Anatomy Exam 3 – 2018

Included Content

• Anterolateral Abdominal Wall 
• Peritoneum & Peritoneal Cavity 
• Esophagus, Stomach, & Spleen 
• Liver & Gallbladder 
• Small & Large Intestine 
• Pancreas, Kidneys, Ureters, & Suprarenal Glands 
• Posterior Abdominal Wall & Diaphragm 
• Pelvic Girdle, Joints, & Ligaments 
• Nerve Tissue 
• Urogenital Triangle & Anal Triangle 
• Male & Female Perineum 
• Pelvic Peritoneum & Urinary Organs
• Internal Genital Organs
• Pelvic Walls, Floor, Fascia, Rectum
• Pelvic Nerves & Vessels
• Muscle Tissue  

1. 1. 1. 1. A 42-year-old white male presents with aortoiliac occlusive disease, which has rendered his inferior epigastric artery incapable of supplying adequate blood to its associated muscles. Which specific muscular action would be most affected by this condition?

1. Flexion of trunk

2. Rotation of trunk

3. Compression of abdominal viscera

4. Lateral side-bending of trunk

5. Tension of linea alba

2. A 34-year-old female has what appears to be secondary bladder cancer. What structure would likely have introduced this cancer, and should be examined immediately to ensure an accurate diagnosis?

1. The cervix

2. The body of the uterus

3. The fundus of the uterus

4. The sigmoid colon

5. The prostate

3. While on rounds with your resident and attending physician, you come across a patient presenting with menstrual irregularities, painful intercourse, bloating, and abnormal fullness after eating. Imaging and labs reveal that she has ovarian cancer. The attending asks the resident which group of lymph nodes they should check first to see if the cancer has spread beyond the ovary and surrounding tissues. The answer would most likely be:

1. Superficial inguinal

2. Deep inguinal

3. Internal iliac

4. Lumbar

5. External iliac

4. If the probe is in the transverse plane near the right anterior axillary line with the orientation marker facing posteriorly, which abdominal viscus would be likely be seen inferiorly as well as posteriorly to the liver?

1. Gallbladder 

2. Stomach 

3. Pancreas

4. Right Kidney 

5. Spleen 

5. What unique characteristic of a pelvis would indicate the patient is a child?

1. Smaller subpubic angle

2. Narrower greater sciatic foramen

3. Presence of triradiate cartilage

4. A heart shaped pelvic inlet

5. Thicker posterior superior iliac spine

6. Antibody binding to the antigenic sites of acetylcholine receptors interferes with activation and leads to intermittent periods of skeletal muscle weakness. In an attempt to counteract this autoimmune disorder, the body internalizes, digests, and replaces junctional folds of sarcolemma of affected sites. Which disorder is described here?

1. Myasthenia gravis

2. Rigor mortis

3. Myoneural gravis

4. Leiomyoma

5. Graves’ disease

7. While observing the closing up of the abdominal cavity after a routine appendectomy, the surgeon mentions that he is closing one subcutaneous structure separately from the rest in an attempt to limit the ability of fluid to spread throughout the abdominal cavity. The structure he is referring to is:

1. Superficial layer

2. Camper fascia

3. Membranous layer

4. Intercrural fibers

5. Inguinal falx

8. Jon H. presents to your clinic with pain in his groin after lifting too much weight at the gym. After careful inspection of his lower abdominal area, you conclude that he has a direct hernia. What structure (s) does this hernia have to pass through to qualify as a direct hernia?

1. Between the medial umbilical fold and lateral umbilical fold

2. Through the femoral canal

3. Lateral to the lateral umbilical fold

4. Through the deep inguinal ring

5. Through the supravesical fossa 

9. Your patient comes in complaining of pain in his inguinal region and testis. He also says that he sometimes has trouble urinating. You are concerned that he has a kidney stone, as he does have a history of ureteric calculi. As you wait for his imaging to return, you start to think about the locations where his kidney stone could be lodged. Where would a kidney stone be LEAST likely to lodge in this patient?

