Review Questions (Intervals 1-5)

Question 1

The 10th intercostal nerve supplies a strip of skin overlying the…

Answer 1

Umbilicus. The umbilicus is supplied by which nerve?

Question 2

What layer of the anterior abdominal wall gives rise to the cremasteric layer of muscle and fascia?

Answer 2

Internal abdominal oblique muscle …gives rise to what layer of tissue in/around the testes?

Question 3

The anterior and superior walls of the inguinal canal are formed by the aponeurosis of what muscles?

Answer 3

External obliques

Question 4

External intercostal muscles: a) have costal parietal pleura covering their inner surface b) are continuous w/ the external intercostal membrane anteriorly c) get their primary blood supply from the lateral thoracic artery d) are innervated by dorsal primary rami

Answer 4

b) External intercostal muscles are continuos w/ the external intercostal membrane anteriorly

Question 5

The sternal angle marks the intervertebral disc between which vertebrae?

Answer 5

T4 and T5 (…the disc between these two vertebrae corresponds to what anterior landmark?)

Question 6

What are the 8 layers of the abdominal wall?

Answer 6

…

Question 7

Describe the lymph drainage of the breast:

Answer 7

Most lymph drains to the axillary lymph nodes. The axillary lymph nodes are drained by the subclavian lymphatic trunk. On the right side, lymph enters the venous system via the right lymphatic duct. Most lymph from the left breast returns to the venous system via the thoracic duct.

Question 8

Between what two muscles/fascia would you most likely find an intercostal artery?

Answer 8

Between internal and innermost intercostal muscles.

Question 9

What nerve pierces the pectoralis minor muscle to reach the pectoralis major muscle?

Answer 9

The medial pectoral nerve (…pierces ____ to reach ____)

Question 10

In a spontaneous pneumothorax, air enters the pleural cavity by passing through the…

Answer 10

…visceral pleura

Question 11

Where can you find the phrenic nerve on the left side?

Answer 11

Between the parietal pleura and the parietal pericardium

Question 12

What part of the nervous system contains cutaneous sensory nerves?

Answer 12

The somatic nervous system

Question 13

How many white rami communicantes exist on one side of the body? How many grey rami communicantes exist on one side of the body?

Answer 13

14 white and 31 grey.

Question 14

What structure is located immediately behind the ligamentum arteriosum?

Answer 14

The trachea

Question 15

Ganglia associated with the sympathetic trunk typically contain which of the following cell bodies?

Answer 15

Postganglionic sympathetic cell bodies

Question 16

How would lung cancer contribute to hoarseness?

Answer 16

By invading the vagus nerves (parasympathetic!) and damaging the recurrent laryngeal nerves

Question 17

What key structures does the RCA supply?

Answer 17

The SA and AV nodes

Question 18

How many parts does the duodenum have? And which are retroperitoneal?

Answer 18

4 parts. Parts 2-4 are all retroperitoneal.

Question 19

Course of the phrenic nerve vs. vagus nerve

Answer 19

…

Question 20

Where would you place your stethoscope to best hear the aortic valve?

Answer 20

The right 2nd intercostal space at the sternal margin

Question 21

Why does an enlarged esophageal hiatus cause the stomach to migrate into the chest?

Answer 21

Negative intrathoracic pressure gradually draws the stomach into the posterior mediastinum through an enlarged hiatus

Question 22

What are the three sites ____ hemorrhoids?

Answer 22

?

Question 23

Parasympathetic innervation to the hindgut originates in the S2-S4 spinal cord segments. Parasympathetic neurons travel to the prevertebral plexus via which nerve?

Answer 23

Pelvic splanchnic nerves

Question 24

Which nerves innervate the penile arteries to cause them to dilate during arousal?

Answer 24

Pelvic splanchnic nerves

Question 25

What vessels could be lacerated by a penetrating wound approximately 1 cm lateral to sternum?

Answer 25

Internal thoracic artery and vein

Question 26

What is a positive Murphy's sign?

Answer 26

Tenderness at junction of 9th costal cartilage with upper lateral border of right rectus sheath with deep inspiration; highly suggestive of acute cholecystitis.

