Applied Anatomy SBA (single best answer) collection

[qwiz]
[q]

Anatomy of the inguinal canal

You are assisting with a primary open right inguinal hernia repair in a 27-year-old male. During the operation, the lead surgeon asks you to define the boundaries of the inguinal canal. Which of the following does not form part of the boundaries of the inguinal canal?

[c] Transversalis fascia and the conjoint tendon

[c] Inguinal ligament

[c*] Pectineal ligament

[c] Aponeuroses of the external and internal oblique fibres

[c] Arching fibres of the internal oblique and transversus abdominis muscles

[f] The boundaries of the inguinal canal are as follows:
Anteriorly: The aponeuroses of the external and internal oblique Posteriorly: The transversalis fascia, and medially, the conjoint tendon that is made up of the merging pubic attachments of the internal oblique and transversus abdominis aponeurosis Superiorly (the roof): Arching fibres of the internal oblique and transversus abdominis Inferiorly (the floor): The inguinal ligament which is the folded lower margin of the aponeurosis of the external oblique muscle

[f] The boundaries of the inguinal canal are as follows:
Anteriorly: The aponeuroses of the external and internal oblique Posteriorly: The transversalis fascia, and medially, the conjoint tendon that is made up of the merging pubic attachments of the internal oblique and transversus abdominis aponeurosis Superiorly (the roof): Arching fibres of the internal oblique and transversus abdominis Inferiorly (the floor): The inguinal ligament which is the folded lower margin of the aponeurosis of the external oblique muscle

[f] Nice job : Answer C is the correct option due to the fact that the pectineal ligament, also known as the ligament of Sir Astley Cooper, forms the inferior border of the femoral canal.

[f] The boundaries of the inguinal canal are as follows:
Anteriorly: The aponeuroses of the external and internal oblique Posteriorly: The transversalis fascia, and medially, the conjoint tendon that is made up of the merging pubic attachments of the internal oblique and transversus abdominis aponeurosis Superiorly (the roof): Arching fibres of the internal oblique and transversus abdominis Inferiorly (the floor): The inguinal ligament which is the folded lower margin of the aponeurosis of the external oblique muscle
[f] The boundaries of the inguinal canal are as follows:
Anteriorly: The aponeuroses of the external and internal oblique Posteriorly: The transversalis fascia, and medially, the conjoint tendon that is made up of the merging pubic attachments of the internal oblique and transversus abdominis aponeurosis Superiorly (the roof): Arching fibres of the internal oblique and transversus abdominis Inferiorly (the floor): The inguinal ligament which is the folded lower margin of the aponeurosis of the external oblique muscle

[q]

Anatomy of the spermatic cord

During a repair of a primary inguinal hernia, you are asked to name the nerve that is located within the spermatic cord. Which of the following is the nerve that is found within the spermatic cord?

[c] Ilioinguinal nerve

[c] Genitofemoral nerve

[c*] Genital branch of the genitofemoral nerve

[c] Iliohypogastric nerve

[c] Lateral femoral cutaneous nerve

[f] No

[f] No

[f] Nice job : Answer is C. The genital branch of the genitofemoral nerve forms part of the structures found within the spermatic cord and supplies the cremasteric muscle (motor) and anterior scrotal skin (sensory). Other structures include the vas deferens, the testicular artery, cremasteric and vas deferens, the pampiniform plexus, sympathetic nerve fibres and lymphatic vessels. The ilioinguinal nerve, which supplies sensation to the scrotum and medial aspect of the thigh, runs anteriorly to the spermatic cord. The iliohypogastric nerve and lateral femoral cutaneous nerve are not found within the spermatic cord. In addition to the genitofemoral nerve, ilioinguinal nerve, femoral nerve and obturator nerve, these nerves originate from the lumbar plexus (L1–L3 ventral primary rami and the superior branch of spinal nerve L4).

[f] No

[f] No

[q]

Midline laparotomy

You are asked to assist the lead surgeon with a midline laparotomy in theatre.The patient has small bowel obstruction confirmed by CT imaging. Before the start of the operation, you are asked what layers, from superficial to deep, would be cut through during a midline laparotomy incision. Which of the following is the most likely answer?

[c] Skin, subcutaneous fat, Scarpa’s fascia, external oblique, internal oblique, transversalis fascia, extraperitoneal fat and peritoneum

[c] Scarpa’s fascia, skin, linea alba, transversalis fascia, extraperitoneal fat, subcutaneous fat and peritoneum

[c] Skin, Scarpa’s fascia, linea alba, transversalis fascia, extraperitoneal fat, subcutaneous fat and peritoneum

[c] Linea alba, Scarpa’s fascia, skin, external oblique, internal oblique, transversalis fascia, extraperitoneal fat, subcutaneous fat and peritoneum

[c*] Skin, subcutaneous fat, Scarpa’s fascia, linea alba, transversalis fascia, extraperitoneal fat and peritoneum

[f] No

[f] No

[f] No

[f] No

[f] Nice job : Answer is E :Skin, subcutaneous fat, Scarpa’s fascia, linea alba, transversalis fascia, extraperitoneal fat and peritoneum
The layers encountered during a midline laparotomy are skin, subcutaneous fat, Scarpa’s fascia, linea alba, transversalis fascia, extraperitoneal fat and peritoneum. In the midline, the external and internal oblique muscles are absent. The linea alba is a fibrous aponeurotic
[/qwiz]


Below I will attach some learning resources to enhance your knowledge on above topics in applied anatomy.

An understanding of the inguinal canal + Anatomy + Surgery techniques
Anatomy tutorial on the layers of the abdominal wall

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