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  • Question 1 - A retroperitoneal structure is: ...

    Correct

    • A retroperitoneal structure is:

      Your Answer: Pancreas

      Explanation:

      Retroperitoneal structures are those that are found behind the peritoneum. They include: kidneys, suprarenal glands, bladder, ureter, inferior vena cava, rectum, oesophagus (part of it), part of the pancreas, 2nd, 3rd and 4th parts of the duodenum and ascending and descending parts of the colon.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      96
      Seconds
  • Question 2 - A patient who underwent emergency appendicectomy complains of having numbness (paraesthesia) of the...

    Correct

    • A patient who underwent emergency appendicectomy complains of having numbness (paraesthesia) of the skin at the pubic region. Which nerve was most likely injured in the operation?

      Your Answer: Iliohypogastric

      Explanation:

      The iliohypogastric nerve comes from L1 and emerges from the upper part of the lateral border of the psoas major. It then crosses obliquely in front of the quadratus lumborum to the iliac crest where it perforates the posterior part of transversus abdominis and divides between that muscle and the internal oblique into a lateral and an anterior cutaneous branch. This provides sensory innervation to the skin of the lower abdominal wall, upper hip and upper thigh.

      The genitofemoral nerve also comes from the lumbar plexus that innervates the skin of the anterior scrotum or labia majora and upper medial thigh.

      The subcostal nerve is the ventral primary ramus of T12 providing sensory innervation to the anterolateral abdominal wall in an area superior to the pubic region.

      A spinal nerve owing to their deep location would not have been injured in the procedure.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      22.2
      Seconds
  • Question 3 - Which of the deep fasciae located in the anterolateral abdominal wall form the...

    Correct

    • 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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      87.9
      Seconds
  • Question 4 - An abdominal aortogram of a 59 year-old female with an abdominal aortic aneurysm...

    Correct

    • 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: 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
      23.4
      Seconds
  • Question 5 - 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: Duodenum

      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
      69.7
      Seconds
  • Question 6 - Which muscle extends to form the cremasteric muscle? ...

    Incorrect

    • Which muscle extends to form the cremasteric muscle?

      Your Answer: Rectus abdominis muscle

      Correct Answer: Internal abdominal oblique muscle

      Explanation:

      The cremasteric muscle is a thin layer of muscle composed of several fasciculi that originate from the middle of the inguinal ligament. At its point of origin the fibres are continuous with the fibres of internal oblique and sometimes with the transversus abdominis. It then passes along the lateral side of the spermatic cord and descends with it through the superficial inguinal ring on the front and sides of the cord.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      239.1
      Seconds
  • Question 7 - A 60-year old patient having a history of cholelithiasis that led to recurrent...

    Correct

    • A 60-year old patient having a history of cholelithiasis that led to recurrent pain, bloating, nausea and vomiting, was scheduled for surgery to have the gallbladder removed. During the cholecystectomy, the registrar conducting the procedure accidentally punctured a blood vessel that lies immediately posterior to the omental foramen and blood filled the operating field. Which of the following blood vessels was likely punctured?

      Your Answer: Inferior vena cava

      Explanation:

      The omental foramen is the pathway that connects the greater peritoneal sac and the lesser peritoneal sac. The omental foramen is bordered posteriorly by the inferior vena cava. This is the blood vessel that would most likely be punctured.

      The aorta and its branch, the renal artery, lie postero-lateral to the omental foramen and are deeper than the inferior vena cava hence making them less likely to be injured.

      The hepatic portal vein, the hepatic artery and the superior mesenteric vein borders the omental foramen anteriorly and would not be injured by a jab on the posterior border of the omental foramen.

      Finally, the splenic artery is found in the splenorenal ligament that borders the omental foramen laterally to the left.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      32.2
      Seconds
  • Question 8 - A urologist makes a transverse suprapubic incision to retrieve a stone from the...

    Correct

    • A urologist makes a transverse suprapubic incision to retrieve a stone from the urinary bladder. Which of the following abdominal wall layers will the surgeon NOT traverse?

      Your Answer: Posterior rectus sheath

      Explanation:

      Pfannenstiel incision (a transverse suprapubic incision) is made below the arcuate line. Thus, there is no posterior layer of the rectus sheath here, only the transversalis fascia lines the inner layer of the rectus abdominis. The layers traversed include: skin, superficial fascia (fatty and membranous), deep fascia, anterior rectus sheath, rectus abdominis muscle, transversalis fascia, extraperitoneal connective tissue and peritoneum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      9.3
      Seconds
  • Question 9 - A nerve is injured during a surgical operation to repair an inguinal hernia....

    Correct

    • A nerve is injured during a surgical operation to repair an inguinal hernia. It passes through the superficial inguinal ring. Which nerve is it most likely to be?

      Your Answer: Ilioinguinal

      Explanation:

      The ilioinguinal nerve doesn’t pass through the deep inguinal ring but enters the inguinal canal from the side and leaves by passing through the superficial ring thus it is at risk of injury during inguinal hernia repair.

