Abdomen — MCQs

Abdomen Indian Medical PG Practice Questions and MCQs

Question 751: Which of the following is not formed by the external oblique muscle?

A. Inguinal ligament
B. Lacunar ligament
C. Pectineal ligament
D. Conjoint tendon (Correct Answer)

Explanation: ***Conjoint tendon*** - The **conjoint tendon** is formed by the conjoined aponeuroses of the **internal oblique** and **transversus abdominis muscles**, not the external oblique [1]. - It provides posterior wall reinforcement to the inguinal canal. - This is the structure that is definitively **NOT formed by the external oblique muscle**. *Lacunar ligament* - The **lacunar ligament** (Gimbernat's ligament) is a triangular fascial band formed by the medial reflection of the **inguinal ligament**. - It is derived from the **external oblique aponeurosis** and forms the medial boundary of the femoral ring. *Pectineal ligament* - The **pectineal ligament** (Cooper's ligament) is a thickening of the periosteum along the pecten pubis (pectineal line) [3]. - While it is continuous with the lacunar ligament, it is not directly formed by the external oblique muscle itself, but rather represents a separate periosteal structure. - For the purposes of this question, the conjoint tendon is the most appropriate answer as it has no contribution from the external oblique. *Inguinal ligament* - The **inguinal ligament** (Poupart's ligament) is formed by the inferomedial border of the **external oblique aponeurosis**, folding back on itself [2]. - It spans between the **anterior superior iliac spine** and the **pubic tubercle**.

Question 752: Which of the following is NOT a boundary of the foramen of Winslow?

A. Inferior vena cava
B. Free border of lesser omentum
C. 4th part of Duodenum (Correct Answer)
D. Caudate lobe of liver

Explanation: 4th part of Duodenum[1] - The foramen of Winslow (epiploic foramen) is an opening that connects the greater sac to the lesser sac of the peritoneum. The 4th part of the duodenum is not a boundary of this foramen. - The 4th part of the duodenum is located at the duodenojejunal junction on the left side of the abdomen, far from the foramen of Winslow. - Note: The 1st part of the duodenum (D1) forms the inferior boundary of the foramen of Winslow, along with the hepatic artery. Inferior vena cava[1] - The inferior vena cava (IVC) forms the posterior boundary of the foramen of Winslow. - It lies behind the peritoneum that forms the posterior wall of the lesser sac at this point. Free border of lesser omentum[1] - The free border of the lesser omentum (hepatoduodenal ligament) forms the anterior boundary of the foramen of Winslow. - This ligament contains the portal triad (hepatic artery proper, portal vein, and common bile duct). Caudate lobe of liver[1] - The caudate lobe of the liver forms the superior boundary of the foramen of Winslow.[1] - It lies above the opening, contributing to its roof.

Question 753: Sensory nerve supply of gall bladder is through -

A. Vagus nerve (Cranial Nerve X) (Correct Answer)
B. Celiac plexus (sympathetic fibers)
C. Trigeminal nerve (Cranial Nerve V)
D. Facial nerve (Cranial Nerve VII)

Explanation: ***Vagus nerve (Cranial Nerve X)*** - The **vagus nerve** provides the primary **sensory (visceral afferent) innervation** to the gallbladder, carrying information about distension, contraction, and physiological state. - These **parasympathetic sensory fibers** travel through the vagus nerve to medullary centers, monitoring gallbladder function and participating in reflex arcs. - The vagus nerve is the main pathway for **general sensory innervation** of the gallbladder as per standard anatomical texts. *Celiac plexus (sympathetic fibers)* - The **celiac plexus** contains **sympathetic afferent fibers** that primarily transmit **pain sensation** from the gallbladder, especially during inflammation or biliary colic [1]. - These pain fibers travel via sympathetic pathways to spinal segments **T8-T9**, mediating referred pain to the epigastric region and right upper quadrant [1]. - While important for pain transmission, the celiac plexus is not classified as the primary sensory nerve supply in anatomical nomenclature. *Trigeminal nerve (Cranial Nerve V)* - The **trigeminal nerve** provides **sensory innervation to the face** and motor innervation to muscles of mastication. - It has no role in innervation of abdominal viscera, including the gallbladder. *Facial nerve (Cranial Nerve VII)* - The **facial nerve** controls **facial expression muscles**, provides taste sensation to the anterior two-thirds of the tongue, and supplies parasympathetic fibers to lacrimal and salivary glands. - It does not innervate any abdominal organs.

