1.
In the following enhanced CT scan of the abdomen, the arrow points to the:
Correct Answer
A. Spleen
Explanation
The arrow in the enhanced CT scan of the abdomen points to the spleen. The spleen is an organ located in the upper left side of the abdomen, and it is responsible for filtering and storing blood, as well as producing certain types of white blood cells. In the image, the arrow is indicating the location of the spleen, which helps in identifying the correct answer.
2.
The hepatorenal recess (Morison pouch):
Correct Answer
C. Receives infected fluids draining from the omental bursa in the supine position.
Explanation
The hepatorenal recess, also known as Morison's pouch, is a potential space located between the liver and the right kidney. It is part of the subphrenic recess, which is a space below the diaphragm. The hepatorenal recess can collect infected fluids draining from the omental bursa, which is a cavity in the peritoneum that contains the stomach and other abdominal organs. This can occur when a person is in the supine position, lying flat on their back. The infected fluids can accumulate in the hepatorenal recess, leading to potential complications such as abscess formation.
3.
The hepatoduodenal ligament:
Correct Answer
B. Contains the portal vein, common bile duct, and hepatic artery.
Explanation
The hepatoduodenal ligament is a double layer of peritoneum that attaches the liver to the duodenum. It contains important structures such as the portal vein, common bile duct, and hepatic artery. These structures are responsible for carrying blood and bile to and from the liver. The hepatoduodenal ligament does not contain the greater omentum, the round ligament of the liver, or attach to the neck of the gallbladder. Therefore, the correct answer is that the hepatoduodenal ligament contains the portal vein, common bile duct, and hepatic artery.
4.
In the following MRI of the abdomen, the arrow points to the:
Correct Answer
E. Inferior vena cava.
Explanation
The correct answer is the inferior vena cava. The arrow on the MRI is pointing to a large blood vessel located on the right side of the image. The inferior vena cava is the largest vein in the body and it carries deoxygenated blood from the lower body back to the heart. Based on its location and size, it is likely that the arrow is indicating the inferior vena cava in this image.
5.
Which of the following is incorrect pertaining to the portal vein?
Correct Answer
C. It is typically the most anterior of the structures within the hepatoduodenal ligament
Explanation
The portal vein is not typically the most anterior structure within the hepatoduodenal ligament. The hepatoduodenal ligament is a double layer of peritoneum that attaches the liver to the duodenum and contains the portal vein, hepatic artery, and common bile duct. The portal vein is located posteriorly to the other structures within the hepatoduodenal ligament.
6.
Which of the following is incorrect pertaining to lymph drainage of the liver?
Correct Answer
D. Hepatic nodes are located in the greater omentum.
Explanation
The incorrect statement is that hepatic nodes are located in the greater omentum. In reality, hepatic nodes are located in the porta hepatis, which is the area where the hepatic artery, hepatic portal vein, and common bile duct enter the liver. The greater omentum is a fatty apron-like structure that hangs down from the greater curvature of the stomach, and it does not contain hepatic nodes.
7.
What structure traverses the opening indicated by the arrow in the following figure?
Correct Answer
C. Aorta
Explanation
The structure that traverses the opening indicated by the arrow in the figure is the aorta.
8.
Cirrhosis of the liver is associated with all of the following except:
Correct Answer
A. Softening of the liver.
Explanation
Cirrhosis of the liver is a condition characterized by the scarring and damage to the liver tissue. It is commonly caused by chronic liver diseases such as hepatitis or long-term alcohol abuse. The destruction of hepatocytes, portal hypertension, alcoholism, and enlargement of the liver are all associated with cirrhosis. However, softening of the liver is not a characteristic feature of cirrhosis. Instead, cirrhosis leads to the hardening and fibrosis of the liver tissue.
9.
When the sphincter of the bile duct contracts:
Correct Answer
B. Bile is forced into the gallbladder for concentration and storage.
Explanation
When the sphincter of the bile duct contracts, it causes bile to be forced into the gallbladder for concentration and storage. This allows the gallbladder to store bile until it is needed for digestion. The contraction of the sphincter prevents bile from entering the duodenum and also occludes the flow of bile in the common hepatic duct and cystic duct.
