PERITONEUM – ABDOMINAL WALL – INGUINAL CANAL

PERITONEUM – ABDOMINAL WALL – INGUINAL CANAL

I. PERITONEUM

1. All of the following statements about the peritoneum are correct EXCEPT:

A – The parietal peritoneum is the portion that lines the inner surface of the abdominal wall.

B – The visceral peritoneum is the portion that covers the organs.

C – The mesentery is the part of the peritoneum that goes from one organ to another.

D – The suspensory ligament is the part of the peritoneum that suspends the organs not belonging to the digestive tract to the abdominal wall.

Answer: D

2. All of the following statements about the peritoneum are correct EXCEPT:

A – The peritoneal cavity is the space between the peritoneal layers.

B – The extraperitoneal space is the space between the peritoneal cavity and the abdominal wall.

C – Organs that are only partially covered are those with a suspensory ligament.

D – Organs completely covered by the peritoneum and with a suspensory ligament are mobile.

Answer: C

3. All of the following descriptions of the mesentery are correct EXCEPT:

A – It suspends some segments of the intestine to the abdominal wall.

B – It consists of two layers.

C – There are blood vessels and nerves between the two layers.

D – The pancreas also has a mesentery.

Answer: D

4. There are all of the following mesenteries EXCEPT:

A – Mesentery of the appendix.

B – Mesentery of the ascending colon.

C – Mesentery of the transverse colon.

D – Mesentery of the sigmoid colon.

Answer: B

5. All of the following descriptions of the lesser omentum are correct EXCEPT:

A – It consists of two peritoneal layers.

B – There are many blood vessels between the two layers.

C – It is the part of the peritoneum that connects the liver to the stomach and duodenum.

D – The hepatoduodenal ligament does not belong to the lesser omentum.

Answer: D

6. Which of the following components does NOT belong to the greater omentum?

A – Gastrophrenic ligament.

B – Gastrohepatic ligament.

C – Gastrocolic ligament.

D – Gastrosplenic ligament.

Answer: B

7. The description of the peritoneal structure is correct EXCEPT:

A – The peritoneal fold is formed by the parietal peritoneum being pushed into the peritoneal cavity by the underlying structures.

B – The peritoneal fossae are the depressions between the peritoneal folds.

C – The recesses located in the lowest regions of the peritoneal cavity are called pouches.

D – The omental bursa is not a peritoneal recess.

Answer: D

8. All of the following descriptions of the omental bursa are correct EXCEPT:

A – The main part of the omental bursa lies between the liver and the stomach.

B – The epiploic foramen connects the omental bursa with the rest of the peritoneal cavity.

C – The vestibule is the part of the omental bursa that lies between the epiploic foramen and the gastrosplenic incisura.

D – The gastrosplenic incisura is located a short distance between the vestibule and the main part of the omental bursa.

Answer: A

9. All of the following descriptions of the vestibule of the omental bursa are correct EXCEPT:

A – The anterior wall is the lesser omentum.

B – The posterior wall is the space between the hepatic artery and the inferior vena cava.

C – The superior wall is the caudate lobe of the liver.

D – The inferior wall is the upper border of the gastroduodenal fold.

Answer: B

10. All of the following descriptions of the ways to access the main part of the omental bursa are correct EXCEPT:

A – The route through the epiploic foramen is the natural route.

B – The route through the hepatoduodenal ligament incision.

C – The route through the 2 anterior layers of the greater omentum incision.

D – The route through the mesentery of the transverse colon incision.

Answer: B

11. Which of the following descriptions of the lesser omentum is correct?

A – Its hepatic border attaches to the margins of the ligamentum teres fossa.

B – It is continuous with the peritoneum of the stomach along the greater curvature.

C – The horizontal part of its hepatic border attaches to the two margins of the porta hepatis.

D – It is continuous with the two layers of the falciform ligament.

Answer: C

12. All of the following statements about the lesser omentum are correct EXCEPT:

A – It is covered by the visceral peritoneum of the liver.

B – It forms the inferior wall of the omental bursa vestibule.

C – It consists of parts connecting the liver to the duodenum, stomach, and esophagus, each part called a ligament.

D – Its right border lies anterior to the inferior vena cava.

Answer: B

13. Which of the following descriptions of the vestibule of the omental bursa is correct:

A – Its left end communicates with the main part of the omental bursa.

B – Its right end is the gastrosplenic incisura.

C – Its superior wall is the quadrate lobe of the liver.

D – Its inferior wall is the body and tail of the pancreas.

Answer: A

14. All of the following descriptions of the omental bursa are correct EXCEPT:

A – It has a recess located between the anterior and posterior layers of the greater omentum.

B – It is the space where the stomach is related to the body of the pancreas and the left kidney.

C – It is bounded on the left by the spleen and its ligaments.

D – It has two natural access routes.

