Abdomen - Appleton and Lange Questions, Abdomen - BRS Gross Anatomy 7th Ed, Abdomen-Big Picture Review Questions, Abdomen-Lippincott Review Question (Study w/Definition First)

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A 38-year-old woman with peptic ulcer disease of the stomach experiences severe abdominal pain. Which of the following nervous structures is most likely involved? (A) Greater splanchnic nerve (B) Ventral roots of the spinal nerve (C) Lower intercostal nerve (D) Vagus nerve (E) Gray ramus communicans

(A) Greater splanchnic nerve

A 58-year-old man is presented with edema of the lower limb and enlarged superficial veins of the abdominal wall. Examination of radiographs and angiograms reveals obstruction of the IVC just proximal to the entrance of the renal vein. This venous blockage may result in dilation of which of the following veins? (A) Left suprarenal vein (B) Right inferior phrenic vein (C) Right hepatic vein (D) Left gastric vein (E) Portal vein

(A) Left suprarenal vein

During an annual health examination of a 46-year-old woman, a physician finds hyper- secretion of norepinephrine from her supra- renal medulla. Which of the following types of nerve fibers are most likely overstimulated? (A) Preganglionic sympathetic fibers (B) Postganglionic sympathetic fibers (C) Somatic motor fibers (D) Postganglionic parasympathetic fibers (E) Preganglionic parasympathetic fibers

(A) Preganglionic sympathetic fibers

A 67-year-old woman with a long history of liver cirrhosis was seen in the emergency department. In this patient with portal hypertension, which of the following veins is most likely to be dilated? (A) Right colic vein (B) Inferior epigastric vein (C) Inferior phrenic vein (D) Suprarenal vein (E) Ovarian vein

(A) Right colic vein

The cystic artery commonly arises from the right hepatic artery in the angle between the common hepatic duct and which of the following structures? (A) cystic duct (B) celiac trunk (C) portal vein (D) proper hepatic artery (E) gastroduodenal artery

(A) cystic duct

The reflected inguinal ligament receives fibers from the contralateral aponeurosis of which of the following structures? (A) external abdominal oblique (B) internal abdominal oblique (C) transverse abdominal oblique (D) rectus abdominis (E) pyramidalis

(A) external abdominal oblique

Rugae are located in which of the following structures? (A) duodenum (B) stomach (C) cecum (D) ileum (E) transverse colon

(B) stomach

A 9-year-old boy was admitted to the emergency department complaining of nausea, vomiting, fever, and loss of appetite. On examination, he was found to have tender- ness and pain on the right lower quadrant. Based on signs and symptoms, the diagnosis of acute appendicitis was made. During an appendectomy performed at McBurney's point, which of the following structures is most likely to be injured? (A) Deep circumflex femoral artery (B) Inferior epigastric artery (C) Iliohypogastric nerve (D) Genitofemoral nerve (E) Spermatic cord

Which of the following statements correctly relates to the 3rd part of the duodenum? (A) It is supported by the suspensory ligament of the duodenum. (B) The bile and pancreatic ducts enter its posteromedial wall. (C) It is crossed by the superior mesenteric artery and vein. (D) It attaches to the hepatoduodenal ligament. (E) It lies to the right and runs parallel to the inferior vena cava.

All of the following statements concerning the central tendon of the diaphragm are correct EXCEPT (A) It has no bony attachments. (B) It is in completely divided into three leaves. (C) It is perforated by the aorta. (D) It lies near the center of the diaphragm. (E) It is perforated by the inferior vena cava.

The first part of the duodenum is located at which of the following vertebral levels? (A) T10 (B) L2 (C) L1 (D) L5 (E) L3

The rectum is continuous with the sigmoid colon at the level of which of the following vertebrae? (A) L3 (B) L5 (C) S3 (D) S5 (E) coccygeal 1

How are the pelvic splanchnic nerves distinct from other splanchnic nerves? (A) derived from ventral primary rami of L2, L3, and L4 (B) derived from the sympathetic trunks (C) convey preganglionic parasympathetic fibers to the inferior hypogastric plexus (D) provide postganglionic sympathetic innervation to the cecum (E) convey postganglionic parasympathetic innervation to the ascending colon

Which of the following muscles is considered to be the chief muscle of inspiration? (A) internal intercostal (B) external intercostal (C) diaphragm (D) scalene (E) sternocleidomastoid

The greater and lesser splanchnic nerves pass through the diaphragm via which of the following structures? (A) sternocostal foramen (B) aortic hiatus (C) diaphragmatic crus (D) vena caval foramen (E) medial arcuate ligament

The testes develop in which of the following areas? (A) scrotum (B) abdominal cavity (C) extraperitoneal (D) rectus sheath (E) superficial fascia

The anatomical left and right lobes of the liver are separated on the diaphragmatic surface of the liver by which of the following structures? (A) fissure for the round ligament of the liver (B) fissure for the ligamentum venosum (C) falciform ligament (D) porta hepatis (E) lesser omentum

The superior anterior and posterior pancreaticoduodenal arteries arise from which of the following arteries? (A) rightcolic (B) ileocolic (C) gastroduodenal (D) hepatic (E) splenic

The renal papillae empty into which of the following structures? (A) renal vein (B) ureter (C) minor calyces (D) renal pyramid (E) renal column

During development, the midgut artery appears to be markedly narrowed at its origin. Which of the following structures is derived from the midgut and may receive inadequate blood supply? (A) Gallbladder (B) Stomach (C) Descending colon (D) Ascending colon (E) Rectum

(D) Ascending colon

A 54-year-old man with a long history of alcohol abuse presents to the emergency department with rapidly increasing abdominal distention most likely resulting from an alteration in portal systemic blood flow. Which of the following characteristics is associated with the portal vein or the portal venous system? (A) Lower blood pressure than in the IVC (B) Least risk of venous varices because of portal hypertension (C) Distention of the portal vein resulting from its numerous valves (D) Caput medusae and hemorrhoids caused by portal hypertension (E) Less blood flow than in the hepatic artery

(D) Caput medusae and hemorrhoids

A 42-year-old man with portal hyperten- sion secondary to cirrhosis of the liver and subsequent massive ascites presents to the emergency department. He refuses to have a transjugular intrahepatic portosystemic shunt (TIPS) procedure and prefers surgery. Which of the following surgical connections is involved in the most practical method of shunting portal blood around the liver? (A) Superior mesenteric vein to the inferior mesenteric vein (B) Portal vein to the superior vena cava (C) Portal vein to the left renal vein (D) Splenic vein to the left renal vein (E) Superior rectal vein to the left colic vein

(D) Splenic vein to the left renal vein

The parasympathetic root of the celiac plexus is a branch of which of the following? (A) greater splanchnic (B) pelvic splanchnic (C) lumbar splanchnic (D) posterior vagal trunk (E) lesser splanchnic

(D) posterior vagal trunk

A 57-year-old patient has a tumor in the body of the pancreas that obstructs the infe- rior mesenteric vein just before joining the splenic vein. Which of the following veins is most likely to be enlarged? (A) Middle colic vein (B) Left gastroepiploic vein (C) Inferior pancreaticoduodenal vein (D) Ileocolic vein (E) Left colic vein

(E) Left colic vein

A radiograph of a 32-year-old woman reveals a perforation in the posterior wall of the stomach in which the gastric contents have spilled into the lesser sac. The general surgeon has opened the lienogastric (gastrosplenic) ligament to reach the lesser sac and notes erosion of the ulcer into an artery. Which of the following vessels is most likely involved? (A) Splenic artery (B) Gastroduodenal artery (C) Left gastric artery (D) Right gastric artery (E) Left gastroepiploic artery

(E) Left gastroepiploic artery

The are no teniae coli in which of the following structures? (A) ascending colon (B) transverse colon (C) descending colon (D) sigmoid colon (E) appendix

(E) appendix

The porta hepatis gives passage to all of the following structures EXCEPT (A) portal vein (B) hepatic artery (C) hepatic ducts (D) lymphatic vessels (E) cystic artery

(E) cystic artery

Rugae are located in which of the following structures? (A) duodenum (B) jejunum (C) ileum (D) cecum (E) stomach

(E) stomach

A 12-year-old boy is brought to the emergency room with a fever, nausea, and pain in his abdomen. Acute appendi- citis is the preliminary diagnosis due to his symptoms and an elevated white blood cell count (leukocytosis). The given axial CT reveals an inflamed radiodense appendix in the retrocecal position, exhibiting a thickened wall and sur- rounding edema. The boy is taken to the operating room for a laparoscopic appendectomy. Branches of what artery will need to be ligated during the procedure to alleviate excessive bleeding? (A) Celiac (B) Superior epigastric (C) Superior mesenteric (D) Inferior epigastric (E) Inferior mesenteric

