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202 Cards in this Set

  • Front
  • Back
how many abdominal regions are there

how many quadrants are there?
9

4
What is lining the deep surface of the transverse aponeurosis (ab muscle)

what lines interal to that?

what is inbetween these two surfaces?
transversalis fascia

parietal peritonium

extraparitoneal fat
How many bilaterally paired muscles in the anterolateral abdominal wall?
5
(3flat and 2 vertical)
3 flat:
external olbiques
internal oblique
transverse abdominus
What are the attachments of the inguinal ligament?
ASIS and pubic turburcle
The linea alba extends from what to what?

what forms it?
xiphoid to pubic symph.

interweaving of the abdominal aponeursosis:
ext oblique
interna oblique
transverse abdomin


which all work togetherto compress and support abdominal viscera
what ribs is the external oblique associated with
5-12
what forms the rectus sheath?
1. ext and int oblique apon
2. post lamina of int obliqu
and transverse abdom aponer
What AAW is inside the rectus sheath?
rectus abominus
List in order the layers from the SKIN to the parietal peritoneum!
1. skin
2. camper fascia (fat)
3. scarpa fascia (membrenous)
4. investing fascia
5. ext oblique
6. investing fascia
7. internal oblique
8. investing fascia
9. trasnverse abdom
10. investing fascia
11. transversalis fascia
12. extraperitoneal fat
13. parietal peritoneum!!
triangle of petite is a site for
hernias
rectus abdom attachment sites
xiphiod process
5-7 costal cartildege
What demarcates the transition between posterior rectus sheath(superior area) and the transversalis fascia covering the inf area.
arcuate line
Contents of the rectus sheath
1. rectus abdominus
2. pyramidalis muscle
3. abastimosing inferior and superior epigastric A and V
4. lymph vesseles
5. distal portions of the anterior rami of spinal nerves t7-t12 (which supply the muscle and overlying skin)
What is made from reminants of the Uracus?
median umbilical fold ligament
what layer of the rectus sheath consists of all three aponeurotic layers?
anterior layer, for a couple inches above the body of the pubis


(this is because transverse ab and posterior internal oblique are posterior and then they come to join the ext oblique and the anterior internal oblique on the lanterior side)
What forms the conjoint tendon?

what type of hernia can occur here?
internal oblique and rectus abdominus


direct hernia
What two nerves originate from the anterior ramus of L1 spinal nerve?
1. iliohypogastric L1
2. ilioinguinal L1
The skin and muscles of the anterolateral abdomincal wall are supplied mainly by the (nerve)
thoroacbdominal
subcostal
branches of anterior L1
What is the direct continuation of the interal thoracic artery



how does it enter the rectus sheath?
superior epigastric artery


superioly through the posterior layer
the level of umbilicus indicates what?
- level of T10 dermatome
- 4th costal disk
what vertebra level is iliac crest?
L4
what demarcates the lateral borders of the rectus abdom and rectus sheath?
semilunar lines
An incisional hernia is a protrusion of?
omentum or organ through a surgical incision
What lymph nodes are in the AAW?
NONE
what drains the posterior abdominal wall?

what drains the anterior abdominal wall
azygos

femoral veins
where is the mcburny point?
right by the iliac crest on the anerior side
the depressions lateral to the unbilical folds are-
peritoneal fossae- each of which is a potential site for hernias
inguinal triangles aka-
hasselbach
where is the site for the most common type of hernia?
lower adom wall lateral to the lateral ubbilica folds
"lateral inguinal fossa"
what is the inferioror most part of the external oblique aponeurosis
inguinal ligament

which most of its fibers insert into the pubic tuburcle
whta is the ligament of COOPER and what is another name for it
another name is the pectineal ligament that runs across the pectin pubius, originating from the lacunar ligament which is on of the attachment thingys for th einguinal ligament
What is it called when the inguinal ligament arches superiorly to blend with te contralateral external oblique oblique aponerosis
refelcted inguinal ligament
what runs parallel and deepo to the inguinal ligament
iliopublic tract
The iliopubic tract transverses what?
subinguinal space