Answer: D

15. Which of the following descriptions of the omental bursa is correct:

A – The posterior wall of the main part of the omental bursa is formed by the body of the pancreas and the right kidney.

B – The superior limit of the main part of the omental bursa is the gastrophrenic ligament.

C – The short gastric arteries run on its posterior wall.

D – It does not extend below the transverse colon.

Answer: B

16. All of the following descriptions of the lesser omentum are correct EXCEPT:

A – Its free right border forms one boundary of the epiploic foramen.

B – Its free right border contains components of the portal triad.

C – It forms the anterior wall of the vestibule of the omental bursa.

D – It attaches to the descending part of the duodenum.

Answer: D

17. (Case study) If a peritoneal infection spreads retroperitoneally, which of the following structures is most likely to be affected?

A – Stomach.

B – Transverse colon.

C – Jejunum.

D – Descending colon.

Answer: D

18. All of the following arteries pass through the mesentery or omentum to reach the organs they supply EXCEPT:

A – Middle colic artery.

B – Sigmoid arteries.

C – Dorsal pancreatic artery.

D – Superior mesenteric artery.

Answer: C

II. ABDOMINAL WALL – INGUINAL CANAL

19. The transversalis fascia contributes to the structure of which of the following structures:

A – Superficial inguinal ring.

B – Deep inguinal ring.

C – Inguinal ligament.

D – Anterior wall of the inguinal canal.

Answer: B

20. Which of the following structures is formed by the remnant of the urachus from the embryonic period:

A – Median umbilical fold.

B – Round ligament of the uterus.

C – Inguinal ligament.

D – Median umbilical fold.

Answer: D

21. Which of the following descriptions of the inguinal ligament is correct:

A – It is formed by the free inferior border of the internal oblique muscle.

B – It runs from the anterior superior iliac spine to the pubic tubercle.

C – It forms the roof of the inguinal canal.

D – It forms the floor of the inguinal canal.

Answer: D

22. Which of the following structures is part of, or formed by, the internal oblique muscle:

A – Conjoint tendon.

B – Inguinal ligament.

C – Cremaster muscle.

D – External spermatic fascia.

Answer: C

23. Which of the following descriptions of the internal oblique muscle is correct:

A – It forms the inferior wall of the inguinal canal.

B – Its aponeurosis contributes to the posterior wall of the inguinal canal.

C – Its aponeurosis contributes to the inguinal falx.

D – Its aponeurosis contributes to the posterior layer of the rectus sheath below the arcuate line.

Answer: C

24. Which of the following structures forms the anterior wall of the inguinal canal:

A – Transversalis fascia.

B – Aponeurosis of the transversus abdominis muscle.

C – Aponeurosis of the external oblique muscle.

D – Conjoint tendon.

Answer: C

25. An indirect inguinal hernia occurs:

A – Lateral to the inferior epigastric artery.

B – Between the inferior epigastric artery and the umbilical cord.

C – Within the umbilical cord.

D – Between the median umbilical fold and the umbilical cord.

Answer: A

26. Which of the following descriptions of the inferior epigastric artery is correct:

A – It lies within a direct inguinal hernia.

B – It lies lateral and posterior to an indirect inguinal hernia.

C – It is a branch of the internal iliac artery.

D – It is a collateral pathway in the presence of aortic stenosis.

Answer: D

27. The aponeurosis of the external oblique muscle contributes to all of the following structures EXCEPT:

A – Inguinal falx.

B – Anterior layer of the rectus sheath.

C – Anterior wall of the inguinal canal.

D – Inguinal ligament.

Answer: A

28. All of the following descriptions of the inguinal canal are correct EXCEPT:

A – It ends at the superficial inguinal ring, within the external oblique aponeurosis.

B – It begins at the deep inguinal ring, within the transversalis fascia.

C – Its anterior wall is mainly formed by the aponeurosis of the transversus abdominis muscle and the transversalis fascia.

D – It is the passageway for the spermatic cord or the round ligament of the uterus.

Answer: C

29. All of the following descriptions of a direct inguinal hernia are correct EXCEPT:

A – It enters the inguinal canal through the posterior wall of the canal.

B – It lies lateral to the inferior epigastric artery.

C – It has a peritoneal sac covering.

D – It may not descend into the scrotum.

Answer: B

30. The following descriptions of the inguinal canal are correct EXCEPT:

A – It is a fascio-muscular gap in the inguinal region of the abdomen (anterolateral abdominal wall).

B – It is shorter than the length of the inguinal ligament.

C – The inguinal region lies medial to the lateral border of the rectus abdominis muscle.

D – It consists of 4 walls and 2 openings.

Answer: C

31. The following descriptions of the walls of the inguinal canal are correct EXCEPT:

A – The superior wall is the inguinal falx or conjoint tendon.

B – The inguinal falx is formed by the aponeurosis of the transversus abdominis muscle and the external oblique muscle.

