ABDOMEN

:The following statements concerning the liver are true except .1

a) The quadrate lobe drains into the right hepatic duct
b) The lesser omentum suspends the stomach from the visceral
surface of the liver
c) The left triangular ligament of the liver lies anterior to the abdominal part of
the esophagus
d) The attachment of the hepatic veins to the inferior vena cava is one of the
most important supports of the liver
e) The ligamentum venosum is attached to the left branch of the portal vein in
the porta hepatis

:The following statements concerning the pancreas are true except .2

a) The pancreas receives part of its arterial supply from the splenic
artery
b) The main pancreatic duct opens into the third part of the duodenum
c) The uncinate process of the pancreas projects from the head of the pancreas
d) The bile duct (common bile duct) lies posterior to the head of the pancreas
e) The transverse mesocolon is attached to the anterior border of the pancreas

The following statements concerning the ileum are true except: .3

a) The circular smooth muscle of the lower end of the ileum serves as a
sphincter at the junction of the ileum and cecum
b) The branches of the superior mesenteric artery serving the ileum form more
arcades than those serving the jejunum
c) Peyer's patches are present in the mucous membrane of the lower ileum
along the antimesenteric border
d) The plicae circulares are more prominent at the distal end of the ileum than
in the jejunum
e) The parasympathetic innervation of the ileum is from the vagus nerve

The hilum of the right kidney contains the following important structures, .4
:except the
a) Renal Pelvis
b) Tributaries of the renal vein
c) Sympathetic nerve fibres
d) Part of the right suprarenal gland
e) Branches of the renal artery

The following statements concerning the left suprarenal gland are incorrect .5
:except
a) It extends behind the inferior vena cava
b) It is separated from the left kidney by the pararenal fat
c) Its vein drains into the left renal vein
d) It is usually located on the upper pole and lateral border of the left kidney
e) The medulla is innervated by postganglionic sympathetic nerve fibres
:The following statements concerning the abdominal aorta are true except .6
a) It bifurcates into the two common iliac arteries in front of the fourth lumbar
vertebra
b) It lies on the right side of the inferior vena cava
c) From its anterior surface arise the celiac, superior mesenteric and inferior
mesenteric arteries
d) It enters the abdomen in front of the twelfth thoracic vertebra
e) The thoracic duct leaves the abdomen through the aortic opening of the
diaphragm on the right side of the aorta

The following statements concerning the abdominal part of the sympathetic .7

:trunk are NOT TRUE except
a) It enters the abdomen behind the lateral arcuate ligament
b) The trunk possesses six segmentally arranged ganglia
c) All the ganglia receive white rami communicantes
d) Gray rami communicantes are given off to the lumbar spinal nerves
e) The splanchnic nerves from the thorax join the trunks below the diaphragm

:The following statements concerning the lumbar plexus are true except .8
a) The plexus lies within the psoas muscle
b) The plexus is formed from the posterior rami of the upper four lumbar
nerves
c) The femoral nerve emerges from the lateral border of the psoas muscle
d) The obturator nerve emerges from the medial border of the psoas muscle
e) The iliohypogastric nerve emerges from the lateral border of the psoas
muscle

:The following veins form important portal-systemic anastamoses, except the .9

a) Esophageal branches of the left gastric vein and tributaries of the azygos
vein
b) Superior rectal vein and the inferior vena cava
c) Paraumbilical vein and the superficial veins of the anterior abdominal wall
d) Veins of the ascending and descending parts of the colon with the lumbar
veins
e) Veins from the bare areas of the liver with the phrenic veins

:The following statements concerning the ureters are true except .10
a) Both have three anatomic sites that are constricted
b) Both receive their blood supply from the testicular or ovarian arteries
c) Both are separated from the transverse processes of the lumbar vertebrae by
the psoas muscle
d) Both pass anterior to the testicular or ovarian vessels
e) Both lie anterior to the sacroiliac joints

Concerning the inferior mesenteric artery, all of the following statements are .11
:true except
a) Its colic branch supplies the descending colon
b) It gives off the inferior pancreaticoduodenal artery
c) It supplies the sigmoid colon
d) Its branches contribute to the marginal artery
e) It arises from the aorta immediately below the third part of the duodenum
?Which of the following structures is NOT present within the lesser omentum .12
a) Portal vein
b) Bile duct
c) Inferior Vena Cava
d) Hepatic artery
e) Lymph Nodes

:The following statements concerning the liver are true except .13
a) Its lymph drainage is to the celiac nodes
b) The quadrate and the caudate lobes are functionally part of
the left lobe
c) Its parasympathetic innervation is from the vagus nerve
d) It receives highly oxygenated blood from the portal vein
e) The triangular ligaments connect the liver to the diaphragm

