Abdomen MCQs with Answers Key (below) (Anterior Abdominal Wall) NOTE:
For each of the following multiple choice questions select the one most appropriate answer:
1.
Rectus Abdominus Muscle is divided in bellies by tendinous intersections. What is by far the most common configuration of the muscle bellies of the rectus Abdominus. (A) 2 Bellies and sym symmetr etric (B) 2 Bellies and asymm symmeetric ric (C) 4 Bellies and asymm symmeetric ric (D) 6 Bellies and sym symmetr etric (E) 8 Be Bellies an and sy symmetric
2.
A person was stung by a bee in the left lumbar region. The nerves supplying the region accompany the branches of (A) Musculophrenic Artery (B) (B) Ant Anteri erior Int Interco ercost stal al Arter rteriies (C) (C) Pos Poster terior ior Int Interco ercost stal al Ar Arter teries ies (D) (D) upe uperi rior or Epi! Epi!as asttric Ar Artery tery (E) In"erior Ep Epi!astric ric Ar Artery
3.
A pati patient ent com comes es to your your clin clinic ic who whom m you you oper operated ated for obst obstruct ructed ed irre irreduc ducible ible indirect Left nguinal hernia one month ago. !e says "t has been over four wee#s from fr om th thee su surg rger ery y an and d st stil illl ha have ve mu much ch di disc scom omfo fort rt.. nsi nside de of my th thig igh h is numb$ burns burns or or simply hur hurts ts when touched. touched. Whe When n mov movee in cert certain ain ways get a stabbing pain in that area accompanied with a sensation of being bit by a bunch of wasps %&ees'.( Which nerve is most li#ely damaged) (A) (A) #eni #enita tall $ra $ranc nch h o" o" #en #enit ito" o"em emor oral al ner% ner%ee (B) Illioin!uinal &er%e (C) Cremasteric &er%e (D) Illiohy ohypo! po!ast astric &er%e (E) u$coastal &er%e
*.
This patient has more chances of developing which type of hernia in future (A) (A) 'i!h 'i!htt Dire Direct ct In!u In!uin inal al er ernia nia (B) e"t Di Direct In! In!u uinal ernia (C) (C) 'i!h 'i!htt Ind Indiirect rect In!ui n!uina nall er erni niaa (D) (D) e"t e"t Indi ndirect ect In! In!ui uina nall er erni niaa (E) *m$ilical ernia
+.
,uring ,urin g Lapr Lapros osco copic pic re repa pair ir of ,ir ,irec ectt ingu inguina inall !ern !ernia$ ia$ the sit sitee of he herni rnia a will will be be located in (A) Median *m *m$ilical "o "old
(B) (C) (D) (E)
Medial *m$ilical "old Medial In!uinal +ossa ateral In!uinal +ossa ateral um$ilical +old
-.
Median mbilical /old (A) Is a remnant o" *rachus (B) Is a remnant o" *m$ilical Artery (C) Contains In"erior Epi!astric Artery (D) Is a remnant *m$ilical ,ein (E) Contains Ductus ,enosus
0.
While operating for ndirect nguinal !ernia there started an unusual rapid oo1ing of blood$ which filled the site with blood. The urgeon had to stop to control the bleed. Which artery is most li#ely inured) (A) In"erior Epi!astric (B) Cremasteric (C) -esticular (D) E.ternal Illiac (E) Internal iliac 5ou are e6amining a patient for !ernia during e6am. The e6aminer as#s you to differentiate between inguinal and /emoral !ernia. 5our best response will be (A) +emoral ernia is a$o%e and medial to Pu$ic tu$ercle (B) +emoral ernia is $elo/ and medial to Pu$ic tu$ercle (C) +emoral ernia is a$o%e and ateral to Pu$ic tu$ercle (D) +emoral ernia is $elo/ and ateral to Pu$ic tu$ercle (E) &one o" A$o%e
4.
7.
A patient was diagnosed with Testicular 8arcinoma %eminoma'. !e comes to you and as#s what stage is his cancer is. 5ou advise him a test. What will you advise (A) C- A$domen (B) E' (C) An!io!ram (D) *ltrasound -estis (E) -esticular Biopsy
9:.
A *+ year old man comes to your clinic and says that he has a ,ragging;li#e or aching pain within scrotum and feeling a bag of worms. 5ou do a
99.
