During an abdominal surgical procedure, the surgeon wishes to locate the ureter in order to ensure that it is not injured.

The ureter may be found immediately anterior to the origin of the A. common iliac artery B. external iliac artery C. internal iliac artery D. gonadal artery E. renal artery

A 15-year-old girl is brought into the emergency room with severe abdominal pain and a fever. Laboratory examination is remarkable for an elevated white blood cell count and a pregnancy test is positive. Upon questioning, it is determined that she attempted to terminate her pregnancy by inserting a sharp object into her vagina. The physician determines that the wall of the posterior fornix of the vagina has been penetrated. Into what region did the sharp object penetrate? A. Deep perineal pouch B. Ischioanal space C. Rectouterine space D. Rectovesical space E. Vesicouterine space

A 35-year-old woman that is pregnant with her fourth child comes to the physician because of painful gastrointestinal bleeding for the past month. The pain and bleeding are worse when she defecates. Which of the following is the most likely diagnosis? (A) Colorectal carcinoma (B) External hemorrhoids (C) Internal hemorrhoids (D) Perianal abscess (E) Squamous cell carcinoma

A 57-year-old woman is scheduled for elective hysterectomy. Severing which of the following structures during surgery would disrupt the most blood flow to the ipsilateral ovary? (A) Cardinal ligament (B) Fallopian tube (C) Round ligament (D) Suspensory ligament (E) Ureter

 With one exception, preganglionic sympathetic axons synapse upon postganglionic sympathetic dendrites or cell bodies. The exception to this general rule occurs within the: Kidney cortex Kidney medulla Suprarenal medulla Suprarenal cortex

 A 2-month-old infant is found to have a horseshoe kidney. Which structure prevents this abnormal kidney from occupying its appropriate position? (A) Aorta (B) Celiac trunk (C) Inferior mesenteric artery (D) Inferior vena cava (E) Superior mesenteric artery

 A 55-year-old man develops a painless pulsatile mass in the scrotum above the testicle, which becomes less evident when the man lies down. Which of the following is the most likely diagnosis? A. Hematocele B. Hydrocele C. Seminoma D. Spermatocele E. Varicocele

 Which of the following secretes a viscous fluid that lubricates the urethra for ejaculation? A. Bulbourethral gland B. Corpus spongiosum C. Prostate D. Rete testis E. Seminal vesicle

 Which of the following secretes a substance that serves as an energy source for spermatozoa? A. Bulbourethral glands B. Corpus spongiosum C. Epididymis D. Prostate E. Seminal vesicle

 Where do sperm mature and increase their fertilizing capacity? A. Ductus deferens B. Ductus epididymis C. Efferent ductules D. Rete testis E. Seminiferous tubule

 Which of the following forms the expanded proximal part of the ureter? A. Collecting duct B. Major calyx C. Renal hilum D. Renal pelvis E. Renal pyramid

 A 24-year-old woman is taken to the emergency department because of severe pelvic pain. The attending physician suspects a rupturing ovarian cyst and wants to take a sample of the contents of the pouch of Douglas. This structure is found between the uterus and which of the following structures? (A) Bladder (B) Cervix (C) Fallopian tube (D) Ovary (E) Rectum

 A medical student is scrubbed in on an inguinal hernia repair.After isolating the spermatic cord, the fascial defect is repaired and the student begins closing. Suddenly, the operative field is full of blood. The nerve that innervates the cells of the suprarenal medulla consists of fibers of the: Greater thoracic splanchnic nerve Lesser thoracic splanchnic nerve Least thoracic splanchnic nerve Anterior vagal trunk Posterior vagal trunk

 The bleeding is bright red and from the spermatic cord. Which of the following inguinal vessels is most likely compromised? (A) Femoral artery (B) Inferior epigastric artery (C) Obturator artery (D) Testicular artery (E) Vas deferens