The following differences exist between the ileum and the ascending colon .14
:except
a) The ascending colon has appendices epiploicae, whereas the ileum
does not
b) The arterial supply to the wall of the ileum is arranged so that it produces
areas of weakness through which mucosal herniations may occur
c) The ascending colon may have a well-developed marginal artery, whereas
the ileum does not
d) The ileum has a longitudinal muscle that forms a continuous layer around
the wall, whereas the ascending colon has tenia coli
e) The ascending colon is retroperitoneal, whereas the ileum is intraperitoneal

Which of the following statements is (are) correct regarding the duodenum? .15
a) The duodenum receives its entire blood supply from the superior mesenteric
artery
b) The first part of the duodenum is completely retroperitoneal
c) The bile duct enters the second (vertical) portion of the duodenum
d) The lymph from the fourth part of the duodenum drains into the celiac
nodes
e) The tip of the appendix cannot reach down into the pelvic cavity

:The following statements concerning the appendix are correct except .16
a) The appendix is situated in the right iliac region
b) At the base of the appendix, the teniae coli of the cecum fuse to form a
complete, longitudinal muscle layer in the wall of the appendix
c) Afferent pain nerve fibers accompany the sympathetic nerves and enter the
spinal cord at the level of the tenth thoracic segment
d) The appendix receives its blood supply from a branch of the posterior cecal
artery
e) The tip of the appendix cannot reach down into the pelvic cavity

:The following statements concerning the pyloric sphincter are correct except .17
a) It receives its motor innervation from the sympathetic autonomic nerves
b) It lies on the level of the third lumbar vertebrae
c) It is inhibited by the impulses passing down the vagus nerve
d) It is formed by a thickening of the circular layer of smooth muscle in the
stomach wall
e) The cavity of the pylorus is called the pyloric canal
The following structures form the boundaries of the entrance into the lesser .18
:sac (epiploic foramen) except
a) The inferior vena cava
b) The bile duct
c) The portal vein
d) The quadrate lobe of liver
e) The first part of the duodenum

After complete occlusion of the origin of the inferior mesenteric artery with a .19
blood clot, the blood supply of the left portion of the colon is maintained by the
:following arteries except
a) The marginal artery (of Drummond)
b) The middle colic artery
c) The left lumbar arteries
d) Anastomoses between the superior, the middle and the inferior
hemorrhoidal arteries
e) The sigmoid arteries

: The following statements concerning the gall bladder are correct except .20
a) The arterial supply is from the cystic artery, which is a branch of the right
hepatic artery
b) The fundus of the gallbladder is located just beneath the tip of the right
ninth costal cartilage
c) The peritoneum completely surrounds the fundus, the body and the neck
d) The nerves of the gallbladder are derived from the celiac plexus
e) Pain sensation from gallbladder disease may be referred along the phrenic
and supraclavicular nerves to the skin over the shoulder

In patients with an obstruction of the superior vena cava, blood may return .21
:to the right atrium through the following anastomotic channels except
a) The lateral thoracic, the lumbar, and the superficial epigastric veins
b) The superior and the inferior epigastric veins
c) The lateral thoracic, the paraumbilical and the portal veins
d) The posterior intercostal and the lumbar veins
e) The lateral thoracic and the superior epigastric veins

Which of the following structures may be eroded by a perforating gastric .22

?ulcer on the posterior wall of the stomach
a) The inferior mesenteric artery
b) The splenic artery
c) The right kidney
d) The second part of the duodenum
e) The quadrate lobe of the liver

?Which of the following statements regarding the left ureter is correct .23
a) It has the inferior mesenteric vein lying on its lateral side
b) Its lumen is constricted at the point where it crosses the brim of the pelvis
c) Its entire arterial supply is derived from the left renal artery
d) It lies in direct contact with the tips of the transverse processes of the
lumbar vertebrae
e) It lies within the peritoneal cavity
The following structures are connected to the liver. Which structures provide .24
?the greatest support for the liver
a) The falciform ligament
b) The coronary ligament
c) The ligamentum teres
d) The hepatic veins joining the inferior vena cava
e) The ligamentum venosum

A gallstone has eroded through the posterior wall of the gallbladder and .25
entered the intestinal tract. Which part of the intestinal tract is likely to initially
?contain the stone
a) The sigmoid colon
b) The descending colon
c) The transverse colon
d) The ascending colon
e) The jejunum

Which of the following statements regarding the superficial inguinal ring is .26
?incorrect
a) It is a perforation in the aponeurosis of the external oblique muscle
b) Its greatest width lies above and medial to the pubic tubercle
c) It is strengthened posteriorly by the conjoint tendon
d) The internal spermatic fascia is attached to its margins
e) In males, it allows passage of the spermatic cord and the ilioinguinal nerve