NAVEL
The inguinal canal is formed in relation to the...
gonads


and quick fact- the inguinal cnal has openings at each ends
the main occupant of the inguinal canal is

also contains...
spermatid cord (or the round ligament of the uterus)


- blood an dlymph, ilioinguinal NERVE
internal enterence to the inguinal canal is called?
deep internal ring


- made by invagination of transversalis facsia
- lateral to the inferior epigastric vessels
the exit from the inguinal canal is called-
supericical (extneral) inguinal ring

- between the external oblique and pubic tuburcle
- formed by the lateral and medial crura- which are prevented from spreading open by the intercural fibers
indirect hernias of the scrotum happen where?
at the opening of the inguinal canal- called deep inguinal ring.
what innervates the cremaster?
genital branch of the genital femoral nerve

(this nerve also brings sensory to scrotum)
what constitutes the SPERMATIC CORD
- ductus deferns+artery
- tresticular artery
- cremaster artery
- pampiniform veins
- smpathetic nerve
- genital branch of genitalfem nerve (motor)
- lymph
- vestige of the processus vanginalus
cancer of the testis mestastizes initially to the
lumbar lymph nodes


where as scrotum cancer goes to the superficial inguinal lymph nodes
what important things are in the lesser omentum?
- portal triad
- hepatogastric ligament
what is the triad in the portal triad?
1. hepatic artery
2. bile duct
3. portal vein
how would a bowel herniation get into the inguinal ring?
(indirect hernia)


how would a direct hernia get into the inguinal canal
- passes lateral to inferior epigastric vessels


- passes medial to the inferior epigastric through the inguinal triangle
where can you palpate an inguinal hernia?
at the superficial inguinal ring
what organs are in the peritoneal cavity?
NONE
what connects the lesser curvature of the stomach and th proximal part of the duadenum to the liver
lesser omentum
what connects the stomach to the liver?
hepatogastric ligament
what conducts the portal triad?
hepatoduodenal ligament
are organs completely covered with visceral peritonium?
No- so there is room for neurovascular streuctures to come in.
what is the "police man" of the abdomen
greater omentum
what has the largest collection of lymph tissue?
spleen
ther peritoneal cavity is devided into
greater sac
omentum bursa
how to you surgicaly enter the greater sac
incision through the anteriorlatreal abdom wall
what is the communication between the greater and lesser sacs?
foramin of winslow
aka omental foreamin
aka epiploic foreamin
what compartment contains the stomach liver and spleen?
supracolic compartment
the arterial supply to the abdominal part of the alimentary tract, spleen, pancreas, gallbladder, and liver is from...
abdominal aorta
3 major branches of the abdominal aorta?
celiak trunk
superior mesinteric A
inferior mesenteric A
what is the lesser sac in front of?
pancreas
what forms the portal vein?
superior mesenteric and splenic veins
what takes blood away from the liver?
hepatic Vein
the right gastric vein empties into?

what else drains into this?
portal vein

- L+R gastric-omental vein
after the portal vein passes the end of the stomach it is called
superior mestenteric vein
the inferior mesenteric vein drains into
splenic vein on its way to forming the portal vein
what takes 75% of blood to the liver?

what takes the rest?
portal V

hepatic artery
what regulates the bolis?
pyloric antrum
where does the celiac trunk come from?

and what the celiac trunk devide into?
T12- just distal to aortic hiatus of diaphram

