The document consists of a series of multiple-choice questions (MCQs) related to the abdomen, specifically focusing on anatomy, surgical procedures, and complications. Each question presents clinical scenarios requiring knowledge of anatomical structures, their relationships, and implications for patient care. The questions cover topics such as hernias, nerve damage, and the anatomy of the abdominal wall and its components.

1. Abdomen MCQs with Answers Key (below)
(Anterior Abdominal Wall)
NOTE: For each of the following multiple choice questions select the one
most appropriate answer:
1. Rectus Abdominus Muscle is divided in bellies by tendinous intersections. What is
by far the most common configuration of the muscle bellies of the rectus
Abdominus.
(A) 2 Bellies and symmetric
(B) 2 Bellies and asymmetric
(C) 4 Bellies and asymmetric
(D) 6 Bellies and symmetric
(E) 8 Bellies and symmetric
2. A person was stung by a bee in the left lumbar region. The nerves supplying the
region accompany the branches of
(A) Musculophrenic Artery
(B) Anterior Intercostal Arteries
(C) Posterior Intercostal Arteries
(D) Superior Epigastric Artery
(E) Inferior Epigastric Artery
3. A patient comes to your clinic whom you operated for obstructed irreducible indire ct
Left Inguinal hernia one month ago. He says “It has been over four weeks from the
surgery and I still have much discomfort. Inside of my thigh is
numb, burns or simply hurts when touched. When I move in certain ways I get a
stabbing pain in that area accompanied with a sensation of being bit by a bunch of
wasps (Bees).” Which nerve is most likely damaged?
(A) Genital branch of Genitofemoral nerve
(B) Illioinguinal Nerve
(C) Cremasteric Nerve
(D) Illiohypogastric Nerve
(E) Subcoastal Nerve
4. This patient has more chances of developing which type of hernia in future
(A) Right Direct Inguinal Hernia
(B) Left Direct Inguinal Hernia
(C) Right Indirect Inguinal Hernia
(D) Left Indirect Inguinal Hernia
(E) Umbilical Hernia
5. During Laproscopic repair of Direct inguinal Hernia, the site of hernia will be
located in
(A) Median Umbilical fold

2. (B) Medial Umbilical fold
(C) Medial Inguinal Fossa
(D) Lateral Inguinal Fossa
(E) Lateral umbilical Fold
6. Median Umbilical Fold
(A) Is a remnant of Urachus
(B) Is a remnant of Umbilical Artery
(C) Contains Inferior Epigastric Artery
(D) Is a remnant Umbilical Vein
(E) Contains Ductus Venosus
7. While operating for Indirect Inguinal Hernia there started an unusual rapid oozing
of blood, which filled the site with blood. The Surgeon had to stop to control the
bleed. Which artery is most likely injured?
(A) Inferior Epigastric
(B) Cremasteric
(C) Testicular
(D) External Illiac
(E) Internal iliac
8. You are examining a patient for Hernia during exam. The examiner asks you to
differentiate between inguinal and Femoral Hernia. Your best response will be
(A) Femoral Hernia is above and medial to Pubic tubercle
(B) Femoral Hernia is below and medial to Pubic tubercle
(C) Femoral Hernia is above and Lateral to Pubic tubercle
(D) Femoral Hernia is below and Lateral to Pubic tubercle
(E) None of Above
9. A patient was diagnosed with Testicular Carcinoma (Seminoma). He comes to you
and asks what stage is his cancer is. You advise him a test. What will you advise
(A) CT Abdomen
(B) ESR
(C) Angiogram
(D) Ultrasound Testis
(E) Testicular Biopsy
10. A 45 year old man comes to your clinic and says that he has a Dragging-like or
aching pain within scrotum and feeling a bag of worms. You do a Physical exam and
make a diagnosis of Varicocele. Considering his age what test will u order?
(A) CT Abdomen
(B) ESR
(C) Angiogram
(D) Ultrasound Testis
(E) Testicular Biopsy
11. Processus vaginalis in males form the Tunica Vaginalis of testis. In females it forms

