Abdomen and Inguinal Region Test Questions College of Medicine Gross Anatomy These Questions have come from

the old tests available in the Center For Academic Excellence. Please note that all of the questions have not been checked, and some of the answers may be wrong.

1. At the margins of the superficial inguinal ring, the aponeurosis of the external abdominal oblique muscle changes to A. processus vaginalis B. internal spermatic fascia C. cremaster muscle D. external spermatic fascia E. tunica dartos 2. The median arcuate ligament lies anterior to the A. psoas muscle B. quadratus lumborum C. inferior vena cava D. aorta E. esophagus 3. The lateral umbilical folds contain A. the urachus B. structures which enter the rectus sheath C. structures which lose their patency at birth D. nerves E. ligamentous remains of structures which were patent before birth 4. Lymphatic drainage from the testis goes first to this group of nodes: A. lumbar (para-aortic) B. superficial inguinal C. deep inguinal D. external iliac E. internal iliac 5. The iliacus muscle: A. arises from the internal aspect of the false pelvis B. passes through the true pelvis C. attaches to the lesser trochanter of the femur D. all the above E. A and C only 6. The deep inguinal ring is a defect in the: A. parietal peritoneum B. transversalis fascia C. transversus abdominis D. internal abdominal oblique E. external abdominal oblique 7. The cremasteric fascia is derived from this abdominal layer: A. parietal peritoneum

B. C. D. E.

transversalis fascia transversus abdominis internal abdominal oblique muscle external abdominal oblique muscle

8. The medial most portion of the posterior wall of the inguinal canal is formed by the fascia transversalis and the: A. conjoint tendon B. lacunar ligament C. inguinal ligament D. pectineal ligament E. ligament of Cooper 9. The lymph vessels from the testis and epididymis: A. ascend within the spermatic cord B. pass to the superficial inguinal nodes C. pass to the L1 lumbar lymph nodes D. all the above E. only A and C 10. The inferior epigastric artery enters the rectus sheath at this level: A. umbilicus B. transpyloric plane C. L3 vertebra D. Arcuate line E. Middle tendinous intersection of the rectus abdominis muscle 11. The pancreas A. is entirely retroperineal B. releases its exocrine secretions by common bile duct C. has an uncinate process arising from the body of the gland D. is supplied by arterial branches from the celiac and superior mesenteric arteries E. lies anterior to the lesser sac 12. The following is a portal-caval anastomosis A. splenic with superior mesenteric vein B. left gastric tributaries with tributaries of the azygos vein C. splenic with inferior mesenteric vein D. superior rectal with inferior mesenteric vein E. none of the above 13. Shortly after arising from the abdominal aorta, the superior mesenteric artery descends A. posterior to the second part of the duodenum B. anterior to the third part of the duodenum

C. D. E. F.

anterior to the first part of the duodenum to the right of the second part of the duodenum anterior to the second part of the duodenum none of the above

14. The left renal vein usually: A. lies posterior to the left renal artery B. is shorter than the right renal vein C. passes posterior to the inferior vena cava D. receives the left suprarenal and left gonadal veins E. passes posterior to the abdominal aorta to enter the inferior vena cava 15. A patient with severe and prolonged portal hypertension secondary to cirrhosis of the liver may exhibit all of the following clinical conditions except: A. esophageal varices B. hemorrhoids C. testicular varicoceles D. caput medusae (varices of the anterior abdominal wall) E. ascites (fluid in the peritoneal cavity) 16. The spleen lies A. in the upper right quadrant of the anterior half of the abdomen B. in the right lumbar fossa C. just above the hepatic flexure of the colon D. in the upper left quadrant of the abdomen E. just inferior to the lower border of the left 12th rib 17. The fold of peritoneum that contains the common bile duct, portal vein and hepatic artery is the: A. hepatoduodenal ligament B. right triangular ligament C. falciform ligament D. gastrophrenic ligament E. gastrocolic ligament 18. True statements concerning the ileum include: A. It usually has more mesenteric fat than the jejunum. B. Its mesenteric blood vessels possess more arcades than in the mesenteric vessels of the jejunum. C. It is usually located inferior to the jejunum. D. All the above E. Both (only) B and C 19. Painful sensations due to inflammation of the parietal peritoneum would be carried to the central nervous system via: A. phrenic nerves

