CSFA Anatomy & Physiology 2 — Questions and Answers
Question 1: Which nerve is at risk during a laparoscopic cholecystectomy when the cystic duct is being dissected near the hepatoduodenal ligament?
- Common hepatic nerve
- Vagus nerve branches (Correct answer)
- Phrenic nerve
- Right celiac ganglion fibers
Correct answer: Vagus nerve branches
Vagal branches run along the hepatoduodenal ligament and can be damaged during dissection near the cystic duct.
Question 2: The lymphatic drainage of the lower rectum primarily flows to which lymph node group?
- Superior mesenteric nodes
- Internal iliac nodes (Correct answer)
- Inguinal nodes
- Para-aortic nodes
Correct answer: Internal iliac nodes
The lower rectum drains primarily to the internal iliac (hypogastric) lymph nodes, which is clinically significant in rectal cancer staging.
Question 3: Which layer of the abdominal wall is absent in the posterior sheath below the arcuate line?
- External oblique aponeurosis
- Internal oblique aponeurosis
- Transversalis fascia
- Posterior layer of internal oblique aponeurosis (Correct answer)
Correct answer: Posterior layer of internal oblique aponeurosis
Below the arcuate line, all aponeurotic layers pass anterior to the rectus muscle, leaving only transversalis fascia posteriorly.
Question 4: During a radical prostatectomy, which anatomical structure must be carefully preserved to maintain urinary continence?
- Bulbourethral glands
- External urethral sphincter (Correct answer)
- Internal urethral sphincter
- Detrusor muscle
Correct answer: External urethral sphincter
The external urethral sphincter (rhabdosphincter) is the primary muscle responsible for continence after radical prostatectomy since the internal sphincter is typically disrupted.
Question 5: The ductus arteriosus connects which two vascular structures in fetal circulation?
- Pulmonary artery to aorta (Correct answer)
- Pulmonary vein to left atrium
- Superior vena cava to pulmonary artery
- Right atrium to left atrium
Correct answer: Pulmonary artery to aorta
The ductus arteriosus shunts blood from the pulmonary artery to the descending aorta, bypassing the non-functional fetal lungs.
Question 6: Which muscle forms the floor of the femoral triangle and lies deep to the femoral vessels?
- Iliopsoas (Correct answer)
- Pectineus
- Adductor longus
- Sartorius
Correct answer: Iliopsoas
The iliopsoas muscle forms the floor of the lateral portion of the femoral triangle, with the pectineus forming the medial floor.
Question 7: What is the clinical significance of the recurrent laryngeal nerve's relationship to the inferior thyroid artery during thyroidectomy?
- The nerve always passes anterior to the artery
- The nerve always passes posterior to the artery
- The nerve has variable relationships to the artery requiring careful identification (Correct answer)
- The artery must always be ligated distal to the nerve crossing
Correct answer: The nerve has variable relationships to the artery requiring careful identification
The recurrent laryngeal nerve has a highly variable relationship to the inferior thyroid artery, requiring visual identification before ligation to prevent vocal cord paralysis.
CSFA Anatomy & Physiology 2
Which nerve is at risk during a laparoscopic cholecystectomy when the cystic duct is being dissected near the hepatoduodenal ligament?