(A) (B) (C) (D) (E)
,a!ina Canal 0" &uc1 -unica Al$u!inea -unica ,a!inalis Clitoris
92.
A 9: year old boy comes to your clinic at 4
n further ?uestioning you came to #now that his Right testis never descended properly. 5ou notice a swelling ust medial to deep inguinal ring. 5ou don@t have any facility of surgery in your office at night but you can operate in the morning. What will you do ne6t (A) #i%e im Pain medicine and Arran!e to 0perate in the mornin! "or Direct In!uinal hernia (B) #i%e im Pain medicine and Arran!e to 0perate in the mornin! "or Indirect In!uinal hernia (C) #i%e im Pain medicine and anti$iotics to treat Epididymitis (D) *r!ently operate "or stran!ulated Indirect In!uinal ernia (E) 'e"er to Emer!ency ur!ical Department
93.
ubcoastal nerve is in relation to which structure (A) Median Arcuate i!ament (B) Medial Arcuate i!ament (C) ateral Arcuate i!ament (D) Arcuate ine o" Anterior A$dominal all (E) Arcuate ine o" Ilium
9*.
There is a phenomenon in which some people are almost immune to anesthesia$ or they metaboli1e anesthetic rapidly and start feeling pain. &ut the muscle rela6ants don@t let them move. Thin#ing this has happened to your patient in nguinal !ernia repair$ which dermatome is responsible for this pain. (A) -3 (B) -5 (C) - (D) -2 (E) &one 0" A$o%e
9+.
nferior epigastric vessels perforate Rectus abdominis Muscle at the level of (A) +irst tendinous intersection (B) econd tendinous intersection (C) -hird tendinous intersection (D) *m$ilicus (E) Arcuate ine o" Anterior A$dominal all
9-.
After nguinal !ernia Repair in a 9: year old boy medial side of thigh is stimulated to chec# the cremasteric refle6$ but it was found to be absent. Which nerve is responsible for contraction of cremaster muscle. (A) Illioin!uinal ne%er (B) +emoral Branch o" #enito"emoral &er%e (C) #enital Branch o" #enito"emoral &er%e (D) Pudendal &er%e (E) Cremasteric &er%e
90.
8remasteric Artery is a branch of (A) Aorta (B) In"erior epi!astric artery (C) E.ternal pudendal (D) Internal pudendal (E) E.ternal iliac
94.
6ternal permatic /ascia arise from 6ternal obli?ue aponerosis$ o nternal permatic /ascia arise from (A) Internal 0$liue Aponeurosis (B) -rans%ersalis "ascia (C) Con7oint tendon (D) E.ternal o$liue aponerosis (E) -rans%eus A$dominus Aponeurosis
97.
Transpyloric plane is (A) al" /ay $et/een o/er $order o" .yphoid and um$ilicus (B) al" /ay $et/een 7u!ular notch and pu$ic symphasis (C) Belo/ lo/er $order o" costal cartila!es (D) Both A and B (E) Both B and C
2:.
Ligamentum teres !epatis is a remanent of (A) *rachus (B) *m$ilical Artery (C) In"erior Epi!astric Artery (D) *m$ilical ,ein (E) Ductus ,enosus
29.
Bust &elow the arcuate line of anterior abdominal wall$ what is in direct contact with rectus abdominus muscle (A) Parietal Peritoneum (B) ,isceral Peritoneum (C) +ascia -rans%ersalis (D) Posterior ayer o" 'ectus heath (E) Con7oint -endon
22.
Lateral mbilical /old 6tends from (A) ateral ide o" Deep In!uinal 'in! to the *m$ilicus (B) Medial ide o" Deep In!uinal 'in! to the *m$ilicus (C) Medial side o" the deep in!uinal rin! to the arcuate line (D) ateral side o" the deep in!uinal rin! to the arcuate line (E) +rom ide o" Bladder to the *m$ilicus
23.
Median mbilical /old lies between (A) Con7oint -endon and +ascia -ran%ersalis (B) Parietal and %isceral Peritoneum (C) +ascia -rans%ersalis and Parital Peritoneum (D) 'ectus a$domius and Posterior rectus heath (E) 'ectus a$domius and Anterior rectus heath
2*.
upravesical /ossa is a depression (A) Bet/een Median and Medial *m$ilical +old (B) Bet/een Medial and ateral *m$ilical +old (C) ateral to ateral *m$ilical +old (D) ust Behind 'ectus A$dominus a$o%e *m$ilicus (E) 0n the upper ur"ace o" Bladder
2+.
