In the dissection hall, the posterior surface of a liver shows a deep fissure separating the caudate lobe from the left lobe, with a fibrous cord in its floor running from the left branch of the portal vein up towards the inferior vena cava. What is this cord, and of what is it a remnant?

Ligamentum venosum; ductus venosus

Ligamentum arteriosum; ductus arteriosus

Falciform ligament; ventral mesogastrium

Ligamentum teres; left umbilical vein

An axial CT at the level of the twelfth thoracic vertebra in a man with an abdominal aortic aneurysm shows the aorta passing behind the median arcuate ligament between the crura of the diaphragm. Which two other structures normally pass through this opening with the aorta?

Sympathetic trunks and greater splanchnic nerves

Inferior vena cava and right phrenic nerve

A medical student in the dissection hall studies a spleen and then examines a patient in the ward with a large mass in the left upper quadrant. On palpation, which feature confirms that the mass is the spleen rather than an enlarged left kidney?

A palpable notch on its anterior border

It moves little with respiration

There is colonic resonance over it

Cross-sectional and cadaveric anatomy

22 NEET-PG practice questions on Cross-sectional and cadaveric anatomy, part of Anatomy. The first 22 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
In the dissection hall, the posterior surface of a liver shows a deep fissure separating the caudate lobe from the left lobe, with a fibrous cord in its floor running from the left branch of the portal vein up towards the inferior vena cava. What is this cord, and of what is it a remnant?
1. ALigamentum arteriosum; ductus arteriosus
2. BFalciform ligament; ventral mesogastrium
3. CLigamentum teres; left umbilical vein
4. DLigamentum venosum; ductus venosus
Show answerHide answer
Answer: D · Ligamentum venosum; ductus venosus
In the fetus the ductus venosus shunts oxygenated blood from the left umbilical vein and left portal branch directly to the IVC, bypassing the liver. After birth it closes and becomes the ligamentum venosum, lying in a fissure that separates the caudate lobe from the left lobe on the posterior surface. The ligamentum teres, from the left umbilical vein, runs in the free edge of the falciform ligament to the same portal branch. Key point: Ligamentum venosum, in the fissure behind the caudate lobe, is the remnant of the ductus venosus.
- A: The ligamentum arteriosum joins the pulmonary trunk to the aortic arch.
- B: The falciform ligament is a peritoneal fold on the anterior surface, not a cord in the fissure.
- C: The ligamentum teres lies in the fissure on the inferior surface and the falciform edge.
Question 2 · Medium
Coronal MRI pelvis of a woman with a left ovarian endometrioma shows the ovary lying in a shallow fossa on the lateral pelvic wall, bounded by the external iliac vessels and the ureter. She complains of pain radiating down the inner side of her left thigh. Which nerve in the floor of this fossa explains the referred pain?
1. AFemoral nerve
2. BGenitofemoral nerve
3. CIlioinguinal nerve
4. DObturator nerve
Show answerHide answer
Answer: D · Obturator nerve
The ovarian fossa on the lateral pelvic wall lies between the external iliac vessels above, and the ureter and internal iliac artery behind. The obturator nerve and vessels run in its floor, on obturator internus, on their way to the obturator canal. Ovarian disease can irritate the nerve and refer pain to the medial thigh, which it supplies. Key point: The obturator nerve lies in the floor of the ovarian fossa; ovarian disease refers pain to the medial thigh.
- A: The femoral nerve lies outside the pelvis, lateral to psoas.
- B: The genitofemoral nerve lies on psoas and supplies the upper anterior thigh.
- C: The ilioinguinal nerve runs through the inguinal canal, not the ovarian fossa.
Question 3 · Medium
An axial CT at the level of the twelfth thoracic vertebra in a man with an abdominal aortic aneurysm shows the aorta passing behind the median arcuate ligament between the crura of the diaphragm. Which two other structures normally pass through this opening with the aorta?
1. AOesophagus and vagal trunks
2. BSympathetic trunks and greater splanchnic nerves
3. CInferior vena cava and right phrenic nerve
4. DThoracic duct and azygos vein
Show answerHide answer
Answer: D · Thoracic duct and azygos vein
The aortic hiatus at T12 lies behind the median arcuate ligament and is strictly behind the diaphragm, so it is not compressed by breathing. It transmits the aorta, the thoracic duct and the azygos vein. The oesophageal hiatus at T10 carries the oesophagus and vagal trunks, and the caval opening at T8 carries the IVC and right phrenic nerve. Key point: Aortic hiatus (T12): aorta, thoracic duct and azygos vein.
- A: The oesophagus and vagal trunks pass at T10.
- B: The sympathetic trunks pass behind the medial arcuate ligaments; splanchnic nerves pierce the crura.
- C: The IVC and right phrenic nerve pass at T8.
Question 4 · Easy