1. In the renal pelvis

2. At the ureteropelvic junction

3. As the ureter crosses the external iliac artery

4. As the ureter crosses the bladder wall

5. As the ureter crosses over the pelvic brim

10. A patient presents with decreased urine output, peripheral edema, shortness of breath, fatigue, confusion, and nausea. Based on the symptoms, you suspect acute renal failure and acquire the ultrasound image pictured below. Which of the following is the most likely diagnosis?

1. IgA nephropathy

2. Adult polycystic disease 

3. Type II Diabetes 

4. Lupus 

5. Reflux nephropathy 

11. You are on rotations in the Emergency Department when a patient presents with internal bleeding after being in a motor vehicle accident. Upon further imaging while the patient is supine, you find that that blood has begun to accumulate in the: 

1. Hepatorenal recess 

2. Omental bursa 

3. Rectouterine pouch

4. Subphrenic recess

5. Retroperitoneal space 

12. A patient presents to your clinic with decreased bowel sounds in the left iliac region. Which organ is likely involved and which artery could potentially be occluded?

1. Cecum and Ileocolic artery

2. Small intestine and supraduodenal artery

3. Descending colon and left colic artery

4. Sigmoid colon and left colic artery

5. Descending colon and superior rectal artery

13. Pancreatic cancer is so often deadly in part because it metastasizes so readily. Where would you suspect that pancreatic cancer would metastasize to first? 

1. Transverse colon

2. Peyer patches

3. Inferior part of the duodenum

4. Inferior vena cava

5. Superior part of the duodenum

14. A patient presents to the Emergency Department writhing in pain. You listen to bowel sounds and find that they are diminished in the left hypochondriac region. You suspect that the patient has developed ischemic bowel disease due to a blocked artery that is of great importance in supplying blood to this region. Which artery is most likely blocked to cause this condition?

1. Superior mesenteric artery

2. Inferior mesenteric artery 

3. Left colic artery 

4. Right colic artery 

5. Marginal artery

15. A 25-year-old victim of an automobile accident has received severe damage to her pelvic inlet. Which of the following structures was spared?

1. Pecten pubis 

2.  Pubic symphysis 

3.  Sacral promontory 

4. Pubic crest 

5. Sacrotuberous ligament

16. Levator ani syndrome is a condition characterized by brief intermittent burning pain of the rectal or perineal area, caused by spasm of the levator ani muscle. Which of the following muscles would be involved in this condition?

1. Pubococcygeus 

2. Iliococcygeus 

3. Coccygeus 

4. A & B

5. A, B, & C 

17. You are doing rotations in the OB-GYN department when a resident asks you to do a pelvic exam on a 23 y/o female who just found out she is pregnant. During the exam, you internally palpate the sacral promontory with the tip of your middle finger and mark the level of the inferior margin of the pubis symphysis on your glove. You know that the lesser pelvis is large enough for childbirth because you: 

1. Determined that the obstetric conjugate was >11 cm by measuring the distance you marked to the tip of your middle finger 

2. Determined that the obstetric conjugate was >11 cm by measuring the distance you marked to the tip of your index finger 

3. Determined that the diagonal conjugate was >11 cm by measuring the distance you marked to the tip of your middle finger 

4. Determined that the diagonal conjugate was >11 cm by measuring the distance you marked to the tip of your index finger 

5. None of the above 

18. In cold environmental conditions the testicles will usually ascend in order to warm themselves so that sperm production and maturation can continue in spite of the frigid temperatures. What structure is responsible for the ascent of the testicles during these conditions?

