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GI Week 2 > Severson Abdominal Vignettes > Flashcards

Severson Abdominal Vignettes Flashcards

1
Q
  1. Which of the following statements regarding the cremaster muscle is CORRECT?
    A. The cremaster muscle is a continuation of the fascia transversalis along with muscle fibers.
    B. The cremaster muscle is a continuation of the internal oblique fibers
    C. The cremaster muscle is a continuation of muscle fibers from the external oblique.
    D. The cremaster muscle does not contribute to a layer surrounding the spermatic cord.
    E. The cremaster muscle is innervated by autonomic nerve fibers.
A

B

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2
Q 
2.	The anterior cutaneous branch of which of the following intercostal nerves terminates in the umbilical region?
A. T6
B. T7
C. T8
D. T9
E. T10
A

E

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3
Q
  1. Which of the following statements regarding the deep inguinal ring is CORRECT?
    A. It is present only in males.
    B. It is involved in a direct inguinal hernia.
    C. It is formed by the external abdominal oblique muscle.
    D. It is located lateral to the inferior epigastric vessels.
    E. It transmits the subcostal nerve.
A

D

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4
Q
  1. Which of the following statements is CORRECT regarding an indirect inguinal hernia?
    A. It usually pierces the conjoined tendon.
    B. It follows the inguinal canal.
    C. It arises medial to the inferior epigastric artery.
    D. It is more common in older men with weak abdominal musculature.
    E. It is not surrounded by the layers of the spermatic cord.
A

B

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5
Q
  1. When extravasated urine passes from the superficial perineal space into the anterior abdominal wall, it is found immediately deep to which of the following layers of the anterior abdominal wall?
    A. External oblique muscle
    B. Fatty layer of superficial fascia (Camper’s fascia)
    C. Internal oblique muscle
    D. Membranous layer of superficial fascia (Scarpa’s fascia)
    E. Transverse abdominis muscle
A

D

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6
Q 
6.	A 6-year-old boy has a large intra-abdominal mass in the midline just above the symphysis pubis.  During an operation, a cystic mass is found attached to the umbilicus and the apex of the bladder.  Which of the following is the most likely diagnosis?
A. Hydrocele
B. Meckel's cyst
C. Meckel's diverticulum
D. Omphalocele
E. Urachal cyst
A

E

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7
Q
  1. Which of the following statements regarding the superficial inguinal ring is CORRECT?
    A. It is a thinning of the external oblique aponeurosis.
    B. It is a perforation in the internal oblique muscle.
    C. It is a perforation in the transversalis fascia.
    D. It is formed in part by the rectus sheath.
    E. It is located lateral to the pubic tubercle.
A

A

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8
Q
  1. Where does a direct inguinal hernia usually begin?
    A. Below the inguinal ligament
    B. Below the pubic tubercle
    C. Lateral to the inferior epigastric vessels
    D. Through the femoral ring
    E. Through the inguinal triangle
A

E

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9
Q 
9.	Where does the pampiniform plexus of veins on the RIGHT side drain?
A. Inferior mesenteric vein
B. Inferior vena cava
C. Internal iliac vein
D. Left renal vein
E. Right renal vein
A

B

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10
Q
  1. A 50-year-old man reported to his family physician that he had felt a solid swelling in his scrotum. The lump was diagnosed as an advanced carcinoma of the testis. The tumor had not eroded through the skin of the scrotum. Where would you search for a lymphogenous spread of cancer cells from this tumor?
    A. Deep inguinal lymph nodes
    B. Inferior epigastric lymph nodes
    C. Inferior rectal lymph nodes
    D. Posterior abdominal (lumbar) lymph nodes
    E. Superficial inguinal lymph nodes
A

D

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11
Q 
11.	The deep inguinal ring represents the point where the testes in its descent passes through what layer of the anterior abdominal wall?
A. External oblique aponeurosis
B. Internal oblique aponeurosis
C. Peritoneum
D. Transversalis fascia
E. Transverse abdominus muscle
A

D

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12
Q 
12.	Which of the following structures is located outside of the spermatic cord?
A. Ductus (vas) deferens
B. Ilioinguinal nerve
C. Lymphatics
D. Pampiniform plexus of veins
E. Testicular artery
A

B

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13
Q
  1. During the last trimester of development of the male fetus, the testis descends into the scrotum. Which of the following statements is INCORRECT?
    A. The evagination of the transversalis fascia occurs at the deep inguinal ring.
    B. The covering of the testis that is continuous with the transversalis fascia is the internal spermatic fascia.
    C. The gubernaculum testis connects the testis to the wall of the scrotum
    D. The covering of the testis that is continuous with the internal oblique fascia is the cremasteric fascia.
    E. The processus vaginalis is an evagination of visceral peritoneum that covers the testes in the scrotum.
A