B. C. D. E.

lower intercostal nerves upper lumbar nerves all the above both (only) B and C

20. In a CT scan at the level of the celiac trunk (artery), the most anterior and medial part of the right adrenal gland lies directly posterior to the: A. first part of the duodenum B. portal vein C. quadrate lobe of the liver D. head of the pancreas E. inferior vena cava 21. Which one of the following structures is usually secondarily retroperitoneal? A. adrenal (suprarenal) gland B. sigmoid colon C. spleen D. ileum E. second part of the duodenum 22. The nipple is innervated by this level of the spinal cord in a woman with pendulous breasts that droop to the level of the umbilicus: A. T4 B. T7 C. T10 D. T12 E. L1 23. The ductus deferens A. enters the abdomen through the deep inguinal ring B. leaves the testicular vessels at the deep inguinal ring C. crosses the external iliac artery D. all the above E. only A and C 24. The inferior epigastric artery A. is usually a branch of the internal iliac artery B. may form a peritoneal fold, known as the lateral umbilical fold C. is always medial to a direct inguinal hernia D. forms the medial boundary of Hesselbachs triangle (inguinal triangle) 25. The right phrenic nerve has branches that pass through the A. right crus B. left crus C. caval hiatus D. aortic hiatus

E. esophageal hiatus 26. The vagus nerves A. descend through the posterior mediastinum in close company with the phrenic nerves B. serve as cardiac accelerator nerves C. carry pain fibers upward from the thoracic viscera D. pass downward anterior to the root of the lung E. form the esophageal plexus, as it accompanies that organ 27. The following organs receive post ganglionic sympathetic fibers from the celiac and/or superior mesenteric ganglia except: A. ascending colon B. suprarenal gland C. ileum D. liver E. stomach 28. A. B. C. Gray communicating rami are found only at thoracic and upper lumbar cord levels are in the abdomen but not in the thorax carry preganglionic (splanchnic) neurons back to their respective spinal nerves D. are found in thoracic, abdominal and cervical regions of the body

29. Areas drained by the superficial inguinal lymph nodes include: A. skin of anterior abdominal wall below the level of the umbilicus B. skin and fascia of the scrotum C. testes D. all the above E. both (only) A and B 30.True statement concerning the usual vertebral levels of the 3 major hiatuses in the diaphragm include A. the caval hiatus is at T8 B. the aortic hiatus is at T10 C. the esophageal hiatus is at T12 D. all the above E. both (only) B and C 31.The conjoint tendon (falx inguinalis) A. is formed by the arching fibers of the external and internal obliques B. contributes to the strength of the posterior wall of the inguinal canal C. inserts onto the pubic crest and pectineal line

D. all the above E. both(only) B and C 32.A patent processus vaginalis would most likely lead to which type of hernia? A. B. C. D. E. femoral direct inguinal indirect inguinal umbilical obturator

33. The lymphatic drainage from the epididymis is to this group of nodes: A. superficial inguinal B. deep inguinal C. external iliac D. internal iliac E. lumbar (L1-L2 level) 34. An indirect inguinal hernia enters the deep side of the anterior abdominal wall: A. lateral to the inferior epigastric artery B. medial to the inferior epigastric artery C. in the inguinal triangle D. through the conjoint tendon E. immediately lateral to and below the lacunar ligament 35. The tunica vaginalis is derived from this layer of abdomen: A. Campers fascia B. Scarpas fascia C. conjoint tendon D. transversalis fascia E. parietal peritoneum 36. The following statement(s) is/are true of the parasympathetic innervation of the gut: A. Parasympathetic postganglionic fingers distribute with the three unpaired arteries of the abdominal aorta. B. Pelvic splanchnic nerves provide parasympathetics to the descending colon and rectum. C. The ascending colon receives parasympathetic fibers via the inferior mesenteric artery. D. Vagal fibers distribute to the stomach and small intestines, but not to the colon. E. All of the above.

37. Pain from a subphrenic abcess that irritates the central portion of the parietal peritoneum lining the diaphragm is usually referred to the: A. umbilical region B. left hypochondriac region C. epigastric region D. medial side of the left arm E. region of the shoulder 38. Lymphatic drainage from the kidneys is to which one of the following group of lymph nodes? A. celiac B. superior mesenteric C. inferior mesenteric D. lumbar (para-aortic) E. common iliac 39. Which one of the following structures is most likely to be located posterior to the second part of the duodenum? A. B. C. D. E. 40. abdominal aorta neck of gallbladder portal vein hilus of right kidney transverse colon A tumor in which part of the pancreas can produce obstructive jaundice by compressing the common bile duct? A. B. C. D. E. 41. head body neck uncinate process tail

