Practice Quiz - Abdominal Wall and Inguinal Region
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  1. The terminal ends of the ilioinguinal nerves in the female are referred to as:
    Anterior cutaneous branches
    Anterior labial
    Cremasterics
    Iliohypogastrics
  2. The usual location for an appendectomy incision is the:
    left lower quadrant
    left upper quadrant
    right lower quadrant
    right upper quadrant
  3. The inferior border of the rectus sheath posteriorly is called the:
    Falx inguinalis
    Inguinal ligament
    Internal inguinal ring
    Arcuate line
    Linea alba
  4. A medical student was asked by her preceptor to palpate the margin of the superficial inguinal ring of a healthy male patient. After passing her finger down the edge of the medial crus of the superficial inguinal ring, she felt a bony protuberance deep to the lateral edge of the spermatic cord, which she correctly identified as the :
    pecten pubis
    pubic symphysis
    pubic tubercle
    iliopubic eminence
    iliopectineal line
  5. You were asked to assist in a surgical operation on a young patient to treat an ulcer in the first part of the duodenum. You would expect that the surgeon will approach the ulcer by doing an anterior abdominal wall incision in the following region:
    Epigastric
    Left inguinal
    Left lumbar
    Right hypochondrial
    Hypogastric
  6. Following an emergency appendectomy your patient complained of having paresthesia (numbness) of the skin at the pubic region. The most likely nerve that has been injured during the operation is:
    Genitofemoral
    Iliohypogastric
    Subcostal
    Spinal nerve T10
    Spinal nerve T9
  7. An obstetrician decides to do a Caesarean section on a 25-year-old pregnant woman. A transverse suprapubic incision is chosen for that purpose. All of the following abdominal wall layers will be encountered during the incision EXCEPT the:
    Anterior rectus sheath
    Posterior rectus sheath
    Rectus abdominis muscle
    Skin and subcutaneous tissue
    Transversalis fascia, extraperitoneal fat, and peritoneum
  8. In order to reduce a hernia (return it to the abdominal cavity), a surgeon finds it necessary to ligate an artery in the extraperitoneal connective tissue (preperitoneal fat) running vertically just medial to the bowel as the bowel passes through the abdominal wall. This artery is the:
    Deep circumflex iliac
    Inferior epigastric
    Superficial circumflex iliac
    Superficial epigastric
    Superficial external pudendal
  9. The posterior layer of the rectus sheath ends inferiorly at the
    Arcuate line
    Intercrestal line
    Linea alba
    Pectineal line
    Semilunar line
  10. Surgical approaches to the abdomen sometimes necessitate a midline incision between the two rectus sheaths, i.e., through the:
    Linea aspera
    Arcuate line
    Semilunar line
    Iliopectineal line
    Linea alba
  11. The internal thoracic artery is sometimes surgically cut near the caudal end of the sternum and used to supply blood to a region of the heart. In these cases, maintenance of adequate blood flow to the rectus abdominis may be dependent on increased flow through which artery?
    Superficial epigastric
    Inferior epigastric
    Umbilical
    Superficial circumflex iliac
    Deep circumflex iliac
  12. The normal pattern of venous and lymphatic drainage of the superficial tissues of the anterior abdominal wall is arranged around a horizontal plane. Above that plane, drainage is in a cranial direction; below the plane drainage is in a caudal direction. This reference plane corresponds to:
    Transpyloric plane
    Level of anterior superior iliac spines
    Transtubercular line
    Level of arcuate line
    Level of umbilicus
  13. During a laparoscopic examination of the deep surface of the lower anterior abdominal wall (using a lighted scope on a thin tube inserted through the wall), the attending physician noted something of interest and asked the young resident to look at the medial inguinal fossa. To do so, the young doctor would have to look at the area between the:
    inferior epigastric artery and urachus
    medial umbilical ligament and urachus
    inferior epigastric artery and lateral umbilical fold
    medial umbilical ligament and inferior epigastric artery
    median umbilical ligament and medial umbilical ligament
  14. If one were to make an incision parallel to and 2 inches above the inguinal ligament, one would find the inferior epigastric vessels between which layers of the abdominal wall?
    Camper's and Scarpa's fascias
    External abdominal oblique and internal abdominal oblique muscles
    Internal abdominal oblique and transversus abdominis muscles
    Skin and deep fascia of the abdominal wall
    Tranversus abdominis muscle and peritoneum
  15. A man is moving into a new house and during the process lifts a large chest of drawers. As he lifts he feels a severe pain in the lower right quadrant of his abdomen. He finds that he can no longer lift without pain and the next day goes to see his physician. Surgery is indicated and during the surgery the surgeon opens the inguinal region and finds a hernial sac with a small knuckle of intestine projecting through the abdominal wall just above the inguinal ligament and lateral to the inferior epigastric vessels. The hernia was diagnosed as:
    A congenital inguinal hernia
    A direct inguinal hernia
    A femoral hernia
    An incisional hernia
    An indirect inguinal hernia
  16. Which structure passes through the deep inguinal ring?
    Iliohypogastric nerve
    Ilioinguinal nerve
    Inferior epigastric artery
    Medial umbilical ligament
    Round ligament of the uterus
  17. A loop of bowel protrudes through the abdominal wall to form a direct inguinal hernia; viewed from the abdominal side, the hernial sac would be found in which region?