1. left gastric
2. splenic
3. commen hepatic
Course of the left gastric artery
ascends retroperitoneally to esophageal hiatus, gives off a branch then runs along lesser curvature of the stomach
what gets blood from the splenic artery?
pancreas
spleen
greater curvature of stomach
fundus
where does the left gastric-omental artery come from?
splenic artery in hilium of spleen
Course of the Celiac Trunk
passes retroparitoneally to reach hepadoduodenal lgament, passes passes between its layers to portal hepatis, then devides into right and left heptaic arteries
what artery acsends onthe head of pancreas?
artery from the superior mesenteric
posteriorly, the stomach is related to

anteriorly?
omental bursa and pancreas


disphram, left liver lobe
the fundus and upper body of stomach recieve blood from
short and posterior gasrtic arteries (branches of the splenic artery)
what surrounds origen of celiac artery?
celiac lymph nodes
what acompanies arteries along the greater and lesser ciurvature of the stomach?
gastric lymph
what synapses at the celiac ganglion and plexus?

what just passes through?
splechnic sympathetic nerves

vagus Nerve
WRT the vertebra- discribe the following...

1. pylorus
2. pyloric part of stomach
3. fundus
4. cardial orifice
1. l2 or l4
2. L1
3. posterior to 5th left rib
4. T10 or 11
the transverse colon is superior to the
duodenum
the majority of the GI tract is innervated by
VAGUS
what supplies symptheit cinnervation to GI tract
greater thoracic splencnic nerve from t6-t9 segments
what constotues the first part of the large intestine
ilieum joins the cecum
what is the first and shortest part of the small intestine?
duodenum
Name the four parts of the Duodenum-
1. bulb/cap- superior (L1)
2. descending (has bile duct)
3. horizontal (anterior to IVC and aorta
4. ascending (left of aorta)
what is the duodenejejunal flexure?
an acute angle formed when the duodenum joins the jejunem. supported by the ligaments of treitz
where would you put yoiur finger to show where the spleen is?
upper left quadrant between 9-11th ribs
together, the jejunum and ilium are ____long in cadavers

they are attached to the posterior abdominal wall via
6-7m

mesentary

(and gets arterial supply from the SMA)
Name all of the things the root of the mesentary crosses!!
- acesding and horizontal dudenum

- abdominal arota
- IVC
- right ureter
- rihgt psoas major muscle
- right testicle/ovarian
what part of the colon is fixed without a mesentary

what is NOT fixed, WITH a mesentary?
left colic flexture

sigmoid colon
what tyoe of stimulation reduces motitly?

how does it reach the suyperior mesenteric nerve plexus
sympathetic
(T8-T10)

through synpathetic trunk and the greater and lesser splanchnic nerves.
Where does the vagus nerve terminate?
near distal end of transverse colon
After the vagus nerve terminates, what takes over for the parasympathetic system?
craniosacral pevis (s2-s4) splanchnic nerves from hypogastric nerve plexus
the large intestine can be distinguished from the snall intestine by:
teniae coli
haustra (cause sacculation)
omental appendices
caliber
what makes up the longitudinal muscle fo the large inestine?
3 tenaie coli (except in the rectum)
common appendix postitions-
- retrocecal
- by pelvis
SMA =
embryonic midgut
how many lobes does the liver have?

what about in terms of bolood supply?

how many segments of the liver?
4
-left lobe
-caudal lobe
-quadrate lobe
-right lobe

only 2 (portal lobes)
(seperated by the right saggital fissue


a line between the IVC and th egallbladder is the physiologiucal lobes

8
the anitomical right lobe of liver is seperated by ____ from the left lobe
falciform lig and left saggital fissure
the liver lies mainly in the
right upper quadrant (where it is hidden from the thoraic cage and disaphgram)
what developes in chronic alchoholics
cirrihosis of liver (the most commen cause of portal hypertension)
what forms the ampulla of vater?
aka- hepatopancreatic ampulla

the distal end of the ampulla opens up to the duodenum through the
bile duct and main pancreatic duct


major duodenal papilla
the bile duct forms in the lesser omentum by the
cycsitc duct and commen hepatic duct
where do you feel gall stone pain?
epigastric pain
referred shoulder pain
what side of the liver is the gallbaldder?
vsiceral surface
what arisses at the angle of the commen hepatic duct and the cycstic duct?
cystic artery (which supplies gallstone and cycti c duct
what is important inthe advent of the intraheptatic or extraheptaic portal venous block
the communication sbetween the portal venous system and the systemic venous sytem

they have no valvues
and if there is liver disease blood can still get to thr heart through the IVC
what can lead to a caput medusa?

