Flashcards in abdomen chung Deck (50):
A 63 year old man has back pain, weakness, and SOB. He has aneurysm of abdominal aorta at aortic hiatus of diaphragm. What pairs of structures would most likely be compressed?
Azygous vein and thoracic duct
What passes through the esophageal hiatus?
A 36 year old woman with yellow pigmentation of the skin and sclerae presents. Which condition most likely is the cause of her obstructive jaundice?
Cancer in the head of the pancreas (obstructs bile duct)
A 2 year old boy presents with pain in his groin that has been increasing in nature over the past few weeks. He has degenerative malformation of transversalis fascia during development. Which structure on anterior abdominal wall is likely defective?
Deep inguinal ring (lies in transversalis fascia just lateral to epigastric vessels)
A 29 year old man has duodenal peptic ulcer and complains of cramping epigastric pain. Which structures harbor the cell bodies of abdominal pain fibers?
Dorsal root ganglion
A 42 year old obese woman with 7 children has large gallstones that have ulcerated through posterior wall of fundus of gallbladder into intestine. Which of the parts of the intestine is more likely to initially contain gallstones?
Transverse colon (fundus of gallbladder is in contact with this)
A 35 year old woman complains of abdominal tenderness and acute pain. Her physician observes that an abdominal infection has spread retroperitoneally. Which structure is most likely affected?
A 46 year old woman has hypersecretion of NE from suprarenal medulla. Which types of nerve fibers are most likely overstimulated?
Preganglionic Sympathetic Fibers
A 6 year old girl has constipation, abdominal distention, and vomiting and diagnosed with Hirschsprung's disease (aganglionic megacolon). This condition is caused by absence of which kind of neural cell bodies?
Enteric ganglia (Parasympathetic postganglionic neuron cell bodies) in the lower part of colon
A pediatric surgeon is resecting a malignant mass from liver of neonate with cerebral palsy. The surgeon divides the round ligament of the liver during surgery. A fibrous remnant of which fetal vessel is severed?
Left umbilical vein --> Ligamentum Teres (round ligament of liver after birth)
A 27 year old woman suffers a gunshot wound to midabdomen. A trauma surgeon locates bleeding from pairs of veins that typically terminate in same vein. Which veins are damaged?
Right and Left Hepatic Veins (drain IVC)
A 43 year old man complains of abdominal pain just above umbilicus. A tumor is found anterior to inferior vena cava. Which structure would most likely be compressed by this tumor?
Third part of duodenum
A 33 year old man with a perforated gastric ulcer complains of excruciating pain in his stomach. The pain comes from peritoneal irritation by gastric contents in lesser sac. Which nerves contain sensory fibers that convey this sharp pain?
Lower intercostal nerves
A boy has pelvic fracture and the doctor tests his reflexes. Which nerves would carry afferent impulses of the cremasteric reflex?
A man receives a penetrating knife wound in abdomen and injures both the superior mesenteric artery and vagus nerve. Which portion of the colon would most likely be impaired?
Ascending and transverse colon
A man with portal hypertension secondary to cirrhosis of the liver and subsequent massive ascites refuses to have a TIPS procedure. Which of the following surgical connections are involved in the most practical method of shunting portal blood around the liver?
Splenic vein to the left renal vein (divert blood from portal to caval system)
A man suffers from ischemia to suprarenal glands. Rapid occlusion of direct branches of which arteries results in this condition?
Aorta, inferior phrenic, and renal arteries
A woman has a perforation in posterior wall of the stomach in which the gastric contents have spilled into the lesser sac. The surgeon has opened the gastrosplenic ligament to reach the lesser sac and notes erosion of the ulcer into the artery. Which vessel is involved?
Left gastroepiploic artery
A woman with a history of cholecystectomy arrives with intractable hiccups most likely caused by an abdominal abscess secondary to surgical infection. Which nerves carries pain sensation caused by irritation of the peritoneum on the central portion of the inferior surface of the diaphragm?
A boy with a ruptured spleen has a splenectomy. After ligation of the splenic artery the patient heals normally. Normal blood flow would occur in which artery?
Inferior pancreatioduodenal artery
A boy complains of nausea, vomiting, fever, and loss of appetite. He has tenderness and pain on the right lower quadrant because he has acute appendicitis. Which structure would be injured at McBurney's point?
A man with ETOH abuse presents with abdominal distention most likely resulting from an alteration in portal systemic blood flow. Which characteristics are associated with portal vein/portal venous system?
Caput medusae and hemorrhoids caused by portal hypertension
A physician is trying to distinguish the jejunum from the ileum. He has observed that the jejunum has:
Fewer mesenteric arterial arcades
A patient with liver cirrhosis has portal hypertension, which vein is most likely dilated?
Right colic vein (belongs to portal venous system and empties into superior mesenteric vein)
A patient is admitted with a retroperitoneal infection. Which artery is most likely to be infected?