A surgeon decides to divide the anterior vagal trunk (vagotomy) as it lies on .27
the anterior surface the abdominal part of the esophagus as therapy for a
chronic gastric ulcer not responding to medical treatment. Which of the
?following is likely to result from this procedure
a) A loss of secretomotor nerve supply to the mucosal glands of the stomach
b) Hoarse voice because of paralysis of the intrinsic muscles of the larynx on
the left side
c) Increased heart rate because of decreased parasympathetic input to the
cardiac plexus
d) Incontinence because of an absence of parasympathetic input to the bladder
e) Compromised input into the greater splanchnic nerves

:The skin of the umbilicus receives its sensory innervation from .28
a) T7
b) T12
c) L1
d) T10
e) L2

:In both sexes, the inguinal canal is formed by .29

a) The descent of the gonad
b) The contraction of the gubernaculum
c) The processus vaginalis
d) The ilioinguinal nerve
e) The contraction of the cremaster muscle
:The lacunar ligament .30
a) Formed from the conjoint tendon
b) Part of the posterior wall of the rectus sheath
c) Not continuous with the inguinal ligament
d) An important medial relation to the femoral ring of the femoral sheath
e) Attached to the inferior ramus of the pubis

The following statements concerning the superficial fascia of the anterior .31
:abdominal wall are true except
a) It has a superficial fatty layer and a deep membranous layer
b) Scarpa's fascia fuses with the fascia lata just below the inguinal ligament
c) Camper's fascia is continuous with the Colles' fascia in the perineum
d) It is continuous with the dartos muscle in the wall of the scrotum
e) It does not contribute to the femoral sheath

:The rectus sheath contains the following structure except .32

a) The pyramidalis muscle (when present)
b) The ligamentum teres
c) The inferior epigastric artery
d) The T7-12 anterior rami
e) The rectus abdominis muscle

:The following statements concerning the epididymis are correct except .33
a) It lies within the scrotum and posterior to the testis
b) It has an expanded upper end called the head
c) The tail gives rise to the vas deferens
d) It is supplied by the testicular artery
e) Its lymph drains into the superficial inguinal nodes

The jejunum and ileum can be differentiated on the basis of the following .34
:anatomic features except
a) Numerous (4-5) arterial arcades are associated with the jejunum
b) The plicae circulares are much more prominent in the jejunum than in the
ileum
c) Fat depositions are generally present throughout the mesentery associated
with the ileum
d) The jejunum is located in the upper left region of the abdominal cavity
e) Peyer's patches are characteristic of the lower ileum and may be visible on
the surface

:The spermatic cord contains the following structures except .35

a) The scrotal arteries and veins
b) The vas deferens
c) The pampiniform plexus
d) The testicular artery
e) Autonomic nerves

The following structures pass through the esophageal hiatus in the .36
:diaphragm except
a) The left vagus nerve
b) Branches of the left gastric artery
c) The left phrenic nerve
d) The right vagus nerve
e) A tributary of the portal vein
:The following statements regarding the peritoneum are incorrect except .37
a) The parietal peritoneum is only sensitive to stretch
b) The parietal peritoneum lining the anterior abdominal wall is innervated by
the lower six thoracic and the first lumbar spinal nerves
c) The visceral peritoneum is innervated by the posterior primary rami of the
twelfth thoracic and the lumbar spinal nerves
d) The visceral peritoneum is sensitive to pain, temperature and touch
e) The peritoneum lining the lesser sac has no nerve supply

If the portal vein becomes blocked, the following venous anastomoses are .38
:important in uniting the portal with the systemic venous systems except
a) Esophageal branches of the left gastric and the azygos veins
b) Veins of the ligamentum teres and the paraumbilical veins
c) The superior and the inferior rectal veins
d) The right colic veins and the lumbar veins
e) The middle and the inferior rectal veins

In a patient with cancer of the stomach who requires a total gastrectomy, the .39
:following arteries must be ligated except
a) The common hepatic artery
b) The short gastric arteries
c) The left and right gastroepiploic arteries
d) The right gastric artery
e) The left gastric artery

When performing a midline abdominal paracentesis (tapping the abdominal .40

cavity) below the umbilicus, the cannula will pass through the following
:anatomic structures except
a) The skin and the fascia
b) The linea alba
c) The transversalis fascia and extraperitoneal fat
d) The rectus abdominis muscle
e) The parietal peritoneum

:The following statements are correct regarding and inguinal hernia except .41
a) The inferior epigastric artery lies medial to the neck of an indirect inguinal
hernia
b) An inguinal hernia is more common than a femoral hernia in females
c) A direct inguinal hernia is more common in elderly men than in boys
d) The opening of the sac of a direct inguinal hernia is wide
e) The contents of an indirect inguinal hernia may be strangulated against the
lacunar ligament

