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  • Question 1 - A 30 year old gym coach presented to the surgical out patient clinic...

    Incorrect

    • A 30 year old gym coach presented to the surgical out patient clinic with a lump in the inguinal region. He was booked for surgery, during which, the surgeon opened the inguinal region and found a hernial sac with a small segment of intestine projecting through the abdominal wall. It was located just above the inguinal ligament and lateral to the inferior epigastric vessels. What type of hernia was this?

      Your Answer: A direct inguinal hernia

      Correct Answer: An indirect inguinal hernia

      Explanation:

      An indirect inguinal hernia exits the abdominal cavity lateral to the inferior epigastric vessels and enters the inguinal canal through the deep inguinal ring. These are the most common types of hernias often caused by heavy weigh lifting. Direct inguinal hernias exit the abdominal cavity medial to the inferior epigastric vessels through weak fascia.

      Congenital inguinal hernias are indirect hernias that occur due to persistence of the processus vaginalis.

      Femoral hernias occur when abdominal viscera push through the femoral ring in the femoral canal.

      Incisional hernia occurs after surgery when the omentum or organ protrudes through a previous site of incision.

      Obturator hernia are a very rare type of hernia where the pelvic or abdominal contents protrude through the obturator foramen.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      130.6
      Seconds
  • Question 2 - During a procedure to treat an ulcer in the first part of the...

    Incorrect

    • During a procedure to treat an ulcer in the first part of the duodenum, the most appropriate site to make the incision on the anterior abdominal wall to approach this ulcer would be the:

      Your Answer:

      Correct Answer: Epigastric region

      Explanation:

      The abdomen is divided into nine regions for descriptive purposes. The epigastric region contains the first part of the duodenum, part of the stomach, part of the liver and pancreas. This would be the region that the surgeon would need to enter to access the ulcer.

      Typically, a midline incision in the epigastric region, extending from just below the xiphoid process down to the umbilicus, provides excellent access to the first part of the duodenum.

      The left inguinal region contains the sigmoid colon.

      The left lumbar region contains the descending colon and kidney.

      The right lumbar region contains the right kidney and descending colon.

      The right hypochondrial region contains part of the liver and gall bladder.

      The hypogastric region contains the urinary bladder and the rectum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 3 - Which of the following is a large artery that runs immediately posterior to...

    Incorrect

    • Which of the following is a large artery that runs immediately posterior to the stomach?

      Your Answer:

      Correct Answer: Splenic

      Explanation:

      The splenic artery is the large artery that would be found running off the posterior wall of the stomach. It is a branch of the coeliac trunk and sends off branches to the pancreas before reaching the spleen. The gastroduodenal artery on the other hand is found inferior to the stomach, posterior to the first portion of the duodenum. The left gastroepiploic artery runs from the left to the right of the greater curvature of the stomach. The common hepatic artery runs on the superior aspect of the lesser curvature of the stomach, and is a branch of the coeliac trunk. The superior mesenteric artery arises from the abdominal aorta just below the junction of the coeliac trunk.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 4 - During an anatomy revision session, medical students are told that the posterior wall...

    Incorrect

    • During an anatomy revision session, medical students are told that the posterior wall of the rectus sheath ends in a thin curved margin whose concavity is directed downwards. What is the name of this inferior border of the rectus sheath?

      Your Answer:

      Correct Answer: Arcuate line

      Explanation:

      The rectus sheath is a tendinous sheath that encloses the rectus abdominis muscle. It covers the entire anterior surface however on the posterior surface of the muscle the sheath is incomplete ending inferiorly at the arcuate line. Below the arcuate line, the rectus abdominis is covered by the transversalis fascia. The linea alba is a band of aponeurosis on the midline of the anterior abdominal wall, which extends from the xiphoid process to the pubic symphysis. It is formed by the combined abdominal muscle aponeuroses. This is a useful site for midline incision during abdominal surgery because it does not carry many blood vessels. All of the other answer choices are related to the inguinal canal.

      The falx inguinalis (sometimes called the inguinal falx or conjoint tendon), is the inferomedial attachment of the transversus abdominis with some fibres of the internal abdominal oblique – it contributes to the posterior wall of the inguinal canal.

      The inguinal ligament is the ligament that connects the anterior superior iliac spine with the pubic tubercle – it makes the floor of the inguinal canal.

      The internal (deep) inguinal ring is the entrance to the inguinal canal, where the transversalis fascia pouches out and creates an opening through which structures can leave the abdominal cavity.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 5 - Enlargement of the spleen as seen in Gaucher's disease pushes the spleen downward...

