MCQs of Anatomy of Kidneys & Retroperitoneum.
- A 57-year-old male complains of intense chest pain, but tests rule out any cardiac pathology. It was determined that the patient suffers from an esophageal (hiatal) hernia in which the stomach herniates through an enlarged esophageal hiatus. Muscle fibers from which of the following parts of the diaphragm would border directly on this hernia?
- Sympathetic fibers in the greater splanchnic nerve arise from neuron cell bodies found in the:
superior mesenteric ganglion
- 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:
inferior vena cava
left hepatic vein
right crus of the diaphragm
right renal artery
- 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:
- The celiac plexus of nerves may contain fibers derived from all of the following sources except:
posterior vagal trunk
greater thoracic splanchnic nerve
lesser thoracic splanchnic nerve
lumbar splanchnic nerves
- 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.
- 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
- Regarding the diaphragm, which, is paired INCORRECTLY?
Vertebrocostal trigone – lateral arcuate ligament
Esophageal hiatus – right crus
Medial arcuate ligament – psoas muscle
Central tendon – aortic hiatus
Vena caval foramen – right phrenic nerve
- 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
- The vagus nerve passes into the abdomen by passing through the
Lateral arcuate ligament
Medial arcuate ligament
- With one exception, preganglionic sympathetic axons synapse upon postganglionic sympathetic dendrites or cell bodies. The exception to this general rule occurs within the:
- The pararenal fat in the kidney bed is an elaboration of:
Extraperitoneal connective tissue
- The cisterna chyli accompanies which structure as it passes through the diaphragm?
Inferior vena cava
Greater thoracic splanchnic nerve
- 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
- A 19-year-old male suffers a tear to the psoas major muscle during the course of a football game. A scar, which formed on the medial part of the belly of the muscle, involved an adjacent nerve, immediately medial to the muscle. The nerve is called the:
- While recovering from an open abdominal hysterectomy (i.e., using a midline abdominal incision to gain entry to the pelvis), a patient realizes that she has lost sensation to the skin of her anterior thigh and cannot extend her knee. Retractors holding the incision open and pressing against the posterior abdominal wall most likely caused injury to which nerve?
Lateral femoral cutaneous
- In the lumbar region, tuberculosis may spread from the vertebrae into an adjacent muscle to produce an abscess. Pus from the abscess may travel within the fascial sheath surrounding the affected muscle. A patient presents with pus surfacing in the superomedial part of the thigh. To which muscle did the tuberculosis most likely spread?
- The nerves of the lumbar plexus are arranged around specific muscles of the posterior abdominal wall. Which of these nerves lies immediately medial to the psoas major muscle?
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