Which of the following veins does not run a course parallel to the artery of the same name? superior epigastric superficial circumflex iliac inferior mesenteric superior rectal ileocolic
The presence of which feature (also obvious on a radiograph with barium contrast) distinguishes small from large bowel? Circular folds of the mucosa Circular smooth muscle layer in the wall Mucosal glands Longitudinal smooth muscle layer in the wall Serosa
Occlusion of the inferior mesenteric artery is seldom symptomatic because its
territory may be supplied by branches of the: Gastroduodenal Ileocolic Middle colic Right colic Splenic
During exploratory abdominal surgery on a 55-year-old male complaining of right lower quadrant pain, the surgeon initially sees no appendix but knows that he can quickly locate it by looking at the confluence of the teniae coli palpating the ileocecal valve and looking just above it following the course of the right colic artery removing the right layer of the mesentery of the jejunoileum palpating and inspecting the pelvic brim
During development of the gut: the sigmoid colon is retroperitoneal the inferior mesenteric artery is the axis for rotation of the midgut loop the stomach rotates around its longitudinal axis causing the ventral border to become the greater curvature the liver is non-functional none of the above
Meckel's diverticulum: is an abnormal persistance of the urachus is a site of ectopic pancreatic tissue is caused by a failure of the midgut loop to return to the abdominal cavity is an abnormal connection of the midgut to the duodenum is associated with polyhydramnios
Visceral pain is often referred to a site on the body wall (where the patient "feels" it) that is innervated by the same spinal cord segment that innervates the visceral organ involved. Pain of appendicitis is often first felt around the umbilicus, indicating that the appendix receives its sympathetic (and thus visceral afferents) from which spinal cord segment? T 9 T 10 T 11 T 12 L 1
A surgical maneuver which takes advantage of the avascular plane of fusion fascia can be applied to mobilize all of the organs below, except the: Ascending colon Descending colon Duodenum Kidney Pancreas
A surgeon performing an appendectomy was unable to identify the base of the appendix due to massive adhesions in the peritoneal cavity. Eventually she identified the cecum and was able to localize the base of the appendix. What anatomical structure(s) on the cecum would she have used to find the base of the appendix? Omental appendages Haustra coli Ileal orifice Semilunar folds Teniae coli
The spleen normally does not descend below the costal margin. However, it pushes downward and medially when pathologically enlarged. What structure limits the straight vertical downward movement? Left colic flexure Left suprarenal gland Ligament of Treitz Pancreas Stomach
During the surgical repair of a hiatal hernia, the celiac branch of the posterior vagal trunk was severed accidentally. The damage to this nerve would affect the muscular movements, as well as some secretory activities, of the gastrointestinal tract (GI). Which segment is least likely to be affected by the nerve damage? Ascending colon Cecum Jejunum Ileum Sigmoid colon
A 70-year-old man with cancer of the ascending colon was admitted to the hospital for tumor removal. The surgeon may perform any of these surgical procedures EXCEPT: an incision in the left lower quadrant to access the tumor. examination of the superior mesenteric lymph nodes for possible metastasis. ligation of the relevant branches of the superior mesenteric artery. mobilization of the concerned intestinal segment by freeing its fusion fascia. protect the peritoneum from possible fecal contamination.
A 60-year-old woman arrived at the emergency room complaining of acute abdominal pain. She was diagnosed with ischemic bowel resulting from an obstruction of one or more branches of the inferior mesenteric artery. Which of the following is most likely NOT to be seriously affected by the ischemia? Cecum Descending colon Rectum Sigmoid colon Splenic flexure
A surgeon has decided to perform a segmental resection of the descending colon on a 70-year-old man with intestinal cancer. In principle, any of these surgical procedures might be necessary EXCEPT: An extended left lower quadrant incision to approach the descending colon. Examining the sacral lymph nodes for possible enlargement. Ligation of the relevant left colic artery branches. Mobilizing the concerned intestinal segment by freeing its fusion fascia. Protecting the peritoneum from possible fecal contamination.
As the bowel is exposed, the surgeon says in amazement, "This is a loop of large bowel!" Which characteristic(s) would identify it specifically as large bowel? A serosa Circular folds Epiploic appendages Tenia C and D
The anastomotic artery running along the border of the large intestine is called the: Arcade Arteriae rectae Coronary Ileocolic Marginal
The inferior mesenteric artery is often occluded by atherosclerosis without symptoms; its normal area of distribution therefore must be supplied by collateral blood flow between which arteries? Ileocolic and right colic Left and middle colic Left colic and sigmoidal Right and middle colic Sigmoidal and superior rectal
The artery of the midgut is the: Celiac trunk Inferior mesenteric Proper hepatic Splenic Superior mesenteric
A 57-year-old male complains of intense chest pain, but tests rule out any cardiac pathology. It was determined that the patient suffers from an esophageal (hiatal) hernia in which the stomach herniates through an enlarged esophageal hiatus. Muscle fibers from which of the following parts of the diaphragm would border directly on this hernia? left crus right crus central tendon costal fibers sternal fibers
Sympathetic fibers in the greater splanchnic nerve arise from neuron cell bodies found in the: brainstem celiac ganglion chain ganglion spinal cord superior mesenteric ganglion
The celiac plexus of nerves may contain fibers derived from all of the following sources except: posterior vagal trunk greater thoracic splanchnic nerve lesser thoracic splanchnic nerve lumbar splanchnic nerves
Regarding the diaphragm, which, is paired INCORRECTLY? Vertebrocostal trigone - lateral arcuate ligament Esophageal hiatus - right crus Medial arcuate ligament - psoas muscle Central tendon - aortic hiatus Vena caval foramen - right phrenic nerve
The vagus nerve passes into the abdomen by passing through the Aortic hiatus Esophageal hiatus Caval foramen Lateral arcuate ligament Medial arcuate ligament
With one exception, preganglionic sympathetic axons synapse upon postganglionic sympathetic dendrites or cell bodies. The exception to this general rule occurs within the: Kidney cortex Kidney medulla Suprarenal medulla Suprarenal cortex
The cisterna chyli accompanies which structure as it passes through the diaphragm? Inferior vena cava Esophagus Greater thoracic splanchnic nerve Aorta
A 19-year-old male suffers a tear to the psoas major muscle during the course of a football game. A scar, which formed on the medial part of the belly of the muscle, involved an adjacent nerve, immediately medial to the muscle. The nerve is called the: femoral genitofemoral iliohypogastric ilioguinal obturator
While recovering from an open abdominal hysterectomy (i.e., using a midline abdominal incision to gain entry to the pelvis), a patient realizes that she has lost sensation to the skin of her anterior thigh and cannot extend her knee. Retractors holding the incision open and pressing against the posterior abdominal wall most likely caused injury to which nerve? Femoral Genitofemoral Iliohypogastric Lateral femoral cutaneous Obturator
In the lumbar region, tuberculosis may spread from the vertebrae into an adjacent muscle to produce an abscess. Pus from the abscess may travel within the fascial sheath surrounding the affected muscle. A patient presents with pus surfacing in the superomedial part of the thigh. To which muscle did the tuberculosis most likely spread? Internal oblique Obturator internus Psoas major Quadratus lumborum Rectus abdominis
The nerves of the lumbar plexus are arranged around specific muscles of the posterior abdominal wall. Which of these nerves lies immediately medial to the psoas major muscle? Femoral Genitofemoral Ilioinguinal Obturator