CRNFA Surgical Anatomy and Physiology 1 — Questions and Answers
Question 1: Which layer of the abdominal wall is the deepest and must be closed separately during abdominal surgery?
- Subcutaneous fascia
- Scarpa's fascia
- Transversalis fascia (Correct answer)
- External oblique aponeurosis
Correct answer: Transversalis fascia
The transversalis fascia is the deepest layer of the abdominal wall and requires separate closure to prevent hernia formation.
Question 2: The portal triad in the liver consists of which structures?
- Hepatic vein, bile duct, lymphatic vessel
- Portal vein, hepatic artery, bile duct (Correct answer)
- Portal vein, hepatic vein, bile duct
- Hepatic artery, hepatic vein, lymphatic vessel
Correct answer: Portal vein, hepatic artery, bile duct
The portal triad consists of a branch of the portal vein, hepatic artery, and bile duct running together within connective tissue.
Question 3: During a thyroidectomy, which nerve must be identified and preserved to prevent permanent hoarseness?
- External laryngeal nerve
- Internal laryngeal nerve
- Recurrent laryngeal nerve (Correct answer)
- Glossopharyngeal nerve
Correct answer: Recurrent laryngeal nerve
The recurrent laryngeal nerve innervates all intrinsic laryngeal muscles except the cricothyroid, and bilateral injury causes permanent hoarseness or airway obstruction.
Question 4: The Triangle of Calot is bounded by which structures?
- Liver, cystic duct, hepatic duct
- Liver, cystic artery, common bile duct
- Cystic duct, common hepatic duct, liver edge (Correct answer)
- Cystic duct, portal vein, hepatic artery
Correct answer: Cystic duct, common hepatic duct, liver edge
The Triangle of Calot is defined by the cystic duct inferiorly, the common hepatic duct medially, and the liver edge superiorly, and contains the cystic artery.
Question 5: Which anatomical landmark is used to identify the ureter during pelvic surgery?
- It crosses over the external iliac artery (Correct answer)
- It runs parallel to the femoral nerve
- It crosses under the ovarian vein
- It lies medial to the psoas muscle only
Correct answer: It crosses over the external iliac artery
The ureter crosses over the bifurcation of the common iliac artery (or the external iliac artery) and is identified at this crossing point during pelvic dissection.
Question 6: The McBurney's point, commonly used in appendectomy, is located where?
- One-third the distance from the umbilicus to the right anterior superior iliac spine
- One-third the distance from the right ASIS to the umbilicus (Correct answer)
- Midway between the umbilicus and the right ASIS
- One-half the distance from the pubic symphysis to the right ASIS
Correct answer: One-third the distance from the right ASIS to the umbilicus
McBurney's point is located one-third of the distance from the right anterior superior iliac spine to the umbilicus, overlying the base of the appendix.
CRNFA Surgical Anatomy and Physiology 1
Which layer of the abdominal wall is the deepest and must be closed separately during abdominal surgery?