403.Pathology within some abdominal organs can occasionally cause
referred pain in the shoulder and neck regions, C3–C5, because the
diaphragm receives its motor and afferent innervation from this level as a
result of its cranial embryonic development. Which of the following
abdominal organs sometimes causes unilateral shoulder/neck pain?
a. Liver; left side
b. Gallbladder; right side
c. Pancreas; right side
d. Spleen; right side
e. Appendix; left side
404.Sensation of fullness in the rectum involves stretch receptors, which
of the following provides innervation for those receptors?
a. Lumbar sympathetic chain
b. Pelvic splanchnic nerves (nervi erigentes)
c. Pudendal nerve
d. Sacral sympathetic chain
e. Vagus nerve
405.A 50-year-old man comes in for a physical so he can attend a boy
scout camp with one of his sons. You suggest a colonoscopy after he
returns from camp. He agrees, but wants you to describe the procedure and
potential risks and complications. You explain that the goal of a
colonoscopy is to look at the entire length of the large intestine from the
anus to the small intestine (ileocecal junction), observing polyps or diver-
ticuli with a flexible fiber optic colonoscope inserted through the anus.
There is a small risk of perforating the bowel especially when the colon
takes a sudden turn or twists on itself at regions where it is intraperitoneal
rather than attached to the posterior abdominal wall (retroperitoneal).
Which of the following regions of the colon generally poses the greatest
risk for perforation because the bowel takes either a sudden change in
direction or is suspended by a mesentery?
a. Rectum, sigmoid colon and descending colon
b. Sigmoid colon, descending colon and splenic flexure
c. Sigmoid colon, splenic flexure and descending colon
d. Sigmoid colon, splenic flexure and hepatic flexure
e. Descending colon, transverse colon and ascending colon
Abdomen 509