(E) Spleen

A 13-year-old girl is brought to the ER after falling from a horse onto her left side. Her pulse is 120/min, blood pressure is 90/60 mm Hg, and respirations are 30/min. Physical examination reveals cold and clammy skin, bruising, and fractured 9th and 10th ribs on her left side at the posterior axillary line. Which of the following organs is most likely damaged in this patient? (A) Stomach (B) Kidney (C) Lung (D) Liver (E) Spleen

A 2-year-old boy is brought to the emergency room with cramping abdominal pain, fever, and vomiting. His parents say these symptoms began 12 hours ago and have progressively worsened. Abdominal radiology indicates a bowel obstruction that appears related to an abnormal intestinal outpocketing connected to the anterior abdominal wall. The consulting surgeon makes a diagnosis of Meckel diverticulitis and recommends surgery to resolve the problem. At which of the following sites does the surgeon expect to find the diverticulum responsible for this condition? (A) Lower duodenum (B) Middle jejunum (C) Lower ileum (D) Cecum (E) Transverse colon

(D) Liver

A 24-year-old man is brought to the ER with a knife wound located in the 9th intercostal space at the right midaxillary line. Given the location of the penetration wound, what struc- ture is most likely damaged? (A) Stomach (B) Kidney (C) Lung (D) Liver (E) Spleen

A 25-year-old woman visits her obstetrician one year after a normal pregnancy and vaginal delivery of healthy twins. Following a physical examination, the physician informs the woman she is in good health and that all postnatal conditions are occurring as they should. At this time, the medial umbilical folds contain which of the following structures? (A) Obliterated umbilical vein (B) Obliteratedurachus (C) Obliterated umbilical arteries (D) Obliterated ductus venosus (E) Obliterated inferior epigastric vessels

A 65-year-old woman is injured in an automobile accident. Examination indicates she suffers fractures of left ribs 8 to 10 and profuse internal bleeding. Which of the structures indicated in the given CT scan of the abdomen will likely need to be surgically removed?

(D) Inferior mesenteric

A 67-year-old woman comes to the ER after experiencing 2 days of red blood in her feces. She reports no vomiting of blood (hematemesis). The given arteriogram shows a stain of contrast material, indicated by the white arrow, at a bleeding diverticulum. What artery gives off direct branches to supply the bleeding portion of the gastrointestinal (GI) tract? (A) Abdominal aorta (B) Celiac trunk (C) Superior mesenteric (D) Inferior mesenteric (E) External iliac

(B) Pyloric stenosis

A breastfeeding 22-day-old infant was suddenly unable to hold down any milk after 3 weeks of normal feeding. In the pediatrician's office, the baby is obviously famished, presents with abdominal pain, appears slightly dehydrated, and has loose, watery stools. His mother nurses him in the office, and approximately 20 minutes later, the infant projectile vomits. The doctor notes the nonbilious and non- bloody vomitus. What is the most likely diagnosis for this infant? (A) Esophageal atresia (B) Pyloric stenosis (C) Upper gastrointestinal (GI) bleed (D) Lower GI bleed (E) Intestinal obstruction

(D) Omphalocele

A fetal ultrasound examination of a 28-year-old pregnant woman reveals a defect in the anterior abdominal wall of the fetus. Further radiologic tests are ordered. The given sagittal T2-weight MRI demonstrates a midline defect involving the umbilical cord, which contains intestinal loops and part of the liver within a membranous sac. What developmental defect is depicted in this MRI? (A) Gastroschisis (B) Congenital umbilical hernia (C) Ilealdiverticulum (D) Omphalocele (E) Prune belly syndrome

(E) Postsynaptic parasympathetic neurons

A woman brings her 4-year-old daughter to the pediatrician because of continuing problems with vomiting, constipation, and abdominal distension. Extensive examination results in a diagnosis of an aganglionic colon. The girl has a deficiency in which of the following neural cell types? (A) Pseudounipolar sensory neurons (B) Presynaptic sympathetic neurons (C) Presynaptic parasympathetic neurons (D) Postsynaptic sympathetic neurons (E) Postsynaptic parasympathetic neurons

(B) Superior mesenteric

An axial CT of a 52-year-old man reveals a cancerous lesion in the middle aspect of the transverse colon compressing the lumen of the otherwise radiolucent colon. Based upon the location of the tumor, which of the following lymph node groups would first receive metastasizing cells from this cancerous lesion? (A) Ileocolic (B) Superior mesenteric (C) Celiac (D) Internal iliac (E) Inferior mesenteric

Which of the following structures is avascular? (A) superior ileocecal fold (B) inferior ileocecal fold (C) mesoappendix (D) appendix (E) cecum

B) inferior ileocecal fold

A 25-year-old medical student in good health develops severe pain in the area around her umbilicus. She com- plains of nausea and is taken to the emergency depart- ment. While there, the pain becomes more localized in the lower right quadrant of her abdomen and the physician diagnoses appendicitis. Which of the following nerves per- ceived pain in the area around the umbilicus and most likely carried the pain sensations to the central nervous system? A. Inferior hypogastric nerves B. Lesser splanchnic nerves C. Pudendal nerves D. Superior hypogastric nerves E. Vagus nerves

B. Lesser splanchnic nerves

A 17-year-old girl is brought to a refugee camp and has significant blood loss. She recently underwent a form of genital mutilation called excision, where the clitoris and labia minora were removed. Direct branches of which of the following arteries are most likely responsible for the blood loss? A. External iliac B. Inferiorrectal C. Internal pudendal D. Ovarian E. Uterine

C. Internal pudendal

Sweat glands within the S2 dermatome along the posterior region of the thigh most likely receive innervation via pre- ganglionic sympathetic neurons originating from which of the following central nervous system levels? A. Brainstem B. C2 spinal cord level C. L2 spinal cord level D. S2 spinal cord level E. T2 spinal cord level

C. L2 spinal cord level

During sexual arousal, an erection is caused by a dilation of arteries filling the erectile tissue of the penis. Innervation of the penile arteries is provided by which of the following nerves? A. Genitofemoral nerves B. Ilioinguinal nerves C. Pelvic splanchnic nerves D. Pudendal nerves E. Sacral splanchnic nerves

C. Pelvic splanchnic nerves

A 42-year-old man has a vasectomy. The physician explains to him that 3 to 4 months after the procedure, when he has an orgasm during sexual intercourse, most likely he will A. no longer produce an ejaculate B. still produce an ejaculate and the ejaculate will contain sperm C. still produce an ejaculate but the ejaculate will not contain sperm

C. still produce an ejaculate but the ejaculate will not con- tain sperm

Which structure can be palpated anterior to the cervix during a pelvic examination? A. Cardinal ligament B. Ovary C. Pelvic diaphragm D. Bladder E. Uterinetube

D. Bladder

Which of the following structures most likely converts the greater sciatic notch to the greater sciatic foramen? A. Obturator membrane B. Obturator internus muscle C. Piriformis muscle D. Sacrospinous ligament E. Sacrotuberous ligament

D. Sacrospinous ligament

During the radical hysterectomy of a 52-year-old woman, the surgeon is careful to avoid damaging the ureters when removing the uterus. The landmark relationship that the surgeon should look for adjacent to the uterus to ensure preservation of each ureter is the ureter coursing A. inferior to the ovarian artery B. superior to the ovarian artery C. inferior to the uterine artery D. superior to the uterine artery E. inferiortotheuterinetube F. superior to the uterine tube

D. superior to the uterine artery

The female pubic arch differs from the male pubic arch to facilitate childbirth. When compared to the male, the female pubic arch can best be described as A. narrower B. shorter C. taller D. wider

D. wider

A 20-year-old woman is involved in a vehicular accident and struck on the driver's side of the automobile she is driving. She is taken to the emergency department, where physical examination shows low blood pressure and tenderness on the left midaxillary line. Upon further examination of the patient, the physician also notes a large swelling that protrudes downward and medially below the left costal margin. Which of the following abdominal organs in this patient was most likely injured? A. Descending colon B. Left kidney C. Liver D. Pancreas E. Spleen F. Stomach

E. Spleen

(B) Gallbladder

Failure of differentiation of the individual organs derived from the embryonic foregut would cause malformation of which of the following organs? (A) Spleen (B) Gallbladder (C) Ascending colon (D) Ileum (E) Descending colon

Following a radical mastectomy, a plastic surgeon uses a pedicled myocutaneous flap of the suprapubic portion of the rectus abdominis muscle to reconstruct the breast. What artery, supplying blood to the myocutaneous flap, needs to be iso- lated, transected, and later grafted to the reconstruction site? (A) Superficial epigastric artery (B) Superior epigastric artery (C) Inferior epigastric artery (D) Inferior mesenteric artery (E) Musculophrenic artery

(A) Fundic portion of the stomach

Following involvement in a car crash, a 20-year-old undergoes a splenectomy due to a lacerated spleen secondary to blunt abdominal trauma. During the procedure, the surgeon ligates the blood supply of the spleen at its hilum. Improper placement of the ligature may lead to damage to the arterial supply of which of the following structures? (A) Fundic portion of the stomach (B) Kidney (C) Pyloric portion of stomach (D) Head of pancreas (E) Splenic flexure of colon

