392.A middle-aged woman describes flushing, severe headaches, and a
feeling that her heart is “going to explode” when she gets excited. At the
beginning of a physical examination her blood pressure (130/85) is notsig-
nificantly above normal. However, on palpation of her upper left quadrant,
the examining physician notices the onset of sympathetic signs. Her blood
pressure (200/135) is abnormally high. A subsequent CT scan confirms the
suspected tumor of the left adrenal gland. The patient is scheduled for
surgery. The symptoms that the patient correlates with the onset of excite-
ment were most likely due to neural stimulation of the adrenal glands. The
adrenal medulla receives its innervation from which of the following?
a. Preganglionic sympathetic nerves
b. Postsynaptic sympathetic nerves
c. Preganglionic parasympathetic nerves
d. Postganglionic parasympathetic nerves
e. Somatic nerves
393.A 42-year-oldman presents with an enlarged left adrenal gland on CT
scan. He is scheduled for adrenalectomy. The left adrenal gland is located,
and the venous drainage is ligated to prevent life-threatening quantities of
adrenalin from entering the bloodstream on manipulation of the gland.
Normally, the left adrenal venous drainage is into which of the following?
a. Inferior vena cava
b. Left azygos vein
c. Left inferior phrenic vein
d. Left renal vein
e. Superior mesenteric vein
394.Which of the following statements concerning a direct inguinal her-
nia is correct?
a. It protrudes through the inguinal (Hesselbach’s) triangle
b. It is the most common type of abdominal hernia in newborn boys
c. It traverses the entire length of the inguinal canal
d. It contains all three fascial layers of the spermatic cord
e. It exits the inguinal canal via the superficial inguinal ring
502 Anatomy, Histology, and Cell Biology