TA Review 2 Questions

Question 1

Right kidney is _____ than the left kidney.

a) Lower
b) Higher
c) Same level as

Answer 1

a) Lower

cuz of the liver

Question 2

Patient with TB was given a X-ray that revealed the following inflammation. Which of his function is affected?

a) Extension of hip
b) Flexion of hip
c) Lateral rotation of hip
d) Medial rotation of hip

Answer 2

b) Flexion of the hip
- psoas sign = pain during extension, but the psoas’ action is to flex the hip

Question 3

Patient with appendicitis presents with positive psoas sign. This is when the hip is _____ against counter resistance.

a) Extended
b) Flexed
c) Laterally rotated
d) Medially rotated

Answer 3

a) Extended

Question 4

Name three clinical features of appendicitis.

Answer 4

1) Periumbilical referred pain (Lesser splanchnic)
2) Lower right quadrant somatic pain (Intercostal)
3) Psoas sign = pain on extension of hip

Question 5

What lumbar nerve travels within the psoas muscle?

a) Subcostal n.
b) Iliohypogastric n.
c) Ilioinguinal n.
d) Genitofemoral n.
e) Lateral cutaneous n. of the thigh

Answer 5

d) Genitofemoral nerve

Question 6

A couple presents with right liver and splenic pathologies respectively. Where might they feel referred pain?

Answer 6

Bare area Liver => Right phrenic => right shoulder

Spleen => Left phrenic => left shoulder pain

Question 7

Quadratus lumborum muscle passes behind which part of the diaphragm?

a) Median arcuate ligament
b) Medial arcuate ligament
c) Lateral arcuate ligament

Answer 7

c) Lateral arcuate ligament

Question 8

Which artery branches first from the abdominal aorta?

a) Celiac trunk
b) Inferior phrenic a.
c) Left and right renal a.
d) Splenic a.

Answer 8

b) Inferior phrenic artery

Question 9

Median sacral artery comes off of the aorta at which vertebral level?

a) T12
b) L2
c) L4
d) S2
e) S4

Answer 9

c) L4 - it comes off at the same place as the bifurcation –> common iliac arteries

Question 10

Which is a sensory nerve originating from T12?

a) Greater splanchnic n.
b) Lesser splanchnic n.
c) Ilioinguinal n.
d) Genitofemoral n.
e) Subcostal n.

Answer 10

e) Subcostal nerve

Question 11

Answer 11

The least splanchnic (T12) synapses at the aortico-renal ganglion –> kidneys

The lumbar splanchnic nerves (L1-L2) synapse at the inferior mesenteric ganglion –> hindgut

Question 12

Patient is sent to the ER after being hit in the groin by a football. What nerve conveys sensation to the testes? To the skin of scrotum?

Answer 12

Testes (visceral):

Lesser (T11) and Least (T12) splanchnics = referred pain to lower abdomen

Skin of scrotum:

Pudendal n. (S2-S4)

Question 13

Cancer of the kidneys will drain into all of the following except:

a) Cisterna chyli
b) Lumbar nodes
c) Lateral aortic nodes
d) Preaortic nodes
e) Thoracic duct

Answer 13

d) Preaortic nodes (they drain the GI system)

Question 14

During routine checkup, non-metastatic kidney cancer was detected in your patient. Where might you find the neoplasm?

a) Anterior pararenal space
b) Perirenal space
c) Posterior pararenal space

Answer 14

b) Perirenal space
- it is benign (contained)

Question 15

During surgery to treat pheochromocytoma of the right side, Dr. W accidently nicked this blood vessel lying anterior to the organ of interest. What is the vessel?

a) Aorta
b) IVC
c) Right renal vein
d) Right inferior phrenic artery
e) Thoracic Duct

Answer 15

b) IVC

Question 16

Patient suffers from severe compression of the right renal vein. Physical examination reveals that the area around the right testes is…

Answer 16

Normal. Right gonadal vein drains into the IVC. The left gonadal trains into the left renal vein.

Question 17

Patient with nutcracker syndrome suffers from edema of the left ovary. This is caused by the compression of ____ by ____?