1. Dartos muscle

2. Cremasteric muscle

3. Inguinal falx

4. Suspensory ligament of the penis

5. Tunica vaginalis

19. Which of the following features would indicate a male pelvic girdle?

1. A shallow lesser pelvis

2. Small acetabulum

3. Subpubic angle of more than 80 degrees

4. Narrower sciatic notch that’s part of the greater sciatic foramen

5. Oval obturator foramen

20. The normal position of the uterus is:

1. Retroflexed and anteverted

2. Anteflexed and anteverted

3. Anteflexed and retroverted

4. Anteverted and retroverted

5. Retroverted and retroflexed

21. Khadijah H. is on her 5th trip to the restroom and it’s only 11:00 AM! This isn’t atypical considering that she’s pregnant (and absolutely glowing) after all. Regarding the process of micturition, which of the following is true regarding Khadijah’s trip to the bathroom?

1. The hypogastric nerve is responsible for contraction of the detrusor muscle during micturition 

2. The pelvic parasympathetic nerves relax the internal urethral sphincter during micturition 

3. The pudendal nerve contracts the external urethral sphincter during micturition 

4. The pelvic parasympathetic nerves contract the internal urethral sphincter during micturition 

5. The hypogastric nerve is responsible for the relaxation of the internal urethral sphincter muscle during micturition 

22. Which ligament of the pelvic girdle is most crucial for the transferring of weight from the upper body to that of the femurs (while standing) and ischial tuberosities (while sitting)?

1. Anterior sacroiliac ligament 

2. Superior pubic ligament 

3. Inferior pubic ligament 

4. Interosseous sacroiliac ligament 

5. Sacrotuberous ligament 

23. Fluid accumulation or infection in the greater vestibular duct, which lies in the groove between the hymen and the labia minora, can cause which of the following?

1. Bartholin’s cysts

2. Vestibular cysts

3. Vestibular bulbs

4. Alcock’s cysts

5. Skene’s cysts

24. Peyronie’s disease is a connective tissue disorder in the soft tissue of the penis. The cause of this disease is thought to be due to trauma during sex, athletic activity, or the result of an accident. During the healing process, scar tissue forms in a disorganized manner and causes deformation to the tissue encasing the corpus cavernosa. This sheath surrounding the corpus cavernosa describes which of the following structures?

1. Vas deferens

2. Mediastinum testis 

3. Tunica vaginalis

4. Tunica albuginea

5. Rete testis

25. A potentially cancerous lesion was noted during endoscopy of a 67-year-old male patient. The lesion was located in the anal canal at a level superior to the pectinate line. A biopsy of which lymph nodes should be taken to determine metastasis?  

1. Superficial Inguinal lymph nodes

2. Internal Iliac lymph nodes

3. Deep inguinal lymph nodes 

4. External iliac lymph nodes 

5. Axillary lymph nodes 

26. During a cholecystectomy (removal of the gallbladder), the surgical resident accidentally jabbed a sharp instrument into the area immediately anterior to the omental foramen (also called epiploic foramen). He was horrified to see the surgical field immediately fill with blood, the source which he knew was the:

1. Aorta 

2. Inferior Vena Cava 

3. Portal vein 

4. Right renal artery 

5. Superior mesenteric vein 

27. A patient was diagnosed with pancreatitis due to a reflux of bile into the pancreatic duct caused by a gallstone. The stone is likely to be lodged at the:

1. Common bile duct

2. Common hepatic duct

3. Cystic duct

4. Hepatopancreatic ampulla

5. Anterior pancreaticoduodenal artery

28. In patients with cirrhosis of the liver or severe portal vein hypertension, blood can stretch the portal vein due to the increased pressure. This increased pressure oftentimes causes blood to flow into the paraumbilical vessels. Which of the following structures allows this to occur? 

1. Ligamentum teres hepatis

2. Superior umbilical vein

3. Ligamentum venosum

4. Ductus venosus

5. Cystic duct

29. A 2-year-old patient was admitted to your Emergency Department after choking on a toy. You discover the toy tore his esophagus, lacerating the visceral peritoneum. Which of the following best describes what the child would feel?

