MCQs:Anatomy ( Abdomen )



1- Which statement best describes the planes of the abdomen?

a. The transpyloric plane lies halfway between the xiphoid and the symphysis pubis.

b. The transpyloric plane passes through the hilar of the kidneys.

c. The subcostal plane is at the level of the body of L2.

d. The iliac crests lie at the level of L5.

e. The umbilicus usually lies at the level of the L4/L5 disc.

Answer :

b. The transpyloric plane also passes through the pylorus, the pancreatic neck, the duodenojejunal flexure and the fundus of the gall bladder. The spinal cord also ends at the level of the transpyloric plane.

 

2- Which statement about the regions of the abdomen is correct?

a. The epigastrium lies medial to the mid-clavicular line and above the transpyloric plane.

b. The suprapubic region lies between the midclavicular lines, the transpyloric plane and the

intertubercular line.

c. The iliac fossa lies lateral to the mid-clavicular line

and above the intertubercular line.

d. The hypochondrium lies below the transpyloric plane and medial to the mid-clavicular line.

e. The mid-clavicular line crosses the midpoint of the inguinal ligament.

Answer :

a. The abdomen is conventionally divided into nine regions by the two mid-clavicular lines running vertically, and the transpyloric plane and intertubercular plane running horizontally.

The intertubercular plane joins the tubercles of the iliac crests. The epigastrium is in the position described relative to these lines.

3- Which statement correctly describes the abdominal wall?

a. The superficial fascia of the abdominal wall contains Camper’s fascia.

b. The deep fascia of the abdominal wall is known as Scarpa’s fascia.

c. Scarpa’s fascia adheres to the superficial fascia of the thigh.

d. The umbilicus receives sensory fibres from T8.

e. The groin is innervated by T12.

Answer :

a. Camper’s fascia is the superficial fatty layer of the fascia of the abdominal wall. This fatty layer is continuous with the fat of the rest of the body.

4- Which statement about the rectus abdominis is correct?

a. It has the transversalis fascia posteriorly throughout its length.

b. It has three tendinous intersections which are visible posteriorly.

c. It has the aponeuroses of the three oblique abdominal muscles anterior to it below the arcuate line.

d. The lower free border of the anterior rectus sheath is called the arcuate line.

e. The linea alba is a highly vascular structure.

Answer :

c. Below the arcuate line the aponeuroses of all three oblique muscles pass in front of the rectus abdominis. Above the arcuate line the external oblique aponeurosis passes anterior, the transverse oblique aponeurosis passes behind, and the internal oblique aponeurosis splits to enclose the rectus muscle.

5- Which statement about the oblique abdominal muscles is incorrect?

a. The fibres of external oblique pass antero-inferiorly.

b. The lower fibres of internal oblique form the inguinal ligament.

c. The external oblique arises from the lower eight ribs.

d. Internal oblique arises from the lumbar fascia.

e. The internal oblique has a free lower border.

Answer :

b. The lower border of the external oblique aponeurosis forms the inguinal ligament.

6- Which statement best completes this sentence? The inguinal canal:

a. Has a deep ring, which is a defect in the transversus abdominis muscle.

b. Is bounded posteriorly by the inguinal ligament.

c. Has the internal oblique as part of its posterior wall throughout.

d. Has the conjoint tendon superiorly.

e. Transmits the ilioinguinal nerve, which enters the canal through the deep ring.

Answer:

d. The conjoint tendon, comprising of the fused fibres of the internal and transverse oblique muscles, arches over the inguinal canal to attach to the pubic crest.

7- Which of the following statements about the peritoneum is correct?

a. The median umbilical fold contains the obliterated remnant of the umbilical artery.

b. The greater omentum consists of four layers of peritoneum.

c. The gastrosplenic ligament contains the splenic vessels.

d. The lienorenal ligament contains the short gastric vessels.

e. The lesser omentum connects the liver to the transverse colon.

Answer :
b. The greater omentum is formed by two double layers of
peritoneum. The anterior two layers are continuous with
the peritoneal layers enclosing the stomach. They then turn,
double over and blend with the peritoneum of the transverse
colon and mesocolon.

8- Which statement about the lesser sac is not correct?

a. It is connected to the greater sac via the epiploic foramen.

b. The stomach is related anteriorly.

c. The pancreas is a posterior relation.

d. The greater omentum is an anterior relation.

e. The right border is formed by the lienorenal and gastrosplenic ligaments.

Answer:
e. These ligamentous structures form the left border of the
lesser sac.

9- Which statement about the borders of the epiploic foramen is correct?
a. The second part of the duodenum forms the inferior border.
b. The quadrate process of the liver forms the superior border.
c. The hepatic vein forms the posterior border.
d. The free edge of the greater omentum forms the anterior border.
e. The common bile duct is contained within the anterior border.

Answer:
e. The free border of the lesser omentum, which forms
the anterior border, contains the hepatic artery and common
bile duct anteriorly and the portal vein posteriorly. The
hepatic artery is found on the left of the common bile duct.
This arrangement of structures allows compression of the
hepatic artery between finger and thumb (Pringle’s manoeuvre)
to control bleeding from the cystic artery and the liver.

10- Which of the following statements regarding peritoneal compartments is correct?
a. The infracolic compartment lies below the lesser omentum.
b. The right and left subphrenic spaces are separated by the coronary ligament.
c. The right subhepatic space lies between the right lobe of the liver and the right kidney.
d. The left subhepatic space is also known as the hepatorenal pouch.
e. The right paracolic gutter lies medial to the colon.

