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1. Which structure supplied by a branch of the celiac artery is not derived from foregut endoderm?

(A) Head of the pancreas

(B) Pyloric duodenum

(C) Cystic duct

(D) Liver hepatocytes

(E) Body of the spleen

2. An infant presents with an omphalocele at birth. Which of the following applies to this condition?

(A) It is also seen in patients with aganglionic megacolon.

(B) It results from a failure of resorption of the vitelline duct.

(C) It results from herniation at the site of regression of the right umbilical vein.

(D) It is caused by failure of recanalization of the midgut part of the duodenum.

(E) It is caused by a failure of the midgut to return to the abdominal cavity after herniation into the umbilical stalk.

3. A stillborn infant succumbed as a result of oligohydramnios caused by bilateral renal agenesis. Which of the following would most likely be observed in an autopsy?

(A) Clubfoot

(B) Urachal cyst

(C) Berry aneurysms

(D) Situs inversus

(E) Gastroschisis

4. Other than the spleen, occlusion of the splenic artery at its origin will most likely affect the blood supply to which structure?

(A) Jejunum

(B) Head of the pancreas

(C) Lesser curvature of the stomach

(D) Duodenum distal to the entrance of the common bile duct

(E) Fundus of the stomach

5. A 38-year-old banker with a history of heartburn suddenly experiences excruciating pain in the epigastric region of the abdomen. Surgery is performed immediately upon admission to the emergency room. There is evidence of a ruptured ulcer in the posterior wall of the stomach. Where will a surgeon first find the stomach contents?

(A) Greater peritoneal sac

(B) Cul-de-sac of Douglas

(C) Omental bursa

(D) Paracolic gutter

(E) Between the parietal peritoneum and the posterior body wall

6. At birth, an infant presents with a stomach that has herniated into the diaphragm. Where is the defect that resulted in the herniation?

(A) Esophageal hiatus

(B) Hiatus for the inferior vena cava

(C) Pleuroperitoneal membrane

(D) Septum transversum

(E) Right crus

7. An infant born with Down syndrome presents with bilious vomiting. What congenital defect does the infant have?

(A) Pyloric stenosis

(B) Meckel diverticulum

(C) Omphalocele

(D) Gastroschisis

(E) Duodenal atresia

8. A patient with cirrhosis of the liver presents with esophageal varices. Increased retrograde pressure in which veins caused the varices?

(A) Paraumbilical

(B) Splenic

(C) Azygous

(D) Gastric

(E) Superior mesenteric

9. Seminal fluid has entered the ejaculatory duct. Where will the fluid next be found?

(A) Penile urethra

(B) Epididymis

(C) Ductus deferens

(D) Prostatic urethra

(E) Urogenital diaphragm

10. A healthy 3-year-old male patient experiences a hernial sac protruding from the anterior abdominal wall about halfway between the anterior superior iliac spine and the pubic tubercle. Pulsations of an artery are palpated medial to the protrusion site through the abdominal wall. Which layer of the anterior abdominal wall will first be traversed by the hernia?

(A) Rectus sheath

(B) External oblique aponeurosis

(C) Inguinal ligament

(D) Transversalis fascia

(E) Cremasteric fascia

After surgical repair of a hernia, the patient experiences numbness in the skin on the anterior aspect of the scrotum. What nerve may have been lesioned during the herniorrhaphy?

(A) Femoral

(B) Obturator

(C) Ilioinguinal

(D) Iliohypogastric

(E) Pudendal

A 23-year-old female secretary in good health suddenly doubles over with pain in the area of the umbilicus. She feels warm and uneasy and has no appetite. That night the pain seems to have moved to the lower right abdominal region, and she calls her family doctor who then arranges for an ambulance to pick her up and take her to the hospital. Which nerves, perceived in the area of the umbilicus, most likely carried the painful sensations into the CNS?

(A) Vagus nerves

(B) Lesser splanchnic nerves

(C) Pudendal nerves

(D) Iliohypogastric nerves

(E) Greater splanchic nerves

A male infant is born with hypospadias. What caused the defect?