On a prosected right atrium, which opening is guarded by a rudimentary crescentic fold, the Eustachian valve?
1. ATricuspid orifice
2. BSuperior vena cava
3. CInferior vena cava
4. DCoronary sinus
Show answerHide answer
Answer: C · Inferior vena cava
The Eustachian valve is a fold at the anterior margin of the opening of the inferior vena cava. In the fetus it directs oxygenated IVC blood across the foramen ovale into the left atrium; after birth it becomes rudimentary. The coronary sinus opening, between the IVC and the tricuspid orifice, has its own Thebesian valve. Key point: The Eustachian valve guards the IVC opening; the Thebesian valve guards the coronary sinus.
- A: The tricuspid orifice has a true three-cusp valve.
- B: The SVC opening has no valve.
- D: The coronary sinus is guarded by the Thebesian valve.
Question 5 · Medium
A medical student in the dissection hall studies a spleen and then examines a patient in the ward with a large mass in the left upper quadrant. On palpation, which feature confirms that the mass is the spleen rather than an enlarged left kidney?
1. AIt moves little with respiration
2. BA palpable notch on its anterior border
3. CThere is colonic resonance over it
4. DIt is ballotable from the loin
Show answerHide answer
Answer: B · A palpable notch on its anterior border
The spleen lies along the 9th to 11th ribs and enlarges downwards and forwards towards the right iliac fossa. Its anterior (superior) border is notched, and the notch can be felt in splenomegaly; the examining hand cannot get above it, and it is dull to percussion and moves well with breathing. An enlarged kidney is ballotable, has resonant colon in front of it, and the hand can get above it. Key point: A notched anterior border and no space above it identify the spleen; a ballotable mass with colonic resonance is kidney.
- A: The spleen moves well with respiration because it is close to the diaphragm.
- C: Colonic resonance over the mass points to a kidney behind the colon.
- D: Ballottement from the loin suggests the kidney.
Question 6 · Medium
A lung specimen in the museum shows a horizontal fissure and impressions of the arch of the azygos vein, the superior vena cava and the oesophagus. During a dental extraction under sedation, an adult patient inhales a broken tooth. Why is the tooth more likely to enter the main bronchus of this lung?
1. AIts bronchus is longer and more horizontal
2. BIts bronchus has a larger cartilage ring at the carina
3. CIts bronchus passes below the arch of the aorta
4. DIts bronchus is wider, shorter and more vertical
Answer and explanation in LearnFree account
Question 7 · Medium
Contrast CT of a lean young man with recurrent painless haematuria, left flank ache and a left-sided varicocele shows the left renal vein dilated near the kidney and narrowed to a slit where it crosses in front of the aorta, with a distended left gonadal vein. Urine culture and cystoscopy are normal. Which artery is compressing the vein?
1. ALeft renal artery
2. BCoeliac trunk
3. CSuperior mesenteric artery
4. DInferior mesenteric artery
Answer and explanation in LearnFree account
Question 8 · Medium
In a prosected heart: 1. The anterior interventricular artery runs in the anterior interventricular groove with the great cardiac vein. 2. In a right-dominant heart, the posterior interventricular artery arises from the right coronary artery. 3. The sinoatrial nodal artery arises from the right coronary artery in about 60% of hearts. 4. The middle cardiac vein accompanies the anterior interventricular artery. Which statements are correct?
1. A2, 3 and 4 only
2. B1, 2, 3 and 4
3. C1, 2 and 3 only
4. D1 and 2 only
Answer and explanation in LearnFree account
Question 9 · Hard
In a dissection of the posterior abdominal wall, one nerve is seen emerging on the anterior surface of psoas major rather than from its borders. Some months after a retroperitoneal lymph node dissection in which this nerve was divided, what deficit is expected in a man?
1. AAbsent cremasteric reflex, numb upper anterior thigh
2. BWeak hip adduction and numb medial thigh
3. CWeak knee extension and absent knee jerk
4. DNumb lateral thigh with normal power
Answer and explanation in LearnFree account
Question 10 · Medium
Barium swallow of a woman with rheumatic mitral stenosis, who complains of difficulty swallowing solids, shows a smooth indentation on the anterior wall of the mid-oesophagus. CT confirms a markedly enlarged cardiac chamber pressing on it, and the ECG shows atrial fibrillation. Which chamber is it?
1. ARight ventricle
2. BPulmonary trunk
3. CLeft atrium
4. DLeft ventricle
Answer and explanation in LearnFree account
Question 11 · Medium
Ten days after appendicectomy for a perforated appendix, a man has spiking fever, frequent loose stools with mucus and frequency of micturition. Rectal examination shows a tender, boggy swelling in front of the rectum. CT confirms a pelvic collection, which is drained through the anterior rectal wall. In which space does this collection lie?
1. APresacral space
2. BIschioanal fossa
3. CRetropubic space of Retzius
4. DRectovesical pouch