C – The anterior wall is the aponeurosis of the external oblique muscle.

D – The inferior wall is the inguinal ligament.

Answer: B

32. The following descriptions of the posterior wall of the inguinal canal are correct EXCEPT:

A – It includes the transversalis fascia, extraperitoneal fat, and peritoneum.

B – It is reinforced by the interfoveolar ligament.

C – It has 3 peritoneal fossae.

D – The deep inguinal ring lies in the area of the medial inguinal fossa.

Answer: D

33. Which of the following components is NOT located in the posterior wall of the inguinal canal?

A – The reflected inguinal ligament.

B – The umbilical cord.

C – The urachus.

D – The inferior epigastric artery.

Answer: A

34. The following descriptions of the boundaries of the peritoneal fossae on the posterior wall of the inguinal canal are correct EXCEPT:

A – The supravesical fossa lies between the median umbilical fold and the medial umbilical fold.

B – The medial inguinal fossa lies lateral to the medial umbilical fold.

C – The lateral inguinal fossa lies between the medial umbilical fold and the lateral umbilical fold.

D – The lateral inguinal fossa lies lateral to the inferior epigastric artery.

Answer: C

35. The following descriptions of the deep inguinal ring are correct EXCEPT:

A – It lies 1.5-1.8 cm superior to the midpoint of the inguinal ligament.

B – It lies in the lateral inguinal fossa.

C – It lies medial to the interfoveolar ligament.

D – It is the place where the components of the spermatic cord converge to enter the inguinal canal.

Answer: C

36. The following descriptions of the superficial inguinal ring are correct EXCEPT:

A – It lies about 0.5 cm above the pubic tubercle.

B – It is large enough to accommodate a thumb.

C – It is surrounded by pillars, the reflected inguinal ligament, and intercrural fibers of the external oblique aponeurosis.

D – It is essentially an opening in the external oblique aponeurosis.

Answer: B

37. The following descriptions of the types of inguinal hernias are correct EXCEPT:

A – Indirect inguinal hernias occur lateral to the interfoveolar ligament.

B – Direct inguinal hernias occur medial to the inferior epigastric artery.

C – Direct inguinal hernias occur from the supravesical fossa.

D – Indirect inguinal hernias occur from the medial inguinal fossa.

Answer: D

38. The following descriptions of the inguinal falx are correct EXCEPT:

A – It is formed by fibers that attach to the inguinal ligament from the internal oblique and transversus abdominis muscles.

B – There is a fascial gap between the inguinal falx and the medial half of the inguinal ligament.

C – It lies over and then posterior to the inguinal canal from lateral to medial.

D – It lies over the inguinal canal at the level of the superficial inguinal ring.

Answer: D

39. The following descriptions of inguinal hernias are correct EXCEPT:

A – They are more common in females.

B – They often occur due to a weak abdominal wall.

C – They are called reducible when the herniated mass lies within the spermatic cord.

D – The principle of hernia repair is to narrow the gap between the inguinal ligament and the inguinal falx.

Answer: A

40. The following descriptions of types of inguinal hernias are correct EXCEPT:

A – Congenital hernias are due to the persistence of the processus vaginalis (the processus vaginalis does not close).

B – Acquired hernias are due to a weak abdominal wall.

C – Congenital hernias are a type of hernia located outside the spermatic cord.

D – Direct inguinal hernias are located outside the spermatic cord.

Answer: C

41. Which of the following descriptions of the inguinal canal is correct:

A – Its posterior wall is formed by the rectus abdominis muscle.

B – Its superior wall is the interfoveolar ligament.

C – Its anterior wall is formed by the transversus abdominis muscle.

D – Its inferior wall is the inguinal ligament.

Answer: D

42. The following descriptions of the inguinal canal are correct EXCEPT:

A – It passes posterior and inferior to the inferior fibers of the internal oblique muscle.

B – It passes posterior to the aponeurosis of the external oblique muscle.

C – It passes posterior to the transversalis fascia.

D – Its lateral end lies lateral to the inferior epigastric artery.

Answer: C

43. Which of the following descriptions of the posterior wall of the inguinal canal is correct:

A – The medial inguinal fossa lies close to the midline of the anterior abdominal wall.

B – The umbilical cord pushes the peritoneum into the median umbilical fold.

C – The inferior epigastric artery ascends between the transversus abdominis muscle and the transversalis fascia.

D – The deep inguinal ring lies at the lateral end of the posterior wall of the inguinal canal.

Answer: D

44. The following descriptions of the inguinal canal are correct EXCEPT:

A – The superficial inguinal ring lies just above the medial end of the inguinal ligament.

B – The deep inguinal ring is the place where the components of the spermatic cord converge to enter the spermatic cord.

C – Only the aponeurosis of the external oblique muscle forms the anterior wall of the inguinal canal.

D – The inguinal ligament lies inferior and along the spermatic cord within the inguinal canal.

Answer: C