1. Well localized pain at the site of the laceration 

2. No pain will be felt

3. Umbilical region

4. Epigastric region

5. Left shoulder 

30. During a bar fight, a OMS1 student gets injured and subsequently transects the distal end of a peripheral nerve in their leg. Assuming secondary cells do not interfere with the healing process of this injury, what cells are the most important in directing the proximal end of the nerve back to its innervation destination?

1. Schwann cells

2. Oligodendrocytes

3. Neurons

4. Macrophages

5. Astrocytes 

31. A panicked OMS1 tripped and fell entering their first patient encounter, landing on their clipboard pen. If the pen was able to puncture their descending colon, it would have had to enter through which abdominal region?

1. Right lateral

2. Left lateral

3. Umbilical

4. Right inguinal

5. Pubic

32. Dick is a 78-year-old male patient who is taking his physician’s advice to stay active by riding his bike daily. Last week Dick injured his perineum when he fell onto the frame of his bike. Coincidently, he has been experiencing fecal incontinence, urinary incontinence, and inability to maintain an erection. Which of the following most likely explains Dick’s symptoms?

1. Richard has injured his tunica albuginea 

2. Richard has injured his perineal artery 

3. Richard has injured his sacrotuberous ligament 

4. Richard has injured his perineal body 

5. Richard is getting older and is exhibiting geriatric atrophy 

33. As part of a routine wellness exam, you screen your patient, a 55 year old male, for colorectal cancer using a flexible sigmoidoscope and find what appears to be a tumor in the inferior half of the rectum. If you were to follow up on this finding looking for potential metastasis of the tumor, where would you first look?

1. The superficial inguinal lymph nodes

2. The internal iliac lymph nodes

3. The sacral lymph nodes

4. The inferior mesenteric lymph nodes

5. The deep inguinal lymph nodes

34. Angel M. enjoys dropping weights after she lifts an unimpressive amount at her cross-fit gym. One day, Angel trips backwards while in the middle of an overhead squat and reflexively drops the weight on her pelvis, indirectly fracturing her ischial tuberosity. Which of the following structures would be spared? 

1. External urethral sphincter 

2. Sacrotuberous ligament  

3. Superficial transverse perineal 

4. Bulbospongiosus muscle 

5. Deep transverse perineal muscle 

35. What of the following muscles is most likely to be injured during childbirth?

1. Iliococcygeus

2. Obturator internus

3. Puborectalis

4. Pubococcygeus

5. Piriformis

36. A patient comes into your office complaining of fecal incontinence. Which of the following is a possible cause of this condition?

1. Hypertonic puborectalis muscle

2. An anorectal angle at 130 degrees

3. A fracture of the sacral bone

4. Anal stenosis 

5. Irritation of the tendinous arch of pelvic fascia

37. A lesion of the greater curvature of the stomach would likely affect which blood vessel?

1. Right gastric artery

2. Cystic Artery 

3. Hepatic Artery Proper 

4. Left gastric artery 

5. Right gastroepiploic artery 

38. You are doing rotations in the Emergency Department when a resident gives you the wonderful task of inserting a foley catheter into a 65-year-old male patient. Because males are notably more difficult to catheterize than females, the resident asks you to explain the catheterization process before proceeding. In which order will the catheter travel before reaching the bladder? 

1. Membranous portion of the urethra → Preprostatic portion of the urethra → The prostatic portion of the urethra → Spongy portion of the urethra → Bladder

2. Spongy portion of the urethra → Preprostatic portion of the urethra → The prostatic portion of the urethra → Membranous portion of the urethra → Bladder

3. Spongy portion of the urethra → The prostatic portion of the urethra → Preprostatic portion of the urethra → Membranous portion of the urethra → Bladder

4. Membranous portion of the urethra → Spongy portion of the urethra → The prostatic portion of the urethra → Preprostatic portion of the urethra → Bladder

5. Spongy portion of the urethra → Membranous portion of the urethra → The prostatic portion of the urethra → Preprostatic portion of the urethra → Bladder

39. Jackie recently underwent surgery to repair a ruptured spleen. In a span of three days, she is already displaying Kehr’s sign. The root of this symptom is due to the spleen compressing on which organ?