10.
Which of the following is incorrect pertaining to the gall bladder?
Correct Answer
D. During cholecystectomy surgeons typically ligate the left hepatic artery.
Explanation
During cholecystectomy, surgeons typically ligate the cystic artery, not the left hepatic artery. The left hepatic artery is an important blood vessel that supplies oxygenated blood to the left lobe of the liver. Ligation of this artery during cholecystectomy would lead to ischemia and potential damage to the liver.
11.
In the following enhanced CT of the abdomen, the arrow points to the:
Correct Answer
B. Right crus of the diapHragm
Explanation
The enhanced CT scan of the abdomen shows an arrow pointing to the right crus of the diaphragm. The diaphragm is a dome-shaped muscle that separates the chest cavity from the abdominal cavity. It has two crura, which are muscular extensions that attach to the spine. The right crus of the diaphragm is located on the right side of the body and helps to support and stabilize the diaphragm.
12.
Which of the following is not associated with portal hypertension?
Correct Answer
C. Increased blood flow in the inferior vena cava
Explanation
Increased blood flow in the inferior vena cava is not associated with portal hypertension. Portal hypertension is a condition characterized by increased blood pressure in the portal vein, which carries blood from the digestive organs to the liver. It is commonly caused by liver cirrhosis, which leads to obstruction of blood flow through the liver and increased pressure in the portal vein. This increased pressure can cause the development of esophageal varices (enlarged veins in the esophagus), caput medusae (enlarged veins in the abdomen), and the need for surgical procedures such as splenorenal anastomosis or connecting the portal vein to the inferior vena cava.
13.
In the following renal arteriogram, the arrow points to:
Correct Answer
D. Rib 12.
Explanation
In the given renal arteriogram, the arrow is pointing to rib 12. This can be determined by identifying the anatomical landmarks and counting the ribs. The rib that is directly below the arrow is the 12th rib.
14.
The renal fascia:
Correct Answer
B. Usually prevents pus from a perinepHric abscess from spreading to the contralateral kidney.
Explanation
The renal fascia usually prevents pus from a perinephric abscess from spreading to the contralateral kidney. The renal fascia is a layer of connective tissue that surrounds the kidney and helps to hold it in place. It acts as a barrier, preventing the spread of infection or pus from one kidney to the other. This is important in cases of perinephric abscess, where an infection has formed around the kidney. The renal fascia helps to contain the infection and prevent it from spreading to the opposite kidney.
15.
In renal transplantation the:
Correct Answer
E. Kidney is placed in the iliac fossa of the greater pelvis
Explanation
In renal transplantation, the kidney is placed in the iliac fossa of the greater pelvis. This is the most common and preferred location for kidney transplantation as it provides optimal blood supply and easy access for surgical procedures. Placing the kidney in the iliac fossa allows for proper connection of the renal artery and vein to the recipient's blood vessels, ensuring adequate blood flow to the transplanted kidney. Additionally, this placement allows for easy connection of the transplanted ureter to the patient's ureter, facilitating urine drainage from the transplanted kidney.
16.
Which of the following is incorrect pertaining to the kidneys?
Correct Answer
C. The renal pelvis is the junction between the renal artery and the renal hilum
Explanation
The renal pelvis is not the junction between the renal artery and the renal hilum. The renal pelvis is actually the funnel-shaped structure in the kidney that collects urine before it enters the ureter. The renal hilum, on the other hand, is the concave medial border of the kidney where the renal artery, renal vein, and ureter enter and exit.
17.