The human pancreas: A. B. C. D. E. is largely intraperitoneal lies dorsal to the lesser peritoneal sac lies ventral to the lesser omentum receives its blood supply from the inferior mesenteric artery is an exclusively exocrine digestive organ

42.The medial arcuate ligament:

A. B. C. D. E.

lies directly anterior to the aorta is formed by the quadratus lumborum fascia is a lower thickened portion of the muscle of the diaphragm connects the transverse process of L1 to the 12th rib is a thickening of the fascia directly anterior to he psoas majors:

43. The femoral nerve and the ________ nerve arise from the same spinal nerves: A. lateral femoral cutaneous B. genitofemoral C. obturator D. iliohypogastric E. ilioinguinal 44. The nerve involved in the cremasteric reflex is the: A. B. C. D. E. genitofemoral femoral obturator ilioinguinal lateral femoral cutaneous

45. This structure lies behind the peritoneum directly posterior to the recess of the sigmoid mesocolon (intersigmoid fossa): A. B. C. D. E. left vas deferens ovary left ureter left testicular artery inferior mesenteric vein

46. The gastroduodenal artery: A. is usually a branch of the superior mesenteric artery B. courses anterior to the first part of the duodenum C. terminates by dividing into superior pancreaticoduodenal and right gastroepiploic arteries D. all the above E. both (only) B and C 47. What structure often runs in the free margin of the paraduodenal fossa? A. B. C. D. left renal vein inferior mesenteric vein left gonadal vein right renal vein

E. left colic vein 48. The correct anatomical explanation for how gall stones may abnormally pass thought a false passage (fistula) from the fundus of the gall bladder to the duodenum is that the fundus of the gall bladder lies directly: A. B. C. D. E. 49. anterior to the third and/or fourth parts of the duodenum anterior to the first and/or second parts of the duodenum posterior to the third and/or fourth parts of the duodenum posterior to the first and /or second parts of the duodenum to the right of the third part of the duodenum

True statements about the appendix include: A. It has a complete longitudinal smooth muscle coat that lacks teniae coli B. It lacks sacculations (haustra coli). C. It has a narrow, hollow organ that typically arises from the posteromedial aspect of the cecum. D. All the above E. Both (only) B and C

50.

The left branches of the hepatic artery and portal vein and the left hepatic duct are usually distributed to the: A. caudate lobe B. left physiological lobe (part of liver that lies to the left of the fissures for ligamentum teres and venosum) C. quadrate lobe D. left anatomical lobe (part of the liver that lies to the left of the attachment of the falciform ligament E. all the above

51.

The structure that lies behind that portion of peritoneum that forms the posterior boundary of the epiploic foramen is the A. B. C. D. E. hepatic artery right adrenal gland aorta inferior vena cava first part of the duodenum

52.

The neck of the pancreas is located ________. A. between the superior mesenteric artery and the aorta B. in the lienorenal ligament C. posterior to the left renal vein

D. on the level of the transpyloric plane E. posterior to the ligament of Treitz 53. The right ureter A. possesses a dilated lumen at the point at which it crosses the brim of the pelvis B. passes directly anterior to the sigmoid colon C. crosses anterior to the right colic vessels D. passes under the lateral lumbocostal/arcuate arch of the diaphragm E. crosses anterior to the common iliac artery The only nerve that usually emerges from the anterior surface of the psoas major muscle A. B. C. D. E. 55. is sensory to the suprapubic region innervates the adductors of the thigh is sensory to the lateral side of the thigh innervates the tunica dartos muscle none of the above

54.

Which one of the following openings in the diaphragm is at the lowest level? A. aortic opening B. esophageal opening C. opening for inferior vena cava D. opening for thoracic duct E. opening for portal vein In addition to the vas deferens, structures normally found within the spermatic cord includes all of the following structures except the A. testicular arteries B. pampiniform plexus C. deferential artery D. testicular nerve E. ilioinguinal nerve The pancreas lies in this abdominal region: A. epigastrum B. right hypogastrium C. umbilical region D. left lumbar region E. right lumbar region The tunica vaginalis of the testis fails to cover the testis on the _______ surface. A. anterior B. posterior

56.

57.

58.

C. medial D. lateral 59. The artery of the foregut is the A. hepatic B. splenic C. celiac D. inferior mesenteric E. superior mesenteric The lower 1/3 of the esophagus receives its arterial blood from this artery: A. B. C. D. E. 61. right gastroepiploic inferior thyroid left gastric short gastric left gastroepiploic

60.