 During a complicated delivery of a nulliparous woman, an episiotomy is performed. Delivery eventually progresses, but postpartum the patient begins to bleed profusely from the episiotomy incision on the perineum. Which of the following vessels provides circulation to the perineum? (A) Inferior gluteal (B) Inferior rectal (C) Internal pudendal (D) Uterine artery (E) Vesicular

 In order to perform an episiotomy prior to childbirth, the perineum must be anesthetized. By inserting a finger in the vagina and pressing laterally, what palpable bony landmark can be used as the posterior limit of the pudendal canal? Coccyx Ischial tuberosity Ischiopubic ramus Obturator groove Ischial spine

 A 50-year-old man with a history of alcoholism presents with lower gastrointestinal bleeding for three hours. The bleeding is brisk, and he is moderately hypotensive. The patient is stabilized with intravenous saline, and endoscopy is performed to evaluate the site of bleeding. Several large hemorrhoids are seen. Which of the following anastomoses form the anatomic basis of hemorrhoids? (A) Paraumbilical vein to the superficial epigastric vein (B) Pudendal artery to the inferior rectal artery (C) Pudendal artery to the middle rectal artery (D) Superior rectal vein to the inferior mesenteric vein (E) Superior rectal vein to the inferior rectal vein

 A 57-year-old male complains of intense chest pain, but tests rule out any cardiac pathology. It was determined that the patient suffers from an esophageal (hiatal) hernia in which the stomach herniates through an enlarged esophageal hiatus. Muscle fibers from which of the following parts of the diaphragm would border directly on this hernia? left crus right crus central tendon costal fibers sternal fibers

 Sympathetic fibers in the greater splanchnic nerve arise from neuron cell bodies found in the: brainstem celiac ganglion chain ganglion spinal cord superior mesenteric ganglion

 After successfully performing two adrenalectomies (removal of the adrenal gland), the surgical resident was disappointed to learn that he would be merely assisting at the next one. The chief of surgery told him: "I'm doing this one, since the one on the right side may be a little too difficult for you." The difficulty he envisioned stems from the fact that the right suprarenal gland is partly overlain anteriorly by the: aorta inferior vena cava left hepatic vein right crus of the diaphragm right renal artery

 During preparations to remove the left kidney from a 28-year-old female patient, the surgeon asked an observing medical student where best to ligate the renal vein. Upon hearing the reply: "as close to the inferior vena cava as possible, leaving just enough stump to ensure tight closure," the surgeon's eyebrow shot up. "Do you mean to say you're willing to compromise the venous drainage of the other structures that drain into the renal vein?" By this he meant all of the following except: diaphragm pancreas ovary suprarenal gland

 Which statement regarding the suprarenal glands is correct? Its entire arterial supply is directly from the abdominal aorta. Veins from both glands drain directly into the inferior vena cava. The glands are localized in the pararenal space. Cells that secrete epinephrine and norepinephrine are innervated by preganglionic fibers from the greater thoracic splanchnic nerve.

 Regarding the diaphragm, which, is paired INCORRECTLY? Quadratus lumborum - lateral arcuate ligament Esophageal hiatus - right crus Medial arcuate ligament - psoas muscle Central tendon - aortic hiatus Vena caval foramen - right phrenic nerve

 The nerves that end on the secretory cells of the medulla of the suprarenal glands are principally: Preganglionic fibers from the greater thoracic splanchnic nerve Postganglionic fibers from the celiac plexus Postganglionic fibers from the aorticorenal ganglia Preganglionic fibers from the lesser thoracic splanchnic nerve Postganglionic fibers from the renal plexus

 The vagus nerve passes into the abdomen by passing through the Aortic hiatus Esophageal hiatus Caval foramen Lateral arcuate ligament Medial arcuate ligament

 The pararenal fat in the kidney bed is an elaboration of: Peritoneum Extraperitoneal connective tissue Transversalis fascia Fusion fascia

