Practice Quiz - Urinary System
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  1. After successfully performing two adrenalectomies (removal of the adrenal gland), the surgical resident was disappointed to learn that he would be merely assisting at the next one. The chief of surgery told him: "I'm doing this one, since the one on the right side may be a little too difficult for you." The difficulty he envisioned stems from the fact that the right suprarenal gland is partly overlain anteriorly by the:
    aorta
    inferior vena cava
    left hepatic vein
    right crus of the diaphragm
    right renal artery
  2. During preparations to remove the left kidney from a 28-year-old female patient, the surgeon asked an observing medical student where best to ligate the renal vein. Upon hearing the reply: "as close to the inferior vena cava as possible, leaving just enough stump to ensure tight closure," the surgeon's eyebrow shot up. "Do you mean to say you're willing to compromise the venous drainage of the other structures that drain into the renal vein?" By this he meant all of the following except:
    diaphragm
    pancreas
    ovary
    suprarenal gland
  3. Which statement regarding the suprarenal glands is correct?
    Its entire arterial supply is directly from the abdominal aorta.
    Veins from both glands drain directly into the inferior vena cava.
    The glands are localized in the pararenal space.
    Cells that secrete epinephrine and norepinephrine are innervated by preganglionic fibers from the greater thoracic splanchnic nerve.
  4. The nerve that innervates the cells of the suprarenal medulla consists of fibers of the:
    Greater thoracic splanchnic nerve
    Lesser thoracic splanchnic nerve
    Least thoracic splanchnic nerve
    Anterior vagal trunk
    Posterior vagal trunk
  5. The nerves that end on the secretory cells of the medulla of the suprarenal glands are principally:
    Preganglionic fibers from the greater thoracic splanchnic nerve
    Postganglionic fibers from the celiac plexus
    Postganglionic fibers from the aorticorenal ganglia
    Preganglionic fibers from the lesser thoracic splanchnic nerve
    Postganglionic fibers from the renal plexus
  6. With one exception, preganglionic sympathetic axons synapse upon postganglionic sympathetic dendrites or cell bodies. The exception to this general rule occurs within the:
    Kidney cortex
    Kidney medulla
    Suprarenal medulla
    Suprarenal cortex
  7. The pararenal fat in the kidney bed is an elaboration of:
    Peritoneum
    Extraperitoneal connective tissue
    Transversalis fascia
    Fusion fascia
  8. Blood from an injured kidney will seep through the perirenal fat until it contacts the internal surface of the renal (Gerota's) fascia. Without perforating this fascia the blood could then continue to pass in what direction?
    inferiorly toward the pelvis
    laterally into the body wall
    medially across the midline to the other kidney
    superiorly into contact with the fascia of the diaphragm
  9. Benign hyperplasia (excessive growth of cells) of which part of the male reproductive system would be most likely to interfere with the passage of urine?
    Periurethral Zone of the Prostate
    Central Zone of the Prostate
    Peripheral Zone of the Prostate
    Ejaculatory Duct
    Seminal Vesicle
  10. Which structure does NOT form part of the boundary defining the trigone of the bladder?
    Interuteric crest
    Left Ureteric Orifice
    Right Ureteric Orifice
    Urachus
    Urethral Orifice
  11. Which structure is found only in males?
    Anterior recess of ischoianal fossa
    Genital Hiatus
    Ischiocavernosus muscle
    Rectovesical pouch
    Sphincter urethrae muscle
  12. During the course of surgery for benign prostatic hypertrophy (benign enlargement of the prostate tissue which occludes the prostatic urethra) an electrical cutting device is inserted into the penile, then prostatic urethra, to remove the hypertrophic tissue. The posterior wall of the prostatic urethra is by necessity removed as well. Which part of the male seminal tract may also be partially removed?
    duct of seminal vesicle
    ductus deferens
    ejaculatory duct
    fossa navicularis
    seminiferous tubule
  13. The prostate gland:
    Contains upper, middle and lower lobes
    Encircles the urethra
    Is well imaged radiologically using an intravenous urogram
    Is extraperitoneal
    B and D
  14. An elderly male patient presents with dysuria and urgency. You suspect benign prostatic hypertrophy which has caused an enlargement of the:
    interureteric crest
    prostatic utricle
    seminal colliculus
    sphincter urethrae
    uvula
  15. An elderly patient is having difficulty in voiding (urinating). He complains that after voiding, he still feels as though he needs "to go" again. You suspect that this patient suffers from benign prostatic hypertrophy, which has caused enlargement of the __________ of the bladder.
    seminal colliculus
    interureteric crest
    ampulla
    trigone
    uvula
  16. Following pregnancy and delivery, a 32-year-old woman continued to have problems with urinary incontinence which developed during pregnancy. Her obstetrician counseled her to strengthen the muscle bordering the vagina and urethra, increasing its tone and exerting pressure on the urethra. This physical therapy was soon adequate to restore urinary continence. What muscle was strengthened?
    Coccygeus
    Ischiocavernosus
    Obturator Internus
    Piriformis
    Puborectalis
  17. Preganglionic parasympathetic nerve fibers within the pelvic (inferior hypogastric) plexus arise from S2, 3, 4 and enter the plexus via:
    gray rami communicantes
    hypogastric nerves
    pelvic splanchnic nerves
    sacral splanchnic nerves
    white rami communicantes
  18. While performing a hysterectomy, the resident must ligate the uterine artery. To avoid iatrogenic injury to the ureters, she must be aware that the ureter passes ___________ the artery at the level of the ______________.
    Over; cervix
    Over; fundus of uterus
    Over; pelvic brim
    Under; cervix
    Under; pelvic brim
  19. After giving birth, a patient complains of urinary stress incontinence characterized by dribbling of urine with an increase in intra-abdominal pressure. Her physician suspects injury to the pelvic floor during delivery which may have altered the position of the neck of bladder and the urethra. Which muscle was most likely damaged during the vaginal delivery?
    Bulbospongiosus
    Coccygeus
    Levator ani
    Obturator internus
    Piriformis
  20. A caudal epidural block is a form of regional anesthetic used in childbirth. Within the sacral canal, the anesthetic agent bathes the sacral spinal nerve roots which would anesthetize all of the following nerves except:
    Pelvic splanchnics
    Pudendal
    S2 dorsal root
    Sacral splanchnics
    S2 ventral primary ramus
  21. After giving birth, a patient complains of dribbling of urine while coughing, sneezing, or laughing. Which muscle was most likely damaged during the vaginal delivery?
    Coccygeus
    Levator ani
    Obturator internus
    Piriformis
    Transverse perineal
  22. Blood supply to the superior portions of the bladder typically arises from the ____________ arteries.
    Umbilical
    Middle rectal
    Obturator
    Inferior gluteal
    Uterine
  23. The pelvic splanchnic nerves primarily carry ____________ to the _____________ plexus.
    Preganglionic parasympathetics--superior hypogastric
    Preganglionic parasympathetics--inferior hypogastric
    Postganglionic parasympathetics--superior hypogastric
    Postganglionic sympathetics--superior hypogastric
    Postganglionic sympathetics--superior hypogastric
  24. The arcus tendineus levator ani is a thickening of fascia of the:
    Coccygeus
    Obturator externus
    Obturator internus
    Piriformis
  25. The sacral outflow of the parasympathetic (craniosacral) system enters the pelvic plexus via:
    Hypogastric nerves
    Pelvic splanchnic nerves
    Pudendal nerves
    Sacral splanchnic nerves