Question 27

Layers of the abdomen

Answer 27

Skin, superficial Fascia, External oblique, Internal oblique, Transversus abdominus, Transversalis fascia, Extra-peritoneal fascia, Peritoneum

Question 28

Layers of pericardium

Answer 28

superficial to deep: fibrous pericardium continuous w/ serous parietal pericardium, [pericardial cavity], visceral serous pericardium as the outer layer of epicardium, myocardium

Question 29

Orientation of the R/L lungs and their hilums

Answer 29


Question 30

Spinal levels for hiatuses in the diaphragm

Answer 30

I ate 10 eggs at 12: IVC (T8), Esophagus (T10), Aota & thoraic duct (T12)

Question 31

Ligaments of the uterus and ovaries

Answer 31

Superior and lateral to ovaries are the suspensory ligaments of the ovary. Medial to the ovary, connected to the liver are the ligaments of the ovary. On the anterior of the mesometrium, connected to the uterus where the tubes meet is the round ligament of the uterus. The four parts of the tube: isthmus, ampulla, infundibulum, fimbriae.

Question 32

What are the veins of the portal drainage system?

Answer 32


Question 33

What is the name for the muscle on the posterior side of the ribcage, running from the ribs to the sternum? What is the name for the artery running alongside this muscle?

Answer 33

Transversus thoracis m. Internal thoracic artery and vein.

Question 34

List the major secondary retroperitoneal organs:

Answer 34

2nd, 3rd, 4th parts of the duodenum head, neck, and body of the pancreas ascending colon descending colon upper rectum

Question 35

List the major primary retroperitoneal organs

Answer 35

kidneys adrenal glands ureters aorta IVC lower rectum anal canal

Question 36

What are the three major pelvic nerves we should watch for, and what kind of nerves are they?

Answer 36

Pudendal: S2,3,4 somatic, volunt. sphincter and maintains erections Lumbar & sacral splanchnics: sympathetic, involuntary sphincter control and hold in act of ejaculation Plevic splanchnics : S2,3,4, parasympathetic, poo, pee, and point (gain an erection)

Question 37

Portal hypertension can lead to bleeding from these sites of portal-caval anastamoses

Answer 37

But (hemorhoids), gut (esophageal varices), caput (umbilical varices)

Question 38

Veins that drain the uterus are direct tributaries of...

Answer 38

...IVC, left renal vein, and the inernal iliac veins

Question 39

The splenic artery supplies which of the following structures? ## Footnote A. the body of the pancreas B. the fundus of the stomach C. the greater curvature of the stomach D. the head of the pancreas

Answer 39

The splenic nerve supplies the fundus of the stomach, the greater curvature of the stomach, and the body of the pancreas. BUT NOT THE HEAD OF THE PANCREAS.

Question 40

35. Which of the following statements is correct concerning nerves? ## Footnote A. a dorsal ramus contains motor fibers that innervate skeletal muscle, preganglionic sympathetic fibers, and sensory fibers. B. preganglionic parasympathetic and preganglionic sympathetic axons course in white communicating rami. C. all of the fibers in a dorsal ramus have their neuron cell bodies in a dorsal root ganglion. D. all of the fibers in a ventral ramus have their neuron cell bodies in the spinal cord. E. splanchnic nerves carry autonomic axons and sensory fibers.

Answer 40

E. is the only one that's true!

Question 41

43. During fetal life, in which of the following structures is the oxygen/hemoglobin saturation level the LOWEST? ## Footnote A. Ductus venosus B. Brachiocephalic artery C. Ductus arteriosus D. Umbilical arteries E. Umbilical vein

Answer 41

Ductus arteriosus!

Question 42

45. A surgical procedure is performed in a patient with myasthenia gravis to remove a thymoma, a tumor of the thymus gland. Which of the following structures that must be avoided during the surgery is directly posterior to the thymoma in the superior mediastinum? ## Footnote A. Arch of the aorta B. Esophagus C. Trachea D. Left brachiocephalic vein E. Left common carotid artery

Answer 42

D. Left brachiocephalic vein