The folds of the mucosa of the jejunum are called A. haustra B. plicae longitudinales C. rugae D. plicae circulares E. gastric pits All lymph from the stomach eventually passes through this group of nodes: A. celiac B. superior mesenteric C. hepatic D. gastroduodenal E. pancreatic The greater and lesser peritoneal sacs communicate via the A. B. C. D. E. subphrenic recess subphrenic foramen an opening anterior to the lesser omentum epiploic foramen retroduodenal foramen

62.

63.

64.

The tunica vaginalis A. covers all surfaces of the testis B. is an open sac connecting to the abdominal cavity C. is derived from the peritoneum D. has lymphatic drainage, that first goes to the upper lumbar nodes E. is derived from the gubernaculums

65.

The deep inguinal ring is a defect in this layer: A. peritoneum B. external abdominal oblique aponeurosis C. transversalis fascia D. internal abdominal oblique aponeurosis E. membranous layer of superficial fascia The portion of the pancreas that lies posterior to the superior mesenteric vessels is the: A. uncinate process B. neck C. body D. tail The medulla of the adrenal (suprarenal) gland is innervated by postganglionic fibers of the splanchnic nerves. A. true B. false

66.

67.

68.

This/These structure(s) lie to the right of the porta hepatis: A. inferior vena cava B. ligamentum teres C. gall bladder D. all the above E. both A and C The lateral umbilical ligaments are A. the remains of the umbilical arteries B. the remnants of the umbilical veins C. formed by the peritoneum overlying the inferior epigastric arteries D. the round ligaments of the ovary E. the round ligaments of the uterus The paracolic gutter that does not freely communicate with the pelvic cavity is the A. B. C. D. right lateral right medial left medial left lateral

69.

70.

71.

The spleen usually lies in this abdominal region: A. left iliac region B. left lumbar region

C. left hypochondrium D. epigastrium E. umbilical region 72. The lienogastric ligament represents: A. a portion of the original mesentery B. a portion of the transverse mesocolon C. a portion of the dorsal mesentery D. a portion of the lesser omentum E. a part of the mesentery proper 73. The anatomical explanation of the clinical condition rebound tenderness of the abdominal wall is that the pain is originating in: A. an umbilical hernia B. an inguinal hernia C. a gastric ulcer D. psoas abcess E. an inflamed parietal peritoneum 74. At a point immediately medial to the deep (internal)inguinal ring, what structures help form the anterior wall of the inguinal canal? A. B. C. D. E. muscle fingers of the transversus abdominis muscle muscle fibers of the internal oblique muscle conjoint tendon (falx inguinalis) lacunar ligament transversalis fascia

75. The celiac trunk: A. normally has three major branches B. is surrounded by a nervous plexus containing sympathetic postganglionic cell bodies C. supplies GI derivatives of the embryonic foregut D. all the above E. only A and B, not C 76. Which one of the following does not face (border) the omental bursa? A. B. C. D. E. hilus of the spleen posterior surface of the stomach posterior surface of the lesser omentum posterior surface of the pancreas anterior surface of the left adrenal

77. The right boundary of the upper recess of the lesser sac (omental bursa) is the :

A. B. C. D. E.

esophagus inferior vena cava hepatoduodenal ligament falciform ligament thoracic aorta (posterior to the diaphragm)

78. A CT scan of a 75 year old lady shows a large cancer in the uncinate process of the pancreas; what artery because of its close proximity to the tumor, would be invaded first by the cancer? A. B. C. D. E. splenic superior mesenteric celiac gastroduodenal inferior mesenteric

79. Most of the nerves in the anterolateral wall of the abdomen lie directly between these two layers: A. B. C. D. E. peritoneum and transversalis fascia transversalis fascia and transverses abdominis muscle transversus abdominis and internal oblique muscles internal oblique and external oblique muscles external oblique muscle and superficial fascia

80. All of the following statements concerning the liver are true, EXCEPT: A. lymphatics from the bare area drain to mediastinal nodes B. the ligamentum teres separates the quadrate and left lobes C. the left lobe and caudate lobe are supplied by the left branch of the hepatic artery D. structures in the porta hepatic include the hepatic vein, artery and duct E. ductus venosus, in the fetus, arises from the left portal vein 81.All of the following are associated with the transpyloric plane except: A. B. C. D. E. pylorus of the stomach tip of the 10th costal cartilage fundus of the gallbladder hilus of the kidney duodenojejunal junction

