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We have just had a lecture on the Abdominal Wall & Inguinal Canal today by a very well trained medical practitioner. Did you understand the lecture clearly? As discussed the quiz below is to test how much you understood and prepare us for the next class where we will tackle the questions you did not understand.
Questions and Answers
1.
A patient present to your ER with a knife wound in the 6-pack region above the arcurate line. Which of the following shows the order or layers the knife would have penetrated?
You are on a rotation with a colorectal surgeon. You are about to go into surgery to remove a cancerous tumer in the middle of the ascending colon. When he asks you in which region he will be working in, you say the:
A.
Epigastric Region
B.
Hypogastric Region
C.
Right Flank
D.
Left Flank
Correct Answer
C. Right Flank
Explanation The correct answer is "Right Flank". The right flank region is located on the right side of the abdomen, between the lower ribs and the pelvis. In this case, the surgeon will be operating in the middle of the ascending colon, which is located in the right flank region. This region is commonly associated with the right side of the body and is the appropriate choice for the surgery described in the question.
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4.
A patient presents to you with a penile injury. All of the following would indicate perforation of the urethrea with penetration of bucks fascia EXCEPT:
A.
Urine collects in the scrotum deep to Dartos Fascia
B.
Urine collects in the penis between buck's fascia and dartos fascia.
C.
Urine collects between camper's fascia and scarpa's fascia
D.
Urine collects between buck's fascia and scarpa's fascia
Correct Answer
C. Urine collects between camper's fascia and scarpa's fascia
Explanation Scarpa's Fascia is continuous with Dartos Fascia, so when urine collects deep to Dartos Fascia, it can also collect deep to Scarpa's Fascia.
Camper's Fascia is superficial to Scarpa's Fascia and the question never gave any indication that the urine penetrated scarpa's or darto's fascia.
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5.
Which of the following when contracted with turn the anterior abdomen to the right side?
A.
Rectus Abdominis
B.
Left Internal Abdominal Oblique
C.
Left External Abdominal Oblique
D.
Right External Abdominal Oblique
Correct Answer
C. Left External Abdominal Oblique
Explanation Flexion of one external abdominal oblique turns the anterior abdomin to the opposite side.
Flexion of one internal abdominal oblique turns the anterior abdomin to the same side.
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6.
While dissecting, you found that most of the major nerves and vessels of the abdominal wall run between which layers?
A.
Internal Abdominal Oblique and Transversus Abdominis
B.
External Abdominal Oblique and Internal Abdominal Obliqe
C.
External Abdominal Oblique and Scarpa's Fascia
Correct Answer
A. Internal Abdominal Oblique and Transversus Abdominis
Explanation Most of the major nerves and vessels of the abdominal wall run between the Internal Abdominal Oblique and Transversus Abdominis layers.
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7.
Which of the following is a branch of the internal thoracic artery?
A.
Musculophrenic A.
B.
Superficial Epigastric A.
C.
Inferior Epigastric A.
D.
Superficial Circumflex Iliac A.
Correct Answer
A. MusculopHrenic A.
Explanation The two branches of the Internal Thoracic Artery that supply blood to the superior portion of the abdomin are the:
1. Musculophrenic A.
2. Superior Epigastric A.
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8.
Which of the following is not a content of the inguinal canal in males?
A.
Spermatic Cord
B.
Inferior Epigastric Artery
C.
Genital Branch of the Genitofemoral Nerve and Vessels
D.
Ilioinguinal Nerve
Correct Answer
B. Inferior Epigastric Artery
Explanation The inguinal canal in males contains the spermatic cord, which includes the vas deferens, testicular artery, and pampiniform plexus. It also contains the genital branch of the genitofemoral nerve and vessels, which innervate the cremaster muscle and supply blood to the scrotum. The ilioinguinal nerve is also present in the inguinal canal, providing sensory innervation to the skin of the scrotum and medial thigh. However, the inferior epigastric artery is not a content of the inguinal canal in males. It is a branch of the external iliac artery and runs superiorly to supply blood to the anterior abdominal wall.
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9.
Which of the following muscles contribute to the Cremaster Muscle of the Spermatic Cord?
A.
External Abdominal Oblique
B.
Internal Abdominal Oblique
C.
Transversus Abdominis
D.
Transversalis Fascia
Correct Answer
B. Internal Abdominal Oblique
Explanation o External oblique contributes to external spermatic fascia
o Internal oblique contributes to cremaster muscle/fascia
o Transversalis fascia contributes to internal spermatic fascia
o Transversus abdominis m DOES NOT contribute to the coverings of the spermatic cord
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10.
A patient presents to you with a protrusion through the deep inguinal ring that is entering the inguinal canal and extending into the scrotum. The protrusion is lateral to the inferior epigastric blood vessels. Which of the following is most likely type of hernal?
A.
Direct Inguinal Hernia
B.
Indirect Inguinal Hernia
Correct Answer
B. Indirect Inguinal Hernia
Explanation The patient's presentation of a protrusion through the deep inguinal ring that extends into the scrotum indicates an inguinal hernia. The fact that the protrusion is lateral to the inferior epigastric blood vessels suggests that it is an indirect inguinal hernia. In an indirect inguinal hernia, the hernia sac follows the pathway of the spermatic cord, entering the inguinal canal through the deep inguinal ring and extending into the scrotum. Direct inguinal hernias, on the other hand, protrude medially to the inferior epigastric blood vessels. Therefore, the most likely type of hernia in this case is an indirect inguinal hernia.
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11.
A patient presents to you with a protrusion in Hesselbach's triangle. You suspect that the patient has a direct inguinal hernia. Which of the following is not a boundary of Hesselbach's Triangle?
A.
Inferior Epigastric blood vessels
B.
Inguinal Ligament
C.
Rectus Abdominis
D.
Linea Alba
Correct Answer
D. Linea Alba
Explanation The Linea Alba is the center line of the rectus abdominis. The Medical border of Hesselbach's Triangle the lateral border of the Rectus Abdominis.
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