CSFA Anatomy & Physiology 5 — Questions and Answers
Question 1: During a femoral hernia repair, which structure forms the medial boundary of the femoral ring and must not be cut unless a corona mortis is present?
- Femoral vein
- Lacunar (Gimbernat's) ligament (Correct answer)
- Inguinal ligament
- Cooper's ligament
Correct answer: Lacunar (Gimbernat's) ligament
The lacunar ligament forms the sharp medial boundary of the femoral ring; it is normally incised to reduce an incarcerated femoral hernia but may contain an anomalous obturator artery (corona mortis).
Question 2: The celiac trunk typically divides into three branches immediately after its origin from the aorta; which vessel is NOT one of them?
- Left gastric artery
- Splenic artery
- Common hepatic artery
- Superior mesenteric artery (Correct answer)
Correct answer: Superior mesenteric artery
The celiac trunk gives rise to the left gastric, splenic, and common hepatic arteries; the superior mesenteric artery arises separately from the aorta below the celiac trunk.
Question 3: Which fascial layer encloses the thyroid gland and forms a surgical plane separating it from the strap muscles?
- Superficial cervical fascia
- Pretracheal fascia (Correct answer)
- Prevertebral fascia
- Investing layer of deep cervical fascia
Correct answer: Pretracheal fascia
The pretracheal (middle cervical) fascia envelops the thyroid gland as a true surgical capsule and forms the anatomical plane used when retracting strap muscles during thyroidectomy.
Question 4: Cushing's triad (hypertension, bradycardia, irregular respirations) indicates dangerous elevation of intracranial pressure through compression of which brainstem structure?
- Medulla oblongata (Correct answer)
- Midbrain
- Pons
- Cerebellum
Correct answer: Medulla oblongata
Rising ICP compresses the medulla oblongata, stimulating vasopressor and cardiovascular control centers, producing the classic Cushing's triad as a late sign of herniation.
Question 5: Which structure passes through the carpal tunnel along with the nine flexor tendons and is most vulnerable to compression in carpal tunnel syndrome?
- Ulnar nerve
- Radial artery
- Median nerve (Correct answer)
- Radial nerve
Correct answer: Median nerve
The median nerve passes through the carpal tunnel and is compressed by swelling within the tunnel, causing the sensory and motor deficits of carpal tunnel syndrome.
Question 6: The vermiform appendix most commonly arises from which surface of the cecum in relation to the taenia coli convergence?
- Anterior surface at the convergence of the three taeniae coli (Correct answer)
- Posterior cecal wall only
- Lateral wall near the ileocecal valve
- Inferior tip of the cecum between two taeniae
Correct answer: Anterior surface at the convergence of the three taeniae coli
The three taeniae coli converge at the base of the appendix on the posteromedial cecum; following any taenia distally leads the surgeon to the appendiceal base.
Question 7: During hip arthroplasty in the lateral decubitus position, injury to which nerve causes foot drop and requires careful padding and positioning?
- Femoral nerve
- Obturator nerve
- Common peroneal nerve (Correct answer)
- Tibial nerve
Correct answer: Common peroneal nerve
The common peroneal nerve wraps around the fibular neck and is compressed by positioning devices or traction in lateral decubitus, causing foot drop if injured.
CSFA Anatomy & Physiology 5
During a femoral hernia repair, which structure forms the medial boundary of the femoral ring and must not be cut unless a corona mortis is present?