    Incorrect

    • Enlargement of the spleen as seen in Gaucher's disease pushes the spleen downward and medially. What structure limits the straight-vertical-downward movement?

      Your Answer:

      Correct Answer: Left colic flexure

      Explanation:

      The left colic flexure (also known as the splenic flexure), is the point where the colon takes a sharp turn downwards. It is the point where the transverse colon ends and the descending colon begins. It is located immediately inferior to the spleen so an enlarged spleen must move medially to avoid this colic flexure.

      The left suprarenal gland is retroperitoneal.

      The Ligament of Treitz suspends the fourth part of the duodenum from the posterior abdominal wall.

      The stomach, pancreas and liver lie medial to the spleen and thus would not prevent a vertical downward movement.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 6 - The fundus of the stomach receives blood supply from the same artery as...

    Incorrect

    • The fundus of the stomach receives blood supply from the same artery as the greater curvature of the stomach. Which of the following arteries when ligated will disrupt blood supply to the fundus of the stomach through this artery?

      Your Answer:

      Correct Answer: Splenic

      Explanation:

      The fundus of the stomach along with the greater curvature of the stomach receive blood supply from the short gastric artery. The short gastric artery arises from the end of the splenic artery. The ligation of the splenic artery therefore would cause a disruption of blood supply to the fundus of the stomach.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 7 - The superior pancreaticoduodenal artery, the artery that supplies blood to the pancreas and...

    Incorrect

    • The superior pancreaticoduodenal artery, the artery that supplies blood to the pancreas and the duodenum, is a branch of the:

      Your Answer:

      Correct Answer: Gastroduodenal artery

      Explanation:

      The superior pancreaticoduodenal artery together with the right gastroepiploic artery form the two branches of the gastroduodenal artery which divides at the lower border of the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 8 - A surgeon ligates the left superior suprarenal artery whilst preforming a left adrenalectomy....

    Incorrect

    • A surgeon ligates the left superior suprarenal artery whilst preforming a left adrenalectomy. Where does the left superior suprarenal artery originate?

      Your Answer:

      Correct Answer: Left inferior phrenic artery

      Explanation:

      The superior suprarenal arteries arises from the inferior phrenic artery on either side.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 9 - A CT-scan report of a patient with gastric carcinoma shows that the lymph...

    Incorrect

    • A CT-scan report of a patient with gastric carcinoma shows that the lymph nodes around the coeliac trunk are enlarged. The coeliac trunk:

      Your Answer:

      Correct Answer: Gives rise to the splenic, left gastric and common hepatic arteries

      Explanation:

      The coeliac trunk is a branch of the aorta arising just below the aortic hiatus of the diaphragm to pass nearly horizontally forward to divide into 3 large branches i.e. the left gastric, the hepatic and the splenic arteries. Occasionally it may give off one of the inferior phrenic arteries. It is covered by the lesser omentum and on the right side bordered by the right coeliac ganglion and the cardiac end of the stomach. Inferiorly it is bordered by the upper border of the pancreas and splenic vein. The embryonic midgut is supplied by the superior mesenteric artery.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 10 - You observe a procedure to harvest the left internal thoracic (mammary) artery to...

    Incorrect

    • You observe a procedure to harvest the left internal thoracic (mammary) artery to be used as a graft for coronary artery bypass surgery. The left internal thoracic artery is mobilised from the inside of the chest wall and divided near the caudal end of the sternum. After dividing the internal thoracic artery at its distal end, the specialist registrar asks you to name the artery that will now have increased blood supply so that adequate blood flow is maintained to the rectus abdominis on the left side. What would your answer be?

      Your Answer:

      Correct Answer: Inferior epigastric artery

      Explanation:

      The rectus abdominis muscle is supplied by the superior epigastric artery which is a branch of the internal thoracic artery. If the internal thoracic artery is thus ligated, blood would no longer flow to it. However, the superior epigastric artery communicates with the inferior epigastric artery (a branch of the external iliac artery). This means that blood could flow from the external iliac, to the inferior epigastric, to the superior epigastric to the rectus abdominis.

      The superficial circumflex iliac artery and the superficial epigastric are two superficial branches of the femoral artery and do not supply the deep branches of the abdomen.

      The deep circumflex iliac artery travels along the iliac crest on the inner surface of the abdominal wall; being too lateral it doesn’t supply blood to the rectus abdominis.