Cavicular fossa is (A) +ossa on the $ody o" Pu$is (B) -he other name o" medial in!uinal "ossa (C) Bet/een Median and Medial In!uinal +osaa (D) -he terminal dilated part o" urethra in the !lans penis (E) -he "ossa $et/een 9yphoid process and coastal cartila!es megma is (A) tored in Ductus De"erens (B) Produced $y -estis (C) tored in Epidydmis (D) -he secretion o" Preputial !lands (E) -he secretion o" ymphatics
2-.
20.
6ternal >bli?ue arises from the outer surfaces Lower 4 ribs ust adacent to the origin of (A) errtus Anterior (B) Internal 0$liue (C) -rans%ersus A$dominus (D) 'ectus A$dominus (E) Pectoralis Minor
24.
A 32;year;old man undergoes vasectomy as a means of permanent birth control. A physician performing the vasectomy by ma#ing an incision on each side of the scrotum should remember which of the following statements most applicable to the scrotum)
(A) (B) (C) (D) (E)
It is inner%ated $y the ilioin!uinal and !enito"emoral ner%es: It recei%es $lood primarily "rom the testicular artery: Its %enous $lood drains primarily into the renal %ein on the le"t: Its lymphatic draina!e is primarily into upper lum$ar nodes: Its dartos tunic is continuous /ith the perineal mem$rane:
27.
A radiologist interprets a lymphangiogram for a 27;year;old patient with metastatic carcinoma. pper lumbar nodes most li#ely receive lymph from which of the following structures) (A) o/er part o" the anal canal (B) a$ium ma7us (C) Clitoris (D) -estis (E) crotum
3:.
A 2-;year;old man comes to a hospital with fever$ nausea$ pain$ and itching in the perineal region. >n e6amination by a urologist$ he is diagnosed as having infected bulbourethral %8owperDs' glands. Which of the following structures isEare affected by this infection) (A) uper"icial perineal space (B) phincter urethrae (C) Production o" sperm (D) -estis (E) eminal %esicles
39.
A 9-;year;old boy presents to the emergency department with rupture of the penile urethra. 6travasated urine from this inury can spread into which of the following structures) (A) crotum (B) Ischiorectal "ossa (C) Pel%ic ca%ity (D) -estis (E) -hi!h
32.
After his bath but before getting dressed$ a *;year;old boy was playing with his puppy. The boyDs penis was bitten by the puppy$ and the deep dorsal vein was inured. The damaged veinF (A) ies super"icial to Buc1;s "ascia (B) Drains into the prostatic %enous ple.us (C) ies lateral to the dorsal artery o" the penis (D) Is "ound in the corpus spon!iosum (E) Is dilated durin! erection
33.
A 37;year;old man is unable to e6pel the last drops of urine from the urethra at the end of micturition because of paralysis of the e6ternal urethral sphincter and
bulbospongiosus muscles. This condition may occur as a result of inury to which of the following nervous structures) (A) Pel%ic ple.us (B) Prostatic ple.us (C) Pudendal ner%e (D) Pel%ic splanchnic ner%e (E) acral splanchnic ner%e 3*.
A 30;year;old man is suffering from carcinoma of the s#in of the penis. 8ancer cells are li#ely to metastasi1e directly to which of the following lymph nodes) (A) E.ternal iliac nodes (B) Internal iliac nodes (C) uper"icial in!uinal nodes (D) Aortic (lum$ar) nodes (E) Deep in!uinal nodes
3+.
A 90;year;old boy suffers a traumatic groin inury during a soccer match. The urologist notices tenderness and swelling of the boyDs left testicle that may be produced by thrombosis in which of the following veins) (A) e"t internal pudendal %ein (B) e"t renal %ein (C) In"erior %ena ca%a (D) e"t in"erior epi!astric %ein (E) e"t e.ternal pudendal %ein
3-.
A 22;year;old woman receives a deep cut in the inguinal canal 9 inch lateral to the pubic tubercle. Which of the following ligaments is lacerated within the inguinal canal) (A) uspensory li!ament o" the o%ary (B) 0%arian li!ament (C) Mesosalpin. (D) 'ound li!ament o" the uterus (E) 'ectouterine li!ament
30.
