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Question 1
Incorrect
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A surgeon ligates the left superior suprarenal artery whilst preforming a left adrenalectomy. Where does the left superior suprarenal artery originate?
Your Answer: Renal artery
Correct Answer: Left inferior phrenic artery
Explanation:The superior suprarenal arteries arises from the inferior phrenic artery on either side.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 2
Correct
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Which is the CORRECT statement regarding the small intestine:
Your Answer: The superior mesenteric artery courses between the body and uncinate process of the pancreas before the artery supplies the jejunum and ileum
Explanation:The small intestine extends from the pylorus to the ileocecal valve where It ends in the large intestine. It is surrounded on the sides and above by the large intestine. It is related anteriorly with the greater omentum and abdominal wall. Is connected to the vertebral column by a fold of peritoneum or otherwise known as the mesentery. Is divided into three portions: the duodenum, jejunum and ileum. The jejunum and ileum are supplied by the superior mesenteric artery that courses between the body and uncinate process of the pancreas before it gives off intestinal branches.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 3
Correct
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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: 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.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 4
Correct
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A 20 year lady is brought to the A&E following a road accident. She is hypotensive and a CT scan of the abdomen reveals a shattered spleen. An emergency splenectomy is performed where the splenic artery is ligated right at its origin. Which of the following arteries will have a diminished blood flow owing to ligation of the splenic artery at its origin?
Your Answer: Left gastroepiploic
Explanation:Ligation of the splenic artery right at its point of origin should cut off blood flow in its branches. The following are the branches of the splenic artery: pancreatic branches, short gastric branches and left gastroepiploic arteries.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 5
Correct
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The specialist registrar, while performing the repair of an infrarenal abdominal aortic aneurysm, decides not to re-implant the inferior mesenteric artery into the repaired abdominal aorta. She says that an anastomotic artery running along the border of the large intestine is good enough to supply blood to the territory of the inferior mesenteric artery. Which vessel is she referring to?
Your Answer: Marginal
Explanation:The marginal artery is a key anastomosis for the large intestine that runs around the border of the large intestine and is formed by the anastomosis of the branches of the ileocolic artery, right colic artery, middle colic artery, left colic artery and sigmoid artery. If a small artery is occluded, these branches allow blood to reach all segments of the colon.
The arcades are anastomotic loops between the arteries that provide alternative pathways for blood flow. They are more prominent in the small intestine than the large intestine.
Arteriae rectae are small branches that run from the marginal artery to reach the colon.
The ileocolic artery is the branch of the superior mesenteric artery that supplies the caecum, appendix and terminal part of the ileum.
The coronary arteries supply blood to the heart.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 6
Correct
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Where does the ejaculatory duct open into?
Your Answer: Prostatic urethra
Explanation:There are two ejaculatory ducts, one on either side of the midline. Each ejaculatory duct is formed by the union of the duct from the seminal vesicles with the ductus deferens. They start at the base of the prostate and run forward and downward between the middle and lateral lobes and along the side of the prostatic utricle to end in the prostatic urethra.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 7
Correct
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Which of the deep fasciae located in the anterolateral abdominal wall form the inguinal ligament?
Your Answer: External abdominal oblique aponeurosis
Explanation:The inguinal ligament is the inferior border of the aponeurosis of the external oblique abdominis and extends from the anterior superior iliac spine to the pubic tubercle from whence it is reflected backward and laterally to attach to the pectineal line and form the lacunar ligament.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 8
Correct
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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: 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.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 9
Correct
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A medical officer was shown an X ray with barium contrast and was asked to distinguish the small from the large bowel. Which of the following features listed is CORRECT?
Your Answer: Circular folds of the mucosa
Explanation:Distinguishing features include:
1. Three strips of longitudinal muscle-taenia coli- on the wall instead of a continuous surrounding longitudinal muscle that is seen in the small intestine
2. The colon has bulges called haustra that are not on the small bowel.
3. The surface of the colon is covered with fatty omental appendages. Both the colon and the small intestine have similar circular smooth muscle layer, serosa. Peyer’s patches are lymphoid tissues that are not visible on X ray with barium contrast.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 10
Correct
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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: 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.
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This question is part of the following fields:
- Abdomen
- Anatomy
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