1. Stomach

2. Diaphragm

3. Gallbladder

4. Liver

5. Pancreas

40. The inability to retract the prepuce from the glans penis due to a constriction in the preputial orifice is normal in newborn males. The glans and the foreskin remain connected for the first few years of life. If this persists into adulthood, however, it can lead to a number of risk factors. This condition is known as;

1. Varicocele

2. Balanitis

3. Glans Fistula

4. Testicular torsion

5. Phimosis

41. A hydrocele is a type of swelling in the scrotum that occurs when fluid collects in the thin sheath surrounding a testicle. Between which two fascial layers in fluid most likely to accumulate in the testes due to this condition?

1. Between the superficial fascia and the deep fascia 

2. Between the visceral vaginal tunic and the parietal vaginal tunic 

3. Between the deep fascia and the parietal vaginal tunic 

4. Between the visceral vaginal tunic, the deep fascia 

5. Between the superficial fascia and the skin 

42. During a routine cholecystectomy, the removal of the gallbladder, a surgeon moves through the hepatoduodenal ligament, finding three distinctive structures. What the structure located most anteriorly?

1. Proper hepatic artery

2. Portal vein

3. Common bile duct

4. Left gastro-omental artery

5. Gastroduodenal artery

43. Which labeled structure functions to conduct nerve impulses to other cells?

1. 1

2. 2

3. 3

4. 4

5. 5

44. Another patient of yours comes in with hematuria, left abdominal pain, and left testicular pain. Based on his MRI, you diagnose him with renal vein entrapment syndrome, or nutcracker syndrome. Where is the left renal vein compressed in this syndrome?

1. Where it dumps into the Inferior Vena Cava

2. As it exits the left renal hilum

3. Between the superior mesenteric artery and abdominal aorta

4. Between the superior mesenteric artery and inferior vena cava

5. As it passes underneath the inferior ascending duodenum   

45. After suffering a pelvic fracture in a car accident, a young male now has bloody extravasation of the deep perineal pouch. When going in for a corrective surgery, the surgeon is likely to find:

1. A ruptured spongy urethra with intact perineal membrane

2. A ruptured spongy urethra with torn perineal membrane

3. A ruptured prostatic urethra with intact perineal membrane

4. A ruptured prostatic urethra with torn perineal membrane

5. A torn spongy and prostatic urethra with intact perineal membrane

46. One possible complication during pregnancy is the development of ovarian vein thrombosis (OVT),  and can be associated with pelvic inflammatory disease and malignancy. In the case of your patient, the condition has developed to sepsis without response to anticoagulant therapy. If your were to evaluate this condition surgically, you would need to first transect which ligament?

1. Ligament of the ovary

2. Suspensory ligament

3. Mesovarium of the broad ligament

4. Round ligament of the uterus

5. Ovarian gubernaculum

47. Which of the following is palpable in a typical rectal exam of a healthy person (allowing for gender variance)?  

1. Distended rectovesical pouch

2. Distended rectouterine pouch

3. Cervix

4. Internal iliac lymph nodes

5. Thickened ureters

48. It was a solemn Wednesday night when the dreaded message popped up on GroupMe: “So, scrubs tomorrow?” Aladdin J. knew he had made a horrible mistake sending that message while driving as he accidentally swerved into oncoming traffic. Thankfully, he survived the car accident although not without damaging his posterior abdominal wall. Specifically, imaging showed damage to his diaphragm at the level of T10. Which of the following structures was most likely damaged in the accident?