(A) Lateral femoral cutaneous nerve

In anticipation for a medical school swimming party, a 60-year-old male professor squeezes into last year's bikini bathing suit despite gaining 25 lb over the winter. Following a day of "impressing" his students and colleagues, he notices numbness, tingling, and a burning sensation in the lateral aspect of his left upper thigh. His symptoms are exacerbated by applying pressure near the left anterior superior iliac spine. What nerve is most likely affected? (A) Lateral femoral cutaneous nerve (B) Femoral branch of genitofemoral nerve (C) Anterior cutaneous branches of femoral nerve (D) Ilioinguinalnerve (E) Iliohypogastric nerve

(D) Omental bursa

The anterior abdominal wall of a 21-year-old woman impacts the steering wheel during a head-on car collision. The blunt trauma resulted in a lacerated pancreas with digestive enzyme spilling anterior. Which of the following locations would initially receive the contents of the lacerated pancreas? (A) Supracolic part of greater peritoneal sac (B) Infracolic part of greater peritoneal sac (C) Subhepatic space (D) Omental bursa (E) Subphrenic space

The given contrast radiograph of the small intestine shows a barium-filled diverticulum of the ileum identified by the white arrow. Branches of what artery will need to be ligated during surgical removal of this diverticulum? (A) Celiac (B) Renal (C) Superior mesenteric (D) Inferior mesenteric (E) Umbilical

(E) Transversalis fascia

The given photo shows a large left bulge in the inguinal canal and a swelling of the left scrotum in a newborn male. Ultrasound examination reveals a portion of the small intestine within the scrotal swelling. What is the deepest layer of the abdominal wall involved with this herniated bowel? (A) Transverse abdominal muscle (B) External oblique muscle (C) Internal oblique muscle (D) Rectus abdominis muscle (E) Transversalis fascia

(E) Ascending colon

Which of the following organs may be directly affected by malrotation of the caudal limb of the primary intestinal loop? (A) Descending colon (B) Stomach (C) Spleen (D) Fourth part of the duodenum (E) Ascending colon

(A) Right kidney

Which of the following structures is indicated with the letter "X" in this coronal CT? (A) Right kidney (B) Liver (C) Stomach (D) Spleen (E) Psoas major

A 41-year-old woman is brought to the emergency department by her family because of acute onset of right upper quad- rant pain, nausea, and vomiting. For this case, it is important to remember that the bile duct: (A) Drains bile into the second part of the duodenum (B) Can be blocked by cancer in the body of the pancreas (C) Joins the main pancreatic duct, which carries hormones (D) Is formed by union of the right and left hepatic duct (E) Lies posterior to the portal vein in the right free edge of the lesser omentum

(A) Drains bile into the second part of the duodenum

Which of the following structures defines the point at which the posterior lamina of the internal oblique and the aponeurosis of the transverse abdominal become part of the anterior rectus sheath? (A) arcuate line (B) inguinal ligament (C) tendinous intersections (D) deep inguinal ring (E) medial crus

(A) arcuate line

The nerves of the kidneys and suprarenal glands are derived from which of the following plexuses? (A) celiac (B) lumbar (C) inferior mesenteric (D) sacral (E) inferior hypogastric

(A) celiac

The bifurcation of the abdominal aorta occurs at the level of which of the following structures? (A) crest of the ilium (B) inguinal ligament (C) pubic tubercle (D) symphysis pubis (E) obturator foramen

(A) crest of the ilium

The cremaster muscle is innervated by which of the following nerves? (A) genital branch of the genitofemoral (B) ilioinguinal (C) T12 (D) femoral (E) obturator

(A) genital branch of the genitofemoral

Which of the following ligaments encloses the portal triad? (A) hepatoduodenal (B) hepatogastric (C) gastrocolic (D) hepatorenal (E) gastrosplenic

(A) hepatoduodenal

All of the following nerves contribute branches to the scrotum EXCEPT (A) lateral femoral cutaneous (B) pudendal (C) ilioinguinal (D) genitofemoral (E) posterior femoral cutaneous

(A) lateral femoral cutaneous

The head of the pancreas rests posteriorly on which of the following structures? (A) left renal vein (B) superior vena cava (C) splenic artery (D) duodenum (E) superior mesenteric artery

(A) left renal vein

Which of the following structures is related to the spleen, stomach, pancreas, and the left crus of the diaphragm? (A) left suprarenal gland (B) left kidney (C) left gonadal vein (D) transverse mesocolon (E) abdominal aorta

(A) left suprarenal gland

The left gastro-omental artery arises from which of the following arteries? (A) splenic (B) hepatic (C) gastroduodenal (D) left gastric (E) right gastric

(A) splenic

In the developing embryo, the midgut rotates 270 degrees around which of the following structures? (A) superior mesenteric artery (B) celiac trunk (C) splenic artery (D) left renal artery (E) inferior vena cava

(A) superior mesenteric artery

The duodenojejunal junction is supported by the attachment of which of the following structures? (A) suspensory muscle of the duodenum (ligament of Treitz) (B) falciform ligament (C) hepatoduodenal ligament (D) greater omentum (E) transverse mesocolon

(A) suspensory muscle of the duodenum (ligament of Treitz)

The round ligament of the liver is the fibrous remnant of which of the following structures? (A) umbilical vein (B) ductus venosus (C) ductus arteriosus (D) umbilical artery (E) urachus

(A) umbilical vein

The bile and pancreatic ducts enter which of the following structures? (A) stomach (B) 2nd portion of the duodenum (C) cecum (D) ileum (E) liver

(B) 2nd portion of the duodenum

A 2-year-old boy presents with pain in his groin that has been increasing in nature over the past few weeks. He is found to have a degenerative malformation of the transversalis fascia during development. Which of the following structures on the anterior abdominal wall is likely defective? (A) Superficial inguinal ring (B) Deep inguinal ring (C) Inguinal ligament (D) Sac of a direct inguinal hernia (E) Anterior wall of the inguinal canal

(B) Deep inguinal ring

While examining radiographs and angiograms of a 52-year-old patient, a physician is trying to distinguish the jejunum from the ileum. He has observed that the jejunum has: (A) Fewer plicae circulares (B) Fewer mesenteric arterial arcades (C) Less digestion and absorption of nutri- ents (D) Shorter vasa recta (E) More fat in its mesentery

(B) Fewer mesenteric arterial arcades

All of the following statements concerning the spleen are correct EXCEPT (A) It is the largest branch of the celiac trunk. (B) It follows a tortuous course along the inferior border of the pancreas. (C) It divides into five or more branches that enter the hilum of the spleen. (D) It runs anterior to the left kidney. (E) It follows posterior to the omental bursa.

(B) It follows a tortuous course along the inferior border of the pancreas.

A physical fitness trainer for a young Hollywood movie star explains the reasons for 100 stomach crunches a day. The young star, a medical student before "hitting it big," reaffirms to his trainer that the lateral mar- gin of the rectus abdominis, the muscle responsible for a washboard stomach, defines which of the following structures? (A) Linea alba (B) Linea semilunaris (C) Linea semicircularis (D) Transversalis fascia (E) Falx inguinalis

(B) Linea semilunaris

A pediatric surgeon has resected a structure that is a fibrous remnant of an embryonic or fetal artery in a 5-year-old child. Which of the following structures is most likely to be divided? (A) Lateral umbilical fold (B) Medial umbilical fold (C) Median umbilical fold (D) Ligamentum teres hepatis (E) Ligamentum venosum

(B) Medial umbilical fold

A 58-year-old man is admitted to a hospital with severe abdominal pain, nausea, and vomiting resulting in dehydration. Emergency CT scan reveals a tumor located between the celiac trunk and the superior mesenteric artery. Which of the following structures is likely compressed by this tumor? (A) Fundus of the stomach (B) Neck of the pancreas (C) Transverse colon (D) Hepatopancreatic ampulla (E) Duodenojejunal junction

(B) Neck of the pancreas

A patient is rushed to the operating room for an emergent cholecystectomy (resection of a gallbladder) because of cholecystitis. While locating landmarks before surgical resection of an infected gallbladder, the surgeon recalls a portal-caval anastomosis. Which of the following pairs of veins form a portal-caval anastomosis? (A) Hepatic veins and IVC (B) Superior and middle rectal vein (C) Left and right gastric vein (D) Inferior and superficial epigastric veins (E) Suprarenal and renal veins

(B) Superior and middle rectal vein

The sympathetic nerve supply of the stomach arises from which of the following cord segments? (A) T1-T5 (B) T6-T9 (C) T6-T12 (D) L1-L3 (E) T10-L2

(B) T6-T9

The portion of the hepatic artery extending between the celiac trunk and the gastroduodenal artery is known as the (A) proper hepatic (B) common hepatic (C) right hepatic (D) left hepatic (E) middle hepatic