      The distal portions of the umbilical arteries are obliterated in adults to form the medial umbilical folds.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 11 - The operating surgeon notices a structure lying alongside a herniated mass whilst repairing...

    Incorrect

    • The operating surgeon notices a structure lying alongside a herniated mass whilst repairing an indirect inguinal hernia in a female patient. Which structure could this be?

      Your Answer:

      Correct Answer: Round ligament of the uterus

      Explanation:

      The main structure traversing the inguinal canal in women is the round ligament. In men, it is the spermatic cord.

      The iliohypogastric nerve innervates the abdominal wall and runs between the transversus abdominis and internal oblique muscles before piercing the internal oblique at the anterior superior iliac spine to run between the internal and external obliques.

      The inferior epigastric artery is between the peritoneum and the transversus abdominis creating the lateral umbilical fold.

      The ovarian artery and the ovarian vein are branches from the descending aorta and inferior vena cava that supply the ovary in the pelvic cavity.

      The pectineal ligament is a thick fascial layer over the pectineal line of the pubis. It doesn’t traverse the canal.

      The broad ligament if found on the lateral sides of the uterus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 12 - Which statement is true regarding the diaphragmatic openings: ...

    Incorrect

    • Which statement is true regarding the diaphragmatic openings:

      Your Answer:

      Correct Answer: The thoracic duct passes through the opening at T12

      Explanation:

      The diaphragmatic openings are:

      T8 – opening for the inferior vena cavaand the right phrenic nerve

      T10 – opening for the oesophagusand the left gastric artery and vein

      T12 – opening for the aorta, the thoracic duct and azygos vein.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 13 - During an exploratory laparotomy of an acute abdomen, the surgeon identified an inflamed...

    Incorrect

    • During an exploratory laparotomy of an acute abdomen, the surgeon identified an inflamed Meckel's diverticulum. This is:

      Your Answer:

      Correct Answer: Is a site of ectopic pancreatic tissue

      Explanation:

      Meckel’s diverticulum is an outpouching of the small intestine. It usually occurs about 0.6 m (2 feet) before the junction with the caecum. It can be lined with the mucosa of the stomach and may ulcerate. It may also be lined by ectopic pancreatic tissue. It represents the remains of the vitelline duct in early fetal life.

      An abnormal persistence of the urachus is called a urachal fistula.

      Failure of the midgut loop to return to the abdominal cavity is called an omphalocele.

      Polyhydramnios is often caused by anencephaly or oesophageal fistula.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 14 - A 70-year old man presents to the surgical out patient clinic with a...

    Incorrect

    • A 70-year old man presents to the surgical out patient clinic with a direct inguinal hernia on the right side. He had undergone and appendicectomy 6 months prior. The examining doctor correlated the development of the hernia to iatrogenic nerve injury that happened during the operation. Which nerve had been injured?

      Your Answer:

      Correct Answer: Ilioinguinal

      Explanation:

      Direct inguinal hernias occur because of weakness in the abdominal muscles. The ilioinguinal nerve is important for innervating the muscles of the lower abdominal wall and damage during appendicectomy therefore prevents the man from being able to contract abdominal muscles to pull the falx inguinalis over the weak fascia.

      The genitofemoral nerve innervates the cremaster muscle and injury to it would cause inability to elevate the testes.

      The subcostal nerve and the ventral primary ramus of T10 innervate the muscles, skin and fascia of the upper abdominal wall.

      The iliohypogastric nerve supplies the skin over the upper part of the buttock behind the area supplied by the subcostal nerve.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 15 - A 19 year old male patient exhibiting signs of shock was brought to...

    Incorrect

    • A 19 year old male patient exhibiting signs of shock was brought to the casualty after he had fallen from the 3rd floor of a building. An examination carried out revealed tenderness on the left mid-posterior axillary line and low blood pressure. Further palpation revealed a large swelling that protruded downward and medially below the left costal margin. X-rays showed that the 9th and the 10th ribs were fractured near their angles. Considering these results, which abdominal organ was likely injured by the fractured ribs.

      Your Answer:

      Correct Answer: Spleen

      Explanation:

      The spleen, left kidney, stomach, the splenic flexure of the colon and the suprarenal glands are all in the same quadrant- the left upper quadrant. However, the spleen is the most readily injured organ when there is fracture to the 10th, 11th and the 12th ribs because of its close association with these ribs. This patient exhibits a great indication of a ruptured spleen (tenderness on the left mid and posterior axillary line). The spleen is a thin capsulated organ with a spongy parenchyma, allowing it to bleed profusely in the event of injury. The liver, head of the pancreas and the duodenum are all in the right upper quadrant.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 16 - During gastrectomy, the operating surgeon ligates the short gastric arteries along the greater...