1. Caval opening 

2. Aortic hiatus 

3. Esophageal hiatus 

4. Phrenic nerve 

5. Thoracic duct 

49. During cardiac hypertrophy, the number of myocardial fibers is not increased; instead the cardiac muscle cells become longer and larger in diameter. How does the heart regenerate damaged muscle tissue?

1. Satellite cells are recruited to the heart and begin to repair cardiac muscles, leading to full regeneration.

2. Mitosis is initiated immediately following ischemia of cardiac muscle tissue, leading to full regeneration

3. Increased extracellular Ca2+ concentration allows for the muscle fibers to contract back to normal size and minimizes damage.

4. The heart is permanently damaged; the heart does not contain muscle satellite cells.

5. The heart is permanently damaged; muscle satellite cells are inactive in anaerobic conditions.

50. A 57-year-old male patient presents with difficulty urinating. You assume it to be due to an issue with his prostate, but you decide to check his bladder just to be on the safe side. Upon performing a urogram, you notice a potentially cancerous mass on the bladder wall. In which set of lymph nodes should you check to make sure the cancer hasn’t yet spread? 

1. Deep inguinal lymph nodes 

2. Superficial inguinal lymph nodes 

3. Internal iliac lymph nodes 

4. External iliac lymph nodes 

5. Pararectal lymph nodes 

51. Your wife just went into labor and you are nervous for a number of natural reasons.  While you know you have been preparing for months, your doctor said her pelvis has only a just-large enough conjugate. Your doctor explained the risks of natural birth vs. cesarean section, but you decided to try for the natural birth.  Which of the following nervous structures are most likely to be injured via a natural birth, as per your doctor’s indication?

1. Lumbosacral Trunk

2. Pelvic Splanchnic nerves

3. Pudendal Nerve

4. Anterior Rami of L4-S3

5. Sacral Splanchnic nerves

52. A patient presents to your urology practice complaining of a lack of semen discharge during ejaculation. The patient expresses concerns about infertility and notes his urine appears cloudy. You determine that the patient’s semen is entering the bladder instead of being dispelled during climax. Which autonomic mechanism is not functioning properly?

1. Presynaptic sympathetic nerve fibers from T12-L2/3 synapse with postsynaptic sympathetic nerves and stimulate contraction of internal urethral sphincter

2. Presynaptic parasympathetic nerve fibers S2-S4 synapse with postsynaptic parasympathetic nerves and stimulates peristaltic-like contractions of the vas deferens

3. Presynaptic sympathetic nerve fibers from T12-L2/3 synapse with postsynaptic sympathetic nerves and stimulates peristaltic-like contractions of the vas deferens

4. Presynaptic parasympathetic nerve fibers S2-S4 synapse with postsynaptic parasympathetic nerves and form cavernous nerves to erectile bodies of the penis

5. Presynaptic sympathetic nerve fibers from T12-L2/3 synapse with postsynaptic sympathetic nerves and stimulate contractions of secretions from the prostate gland

53. Jonathan H. is on hour 6 at the gym when he drops 550 lbs on his abdomen doing a bench press. He seems to be ok, but he has lost the sympathetic innervation to his spleen. Which of the following spinal nerves have been damaged?

1. T5-T8

2. T6-T9

3. T6-T8

4. T8-T10 

5. T5-T9

54. Your sister and her husband have been trying to get pregnant for four years. Though she is only 29 years old, healthy, and still menstruating, her doctor just informed her that she will not be able to have children.  She is terribly distraught, but decides she should have a hysterectomy because doesn’t want to have her period any more if she cannot bear children anyway. As a first year medical student you try and explain to her why she should first discuss the risks with her doctor. An example you might give is:

1. The uterine artery passes over the ureter and this could be severed during surgery

2. The doctor could be wrong, and you should just keep trying to have a kid just in case!

3. The bladder and the uterus are very close together and an infection from the surgery could give her bladder cancer

4. Removing the uterus is a complicated process, and sometimes the sciatic nerve is damaged.

5. Hysterectomies aren’t possible for someone so young because her ovaries are too well vascularized.

55. Seth B. had a bit too much coffee one morning and develops a strong urge to use the restroom right in the middle of an exciting anatomy lecture over the urinary organs. Since he’s enjoying the lecture so much, he decides to “hold it” until class is over. Which of the following nerves is most likely responsible for Seth’s ability to inhibit micturition despite his relatively full bladder? 

