colic vein
Splenic vein to left renal vein
Superior mesenteric vein to splenic vein
SPlenic Vein & Left Renal Vein
A patient with jaundice was diagnosed with cancer of the head of the pancreas. Which structure was compressed by the tumor? Common bile duct Common hepatic duct Cystic duct Left hepatic duct Right hepatic duct
Common Bile Duct
In order to do a vagotomy (section of vagal nerve trunks) to reduce the secretion of acid by cells of the stomach mucosa in patients with peptic ulcers, one needs to cut the gastric branches and retain vagal innervation to other abdominal organs. Where would a surgeon look for these branches in relation to the stomach? along the gastroepiploic vessels along the greater curvature along the lesser curvature in the base of the omental apron in the gastrocolic ligament
Lesser Curvature
Which of the following structures does not lie at least partially in the retroperitoneum? adrenal gland duodenum kidney pancreas spleen
Spleen
Which ligament is a derivative of the dorsal mesogastrium? Coronary Falciform Hepatoduodenal Hepatogastric Gastrocolic
Gastrocolic
A 60-year-old male executive who had a history of a chronic duodenal ulcer was admitted to the ER exhibiting signs of a severe internal hemorrhage. He was quickly diagnosed with perforation of the posterior wall of the first part of the duodenum and erosion of an artery behind it by the gastric expellent. The artery is most likely the: Common hepatic Gastroduodenal Left gastric Proper hepatic Superior mesenteric
Gastoduodenal
During emergency surgery, it was found that a chronic gastric ulcer had perforated the posterior wall of the stomach and eroded a large artery running immediately posterior to the stomach. The artery is the: Gastroduodenal Common hepatic Left gastroepiploic Splenic Superior mesenteric
SPLENIC
The fundus of the stomach receives its arterial supply from the: Common hepatic Inferior phrenic Left gastroepiploic Right gastric Splenic
Splenic