E

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14
Q
  1. Which of the following is NOT provided to the small intestine by the structure called “the mesentery”?
    A. Arterial blood from the superior mesenteric artery
    B. Lymphatic ducts that drain toward the cisterna chyli
    C. Parasympathetic preganglionic fibers from the vagus
    D. Sympathetic postganglionic fibers from the prevertebral (e.g., superior mesenteric) ganglia
    E. Venous drainage to the inferior vena cava
A

E

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15
Q
  1. Which of the following is NOT a distinguishing feature of the large intestine?
    A. Appendices epiploicae
    B. Complete circular coat of smooth muscle
    C. Complete longitudinal coat of smooth muscle
    D. Sacculations or haustra
    E. Taenia coli
A

C

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16
Q 
3.	A left testicle that is tender and swollen may be due to a thrombosis in which one of the following veins?
A. Inferior mesenteric vein
B. Left internal iliac vein
C. Left internal pudendal vein
D. Left obturator vein
E. Left renal vein
A

E

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17
Q 
4.	Which of the following visceral structures does NOT drain directly or indirectly into the portal venous system?
A. Ascending colon
B. Distal anal canal
C. Sigmoid colon
D. Spleen
E. Stomach
A

B

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18
Q 
5.	Which of the following structures is NOT found in the free right-hand margin of the lesser omentum  when the lesser omentum is grasped between a thumb and index finger? 
A. Common bile duct
B. Hepatic artery
C. Inferior vena cava
D. Peritoneum
E. Portal vein
A

C

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19
Q 
6.	Which of the following visceral structures would NOT lose its oxygenated blood supply given a normal arterial branching following a total ligation of the celiac artery?
A. Duodenum and pancreas
B. Stomach
C. Spleen
D. Liver
E. Gallbladder
A

A

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20
Q
  1. Which of the following statements regarding the comparison of the upper and lower halves of the anal canal is INCORRECT?
    A. The upper one-half is innervated by visceral afferents and the lower one-half by somatic afferents.
    B. Lymph drainage of the upper one-half is to inferior mesenteric nodes and of the lower one-half is to inguinal nodes.
    C. Venous drainage of the upper one-half is to the portal system and that of the lower one-half is to the caval system.
    D. The blood supply to the upper one-half is via branches of superior mesenteric artery and to the lower one-half is via a branch of the internal iliac artery.
    E. The upper one-half has a different embryological origin than the lower one-half.
A

D

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21
Q 
8.	Which of the following is NOT largely retroperitoneal?
A. Ascending colon
B. Duodenum
C. Kidney
D. Pancreas
E. Spleen
A

E

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22
Q
  1. Which of the following statements is INCORRECT?
    A. The splenic artery runs along the upper border of the pancreas and lies behind the stomach.
    B. The lesser curvature of the stomach receives blood from the gastro-omental (gastroepiploic) arteries.
    C. The thoracic duct leaves the abdomen by passing through the aortic hiatus.
    D. The quadrate and caudate lobes of the liver are functionally part of the left lobe.
    E. The ascending colon is retroperitoneal.
A

B

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23
Q
  1. Which of the following statements is INCORRECT with regard to the peritoneum?
    A. The visceral layer is devoid of somatic afferent fibers for pain.
    B. The potential space between the parietal and visceral layers is called the peritoneal cavity.
    C. The peritoneal cavity is a completely closed cavity in the male, but not in the female.
    D. The peritoneal cavity or greater sac contains a smaller compartment known as the omental bursa.
    E. The epiploic foramen connects the greater sac with the retroperitoneal compartment occupied by the kidneys
A

E

24
Q 
11.	The superior suprarenal arteries are usually derived from which of the following arteries?
A. Aorta
B. Celiac
C. Inferior phrenic
D. Renal
E. Splenic
A

C

25
Q
  1. Which of the following statements regarding the lumbar plexus is INCORRECT?
    A. It is formed by the ventral primary rami of spinal nerves L1-3 and part of L4.
    B. Many of its terminal branches appear at the lateral border of the psoas muscle.
    C. It is an autonomic plexus.
    D. The femoral nerve is its largest terminal branch.
    E. Its genitofemoral branch usually appears on the anterior surface of the psoas muscle.
A

C

26
Q 
13.	What artery gives rise to the right gastroepiploic artery?
A. Gastroduodenal artery
B. Left gastric artery
C. Right gastric artery
D. Right hepatic artery
E. Splenic artery
A

A

27
Q 
14.	The cystic artery supplying the gallbladder is usually a branch of what artery?
A. Gastroduodenal
B. Left hepatic
C. Proper hepatic
D. Right gastric
E. Right hepatic
A

