CFA Anatomy, Physiology & Surgical Pathology 2 — Questions and Answers
Question 1: Which layer of the abdominal wall is incised last before entering the peritoneal cavity during a midline laparotomy?
- Scarpa's fascia
- External oblique aponeurosis
- Transversalis fascia (Correct answer)
- Camper's fascia
Correct answer: Transversalis fascia
The transversalis fascia lies immediately deep to the transversus abdominis muscle and is the last fascial layer incised before entering the peritoneum.
Question 2: The common bile duct is formed by the union of the:
- Right and left hepatic ducts
- Cystic duct and common hepatic duct (Correct answer)
- Pancreatic duct and cystic duct
- Common hepatic duct and pancreatic duct
Correct answer: Cystic duct and common hepatic duct
The common bile duct is formed where the cystic duct from the gallbladder joins the common hepatic duct.
Question 3: Hyperkalemia is most dangerous to which organ system in the surgical patient?
- Renal
- Cardiac (Correct answer)
- Hepatic
- Pulmonary
Correct answer: Cardiac
Elevated serum potassium disrupts cardiac membrane potentials and can cause life-threatening arrhythmias including ventricular fibrillation.
Question 4: Which anatomical triangle is the primary landmark for carotid endarterectomy?
- Muscular triangle
- Carotid triangle (Correct answer)
- Submental triangle
- Posterior triangle
Correct answer: Carotid triangle
The carotid triangle of the anterior neck provides direct access to the common, internal, and external carotid arteries.
Question 5: In surgical pathology, a 'frozen section' is used primarily to:
- Identify bacterial contamination intraoperatively
- Determine tumor margins and tissue diagnosis during surgery (Correct answer)
- Assess blood supply to the specimen
- Measure hormone receptor status
Correct answer: Determine tumor margins and tissue diagnosis during surgery
Intraoperative frozen sections allow rapid histological assessment so the surgeon can determine if margins are clear or if further resection is needed.
Question 6: The phrenic nerve, which innervates the diaphragm, arises from which cervical nerve roots?
- C1-C2
- C2-C3
- C3-C5 (Correct answer)
- C5-C7
Correct answer: C3-C5
The phrenic nerve originates from cervical nerve roots C3, C4, and C5, summarized by the mnemonic 'C3, 4, 5 keeps the diaphragm alive.'
Question 7: During a right hemicolectomy, which structure must be carefully identified to avoid injuring the right ureter?
- Inferior mesenteric artery
- Right gonadal vein
- Right ureter crossing the iliac vessels (Correct answer)
- Ileocolic artery
Correct answer: Right ureter crossing the iliac vessels
The right ureter crosses anterior to the iliac vessels and is at risk of injury during mobilization of the right colon mesentery.
CFA Anatomy, Physiology & Surgical Pathology 2
Which layer of the abdominal wall is incised last before entering the peritoneal cavity during a midline laparotomy?