Answer and explanation in LearnFree account
Question 12 · Medium
After an elective splenectomy for hereditary spherocytosis, the abdominal drain on day 3 yields 400 mL/day of clear fluid with an amylase of 5,200 U/L (serum 90 U/L). Injury to which structure explains this, and why was it at risk?
1. ABody of the pancreas, in the gastrosplenic ligament
2. BLeft kidney, beneath the phrenicocolic ligament
3. CJejunum, at the duodenojejunal flexure
4. DTail of the pancreas, lying in the splenorenal ligament
Answer and explanation in LearnFree account
Question 13 · Medium
In a prosected right atrium, a smooth muscular ridge separates the smooth sinus venarum from the rough pectinate part of the atrium. At the upper end of this ridge, near the opening of the superior vena cava, lies which structure?
1. AAtrioventricular node
2. BFossa ovalis
3. CCoronary sinus opening
4. DSinoatrial node
Answer and explanation in LearnFree account
Question 14 · Hard
A dissected left kidney is lifted from the posterior abdominal wall to show the structures it rested on: 1. Tail of the pancreas. 2. Psoas major. 3. Quadratus lumborum. 4. Subcostal nerve. Which of these are posterior relations of the left kidney?
1. A2, 3 and 4 only
2. B1, 2, 3 and 4
3. C1, 2 and 4 only
4. D2 and 3 only
Answer and explanation in LearnFree account
Question 15 · Medium
On an axial CT at the level of the fourth thoracic vertebra in a man with pulmonary tuberculosis, a vessel is seen arching forward over the right main bronchus to join the superior vena cava. A large necrotic lymph node lies in the angle beneath it. Which vessel is this?
1. AHemiazygos vein
2. BAzygos vein
3. CRight brachiocephalic vein
4. DRight pulmonary artery
Answer and explanation in LearnFree account
Question 16 · Easy
In a prosected right ventricle, a muscular bar crosses from the interventricular septum to the base of the anterior papillary muscle. Which part of the conducting system does it carry?
1. ARight bundle branch
2. BLeft bundle branch
3. CBachmann bundle
4. DBundle of His
Answer and explanation in LearnFree account
Question 17 · Medium
CT of a cyclist who was thrown against his handlebar shows air bubbles outlining the right kidney and the right psoas, but no air under the diaphragm. At laparotomy, a tear is found in the posterior wall of the second part of the duodenum. Why is the air confined to this region?
1. AThe hepatorenal pouch walls it off
2. BThe lesser sac traps the leaking air
3. CThe transverse mesocolon seals the tear
4. DThe second part of the duodenum is retroperitoneal
Answer and explanation in LearnFree account
Question 18 · Easy
Two loops of small intestine are laid out in the dissection hall. One has a thick wall, closely set circular folds, long vasa recta and only one or two arterial arcades in its mesentery, with little fat near the gut wall. Which part is it?
1. ATerminal ileum
2. BJejunum
3. CAscending colon
4. DDuodenum
Answer and explanation in LearnFree account
Question 19 · Hard
Intravenous urography in a young man with intermittent right loin pain shows right hydronephrosis with the upper ureter swinging medially in a 'fish-hook' (reverse J) shape over the third lumbar vertebra. CT urography confirms that the right ureter passes behind the inferior vena cava and emerges between it and the aorta before descending normally. The left kidney is normal; serum creatinine is 0.9 mg/dL, and a DTPA scan shows obstructed drainage on the right with a split function of 41%. Which developmental error of the venous system explains this anomaly?
1. APersistence of the left anterior cardinal vein
2. BPersistence of the left supracardinal vein
3. CPersistent right posterior cardinal vein as the infrarenal IVC
4. DFailure of the right vitelline vein to form the hepatic IVC
Answer and explanation in LearnFree account
Question 20 · Easy
A prosected left kidney is examined at its hilum. From front to back, what is the usual order of structures?
1. AArtery, vein, pelvis
2. BPelvis, artery, vein
3. CVein, pelvis, artery
4. DVein, artery, pelvis
Answer and explanation in LearnFree account
Question 21 · Hard
Contrast CT angiography in a woman with an open-book pelvic fracture and falling blood pressure shows active contrast extravasation behind the superior pubic ramus, from a vessel joining the inferior epigastric artery to the obturator artery. It is embolised. The radiologist explains that surgeons call this vascular connection the corona mortis. In which hernia operation is this vessel classically at risk?
1. ALumbar hernia repair
2. BParaumbilical hernia repair
3. CFemoral hernia repair, when the lacunar ligament is cut
4. DIndirect inguinal hernia repair at the deep ring
Answer and explanation in LearnFree account
Question 22 · Medium
Abdominal CT angiography in a man with buttock claudication shows a stenosis just where the aorta divides into the two common iliac arteries. At which vertebral level does this division normally lie, roughly on the line joining the highest points of the iliac crests?
1. AS1
2. BL4
3. CL2
4. DL1
Answer and explanation in LearnFree account

