Download Abdomen

Abdomen
1. An aneurysm of the abdominal aorta at the aortic hiatus of the diaphragm
is most likely to result in compression of which of the following pairs
of structures?
(A)
(B)
(C)
(D)
(E)
Vagus nerve and azygos vein
Esophagus and vagus nerve
Azygos vein and thoracic duct
Thoracic duct and vagus nerve
Inferior vena cava and phrenic nerve
2.A 36-year-old woman with yellow pigmentation of the skin and sclerae
presents at the outpatient clinic,Which of the following conditions most
likely causes obstructive jaundice?
(A)
(B)
(C)
(D)
(E)
Aneurysm of the splenic artery
Perforated ulcer of the stomach
Damage to the pancreas during splenectomy
Cancer in the head of the pancreas
Cancer in the body of the pancreas
3.If the transversalis fascia has been damaged during development, which
of the following structures on the anterior abdominal wall is defective?
(A)
(B)
(C)
(D)
(E)
Superficial inguinal ring
Deep inguinal ring
Inguinal ligament
Sac of a direct inguinal hernia
Anterior wall of the inguinal canal
4.Lack of preganglionic parasympathetic fibers in the liver may result
from a lesion in which of the following nerves?
(A)
(B)
(C)
(D)
(E)
Phrenic nerve
Lumbar splanchnic nerve
Intercostal nerve
Vagus nerve
Greater splanchnic nerve
5.Destruction of cell bodies of efferent and afferent nerve fibers in
visceral branches(splanchnic nerve )of the sympathetic trunk affects
which of the following locations?
(A)
(B)
(C)
(D)
(E)
Ventral horn of the spinal cord,collateral ganglia
Lateral horn of the spinal cord ,dorsal root ganglia
Ventral horn of the spinal cord, dorsal root ganglia
Dorsal horn of the spinal cord,sympathetic chain ganglia
Lateral horn of the spinal cord , sympathetic chain ganglia
6.If an abdominal infection spreads retroperitoneally, which of the
following structures is most likely affected?
(A)
(B)
(C)
(D)
(E)
Stomach
Transverse colon
Jejunum
Descending colon
Spleen
7.Which of the following types of nerve fibers stimulates the supraarenal
medulla to secrete nor-epinephrine?
(A)
(B)
(C)
(D)
(E)
Preganglionic sympathetic fibers
Postganglionic sympathetic fibers
Somatic motor fibers
Postganglionic parasympathetic fibers
Preganglionic parasympathetic fibers
8.Hirschsprung’s disease (aganglionic megacolon) is a congenital
disease characterized by a dysfunctional distal portion of the
colon ,which results in an inability to evacuate the bowels .this
condition is caused by an absence of which of the following kinds of neural
cell bodies ?
(A)
(B)
(C)
(D)
(E)
Sympathetic preganglionic neuron cell bodies
Sympathetic postganglionic neuron cell bodies
Parasympathetic preganglionic neuron cell bodies
Parasympathetic postganglionic neuron cell bodies
Sensory neuron cell bodies
9.Which of the following fetal vessels becomes the round ligament of the
liver after birth?
(A)
(B)
(C)
(D)
Ductus venosus
Paraumbilical vein
Umbilical artery
Ductus arteriosus
(E) Umbilical vein (left)
10. Which of the following pairs of veins typically terminates in the same
vein ?
(A)
(B)
(C)
(D)
(E)
Left
Left
Left
Left
Left
and
and
and
and
and
right
right
right
right
right
ovarian veins
gastroepiploic veins
colic veins
suprarenal veins
hepatic veins
11.A small tumor located to the inferior vena cava would most likely damage
which of the following structures ?
(A)
(B)
(C)
(D)
(E)
Right sympathetic trunk
Left third lumbar artery
Third part of the duodenum
Left renal artery
Cisterna chyli
12.A male patient with a perforated gastriculcer complains of
excruciating pain in his epigastrium.If the pain comes from peritoneal
irritation by gastric contents in the lesser sac , which of the following
nerves contains the fibers that convey this sharp,stabbing pain ?