what is often seen alonh with this?
portal hypertension

bleeding from the esp[hageal varices at the distal end of the esophagus
a commen method for reducing portal hypertension is-
divert blood from the portal system to the systemic venous system by creating a communication between the portal vein and the IVC
-portacacal anastinmosis
-portosystemic shunt
what seperates right kidney from liver?
morrisons pouch
postior muscles of the kidney
psoas maj
quad lumborum
wat vertibral level are the idneys at?

which kidney is higher and why?
T12- L3

the left kidney- becuase the right is pushed down by the liver
what is the enterce to the sapce within the kidney?
renal hilum

but all the nerves and stuff are embedded in the renal sinus
the renal pyramids drain into the _____ with drain into the____ which drain into the______ which drains into the _______
the top 3 minor calyx drains into the maor calyx which drains into the renal pelvis with drains into the ureter
due to distention, the ureter has refeered pain- what is carrying this
visceral afferent in sympathtic fibers
what places are the ureters constricted?
aka- sites of kidney stones
1. junciton of ureter and renal pevis
2. where they ross brim of pelvic inlet
3. passage of urinary bladder wall
whats the difference between the left and right suprarenal glands?
RIGHT
- pyramid shaped
- anterior to diaphram
- contacts IVC (AntMed)
- conects to liver (ANTLAT)

LEFT
- crescent shaped
- related to spleen, stomach, pancrase, and left crus of diaphram
the renal arteries are at the level of

which one passes posterior to the IVC
4th disk between L1 +L2


right(longer too)
The renal veins lie anterior to _______


which renal vein passes anterior to the aorta?
renal arteries

Left (longer too)
the suprarenal arteries arise from 3 sources
(superior (6-8) , medial and inferior)

1. sup-from inferior phrenic
2. mid-between aorta and SMA
3. inf- from renal artery
3.
discribe how the two suprarenal veins drain
short right-> IVC
long left -> joins the inferior phrenic vein and empties into left renal vein
discribe how the gonadal veins drain
RT - direct to IVC
LFT- to left renal vein, then to IVC
what conveys presynaptic sympathetic fibers to the abominopelvic cavity?
abdomino pelvic splanchnic nerves t7-L2 (from anterior roots)

- pass the synpathetic trunk without suynpasing to enter the splanichnic which take them to gnaglia of abdominal cavity)
the abdominopevlic splanchinic nerves include the

which is the main source to abdominal vicsera

which go to the inferior and supoerior mesenteric and superior hypogastric plexus?
lower thoraco(greater and lesser and least) and lumbar splanchnic

- lower thoracic(SYMP)


- lumbar (SYMP)



btw- the superior hypogastric is symp only and the iunferior is MIXED
what brings autonomicness (hehe) to the gut
vagal trunks
the pelvic splanchnic nerves are distant from other splanchinic nerves in that they...
1. have nothing to do with sympathetic trunks