Answer 17

Compression of the left renal vein by the SMA

Question 18

Gonadal arteries comes from ____?

Gonadal veins drain into ____?

Answer 18

Gonadal arteries come from the aorta.

Right gonadal vein drains into the IVC. Left one drains into the left renal vein first, then to the IVC.

Question 19

Left renal a. is _____ than right renal a.

Left renal v. is _____ than right renal v.

a) Longer
b) Shorter

Answer 19

Left renal artery is shorter than the right.

Left renal vein is longer than the right.

Question 20

Ascent of a horseshoe kidney would be blocked by this vascular structure.

a) Celiac trunk
b) Superior mesentery artery
c) Inferior mesentery artery
d) Renal arteries
e) Renal veins

Answer 20

c) Inferior mesenteric artery

Question 21

Patient with kidney stone may feel referred pain in these dermatones.

a) T5-T9
b) T10-T11
c) T12-L1
d) L2-L4
e) S2-S4

Answer 21

c) T12-L1 (least splanchnic - upper part of kidneys, lumbar splanchnic - lower ureters, bladder)

Question 22

The level of the iliac crest (L4) denotes:

a) False pelvis
b) True pelvis

Answer 22

a) False pelvis

Question 23

What makes up the pelvic floor?

Answer 23

Pelvic diaphragm + urogenital diaphragm

Question 24

What makes up the pelvic diaphragm? (3+1 muscles)

Answer 24

Levator ani

• Puborectalis (innermost = closest to rectum)
• Pubococcygeus
• Iliococcygeus

Coccygeus

Question 25

During laparoscopic surgery of a female patient, a needle pierces the anterior vaginal fornix to reach this space.

a) Rectouterine pouch
b) Rectovesical pouch
c) Vesicouterine pouch
d) Deep perineal pouch
e) Superficial perineal pouch

Answer 25

c) Vesicouterine pouch

Question 26

What is the normal position of the uterus?

a) Anteflexed and Anteverted
b) Retroflexed and Anteverted
c) Anteflexed and Retroverted
d) Retroflexed and Retroverted

Answer 26

a) Anteflexed and Anteverted

Question 27

What does “water under the bridge” refer to in anatomy?

a) Position of ureter vs. uterine artery
b) Position of ovarian artery vs. uterus
c) Position of ureter vs. uterus
d) How to distinguish a bridge from an aqueduct

Answer 27

a) Position of ureter vs. uterine artery

Question 28

Dr. Butterfingers was confused about the previous reference and ligated the ureter instead of the uterine artery during surgery. What might his patient develop?

a) Portal hypertension
b) Hydronephrosis
c) Kidney stones
d) Cholesystitis
e) Jaundice

Answer 28

b) Hydronephrosis

Question 29

Which resembles a poorly made ghost costume?

a) Broad ligament of the uterus
b) Round ligament of the uterus
c) Transverse cervical ligament
d) Uterosacral ligament
e) Pubovesical ligament

Answer 29

a) Broad ligament of the uterus

Question 30

The bulb of the vestibule lies deep to which structure?

a) Ischiocavernosus
b) Bulbocavernosus
c) Bulbospongiosus
d) Bartholin’s gland

Answer 30

b) Bulbocavernosus and c) Bulbospongiosus

they are the same thing

Question 31

X-ray shows an organ with mucosa folds/ridges that run across the entire diameter of the structure. What organ is being visualized?

a) Jejunum
b) Ascending colon
c) Anus

Answer 31

a) Jejunum
- plicae circulares traverse the entire diameter, haustra (large intestine) are only indentations

Question 32

What is found in the upper left quadrant?

a) Hepatic flexure
b) Gallbladder
c) Appendix
d) Splenic flexure

Answer 32

d) Splenic flexure
- remember that this is a “watershed” area

Question 33

Patient who has a poor diet composed of little or no fiber may have pain in this quadrant.

a) RUQ
b) RLQ
c) LUQ
d) LLQ

Answer 33

no fiber, think diverticulosis (happens in distal colon)

d) LLQ

other choices:

a) RUQ => liver pathology or cholecystitis
b) RLQ => appendicitis
c) LUQ => spleen rupture