Answer:
c. This space communicates medially with the lesser sac via
the epiploic foramen. The lateral border is the diaphragm. The
superior border is the inferior border of the coronary ligament
and the triangular ligament.

11- Which of these statements about the coeliac trunk is not correct?
a. It supplies the foregut and its derivatives.
b. It leaves the aorta at the level of L1.
c. It gives a left gastric branch that supplies the oesophagus.
d. It gives a splenic branch.
e. It gives rise to the gastroduodenal artery via its hepatic branch.

Answer:
b. The coeliac trunk arises from the aorta at the level of T12,
a little below the median arcuate ligament.

12- Which statement best describes the blood supply of the
stomach?
a. It is derived entirely from the superior mesenteric artery.
b. The gastroepiploic arteries supply the lesser curvature.
c. The right gastric artery is a direct branch of the coeliac axis.
d. The left gastroepiploic artery arises directly from the coeliac trunk.
e. The short gastric arteries arise from the splenic artery.

Answer:
e. The short gastric arteries are variable in number. Most
commonly six are present. They run in the gastrosplenic ligament
to supply the lateral surface of the stomach.

13- Which statement best describes the venous drainage of
the alimentary tract?
a. All blood drains into the portal system.
b. The portal vein is formed from the union of the inferior mesenteric and splenic veins.
c. The superior mesenteric vein crosses the uncinate process of the pancreas.
d. The inferior mesenteric vein passes behind the left renal vein.
e. The prepyloric vein is variable in position.

Answer:
c. The superior mesenteric vein passes over the uncinate
process of the pancreas before joining the splenic vein behind
its neck. It is trapped in this position by the fusion of the dorsal
and ventral pancreatic diverticulae during development of
the pancreas.

14- Which statement best completes this sentence? The
superior mesenteric artery:
a. Supplies the gut from the pylorus to the terminal ileum.
b. Arises from the aorta at the level of L1.
c. Runs in front of the body of the pancreas.
d. Crosses the second part of the duodenum.
e. Supplies the appendix via its right colic branch.

Answer:
b. The superior mesenteric artery arises from the aorta at
the level of L1 and then descends. It then passes behind the
splenic vein and the body of the pancreas.

15- Which statement best describes the inferior mesenteric artery?
a. It arises from the aorta at the level of the transpyloric plane.
b. It supplies the mucus membrane of the gut as far as the mid-rectum.
c. It gives off a left colic branch.
d. It crosses the pelvic brim at the point of bifurcation of the right common iliac vessels.
e. It anastomoses with the superior mesenteric artery via its sigmoid branch.

Answer:
c. The left colic artery has ascending and descending branches.
In a sigmoid colectomy the ascending branch is preserved to
maintain the blood supply of the proximal descending colon.

16- Which statement best describes the lymphatics of the
gastrointestinal tract?
a. They generally follow routes which are distinct from those taken by the venous drainage of the bowel.
b. Peyer’s patches are found on the mesenteric surface of the large bowel.
c. Lymphoid follicles become less numerous in the distal part of the gut.
d. Preaortic nodes lie at the origins of major blood vessels.
e. Lymph from the alimentary tract eventually passes into the portal system of veins.

Answer:
d. There are coeliac, superior mesenteric and inferior
mesenteric groups of lymph nodes which lie around the origins
of the major blood vessels and drain lymph from their
territories of supply.

17- Which statement best describes the stomach?
a. Lymph from the superior 2/3 of the stomach drains into the suprapancreatic nodes.
b. All lymph from the stomach drains through the coeliac nodes.
c. The gastric branches of the vagi are given of in the greater curve.
d. The lower oesophageal sphinchter is supplied by the nerves of Latarjet.
e. The antral part of the stomach secretes an acid solution.

Answer:
b. All the lymph drainage from the stomach eventually
drains into the coeliac nodes and then into the cisterna chyli.

18- Which of the following statements about the duodenum is incorrect?
a. The second part overlies the right kidney.
b. The transverse mesocolon attaches over the second part.
c. The ampulla of Vater lies in the third part.
d. The inferior vena cava and aorta lie directly behind the third part.
e. The gall bladder overlies the first part.

Answer:
c. The ampulla of Vater opens into the second part of the
duodenum. It opens onto an eminence called the duodenal
papilla which is formed by the union of the common bile duct
and pancreatic duct.

19- Which statement regarding the jejunum and ileum is incorrect?
a. The ileum has thicker walls than the jejunum.
b. The proximal small intestine is of greater diameter than the distal.
c. The mesentery of the small intestine is thicker distally.
d. The jejunum lies mainly in the umbilical region.
e. The mesenteric vessels form more numerous arcades in the ileum.

Answer:
a. The jejunum has thicker walls than the ileum as the valvulae
conniventes are larger proximally.

20- Which of these statements regarding Meckel’s diverticulum is correct?
a. It is found in about 4% of the population.
b. Is always found on the antimesenteric border of the ileum.
c. Is usually about 2 cm in length.
d. Is usually located about 20 cm from the ileocaecal junction.
e. Is usually attached to the umbilicus.

Answer:
b. Meckel’s diverticulum represents the proximal remnant
of the embryonic yolk stalk, and as such is found at the site
of attachment of the yolk stalk at the border of the intestine
opposite its mesenteric attachment.