(B) common hepatic

The suprarenal glands are located between the superomedial aspects of the kidneys and which of the following structures? (A) neck of the pancreas (B) diaphragm (C) quadrate lobe of the liver (D) mesentery (E) 1st part of the duodenum

(B) diaphragm

The inguinal canal contains which of the following nerves? (A) iliohypogastric (B) ilioinguinal (C) genital branch of the genitofemoral (D) obturator (E) lateral femoral cutaneous

(B) ilioinguinal

The hepatic veins drain into which of the following structures? (A) liver (B) inferior vena cava (C) spleen (D) portal vein (E) superior vena cava

(B) inferior vena cava

Inferiorly, the inferior margin of the external oblique aponeurosis thickens and folds back on itself to form which of the following structures? (A) rectus sheath (B) inguinal ligament (C) arcuate line (D) deep inguinal ring (E) fundiform ligament

(B) inguinal ligament

All of the following structures may herniate into the thoracic cavity when there is a traumatic diaphragmatic hernia EXCEPT (A) stomach (B) kidney (C) intestine (D) mesentery (E) spleen

(B) kidney

The anterolateral abdominal wall is bounded by all of the following structures EXCEPT (A) cartilages of the 7th through 10th ribs (B) linea alba (C) xiphoid process (D) inguinal ligament (E) pelvic bone

(B) linea alba

Which of the following fossae are potential sites for direct inguinal hernias? (A) supravesical (B) medial inguinal (C) lateral inguinal (D) ischiorectal (E) iliac

(B) medial inguinal

The superior mesenteric and splenic veins unite to form the portal vein posterior to which of the following structures? (A) right kidney (B) neck of the pancreas (C) pylorus of stomach (D) 2nd portion of the duodenum (E) spleen

(B) neck of the pancreas

The lateral arcuate ligaments are formed from thickenings from which of the following muscular fasciae? (A) psoas major (B) quadratus lumborum (C) transversus abdominis (D) rectus abdominis (E) sternalis

(B) quadratus lumborum

The superficial muscle fibers of the external abdominal oblique arising from the middle to lower ribs interdigitate with which of the following muscles? (A) internal abdominal oblique (B) serratus anterior (C) rectus abdominis (D) pyramidalis (E) transversus abdominis

(B) serratus anterior

Which of the following structures receives parasympathetic innervation from the pelvic splanchnic nerves? (A) appendix (B) sigmoid colon (C) ileum (D) ascending colon (E) duodenum

(B) sigmoid colon

The iliopubic tract is the thickened inferior margin of which of the following structures? (A) inguinal ligament (B) transversalis fascia (C) conjoined tendon (D) falciform ligament (E) round ligament

(B) transversalis fascia

The testes are covered by a tough fibrous coat known as the (A) cremaster fascia (B) tunica albuginea (C) gubernaculum (D) tunica dartos (E) Scarpa's fascia

(B) tunica albuginea

The two medial umbilical folds represent remnants of which of the following structures? (A) urachus (B) umbilical arteries (C) umbilical veins (D) ductus venosus (E) ductus arteriosus

(B) umbilical arteries

The parasympathetic innervation of the testis includes which of the following nerves? (A) pelvic splanchnic (B) vagus (C) iliohypogastric (D) ilioinguinal (E) pudendal

(B) vagus

The inferior vena cava begins anterior to which of the following structures? (A) right crus of the diaphragm (B) right kidney (C) 5th lumbar vertebra (D) crest of the ilium (E) bifurcation of the aorta

A 78-year-old man is suffering from ischemia of the suprarenal glands. This condition results from rapid occlusion of direct branches of which of the following arteries? (A) Aorta, splenic, and inferior phrenic arteries (B) Renal, splenic, and inferior mesenteric arteries (C) Aorta, inferior phrenic, and renal arteries (D) Superior mesenteric, inferior mesenteric, and renal arteries (E) Aorta and hepatic and renal arteries

A 63-year-old man comes to the emergency department with back pain, weakness, and shortness of breath. On examination, he has an aneurysm of the abdominal aorta at the aortic hiatus of the diaphragm. Which of the following pairs of structures would most likely be compressed? (A) Vagus nerve and azygos vein (B) Esophagus and vagus nerve (C) Azygos vein and thoracic duct (D) Thoracic duct and vagus nerve (E) Inferior vena cava (IVC) and phrenic nerve

A 29-year-old man comes to a local hospital with duodenal peptic ulcer and com- plains of cramping epigastric pain. Which of the following structures harbors the cell bodies of abdominal pain fibers? (A) Lateral horn of the spinal cord (B) Anterior horn of the spinal cord (C) Dorsal root ganglion (D) Sympathetic chain ganglion (E) Celiac ganglion

An oncologist is reviewing a CT scan of a 74-year-old man with newly diagnosed hepatocellular carcinoma. He locates the affected quadrate lobe of the liver that: (A) Lies between the IVC and ligamentum venosum (B) Receives blood from the right hepatic artery (C) Drains bile into the left hepatic duct (D) Is a medial superior segment (E) Is functionally a part of the right lobe

A neonatal baby was born with diabetes mellitus due to an inadequate production of insulin. Cells in the endocrine portion of the pancreas that secrete insulin, glucagon, and somatostatin are derived from which of the following? (A) Ectoderm (B) Mesoderm (C) Endoderm (D) Proctodeum (E) Neural crest cells

An emergent hernia repair is scheduled. As the attending physician is driving to the hospital, the medical student assisting on the case quickly reviews his anatomy atlas and is trying to commit to memory that the internal oblique abdominis muscle contributes to the formation of which of the follow- ing structures? (A) Inguinal ligament (B) Deep inguinal ring (C) Falx inguinalis (conjoint tendon) (D) Internal spermatic fascia (E) Reflected inguinal ligament

A young boy is brought to the hospital after a bicycle accident and possible pelvic fracture. While awaiting a computed tomography (CT) scan of his pelvis, a physician proceeds with a focal neurologic examination. In testing the child's reflexes, which of the following nerves would carry afferent impulses of the cremasteric reflex? (A) Subcostal nerve (B) Lateral femoral cutaneous nerve (C) Genitofemoral nerve (D) Iliohypogastric nerve (E) Femoral nerve

A 19-year-old man with a ruptured appendix is sent to the emergency department for surgery. To cut off the blood supply to the appendix (if collateral circulation is discounted), a surgeon should ligate which of the following arteries? (A) Middle colic artery (B) Right colic artery (C) Ileocolic colic artery (D) Inferior mesenteric artery (E) Common iliac artery

A 16-year-old boy with a ruptured spleen comes to the emergency department for splenectomy. Soon after ligation of the splenic artery just distal to its origin, a surgi- cal resident observes that the patient is heal- ing normally. Normal blood flow would occur in which of the following arteries? (A) Short gastric arteries (B) Dorsal pancreatic artery (C) Inferior pancreaticoduodenal artery (D) Left gastroepiploic artery (E) Artery in the lienorenal ligament

Because of an inflammatory bowel disease (Crohn's disease) and a small bowel obstruction leading to bowel ischemia, an elderly woman requires bypass of her ileum and jejunum and is scheduled for a gastrocolostomy. The surgeon will ligate all arteries that send branches to the stomach. Which of the following arteries may be spared? (A) Splenic artery (B) Gastroduodenal artery (C) Inferior pancreaticoduodenal artery (D) Left gastroepiploic artery (E) Proper hepatic artery

All of the following statements concerning the esophagus are correct EXCEPT (A) It extends from the pharynx to the stomach. (B) It is crossed by the arch of the aorta. (C) It is crossed by the right main bronchus. (D) It passes through the esophageal hiatus. (E) It normally has four constrictions.

A pediatric surgeon is resecting a possible malignant mass from the liver of a neonate with cerebral palsy. The surgeon divides the round ligament of the liver during surgery. A fibrous remnant of which of the following fetal vessels is severed? (A) Ductus venosus (B) Ductus arteriosus (C) Left umbilical vein (D) Right umbilical vein (E) Umbilical artery

A 33-year-old man with a perforated gastric ulcer complains of excruciating pain in his stomach. It is observed that the pain comes from peritoneal irritation by gastric contents in the lesser sac. Which of the following nerves contain sensory nerve fibers that convey this sharp, stabbing pain? (A) Vagus nerves (B) Greater splanchnic nerves (C) Lower intercostal nerves (D) White rami communicantes (E) Gray rami communicantes

A 35-year-old woman with a history of cholecystectomy arrives in the emergency department with intractable hiccups most likely caused by an abdominal abscess secondary to surgical infection. Which of the following nerves carries pain sensation caused by irritation of the peritoneum on the central portion of the inferior surface of the diaphragm? (A) Vagus nerve (B) Lower intercostal nerve (C) Phrenic nerve (D) Greater splanchnic nerve (E) Subcostal nerve

A 43-year-old woman is admitted to a hospital because of deep abdominal pain in her epigastric region. On examination, it is observed that a retroperitoneal infection erodes an artery that runs along the superior border of the pancreas. Which of the following arteries is likely injured? (A) Right gastric artery (B) Left gastroepiploic artery (C) Splenic artery (D) Gastroduodenal artery (E) Dorsal pancreatic artery

The sympathetic fibers in the nerves to the jejunum and ileum originate in which of the following spinal cord segments? (A) C5-T1 (B) T1-T5 (C) T5-T9 (D) T9-T12 (E) L1-L2

All of the following statements concerning the psoas major muscle are correct EXCEPT (A) It passes inferolaterally, deep to the inguinal ligament. (B) It inserts on the lesser trochanter of the femur. (C) The pelvic splanchnic nerves are embedded in the posterior part of the psoas. (D) It is a long, thick and fusiform muscle. (E) Its name stems from a Greek word meaning "muscle of the loin."

