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  • Question 1 - You are taking care of a 55-year-old male patient with a direct inguinal...

    Incorrect

    • You are taking care of a 55-year-old male patient with a direct inguinal hernia. In explaining his hernia, which of the following layers was compromised and had resulted in his condition?

      Your Answer: Transversus abdominis muscle

      Correct Answer: Transversalis fascia

      Explanation:

      Direct inguinal hernias are most often caused by a weakness in the muscles of the abdominal wall that develops over time, or are due to straining or heavy lifting.

      A direct inguinal hernia protrudes through the Transversalis fascia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      1
      Seconds

  • Question 2 - The lymph drainage of the anal canal above the pectinate line is initially...

    Incorrect

    • The lymph drainage of the anal canal above the pectinate line is initially to the:

      Your Answer:

      Correct Answer: Internal iliac nodes

      Explanation:

      Above the pectinate line, the anal canal drains to the internal iliac lymph nodes which subsequently drain to the lumbar (para-aortic) nodes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 3 - An 82 year old man has fever, left sided abdominal and back pain...

    Incorrect

    • An 82 year old man has fever, left sided abdominal and back pain and presents to the emergency room. Imaging reveals a large perinephric abscess. Which of the following most likely describes the fluid location:

      Your Answer:

      Correct Answer: Between the renal capsule and the renal fascia

      Explanation:

      The perinephric fat is immediately external to the renal capsule and completely surrounds the kidney. The renal fascia surrounds the perinephric fat and the paranephric fat is external to the renal fascia. The location of a perinephric abscess is in the perinephric fat between the renal capsule and the renal fascia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 4 - A 25 year old man presents to the emergency room with abdominal pain,...

    Incorrect

    • A 25 year old man presents to the emergency room with abdominal pain, vomiting and constipation. A CT scan is done which is suggestive of Meckel's diverticulum. Where does the blood supply of the Meckel's diverticulum originate?

      Your Answer:

      Correct Answer: Superior mesenteric artery

      Explanation:

      Meckel’s diverticulum has certain classic characteristics.
      1. It lies on the antimesenteric border of the middle-to-distal ileum
      2. It is approximately 2 feet proximal to the ileocaecal junction
      3. It appears as a blind-ended tubular outpouching of bowel
      4. It is about 2 inches long,
      5. It occurs in about 2% of the population,
      6. It may contain two types of ectopic tissue (gastric and pancreatic).
      7. The diverticulum is supplied by the superior mesenteric artery.
      8. Proximal to the major duodenal papilla the duodenum is supplied by the gastroduodenal artery (branch of the coeliac trunk)
      9. Distal to the major duodenal papilla it is supplied by the inferior pancreaticoduodenal artery (branch of superior mesenteric artery).
      10. The arterial supply to the jejunoileum is from the superior mesenteric artery.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 5 - Which of the following is where the rectovesical fascia is located: ...

    Incorrect

    • Which of the following is where the rectovesical fascia is located:

      Your Answer:

      Correct Answer: Between the fundus of the bladder and the ampulla of the rectum

      Explanation:

      In a triangular area between the vasa deferentia, the bladder and rectum are separated only by rectovesical fascia, commonly known as Denonvillier’s fascia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 6 - A patient is sent in by her GP with suspected ectopic pregnancy. Tubal...

    Incorrect

    • A patient is sent in by her GP with suspected ectopic pregnancy. Tubal ectopic pregnancies occur most commonly in which part of the uterine tube:

      Your Answer:

      Correct Answer: Ampulla

      Explanation:

      Ectopic pregnancy most commonly occurs in the ampulla (70% of cases).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 7 - A tumour is discovered behind the pectinate line during an examination of a...

    Incorrect

    • A tumour is discovered behind the pectinate line during an examination of a 72-year-old patient with rectal bleeding. Which of the following is the lymphatic drainage of the pectinate line?

      Your Answer:

      Correct Answer: Superficial inguinal nodes

      Explanation:

      The pectinate line is known as the watershed line because it divides the anal canal into two sections. Below the pectinate line, lymphatic drainage drains to the superficial inguinal lymph nodes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 8 - Which of the following describes the site of a Meckel's diverticulum: ...