Cross-sectional and cadaveric anatomy

In the dissection hall, the posterior surface of a liver shows a deep fissure separating the caudate lobe from the left lobe, with a fibrous cord in its floor running from the left branch of the portal vein up towards the inferior vena cava. What is this cord, and of what is it a remnant?

An axial CT at the level of the twelfth thoracic vertebra in a man with an abdominal aortic aneurysm shows the aorta passing behind the median arcuate ligament between the crura of the diaphragm. Which two other structures normally pass through this opening with the aorta?

On a prosected right atrium, which opening is guarded by a rudimentary crescentic fold, the Eustachian valve?

A medical student in the dissection hall studies a spleen and then examines a patient in the ward with a large mass in the left upper quadrant. On palpation, which feature confirms that the mass is the spleen rather than an enlarged left kidney?

In a dissection of the posterior abdominal wall, one nerve is seen emerging on the anterior surface of psoas major rather than from its borders. Some months after a retroperitoneal lymph node dissection in which this nerve was divided, what deficit is expected in a man?

Barium swallow of a woman with rheumatic mitral stenosis, who complains of difficulty swallowing solids, shows a smooth indentation on the anterior wall of the mid-oesophagus. CT confirms a markedly enlarged cardiac chamber pressing on it, and the ECG shows atrial fibrillation. Which chamber is it?

After an elective splenectomy for hereditary spherocytosis, the abdominal drain on day 3 yields 400 mL/day of clear fluid with an amylase of 5,200 U/L (serum 90 U/L). Injury to which structure explains this, and why was it at risk?

In a prosected right atrium, a smooth muscular ridge separates the smooth sinus venarum from the rough pectinate part of the atrium. At the upper end of this ridge, near the opening of the superior vena cava, lies which structure?

A dissected left kidney is lifted from the posterior abdominal wall to show the structures it rested on: 1. Tail of the pancreas. 2. Psoas major. 3. Quadratus lumborum. 4. Subcostal nerve. Which of these are posterior relations of the left kidney?

On an axial CT at the level of the fourth thoracic vertebra in a man with pulmonary tuberculosis, a vessel is seen arching forward over the right main bronchus to join the superior vena cava. A large necrotic lymph node lies in the angle beneath it. Which vessel is this?

In a prosected right ventricle, a muscular bar crosses from the interventricular septum to the base of the anterior papillary muscle. Which part of the conducting system does it carry?

CT of a cyclist who was thrown against his handlebar shows air bubbles outlining the right kidney and the right psoas, but no air under the diaphragm. At laparotomy, a tear is found in the posterior wall of the second part of the duodenum. Why is the air confined to this region?

Two loops of small intestine are laid out in the dissection hall. One has a thick wall, closely set circular folds, long vasa recta and only one or two arterial arcades in its mesentery, with little fat near the gut wall. Which part is it?

A prosected left kidney is examined at its hilum. From front to back, what is the usual order of structures?

Abdominal CT angiography in a man with buttock claudication shows a stenosis just where the aorta divides into the two common iliac arteries. At which vertebral level does this division normally lie, roughly on the line joining the highest points of the iliac crests?