    Incorrect

    • During gastrectomy, the operating surgeon ligates the short gastric arteries along the greater curvature of the stomach. Where do the short gastric arteries branch from?

      Your Answer:

      Correct Answer: Splenic artery

      Explanation:

      Short gastric arteries arise from the splenic artery at the end or from its terminal divisions. They are about 5 or 7 in number, passing from the left to the right in between the layers of the gastrosplenic ligament to be distributed along the greater curvature of the stomach.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 17 - The pattern of drainage of the lymphatic and venous systems of the anterior...

    Incorrect

    • The pattern of drainage of the lymphatic and venous systems of the anterior abdominal wall is arranged around a horizontal plane above which drainage is in a cranial direction and below which drainage is in a caudal direction. Which horizontal plane is being referred to?

      Your Answer:

      Correct Answer: Level of the umbilicus

      Explanation:

      The umbilicus is a key landmark for the lymphatic and venous drainage of the abdominal wall. Above it, lymphatics drain into the axillary lymph nodes and the venous blood drains into the superior epigastric vein, into the internal thoracic vein. Below it, lymphatics drain into the superficial inguinal lymph nodes while venous blood drains into the inferior epigastric vein and the external iliac vein.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 18 - An abdominal aortogram of a 59 year-old female with an abdominal aortic aneurysm...

    Incorrect

    • An abdominal aortogram of a 59 year-old female with an abdominal aortic aneurysm shows occlusion of the inferior mesenteric artery. The patient, however, does not complain of any symptoms. Occlusion of the inferior mesenteric artery is rarely symptomatic because its territory is supplied by branches of the:

      Your Answer:

      Correct Answer: Middle colic artery

      Explanation:

      The transverse colon is supplied by the middle colic artery which is a branch from the superior mesenteric artery. If the inferior mesenteric artery was occluded, branches from the middle colic may go to the marginal artery which supplies the descending colon, sigmoid colon and rectum.. Ileocolic and right colic arteries also branch from the superior mesenteric artery that supply the colon but the middle colic, which serves the more distal part of the colon is the better answer. The gastroduodenal artery branches off the common hepatic artery, which supplies part of the duodenum, pancreas and stomach. The splenic artery supplies the spleen, pancreas and curvature of the stomach.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 19 - A specialist registrar was performing the bi-lateral surgical removal of the adrenal glands....

    Incorrect

    • A specialist registrar was performing the bi-lateral surgical removal of the adrenal glands. He first removed the left adrenal gland before moving on to the right one. However, the registrar noticed that the removal of the right adrenal gland would be a challenge because of an overlying structure. What was this structure that overlies the right suprarenal glad?

      Your Answer:

      Correct Answer: Inferior vena cava

      Explanation:

      The adrenal glands or the suprarenal glands are small glands that are found on top of each of the kidneys. They are retroperitoneal glands. The right adrenal gland is found on top of the right kidney and is closely associated with the inferior vena cava as it directly drains into this large vein. In the case where the right adrenal gland is to be surgically removed, the inferior vena cava might prove a problem to manoeuvre as it overlies the right suprarenal gland. The other blood vessels such as the aorta, right renal, superior mesenteric, splenic artery and the hepatic vein as well as the right crus are not closely associated with either of the suprarenal glands.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 20 - Which nerve lies immediately medial to the psoas major muscle? ...

    Incorrect

    • Which nerve lies immediately medial to the psoas major muscle?

      Your Answer:

      Correct Answer: Obturator

      Explanation:

      The obturator nerve is formed from the ventral divisions of the 2nd, 3rd and 4th lumbar nerves. It courses through the fibres of the psoas major and emerges from the medial border near the pelvic brim.

      The iliohypogastric nerve comes from the first lumbar nerve and emerges from the upper part of the lateral border of psoas major.

      The ilioinguinal nerve arises with the iliohypogastric nerve from the first lumbar nerve and also emerges from the lateral border of the psoas major muscle.

      The lateral femoral cutaneous nerve comes from the posterior division of the 2nd and 3rd lumbar nerves to emerge from the lateral border of the psoas major muscle near its middle.

      The femoral nerve also arises from the dorsal divisions, but of the 2nd, 3rd and 4th lumbar nerves and courses through the muscle fibres to emerge at the lower part of the lateral border.