3. (A) Vagina
(B) Canal Of Nuck
(C) Tunica Albuginea
(D) Tunica Vaginalis
(E) Clitoris
12. A 10 year old boy comes to your clinic at 8 PM for sudden Pain in his inguinal region.
He is otherwise healthy. On further questioning you came to know that his Right testis
never descended properly. You notice a swelling just medial to deep inguinal ring.
You don’t have any facility of surgery in your office at night but you can operate in
the morning. What will you do next
(A) Give Him Pain medicine and Arrange to Operate in the morning for Direct
Inguinal hernia
(B) Give Him Pain medicine and Arrange to Operate in the morning for Indirect
Inguinal hernia
(C) Give Him Pain medicine and antibiotics to treat Epididymitis
(D) Urgently operate for strangulated Indirect Inguinal Hernia
(E) Refer to Emergency Surgical Department
13. Subcoastal nerve is in relation to which structure
(A) Median Arcuate Ligament
(B) Medial Arcuate Ligament
(C) Lateral Arcuate Ligament
(D) Arcuate Line of Anterior Abdominal Wall
(E) Arcuate Line of Ilium
14. There is a phenomenon in which some people are almost immune to anesthesia, or
they metabolize anesthetic rapidly and start feeling pain. But the muscle relaxants
don’t let them move. Thinking this has happened to your patient in Inguinal Hernia
repair, which dermatome is responsible for this pain.
(A) T9
(B) T10
(C) T11
(D) T12
(E) None Of Above
15. Inferior epigastric vessels perforate Rectus abdominis Muscle at the level of
(A) First tendinous intersection
(B) Second tendinous intersection
(C) Third tendinous intersection
(D) Umbilicus
(E) Arcuate Line of Anterior Abdominal Wall

4. 16. After Inguinal Hernia Repair in a 10 year old boy medial side of thigh is stimulated
to check the cremasteric reflex, but it was found to be absent. Which nerve is
responsible for contraction of cremaster muscle.
(A) Illioinguinal never
(B) Femoral Branch of Genitofemoral Nerve
(C) Genital Branch of Genitofemoral Nerve
(D) Pudendal Nerve
(E) Cremasteric Nerve
17. Cremasteric Artery is a branch of
(A) Aorta
(B) Inferior epigastric artery
(C) External pudendal
(D) Internal pudendal
(E) External iliac
18. External Spermatic Fascia arise from External oblique aponerosis, So Internal
Spermatic Fascia arise from
(A) Internal Oblique Aponeurosis
(B) Transversalis fascia
(C) Conjoint tendon
(D) External oblique aponerosis
(E) Transveus Abdominus Aponeurosis
19. Transpyloric plane is
(A) Half way between Lower border of xyphoid and umbilicus
(B) Half way between jugular notch and pubic symphasis
(C) Below lower border of costal cartilages
(D) Both A and B
(E) Both B and C
20. Ligamentum teres Hepatis is a remanent of
(A) Urachus
(B) Umbilical Artery
(C) Inferior Epigastric Artery
(D) Umbilical Vein
(E) Ductus Venosus
21. Just Below the arcuate line of anterior abdominal wall, what is in direct contact
with rectus abdominus muscle
(A) Parietal Peritoneum
(B) Visceral Peritoneum
(C) Fascia Transversalis
(D) Posterior Layer of Rectus Sheath
(E) Conjoint Tendon

5. 22. Lateral Umbilical Fold Extends from
(A) Lateral Side of Deep Inguinal Ring to the Umbilicus
(B) Medial Side of Deep Inguinal Ring to the Umbilicus
(C) Medial side of the deep inguinal ring to the arcuate line
(D) Lateral side of the deep inguinal ring to the arcuate line
(E) From Side of Bladder to the Umbilicus
23. Median Umbilical Fold lies between
(A) Conjoint Tendon and Fascia Tranversalis
(B) Parietal and visceral Peritoneum
(C) Fascia Transversalis and Parital Peritoneum
(D) Rectus abdomius and Posterior rectus Sheath
(E) Rectus abdomius and Anterior rectus Sheath
24. Supravesical Fossa is a depression
(A) Between Median and Medial Umbilical Fold
(B) Between Medial and Lateral Umbilical Fold
(C) Lateral to Lateral Umbilical Fold
(D) Just Behind Rectus Abdominus above Umbilicus
(E) On the upper Surface of Bladder
25. Navicular fossa is
(A) Fossa on the body of Pubis
(B) The other name of medial inguinal fossa
(C) Between Median and Medial Inguinal Fosaa
(D) The terminal dilated part of urethra in the glans penis
(E) The fossa between Xyphoid process and coastal cartilages
26. Smegma is
(A) Stored in Ductus Deferens
(B) Produced by Testis
(C) Stored in Epidydmis
(D) The secretion of Preputial glands
(E) The secretion of Lymphatics
27. External Oblique arises from the outer surfaces Lower 8 ribs just adjacent to the
origin of
(A) Serrtus Anterior
(B) Internal Oblique
(C) Transversus Abdominus
(D) Rectus Abdominus
(E) Pectoralis Minor
28. A 32-year-old man undergoes vasectomy as a means of permanent birth control. A
physician performing the vasectomy by making an incision on each side of the
scrotum should remember which of the following statements most applicable to the
scrotum?