:The following statements regarding the portal vein are true except .42
a) It courses through a portion of the lesser omentum
b) It enters the liver at the porta hepatis
c) It receives venous blood from both the large and small intestines
d) It originates at the junction of the superior mesenteric and the splenic veins
e) It passes in front of the neck of the pancreas
If the common hepatic artery is unavoidably ligated during surgery, the .43
arterial supply to the liver is maintained by the following anastomic connections
:except
a) The superior pancreaticoduodenal artery anastomosing with the inferior
pancreaticduodenal artery
b) The right gastric artery anastomosing with the left gastric artery
c) The gastroduodenal artery anastomosing with the splenic artery
d) The esophageal arteries anastomosing with the inferior phrenic arteries
e) The right gastroepiploic artery anastomosing with left gastroepiploic artery

:The following general statements are incorrect except .44

a) The superior and inferior epigastric vessels anastomose on the anterior
surface of the rectus abdominis muscle
b) The inguinal ligament is attached laterally to the anterior inferior iliac spine
c) The abdominal aorta bifurcates below, in front of the fourth lumbar
vertebrae
d) The foregut ends in the third (inferior) segment of the duodenum
e) The umbilicus is located approximately at the vertebral level L5

:The following veins drain directly into the inferior vena cava except .45
a) The hepatic veins
b) The renal veins
c) The lumbar veins
d) The inferior mesenteric vein
e) The right testicular (ovarian) vein

To tap a hydrocele (collection of fluid in the tunica vaginalis) a cannula must .46
:pierce the following structures except
a) The skin
b) The fatty subcutaneous tissue (fascia of Camper)
c) Dartos muscle
d) The cremasteric fascia
e) The external and the internal spermatic fasciae

:Which of the following arteries supplies the suprarenal (adrenal) gland .47
a) The aorta
b) The lumbar arteries
c) The superior phrenic artery
d) The testicular (ovarian) artery
e) The subcostal artery

:The following structures are present in the porta hepatic except .48
a) Lymph nodes
b) The right and left branches of the portal vein
c) The right and left hepatic ducts
d) The right and left hepatic veins
e) The right and left branches of the hepatic artery
: The following statements regarding the celiac plexus are true except .49
a) The celiac plexus is not a purely sympathetic plexus
b) The celiac plexus does not surround the celiac artery
c) The celiac ganglia are made of nerve cell bodies and nerve fibers
d) Parasympathetic preganglionic fibers pass through the plexus, generally
synapsing with postganglionic neurons within the walls of the organs they
innervate
e) Sympathetic preganglionic fibers to the celiac plexus originate from the
thoracic spinal segments and travel in thoracic splanchnic nerves

:The right kidney has the following important relationships except .50
a) It is related to the neck of the pancreas
b) It is anterior to the right costodiaphragmatic recess
c) It is related to the second part of the duodenum
d) It is related to the right colic flexure
e) It is anterior to the right twelfth rib

The following structures form the walls of the inguinal canal except the: .51
a) Conjoint tendon
b) Aponeurosis of external oblique muscles
c) Internal oblique muscle
d) Lacunar ligament
e) Fascia transversalis

The following structures and events serve to strengthen the walls of the .52
:inguinal canal except
a) The inguinal ligament is made tense by extending the hip joint
b) The contracting internal oblique muscle reinforces the anterior wall of the
the canal in front of the weak deep inguinal ring
c) The strong conjoint tendon reinforces the posterior wall of the canal behind
the weak superficial inguinal ring
d) Contraction of the arching fibres of the internal oblique and transverse
abdominis muscles lowers the roof of the canal so that the canal is
practically obliterated
e) After birth, as the result of growth, the deep inguinal ring moves laterally
away from the superficial ring so that the canal becomes oblique and the
two rings no longer lie opposite one another

In the female, the inguinal canal contains the following structures except the: .53
a) Ilioinguinal nerve
b) Remnant of the processus vaginalis
c) Round ligament of the uterus
d) Inferior epigastric artery
e) Lymph vessels from the fundus of the uterus

:All of the following structures concerning the spermatic cord are true except .54
a) It extends from the deep inguinal ring to the scrotum
b) It contains the testicular artery
c) It is covered by five layers of spermatic fascia
d) It contains the pampiniform plexus
e) It contains lymph vessels that drain the testis
All the following structures are present in the inguinal canal in the male .55
:except
a) Internal spermatic fascia
b) Genital branch of the genitofemoral nerve
c) Testicular vessels
d) Deep circumflex iliac artery
e) Ilioinguinal nerve

All of the following statements concerning the conjoint tendon are true .56
:except
a) It is attached to the pubic crest and the pectineal line
b) It is formed by the fusion of the aponeuroses of the transverses abdominis
and internal oblique muscles
c) It is attached medially to the linea alba
d) It is continuous with the inguinal ligament
e) It may bulge forward in a direct inguinal hernia

All of the following statements concerning the an indirect inguinal hernia are .57
:true except
a) It is the most common form of abdominal hernia
b) The neck of the hernial sac lies medial to the inferior epigastric artery
c) The sac is the remains of the processus vaginalis
d) The hernial sac can extend into the scrotum
e) At the superficial inguinal ring, the hernial sac lies above and medial to the
pubic tubercle