2. directly from anterior rami of S2-S4

3. convey presynaptic parasympathetic fibers to the inferior hypogastric (pelvic) plexus
postior venous drainage of diaphram go to
azygos and hemiazygos
Upon rectal examination, a firm structure, directly in front of the rectum in the midline, is palpated through the anterior wall of the rectum. This structure is the:
cervix
The most inferior extent of the peritoneal cavity in the female is the:
rectouniterin pouch
The terminal ends of the ilioinguinal nerves in the female are referred to as:
anteriolabial
The usual location for an appendectomy incision is the:
right lower quadrant
what happens to the iolioinguinal N after is passes through the superior inguinal ring
However, the ilioinguinal nerve does not pass through the deep ring - it enters the inguinal canal on the side.
, you would indicate the position of the deep inguinal ring to be:
Above the midpoint of the inguinal ligament
An elderly patient with a large indirect inguinal hernia came to your clinic complaining of pain in the scrotum. You conclude that the hernial sac is compressing the following nerve:
The ilioinguinal nerve runs in the inguinal canal, so this nerve could easily be compressed by an inguinal hernia. The ilioinguinal nerve also gives off the anterior scrotal nerve, which is the nerve responsible for sensory innervation to the anterior scrotum. The location of this hernia and the scrotal pain both fit with an injury to the ilioinguinal nerve
what abdominal wall layers surround the superficial inguinal ring?
External spermatic fascia
Peritoneum and extraperitoneal connective tissue
Weak fascia of the transversus abdominis muscle lateral to the falx
15-year-old boy was admitted to the emergency room for having large bowel obstruction resulting from a left-sided indirect inguinal hernia. The most likely intestinal segment involved in this obstruction is the:
The sigmoid colon is the most likely intestinal segment to be involved in a left-sided indirect inguinal hernia. Although the descending colon is also on the left side of the abdomen, it is a bit superior to be herniating through the deep inguinal ring.
The boundaries of the inguinal triangle include
Inferior epigastric vessels
Inguinal ligament
Lateral border of rectus abdominus muscle
The superficial inguinal ring is an opening in which structure?
External abdominal oblique aponeurosis
If a hernia enters into the scrotum, it is most likely a(n):
Indirect inguinal hernias cross through the deep inguinal ring, passing deep to the internal spermatic fascia. This means that they can enter the scrotum fairly easily, and indirect inguinal hernias are often found in the scrotum. Direct inguinal hernias are not covered by the internal spermatic fascia; they enter the inguinal canal next to the spermatic cord, and rarely enter the scrotum
herniation of bowel between the lateral edge of the rectus abdominis muscle, the inguinal ligament and the inferior epigastric vessels. These boundaries defined the hernia as a(n):
direct inguinal hernia
Which of the following veins does not run a course parallel to the artery of the same name?
inferior mesenteric
The presence of which feature (also obvious on a radiograph with barium contrast) distinguishes small from large bowel?
circular folds of the mucosa
Occlusion of the inferior mesenteric artery is seldom symptomatic because its territory may be supplied by branches of the
middle colic
male complaining of right lower quadrant pain, the surgeon initially sees no appendix but knows that he can quickly locate it by
looking at the confluence of the teniae coli
The teniae coli are three bands of longitudinal muscle on the surface of the large intestine. Remember, the large intestine does not have a continuous layer of longitudinal muscle--instead, it has teniae coli. These three bands meet at the appendix. which is the terminal portion of the cecum.
Meckel's diverticulum
is a site of ectopic pancreatic tissue
Pain of appendicitis is often first felt around the umbilicus, indicating that the appendix receives its sympathetic (and thus visceral afferents) from which spinal cord segment
Sensation from around the umbilicus is mediated by T10
The spleen normally does not descend below the costal margin. However, it pushes downward and medially when pathologically enlarged. What structure limits the straight vertical downward movement?
The left colic flexure, also called the splenic flexure, is the point where the colon takes a sharp downward turn
what part of colon is not effected by damage to the vagus nerve?
Sigmoid colon
what part of colon gets blood NOT from the inferior mesenteric artery?
cecum--->superior mesenteric artery
This is a loop of large bowel!" Which characteristic(s) would identify it specifically as large bowel?
Large Inestine:
tinea coli
haustra
omental appendages
The anastomotic artery running along the border of the large intestine is called the:
The marginal artery is an important anastomosis for the large intestine. It runs around the border of the large intestine, and it is formed by the anastomosis of branches of the ileocolic artery, right colic artery, middle colic artery, left colic artery, and sigmoid artery. If a small artery becomes occluded, these branches allow blood to reach all segments of the colon.
the artery of the midgut is the
The superior mesenteric artery is the artery of the midgut. The celiac trunk is the artery of the foregut, and the inferior mesenteric arery is the artery of the hindgut. The splenic artery is a branch of the celiac artery, and the proper hepatic artery is a branch of the common hepatic artery, which is a branch of the celiac artery.
