Cross-sectional anatomy Practice Questions

Question 1

During a surgical procedure to repair an abdominal aortic aneurysm, the surgeon must be careful to avoid injury to which of the following arterial structures that originates near the level of the renal vessels?

Accepted Answer

Left renal artery

Answer

Celiac trunk

Answer

Right renal artery

Answer

Superior mesenteric artery

Question 2

A research team develops a new monoclonal antibody checkpoint inhibitor for advanced melanoma that has shown promise in animal studies as well as high efficacy and low toxicity in early phase human clinical trials. The research team would now like to compare this drug to existing standard of care immunotherapy for advanced melanoma. The research team decides to conduct a non-randomized study where the novel drug will be offered to patients who are deemed to be at risk for toxicity with the current standard of care immunotherapy, while patients without such risk factors will receive the standard treatment. Which of the following best describes the level of evidence that this study can offer?

Accepted Answer

Level 3

Answer

Level 1

Answer

Level 5

Answer

Level 4

Answer

Level 2

Question 3

A 32-year-old man comes to the emergency department because of a wound in his foot. Four days ago, he stepped on a nail while barefoot at the beach. Examination of the plantar surface of his right foot shows a purulent puncture wound at the base of his second toe with erythema and tenderness of the surrounding skin. The afferent lymphatic vessels from the site of the lesion drain directly into which of the following groups of regional lymph nodes?

Accepted Answer

Superficial inguinal

Answer

Popliteal

Answer

Deep inguinal

Answer

Anterior tibial

Answer

External iliac

Question 4

A 65-year-old man presents to his primary care provider after noticing increasing fatigue over the past several weeks. He now becomes short of breath after going up 1 flight of stairs. He was previously healthy and has not seen a doctor for several years. He denies any fever or changes to his bowel movements. On exam, his temperature is 98.8°F (37.1°C), blood pressure is 116/76 mmHg, pulse is 74/min, and respirations are 14/min. On basic labs, his hemoglobin is found to be 9.6 g/dL and MCV is 75 fL. Fecal blood testing is positive for occult blood. Imaging is notable for a mass in the cecum that is partially obstructing the lumen, as well as several small lesions in the liver. Which of the following structures is most at risk for involvement in this patient’s disease?

Accepted Answer

Superior mesenteric vein

Answer

Right gonadal vein

Answer

Inferior mesenteric vein

Answer

Inferior rectal vein

Answer

Right renal vein

Question 5

A 28-year-old man is brought to the emergency department by ambulance after developing an altered mental state following blunt trauma to the head. The patient was competing at a local mixed martial arts competition when he was struck in the head and lost consciousness. A few minutes later, upon regaining consciousness, he had a progressive decline in mental status. Past medical history is noncontributory. Upon arrival at the hospital, the temperature is 37.0°C (98.6°F), the blood pressure is 145/89 mm Hg, the pulse is 66/min, the respiratory rate is 14/min, and the oxygen saturation is 99% on room air. He is alert now. A noncontrast CT scan is performed, and the result is provided in the image. Which of the following structures is most likely affected in this patient?

Accepted Answer

Middle Meningeal artery

Answer

Subarachnoid space

Answer

Suprasellar cistern

Answer

Ventricular system

Answer

Bridging veins

Question 6

A 27-year-old soldier is brought to the emergency department of a military hospital 20 minutes after being involved in a motor vehicle accident during a training exercise. He was an unrestrained passenger. On arrival, he has shortness of breath and chest pain. He appears pale and anxious. His temperature is 37°C (98.6°F), pulse is 110/min, respirations are 20/min, and blood pressure is 100/65 mm Hg. He is alert and oriented to person, place, and time. Examination shows pale conjunctivae and mucous membranes. There is bruising on the chest, extremities, and abdomen. The lungs are clear to auscultation. He has normal heart sounds and flat neck veins. The abdomen is flat, soft, and mildly tender. The remainder of the physical examination shows no abnormalities. High-flow oxygen is applied, and intravenous fluid resuscitation is begun. A chest x-ray is obtained. Which of the following is the most appropriate next step in management?

Accepted Answer

CT scan of the chest with contrast

Answer

Placement of a chest tube

Answer

Pericardiocentesis

Answer

Abdominal ultrasonography

Answer

Intubation with positive pressure ventilation

Question 7

A 49-year-old man comes to the physician because of tender, red nodules that appeared on his chest 3 days ago. Three weeks ago, he had similar symptoms in his right lower limb and another episode in his left foot; both episodes resolved spontaneously. He also has diarrhea and has had a poor appetite for 1 month. He has a history of dry cough and joint pain, for which he takes albuterol and aspirin as needed. He has smoked 2 packs of cigarettes daily for 15 years. He does not drink alcohol. Physical examination shows a linear, erythematous lesion on the right anterior chest wall, through which a cord-like structure can be palpated. The lungs are clear to auscultation. The abdomen is soft, nontender, and non-distended. Examination of the legs is normal. An ultrasound of the legs shows no abnormalities. Which of the following is the most appropriate next step in diagnosis of the underlying condition?

Accepted Answer

X-ray of the chest

Answer

Coagulation studies

Answer

Ankle brachial index

Answer

Serum angiotensin-converting enzyme level

Answer

CT scan of the abdomen

Question 8

A 22-year-old Caucasian male is stabbed in his left flank, injuring his left kidney. As the surgeon undertakes operative repair, she reviews relevant renal anatomy. All of the following are correct regarding the left kidney EXCEPT?

Accepted Answer

The left kidney has a longer renal artery than the right kidney

Answer

The left kidney has a longer renal vein than the right kidney

Answer

The left kidney underlies the left 12th rib

Answer

The left kidney moves vertically during deep breathing

Answer

The left kidney lies between T12 and L3

Question 9

A researcher is investigating the blood supply of the adrenal gland. While performing an autopsy on a patient who died from unrelated causes, he identifies a vessel that supplies oxygenated blood to the inferior aspect of the right adrenal gland. Which of the following vessels most likely gave rise to the vessel in question?

Accepted Answer

Renal artery

Answer

Inferior phrenic artery

Answer

Abdominal aorta

Answer

Superior mesenteric artery

Answer

Common iliac artery

Question 10

A 72-year-old male presents to a cardiac surgeon for evaluation of severe aortic stenosis. He has experienced worsening dyspnea with exertion over the past year. The patient also has a history of poorly controlled hypertension, diabetes mellitus, and hyperlipidemia. An echocardiogram revealed a thickened calcified aortic valve. The surgeon is worried that the patient will be a poor candidate for open heart surgery and decides to perform a less invasive transcatheter aortic valve replacement. In order to perform this procedure, the surgeon must first identify the femoral pulse just inferior to the inguinal ligament and insert a catheter into the vessel in order to gain access to the arterial system. Which of the following structures is immediately lateral to this structure?

Accepted Answer

Femoral nerve

Answer

Lymphatic vessels

Answer

Femoral vein

Answer

Sartorius muscle

Answer

Pectineus muscle

Cross-sectional anatomy

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Principles of cross-sectional imaging

Head and neck cross-sections

Thoracic cross-sections

Cardiac cross-sections

Upper abdominal cross-sections

Lower abdominal cross-sections

Pelvic cross-sections

Upper limb cross-sections

Lower limb cross-sections

Anatomical planes and reference lines

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