Anatomy Exam 3 (2018) Published on October 5, 2020 by ehudspeth Welcome to your Anatomy Exam 3 (2018) 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? Flexion of trunk Rotation of trunk Compression of abdominal viscera Lateral side-bending of trunk Tension of linea alba 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? The cervix The body of the uterus The fundus of the uterus The sigmoid colon The prostate 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: Superficial inguinal Deep inguinal Internal iliac Lumbar External iliac 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? Gallbladder Stomach Pancreas Right kidney Spleen What unique characteristic of a pelvis would indicate the patient is a child? Smaller subpubic angle Narrower greater sciatic foramen Presence of triradiate cartilage A heart shaped pelvic inlet Thicker posterior superior iliac spine 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? Myasthenia gravis Rigor mortis Myoneural gravis Leiomyoma Graves Disease 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: Superficial layer Camper fascia Membranous layer Intercrural fibers Inguinal falx 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? Between the medial umbilical fold and lateral umbilical fold Through the femoral canal Lateral to the lateral umbilical fold Through the deep inguinal ring Through the supravesical fossa 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? In the renal pelvis At the ureteropelvic junction As the ureter crosses the external iliac artery As the ureter crosses the bladder wall As the ureter crosses over the pelvic brim 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? IgA nephropathy Adult polycystic disease Type II Diabetes Lupus Reflux nephropathy 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: Hepatorenal recess Omental bursa Rectouterine pouch Subphrenic recess Retroperitoneal space 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? Cecum and Ileocolic artery Small intestine and supraduodenal artery Descending colon and left colic artery Sigmoid colon and left colic artery Descending colon and superior rectal artery Pancreatic cancer is so often deadly in part because it metastasizes so readily. Where would you suspect that pancreatic cancer would metastasize to first? Transverse colon Peyer patches Inferior part of the duodenum Inferior vena cava Superior part of the duodenum 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? Superior mesenteric artery Inferior mesenteric artery Left colic artery Right colic artery Marginal artery A 25-year-old victim of an automobile accident has received severe damage to her pelvic inlet. Which of the following structures was spared? Pecten pubis Pubic symphysis Sacral promontory Pubic crest Sacrotuberous ligament 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? Pubococcygeus Iliococcygeus Coccygeus A & B A, B, & C 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 determined which of the following? The obstetric conjugate was >11 cm by measuring the distance you marked to the tip of your middle finger The obstetric conjugate was >11 cm by measuring the distance you marked to the tip of your index finger The diagonal conjugate was >11 cm by measuring the distance you marked to the tip of your middle finger The diagonal conjugate was >11 cm by measuring the distance you marked to the tip of your index finger None fo the above 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? Dartos muscle Cremasteric muscle Inguinal falx Suspensory ligament of the penis Tunica vaginalis Which of the following features would indicate a male pelvic girdle? A shallow lesser pelvis Small acetabulum Subpubic angle of more than 80 degrees Narrower sciatic notch that’s part of the greater sciatic foramen Oval obturator foramen The normal position of the uterus is which of the following? Retroflexed and anteverted Anteflexed and anteverted Anteflexed and retroverted Anteverted and retroverted Retroverted and retroflexed 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? The hypogastric nerve is responsible for contraction of the detrusor muscle during micturition The pelvic parasympathetic nerves relax the internal urethral sphincter during micturition The pudendal nerve contracts the external urethral sphincter during micturition The pelvic parasympathetic nerves contract the internal urethral sphincter during micturition The hypogastric nerve is responsible for the relaxation of the internal urethral sphincter muscle during micturition 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)? Anterior sacroiliac ligament Superior pubic ligament Inferior pubic ligament Interosseous sacroiliac ligament Sacrotuberous ligament 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? Bartholin’s cysts Vestibular cysts Vestibular bulbs Alcock’s cysts Skene’s cysts 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? Vas deferens Mediastinum testis Tunica vaginalis Tunica albuginea Rete testis 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? Superficial Inguinal lymph nodes Internal Iliac lymph nodes Deep inguinal lymph nodes External iliac lymph nodes Axillary lymph nodes 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: Aorta Inferior Vena Cava Portal vein Right renal artery Superior mesenteric vein Time is Up!