To pass a needle into the cavity of the tunica vaginalis in the scrotum, the .58
:following structures have to be pierced except
a) Skin
b) Dartos muscle and Colles' fascia
c) Tunica albuginea
d) Internal spermatic fascia
e) Cremasteric fascia

The following statements are true about muscles forming the posterior .59
:abdominal wall except
a) The psoas major muscle has a fascial sheath that extends down into the
thigh as far as the lesser trochanter of the femur
b) The quadratus lumborum is covered anteriorly by fascia that forms the
lateral arcuate ligament
c) The iliacus muscles is innervated by the femoral nerve
d) The transverses abdominis muscles does form part of the posterior
abdominal wall
e) The diaphragm does not contribute to the musculature on the posterior
abdominal wall

Regarding hernias in the inguinal region .60

a) The sac of an indirect hernia lies posterior to the spermatic cord
b) The sac of a direct hernia lies lateral to the internal ring
c) The sac of a direct hernia lies medial to the inferior epigastric vessels
d) The sac of a direct inguinal hernia usually comes down to the scrotum
e) The sac of the femoral hernia has a wide neck
The borders of Hesselbech's trangle include the epigastric vessels, the edge of .61
:the rectus sheath and
a) Poupart''s ligament (the reflected inguinal ligament)
b) The internal oblique aponeurosis
c) The external oblique aponeurosis
d) Transversalis fascia
e) The conjoint tendon

:The only statement regarding the small bowel which is true is .62
a) The entire small bowel is intra-peritoneal
b) The jejunum is longer in length, large in diameter, and thinner-walled than
the ileum
c) The muscularis, the muscle layer, provides the strength for the
placement of sutures or staples for surgical anastomoses
d) Peyer's patches are most prominent in the distal ileum
e) The marginal artery of Drummond provides the blood supply to the
duodenum

The following layers are encountered in a paramedian surgical incision (an .63
:incision lateral to midline) from above downwards
a) The skin, subcutaneous fat, deep fascia, rectus muscle and peritoneum
b) The skin, superficial fascia, subcutaneous fat, anterior rectus sheath, rectus
muscle and peritoneum
c) The skin, subcutaneous fat, anterior rectus sheath, rectus muscle, posterior
rectus sheath and peritoneum
d) The skin, subcutaneous fat, extraperitoneal fat, anterior rectus sheath and
muscle
e) The skin, subcuataneous fat, anterior rectus sheath, peritoneum and
posterior rectus sheath

:The appendix .64

a) Arises from the posteromedial aspect of the caecum below the ileoceccal
valve
b) Has an extremely variable position
c) Is supplied by a branch from the right colic artery
d) Is devoid of lymph nodes
e) Is removed surgically through akocher incision

:The following are correct regarding the gall-bladder except .65

a) The Hartmann's pouch lies close to the fundus
b) The cystic artery will be found in Calot's triangle in the majority of cases
c) The cystic artery has no accompanying vein
d) Bleeding during surgery can be controlled by compressing the hepatic
artery
e) Cholecystectomy can be done through a right paramedian incision

Below the arcuate line, which of the following structures lies posterior to the .66
?rectus muscle
a) Linea alba
b) Aponeurosis of transverses abdominis
c) Aponeurosis of internal oblique
d) Transversalis fascia
e) Aponeurosis of external oblique
Which of the following structures of the spermatic cord is derived from the .67
?internal oblique muscle
a) Internal spermatic fascia
b) External spermatic fascia
c) Cremaster muscle
d) Dartos muscle
e) Vas deferens

Which of the following organs does not receive its blood supply from the .68
?celiac trunk
a) Liver
b) Stomach
c) Spleen
d) Jejunum
e) Gall bladder

:The common bile duct and the main pancreatic duct empty into the .69
a) First part of the duodenum
b) Second part of the duodenum
c) Third part of the duodenum
d) Gall bladder
e) Vermiform appendix

?Which of the following organs is retroperitoneal .70

a) Spleen
b) Stomach
c) Jejunum
d) Pancreas
e) Transverse colon

?Which of the following is not a symptom of portal vein hypertension .71

a) Esophageal bleeding
b) Hemorrhoids
c) Caput medusae
d) Indirect inguinal hernia
e) Engorged veins of the posterior abdominal wall

What structure passes behind the medial arcuate ligament of the abdominal .72
:diaphragm
a) The aorta
b) The esophagus
c) The psoas major muscle
d) The quadratus lumborum muscle
e) The inferior vena cava

?Which of the following is not a branch of the superior mesenteric artery .73
a) Right colic artery
b) Left colic artery
c) Middle colic artery
d) Iliocolic artery
e) Inferior pancreaticoduodenul artery
?Which of the following is not characteristic of the large intestine .74
a) Taenia coli
b) Haustra
c) Appendices epiploicae
d) Vermiform appendix
e) Epiploic foramen