      The femoral branch of genitofemoral nerve travels lateral to the superficial inguinal ring.

      The iliohypogastric nerve and the subcostal nerve travel superior to the inguinal canal and superficial inguinal ring.

      The obturator nerve is a branch of the lumbar plexus that innervates the muscles of the thigh.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      7.8
      Seconds
  • Question 10 - You observe a procedure to harvest the left internal thoracic (mammary) artery to...

    Correct

    • 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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      6.2
      Seconds
  • Question 11 - The operating surgeon notices a structure lying alongside a herniated mass whilst repairing...

    Correct

    • 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: 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
      9.4
      Seconds
  • Question 12 - The midgut loop, also called the primary intestinal loop in a developing embryo,...

    Correct

    • The midgut loop, also called the primary intestinal loop in a developing embryo, is formed when the midgut bends around which of the following arteries?

      Your Answer: Superior mesenteric

      Explanation:

      In a developing foetus, the midgut develops to form most of the intestines. During this development process, the midgut usually bends around the superior mesenteric artery and forms what is referred to as the midgut loop.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      14.9
      Seconds
  • Question 13 - During clinic, a medical student conducts a physical examination on a teenage boy...

    Incorrect

    • During clinic, a medical student conducts a physical examination on a teenage boy with a lump in the inguinal region. The lump is protruding from the superficial inguinal ring. The student correctly concluded that it was:

      Your Answer: Definitely a direct inguinal hernia

      Correct Answer: Either a direct or an indirect inguinal hernia

      Explanation:

      It is not possible to tell if an inguinal hernia is direct or indirect just by palpating it. Despite the fact that indirect inguinal hernias commonly come out of the superficial inguinal ring to enter the scrotum, direct inguinal hernia might still do this.

      Femoral hernia goes through the femoral ring into the femoral canal (has nothing to do with the superficial inguinal ring).

      Superficial inguinal lymph nodes lie in the superficial fascia parallel to the inguinal ligament; it would therefore feel more superficial and would not be mistaken for a hernia protruding through the inguinal ring.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      69.3
      Seconds
  • Question 14 - A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which...

    Correct

    • A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which is the LEAST likely place to find the testis?

      Your Answer: Perineum

      Explanation:

      Embryologically the testes are retroperitoneal structures in the posterior abdominal wall, attached to the anterolateral abdominal wall by the gubernaculum. The gubernaculum ‘pulls’ the testes through the deep inguinal ring, inguinal canal and superficial inguinal ring and over the pelvic brim. The gubernaculum is preceded by the processus vaginalis that is derived from the peritoneum anterior to the testes. The processus vaginalis pushes the muscle and fascial layers. These eventually make up the canal and the spermatic cord, into the scrotum. The gubernaculum persists as the scrotal ligament while part of the processus vaginalis remains as a bursa-like sac i.e. the tunica vaginalis testes. The testes therefore could be caught in any one of these places along its path of descending. The testes are never in the perineum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      8.5
      Seconds
  • Question 15 - Which of the following arteries, that runs on the superior aspect of the...

    Correct

    • Which of the following arteries, that runs on the superior aspect of the first part of the duodenum, forms the lower boundary of the epiploic foramen (also known as the foramen of Winslow)?

      Your Answer: Hepatic

      Explanation:

      The epiploic foramen is an important anatomical opening that allows for the communication between the greater peritoneal sac and the lesser peritoneal sac. Its boundaries are formed; superiorly by the caudate lobe of the liver, anteriorly by the hepatoduodenal ligament (containing the components of the portal triad), inferiorly by the first part of the duodenum and posteriorly by the peritoneum covering the inferior vena cava. The superior aspect of the first part of the duodenum, which forms the inferior boundary of the foramen of Winslow, forms the course of the hepatic artery before it ascends to the porta hepatis where it divides into its right and left branches.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      17.7
      Seconds
  • Question 16 - A patient who has used NSAIDS for many years presents to the A&E...

    Correct

    • 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: 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
      7.3
      Seconds
  • Question 17 - A 30 year old gym coach presented to the surgical out patient clinic...

    Correct

    • 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: 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
      43.4
      Seconds
  • Question 18 - When conducting an exploratory laparotomy procedure of a patient diagnosed with a bleeding...

    Incorrect

    • When conducting an exploratory laparotomy procedure of a patient diagnosed with a bleeding ulcer of the lesser curvature of the stomach, which artery in this patient are you most likely to ligate to control the bleeding?

      Your Answer: Right gastroepiploic

      Correct Answer: Left gastric

      Explanation:

      The lesser curvature of the stomach is supplied by the left gastric artery along with the right gastric artery. These two arteries are the ones to most likely be ligated if bleeding was to be stopped at the lesser curvature of the stomach. The splenic artery branches from the celiac branch and supplies the spleen. The left gastro-omental, the right and left gastroepiploic arteries supply the greater curvature.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      48.2
      Seconds
  • Question 19 - Which is the correct statement regarding gonadal venous drainage: ...