(A)
(B)
(C)
(D)
(E)
Vagus nerve
Greater splanchnic nerve
Lower intercostal nerve
White rami communicantes
Gray rami communicantes
13.Which of the following nerves would carry afferent impulses of the
cremasteric reflex?
(A)
(B)
(C)
(D)
(E)
Subcostal nerve
Lateral femoral cutaneous nerve
Genitofemoral nerve
Iliohypogastric nerve
Femoral nerve
14.Injury to both the superior mesenteric artery and the vagus nerve
affects which portion of the colon?
(A) Ascending and descending segments
(B)
(C)
(D)
(E)
Transverse and sigmoid segments
Descending and sigmoid segments
Ascending and transverse segments
Transverse and descending segment
15.A 42-year-old man with portal hypertension resulting from cirrhosis
of the liver presents to the emergency department .The most practical
method of shunting portal blood around the liver in volves .which of the
following surgical connections?
(A)
(B)
(C)
(D)
(E)
Superior mesenteric vein to the inferior mesenteric vein
Portal vein to the superior vena cava
Portal vein to the left renal vein
Splenic vein to the left renal vein
Superior rectal vein to the left colic vein
16.Rapid occlusion of direct branches of which of the following arteries
results in ischemia of the suprarenal glands?
(A)
(B)
(C)
(D)
(E)
Aorta ,splenic and inferior phrenic arteries
Renal, splenic and inferior mesenteric arteries
Aorta, inferior phrenic and renal arteries
Superior mesenteric , inferior mesenteric and renal arteries
Aorta ,hepatic and renal arteries
17.A radiograph of a 32-year-old women reveals a perforation in the
posterior wall of the stomach in which the gastric contents have spilled
into the lesser sac.The abdominal surgeon who opened the lienogastric
(gastrosplenic) ligament to reach the lesser sac cut an artery
accidentally.Which of the following vessels is most likely to be injured?
(A)
(B)
(C)
(D)
(E)
Splenic artery
Gastroduodenal artery
Left gastric artery
Right gastric artery
Left gastroepiploic artery
18.Which of the following nerves carries pain sensation caused by
irritation of the peritoneum on the central portion of the inferior
surface of the diaphragm?
(A) Vagus nerve
(B) Lower intercostal nerve
(C) Phrenic nerve
(D) Greater splanchnic nerve
(E) Subcostal nerve
19.Soon after ligation of the splenic artery just distal to its origin,a
surgical resident observes normal blood flow in which of the following
arteries?
(A)
(B)
(C)
(D)
(E)
Short gastric arteries
Dorsal pancreatic artery
Inferior pancreaticoduodenal artery
Left gastroduodenal artery
Artery in the lienorenal ligament
20.During an appendectomy at McBurney;s point , which of the following
structures is most likely to be injured?
(A)
(B)
(C)
(D)
Deep circumflex femoral artery
Inferior epigastric artery
Iliohypogastric nerve
Genitofemoral nerve Spermatic cord
21. Which of the following characteristics is associated with the portal
vein or the portal venous system?
(A) Lower blood pressure than in the inferior vena cava
(B) Least risk of venous varices at the lower end of the esophagus as a
result of portal hypertension
(C) Distention of the portal vein due to its numerous valves
(D) Caput medusae and hemorrhoids caused by portal hypertension
(E) Less blood flow than in the hepatic artery
22.A physician who is trying to distinguish the jejunum from the ileum
has observed that the jejunum has
(A)
(B)
(C)
(D)
(E)
fewer plicae
fewer mesenteric arterial arcades
less digestion and absorption of nutrients
shorter vasa recta
more fat in its mesentery
23.In a patient with portal hypertension , which of the following veins
is is most likely to be dilated ?
(A) Right colic vein
(B) Inferior epigastric vein
(C) Inferior phrenic vein
(D) Ovarian vein
24.A 26-year-old patient is admitted to the university hospital with a
retroperitoneal infection .Which of the following arteries is most likely
to be infected?
(A)
(B)
(C)
(D)
(E)
Left gastric artery
Proper hepatic artery
Middle colic artery
Sigmoid artery
Dorsal pancreatic artery
25.A pediatric surgeon has cut a structure that is not related to embryonic
or fetal blood vessels in a 5-year-old child . Which of the following
structures is most likely to be divided?