    Deep inguinal ring
    Lateral inguinal fossa
    Medial inguinal fossa
    Superficial inguinal ring
    Supravesical fossa
  18. A patient presents with a hernia that is palpable at the superficial inguinal ring. Is this an indirect inguinal hernia?
    Yes
    No
    There is insufficient evidence to tell
  19. In a female with an indirect inguinal hernia, the herniated mass lies along side of which structure as it traverses the inguinal canal?
    Iliohypogastric nerve
    Inferior epigastric artery
    Ovarian artery and vein
    Pectineal ligament
    Round ligament of the uterus
  20. The skin of the mons pubis is supplied by which nerve?
    Anterior scrotal
    Anterior labial
    Femoral branch of the genitofemoral
    Iliohypogastric nerve
    Subcostal nerve
  21. While performing a routine digital examination of the inguinal region in a healthy teen-aged male, the physician felt a walnut-sized lump protruding from the superficial inguinal ring. She correctly concluded that it was :
    definitely an indirect inguinal hernia
    possibly an unusual femoral hernia
    definitely a direct inguinal hernia
    possibly an enlarged superficial inguinal lymph node
    either a direct or an indirect inguinal hernia
  22. During your peer presentation of the inguinal region dissection, you would indicate the position of the deep inguinal ring to be:
    Above the anterior superior iliac spine
    Above the midpoint of the inguinal ligament
    Above the pubic tubercle
    In the supravesical fossa
    Medial to the inferior epigastric artery
  23. An elderly patient with a large indirect inguinal hernia came to your clinic complaining of pain in the scrotum. You conclude that the hernial sac is compressing the following nerve:
    Femoral branch of the genitofemoral
    Femoral
    Iliohypogastric
    Ilioinguinal
    Subcostal
  24. A 45-year-old porter develops a direct inguinal hernia. If the hernia extended through the superficial inguinal ring, it would be surrounded by all of the abdominal wall layers EXCEPT the:
    External spermatic fascia
    Internal spermatic fascia
    Peritoneum and extraperitoneal connective tissue
    Weak fascia of the transversus abdominis muscle lateral to the falx
  25. A pediatrician has diagnosed a newborn baby of having right-sided cryptorchidism (undescended testis). The testis may have been trapped in any site EXCEPT:
    At the deep inguinal ring
    Just outside the superficial inguinal ring
    Pelvic brim
    Perineum
    Somewhere in the inguinal canal
  26. A 15-year-old boy was admitted to the emergency room for having large bowel obstruction resulting from a left-sided indirect inguinal hernia. The most likely intestinal segment involved in this obstruction is the:
    ascending colon
    cecum
    descending colon
    rectum
    sigmoid colon
  27. A 45-year-old man had developed a direct inguinal hernia several months after having an emergency appendectomy. The examining doctor linked the cause of hernia to accidental nerve injury that happened during appendectomy and weakened the falx inguinalis. Which nerve had been injured?
    Femoral branch of the genitofemoral
    Genital branch of the genitofemoral
    Ilioinguinal
    Subcostal
    Ventral primary ramus of T10
  28. The boundaries of the inguinal triangle include all except:
    Arcuate line
    Inferior epigastric vessels
    Inguinal ligament
    Lateral border of rectus abdominus muscle
  29. The superficial inguinal ring is an opening in which structure?
    External abdominal oblique aponeurosis
    Falx inguinalis
    Internal abdominal oblique muscle
    Scarpa's fascia
    Transversalis fascia
  30. If a hernia enters into the scrotum, it is most likely a(n):
    Direct inguinal hernia
    Indirect inguinal hernia
    Femoral hernia
    Obturator hernia
  31. Which nerve passes through the superficial inguinal ring and may therefore be endangered during inguinal hernia repair?
    Femoral branch of the genitofemoral
    Ilioinguinal
    Iliohypogastric
    Obturator
    Subcostal
  32. During exploratory surgery of the abdomen, an incidental finding was a herniation of bowel between the lateral edge of the rectus abdominis muscle, the inguinal ligament and the inferior epigastric vessels. These boundaries defined the hernia as a(n):
    Congenital inguinal hernia
    Direct inguinal hernia
    Femoral hernia
    Indirect inguinal hernia
    Umbilical hernia