    Correct

    • Which is the correct statement regarding gonadal venous drainage:

      Your Answer: The left ovarian vein drains into the left renal vein

      Explanation:

      Spermatic or testicular veins arise from the posterior aspect of the testis and receive tributaries from the epididymis. Upon uniting, they form the pampiniform plexus that makes up the greater mass of the spermatic cord. The vessels that make up this plexus rise up the spermatic cord in front of the ductus deferens. They then unite, below the superficial ring, to form three or four veins that traverse the inguinal canal and enter the abdomen through the deep inguinal ring. They further unite to form 2 veins that ascend up the psoas major muscle behind the peritoneum each lying on either side of the testicular artery. These further unite to form one vein that empties on the right side of the inferior vena cava at an acute angle and on the left side into the renal vein, at a right angle. The left testicular vein courses behind the iliac colon and is thus exposed to pressure from the contents of this part of the bowel. The ovarian vein is the equivalent of the testicular vein in women. They form a plexus in the broad ligament near the ovary and uterine tube and communicate with the uterine plexus. They drain into similar vessels as in a man.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      72.1
      Seconds
  • Question 20 - During a laparoscopic inguinal hernia repair, the surgeon finds an artery in the...

    Correct

    • 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: 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
      138.8
      Seconds
  • Question 21 - Which is the CORRECT statement regarding the small intestine: ...

    Incorrect

    • Which is the CORRECT statement regarding the small intestine:

      Your Answer: Peyer’s patches are more prominent in the proximal jejunum than the distal ileum

      Correct 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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      30.3
      Seconds
  • Question 22 - A specialist registrar was performing the bi-lateral surgical removal of the adrenal glands....

    Correct

    • 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: 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
      41.5
      Seconds
  • Question 23 - A medical officer was shown an X ray with barium contrast and was...

    Correct

    • 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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      43
      Seconds
  • Question 24 - The specialist registrar, while performing the repair of an infrarenal abdominal aortic aneurysm,...

    Incorrect

    • 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: Arcade

      Correct 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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      36.4
      Seconds
  • Question 25 - Which of the following is a large artery that runs immediately posterior to...

    Correct

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

      Your 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
      25.3
      Seconds
  • Question 26 - During an exploratory laparotomy a herniation of bowel is identified between the lateral...

    Incorrect

    • During an exploratory laparotomy a herniation of bowel is identified between the lateral edge of the rectus abdominis, the inguinal ligament and the inferior epigastric vessels. These boundaries define the hernia as being a:

      Your Answer: Indirect inguinal hernia

      Correct Answer: Direct inguinal hernia

      Explanation:

      The boundaries given define the inguinal triangle which is the site for direct inguinal hernias. Indirect inguinal hernias occur lateral to the inferior epigastric vessels.

      Femoral hernias protrude through the femoral ring, into the femoral canal.

      Umbilical hernias protrude through a defect in the umbilical area.

      Obturator hernias, occur through the obturator foramen. These are very rare.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      35.4
      Seconds
  • Question 27 - 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
      0
      Seconds
  • Question 28 - The Brunner glands secrete an alkaline product that helps maintain an optimal pH...

    Incorrect

    • The Brunner glands secrete an alkaline product that helps maintain an optimal pH for pancreatic enzyme activity. Where are these glands located?

      Your Answer:

      Correct Answer: Submucosa of the duodeneum

      Explanation:

      The Brunner glands are located in the submucosa of the duodenum. These glands are connected to the interstitial lumen by ducts that open into certain crypts. They secrete an alkaline product that protects the duodenal mucosa from the acidic chyme and helps achieve an optimal pH for the enzymes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 29 - A 20 year old is brought to the A&E after he fell from...

    Incorrect

    • A 20 year old is brought to the A&E after he fell from a moving cart. The boy has sustained blunt abdominal injury, and the there is a possibility of internal bleeding as the boy is in shock. An urgent exploratory laparotomy is done in the A&E theatre. On opening the peritoneal cavity, the operating surgeon notices a torn gastrosplenic ligament with a large clot around the spleen. Which artery is most likely to have been injured in this case?

      Your Answer:

      Correct Answer: Short gastric

      Explanation:

      The short gastric arteries branch from the splenic artery near the splenic hilum to travel back in the gastrosplenic ligament to supply the fundus of the stomach. Therefore, these may be injured in this case.

      The splenic artery courses deep to the stomach to reach the hilum of the spleen. It doesn’t travel in the gastrosplenic ligament although it does give off branches that do.

      The middle colic artery is a branch of the superior mesenteric artery that supplies the transverse colon.

      Gastroepiploic artery is the largest branch of the splenic artery that courses between the layers of the greater omentum to anastomose with the right gastroepiploic.

      Left gastric artery, a branch of the coeliac trunk. It supplies the left half of the lesser curvature.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 30 - 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
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