    Incorrect

    • Which of the following describes the site of a Meckel's diverticulum:

      Your Answer:

      Correct Answer: Ileum

      Explanation:

      Meckel’s lies on the antimesenteric surface of the middle-to-distal ileum, approximately 2 feet proximal to the ileocaecal junction. It appears as a blind-ended tubular outpouching of bowel, about 2 inches long, occurring in about 2% of the population, and may contain two types of ectopic tissue (gastric and pancreatic). The rich blood supply to the diverticulum is provided by the superior mesenteric artery.Proximal to the major duodenal papilla the duodenum is supplied by the gastroduodenal artery (branch of the coeliac trunk) and distal to the major duodenal papilla it is supplied by the inferior pancreaticoduodenal artery (branch of superior mesenteric artery). The arterial supply to the jejunoileum is from the superior mesenteric artery.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 9 - The pelvic bone is formed by which of the following: ...

    Incorrect

    • The pelvic bone is formed by which of the following:

      Your Answer:

      Correct Answer: Ilium, ischium and pubis

      Explanation:

      Each pelvic bone is formed by three elements: the ilium (superiorly), the pubis (anteroinferiorly) and the ischium (posteroinferiorly).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 10 - A 45-year-old man had a painless superficial inguinal lymphadenopathy. It was later found...

    Incorrect

    • A 45-year-old man had a painless superficial inguinal lymphadenopathy. It was later found to be malignant. Which of the following parts of the body is most likely the origin of this cancerous lymph node?

      Your Answer:

      Correct Answer: Anal canal

      Explanation:

      A cancer of the anal canal below the pectinate line would spread to the superficial inguinal lymph nodes.

      Anal cancer often spreads through lymphatic drainage to the internal iliac lymph nodes in lesions above the pectinate line and to the superficial inguinal lymph nodes in lesions below the pectinate line.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 11 - You note that the prostate of a 60-year-old patient is enlarged during the...

    Incorrect

    • You note that the prostate of a 60-year-old patient is enlarged during the examination. You suspect BPH. Anatomically, the prostate has four main lobes. Which of the lobes is affected by benign prostatic hypertrophy?

      Your Answer:

      Correct Answer: Median lobe

      Explanation:

      Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is characterized by an enlarged prostate gland.

      The prostate is divided into four major lobes. The median lobe is the most commonly affected by benign prostatic enlargement, resulting in urethral obstruction and urine symptoms.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 12 - A 68-year-old man with BPH presents to the emergency department in significant pain...

    Incorrect

    • A 68-year-old man with BPH presents to the emergency department in significant pain secondary to urinary retention. What is the location of the neuronal cell bodies that are responsible for urinary bladder discomfort sensation?

      Your Answer:

      Correct Answer: Dorsal root ganglia of spinal cord levels S2, S3 and S4

      Explanation:

      The activation of stretch receptors with visceral afferents relayed through the pelvic nerve plexus and into the pelvic splanchnic nerves causes bladder pain. The sensory fibres of spinal nerves S2 – S4 enter the dorsal root ganglia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 13 - Which of the following statement is correct with regards to the female urethra?...

    Incorrect

    • Which of the following statement is correct with regards to the female urethra?

      Your Answer:

      Correct Answer: The urethra opens in the vestibule that lies between the labia minora.

      Explanation:

      The urethra in women is short (about 4 cm long), and begins at the base of the bladder. Its course runs inferiorly through the urogenital diaphragm, then into the perineum. It then opens in the vestibule which lies between the labia minora. The inferior aspect of the urethra is bound to the anterior surface of the vagina. The urethral opening is anterior to the vaginal opening in the vestibule. As the urethra passes through the pelvic floor, it is surrounded by the external urethral sphincter.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 14 - Which of the following best describes the main sites of constriction of the...

    Incorrect

    • Which of the following best describes the main sites of constriction of the ureters:

      Your Answer:

      Correct Answer: At the ureteropelvic junction, at the pelvic brim and where the ureters enter the bladder

      Explanation:

      At three points along their course, the ureters are constricted denoting the most likely areas for renal calculi to lodge:the first point is at the ureteropelvic junction (where the renal pelvis becomes continuous with the ureter)the second point is where the ureter crosses the common iliac vessels at the pelvic brimthe third point is at the vesicoureteric junction (where the ureter enters the wall of the bladder)

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 15 - All these structures make up the portal triad EXCEPT? ...

    Incorrect

    • All these structures make up the portal triad EXCEPT?