E

28
Q 
15.	In the event of a peptic ulcer of the duodenal cap, what artery is most likely eroded?
A. Celiac trunk
B. Inferior mesenteric artery
C. Gastroduodenal artery
D. Left gastric artery
E. Right gastroepiploic artery
A

C

29
Q
  1. Which of the following statements is INCORRECT regarding the ascending colon?
    A. It receives its parasympathetic nerve supply from pelvic splanchnics.
    B. It receives its arterial blood supply from the superior mesenteric artery.
    C. It has sacculations called haustra.
    D. It is retroperitoneal.
    E. It lies in the right paracolic gutter.
A

A

30
Q 
17.	Which of the following veins classically join to form the portal vein?
A. Hepatic, inferior mesenteric
B. Hepatic, splenic
C. Hepatic, superior mesenteric
D. Splenic, inferior mesenteric
E. Splenic, superior mesenteric
A

E

31
Q 
18.	In traumatic injuries, the spleen may be ruptured and result in massive internal bleeding.  In an emergency splenectomy, clamping which of the following structures would stop the bleeding?
A. Falciform ligament
B. Gastrosplenic ligament 
C. Hepatoduodenal ligament
D. Hepatogastric ligament
E. Transverse mesocolon
A

D

32
Q 
19.	Which of the following is NOT a branch of the superior mesenteric artery?
A. Ileocolic artery
B. Jejunal arteries
C. Middle colic artery
D. Right colic artery
E. Superior pancreaticoduodenal artery
A

E. Superior pancreaticoduodenal artery

33
Q 
20.	The medial arcuate ligament of the diaphragm spans over what structure?
A. Aorta
B. Esophagus
C. Psoas major
D. Quadratus lumborum
E. Right crus of the diaphragm
A

C

34
Q 
21.	The bare area of the liver refers to that part in contact with what structure?
A. Anterior body wall
B. Diaphragm
C. Duodenum
D. Kidney
E. Stomach
A

B

35
Q
  1. Which of the following statements is INCORRECT regarding the descending colon?
    A. It receives its parasympathetic nerve supply from the pelvic splanchnics.
    B. It receives its arterial blood supply primarily from the superior mesenteric artery.
    C. It has sacculations called haustra.
    D. It is retroperitoneal.
    E. It lies in the left paracolic gutter.
A

B

36
Q
  1. Which of the following statements is INCORRECT regarding the diaphragm?
    A. The esophageal hiatus can become lax and potentially be the site for herniation of the stomach.
    B. It inserts into the central tendon.
    C. It originates, in part, from a right crus and a left crus.
    D. It descends when it contracts, increasing the vertical diameter of the pleural cavity.
    E. Its motor innervation is derived from T7 - T12 intercostal nerves
A

E

37
Q
  1. Which of the following statements concerning the second part of the duodenum is INCORRECT?
    A. It is called the descending part of the duodenum.
    B. It is frequently the site of a peptic ulcer.
    C. Sphincter muscles are usually found surrounding the ducts
    D. The pancreatic and common bile ducts enter the duodenum together at the major duodenal papilla.
    E. The pancreatic and common bile ducts may open separately.
A

B

38
Q 
25.	What retroperitoneal structure forms the posterior boundary of the omental (epiploic) foramen?
A. Aorta
B. Hepatic artery
C. Inferior vena cava
D. Right adrenal gland
E. Right celiac ganglion
A

C

39
Q
  1. Which of the following statements regarding the lesser omentum is CORRECT?
    A. It has a free border bounding the omental (epiploic) foramen.
    B. It provides a route for the superior mesenteric artery to the jejunum.
    C. It covers the transverse colon anteriorly.
    D. It contains the falciform ligament of the river.
    E. It contains a remnant of the umbilical artery.
A

A

40
Q 
27.	The small intestine becomes a peritoneal structure at the duodenojejunal flexure.  What holds this flexure in place?
A. Greater omentum
B. Hepatoduodenal ligament
C. Lesser omentum
D. Mesentery proper
E. Suspensory ligament (of Treitz)
A

E. Suspensory ligament (of Treitz)

41
Q
  1. Which of the following statements is INCORRECT?
    A. The right gastro-omental (gastroepiploic) artery is a branch of the gastroduodenal artery.
    B. The splenic artery gives origin to short gastric branches to the fundus of the stomach.
    C. The cystic artery usually originates from the right hepatic artery.
    D. The testicular artery is a branch of the internal iliac artery.
    E. A branch of the superior mesenteric artery supplies the appendix.
A