1. Pelvic nerve 

2. Hypogastric nerve 

3. Pudendal nerve 

4. Inferior inguinal nerve 

5. Sciatic nerve 

56. The picture below displays an angiogram of the lower abdominal region. Which of the following correctly identifies the vessel indicated by the red arrow?

1. Left common iliac artery

2. Right internal iliac artery

3. Left internal iliac artery

4. Right external iliac artery

5. Left external iliac artery

57. Muscle contraction occurs when myosin shifts. Normally, an enzyme called SERCA allows the muscle to relax at the expense of ATP. When mitochondrial activity halts after death, the muscles become rigid. Which statement best explains this phenomenon?

1. In the absence of ATP, actin-myosin cross-bridges become stable and are unable to detach.

2. In the absence of ATP, neural impulses decrease in frequency and thin filaments condense.

3. In the absence of ATP, troponin fails to cover the myosin-binding sites on actin.

4. Binding actin produces a pivot in the myosin which pulls thin filaments father away from the A band.

5. In the absence of ATP, myosin heads cannot bind actin.

58. Myocardial structure alteration can result in reduced cardiomyocyte adhesions. Which structure is most likely altered in such an event?

1. Epimysium

2. Intercalated disc

3. Intrafusal fibers

4. T-tubules

5. Perimysium

59. A patient presents to your clinic with constant headaches increasing in pain over the past few months with no prior history. After checking all of their basic labs, you suspect the possibility of a tumor compressing a part of the brain. You order a lab level to be drawn of the GFAP protein (glial fibrillary acid protein). The lab test comes back with a high GFAP value. What type of cell does this tumor come from?

1. Schwann cell

2. Oligodendrocyte

3. Ependymal cell

4. Astrocyte

5. Microglial cell

60. The following picture shows a cross section of muscle. Which of the following best describes the structure and the function outlined in yellow?

1. Extrafusal fibers – generate tension to allow for skeletal movement

2. Intercalated disc – stretch reflex

3. Intrafusal fibers – proprioception

4. Extrafusal fibers – proprioception

5. Intrafusal fibers – generate tension to allow for skeletal movement

61. In relation to the peritoneum, the stomach is considered?

1. Intraperitoneal

2. Extraperitoneal

3. Retroperitoneal

4. Subperitoneal

5. Metroperitoneal

62. Chris F. is walking into Sodies to stock up for the weekend following his big anatomy exam. Unfortunately, he is stabbed (just like Seth!) in the inguinal region by an enraged alcoholic who wanted the tequila he had just bought. Laying there frantic, Chris recalled the lecture over the posterior abdominal wall and realized that he had no feeling in the superior anterior compartment of the thigh. Which of the following muscles would experience a loss of function based upon the nerve that was damaged in this encounter?

1. Dartos muscle 

2. Cremaster muscle 

3. Diaphragm 

4. Superficial transverse perineal muscle 

5. Adductor longus 

63. Emily H. decided to parachute out of a plane. Upon her descent, she realized very quickly that she was landing in the middle of a forest. As she plummeted through the branches, her left buttock was punctured along with her inferior gluteal artery. What muscles would be at risk for due to lack of blood supply?

1. Obturator internus

2. Coccygeus

3. Internal anal sphincter

4. Piriformis

5. Compressor urethrae

64. A running back for a certain swine-themed American college football team took a particularly nasty hit and suffered blunt trauma to the abdomen resulting in a duodenal perforation. Any blood and fluids that may escape from this perforation would most immediately in up in where?