A 43-year-old man complains of abdom- inal pain just above his umbilicus. On exam- ination, a tumor is found anterior to the IVC. Which of the following structures would most likely be compressed by this tumor? (A) Right sympathetic trunk (B) Left third lumbar artery (C) Third part of the duodenum (D) Left renal artery (E) Cisterna chyli

A 42-year-old obese woman with seven children is brought to a local hospital by her daughter. Physical examination and her radi- ograph reveal that large gallstones have ulcer- ated through the posterior wall of the fundus of the gallbladder into the intestine. Which of the following parts of the intestine is most likely to initially contain gallstones? (A) Cecum (B) Ascending colon (C) Transverse colon (D) Descending colon (E) Sigmoid colon

A 3-year-old boy is admitted to the children's hospital with complaints of restless- ness, abdominal pain, and fever. An MRI examination reveals that he has a double ureter. Which of the following embryonic structures is most likely failed to develop normally? (A) Mesonephric (Wolffian) duct (B) Paramesonephric (Müllerian) duct (C) Ureteric bud (D) Metanephros (E) Pronephros

The crura of the diaphragm are musculotendinous bundles that arise from which of the following structures? (A) posterior longitudinal ligament (B) sternum (C) bodies of lumbar vertebrae L1, L2, and L3 (D) renal fascia (E) psoas major muscle

Which of the following structures forms the superior boundary of the omental foramen? (A) inferior vena cava (B) duodenum (C) caudate lobe of the liver (D) head of the pancreas (E) hepatoduodenal ligament

Which of the following statements correctly applies to the suprarenal medulla? (A) derived from mesoderm (B) secretes corticosteroids and androgens (C) contains chromaffin cells (D) secretes acetylcholine (E) produces hormones that cause the kidney to retain sodium and water in response to stress

Which of the following structures is often referred to as the "abdominal policeman"? (A) hepatoduodenal ligament (B) gastrohepatic ligament (C) greater omentum (D) gastrocolic ligament (E) falciform ligament

The appendicular artery is a branch of which of the following arteries? (A) inferior mesenteric (B) inferior epigastric (C) ileocolic (D) testicular (E) renal

Between the internal oblique and transverse abdominal muscles is a neurovascular plane that contains all of the following EXCEPT (A) iliohypogastric nerve (B) deep circumflex iliac artery (C) inferior epigastric artery (D) subcostal nerve (E) ilioinguinal nerve

The superior suprarenal arteries are branches of which of the following arteries? (A) abdominal aorta (B) renal (C) inferior phrenic (D) celiac trunk (E) superior mesenteric

The artery of the ductus deferens arises from which of the following structures? (A) aorta (B) inferior epigastric (C) inferior vesical (D) pudendal (E) common iliac

The cremaster muscle and fascia are derived from which of the following structures? (A) external abdominal oblique muscle (B) transverse abdominal muscle and fascia (C) internal abdominal muscle (D) transversalis fascia (E) external abdominal aponeurosis

Circular folds (plicae circulares) are characteristic of which of the following structures? (A) transverse colon (B) stomach (C) jejunum (D) cecum (E) sigmoid

Which of the following arteries provides the abdominal parts of the esophagus with its arterial supply? (A) cystic (B) gastroduodenal (C) left gastric (D) hepatic (E) left gastroepiploic

The aponeuroses of all three flat muscles of the anterolateral abdominal wall interlace in which of the following structures? (A) inguinal ligament (B) transversalis fascia (C) linea alba (D) anterior superior iliac spine (E) rectus abdominis

All of the following statements concerning the spleen are correct EXCEPT (A) largest of the lymphatic organs (B) associated posteriorly with the left 9th through 11th ribs (C) located retroperitoneally (D) normally , does not descend inferior to the costal region (E) varies considerably in size, weight, and shape

The spiral valve is located in which of the following structures? (A) head of pancreas (B) pylorus (C) neck of gallbladder (D) cecum (E) rectum

The splenic artery usually follows a tortuous course along which of the following structures? (A) left kidney (B) greater curvature of the stomach (C) pancreas (D) transverse colon (E) cecum

Digestion occurs mainly in which of the following structures? (A) cecum and ascending colon (B) transverse colon (C) stomach and duodenum (D) jejunum and ileum (E) transverse and sigmoid colon

The epididymis is located on the posterior aspect of which of the following structures? (A) urinary bladder (B) prostate (C) testis (D) ovary (E) uterine tube

The fascial layer that covers the deep surface of the transverse abdominal muscle is known as which of the following? (A) parietal peritoneum (B) deep fascia (C) transversalis fascia (D) Scarpa's fascia (E) Camper's fascia

Inferiorly, the posterior surfaces of the kidney are related to all of the following structures EXCEPT (A) subcostal nerve (B) iliohypogastric nerve (C) ilioinguinal nerve (D) 2nd portion of the duodenum (E) quadratus lumborum

(D) 2nd portion of the duodenum

A 21-year-old man receives a penetrat- ing knife wound in the abdomen and is injured in both the superior mesenteric artery and the vagus nerve. Which portion of the colon would most likely be impaired by this injury? (A) Ascending and descending colons (B) Transverse and sigmoid colons (C) Descending and sigmoid colons (D) Ascending and transverse colons (E) Transverse and descending colons

(D) Ascending and transverse colons

A 9-year-old girl has crashed into her neighbor's brick fence while riding her bike and is brought to the emergency department Chapter 5 Abdomen 235 236 BRS Gross Anatomy with a great deal of abdominal pain. Her radiogram and angiogram show laceration of the superior mesenteric artery immediately distal to the origin of the middle colic artery. If collateral circulation is discounted, which of the following organs may become ischemic? (A) Descending colon (B) Duodenum (C) Pancreas (D) Ascending colon (E) Transverse colon

(D) Ascending colon

The head of the pancreas is embraced by which of the following structures? (A) stomach (B) spleen (C) cecum (D) C-shaped curve of the duodenum (E) transverse mesocolon

(D) C-shaped curve of the duodenum

A 36-year-old woman with yellow pig- mentation of the skin and sclerae presents at the outpatient clinic. Which of the following conditions most likely is the cause of her obstructive jaundice? (A) Aneurysm of the splenic artery (B) Perforated ulcer of the stomach (C) Obstruction of the main pancreatic duct (D) Cancer in the head of the pancreas (E) Cancer in the body of the pancreas

(D) Cancer in the head of the pancreas

A 35-year-old woman comes to a local hospital with abdominal tenderness and acute pain. On examination, her physician observes that an abdominal infection has spread retroperitoneally. Which of the following structures is most likely affected? (A) Stomach (B) Transverse colon (C) Jejunum (D) Descending colon (E) Spleen

(D) Descending colon

A patient with cirrhosis is scheduled for liver transplant surgery. During the opera- tion rounds, the transplant physician explains to his residents that one of the rea- sons a surgeon must pay close attention to the anatomic location of the liver is that this organ: (A) Receives blood only from the hepatic arteries (B) Manufactures red blood cells in an adult (C) Drains bile from the quadrate lobe into the right hepatic duct (D) Drains venous blood into the hepatic veins (E) Functions to concentrate and store bile

(D) Drains venous blood into the hepatic veins

A 3-year-old boy is diagnosed as having a persistent processus vaginalis in its middle portion. Which of the following conditions is most likely to be associated with this developmental anomaly? (A) Direct inguinal hernia (B) Gubernaculum testis (C) Hematocele (D) Hydrocele (E) Cryptorchidism

(D) Hydrocele

Mrs. Jones is undergoing a routine colonoscopy for colon cancer prevention. The gastroenterologist finds a Meckel's diverticulum. Which of the following statements is true about the diverticulum? (A) It is found 2 ft distal to the ileocecal junction (B) It is located on the mesenteric side of the ileum (C) It occurs in approximately 20% of the population (D) It is a persistent remnant of the embryonic yolk stalk (E) It may contain renal and suprarenal tissues

(D) It is a persistent remnant of the embryonic yolk stalk

A 19-year-old young woman with a long history of irritable bowel syndrome presents for the possibility of surgical resection of the gastrointestinal (GI) tract where the vagal parasympathetic innervation terminates. Which of the following sites is most appropriate for surgical resection? (A) Duodenojejunal junction (B) Ileocecal junction (C) Right colic flexure (D) Left colic flexure (E) Anorectal junction