      The coccygeal nerve doesn’t arise from the lumbar plexus but from the sacral plexus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 21 - Which of the following is a fact worth noting about the development of...

    Incorrect

    • Which of the following is a fact worth noting about the development of the spleen?

      Your Answer:

      Correct Answer: It develops in the dorsal mesogastrium

      Explanation:

      The spleen in the human embryo arises in week 5 of intrauterine life. It appears as a proliferating mesenchyme above the pancreas. The spleen is one the organs that develops in the dorsal mesogastrium. When the stomach changes its position during development, the spleen is made to move behind the stomach and stays in contact with the left kidney. The spleen is found within the peritoneum of the abdominal cavity thus it is an intraperitoneal organ.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 22 - A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of...

    Incorrect

    • A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of a 25 - year old male patient, accidentally jabbed and injured a vital structure that lies anterior to the left suprarenal organ. Which of the following was the structure most likely injured?

      Your Answer:

      Correct Answer: Pancreas

      Explanation:

      The adrenal (suprarenal) glands are organs of the endocrine system located on top of each of the kidneys. The left suprarenal gland, in question, is crescent in shape and slightly larger than the right suprarenal gland. It is posteriorly located to the lateral aspect of the head of the pancreas which is thus the most likely to be injured. The other organs like the duodenum, liver and the inferior vena cava are related to the right suprarenal gland. The spleen and the colon are not in close proximity with the left suprarenal gland and are not likely to be the organs injured.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 23 - During a laparoscopic inguinal hernia repair, the surgeon finds an artery in the...

    Incorrect

    • During a laparoscopic inguinal hernia repair, the surgeon finds an artery in the extraperitoneal connective tissue (preperitoneal fat) that courses vertically and just medial to the bowel as the bowel passes through the abdominal wall. Which artery is this?

      Your Answer:

      Correct Answer: Inferior epigastric

      Explanation:

      The inferior epigastric artery comes from the external iliac artery just above the inguinal ligament to curve forward in the subperitoneal tissue and then ascend obliquely along the medial margin of the deep inguinal ring. It continues to ascend between the rectus abdominis and the posterior lamella of its sheath after piercing the fascia transversalis and passing anterior to the linea semicircularis. Finally it gives off numerous branches that anastomose above the umbilicus with the superior epigastric branch of the internal mammary artery and with the lower intercostal arteries. As this artery ascends obliquely upwards from its origin it lies along the lower medial margins of the deep inguinal ring and posterior to the start of the spermatic cord. It is found in the preperitoneal fat of the abdomen lying just superficial to the peritoneum and forms the lateral umbilical fold. Hernias that pass lateral to this are indirect and medial to this, direct hernias.

      The deep circumflex artery travels along the iliac crest on the inner surface of the abdominal wall. It is very lateral to the abdominal wall and hernias would pass medial to it.

      The superficial circumflex iliac, superficial epigastric, superficial external pudendal arteries are all superficial arteries found in the superficial fascia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 24 - Point of entry of the vagal trunk into the abdomen: ...

    Incorrect

    • Point of entry of the vagal trunk into the abdomen:

      Your Answer:

      Correct Answer: Oesophageal hiatus

      Explanation:

      The oesophageal hiatus is located in the muscular part of the diaphragm a T10 and is above, in front and a little to the left of the aortic hiatus. It transmits the oesophagus, the vagus nerves and some small oesophageal arteries.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 25 - While conducting a physical examination of a patient, the GP passed a finger...

    Incorrect

    • While conducting a physical examination of a patient, the GP passed a finger down the edge of the medial crus of the superficial inguinal ring and felt a bony prominence deep to the lateral edge of the spermatic cord. What was this bony prominence?

      Your Answer:

      Correct Answer: Pubic tubercle

      Explanation:

      At the superficial inguinal ring, the pubic tubercle would be felt as a bony prominence lateral to the edge of the spermatic cord. This tubercle is the point of attachment of the inguinal ligament that makes up the floor of the inguinal canal.

      Pecten pubis is the ridge on the superior surface of the superior pubic ramus and the point of attachment of the pectineal ligament.

      The pubic symphysis is the joint between the two pubic bones and the iliopubic eminence is a bony process on the pubis found near the articulation of the pubis and the ilium.

      The iliopectineal line is formed by the arcuate line of the ilium and the pectineal line of the pubis. It is the line that marks the transition between the abdominal and pelvic cavity.

