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

Reviewed by: awaiting review

Abdominal Anatomy Part Three MCQ

Congratulations - you have completed Abdominal Anatomy Part Three MCQ. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1

Stem 1 of 4

Joseph, a 55 year-old male, presents to his GP with diffuse T10 dermatome pain, a history of bleeding from his rectum and vomitus for the past two days.  After a thorough history and examination, the doctor concludes the patient may have a volvulus.
Based on the referred pain location above, which of the following is NOT likely to be the site of the volvulus?
A
Proximal duodenum
B
Jejunum
C
Ileum
D
Caecum
Question 2

Stem 2 of 4

The patient is blue-lighted to ED for emergent laparoscopy. The surgeon insists on a median-line incision into the anterior abdominal wall, in order to preserve neurovasculature.  What is the risk of this operative procedure?
A
Damage to the transversus abdominis muscle fibres
B
Damage of the inguinal ligamenet
C
Damage to the superior epigastric vessels
D
Slow healing time of the linea alba
Question 2 Explanation: 
The linea alba is the site of median-line insertion during emergent exploratory abdominal surgery when laparoscope is not advised - eg time, etc. The concern is the relative avascularity of the structure and therefore its slow healing time.
Question 3

Stem 3 of 4

The doctor's differential included Crohn's disease.  Which of the below symptoms are most suggestive of this diagnosis?
A
Haematochezia
B
Haemoptysis
C
Diffuse abdominal pain
D
Decreased level of consciousness
Question 4

Stem 4 of 4

A plain radiograph of the abdomen is ordered confirming volvulus to the distal ileum.  As the surgeon later explores, he notes ischaemic change of the ileum.  What is the origin of these impinged structures?
A
Coeliac axis
B
Coeliac trunk
C
Superior mesenteric artery
D
Inferior mesenteric artery
Question 5
A patient has had iatrogenic-destruction of the iliohypogastric nerve, resulting in a direct inguinal hernia.  Which of the following structures are best implicated in this mechanism?
A
Atrophied external oblique muscles
B
Inferior epigastric aneurysm
C
Linea alba resection
D
Conjoint tendon atrophy
Question 6
A patient has suffered major abdominal trauma with viscus extra-corpus.  You look at the loop of intestine that has herniated from a laceration and see that the mesentery is full of fat.  Which of the following is this most likely to be?
A
Duodenum
B
Proximal jejunum
C
Proximal ileum
D
Distal jejunum
Question 7
A longitudinal line of smooth muscle lies externa to the adventitia of the large bowel.  What is the function of this?
A
Peristalsis
B
Mass movement coordination
C
Passive structural support
D
Haustration formation
Question 8
A patient with a rare anatomic variation results in distal caecal-proximal ascending colon volvulus and megacolon proximally as a result.  Postulate what may have caused this?
A
Retroperitoneal hepatic flexure
B
Ischaemia of the small bowel
C
Upper GI bleed
D
Intraperitoneal proximal large bowel
Question 9
A patient, with prior diagnosis of overflow incontinence second to BPH, presents to GP with a two week history of perineal diffuse pain that has localised to the suprapubic region recently. A diagnosis of cystitis with secondary _____ is given.  Fill-in the blank
A
Pleuritis
B
Parietal peritonitis
C
Visceral peritonitis
D
Pericarditis
Question 10
A patient with previous diagnosis of endometriosis has uncontrolled cystic inflammation to her cervix and presents to her OBGYN for review.  Suggest where the pain will most likely refer.
A
L1
B
L4
C
S3
D
S5
Question 10 Explanation: 
The cervix lies below the pelvic pain line, but is not ectoderm-derived as the distal vagina. Thus the localisation must be related to the S2-4 dermatome.
Question 11
Of the dentate line
A
It is formed of mesoderm
B
it is the boundary between anus and rectum
C
It is the division of hindgut-ectoderm marking
D
It is a common site of colonic cancer
Question 12
A patient with notable general examination of scleral jaundice and asterixis states a 24 year history of "heavy drinking" of alcohol.   He reports to the GP with pain on defecation and some spotty bleeding in the stool.  Which of the following is best representative of the diagnosis?
A
Anorectal varices
B
Internal haemorrhoids
C
External haemorrhoids
D
Visceral haemorrhoids
Question 13
A patient with notable general examination of scleral jaundice and asterixis states a 24 year history of "heavy drinking" of alcohol.   He reports to the GP with pain on defecation and some spotty bleeding in the stool.  Of this patient, which of the following are correct?
A
Patient has decreased risk of oesophageal varices
B
Patient may have increased risk of cerebral oedema
C
Patient may have increased clearance of ammonia
D
Patient asterixis is a sign of CO2 retention
Question 13 Explanation: 
Liver cirrhosis, or dysfunction, will lead to hypoalbuminaemia, and thus cause a decrease of serum oncotic potential. This risks extravasation, such as from the cerebral capillaries.
Question 14
Patient presents with external haemorrhoids on examination and a pain history of dull diffuse pain in the posterior leg running to the posterior thigh.  Recently the pain has spread to the perianal region.  What constitutes the former sign?
A
Haemorrhoid was distal to the pectinate line
B
Haemorrhoid had herniated through the external anal orifice
C
Haemorrhoid had perforated distal to the dentate line
D
Haemorrhoid was present only proximal to the dentate line
Question 15
Which of the following is the more powerful mediator of defecation?
A
Mechanoreception
B
Baroreception
C
Chemoreception
D
Osmoreception
Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results
There are 15 questions to complete.

Spotted an error?

6 + 6 =