Question 754: Which of the following structures does NOT pass through the deep inguinal ring?

A. Spermatic cord
B. Internal spermatic fascia
C. Round ligament
D. Ilioinguinal nerve (Correct Answer)

Explanation: The ilioinguinal nerve typically passes through the superficial inguinal ring but does not travel through the deep inguinal ring [1]. It lies in the inguinal canal, superficial to the spermatic cord in males and the round ligament in females [1]. The spermatic cord in males enters the inguinal canal through the deep inguinal ring [2]. It contains structures like the vas deferens, testicular artery, pampiniform plexus, and nerves. The internal spermatic fascia is a covering of the spermatic cord that originates from the transversalis fascia at the deep inguinal ring [2]. In females, the round ligament of the uterus is the homologous structure to the spermatic cord in males, and it passes through the deep inguinal ring to enter the inguinal canal. It helps maintain the anteversion of the uterus.

Question 755: Ligament which prevents the spleen from falling in left iliac fossa -

A. Phrenicocolic ligament (Correct Answer)
B. Lienorenal ligament
C. Upper pole of right kidney
D. Sigmoid colon

Explanation: ***Phrenicocolic ligament*** - The **phrenicocolic ligament** is a fold of peritoneum that extends from the left colic flexure to the diaphragm, under the spleen. - It forms a shelf that **supports the spleen** and prevents it from descending into the left iliac fossa. *Lienorenal ligament* - The **lienorenal (splenorenal) ligament** connects the hilum of the spleen to the posterior abdominal wall (specifically over the left kidney) [1]. - While it helps to anchor the spleen, its primary role is not preventing caudal displacement, but rather containing the **splenic artery and vein** and the tail of the pancreas [1]. *Upper pole of right kidney* - The **right kidney** is located on the opposite side of the abdominal cavity from the spleen. - It plays no role in supporting the spleen or preventing its descent. *Sigmoid colon* - The **sigmoid colon** is a part of the large intestine located in the left lower quadrant of the abdomen and pelvis. - It is situated far below the spleen and has no direct anatomical connection or supporting role for the spleen.

Question 756: What is the posterior relation of the neck of the pancreas?

A. IVC
B. Aorta
C. Common bile duct
D. Origin of portal vein (Correct Answer)

Explanation: ***Origin of portal vein*** - The **neck of the pancreas** is intimately associated with the formation of the **hepatic portal vein** [1]. - The **superior mesenteric vein** and **splenic vein** unite behind the pancreatic neck to form the **hepatic portal vein** [1]. *IVC* - The **inferior vena cava (IVC)** lies posterior to the **head of the pancreas**, not the neck. - While it's in proximity, it does not directly relate to the neck in the same way the portal vein does. *Aorta* - The **abdominal aorta** lies posterior to the **body** and **tail of the pancreas**, further superior and to the left. - It is not a direct posterior relation of the pancreatic neck. *Common bile duct* - The **common bile duct** passes through a groove on the posterior surface of the pancreatic **head**, sometimes even embedded within it. - It is not a direct posterior relation of the pancreatic neck, which is a different segment.

Question 757: Which of the following is not a branch of the splenic artery?

A. Hilar branches of the splenic artery
B. Short Gastric Arteries
C. Arteria Pancreatica Magna
D. Right Gastroepiploic Artery (Correct Answer)

Explanation: ***Right Gastroepiploic Artery*** - This artery originates from the **gastroduodenal artery**, which is a branch of the **common hepatic artery**, not the splenic artery. - It supplies the greater curvature of the stomach and the greater omentum. *Hilar branches of the splenic artery* - These are direct branches of the splenic artery that enter the **hilum of the spleen** [1] to supply the organ itself. - They are essential for the blood supply to the spleen [1]. *Short Gastric Artery* - The **short gastric arteries** arise directly from the splenic artery or its terminal branches [1]. - They supply the fundus and a part of the greater curvature of the stomach [1]. *Arteria Pancreatica Magna* - Also known as the **great pancreatic artery**, this is a significant branch that typically arises from the **splenic artery**. - It supplies the body and tail of the pancreas [1].