?Which of the following statements about the liver is false .75

a) Its blood supply normally comes from the celiac trunk
b) It is the largest gland in the body
c) It has four lobes right, left, quadrate and caudate
d) It is connected to the stomach by the lesser omentum
e) Its venous drainage is via the portal vein

Which of the following is false about the normal pattern of arterial blood .76
:supply to the stomach
a) Lesser curvature/ Right gastric artery
b) Pylorus/ Left gastric artery
c) Greater curvature/ left gastroepiploic artery
d) Greater curvature/ right gastroepiploic artery
e) Fundus/ Short gastric arteries

:The area around the umbilicus receives sensory innervation from the .77
a) Superficial epigastric arteries
b) Anterior branch of the ventral ramus of the spinal nerve T10
c) Subcostal nerve
d) Splanchnic nerve
e) Vagus

Inferior the arcuate line, which of the following structures lies posterior to .78
?the rectus muscle
a) Aponeurosis of external oblique
b) Aponeurosis of internal oblique
c) Aponeurosis of internal oblique and tranversus abdominis
d) Internal oblique fascia
e) Transversalis fascia, peritoneum

Which layer of the spermatic cord is derived from the internal oblique .79
?muscle of the abdominal wall
a) External spermatic fascia
b) Cremaster muscle
c) Internal spermatic fascia
d) Tunica vaginalis
e) Tunica albuginea

?Which of the following statements about indirect inguinal hernia is false .80
a) They enter the abdominal wall lateral to the inferior epigastric artery
b) They are more common in the males than in females
c) They follow the path of the inguinal canal
d) They often result from a patent processus vaginalis
e) They involve and outpouching of gut below the inguinal ligament
81. Which of the following is not a site of portal systemic anastomosis?
a) Lower part of esophagus
b) Umbilicus
c) Rectum
d) Greater curvature of the stomach
e) Posterior abdominal wall

:The conjoint tendon (falx ingunalis) is formed by the .82

a) Transverse abdominis muscle or its aponeurosis
b) Internal abdominal oblique muscle or its aponeurosis
c) Both A and B
d) Neither A nor B

?Which of the following supply the lesser curvature of the stomach .83
a) Left gastric artery
b) Right gastric artery
c) Short gastric arteries
d) All of the above
e) Both A and B

Which of the following is not involved in arterial blood supply to the anterior .84
?abdominal wall
a) Superior epigastric artery
b) Intercostal arteries
c) Deep circumflex iliac artery
d) Musculophrenic artery
e) Inferior epigastric artery

:The external oblique muscle .85

a) Inserts on the internal surfaces of the seventh through twelfth costal
cartilages
b) Makes up the entire rectus sheath inferior to the umbilicus
c) Originates on the pubic symphysis and pubic crest
d) Extends the trunk
e) Is innervated by the inferior six thoracic spinal nerves (intercostals nerves
)and subcostal nerves

?Which of the following is the obliterated umbilical vein .86

a) Ligamentum venosum
b) Ligamentum teres
c) Median umbilical ligament
d) Lateral umbilical ligament
e) Falciform ligament

:The hepatic hilum consists of .87

a) Hepatic duct
b) Branches of the portal vein
c) The hepatic artery
d) The hepatic vein, cystic duct and main pancreatic duct
e) The portal vein, hepatic artery and common hepatic duct
 :The abdominal aorta .88
a) Is surrounded by the central portion of the diaphragm
b) Is surrounded by plexus of autonomic nerve fibers
c) Both A and B
d) Neither A nor B

:Position of the deep inguinal ring relative to the inferior epigastric vessels is .89
a) Medial
b) Lateral
c) Posterior
d) Anterior
e) Superior

:Regarding the pancreas .90

a) Exocrine secretions are released into the interstitial spaces
b) The pancreas is invested by a prominent and distinct connective tissue
capsule
c) The pancreas is retroperitoneal except for the tail which is intraperitoneal
d) Centroaciner cells appear acidophilic when stained by routine hematoylin
and eosin methods due to the high number of secretory vesicles
e) All of the above

91. Primary arterial supply of which region travels via the superior mesenteric
artery?
a) Infradiaphragmatic foregut
b) Midgut
c) Hindgut
d) Both A and C
e) All of the above

:The renal arteries .92

a) Originate directly from the abdominal aorta
b) Provide arterial blood to the adrenal glands
c) Provide arterial blood to the kidneys
d) Usually form four anterior segmental arteries within the hilum of the kidney
e) All of the above

The median, medial and lateral umbilical folds of the anterior abdominal .93
:wall are formed respectively by the
a) Urachus, obliterated umbilical arteries and inferior epigastric arteries
b) Urachus, obliterated umbilical arteries and veins
c) Obliterated umbilical arteries and veins
d) Urachus and inferior epigastric artery
e) Urachus, obliterated umbilical arteries and superficial epigastric arteries