D

42
Q
  1. Which of the following characteristics of the transverse colon is INCORRECT?
    A. It has its longitudinal muscles grouped into three distinct bundles.
    B. It possesses a mesentery (mesocolon).
    C. It is innervated by the sacral splanchnic nerves.
    D. It depends on the superior mesenteric artery for most of its blood supply.
    E. Its venous blood drains into the portal venous system.
A

C

43
Q
  1. Which of the following structures is retroperitoneal?
    A. Liver
    B. Second and third parts of the duodenum
    C. Sigmoid colon
    D. Stomach
    E. Transverse colon
A

B

44
Q
  1. Which of the following statements regarding the characteristics of the jejunum is INCORRECT?
    A. It has circular folds.
    B. Its blood supply is from the superior mesenteric artery.
    C. Its venous drainage is into the inferior vena cava.
    D. It is suspended by the mesentery.
    E. It is innervated by the vagus nerve.
A

C

45
Q 
32.	Which of the following structures is retroperitoneal?
A. Jejunum
B. Pancreas
C. Spleen
D. Stomach
E. Transverse colon
A

B

46
Q
  1. To which of the following does the external oblique muscle and its fascia NOT contribute?
    A. Anterior sheath of the rectus abdominus muscle
    B. Conjoined tendon
    C. External spermatic fascia
    D. Inguinal ligament
    E. Lacunar ligament
A

B

47
Q 
34.	What adult structure represents the embryological remnant of the upper part of the gubernaculum?
A. Ligamentum teres
B. Obliterated umbilical artery
C. Round ligament of the uterus
D. Round ligament of the ovary
E. Urachus
A

D

48
Q
  1. When surgically removing a malignant tumor of the descending colon located 10 inches distal to the left colic flexure, which of the following anatomical concepts is INCORRECT?
    A. The left colic artery must be ligated in this procedure.
    B. Lymph nodes in the inferior mesenteric group of lymph nodes may contain tumor cells.
    C. The portal venous system may have carried tumor cells to the liver.
    D. If the vagal nerves to the descending colon are damaged, the lumen may increase in diameter.
    E. Several intestinal veins must be ligated in this procedure.
A

D

49
Q
  1. Which of the following vessels is NOT an anastomoses between the portal and caval system?
    A. Inferior rectal veins and tributaries of the inferior mesenteric vein
    B. Paraumbilical veins and epigastric veins on the anterior abdominal wall
    C. Superior and inferior epigastric veins
    D. Veins of the retroperitoneal abdominal viscera and veins of the body wall
    E. Veins in the lower 1/3 of the esophagus
A

C

50
Q
  1. Which of the following structures may be eroded by a perforating gastric ulcer on the posterior wall of the stomach?
    A. Descending (second) part of the duodenum
    B. Inferior mesenteric artery
    C. Quadrate lobe of the liver
    D. Right kidney
    E. Splenic artery
A

E

51
Q 
38.	The head of the pancreas is anatomically most closely related to which of the following structures?
A. Ascending colon
B. Caudate lobe of the liver
C. Fundic portion of stomach
D. Second part of duodenum
E. Spleen
A

D

52
Q
  1. Which of the following statements is INCORRECT?
    A. The ascending colon is retroperitoneal.
    B. The inferior mesenteric artery terminates as the superior rectal artery.
    C. The lesser curvature of the stomach receives blood from the gastro-omental (gastroepiploic) arteries.
    D. The quadrate and caudate lobes of the liver are functionally part of the left lobe.
    E. The splenic artery runs along the upper border of the pancreas and lies behind the stomach.
A

C

53
Q
  1. Which of the following statements regarding differences between the jejunum and the ileum is INCORRECT?
    A. Lymphatic nodules (Peyer’s patches) are present usually in the anti-mesenteric border of the ileum.
    B. Part of the jejunum is retroperitoneal, while the entire ileum is suspended by the mesentery proper.
    C. The ileum is characterized by more complex and numerous arterial arcades than the jejunum.
    D. The jejunum is thicker and redder than the ileum in the living person.
    E. The plicae circularis (circular folds) are larger and more well developed in the jejunum compared to the ileum.
A

B

54
Q
  1. When the stomach is connected to the pharynx in a surgical resection of the esophagus due to cancer, what artery has the potential to supply blood to the entire stomach?
    A. Left gastric artery
    B. Left gastro-omental (gastroepiploic) artery
    C. Right gastro-omental (gastroepiploic) artery)
    D. Right gastric artery
    E. Short gastric arteries
A

C

55
Q 
42.	Which portion of the GI tract is LEAST likely to present with signs of obstruction caused by cancer?
A. Distal esophagus
B. Left side of colon
C. Mid-esophagus
D. Small bowel
E. Stomach
A

E

GI Week 2 (11 decks)

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