CSFA Advanced Surgical Anatomy 2 — Questions and Answers
Question 1: Which nerve is at greatest risk during a right hemicolectomy due to its course along the lateral abdominal wall?
- Iliohypogastric nerve (Correct answer)
- Ilioinguinal nerve
- Lateral femoral cutaneous nerve
- Genitofemoral nerve
Correct answer: Iliohypogastric nerve
The iliohypogastric nerve courses along the lateral abdominal wall and can be injured during flank or right-sided abdominal incisions.
Question 2: The triangle of Calot, critical for safe cholecystectomy, is bounded superiorly by which structure?
- Cystic duct
- Common hepatic duct
- Liver (visceral surface) (Correct answer)
- Cystic artery
Correct answer: Liver (visceral surface)
The triangle of Calot is bounded superiorly by the visceral surface of the liver, medially by the common hepatic duct, and inferiorly by the cystic duct.
Question 3: During a posterior approach to the hip, which nerve is most at risk from excessive internal rotation or retraction?
- Femoral nerve
- Obturator nerve
- Sciatic nerve (Correct answer)
- Superior gluteal nerve
Correct answer: Sciatic nerve
The sciatic nerve exits the greater sciatic foramen and lies posterior to the hip, making it vulnerable during posterior hip approaches.
Question 4: The recurrent laryngeal nerve is most vulnerable during which thyroid surgical maneuver?
- Ligation of the inferior thyroid artery near the gland (Correct answer)
- Division of the superior thyroid vessels
- Mobilization of the superior pole
- Removal of the thyroid isthmus
Correct answer: Ligation of the inferior thyroid artery near the gland
The RLN crosses near or behind the inferior thyroid artery close to the gland, so ligation near the parenchyma risks nerve injury.
Question 5: Which anatomical landmark identifies the level of the aortic bifurcation during open abdominal aortic surgery?
- Umbilicus
- L4 vertebral body (Correct answer)
- L2 vertebral body
- Iliac crest
Correct answer: L4 vertebral body
The aorta bifurcates into the common iliac arteries at approximately the level of the L4 vertebral body.
Question 6: During a Whipple procedure (pancreaticoduodenectomy), which structure must be carefully preserved to maintain venous drainage of the remnant pancreas?
- Inferior mesenteric vein
- Portal vein
- Superior mesenteric vein (Correct answer)
- Splenic vein
Correct answer: Superior mesenteric vein
The superior mesenteric vein runs posterior to the neck of the pancreas and must be preserved to allow venous drainage of the pancreatic remnant.
Question 7: The McBurney's point, used to locate the appendix, lies at what anatomical position?
- One-third the distance from the ASIS to the umbilicus
- One-third the distance from the umbilicus to the ASIS
- Two-thirds the distance from the umbilicus to the ASIS (Correct answer)
- Midpoint between the ASIS and the pubic symphysis
Correct answer: Two-thirds the distance from the umbilicus to the ASIS
McBurney's point is located two-thirds of the distance from the umbilicus to the right anterior superior iliac spine (ASIS).
CSFA Advanced Surgical Anatomy 2
Which nerve is at greatest risk during a right hemicolectomy due to its course along the lateral abdominal wall?