:The following statements are true about the cisterna cyli except .94
a) Receives lymph from nodes draining the posterior abdominal wall
b) Is in direct continuity with the inferior vena cava
c) Is a terminal dilation of the thoracic duct
d) Is generally located inferior to the aortic hiatus
:The following statements about the kidney are true except .95
a) Is in contact with the spleen on the left side
b) Is in contact with duodenum on the right side
c) Is located retroperitoneally
d) Receives its blood supply from a branch of the celiac trunk

:Select the one best answer .96

a) The superior epigasrtic artery is a branch of the external iliac artery
b) The anterior portion of the rectus sheath is formed by the aponeurosis of the
external abdominal oblique and transverses abdominis muscle
c) The inguinal canal terminates at the superficial inguinal ring ( a defect in
)the external abdominal oblique muscle
d) The conjoint tendon consists of lower fibers of the external abdominal
muscle and the inguinal ligament
e) The internal spermatic fascia is derived from the internal oblique muscle

97. Which of the following is not true in relation to the stomach?

a) It is located at the supramesocolic compartment
b) The right gastroepiploic artery running along the greater curvature, is a
branch of the gastrodudodenal artery
c) The cardiac notch is an incisure found at the most dependent point of the
lesser curvature
d) The greater curvature gives attachment to the greater omentum
e) Cardiac orifice is at T11 vertebral level

:Select the correct statement .98

a) Falciform ligament
b) The liver occupies the right hypochondriac and epigastric region of the
abdomen
c) The quadrate lobe of the liver is adjacent to the inferior vena cava
d) The caudate lobe is the bed for the gallbladder
e) The cystic bile duct leads into the proximal duodenum

:The posterior limit of the omental (epiploic) foramen is .99

a) The free border of the lesser omentum
b) The hepatic artery
c) The caudate lobe
d) The duodenum
e) The inferior vena cava

100. Indicate the correct statement:

a) The pancreas is located in the epigastric and right hypochondriac regions
b) The pancreas is divided into head, neck and tail
c) The uncinate process projects medially behind the superior mesenteric
vessels
d) The posterior surface of the head of the pancreas is related to the left crus
e) The posterior aspect of the neck of the pancreas is covered with peritoneum
and is adjacent to the pylorus
:The common bile duct and the pancreatic ducts empty into the .101
a) First part of the duodenum
b) Second part of the duodenum
c) Third part of the duodenum
d) Second part of the duodenum (8cm) from the pylorus
e) Middle of the 2nd part of the duodenum

?Which of the following is retroperitoneal .102

a) Spleen
b) Stomach
c) Jejunum
d) Head of pancreas
e) Transverse colon

103. What structure passes behind the medial arcuate ligament of the abdominal
diaphragm:
a) The aorta
b) The oesophagus
c) The psoas major
d) The quadratus lumborum
e) The inferior vena cava

A posterior ulcer of the first part of the duodenum may penetrate the wall .104
and erode an artery running behind it, causing severe internal haemorrhage.
:This artery is likely to be
a) Hepatic
b) Right gastric
c) Gastroduodenal
d) Left gastric
e) Splenic

105. A tumor originating from the sigmoid colon may reach the liver via the
blood stream. Which of the following veins would be first involved in the
pathway?
a) Inferior vena cava
b) External iliac vein
c) Splenic vein
d) Ascending lumbar veins
e) Left renal vein

106. Bleeding from the cystic artery during cholecystectomy can be controlled by
digital pressure on:
a) The fundus of the gall bladder
b) The region of Hartmann's pouch
c) The anterior wall of the foramen of Winslow
d) The lesser curvature of the stomach
e) The celiac artery
107. Which of the following structures forms the floor (inferior border) of the
inguinal canal:
a) Conjoint tendon
b) Inguinal ligament
c) Transversalis fascia
d) Peritoneum
e) Aponeurosis of internal abdominal oblique

Which of the following groups of structures receives its arterial blood .108
?supply from the superior mesenteric artery
a) Ascending colon, transverse colon, descending colon, sigmoid colon
b) Left colic flexure, descending colon, ascending colon, rectum
c) Left colic flexure, descending colon, spleen, sigmoid colon
d) Jejunum, ileum, cecum, ascending colon
e) Descending colon, left colic flexure, rectum, sigmoid colon

Which of the following statements regarding circulation to abdominal .109

?organs is false
a) The common hepatic artery gives rise to the gastroduodenal artery and
propehepatic artery
b) Blood from the kidneys returns to the heart via the hepatic portal system
c) The superior mesenteric vein drains the ileum and jejunum
d) The superior portion of the rectum receives its blood from the inferior
mesenteric artery
e) The duodenum receives its arterial blood via the celiac trunk and the
superior mesenteric artery

?Which of the following statements regarding the abdomen is false .110

a) The falciform ligament is a dorsal mesentery
b) The bile duct enters the duodenum through the major duodenal papilla
c) The gastric arteries run parallel to the lesser curvature of the stomach
d) The epiploic foramen (of Winslow) is the opening into the lesser sac
e) The hepatic veins drain into the inferior vena cava