      Your Answer:

      Correct Answer: Branches of the hepatic vein

      Explanation:

      The portal triad, is made up of a portal arteriole (a branch of the hepatic artery), a portal venule (a branch of the hepatic portal vein) and a bile duct. Also contained within the portal triad are lymphatic vessels and vagal parasympathetic nerve fibres.

      Branches of the hepatic vein is not part of the portal triad

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 16 - A 30 year old man presents to ED after a road traffic accident....

    Incorrect

    • A 30 year old man presents to ED after a road traffic accident. Free intraperitoneal fluid is found on FAST (Focussed assessment for sonography in trauma) done in the supine position.

      Which of these is most likely to be affected?

      Your Answer:

      Correct Answer: Hepatorenal recess

      Explanation:

      Fluid accumulates most often in the hepatorenal pouch (of Morrison) in a supine patient. The hepatorenal pouch is located behind the liver and anterior to the right kidney and is the lowest space in the peritoneal cavity in the supine position.

      Although the vesicouterine and rectouterine spaces are also potential spaces for fluid accumulation, fluid accumulation in them occur in the erect position.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 17 - Which of the following movements does the iliacus muscle produce? ...

    Incorrect

    • Which of the following movements does the iliacus muscle produce?

      Your Answer:

      Correct Answer: Flexion of the thigh at the hip joint

      Explanation:

      The iliacus flexes the thigh at the hip joint when the trunk is stabilised. It flexes the trunk against gravity when the body is supine.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 18 - You are taking care of a 55-year-old male patient who is a weightlifter....

    Incorrect

    • You are taking care of a 55-year-old male patient who is a weightlifter. He is suspected of having a direct inguinal hernia. Where would this hernia appear?

      Your Answer:

      Correct Answer: Medial to the inferior epigastric artery

      Explanation:

      A direct inguinal hernia is a form of groin hernia that occurs when abdominal viscera protrude through a weakness in the posterior wall of the inguinal canal, notably through Hesselbach’s triangle, medial to the inferior epigastric veins.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 19 - External haemorrhoids may cause anal pain. When explaining to your patient why it...

    Incorrect

    • External haemorrhoids may cause anal pain. When explaining to your patient why it does so, which of the following nerves will you point out as being affected?

      Your Answer:

      Correct Answer: Pudendal nerve

      Explanation:

      The pain associated with external haemorrhoids is carried by a branch of the pudendal nerve, specifically the somatic fibres (S2-S4).

      It innervates the external anal sphincter and most of the skin over the perineum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 20 - The common bile duct drains into the duodenum in which of the following...

    Incorrect

    • The common bile duct drains into the duodenum in which of the following regions:

      Your Answer:

      Correct Answer: Second part of the duodenum

      Explanation:

      As the common bile duct descends, it passes posterior to the first part of the duodenum before joining with the pancreatic duct from the pancreas, forming the hepatopancreatic ampulla (ampulla of Vater) at the major duodenal papilla, located in the second part of the duodenum. Surrounding the ampulla is the sphincter of Oddi, a collection of smooth muscle which can open to allow bile and pancreatic fluid to empty into the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 21 - The parasympathetic supply to the rectum is from which of the following: ...

    Incorrect

    • The parasympathetic supply to the rectum is from which of the following:

      Your Answer:

      Correct Answer: Pelvic splanchnic nerves

      Explanation:

      Parasympathetic supply is from the pelvic splanchnic nerves (S2 – S4) and inferior hypogastric plexus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 22 - Regarding the penis, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the penis, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: The corpus spongiosum is ventral in the erect penis.

      Explanation:

      Because the anatomical position of the penis is erect, the paired corpora cavernosa are defined as dorsal in the body of the penis and the single corpus spongiosum as ventral. The nerves and vessels lie superficial to the corpus cavernosum. The urethra lies within the corpus spongiosum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 23 - A 45-year-old obese patient goes to the emergency department with a fever and...

    Incorrect

    • A 45-year-old obese patient goes to the emergency department with a fever and significant right upper quadrant pain. The pain radiates to her right shoulder tip.  Murphy's sign is positive and acute cholecystitis is diagnosed. The pain referred to the shoulder tip is caused by one of the following nerves:

      Your Answer:

      Correct Answer: Phrenic nerve

      Explanation:

      Gallbladder inflammation can cause pain in the right upper quadrant and right shoulder, which is caused by irritation of the diaphragmatic peritoneum. Pain from areas supplied by the phrenic nerve is often referred to other somatic regions served by spinal nerves C3-C5.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

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