Dorsal pancreatic artery
A pediatric doctor resected a structure that is a fibrous remnant of embryonic/fetal artery in a 5 year old child. Which structure is most likely divided?
Medial umbilical fold
A patient has a tumor in the body of the pancreas that obstructs the inferior mesenteric vein just before joining the splenic vein. Which vein is most likely to be enlarged?
A man with prostatic hypertrophy returns to his urologist with epididymitis. An acute infection involving dartos muscle layer of the scrotum most likely leads to an enlargement of which of the following lymph nodes?
Superficial inguinal nodes
A patient with cryptogenic cirrhosis is scheduled for a liver transplant. The reason the doctor must play close attention to the anatomic location of the liver is that this organ:
Drains venous blood into the hepatic veins
A woman is brought to the ER for right upper quadrant pain, nausea, and vomiting. For this case, it is important to remember that the bile duct:
Drains bile into the second part of the duodenum
A patient with diverticulosis of the colon presents with ongoing complaints of left lower quadrant pain and occasionally bloody stools. His physician begins workup with appropriate test by recalling that the sigmoid colon:
Has teniae coli and epiploic appendages
A man with a ruptured appendix is sent to the ED for surgery. To cut off blood supply to the appendix (if collateral circulation is discounted), a surgeon should ligate which artery?
Ileocolic colic artery
Base of Crohn's disease and a small bowel obstruction leading to bowel ischemia, an elderly woman requires bypass of her ileum and jejunum and is scheduled for a gastrocolostomy. The surgeon will ligate all arteries that send branches to the stomach. Which arteries are spared?
Inferior pancreaticoduodenal artery
A woman with peptic ulcer disease of the stomach experiences severe abdominal pain. Which of the nervous structures would most likely be involved?
Greater splanchnic nerve
Before beginning Csection the OBGYN noted the patient had an aponeurosis of the transverse abdominal muscle. This aponeurosis most likely contributes to the formation of what?
Anterior layer of the rectus sheath below the arcuate line
A man has an isolated tumor located in the porta hepatis. This tumor most likely compresses which structure?
Branches of the portal vein
A patient had an emergent cholecystectomy because of cholecystitis. The surgeon recalls that one pair of veins forms a portal-caval anastomoses. Which pairs of veins form a porta-caval anastomoses?
1. Superior and middle rectal vein
2. Left gastric vein and esophageal vein of the azygous
3. Paraumbilical and superficial epigastric vein
4. Rectocolic vein and twigs of the renal vein
What is a Meckel's diverticulum. Which statement is true about the diverticulum?
It is a persistent remnant of the embryonic yolk sac
A patient is jaundice and complains of abdominal pain, loss of appetite and weight loss. The CT shows a tumor in the uncinate process of the pancreas. Which structure is most likely compressed by this tumor?
Superior mesenteric artery
A boy has a lump in the groin near the thigh and pain in the groin. On examination, the physician makes a diagnosis of a direct inguinal hernia because the herniated tissue:
Develops after birth
A 21 year old man lifting heavy boxes results in a hernia. The urologist recalls that the genitofemoral nerve:
Passes through the deep inguinal ring (gives off the genital branch)
A man has hepatocellular carinoma. The surgeon locates the affected quadrate lobe of the liver that:
Drains bile into the left hepatic duct
A man with edema of the lower limb and enlarged superficial veins of the abdominal wall. Examination reveals obstruction of the inferior vena cava just proximal to the origin of the renal vein. This venous blockage may result in dilation of which vein?
Left suprarenal vein
During surgical treatment of portal hypertension of a man with liver cirrhosis, a surgeon inadvertently lacerates the dilated paraumbilical veins. The veins must be repaired to allow collateral flow. Which ligaments is most likely severed?
A woman is admitted for deep abdominal pain in her epigastric region. It is observed that a retroperitoneal infection erodes an artery that runs along the superior border of the pancreas. Which artery is likely injured?
A woman with a history of IBS presents for possibility of surgical resection of the GI tract where vagal parasympathetic innervation terminates. Which of the following sites is most appropriate for surgical resection?
Left colic flexture
A man is admitted for severe abdominal pain, nausea, and vomiting resulting in dehydration. CT reveals a tumor located between the celiac trunk and the superior mesenteric artery. Which structure is likely compressed by this tumor?
Neck of the pancreas
An emergent hernia repair is scheduled. The internal oblique abdominis muscle contributes to the formation of which structure?
Falx inguinalis (formed by aponeurosis of internal oblique and transverse muscle of abdomen)
A 9 year old girl crashed into a brick fence. Her radiogram and angiogram shows a laceration of the superior mesenteric artery immediately distal to the origin of the middle colic artery. If collateral circulation is discounted, which organ may become ischemic?