82. The gallbladder A. is entirely covered by visceral peritoneum

B. C. D. E.

stores bile receives and sends some blood vessels from and to the liver separates the caudate and left lobes of the liver all of the above

83. Most of the duodenum is primarily retroperitoneal: A. true B. false 84. The common bile duct and pancreatic ducts empty into this part of the duodenum: A. first B. second C. third D. fourth 85. The liver is attached to the anterior abdominal wall and the diaphragm by this peritoneal ligament: A. falciform B. teres C. venosum D. median umbilical E. phrenicocolic 86. The following structure(s) is / are found in the free border of the lesser omentum: A. inferior vena cava B. hepatic vein C. hepatic artery D. all the above E. B and C only 87. The retroperitoneal structure that lies behind the mouth of the intersigmoid fossa is the: A. inferior vena cava B. inferior mesenteric vein C. right common iliac artery D. left ureter E. obliterated left umbilical artery 88. The following portion(s) of the gut normally has/have a mesentery and therefore is/are intraperitoneal: A. ascending colon B. appendix C. rectum D. transverse colon E. both (only) B and D above

89. The greater omentum: A. is derived from dorsal mesogastrium (mesentery) B. forms part of the wall of the omental bursa (lesser sac) C. is normally fused with the transverse mesocolon D. contains the left and right gastroepiploic arteries E. all of the above 90. The following are abdominal lymphatic structures except: A. spleen B. appendix C. suprarenal gland D. para-aortic lymph nodes E. cisterna chyli 91. If an ulcer on the posterior wall of the body of the stomach should rupture, the gastric contents then could empty directly into the: A. space between perirenal fascia and left kidney B. greater peritoneal sac C. omental bursa D. left paracolic gutter E. left subphrenic space 92. The presence of the tail of the pancreas in the ______ligament sometimes results in its damage during splenectomy. A. gastrosplenic B. pancreaticosplenic C. lienorenal D. lienocolic E. lienophrenic F. greater omentum 93. True statements concerning the left renal vein include: A. It usually receives the left gonadal vein. B. It is usually longer than the right renal vein. C. It is usually located anterior to the left renal artery and ureter. D. It passes between the abdominal aorta and the superior mesenteric artery. E. All the above 94. Correct boundaries of the epiploic foramen include: A. posterior boundary is the portal vein B. anterior boundary is the lesser omentum C. inferior boundary is transverse colon D. superior boundary is the first part of the duodenum 95. Structures usually passing directly posterior to the first part of the duodenum include:

A. B. C. D. E.

gastroduodenal artery common bile duct portal vein all the above none of the above

96. True statements useful in differentiating ileum form the jejunum include: A. Plicae circulares are larger, more numerous and more closely set in the ileum. B. Arterial arcades in the mesentery are generally more numerous in the region of the ileum. C. Mesenteric fat extends closer to the gut wall in the region of the jejunum. D. All of the above. E. Both (only) A and B 97. Correct boundaries of the inguinal (Hasselbachs) triangle include: A. B. C. D. E. lateral boundary is the obliterated umbilical artery medial boundary is the linea alba inferior boundary is the inguinal ligament all the above both (only) A and B

98. Which one of the following coverings of the testes is derived from the peritoneum? A. B. C. D. E. tunica albuginea tunica vaginalis tunica dartos rete testis gubernaculums testis

99. This/These arteries are predominantly retroperitoneal: A. renal B. right colic C. middle colic D. all the above E. both A and B 100. The vagus nerve supplies all the following except: A. stomach B. ileum C. cecum D. appendix E. descending colon 101. Lymph from the splenic flexure of the colon goes first to this major group of nodes:

A. B. C. D. E.

inferior mesenteric superior mesenteric celiac lumbar internal iliac

102. The left gonadal vein drains directly into the: A. inferior vena cava B. inferior mesenteric vein C. superior mesenteric vein D. left renal vein E. left internal iliac vein 103. The tenth thoracic nerve provides cutaneous innervation to the area of the: A. Inguinal region B. Inner thigh C. Hypochondrium D. Umbilicus E. Scrotum

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D D B A D B D A E D D B B D C D A D D E E A D B C E B D E A E C E A E B E D D A

41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80

B E C A C C B B D E D D E A A E A B C C D A D C C A B E C B C C E B D D B B C D

81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103

B B B B A C D E E C C C E B D B C B A E A D D