Sympathetic fibers in the greater splanchnic nerve arise from neuron cell bodies found in the
spinal cord
The celiac plexus of nerves may contain fibers derived from all of the following sources
posterior vagal trunk
greater thoracic splanchnic nerve
lumbar splanchnic nerves
Cells that secrete epinephrine and norepinephrine are innervated by preganglionic fibers from
the greater thoracic splanchnic nerve.
The vagus nerve passes into the abdomen by passing through the
esophageal hiatus
The cisterna chyli accompanies which structure as it passes through the diaphragm?
IVC
Blood from an injured kidney will seep through the perirenal fat until it contacts the internal surface of the renal (Gerota's) fascia. Without perforating this fascia the blood could then continue to pass in what direction?
inferiorly towards pevlis
A 19-year-old male suffers a tear to the psoas major muscle during the course of a football game. A scar, which formed on the medial part of the belly of the muscle, involved an adjacent nerve, immediately medial to the muscle. The nerve is called the:
obterator!
Which of these nerves lies immediately medial to the psoas major muscle.
obterator
A patient was diagnosed with bleeding ulcer of the lesser curvature of the stomach. Which artery is most likely involved?
left gastric artery (from the celiac trunk)
the spleen developes in the
The spleen and pancreas develop behind the stomach in the dorsal mesogastrium; the liver develops in the ventral mesogastrium. The spleen is not a retroperitoneal organ--it is covered by visceral peritoneum on all its surfaces.
gastric nerve branches are located in great amount near what stomach area?
lesser curvature
Which of the following structures does not lie at least partially in the retroperitoneum?
spleen
if an ulcer distrypoed the posterior wall of the duodenum, what artery would be injured?
The gastroduodenal artery is a branch of the common hepatic artery; it descends behind the first part of the duodenum
X-rays revealed that her 9th and 10th ribs were fractured near their angles on the left side. The abdominal organ most likely to be injured by the fracture is:
spleeeeeeeeeeeeeeeeeeen
A patient presented with a swollen spleen, which protruded medially toward the umbilicus in the abdomen. A vertical and downward expansion of the spleen was resisted by the:
left colic flexure
During emergency surgery, it was found that a chronic gastric ulcer had perforated the posterior wall of the stomach and eroded a large artery running immediately posterior to the stomach. The artery is the:
splenic A
The spleen contacts all of the following organs
Kidney
Left colic flexure
Tail of the pancreas
Stomach
what are the boundaries of the omental foramine?
Caudate lobe of the liver
First part of the duodenum
Hepatoduodenal ligament
Before incising the mesentery she was careful to find and preserve a nerve lying in the upper portion of the hepatogastric ligament, i.e., the
Hepatic branch of the anterior vagal trunk
Which of the following is NOT in contact with the spleen?
Colon
Diaphragm
Duodenum
Pancreas
Stomach
duodenum
Which organ becomes retroperitoneal during rotation of the gut tube?
duodenum
To stop hemorrhaging from a ruptured spleen, it was necessary to temporarily ligate the splenic artery near the celiac trunk. The blood supply to which structure is least likely to be affected by the ligation?
duodenum
Further examination revealed that the obstruction was caused by the nutcracker-like compression of the bowel between the superior mesenteric artery and the aorta. The compressed bowel is most likely the
duodenum!
what is the one duodenum segment with no circular folds?
The superior part of the duodenum is the one segment of the duodenum that has no circular folds
"In the triangle of Calot." What stuctures form this triangle and are the keys to finding the artery?
Common hepatic duct, liver and cystic duct
large tumor in the quadrate lobe of the liver. During the surgical removal of the tumor, one of the vessels that needs to be clamped to effectively control bleeding is the:
LEFT heptatic artery
examination, it was found that the third (transverse) portion of the duodenum was compressed by a large vessel causing the obstruction. The vessel involved is most likely to be the:
The superior mesenteric artery crosses over the third part of the duodenum, and the aorta is posterior to the third part of the duodenum
atient was diagnosed with pancreatitis due to a reflux of bile into the pancreatic duct caused by a gallstone. The stone is likely to be lodged at the:
Hepatopancreatic ampulla
The blockage of a main bile duct in the quadrate lobe will likely cause reduced flow of bile secretion in the:
left hepatic duct
The inferior mesenteric vein usually joins which vein?
splenic
A surgeon needs to construct a bypass between the veins of the portal and caval systems to circumvent insufficient drainage through the natural portacaval anastomoses. Which plan is likely to be successful?
splenic vein to left renal
head of the pancreas. Which structure was compressed by the tumor?
common bile duct
The second way of dividing the abdominal surface is into 9 regions:
left hypochondriac LH
left lumbar LL
left iliac LI
epigastric E
umbilical U
hypogastric H
right hypochondriac RH
right lumbar RL
right iliac RI
These regions are formed by two vertical planes and two horizontal planes. The two vertical planes are the lateral lines LLL and RLL. These lines are dropped from a point half way between the jugular notch and the acromion process.

