Anterolateral Abdominal Wall and Inguinal Canal- Dr. Lane

Exam 2 Practice Questions Jeff Weiner

Anterolateral Abdominal Wall and Inguinal Canal- Dr. Lane

1. The abdominal cavity:

A.  Is bordered anteriorly by ribs 5-12

B.  Contains the heart, lungs, and phrenic nerve

C.  Is continuous with the pelvic cavity, and together with the pelvic cavity is known as the abdominopelvic cavity.

D.  Is bordered posteriorly by spinous processes of lumbar vertebrae

2. Which of the following statements about the anterior abdominal wall is NOT true?

A.  It functions to bend and rotate the trunk

B.  It may raise abdominal pressure for loud speech, vomiting, defecation, and child birth

C.  Enlargement of the abdominal wall may indicate (among others) flatus, tumors, and ascites.

D.  The linea semilunaris is bordered by two linea alba

3. Place the contents of the abdominal wall in correct order, from superficial to deep:

A.  Skin, Muscles, Camper’s Fascia, Transversalis fascia, parietal peritoneum

B.  Skin, Superficial Fascia, Muscles/Deep Fascia, Endoabdominal fascia, Extraperitoneal fat, parietal peritoneum

C.  Parietal peritoneum, extraperitoneal fat, endoabdominal fascia, muscles/deep fascia, superficial fascia, skin

D.  Parietal peritoneum, Scarpa’s fascia, falx inguinalis, renal pelvis, this is wrong.

4. Which of the following statements regarding anatomical subdivisions of the anterior abdominal wall is true?

A.  The abdominal wall is divided into 4 quadrants by the transumblical plane (L3 & L4) and the median plane

B.  The abdominal wall can be divided into 9 regions by 2 midclavicular lines, the subcostal plane (L2) and the Transtubercular plane (L5)

C.  The interspinous plane runs between the two anterior superior iliac spines (ASIS), and is roughly at the S1 vertebral level.

D.  A and B

E.  All of the Above

5. The inguinal ligament:

A.  Is an extension of the internal oblique muscle, and is anchored to the iliac crest.

B.  Is an extension of the internal oblique muscle, and is anchored to the pubic tubercle

C.  Is an extension of the external oblique muscle, and is anchored to the pubic tubercle.

D.  Is an extension of the external oblique muscle, and is anchored to the iliac crest.

6. The arcuate line is:

A.  A crescent shaped ligament

B.  The crescent shaped inferior border of the rectus sheath on the posterior aspect of the anterior abdominal wall

C.  The crescent shaped inferior border of the rectus sheath on the anterior aspect of the posterior abdominal wall

D.  Located 1/3 of the distance from the umbilicus to the sternal angle

7. Which of the following statements regarding the innervation of the anterior abdominal wall is FALSE?

A.  The subcostal nerve arises from spinal cord segment T12

B.  The iliohypogastric nerve arises from spinal cord segment L1

C.  All nerves innervating the anterior abdominal wall travel between internal oblique and transversus abdominis muscle, and pierce the rectus sheath to supply the rectus abdominis and provide anterior cutaneous branches branches

D.  The ilioinguinal nerve arises from spinal cord segment L2-L4

8. Which of the following statements regarding surgical incision points of the abdominal wall are true?

A.  Median incisions heal faster than paramedian incisions

B.  McBurney’s point is a common access point for appendectomies

C.  Suprapubc sections are used to repair kidney stones

D.  Subcostal incisions will obliterate the subcostal nerve

9. Which of the following statements regarding arterial supply of the anterior abdominal wall is NOT true?

A.  Branches of the internal thoracic contribute to the supply of the anterior abdominal wall.

B.  The 10th and 11th intercostal arteries contribute to the supply of the anterior abdominal wall.

C.  The inferior epigastric and deep circumflex iliac arteries are branches of the internal iliac artery.

D.  The superficial epigastric and superficial circumflex arteries are branches of the femoral artery.

10. The inguinal canal:

A.  Courses from deep to superficial.

B.  Contains the spermatic cord in males and the round ligament in females.

C.  Extends from the deep inguinal ring to the superficial inguinal ring

D.  Serves as a route of passage for the testes from the posterior abdominal wall to the scrotum during development

E.  All of the above

11. Which of the statements regarding the borders of the inguinal canal is FALSE?

A.  The anterior wall is formed from the aponeurosis of the external abdominal oblique

B.  The posterior wall is formed by transversalis fascia and medially reinforced by the conjoined tendon.

C.  The floor is formed by the inguinal and lacunar ligaments.

D.  The roof is formed by fibers from the external oblique and the rectus abdominus.

12. The spermatic cord:

A.  Contains the ductus deferens and testicular artery.

B.  Has the clitoral ligament as an analogue in females.

C.  Is a vestigial remnant from an earlier embryonic stage.

D.  Is innervated by the genitofemoral and the iliohypogastric nerves.

13. In the spermatic cord:

A.  The layers proceed (external to internal) external spermatic fascia, cremasteric fascia, internal spermatic fascia.

B.  The external spermatic fascia is an extension of the external oblique muscle.

C.  The cremasteric fascia is an extension of internal oblique muscle, and the internal spermatic fascia is an extension of transversalis fascia.

D.  A and B

E.  All of the above

14. Which of the following statements regarding the scrotum is TRUE?

A.  Dartos tunic consists of the cremaster muscle and Colles’ fascia

B.  Tunica vaginalis is found external to peritoneum.

C.  Only extensions of Scarpa’s fascia are found in the scrotum

D.  Camper’s fascia extends inferiorly as the Dartos muscle

15. Which of the following statements are true?

A.  A hydrocele consists of excess fluid in a persistent process vaginalis and can be found in either cord or the testis

B.  A hematocele can not be caused by a vicious blow to the groin

C.  While they are palpably the same, an inguinal hernia can be differentiated from a hydrocele by shining a flashlight through the scrotum

D.  A and C

E.  All of the above

16. The testes:

A.  Have arterial blood supplied by the right and left testicular arteries.

B.  Are drained by the right and left testicular veins, which are tributaries of the inferior vena cava.

C.  Are autonomically innervated by cranial nerve IX

D.  Do not drain lymphatics, rather lymph is included in ejaculate

17. A direct hernia:

A.  Leaves the abdominal cavity lateral to the inferior epigastric artery.

B.  Is more common in females.

C.  Is covered by all three layers of the spermatic cord.

D.  Travels anteriorly through the posterior wall of the inguinal canal that is formed by transversalis fascia and exits via the superficial ring, hence only the medial portion of the inguinal canal is travelled.

18. The inguinal triangle:

A.  Is the site of indirect hernias.

B.  Is bordered laterally by the lateral border of the rectus abdominis muscle.

C.  Is bordered medially by the lateral border of the rectus abdominis muscle and laterally by inferior epigastric vessels.

D.  Is bordered superiorly by the inguinal ligament.

19. Which of the following statements regarding hernias are FALSE?

A.  The flashlight test is both a way of distinguishing a hydrocele from a hernia, and a funny concept known as a ‘sack-o-lanern.’

B.  Retractable hernias are debilitating and require immediate surgery.

C.  Incarcerated hernias are fixed in position, narrow, and may still have a decent blood supply.

D.  Strangulated hernias are formed when the hernial sac is too small, and pressure can cause blood supply to be cut off, endangering a loop of intestine.