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421.A 19-year-old female college student presents to the emergency room
at 10:30 PMon a Friday night with severe left side, back, and pelvic pain.
While she has never had them before, she states that she thinks she has kid-
ney stones. The pain started in her mid back about a week ago and then
subsided and now the pain has decreased somewhat and also extends down
into her labia majora. She is on birth control pills, but denies any sexual
activity. She is having her period, but denies the pain is menstrual. You have
her do a urine pregnancy test while she is waiting to get an abdominal and
pelvic computer tomography (CT) to look for ureteric calculi. What specific
location(s) will you look for in the CTs for obstructing calculi?


a. At the junction of the renal pelvis with the ureters
b. As the ureters cross the cranial edge of the greater pelvis
c. As the ureters cross the external iliac artery at the pelvic brim
d. As the ureters pass through the wall of the bladder
e. a, b, and c
f. a, c, and d


422.You deliver a full-term baby boy who is healthy and receives an
Apgar score of 9 out of 10. You do note that his scrotum is rather large
compared to his penis and when he cries and strains, the scrotum gets even
bigger. You palpate for testes and epididymides and think both are present
and don’t feel any abnormal structures. You tell the parents the newborn
has which of the following?


a. Cryptorchidism
b. Direct inguinal hernia
c. Varicocele
d. Hydrocele
e. Klinefelter’s syndrome


423.A 6-year-old boy badly bruised his perineum on the horizontal bar of
his bicycle as he was learning to ride a bike. Blood extended into his scro-
tum, and onto the anterior abdominal wall from 3 in. below his umbilicus
to just anterior to his anus, but did not pass into his thigh. Which anatom-
ical layers most likely explain the distribution of extravasated blood?


a. Superficial membranous fascia and Camper’s fascia
b. Superficial membranous fascia and transversalis fascia
c. Dartos fascia and the perineal membrane
d. Superficial membranous fascia and the perineal membrane
e. Deep perineal fascia and inferior fascia of the pelvic diaphragm


534 Anatomy, Histology, and Cell Biology

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