Which of the following combinations is not a postal-systemic (portocaval) .111

?anastomosis
a) Left gastric veins and esophageal veins
b) Superior, middle and inferior rectal veins
c) Superior and inferior epigastric veins
d) Para-umbilical veins and epigastric veins
e) Colic veins and retroperitoneal veins

Which of the following statements regarding the posterior abdominal wall is .112
?false
a) The iliopsoas muscle flexes the hip
b) The quadratus lumborum muscle receives somatic motor innervation via the
lateral femoral cutaneous nerve
c) The medial and lateral arcuate ligaments serves as attachment sites to the
thoracic diaphragm
d) Lumbar arteries arising from the abdominal aorta, supply blood to the
posterior abdominal wall
e) The cisterna chyli is an enlargement at the inferior end of the thoracic duct
?Which of the following statements regarding the kidney is false .113
a) The superior (proximal), expanded end of the ureter is called the renal
pelvis
b) Renal arteries arise directly from the abdominal aorta
c) The right gonadal vein drains into the right renal vein
,d) The suprarenal glands receive their blood supply from the inferior, middle
and superior suprarenal arteries
e) The renal pyramids collect urine and empty it into the minor calyces via the
renal papillae

Inferior to the arcuate line, which of the following structures lies posterior .114
?to the rectus muscle
a) Aponeurosis of external oblique
b) Deep inguinal ring
c) Aponeurosis of internal oblique
d) Internal oblique fascia
e) Transversalis fascia

Which of the following statements regarding the autonomic innervation of .115

?abdominal organs is false
a) Autonomic axons carried in the vagus nerve synapse in ganglia in the celiac
plexus
b) The superior hypogastric plexus is composed of autonomic nerves and
ganglia
c) Preganglionic cell bodies for axons comprising the least splanchnic nerves
lie in the spinal cord segment T12
d) The lumbar splanchnic nerves carry preganglionic sympathetic axons
e) The pelvic splanchnic nerves provide preganglionic parasympathetic axons
to the digestive tract beyond (distal to) the left colic flexure

:Caput medusae signify .116

a) Cirrhosis
b) Portal hypertension
c) Essential hypertension
d) Umbilical hernia
e) Epigastric hernia

:The ureter crosses all except .117

a) Vas deferens
b) Uterine artery
c) Inferior mesenteric artery
d) Pelvic brim
e) Sacro-iliac joint

:Which is true regarding the kidneys .118

a) The anterior surface of the right kidney includes a colic area
b) The anterior surface of the left kidney does not include a colic area
c) The suprarenal, pancreatic and colic areas of the left kidney are covered
with peritoneum
d) The perirenal fascia is a synonym for renal fascia
e) The inferior poles may extend to the level of the first sacral vertebra
:Which is false regarding the appendix .119
a) In the majority of cases hangs down below the caecum
b) Receives arterial blood from the anterior caecal artery
c) May be over 20 cm long
d) Has a wider lumen in infants
e) Has a base which is said to lie at the point where the three taenia coli meet

There are a number of features which allow distinction between the large .120
:and small intestine, including
a) The taenia coli of the large intestine, which are aggregates of circular
smooth muscle
b) The appendices epiploicae of the large intestine, which have no blood
supply
c) The haustrations of the large intestine, which are caused by contractions of
both layers of intramural smooth muscle
d) Peyer's patches will occur in both small & large intestines
e) Brunner's glands which are present in the duodenum

:Which is incorrect regarding the pancreas .121

a) Its venous drainage is via the splenic vein
b) The congenital malformation known as annular pancreas arises because of
malrotation of the ventral bud of the pancrease
c) It is supplied by the arterial blood via the celiac, superior mesenteric and
splenic arteries
d) The tip of the tail lies in the gastrosplenic ligament
e) The bile duct is sometimes embedded within its substance

:Which is false about the superior mesenteric artery .122

a) It arises about the level of L1
b) It has no branches which supply the large intestine
c) It does not supply the jejunum by its first branch
d) It emerges from the substance of the pancreas
e) It supplies the transverse colon by its last branch

:The duodenum .123

a) Has the common bile duct passing posterior to its first part
,b) Has posterior relationships in its third part with the inferior vena cava
abdominal aorta and the common bile duct
c) Receives artrial blood from the superior pancreaticoduodenal, inferior
pancreaticoduodenal and inferior mesenteric artery
d) Has an interior that is thrown into folds throughout the length of the
duodenum
e) Is entirely retroperitoneal

A femoral hernia descends through the femoral canal, and the neck of the .124
:hernial sac lies
a) At the saphenous opening
b) Above and medial to the pubic tubercle
c) Below and lateral to the pubic tubercle
d) In the obturator canal
e) Lateral to the iliacus muscle