Question 758: Superficial inguinal ring is a defect in the:

A. Internal oblique muscle
B. Transverse abdominis aponeurosis
C. External oblique aponeurosis (Correct Answer)
D. Internal oblique aponeurosis

Explanation: ***External oblique aponeurosis*** - The **superficial inguinal ring** is a triangular opening in the **aponeurosis of the external oblique muscle** [1]. - It allows passage of the **spermatic cord** in males and the **round ligament of the uterus** in females. *Transverse abdominis aponeurosis* - The **transverse abdominis aponeurosis** contributes to the posterior wall of the **inguinal canal**, but not the superficial inguinal ring itself [2]. - The deepest abdominal muscle, its aponeurosis forms the **conjoint tendon** with the internal oblique aponeurosis. *Internal oblique muscle* - The **internal oblique muscle** forms the arching roof and part of the anterior wall of the **inguinal canal** [2]. - Its aponeurosis contributes to the **conjoint tendon** and the falx inguinalis. *Internal oblique aponeurosis* - The **internal oblique aponeurosis** is part of the anterior wall and forms the conjoint tendon with the transverse abdominis aponeurosis [2]. - This aponeurosis does not form the superficial inguinal ring; instead, it is found deeper to the external oblique aponeurosis.

Question 759: Which of the following vessels runs through the transverse mesocolon?

A. Right colic artery
B. Left colic artery
C. Middle colic artery (Correct Answer)
D. Iliocolic artery

Explanation: * **Middle colic artery** - The **middle colic artery** arises from the superior mesenteric artery and supplies the **transverse colon**, traversing between the two layers of the **transverse mesocolon** [1]. - Its location within the mesocolon makes it susceptible to injury during surgical procedures involving the transverse colon [2]. * *Right colic artery* - The **right colic artery** supplies the **ascending colon** and the right colic flexure, typically lying within retroperitoneal tissue and not the transverse mesocolon itself [2]. - It arises from the superior mesenteric artery but branches to supply structures primarily to the right side of the abdominal cavity. * *Left colic artery* - The **left colic artery** arises from the **inferior mesenteric artery** and supplies the descending colon and the left colic flexure [1]. - This vessel is located within the retroperitoneum and is not associated with the transverse mesocolon. * *Iliocolic artery* - The **iliocolic artery** is a terminal branch of the superior mesenteric artery, supplying the **ileum, cecum, appendix**, and beginning of the ascending colon. - It descends retroperitoneally to reach these structures and does not traverse the transverse mesocolon.

Question 760: Gastrosplenic ligament contains ?

A. Splenic vessels
B. Tail of pancreas
C. Short gastric artery (Correct Answer)
D. Portal vein

Explanation: ***Short gastric artery*** - The **short gastric arteries** are branches of the **splenic artery** and supply the **fundus** and upper part of the **greater curvature** of the stomach. - These vessels travel within the **gastrosplenic ligament** (or gastrosplenic omentum), connecting the greater curvature of the stomach to the hilum of the spleen [1]. *Splenic vessels* - The **splenic artery** and **vein** primarily travel within the **splenorenal ligament** (or lienorenal ligament), connecting the spleen to the posterior abdominal wall. - These major vessels supply and drain the spleen itself, not typically running within the gastrosplenic ligament [1]. *Tail of pancreas* - The **tail of the pancreas** is typically located within the **splenorenal ligament**, closely associated with the **hilum of the spleen** [1]. - It does not extend into the gastrosplenic ligament, which connects the stomach to the spleen. *Portal vein* - The **portal vein** is a major vessel formed by the confluence of the **splenic vein** and **superior mesenteric vein**, and it is located in the **hepatoduodenal ligament** (part of the lesser omentum) along with the hepatic artery and common bile duct. - This vessel is far removed from the gastrosplenic ligament, which is situated between the stomach and spleen.

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Anterior Abdominal Wall

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Peritoneum and Peritoneal Cavity

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Stomach and Intestines

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Liver, Gallbladder and Biliary Tract

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Pancreas and Spleen

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Kidneys and Suprarenal Glands

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Abdominal Vasculature

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Posterior Abdominal Wall

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Innervation of Abdominal Viscera

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Abdomen — MCQs

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