The two horizontal planes are the transpyloric plane TPP and the transtubercular plane TTP. The tubercles are the tubercles of the iliac crests.
check it
what does the portal hepatis transmit?
hepatic arteries
hepatic ducts
autonomic nerves from the celiac plexus
portal vein
what nerve passes through the superficial inguinal ring?
ilioinguinal nerve
The posterior boundary of the epiploic foramen is the
IVC
whta is the floor of the inguinal canal?
inguinal ligament
the deep ring is located lateral to?
located just lateral to the inferior epigastric artery
what bounds the epiploic foramin anteriorly?
hepatoduodenal ligament
The common bile duct and major pancreatic duct join to form the:
ampulla of vater
what is located at the opening between the small and large intestines?
ileocecal valve
left gastroepiploic is an important branch of the
spleenic A
Which of the following arteries is used to characterize an inguinal hernia as direct or indirect?
inferior epigastric
Which nerve is identified by its position on the anterior surface of the psoas major muscle?
genitofermoral N
what is the female counterpart of the scrotum
labia majora
A


C
1. The ligament that extends from the anterior superior iliac spine to the pubic tubercle and forms the lower lateral boundary of the abdominal wall, is the: lacunar
interfoveolar
inguinal
ilio-pectineal
pectineal

2. The "porta hepatis" of the liver transmits all of the following EXCEPT the: hepatic arteries
hepatic ducts
autonomic nerves from the celiac plexus
portal vein
hepatic veins

3. Most of the small intestine receives its blood supply from branches of a single artery. The artery that supplies most of the small bowel is the: middle colic
celiac
gastroduodenal
inferior mesenteric
superior mesenteric

4. Which of the following nerves passes through the superficial inguinal ring? iliohypogastric nerve
obturator nerve
lateral femoral cutaneous nerve
ilioinguinal nerve
pudendal nerve

5. The posterior boundary of the epiploic foramen (of Monro) is the: caudate lobe of the liver
first part of the duodenum
portal vein
common bile duct
inferior vena cava

6. Regarding the anatomy of the inguinal canal, all of the following statements are true about it EXCEPT: its floor is predominately formed by the inguinal ligament
its deep ring is located just lateral to the inferior epigastric artery
its roof is formed by arching fibers of the internal oblique and transversus muscles
its deep ring is formed by peritoneum
its superficial ring is formed by the aponeurosis of the external oblique muscle

7. The abdominal aorta passes through the diaphragm at which vertebral level? T8
T10
T12
L1
L2

8. The common bile duct, hepatic artery and postal vein are found grouped together in the: gastrosplenic ligament
gastrohepatic ligament
hepatoduodenal ligament
gastrocolic ligament
falciform ligament

