90 ° to become the anterior vagal trunk 90 ° to become the posterior vagal trunk

1. Rotation of the stomach during development results in movement of the left vagus nerve from its original position. Through approximately how many degrees of rotation does the nerve move, and what is its final position? • 90° to become the anterior vagal trunk • 90° to become the posterior vagal trunk • 270° to become the anterior vagal trunk • 270° to become the posterior vagal trunk • 180° to become the posterior vagal trunk

2. A 32 year old male is admitted to the emergency department with groin pain. Examination reveals that the patient has an indirect inguinal hernia. Which of the following nerves is compressed by the herniating structure in the inguinal canal to give the patient pain? • Iliohypogastirc • Lateral femoral cutaneous • Ilioinguinal • Subcostal • Pudendal

3. During a scheduled laparoscopic cholecystectomy in a 47 year old female patient, the resident accidentally clamped the hepatoduodenal ligament instead of they cystic artery. Which of the following vessels would most likely be occluded in this iatrogenic injury? • Superior mesenteric artery • Proper hepatic artery • Splenic artery • Common hepatic artery • Inferior vena cava

4. A 45 year old male was admitted to the hospital with groin pain and a palpable mass just superior to the inguinal ligament. The patient was diagnosed with an inguinal hernia and a surgical repair was performed. During the operation the surgeon found a loop of intestine passing through the deep inguinal ring. Which of the following types of hernia was this? • Direct inguinal • Umbilical • Femoral • Lumbar • Indirect inguinal

5. A 55 year old man was admitted to the hospital with severe abdominal pain. Gastroscopy and CT scan examinations revealed a perforating ulcer in the posterior wall of the stomach. Where would peritonitis most likely develop initially? • Right subhepatic space • Hepatorenal space (of Morison) • Omental bursa (lesser sac) • Right subphrenic space • Greater sac

6. A 58 year old male alcoholic is admitted to the hospital after vomiting dark red blood (hematemesis). Endoscopy reveals ruptured esophageal varices, resulting from portal hypertension. Which of the following venous tributaries to the portal system anastomoses with caval veins to cause the varices? • Splenic • Left gastroomental • Left gastric • Left hepatic • Right Gastric

7. A 45 year old male entered the emergency department with a complaint of severe abdominal pain. During physical examination it is observed that his cremasteric reflex is absent. Which of the following nerves is responsible for the efferent limb of the cremasteric reflex? • Ilioinguinal • Iliohypogastric • Genitofemoral • Pudendal • Ventral ramus of T12

8. The decision is made by emergency department surgeons to perform an exploratory laparotomy on a 32 year female with severe abdominal pain. Where would the incision most likely be made to separate the left and right rectus sheaths? • Midaxillary line • Arcuate line • Semilunar line • Tendinous intersection • Linea alba

9. A 44 year old man is admitted to the emergency department with excessive vomiting and dehydration. Radiographic images demonstrate that part of the bowel is being compressed between the abdominal aorta and the superior mesenteric artery. Which of the following intestinal structures is most likely being compressed? • Second part of duodenum • Transverse colon • Third part of duodenum • First part of duodenum • Jejunum

10. During the surgical repair of a perforated duodenal ulcer in a 47 year old male patient the gastroduodenal artery is ligated. A branch of which of the following arteries will continue to supply blood to the pancreas in this patient? • Inferior mesenteric • Left gastric • Right gastric • Proper hepatic • Superior mesenteric

11. A 70 year old man is admitted to the emergency department with severe diarrhea. An arteriogram reveals 90% blockage at the origin of the inferior mesenteric artery from the aorta. Which of the following arteries would most likely provide collateral supply to the descending colon? • Left gastroepiploic artery • Middle colic artery • Sigmoid artery • Splenic artery • Superior rectal artery

12. In a routine visit to the outpatient clinic for his annual checkup, a 42 year old male is informed that radiographic examination has given strong evidence that he has a malignancy of his scrotum. Which of the following nodes are the first lymph nodes that drain the affected area? • Superficial inguinal • Internal iliac • Lumbar • Presacral • Axilliary

13. A 34 year old man is undergoing an emergency appendectomy. After the appendectomy has been performed successfully, the patient undergoes an exploratory laparoscopy. Which of the following anatomic features are the most useful to distinguish the jejunum from the ileum? • Jejunum has thinner walls compared with the ileum. • Jejunum has less encroaching mesenteric fat compared with the ileum. • Jejunum has more numerous vascular arcades compared with the ileum. • Jejunum has more numerous lymphatic follicles beneath the mucosa compared with the ileum. • Jejunum has fewer villi compared with the ileum.

14. A 61 year old woman had been scheduled for a cholecystectomy. During the operation the scissors of the surgical resident accidentally entered the tissues immediately posterior to the epiploic (omental) foramen (its posterior boundary). The surgical field was filled immediately by profuse bleeding. Which of the following vessels was the most likely source of bleeding? • Aorta • Inferior vena cava • Portal vein • Right renal artery • Superior mesenteric vein

15. A 32 year old woman was admitted to the hospital with a complaint of pain over her umbilicus. Radiographic examination revealed acute appendicitis. The appendix was removed successfully in an emergency appendectomy. One week postoperatively the patient complained of parathesia of the skin over the pubic region and the anterior portion of her perineum. Which of the following nerves was most likely injured during the appendectomy. • Genitofemoral • Ilioinguinal • Subcostal • Iliohypogastric • Spinal nerve T9