      The sacral promontory is found on the posterior wall of the pelvis and would not be felt through the inguinal ring.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 26 - A patient who has used NSAIDS for many years presents to the A&E...

    Incorrect

    • A patient who has used NSAIDS for many years presents to the A&E with symptoms of acute haemorrhagic shock. An emergency endoscopy is done that shows that a duodenal ulcer has perforated the posterior wall of the first part of the duodenum. Which artery is most likely to be the cause of the haemorrhage?

      Your Answer:

      Correct Answer: Gastroduodenal

      Explanation:

      The gastroduodenal artery is a branch of the hepatic artery and descends near the pylorus between the first part of the duodenum and the neck of the pancreas to divide at the lower border of the duodenum into the right gastroepiploic and pancreaticoduodenal arteries. Before it divides, it gives off a few branches to the pyloric end of the stomach and to the pancreas. The artery that is most likely involved in this situation is the gastroduodenal artery since it is posterior to the first part of the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 27 - During a splenectomy procedure of a 45-year old male patient with a bleeding...

    Incorrect

    • During a splenectomy procedure of a 45-year old male patient with a bleeding ruptured spleen, the surgeon decided to clamp the splenic artery near the coeliac trunk to stop the bleeding. Which of the following organ/s parts will be least affected by the clamping?

      Your Answer:

      Correct Answer: Duodenum

      Explanation:

      The duodenum is the only organ in the list that would not be affect by the clumping of the splenic artery as it is supplied by common hepatic artery (through the gastroduodenal artery) and the superior mesenteric artery (through the inferior pancreaticoduodenal artery). The splenic artery is the artery that supplies the spleen with oxygenated blood. The splenic artery before reaching the spleen also gives off branches that supply the stomach and the pancreas. The greater curvature and the fundus of the stomach is supplied the short gastric artery which branches off from the splenic artery. The left portion of the greater curvature of the stomach together with the greater omentum is supplied by the left gastro-omental artery of the splenic artery. The body and tail of the pancreas is supplied by branches of the splenic artery through the dorsal and superior pancreatic arteries and the caudal pancreatic arteries respectively.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 28 - A 39-year old female patient was diagnosed with a tumour of the left...

    Incorrect

    • A 39-year old female patient was diagnosed with a tumour of the left adrenal gland. The tumour, which is metastasizing to the adjacent tissues, has already extended to the left suprarenal vein. If the tumour is still spreading, which of the following veins will most likely be affected after the involvement of the left suprarenal vein?

      Your Answer:

      Correct Answer: Left renal vein

      Explanation:

      The suprarenal veins or also known as the veins of Warshaw, are the veins that receive blood from the suprarenal glands. These veins receive blood from the medullary venous plexus and the cortex of the adrenal glands (suprarenal glands). They are two in number – the left and the right suprarenal veins. The right suprarenal vein drains into the inferior vena cava while the left suprarenal vein drains into the left renal vein. This therefore means that in the case of a metastasizing tumour involving the left suprarenal vein, the tumour will most likely extend from the left suprarenal vein to the left renal vein into which it drains.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 29 - The superior rectal artery is a continuation of the: ...

    Incorrect

    • The superior rectal artery is a continuation of the:

      Your Answer:

      Correct Answer: Inferior mesenteric artery

      Explanation:

      The superior rectal artery or superior haemorrhoidal artery is the continuation of the inferior mesenteric artery. It descends into the pelvis between the layers of the mesentery of the sigmoid colon, crossing the left common iliac artery and vein.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 30 - A 35 year old patient presenting with haematemesis, heart burn and bloody stool...

    Incorrect

    • A 35 year old patient presenting with haematemesis, heart burn and bloody stool was diagnosed with a duodenal ulcer that had eroded the gastroduodenal artery. The patient was then rushed into theatre for an emergency procedure to control the haemorrhage. If the surgeon decided to ligate the gastroduodenal artery at its origin, which of the following arteries would most likely experience retrograde blood flow from collateral sources as a result of the ligation?

      Your Answer:

      Correct Answer: Right gastroepiploic

      Explanation:

      In the stomach and around the duodenum, there are many arterial anastomoses. Ligation of the gastroduodenal artery would result in the retrograde flow of blood from the left gastroepiploic artery to the right gastroepiploic artery. The blood flows into the right gastroepiploic artery, a branch of the gastroduodenal artery from the left gastroepiploic artery that branches from the splenic artery. This retrograde blood flow is aimed at providing alternate blood flow to the greater curvature of the stomach.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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