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coronary ligaments, which define the bare area of the liver. The coronary
ligaments(answer e)come together again to form the gastrohepatic ligament
of the lesser omentum (answer d).


372.The answer is c.(Moore and Dalley, p 304.)Obstruction of any portion
of the biliary tree will produce symptoms of gallbladder obstruction. If the
common hepatic duct (answer b)or bile duct (answer a)is occluded by
stone or tumor, biliary stasis with accompanying jaundice occurs. In addition,
blockage of the duodenal papilla (of Vater), distal to the juncture of the bile
duct with the pancreatic duct (answer e),can lead to complicating pancreati-
tis. If only the cystic duct is obstructed, jaundice will not occur because bile
may flow freely from the liver to the duodenum. Bile duct obstruction also
may arise as a result of pressure exerted on the duct by an external mass, such
as a tumor in the head of the pancreas. Answser dis not anatomically correct.


373.The answer is d.(Moore and Dalley, pp 225–226.)The newborn boy
has a hydrocele. The testicles develop on the posterior abdominal wall and
are pulled down and out of the abdominal cavity by the gubernaculum.
The final descent through the inguinal canal does not generally occur until
the 9th month in utero. The testis remains a retroperitoneal organ behind
the fluid-filled space which is connected to the abdominal cavity by the
process vaginalis (Moore & Dalley, p 218). In this case the testicles suc-
cessfully migrated into the scrotum on both sides [so he did not have cryp-
torchid testes (answer b)], but rather the processus vaginalis failed to seal
itself off from the abdominal cavity. Congenital hydrocele normally resolves
itself after 2–3 months without any intervention. An abdominal hernia
(answer a)is a defect on the anterior abdominal wall and is not present.
Varicoceles (answer c)are a stasis of venous blood around the testicle and
often present as a bluish scrotal mass. Femoral hernias (answer e)are
defects in both the femoral sheath and fascia lata and present on the ante-
rior thigh below the inguinal ligament.


374.The answer is c.(Moore and Dalley, pp 207, 209.)The cutaneous
nerves are at risk with this type of incision is the iliohypogastric nerve (L1).
The thoracoabdominal (intercostal) nerve T10 (answer a)generally supplies
the dermatome that includes the umbilicus while the skin over the inguinal
ligament is generally served by the L1 spinal level. T11 (answer b)is also too


Abdomen Answers 515
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