This is the third in a series of comprehensive clinical anatomy and imaging questions for the abdomen. Good luck!
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Abdominal Anatomy Part Three MCQ
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?
Stem 2 of 4The 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?
Damage to the transversus abdominis muscle fibres
Damage of the inguinal ligamenet
Damage to the superior epigastric vessels
Slow healing time of the linea alba
Stem 3 of 4The doctor's differential included Crohn's disease. Which of the below symptoms are most suggestive of this diagnosis?
Diffuse abdominal pain
Decreased level of consciousness
Stem 4 of 4A 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?
Superior mesenteric artery
Inferior mesenteric artery
Atrophied external oblique muscles
Inferior epigastric aneurysm
Linea alba resection
Conjoint tendon atrophy
Mass movement coordination
Passive structural support
Retroperitoneal hepatic flexure
Ischaemia of the small bowel
Upper GI bleed
Intraperitoneal proximal large bowel
It is formed of mesoderm
it is the boundary between anus and rectum
It is the division of hindgut-ectoderm marking
It is a common site of colonic cancer
Patient has decreased risk of oesophageal varices
Patient may have increased risk of cerebral oedema
Patient may have increased clearance of ammonia
Patient asterixis is a sign of CO2 retention
Haemorrhoid was distal to the pectinate line
Haemorrhoid had herniated through the external anal orifice
Haemorrhoid had perforated distal to the dentate line
Haemorrhoid was present only proximal to the dentate line