(D) Left colic flexure

During surgical treatment of portal hypertension in a 59-year-old man with liver cirrhosis, a surgeon inadvertently lacerates the dilated paraumbilical veins. The veins must be repaired to allow collateral flow. Which of the following ligaments is most likely severed? (A) Lienorenal ligament (B) Lienogastric ligament (C) Gastrophrenic ligament (D) Ligamentum teres hepatis (E) Ligamentum venosum

(D) Ligamentum teres hepatis

A 6-year-old girl comes to her pediatri- cian with constipation, abdominal disten- tion, and vomiting. After thorough examina- tion, she is diagnosed as having Hirschsprung's disease (aganglionic megaco- lon), which is a congenital disease and leads to dilation of the colon. This condition is caused by an absence of which of the following kinds of neural cell bodies? (A) Sympathetic preganglionic neuron cell bodies (B) Sympathetic postganglionic neuron cell bodies (C) Parasympathetic preganglionic neuron cell bodies (D) Parasympathetic postganglionic neuron cell bodies (E) Sensory neuron cell bodies

(D) Parasympathetic postganglionic neuron cell bodies

A 21-year-old man developed a hernia after lifting heavy boxes while moving into his new house. During the repair of his resulting hernia, the urologist recalls that the genitofemoral nerve: (A) Runs in front of the quadratus lumborum (B) Is a branch of the femoral nerve (C) Supplies the testis (D) Passes through the deep inguinal ring (E) Gives rise to an anterior scrotal branch

(D) Passes through the deep inguinal ring

An elderly man with prostatic hypertrophy returns to his urologist with another case of epididymitis. An acute infection involving the dartos muscle layer of the scrotum most likely leads to an enlargement of which of the following lymph nodes? (A) Preaortic nodes (B) Lumbar nodes (C) External iliac nodes (D) Superficial inguinal nodes (E) Common iliac nodes

(D) Superficial inguinal nodes

A 54-year-old man comes to a hospital with abdominal pain, jaundice, loss of appetite, and weight loss. On examination of his radiograms and CT scans, a physician finds a slowly growing tumor in the uncinate process of the pancreas. Which of the follow- ing structures is most likely compressed by this tumor? (A) Main pancreatic duct (B) Splenic artery (C) Portal vein (D) Superior mesenteric artery (E) Superior pancreaticoduodenal artery

(D) Superior mesenteric artery

A 53-year-old woman with known kidney disease presents to a hospital because her pain has become increasingly more severe. A physician performing kidney surgery must remember that: (A) The left kidney lies a bit lower than the right one (B) The perirenal fat lies external to the renal fascia (C) The renal fascia does not surround the suprarenal gland (D) The left renal vein runs anterior to both the aorta and the left renal artery (E) The right renal artery is shorter than the left renal artery

(D) The left renal vein runs anterior to both the aorta and the left renal artery

Which of the following structures can be located deep to a point that is one-third of the way along the oblique line, joining the right anterior superior iliac spine to the umbilicus? (A) gallbladder (B) spleen (C) right kidney (D) appendix (E) urinary bladder

(D) appendix

Most reabsorption of water occurs in which of the following structures? (A) stomach (B) jejunum (C) sigmoid colon (D) ascending colon (E) rectum

(D) ascending colon

Omental appendices are located on which of the following structures? (A) stomach (B) duodenum (C) ileum (D) ascending colon (E) liver

(D) ascending colon

All of the following statements concerning the suprarenal cortex are correct EXCEPT (A) derives from mesoderm (B) secretes corticosteroids (C) secretes androgens (D) associated with the sympathetic nervous system (E) causes the kidney to retain sodium

(D) associated with the sympathetic nervous system

All of the following structures are located within the rectus sheath EXCEPT (A) pyramidalis (B) rectus abdominis (C) inferior epigastric arteries and veins (D) deep inguinal ring (E) ventral primary rami of T7-T12 nerves

(D) deep inguinal ring

Which of the following structures contains both smooth and skeletal muscles? (A) stomach (B) jejunum (C) cecum (D) esophagus (E) rectum

(D) esophagus

Which of the following ligaments conducts the portal triad (portal vein, hepatic artery, and bile duct)? (A) greater omentum (B) falciform ligament (C) gastrohepatic ligament (D) hepatoduodenal ligament (E) gastrocolic ligament

(D) hepatoduodenal ligament

The lacunar ligament is a reflection or extension from the deep aspect of which of the following structures? (A) falciform ligament (B) round ligament (C) rectus sheath (D) inguinal ligament (E) transversalis fascia

(D) inguinal ligament

The midclavicular planes pass through the mid- point of the clavicles to the midpoint of which of the following structures? (A) anterior superior iliac spine (B) symphysis pubis (C) umbilicus (D) inguinal ligament (E) xiphoid process

(D) inguinal ligament

Which of the following structures connects the lesser curvature of the stomach and the proximal part of the duodenum to the liver? (A) lesser omentum (B) peritoneal ligament (C) mesentery (D) lesser omentum (E) peritoneal fold

(D) lesser omentum

Which of the following veins, when dilated, produces caput medusae? (A) proper hepatic (B) splenic (C) cystic (D) paraumbilical (E) rectal

(D) paraumbilical

The gubernaculum is represented postnatally by which of the following structures? (A) tunica vaginalis testes (B) processus vaginalis (C) ductus deferens (D) scrotal ligament (E) internal spermatic fascia

(D) scrotal ligament

The left gastro-omental artery arises from which of the following arteries? (A) celiac trunk (B) right gastric (C) gastroduodenal (D) splenic (E) hepatic

(D) splenic

Which of the following structures crosses over the inferior or horizontal (third) portion of the duodenum? (A) pancreas (B) hepatic artery (C) portal vein (D) superior mesenteric artery

(D) superior mesenteric artery

The rectus abdominis muscle is anchored transversely by attachment to the anterior layer of the rectus sheath by which of the following structures? (A) pubic tubercle (B) xiphoid process (C) linea alba (D) tendinous intersections (E) umbilicus

(D) tendinous intersections

The pampiniform plexus provides which of the following testicular functions? (A) lymphatic drainage (B) blood supply (C) nerve supply (D) thermoregulatory system (E) hormonal production

(D) thermoregulatory system

All of the following structures pass through the esophageal hiatus EXCEPT (A) posterior vagal trunk (B) esophageal branches of the left gastric vessels (C) anterior vagal trunk (D) thoracic duct (E) esophagus

(D) thoracic duct

For general clinical descriptions, which of the following planes is used as one of the planes to define four quadrants of the abdominal cavity? (A) subcostal (B) transtubercular (C) midclavicular (D) transumbilical (E) midaxillary

(D) transumbilical

Which of the following structures represents the closed-off distal part of the embryonic processus vaginalis? (A) gubernaculum (B) tunica albuginea (C) epididymis (D) tunica vaginalis (E) urogenital diaphragm

(D) tunica vaginalis

Examination of a 54-year-old man reveals an isolated tumor located at the porta hepatis. This tumor most likely com- presses which of the following structures? (A) Cystic duct (B) Hepatic veins (C) Common hepatic artery (D) Left gastric artery (E) Branches of the portal vein

(E) Branches of the portal vein

A 6-year-old boy comes to his pediatrician with a lump in the groin near the thigh and pain in the groin. On examination, the physician makes a diagnosis of a direct inguinal hernia because the herniated tissue: (A) Enters the deep inguinal ring (B) Lies lateral to the inferior epigastric artery (C) Is covered by spermatic fasciae (D) Descends into the scrotum (E) Develops after birth

(E) Develops after birth

A 26-year-old patient is admitted to a local hospital with a retroperitoneal infection. Which of the following arteries is most likely to be infected? (A) Left gastric artery (B) Proper hepatic artery (C) Middle colic artery (D) Sigmoid arteries (E) Dorsal pancreatic artery

(E) Dorsal pancreatic artery

A patient with diverticulosis of the colon presents for follow-up to his primary care physician with ongoing complaints of left lower quadrant pain and occasionally bloody stools. His physician begins workup with appropriating test by recalling that the sigmoid colon: (A) Is drained by systemic veins (B) Is a retroperitoneal organ (C) Receives parasympathetic fibers from the vagus nerve (D) Receives its blood from the superior mesenteric artery (E) Has teniae coli and epiploic appendages

(E) Has teniae coli and epiploic appendages

A 27-year-old woman has suffered a gun- shot wound to her midabdomen. After examining the patient's angiogram, a trauma surgeon locates the source of bleeding from pairs of veins that typically terminate in the same vein. Which of the following veins are damaged? (A) Left and right ovarian veins (B) Left and right gastroepiploic veins (C) Left and right colic veins (D) Left and right suprarenal veins (E) Left and right hepatic veins