9. The inguinal ligament runs between the: symphysis pubis and the inferior iliac spine
anterior and posterior superior iliac spines
left and right iliac tubercles
pubic tubercle and iliac tubercle
anterior superior iliac spine and pubic tubercle

10. In the human kidney, the renal papilla projects directly into the: renal pyramid
ureter
major calyx
renal columns
minor calyx

11. The epiploic foramen is bounded anteriorly by the: hepatoduodenal ligament
peritoneum over the inferior vena cava
peritoneum on the caudate lobe of the liver
free border of the greater omentum
peritoneum at the beginning of the duodenum

11. Motor innervation to the respiratory diaphragm is the: vagus nerve
thoracic splanchnic nerve
3rd, 4th and 5th thoracic nerves
phrenic nerve
recurrent laryngeal nerve

12. The common bile duct and major pancreatic duct join to form the: hepatic duct
common hepatic duct
cystic duct
cisterna chyli
ampulla of Vater

13. Each of the following forms a boundary of the lesser peritoneal sac EXCEPT the: gastrosplenic ligament
left triangular ligament of the liver
greater omentum
lesser omentum
splenorenal ligament

14. Which of the following is located at the opening between the small and large intestines? ligament of Treitz
cardiac sphincter
ileocecal valve
pyloric sphincter
tricuspid valve

15. When removing the spleen, a surgeon must be careful not to cut one of its branches, the: superior mesenteric
left gastric
left gastroepiploic
superior pancreaticoduodenal
left renal

16. Which of the following arteries is used to characterize an inguinal hernia as direct or indirect? obturator
deep external pudendal
femoral
superficial circumflex iliac
inferior epigastric

17. When performing surgery in the ischiorectal fossa, the internal pudendal vessels and pudendal nerve should be avoided by staying away from the: base of the fossa
medial wall of the fossa
lateral wall of the fossa
anterior wall of the fossa
posterior wall of the fossa

18. Infected glands of the anus (near the pectinate line) may erode the wall of the anal canal and rupture laterally into the: ischiorectal fossa
deep perineal pouch (or space)
rectovesical fossa
superficial perineal pouch (or space)
retropubic space

19. Which nerve is identified by its position on the anterior surface of the psoas major muscle? femoral
ilioinguinal
genitofemoral
obturator
lateral femoral cutaneous

20. The external spermatic fascia is derived from the: tunica vaginalis
transversus abdominis aponeurosis
external oblique aponeurosis
extraperitoneal fascia
internal oblique aponeurosis

21. The perineum is bounded by all of the following EXCEPT the: ischiopubic ramus
pubic symphysis
apex of the coccyx
urogenital diaphragm
sacrotuberous ligament

22. The portion of the male urethra that passes through the urogenital diaphragm is called the: penile urethra
spongy urethra
membranous urethra
prostatic urethra
external urethral sphincter

23. The scrotum has as its counterpart in the female the: bulb of the vestibule
crura of the clitoris
labia majora
labia minora
clitoris

24. When a surgeon removes the uterus and cuts the uterine artery, he must be careful not to cut the: ovarian artery
ureter
urethra
internal pudendal artery
vagina

25. The portion of the broad ligament of the uterus that attaches to the uterine tube is known as the: round ligament
mesovarium
mesometrium
mesosalpinx
parametrium

In the adjacent diagram of a sagittal section through the female pelvis, select a letter that answers the question or statement:

26. A space or recess used to reach the urinary bladder without entering the peritoneal cavity:







27. A space or recess easily entered from the posterior fornix of the vagina
throughout most of its extent, the aponeurosis of this muscle contributes only to the posterior layer of the rectus sheath
transverse abdominus
contraction of this muscle stabilizes the 12th rib

independent contraction of this muscle results in trunk flexion
quadratus lumborum


rectus abdom
this muscle is innervated by the femoral nerve
iliacis!
the tunica vaginalis is formed from the
peritonium