6. (A) It is innervated by the ilioinguinal and genitofemoral nerves.
(B) It receives blood primarily from the testicular artery.
(C) Its venous blood drains primarily into the renal vein on the left.
(D) Its lymphatic drainage is primarily into upper lumbar nodes.
(E) Its dartos tunic is continuous with the perineal membrane.
29. A radiologist interprets a lymphangiogram for a 29-year-old patient with metastatic
carcinoma. Upper lumbar nodes most likely receive lymph from which of the
following structures?
(A) Lower part of the anal canal
(B) Labium majus
(C) Clitoris
(D) Testis
(E) Scrotum
30. A 26-year-old man comes to a hospital with fever, nausea, pain, and itching in the
perineal region. On examination by a urologist, he is diagnosed as having infected
bulbourethral (Cowper's) glands. Which of the following structures is/are affected by
this infection?
(A) Superficial perineal space
(B) Sphincter urethrae
(C) Production of sperm
(D) Testis
(E) Seminal vesicles
31. A 16-year-old boy presents to the emergency department with rupture of the penile
urethra. Extravasated urine from this injury can spread into which of the following
structures?
(A) Scrotum
(B) Ischiorectal fossa
(C) Pelvic cavity
(D) Testis
(E) Thigh
32. After his bath but before getting dressed, a 4-year-old boy was playing with his
puppy. The boy's penis was bitten by the puppy, and the deep dorsal vein was
injured. The damaged vein:
(A) Lies superficial to Buck's fascia
(B) Drains into the prostatic venous plexus
(C) Lies lateral to the dorsal artery of the penis
(D) Is found in the corpus spongiosum
(E) Is dilated during erection
33. A 39-year-old man is unable to expel the last drops of urine from the urethra at the
end of micturition because of paralysis of the external urethral sphincter and

7. bulbospongiosus muscles. This condition may occur as a result of injury to which of
the following nervous structures?
(A) Pelvic plexus
(B) Prostatic plexus
(C) Pudendal nerve
(D) Pelvic splanchnic nerve
(E) Sacral splanchnic nerve
34. A 37-year-old man is suffering from carcinoma of the skin of the penis. Cancer cells
are likely to metastasize directly to which of the following lymph nodes?
(A) External iliac nodes
(B) Internal iliac nodes
(C) Superficial inguinal nodes
(D) Aortic (lumbar) nodes
(E) Deep inguinal nodes
35. A 17-year-old boy suffers a traumatic groin injury during a soccer match. The
urologist notices tenderness and swelling of the boy's left testicle that may be
produced by thrombosis in which of the following veins?
(A) Left internal pudendal vein
(B) Left renal vein
(C) Inferior vena cava
(D) Left inferior epigastric vein
(E) Left external pudendal vein
36. A 22-year-old woman receives a deep cut in the inguinal canal 1 inch lateral to the
pubic tubercle. Which of the following ligaments is lacerated within the inguinal
canal?
(A) Suspensory ligament of the ovary
(B) Ovarian ligament
(C) Mesosalpinx
(D) Round ligament of the uterus
(E) Rectouterine ligament
37. A 2-year-old boy presents with pain in his groin that has been increasing in nature
over the past few weeks. He is found to have a degenerative malformation of the
transversalis fascia during development. Which of the following structures on the
anterior abdominal wall is likely defective?
(A) Superficial inguinal ring
(B) Deep inguinal ring
(C) Inguinal ligament
(D) Sac of a direct inguinal hernia
(E) Anterior wall of the inguinal canal
38. A young boy is brought to the hospital after a bicycle accident and possible pelvic
fracture. While awaiting a computed tomography (CT) scan of his pelvis, a physician