(E) Left and right hepatic veins

Where is extraperitoneal fat located? (A) between the abdominal oblique muscles (B) deep to the parietal peritoneum (C) superficial to Camper's fascia (D) superficial to the deep fascia (E) deep to the transversalis fascia

(E) deep to the transversalis fascia

The main pancreatic duct and the bile duct unite to form which of the following structures? (A) common bile duct (B) hepatic duct (C) accessory pancreatic duct (D) cystic duct (E) hepatopancreatic ampulla

(E) hepatopancreatic ampulla

All of the following statements concerning the renal hilum are correct EXCEPT (A) the renal vein is anterior to the renal artery (B) the renal artery is anterior to the renal pelvis (C) it is the entrance to the renal sinus (D) it is located on the concave medial margin of the kidney (E) it contains the renal pyramids

(E) it contains the renal pyramids

The peritoneal cavity contains which of the following? (A) liver (B) pancreas (C) large intestine (D) kidney (E) peritoneal fluid

(E) peritoneal fluid

The root of the mesentery crosses all of the following structures EXCEPT (A) ascending and horizontal parts of the duodenum (B) abdominal aorta (C) inferior vena cava (D) right ureter (E) splenic artery

(E) splenic artery

The cisterna chyli is the inferior end of which of the following structures? (A) inferior vena cava (B) abdominal aorta (C) renal vein (D) testicular artery (E) thoracic duct

(E) thoracic duct

Which of the following structures give rise to the deep inguinal ring? (A) gubernaculum (B) conjoined tendon (C) lacunar ligament (D) external abdominal oblique aponeurosis (E) transversalis fascia

(E) transversalis fascia

(B) Diaphragm

A 45-year-old man presents with pain in his left lower abdomen and proximal medial thigh, but the pain also radiates to his left shoulder. Physical examination of the left shoulder reveals no structural abnormalities or paresis (weakness). The given plain abdominal film reveals a left renal and perirenal abscess. Which of the following organs is irritated by the abscess, resulting in the radiating pain to the left shoulder? (A) Transverse colon (B) Diaphragm (C) Pancreas (D) Duodenum (E) Liver

(B) Liver

A 47-year-old woman has lost 15 lb over the last 2 months and presents with upper abdominal pain that radiates to the mid- dle and upper back. During physical examination, the doctor notes the sclera of her eyes are icteric (yellow in color), as seen on the given photo. An abdominal CT reveals a tumor within the head of the pancreas. The exocrine secretions of which of the following organs is being blocked leading directly to icteric sclera in this patient? (A) Duodenum (B) Liver (C) Gallbladder (D) Pancreas (E) Stomach

A 52-year-old woman presents with severe upper right quad- rant abdominal pain. She is jaundiced, obese, and has a history of gallstones. Further examination indicates acute cholecystitis, and she undergoes an open abdominal cholecystectomy (removal of gall bladder). During the surgery, the doctor inserts her index finger into the omental (epiploic) foramen to palpate the structures in the hepatoduodenal ligament. Which of the following structures lies immediately posterior to her finger? (A) Bile duct (B) Liver (C) Inferior vena cava (IVC) (D) Abdominal aorta (E) Head of the pancreas

A 55-year-old woman develops a hiatal hernia in which the fundus of the stomach protrudes through the esophageal hiatus of the diaphragm into the thorax. Which of the following structures is/are at greatest risk of injury during surgical repair of this hernia? (A) Thoracicduct (B) Azygosvein (C) Vagus nerves (D) Sympathetic chains (E) Superior epigastric vessels

A 58-year-old man with a history of alcoholism arrives at the ER vomiting blood. The given endoscopy reveals esophageal varices, secondary to portal hypertension. Which of the following surgical venous anastomoses could relieve this patient's symptoms of portal hypertension in the short term? (A) Inferior mesenteric to superior mesenteric (B) Left gastric to splenic (C) Superior mesenteric to right renal (D) Right gastric to left gastric (E) Right testicular to right renal

A 58-year-old woman presents with pain in her side that radi- ates to the suprapubic (hypogastric) region of her abdomen, hematuria (blood in urine), and a reported history of urinary tract infections. The given axial CT scan verifies advanced polycystic kidney disease. Which of the following nerves would convey visceral sensory fibers from the stretched renal capsule and cause referred pain to the skin of the suprapubic region of her abdomen? (A) Greater splanchnic (B) Lesser splanchnic (C) Least splanchnic (D) Pelvic splanchnic (E) Vagus

(A) Celiac artery

A 58-year-old woman with a history of hypercholesterolemia came to the ER with severe abdominal pain, nausea, and vomiting. She is diagnosed with advanced atherosclerosis after radiologic imaging reveals atherosclerotic plaque narrowing the blood vessel supplying the embryonic foregut and its derivatives. What blood vessel is most likely affected? (A) Celiac artery (B) Superior mesenteric artery (C) Inferior mesenteric artery (D) Portal vein (E) Umbilical vein

(B) Sympathetic supply to the ascending colon

A 60-year-old man is diagnosed with a posterior abdominal wall tumor that is causing lesions in the superior mesenteric plexus. Which of the following pathways is most likely affected? (A) Parasympathetic supply to the posterior aspect of the stomach (B) Sympathetic supply to the ascending colon (C) Lymph drainage from the liver (D) Venous drainage from the transverse colon (E) Visceral afferents from the proximal duodenum

(E) Second part of the duodenum

A 62-year-old woman undergoes a Nissen fundoplication, in which the fundus of the stomach is completely sutured around the gastroesophageal junction, to treat a severe case of gastroesophageal reflux disease (GERD). During the procedure, the surgeon accidentally damages the right (posterior) vagal trunk while inserting staples into the stomach. Which of the following organs is most likely affected? (A) Esophagus (B) Urinary bladder (C) Descending colon (D) Prostate gland (E) Second part of the duodenum

A 52-year-old man undergoes surgery to biopsy iliac lymph nodes. The physician tells the patient that it is important to identify the peripheral spinal nerves to protect them from being damaged during the surgery. The most likely location to find the genitofemoral nerve is coursing along which of the following surfaces? A. Anterior surface of the psoas major muscle B. Anterior surface of the quadratus lumborum muscle C. Inferior surface of the iliacus muscle D. Inferior surface of rib 12 E. Medial surface of the quadratus lumborum muscle F. Medial surface of psoas major muscle

A. Anterior surface of the psoas major muscle

Collateral circulation between the subclavian and external iliac arteries is created by an anastomosis between which of the following structures? A. Epigastric arteries B. Lumbar arteries C. Posterior intercostal arteries D. Round ligament of the liver E. Superficial epigastric arteries

A. Epigastric arteries

A 55-year-old man who has alcoholic cirrhosis of the liver is brought to the emergency department because he has been vomiting blood for the past 2 hours. He has a 2-month history of abdominal distention, dilated veins over the anterior abdominal wall, and internal hemorrhoids. Which of the following veins is the most likely origin of the hematemesis? A. Esophageal veins B. Inferiormesentericveins C. Paraumbilical veins D. Superior mesenteric vein E. Superior vena cava

A. Esophageal veins.

The ischiopubic or conjoint ramus is formed when the ischial ramus joins which of the following structures? A. Inferior pubic ramus B. Ischial spine C. Pubic symphysis D. Pubic tubercle E. Superior pubic ramus F. Sciatic notch

A. Inferior pubic ramus

(A) Direct inguinal hernia

After moving heavy equipment at a construction site, a 42-year-old man goes to his family physician with a bulge in his left groin that does not descend into the scrotum.The patient reports the bulge becomes more prominent when he is standing up, defecating, and coughing. On examination, the doctor places his finger in the location of the bulge and notes that his finger feels like it can pass into the abdominal cavity. Given his presentation and history, what is the most likely diagnosis? (A) Direct inguinal hernia (B) Indirect inguinal hernia (C) Femoral hernia (D) Lymphadenitis of superficial inguinal nodes (E) Hydrocele testis

(E) Relaxation of the teniae coli in the descending colon

An 18-year-old boy is brought to the ER after suffering a gunshot wound to his back. Radiographic imaging reveals extensive damage to the neural arches of the L1 and L2 vertebrae, with bone and bullet fragments lodged in the vertebral canal at these levels. Comprehensive neurologic examination indicates destruction of the sacral segments of the spinal cord. Which of the following functional outcomes is most likely present? (A) Reduced sweat gland secretion in the abdominal wall (B) Decreased motility in the duodenum (C) Increased motility in the ileum (D) Paralysis of the psoas major muscle (E) Relaxation of the teniae coli in the descending colon

(D) Septum transversum

An infant is born with a large defect in the central tendon of the diaphragm. This condition is most likely the result of malformation of which of the following structures? (A) Dorsal mesentery of the esophagus (B) Ventral mesentery of the gut tube (C) Pleuroperitoneal folds (D) Septum transversum (E) Cervical somites

When performing gastric bypass surgery on a 36-year-old woman, the surgeon identifies the hepatogastric and hepa- toduodenal ligaments. Together, both ligaments create which of the following structures? A. Greater omentum B. Lesser omentum C. Mesentery D. Parietal peritoneum E. Omental bursa F. Visceral peritoneum