(A) Degeneration of the ureteric bud

(B) Failure of the urethral folds to fuse

(C) Absence of androgen receptors in the external genitalia

(D) 5 alpha-reductase 2 deficiency

(E) Inadequate production of mullerian inhibitory substance

A 62-year-old male patient presents with difficulty initiating and stopping urination and polyuria. Cys to urethroscopy reveals hypertrophy and trabeculation of the bladder. Which of the following might you expect in this patient?

(A) A hydrocele

(B) Urine leaking from the umbilicus

(C) Urinary incontinence due to weakness of the sphincter urethrae muscle

(D) A varicocele

(E) Difficulty in emission

The cause of the prostatic hypertrophy is due to an adenocarcinoma. During prostatic surgery, the nerves that innervate the prostate are lesioned. Which of the following is most likely to be seen in the patient?

(A) Inability to have a voluntary erection

(B) Inability to contract the levator ani muscle

(C) Altered sensation in skin of the perineum

(D) Fecal incontinence

(E) Retrograde ejaculation into the bladder

16. A mass has compressed an internal iliac artery at its branch point from the common iliac artery. Which of the following structures will not require collateral circulation to maintain an adequate arterial blood supply?

(A) Bladder

(B) Prostate

(C) Testis

(D) Uterus

(E) Corpus spongiosum

17. An obstetric resident is preparing to do a nerve block to anesthetize the perineum during delivery. What structure does the resident need to palpate to perform this procedure?

(A) Pubic tubercle

(B) Ischial spine

(C) Ischial tuberosity

(D) Cervix

(E) S aero tuberous ligament

18. The obstetric nerve block is performed successfully and results in urinary incontinence. The anesthetized muscle is located in the

(A) urogenital diaphragm

(B) superficial perineal pouch

(C) pelvic diaphragm

(D) external genitafia

(E) trigone of the bladder

19. Muscles in which of the following regions contract during the Valsalva maneuver to help increase intra-abdominal pressure?

(A) Gluteal

(B) Posterior abdominal wall

(C) Pelvic diaphragm

(D) Urogenital diaphragm

(E) Superficial perineal pouch

20. CT cross-sectional imaging at the level of the L2 vertebra reveals parts of the gut that are pressed against the posterior abdominal wall. Which part of the GI tract might be seen normally in this position?

(A) Transverse colon

(B) Descending colon

(C) Duodenum proximal to the entrance of the common bile duct

(E) Sigmoid colon

21. An infant is bom with a congential diaphragmatic hernia. Which of the following are you most likely to see in this newborn infant?

(A) Renal agenesis

(B) Poor upper limb development

(C) Craniofacial anomalies

(D) Pulmonary hypoplasia

(E) Polycystic kidney disease

22. A CT reveals carcinoma in the body of the pancreas. Which blood vessel that courses immediately posterior to the body of the pancreas is the most likely to be compressed?

(A) Splenic artery

(B) Abdominal aorta

(C) Portal vein

(D) Splenic vein

(E) Renal vein

23. A young individual with fully developed female external genitalia presents with bilateral inguinal masses. Karyotyping reveals that the individual is 46 XY. What is the cause of the pseudointersexuality?

(A) Adrenal hyperplasia

(B) Inadequate production of testosterone

(C) Inactive androgen receptors in the external genitalia

(D) Failure of Sertoli cells to produce mullerian inhibitory substance

(E) Absence of an SRY gene on the Y chromosome

24. You evaluate a patient's prostate during a digital rectal exam. Which of the following structures may also be palpated during such an exam?

(A) Superior gluteal artery

(B) Epididymis

(C) Bulbourethral glands

(D) Seminal vesicle

(E) Penile urethra

25. The transitional epithelium lining the urethra and the bladder is derived from

(A) mesoderm

(B) endoderm

(C) wall of die yolk sac

(D) urogenital ridge

(E) paramesonephric duct

26. A young female patient in the emergency room complains of intense pain in the lower right part of the abdominal wall. She appears to be in a state of shock and shows signs of an internal hemorrhage. A vaginal exam reveals that the patient's cervix is soft, and the patient indicates that she missed her last period. Your diagnosis is that of an ectopic pregnancy. Which is the most likely site of the ruptured implantation?