8. proceeds with a focal neurologic examination. In testing the child's reflexes, which of
the following nerves would carry afferent impulses the cremasteric reflex?
(A) Subcostal nerve
(B) Lateral femoral cutaneous nerve
(C) Genitofemoral nerve
(D) Iliohypogastric nerve
(E) Femoral nerve
39. A 9-year-old boy was admitted to the emergency department complaining of nausea,
vomiting, fever, loss of appetite. On examination, he was found to have tenderness
and pain on the right lower quadrant. Based on signs and symptoms, the diagnosis of
acute appendicitis was made. During an appendectomy performed at McBurney's
point, which of the following structures is most likely to be injured?
(A) Deep circumflex femoral artery
(B) Inferior epigastric artery
(C) Illiohypogastric nerve
(D) Genitofemoral nerve
(E) Spermatic cord
40. A pediatric surgeon has resected a structure that is a fibrous remnant of an
embryonic or fetal artery 5-year-old child. Which of the following structures is most
likely to be divided?
(A) Lateral umbilical fold
(B) Medial umbilical fold
(C) Median umbilical fold
(D) Ligamentum teres hepatis
(E) Ligamentum venosum
41. A 21-year-old man developed a hernia after lifting heavy boxes while moving into
his new house. During the repair of his resulting hernia, the urologist recalls that the
genitofemoral nerve:
(A) Runs in front of the quadratus lumborum
(B) Is a branch of the femoral nerve
(C) Supplies the testis
(D) Passes through the deep inguinal ring
(E) Gives rise to an anterior scrotal branch
42. An emergent hernia repair is scheduled. As the attending physician is driving to the
hospital, the medical student assisting on the case quickly reviews his anatomy atlas
and is trying to commit to memory that the internal oblique abdominis muscle
contributes to the formation of which of the following structures?
(A) Inguinal ligament
(B) Deep inguinal ring
(C) Falx inguinalis (conjoint tendon)
(D) Internal spermatic fascia
(E) Reflected inguinal ligament

9. 43. A patient was operated for Direct Inguinal Hernia and Mesh was placed. Now the
Abdminal layers from Anterior to posterior are composed of in this patient AFTER
Mesh Placement.
1. Fascia Tranversalis
2. Campers Fascia
3. Parietal Peitoneum
4. Mesh
5. External Oblique Aponerosis
6. Conjoint tendon
7. Spermatic Cord
8. Skin
9. Scarpa Fascia
(A) 8, 2, 9, 5, 7, 6, 1, 4, 3
(B) 8, 9, 2, 5, 7, 4, 6, 1, 3
(C) 8, 2, 9, 5, 4, 7, 6, 1, 3
(D) 8, 2, 9, 5, 7, 6, 4, 1, 3
(E) 8, 2, 9, 5, 7, 4, 6, 1, 3
44. Anastomosis over Lacunar ligament is from the branches of
(A) Testicular and Inferior Epigasric Artery
(B) Obturator Artery and Cremasteric Artery
(C) Cremasteric and Accesory Obturator Artery
(D) Obturtor Artery and Inferior Epigasric Artery
(E) Accesory Obturator Artery and Testicular Artery
45. Which of the following is not a content of spermatic cord?
(A) The genital branch of the genitofemoral nerve
(B) Illioinguinal Nerve
(C) Sympathetic and visceral afferent nerve fibers
(D) Lymphatics
(E) Remnants of the processus vaginalis
Answers Key
1 D
2 C
3 B
4 B
5 C
6 A
7 A
8 D
9 A
10 A
11 B

10. 12 E
13 C
14 E
15 E
16 C
17 B
18 B
19 B
20 D
21 C
22 C
23 C
24 A
25 D
26 D
27 A
28 A
29 D
30 B
31 A
32 B
33 C
34 C
35 B
36 D
37 B
38 C
39 C
40 B
41 D
42 C
43 E
44 D
45 B