This is the fourth in a series of comprehenisve clinical anatomy and imaging questions for the abdomen.  Good luck!

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Abdominal Anatomy Part Four MCQ

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Question 1
Which of the following are not constituents within the root of the mesentery?
A
Superior mesenteric artery
B
Superior mesenteric vein
C
T11 SNS fibres
D
T12 SNS fibres
Question 2
Of the mesenteric root
A
It divides the lateral colic gutters
B
It runs from the point delineating upper and lower GI bleeds clinically
C
It contains the inferior mesenteric vein
D
It contains T5 SNS afferents
Question 3
The root of the mesentery runs inferolaterally to the
A
Ileal diverticulum
B
Ascending colon
C
Hepatic flexure
D
Ileocecal junction
Question 4
Jejunal peristalsis is partly regulated by
A
Autonomics of the coeliac plexus
B
Fibres running with the inferior mesenteric artery
C
PaNS T5 root value
D
The vagus nerve
Question 5
A patient presents with fever, malaise and periumbilical pain localising to the right inguinal region.  Which of the following is not an appropriate differential for the initial presentation?
A
Gallstones pancreatitis
B
Appendicitis
C
Haemoperitoneum second to fallopian tubular ectopic rupture
D
Ileal diverticulum of Meckel
Question 6
Which of the following is the appropriate surface anatomy of the initial bifurcation of the major arterial supply to the lower limb, abdominopelvis and perineum?
A
Subcostal plane
B
Supracristal plane
C
Transpyloric plane
D
Transtubercular plane
Question 7
Abdominal surface anatomy finds organs at all of the below with the exception of ...
A
LUQ, posterior abdominal wall between ribs 9-11
B
5th intercostal space midclavicular line bilaterally, following the right costal margin
C
Renal hila found at the transpyloric plane
D
McBurney's point of the medial third between ASIS and umbilicus
Question 7 Explanation: 
LUQ describes the spleen, 5th ICS describes the liver, renal hila are found at L1 bilaterally, and McBurney's point - the correct answer in this instance - is the LATERAL third between ASIS and umbilicus.
Question 8
A patient has fallen off his horse and landed on his left side.  Inspection reveals painful, tender and red ipsilateral flank signs with visible signs of hypovolaemic shock occurring on ED presentation by ambulance.  The paramedic on scene ?fracture of L rib 10.  Which organ should be first FAST-scanned (USS) to ascertain integrity?
A
Pancreas
B
Left kidney
C
Spleen
D
Stomach
Question 9
An infection has tracked from the umbilicus through the patient's coronary ligament distally to the viscera of which it is associated.  Which test would best indicate the true functionality of the now infected organ?
A
ALT
B
ALP
C
Prothrombin time
D
Oligoclonal band concentration
Question 9 Explanation: 
The patient has hepatitis. Thus a true test of liver function, aka bilirubin, urea, PT time or albumin can be ascertained to check functionality decline - if any are present.
Question 10
A patient begins iatrogenic exsanguination due to surgical complications in a liver lobar resection.  What is the origin of the major supply of blood TOWARD the liver?
A
L3
B
The superior mesenteric artery
C
T12, the coeliac trunk
D
Formed posterior to the neck of the pancreas
Question 10 Explanation: 
The vast majority of blood travelling toward the liver is venous, not arterial, and thus is derived from the hepatic portal vein. There are a lot of anatomic varieties associated with this structure, but classically-speaking it is formed posterior to the pancreatic neck by the union of the splenic and superior mesenteric veins.
Question 11
The following are not regions of localised dilatation and tortuosity at an anastomotic site in a patient with severe liver cirrhosis and secondary portal hypertension ...
A
Between the internal and external rectal venous plexuses
B
Between the left gastric and azygous venous branches
C
Between the coronary ligament venous branches and superficial epigastric veins
D
Between the inferior vena cava and hepatic vein
Question 11 Explanation: 
Though note there is an oft-forgotten intrahepatic portocaval anastomosis where the ductus venous undergoes recanalisation to shunt into the IVC as in the foetus.
Question 12
Name structures 6, 8, 9 respectively please ...  
A
Common hepatic duct, hepatopancreatic ampulla and gallbladder
B
Common bile duct, hepatopancreatic ampulla and gallbladder
C
Pancreatic duct, hepatopancreatic ampulla and gallbladder
D
Common bile duct, major duodenal papilla and gallbladder
Question 13
Which of the following is not a constituent of the lower urinary tract?
A
The external urethral sphincter
B
The renal pelvis
C
The urinary trigone
D
The cavernous urethra
Question 14
Through which plane can a renal abscess spread bilaterally to include the other renal parenchyma and even vasculitis of the IVC and aorta?
A
Immediately superficial to pararenal fascia
B
Immediately superficial to prerenal fascia
C
Within the renal cortex
D
Only in pelvic kidney second to nephroptosis
Question 15
A patient presents with haemoptysis, vomitus and severe pain score of 10/10 from the loin and migrating to the groin periodically.  The patient is diagnosed, after imaging, with ureteric calculi. Which of the following sites is the least likely location of said stone?
A
The pelvicouterine junction
B
At the internal urethral sphincter
C
As the ureter cross the pelvic brim
D
As the ureter crosses the sacroiliac joint
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