B. Lesser omentum

A 70-year-old-man has a blockage at the origin of the infe- rior mesenteric artery. He does not have ischemic pain because of collateral arterial supply. Which of the following arteries is the most likely additional source of blood to the descending colon? A. Left gastroepiploic B. Middle colic C. Sigmoid D. Splenic E. Superior rectal

B. Middle colic

A 56-year-old man who is diagnosed with rectal cancer is undergoing biopsy of several lymph nodes. The nodes most likely to be sampled from this patient will be from the inferior mesenteric nodes, inguinal nodes, and the A. gonadal nodes B. internal iliac nodes C. portal vein nodes D. renal nodes E. superior mesenteric nodes

B. internal iliac nodes

The external oblique, internal oblique, and transversus abdominis aponeuroses all have a common insertion into which structure? A. Arcuate line B. Inguinal ligament C. Linea alba D. Pectineal line E. Pubic tubercle

C. Linea alba

A 30-year-old woman sustains a stage 4 tear in the per- ineum during a difficult delivery. In preparation to repair the tear, an anesthetic nerve block is administered to the pudendal nerve as it courses around the sacrospinous liga- ment. Which of the following areas is most likely blocked by the anesthetic? A. L2-L4 cutaneous field B. S1 cutaneous field C. S2-S4 cutaneous field D. L2-L4 dermatomes E. S1dermatome F. S2-S4 dermatomes

C. S2-S4 cutaneous field

During the initial examination of a 3.6kg(8lb) male infant delivered at term, urine is found to be leaking from the umbilicus. This infant most likely has an abnormality of which of the following fetal structures? A. Umbilical arteries B. Umbilical vein C. Urachus D. Urogenital sinus E. Urorectal septum

C. Urachus

Three days after giving birth, a 32-year-old woman develops a fever and right lower abdominal pain. Ultrasonography shows a right ovarian vein thrombosis extending proximally. The thrombus most likely extends into the A. ascending lumbar vein B. hepatic portal vein C. inferior vena cava D. renal vein E. right internal iliac vein

C. inferior vena cava

A 38-year-old man with a history of "heartburn" suddenly experiences excruciating pain in the epigastric region of his abdomen. Surgery is performed immediately, and evidence of a perforated ulcer in the posterior wall of the stomach is noted. Stomach contents that have seeped out will most likely be found in which of the following structures? A. Between the parietal peritoneum and the posterior body wall B. Greater peritoneal sac C. Ischioanal fossa D. Lesser peritoneal sac E. Paracolic gutter

D. Lesser peritoneal sac

A potential complication of multiple term gestational births and vaginal deliveries is a prolapsed uterus. To pre- vent this condition, Kegel exercises may be advised for sup- porting the uterus. Which pelvic floor muscle is most likely targeted in Kegel exercises? A. External anal sphincter B. Bulbospongiosus muscle C. Obturator internus muscle D. Pelvic diaphragm E. Superficial transverse perineal muscle

D. Pelvic diaphragm

(B) Genital branch of the genitofemoral

During a physical examination of a 35-year-old man with a spinal cord injury, the neurologist lightly strokes the right upper medial side of the thigh to test the integrity of the L1-2 spinal cord segments. He notes the cremasteric reflex is absent. Which of the following nerves carries the efferent limb of this reflex arc? (A) Iliohypogastric (B) Genital branch of the genitofemoral (C) Femoral branch of the genitofemoral (D) Femoral (E) Ilioinguinal

(D) Lienorenal ligament

During a splenectomy, a surgeon carefully dissects the peritoneal ligament containing the splenic vessels at the hilum of the spleen. Which of the following peritoneal ligaments is being dissected by the surgeon? (A) Hepatoduodenal ligament (B) Coronary ligament (C) Transverse mesocolon (D) Lienorenal ligament (E) Gastrolienal ligament

During inspections of a secret government biological warfare laboratory, a team of investigators discovers a genetically engineered virus that selectively attacks the cells bodies of post-synaptic parasympathetic neurons. In which of the following locations would this virus be found in the highest density if it were introduced into the body? (A) Celiac plexus (B) Paravertebral ganglia (C) Myenteric plexus (D) Hypogastric plexuses (E) Gray matter of sacral spinal cord segments

(E) Proper hepatic

During surgery to remove the gallbladder (cholecystectomy), a surgery resident damages the cystic artery before a clamp is properly placed. The attending physician applies pressure to the free edge of the hepatoduodenal ligament of the lesser omentum to control the bleeding until the damaged artery is clamped and ligated. Which of the following arteries was compressed by the attending physician? (A) Celiac (B) Splenic (C) Gastroduodenal (D) Common hepatic (E) Proper hepatic

Parasympathetic innervation to the hindgut originates in the S2-S4 spinal cord segments. Parasympathetic neurons travel to the prevertebral plexus via which of the following nerves? A. Greater splanchnic nerves B. Least splanchnic nerves C. Lesser splanchnic nerves D. Lumbar splanchnic nerves E. Pelvic splanchnic nerves F. Sacral splanchnic nerves

E. Pelvic splanchnic nerves

Diagnosis of an indirect inguinal hernia is determined when intestine protrudes lateral to the inferior epigastric artery through the abdominal body wall. During the phys- ical examination of a male patient, a physician will assess for an indirect hernia by inserting a finger in the scrotum and feeling for bowel that protrudes, as the patient is instructed to turn his head and cough. If an indirect inguinal hernia is present, the physician will most likely feel bowel at which of the following sites? A. Anterior superior iliac spine B. Deep inguinal ring C. McBurney's point D. Pubic symphysis E. Superficial inguinal ring

E. Superficial inguinal ring

A 65-year-old man is admitted to hospital with symptoms of an upper bowel obstruction. A CT scan reveals that a large vessel is compressing the third (transverse) portion of the duodenum. Which of the following vessels is most likely involved in the obstruction? A. Gastroduodenal artery B. Inferior mesenteric artery C. Portal vein D. Splenic artery E. Superior mesenteric artery

E. Superior mesenteric artery

(D) Diaphragm

Familial dysautonomia is a rare genetic disorder of the autonomic nervous system. Problems include difficulty in feeding and respiration, vasomotor instability, insensitivity to pain, and ataxia (an unsteady gait). Patients with this syndrome have low numbers of autonomic neurons, probably related to defects in production and/or survival of the neural crest precursors of these neurons. Which of the following structures would not be affected by this disorder? (A) Pyloricsphincter (B) Abdominalaorta (C) Teniaecoli (D) Diaphragm (E) Hepatopancreatic sphincter

(D) Umbilical vein

A 27-year-old woman comes to the hospital in the early stages of labor. She is 37 weeks pregnant in her first pregnancy, which has been normal. She has no notable past medical history, does not smoke or drink, and is not taking any medications. The examination in the labor and delivery unit is normal, and all appears well with the fetus. At this time, which of the following fetal vessels is carrying the highest concentration of oxygen? (A) Abdominal aorta (B) Umbilical arteries (C) Pulmonary artery (D) Umbilical vein (E) Pulmonary veins

A 35-year-old man suffers sharp abdominal pain accompanied by hematemesis (vomiting of blood) for 2 days. He dies without seeking medical help. Autopsy findings reveal a perforated ulcer in the posterior wall of the first part of the duodenum, which damaged the artery in close proximity. Which of the following arteries was most likely ruptured? (A) Shortgastric (B) Left gastroomental (C) Gastroduodenal (D) Splenic (E) Left gastric

(B) Endoderm

The given T1-weighted gradient echo of the abdomen demonstrates a malignant pancreatic islet cell tumor of the pancreas near the junction of the pancreatic body and tail. The pancreatic islet cells involved with this tumor are derived from which of the following embryonic sources? (A) Ectoderm (B) Endoderm (C) Somatic mesoderm (D) Visceral mesoderm (E) Neural crest

The given coronal MR arteriogram, taken after an appropriate time lapse, demonstrates abdominal venous anatomy. Which of the indicated veins drains the embryonic midgut?

Which of the following functional outcomes could result from failure of synaptic transmission in the celiac ganglion? (A) Decreased secretions from the gastric glands on the anterior wall of the stomach (B) Reduced secretion of epinephrine from the adrenal (suprarenal) medulla (C) Permanent relaxation of the pyloric sphincter (D) Increased motility in the wall of the descending colon (E) Paralysis of the quadratus lumborum muscle

(D) Falciform ligament

Which of the following structures is a remnant of the embryonic ventral mesentery? (A) Sigmoidmesocolon (B) Mesentery of the small intestine (C) Greateromentum (D) Falciform ligament (E) Transverse mesocolon

Abdomen - Appleton and Lange Questions, Abdomen - BRS Gross Anatomy 7th Ed, Abdomen-Big Picture Review Questions, Abdomen-Lippincott Review Question (Study w/Definition First)

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