You see a female patient in the emergency room with severe, intermittent "loin" (lumbar region) pain who is also having great difficulty urinating. Your most likely first diagnosis is:
Correct Answer
E. Ureteric calculus
Explanation
The most likely first diagnosis for a female patient with severe, intermittent "loin" pain and difficulty urinating is a ureteric calculus, also known as a kidney stone. Kidney stones can cause intense pain in the back or side, which can radiate to the lower abdomen and groin. The difficulty in urinating is due to the stone blocking the flow of urine from the kidney to the bladder through the ureter. This combination of symptoms is characteristic of a ureteric calculus. Kidney disease, ureteric ischemia, ruptured renal artery, and ectopic pregnancy are less likely based on the given symptoms.
18.
The suprarenal glands:
Correct Answer
A. Are typically each drained by one vein
Explanation
The suprarenal glands are typically each drained by one vein. This means that each gland has its own vein that carries blood away from it. This is important for the proper functioning of the glands, as it allows for the removal of waste products and the transport of hormones and other substances to the rest of the body. Having a separate vein for each gland also helps to maintain the balance of blood flow and pressure in the adrenal glands.
19.
Which of the following is incorrect pertaining to the celiac plexus?
Correct Answer
D. It supplies the descending colon
Explanation
The celiac plexus is a network of nerves located in the abdomen. It surrounds the root of the celiac arterial trunk, contains both sympathetic and parasympathetic fibers, and supplies the stomach and gallbladder. However, it does not supply the descending colon. Therefore, the statement "It supplies the descending colon" is incorrect.
20.
In the following MRI of the abdomen, the arrow points to the:
Correct Answer
B. Right kidney
Explanation
The arrow in the MRI is pointing to the right kidney. The kidney is located in the abdomen and is responsible for filtering waste products from the blood and producing urine. In the image, the shape and position of the organ match that of the right kidney, confirming it as the correct answer.
21.
Which of the following is incorrect pertaining to the diaphragm?
Correct Answer
B. Its crura attach to the inferior six costal cartilages.
Explanation
The diaphragm is a dome-shaped muscle that separates the thoracic and abdominal cavities. Its central tendon is in contact with the fibrous pericardium, which is the outer layer of the heart. The diaphragm is partially supplied with blood via branches of the internal thoracic artery. It is at its most superior level when a person is supine, meaning lying flat on their back. Irritation of the diaphragmatic pleura can result in pain that is referred to the shoulder. However, the statement that its crura attach to the inferior six costal cartilages is incorrect. The crura of the diaphragm actually attach to the lumbar vertebrae, not the costal cartilages.
22.
A positive psoas sign:
Correct Answer
D. Could indicate pancreatitis
Explanation
A positive psoas sign could indicate pancreatitis. Pancreatitis is inflammation of the pancreas, which can cause irritation and swelling of the surrounding tissues, including the psoas muscle. This can lead to pain and discomfort in the lower abdomen and can be detected through a positive psoas sign.
23.
The ilioinguinal and iliohypogastric nerves:
Correct Answer
C. Are both L1 ventral rami.
Explanation
The ilioinguinal and iliohypogastric nerves are both L1 ventral rami. This means that they originate from the anterior divisions of the L1 spinal nerve. These nerves provide sensory innervation to the lower abdomen, pubic region, and external genitalia. They do not innervate the psoas muscle, pass posterior to the quadratus lumborum, form the lumbosacral trunk, or supply the adductor muscles of the thigh.
24.
Which of the following is not an anterior relation of the abdominal aorta?
Correct Answer
B. Horizontal part of duodenum
Explanation
The horizontal part of the duodenum is not an anterior relation of the abdominal aorta. The abdominal aorta is located posterior to the horizontal part of the duodenum. The other options listed (pancreas, left kidney, coils of jejunum and ileum, root of the mesentery) are all anterior relations of the abdominal aorta.
25.
The inferior vena cava:
Correct Answer
B. Receives the right testicular vein.
Explanation
The inferior vena cava is a large vein that carries deoxygenated blood from the lower body back to the heart. It receives blood from various veins, including the right testicular vein. This is an accurate statement as the inferior vena cava does receive the right testicular vein, which drains blood from the testicles. The other statements provided in the question are not correct explanations for the given answer.