Cervix of the uterus Body of the uterus Ampulla of the uterine tube Posterior fornix of the vagina Isthmus of the uterine tube

27. Your diagnosis in the case above is made on the basis of the presence of a palpable fluidlike mass. The mass is located in the posterior fornix of the vagina in the broad ligament in the lesser peritoneal sac in the rectouterine pouch in the vesicouterine pouch

28. Which of the following structures helps prevent uterine prolapse after a normal vaginal delivery?

Round ligament of the uterus Broad ligament Transverse cervical ligament Suspensory ligament Proper ovarian ligament

29. A patient has a penetrating ulcer of the posterior wall of the first part of the duodenum. Which blood vessel is subject to erosion?

Common hepatic artery Gastroduodenal artery Proper hepatic artery Celiac artery

Anterior Inferior pancreaticoduodenal artery

30. Your patient has been diagnosed with a carcinoma localized to the head and neck of the pancreas. Another clinical sign would be

(A) esophageal varices

(B) hemorrhoids

(C) a caput medusa

(D) increased pressure in the hepatic veins

(E) enlarged right supraclavicular lymph nodes

; 31. Which structure can be palpated anterior to the cervix during a pelvic exam?

(A) Pelvic diaphragm

(B) Cardinal ligament

(D) Ureter

(E) Trigone of bladder

32. A young male suffers a traumatic injury that lacerates the penile urethra. Urine leaks out into the perineum. Where else might the extravasated urine be found?

(A) Ischioanal fossa

(B) Anterior thigh

(C) Anterior abdominal wall

(D) Rectovesical pouch j (E) Deep perineal pouch

33. A male patient develops malignant testicular carcinoma. Which lymph nodes are most likely to be involved first by a metastasis?

(A) Internal iliac

(B) External iliac

; (C) Superficial inguinal

(D) Para-aortic

(E) Deep inguinal

34. Which of the following structures develops in the ventral mesentery? (A) Spleen

(C) Head of the pancreas

(D) Transverse colon : (E) Stomach

' 35. A female patient presents with a femoral hernia. Which structure is the surgeon most likely to see just lateral to the hernial sac?

(A) Femoral nerve

(B) Sartorius muscle

(C) Femoral vein

(D) Femoral artery

(E) Adductor longus muscle

: 36. Failure of fusion of the paramesonephric ducts gives rise to a bicornuate uterus. What else may show a congenital defect?

(A) Ureters

(C) Upper part of the vagina

(D) Labia minora

(E) Vestibule

37. An adult man widi adult polycystic kidney disease (APKD) suddenly collapses and dies. The cause of death can be attributed to

(A) occlusive stroke

(B) ruptured berry aneurysm

(C) pulmonary embolism

(D) obstructive hydrocephalus

(E) myocardial infarction

38. tn the following cross-sectional image, which of the labeled structures will drain into the hepatic portal vein?

39. In the following cross-sectional image, the structure labeled at "A" is derived from:

Vitelline Duct Adults

(A) cardinal vein

(B) urogenital sinus

(C) mesonephric duct

(D) paramesonephric duct

(E) vitelline vein

The structure indicated by the arrow at "A"

(A) drains into the inferior vena cava

(B) transports bile to the lumen of the duodenum

(C) will be dilated in portal hypertension

(D) supplies oxygenated blood to liver sinusoids

(E) supplies structures derived from the midgut

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  • albino
    Which nerve percieves in the area of umbilicus carries pain?
    3 years ago
  • Pierino
    Which structure can be palpated anterior to cervix during a pelvic exam?
    3 years ago
  • aurelio rizzo
    Which nerves perceived inarea of umbilicus carry pain to cns?
    3 years ago

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