A 2;year;old boy presents with pain in his groin that has been increasing in nature over the past few wee#s. !e is found to have a degenerative malformation of the transversalis fascia during development. Which of the following structures on the anterior abdominal wall is li#ely defective) (A) uper"icial in!uinal rin! (B) Deep in!uinal rin! (C) In!uinal li!ament (D) ac o" a direct in!uinal hernia (E) Anterior /all o" the in!uinal canal
34.
A young boy is brought to the hospital after a bicycle accident and possible pelvic fracture. While awaiting a computed tomography %8T' scan of his pelvis$ a
physician proceeds with a focal neurologic e6amination. n testing the childDs refle6es$ which of the following nerves would carry afferent impulses the cremasteric refle6) (A) u$costal ner%e (B) ateral "emoral cutaneous ner%e (C) #enito"emoral ner%e (D) Iliohypo!astric ner%e (E) +emoral ner%e 37.
A 7;year;old boy was admitted to the emergency department complaining of nausea$ vomiting$ fever$ loss of appetite. >n e6amination$ he was found to have tenderness and pain on the right lower ?uadrant. &ased on signs and symptoms$ the diagnosis of acute appendicitis was made. ,uring an appendectomy performed at Mc&urneyDs point$ which of the following structures is most li#ely to be inured) (A) Deep circum"le. "emoral artery (B) In"erior epi!astric artery (C) Illiohypo!astric ner%e (D) #enito"emoral ner%e (E) permatic cord
*:.
A pediatric surgeon has resected a structure that is a fibrous remnant of an embryonic or fetal artery +;year;old child. Which of the following structures is most li#ely to be divided) (A) ateral um$ilical "old (B) Medial um$ilical "old (C) Median um$ilical "old (D) i!amentum teres hepatis (E) i!amentum %enosum
*9.
A 29;year;old man developed a hernia after lifting heavy bo6es while moving into his new house. ,uring the repair of his resulting hernia$ the urologist recalls that the genitofemoral nerveF (A) 'uns in "ront o" the uadratus lum$orum (B) Is a $ranch o" the "emoral ner%e (C) upplies the testis (D) Passes throu!h the deep in!uinal rin! (E) #i%es rise to an anterior scrotal $ranch
*2.
An emergent hernia repair is scheduled. As the attending physician is driving to the hospital$ the medical student assisting on the case ?uic#ly reviews his anatomy atlas and is trying to commit to memory that the internal obli?ue abdominis muscle contributes to the formation of which of the following structures) (A) In!uinal li!ament (B) Deep in!uinal rin! (C) +al. in!uinalis (con7oint tendon) (D) Internal spermatic "ascia
(E)
'e"lected in!uinal li!ament
*3.
A patient was operated for ,irect nguinal !ernia and Mesh was placed. Cow the Abdminal layers from Anterior to posterior are composed of in this patient A/TR Mesh : permatic Cord 8: 1in 3: carpa +ascia (A) 8? 2? 3? =? >? 6? ? 4? < (B) 8? 3? 2? =? >? 4? 6? ? < (C) 8? 2? 3? =? 4? >? 6? ? < (D) 8? 2? 3? =? >? 6? 4? ? < (E) 8? 2? 3? =? >? 4? 6? ? <
**.
Anastomosis over Lacunar ligament is from the branches of (A) -esticular and In"erior Epi!asric Artery (B) 0$turator Artery and Cremasteric Artery (C) Cremasteric and Accesory 0$turator Artery (D) 0$turtor Artery and In"erior Epi!asric Artery (E) Accesory 0$turator Artery and -esticular Artery
*+.
Which of the following is not a content of spermatic cord) (A) -he !enital $ranch o" the !enito"emoral ner%e (B) Illioin!uinal &er%e (C) ympathetic and %isceral a""erent ner%e "i$ers (D) ymphatics (E) 'emnants o" the processus %a!inalis
Answers Key 2 < 4 = 6 > 8 3 5
D C B B C A A D A A
2 < 4 = 6 > 8 3 25 2 22 2< 24 2= 26 2> 28 23 <5 < <2 << <4 <= <6 <> <8 <3 45 4 42 4< 44 4=
B E C E E C B B B D C C C A D D A A D B A B C C B D B C C B D C E D B