(A)
(B)
(C)
(D)
(E)
Lateral umbilical fold
Medial umbilical fold
Ligamentum venosum
Ligamentum teres hepatis
Ligamentum arteriosum
26.An obstruction of the inferior mesenteric vein just before joining the
splenic vein is most likely to enlarge which of the following veins?
(A)
(B)
(C)
(D)
(E)
Middle colic vein
Right colic vein
Inferior pancreaticoduodenal vein
Ileocolic vein
Left colic vein
27.An acute infection involving the dartos muscle most likely leads to
an enlargement of which of the following lymph nodes ?
(A)
(B)
(C)
(D)
(E)
Preaortic nodes
Lumbar nodes
External iliac nodes
Superficial inguinal nodes
Common iliac nodes
28.The liver
(A)
(B)
(C)
(D)
(E)
receives blood only from the hepatic arteries
manufactures red blood cells in an adult
drains bile from the quadrate lobe into the right hepatic duct
drains venous blood into the hepatic veins
functions to concentrate and store bile
29.The common bile duct
(A)
(B)
(C)
(D)
(E)
drains bile into the second part of the duodenum
can be blocked by cancer in the body of the pancreas
joins the main pancreatic duct ,which carries hormones
is formed by union of the right and left hepatic duct
lies posterior to the portal vein in the right free edge of the lesser
omentum
30.The sigmoid colon
(A)
(B)
(C)
(D)
(E)
is drained by systemic veins
is a retroperitoneal organ
receives parasympathetic preganglionic fibers from the vagus nerve
receives its blood from the superior mesenteric artery
has teniae coli and epiploic appendages
31.To cut off the blood supply to the appendix (if collateral circulation
is discounted),a surgeon ligates which of the following arteries ?
(A)
(B)
(C)
(D)
(E)
Middle colic artery
Right colic artery
Ileocolic colic artery
Inferior mesenteric artery
Common iliac artery
32.During gastrocolostomy ,a surgeon is ligating all arteries that send
branches to the stomach.Which of the following arteries may be spared ?
(A)
(B)
(C)
(D)
(E)
Splenic artery
Gastroduodenal artery
Inferior pancreaticoduodenal artery
Left gastroepiploic artery
Proper hepatic artery
33.Loss of pain sensation from the abdominal viscera may result from a
lesion of which of the following structures ?
(A)
(B)
(C)
(D)
(E)
Greater splanchnic nerve
Ventral roots of the spinal nerve
Lower intercostal nerve
Vagus nerve
Gray ramus communicans
34.The aponeurosis of the transverse abdominal muscle most likely
contributes to the formation of which of the following ?
(A)
(B)
(C)
(D)
(E)
Linea alba
Anterior layer of rectus sheath above the umbilicus
Posterior layer of rectus sheath below the arcuate line
Lacunar ligament
Internal spermatic fascia
35.A tumor located at the porta hepatis most likely compresses which of
the following structures ?
(A)
(B)
(C)
(D)
(E)
Cystic duct
Hepatic veins
Common hepatic artery
Left gastric artery
Branches of the portal vein
36.Which of the following pairs of veins is considered a portal-caval
anastomosis?
(A)
(B)
(C)
(D)
(E)
Hepatic veins and inferior vena cava
Superior and middle rectal vein
Left and right gastric veins
Inferior and superficial epigastric veins
Suprarenal and renal veins
37.The Meckel’s diverticulum
(A)
(B)
(C)
(D)
(E)
is found 2 feet distal to the ileocecal junction
is located on the mesenteric side of the ileum
occurs in about 10% of the population
is a persistent remnant of the embryonic yolk sac
may contain renal and suprarenal tissues
38. A slowly growing tumor in the uncinate process of the pancreas most
likely compresses which of the following structures ?
(A)
(B)
(C)
(D)
(E)
Main pancreatic duct
Splenic artery
Portal vein
Superior mesenteric artery
Superior pancreaticoduodenal artery
39.Dignosis of a direct inguinal hernia requires that the herniated
tissue ?