1. Supracolic compartment

2. Infracolic compartment

3. Superior recess of omental bursa

4. Inferior recess of omental bursa

5. Another 1-7 season

65. A medical student is running with sharp scissors to show Dr. Throckmorton that his donor has three kidneys. However, the student inadvertently stabs himself in the left lumbar region of the abdomen (should not have been running with scissors!). Dr. Throckmorton rolls his eyes and proceeds to examine the student. He informs the student that the peritoneal cavity has been punctured but the visceral peritoneum is still intact. The student realizes that the mostly likely organ punctured is the:

1. Duodenum

2. Jejunum

3. Descending Colon

4. Sigmoid Colon

5. None of the above

66. During a full workup on a 2-month-old infant with a history of intermittent gastrointestinal pain and vomiting, physicians discovered that the cause was lack of emptying of the stomach. They immediately suspected that the cause was a spasmodic contraction of which of the following parts of the stomach?

1. Cardiac notch 

2. Fundus 

3. Lesser curvature 

4. Pylorus 

5. Rugae 

67. Where would one put the probe on a patient when seeking to view the abdominal viscera, such as the pancreas?

1. Transpyloric plane

2. Interlumburcular plane 

3. Right midclavicular line 

4. Left midclavicular line

5. Umbilical region 

68. You are performing an abdominal ultrasound on your good friend Lucas T., who is conveniently pictured below. You place the probe in the transverse plane with the orientation marker facing his right side. In which order (anterior to posterior) would you encounter the abdominal viscera in this region? 

1. Body of the pancreas, left lobe of the liver, splenic vein, superior mesenteric artery, body of the vertebrae

2. Body of the pancreas, left lobe of the liver, superior mesenteric artery, splenic vein, body of the vertebrae 

3. left lobe of the liver, Body of the pancreas, splenic vein, superior mesenteric artery, body of the vertebrae

4. left lobe of the liver, Body of the pancreas, superior mesenteric artery, splenic vein, body of the vertebrae

5. Body of the pancreas, superior mesenteric artery, left lobe of the liver, splenic vein, body of the vertebrae 

69. A patient presents with a vaginoperineal fistula. Which of the following fascial layers will this structure penetrate?

1. Uterovaginal fascia 

2. Scarpa’s fascia 

3. Peritoneal membrane 

4. A & B

5. A & C 

70. Many cases of female stress urinary incontinence, which affects nearly a quarter of all women, can be treated with transvaginal mid-urinary slings. This is not an entirely risk-free procedure, and occasionally patients report diminished superomedial sensation of the thigh and a weakness with adduction of the lower limb. What could have occurred during this procedure that would lead to this outcome? 

1. Damage to the puborectalis muscle

2. Damage to the obturator nerve

3. Damage to the median sacral artery

4. Damage to the perineal body

5. Damage to the genitofemoral nerve

71. Nemo Incognito ate only cookie dough for 3 months and began experiencing pain in his umbilical region which radiated into his right inguinal region. His friends cut him open to perform an emergency appendectomy only to discover that the appendix had long since ruptured (cautionary tale: eat fiber). Infection had most likely spread to which of the following areas?

1. Hepatorenal recess

2. Superior recess

3. Inferior recess

4. Left colic flexure

5. Supraduodenal recess

72. Appendicitis is a medical emergency that almost always requires prompt surgery to remove the appendix. Left untreated, an inflamed appendix will eventually burst, or perforate, spilling infectious materials into the abdominal cavity. Which of the following organs are LEAST likely to be affected by the infectious material resulting from a ruptured appendix?

1. Ileum 

2. Pancreas 

3. Jejunum

4. Stomach 

5. Liver 

73. The left gonadal vein drains into the _______ and the right gonadal vein drains into the _______.

1. Left renal vein, right renal vein

2. Left renal vein, inferior vena cava

3. Splenic vein, right renal vein

4. Inferior vena cava, right renal vein

5. Inferior vena cava, Inferior vena cava