(A)
(B)
(C)
(D)
(E)
enters the deep inguinal ring
lies lateral to the inferior epigastric artery
is coverd by spermatic fasciae
descends into the scrotum
develops after birth
40.The genitofemoral nerve
(A)
(B)
(C)
(D)
(E)
runs in front of the quadratus lumborum
is a branch of the femoral nerve
supplies the testis
passes through the deep inguinal ring
gives rise to an anterior scrotal branch
41.The quadrate lobe of the liver
(A)
(B)
(C)
(D)
(E)
lies between the inferior vena cava and ligamentum venosum
receives blood from the right and left hepatic arteries
drains bile into the left hepatic duct
is a medial superior segment
is functionally a part of the right lobe
42.Obstruction of the inferior vena cava may result in dilation of the
which of the following veins ?
(A)
(B)
(C)
(D)
(E)
Left suprarenal vein
Left ascending lumbar vein
Left hepatic vein
Left gastric vein
Portal vein
43.Which of the following structures defines the lateral margin of the
rectus abdominis?
(A) Linea alba
(B)
(C)
(D)
(E)
Linea semilunaris
Linea semicircularis
Transversalis fascia
Falx inguinalis
44.Severance of which of the following ligaments may damage the
paraumbilical vein ?
(A)
(B)
(C)
(D)
(E)
Lienorenal ligament
Lienogastric ligament
Gastrophrenic ligament
Falciform ligament
Hepatoduodenal ligament
45.A knief wound has cut an artery that runs along the superior border
of the pancreas . Which of the following arteries is injured?
(A)
(B)
(C)
(D)
(E)
Right gastric artery
Left gastroepiploic artery
Splenic artery
Gastroduodenal artery
Dorsal pancreatic artery
46.The vagal parasympathetic innervation of the gastrointestinal(GI)
tract terminates approximately at which of the following structures ?
(A)
(B)
(C)
(D)
(E)
Duodenojejunal junction
Ileocecal junction
Right colic flexure
Left colic flexure
Anorectal junction
47.Which of the following structures is located between the celiac trunk
and the superior mesenteric artery?
(A)
(B)
(C)
(D)
(E)
Spleen and body of the stomach
Pyloric canal and neck of the pancreas
Transverse colon and ileum
Kidney and head of the pancrea
Duodenal cap and cecum
48.The internal oblique abdominis muscle contributes to the formation of
which of the following structures ?
(A)
(B)
(C)
(D)
(E)
Inguinal ligament
Deep inguinal ring
Falx inguinalis
Internal spermatic fascia
Reflected inguinal ligament
49.Laceration of the superior mesenteric artery immediately inferior to
the origin of the middle colic artery may reduce blood supply to the
(A)
(B)
(C)
(D)
(E)
descending colon
duodenum
pancreas
ascending colon
spleen
50. Which of the following statements concerning the kidney and associated
structures is correct?
(A)
(B)
(C)
(D)
The left kidney lies a bit lower than the right one
The perirenal fat lies external to the renal fascia
The renal fascia does not surround the suprarenal gland
The left renal vein runs anterior to both the aorta and the left renal
artery
(E) The right renal artery is shorter than the left one
Match each of the following descriptions with the most appropriate
lettered structure in the computed tomography(CT) scan of the abdomen at
the level of the twelfth thoracic vertebra.
51.Structure that is hematopoietic in early life and later destroys
worn-out red blood cells.
52. Structure that runs along the superior border of the pancreas and
enters the lienorenal ligament .
53. Structure that is divided into the proper hepatic and gastroduodenal
arteries.
54. Structure that provides an attachment of the suspensory muscle of the
duodenum (ligament of Treitz).
55. Structure that is retroperitoneal in position and receives blood from
the splenic artery.
Match each of the following descriptions with the most appropriate
lettered structure in the computed tomography(CT) scan of the abdomen at
he level of the upper lumbar vertebra.
56. Structure that is a direct branch of the aorta and supplies blood to
the ascending and transverse colons.
57. Structure that receivers blood from the liver and kidney and enters
the thorax by piercing the central tendon of the diaphragm.
58. Structure that receivers bile,concentrates it by absorbing water and
salt,and stores it.
59. Structure that receivers blood from the left gonad and suprarenal
gland.
60. Structure that runs behind the inferior vena cava.