 The cisterna chyli accompanies which structure as it passes through the diaphragm? Inferior vena cava Esophagus Greater thoracic splanchnic nerve Aorta

 Blood from an injured kidney will seep through the perirenal fat until it contacts the internal surface of the renal fascia. Without perforating this fascia the blood could then continue to pass in what direction? inferiorly toward the pelvis laterally into the body wall medially across the midline to the other kidney superiorly into contact with the fascia of the diaphragm

 A 19-year-old male suffers a tear to the psoas major muscle during the course of a football game. A scar, which formed on the medial part of the belly of the muscle, involved an adjacent nerve, immediately medial to the muscle. The nerve is called the: femoral genitofemoral iliohypogastric ilioguinal obturator

 While recovering from an open abdominal hysterectomy (i.e., using a midline abdominal incision to gain entry to the pelvis), a patient realizes that she has lost sensation to the skin of her anterior thigh and cannot extend her knee. Retractors holding the incision open and pressing against the posterior abdominal wall most likely caused injury to which nerve? Femoral Genitofemoral Iliohypogastric Lateral femoral cutaneous Obturator

 In the lumbar region, tuberculosis may spread from the vertebrae into an adjacent muscle to produce an abscess. Pus from the abscess may travel within the fascial sheath surrounding the affected muscle. A patient presents with pus surfacing in the superomedial part of the thigh. To which muscle did the tuberculosis most likely spread? Internal oblique Obturator internus Psoas major Quadratus lumborum Rectus abdominis

 The nerves of the lumbar plexus are arranged around specific muscles of the posterior abdominal wall. Which of these nerves lies immediately medial to the psoas major muscle? Femoral Genitofemoral Ilioinguinal Obturator

 The part of the uterine wall which is not shed during menstruation is the: Endometrium Myometrium Mesometrium Cervical mucosa Rugae

 The extension of the vaginal lumen around the intravaginal part of the uterine cervix is the: Cervical canal Uterine lumen Fornix Rectouterine Pouch Uterovesical Pouch

 Which of the following would be most likely to be damaged by a stab wound into the ischiorectal (ischioanal) fossa 2 cm lateral to the anal canal? Crus of the Penis Perineal Body Pudendal Nerve Inferior Rectal Artery Vesicular Bulb

 Lymphatic drainage of the terminal portion of the gastrointestinal tract may flow initially into either the superficial inguinal nodes or the pararectal nodes, depending upon whether the lymph is formed above or below the: Anorectal Junction Muscular Sling of the Puborectalis Muscle Pectinate Line White Line Cutaneous Zone

 Under normal conditions, fertilization occurs in which part of the female reproductive tract? Infundibulum of the Uterine Tube Ampulla of the Uterine Tube Isthmus of the Uterine Tube Uterine Lumen Cervical Canal

 Benign hyperplasia (excessive growth of cells) of which part of the male reproductive system would be most likely to interfere with the passage of urine? Periurethral Zone of the Prostate Central Zone of the Prostate Peripheral Zone of the Prostate Ejaculatory Duct Seminal Vesicle

 After agreeing to have no more children, a man and his wife decided he should have a vasectomy. What structure would then be surgically ligated? Ductus deferens Ejaculatory duct Epididymis Fossa navicularis Seminal vesicle

 Which structure does NOT form part of the boundary defining the trigone of the bladder? Interuteric crest Left Ureteric Orifice Right Ureteric Orifice Urachus Urethral Orifice

 Which structure is found only in males? Anterior recess of ischoianal fossa Genital Hiatus Ischiocavernosus muscle Rectovesical pouch Sphincter urethrae muscle

 Which structure is outlined with contrast on a CT using intraperitoneal contrast material? Ovary Prostate Rectum Seminal Vesicles Vagina

 The prostate is often imaged using an ultrasound transducer placed in which location? Penis Perineum Rectum Urethra Urinary Bladder

 Which of the following is considered a part of the broad ligament? Mesovarium Ovarian ligament Round ligament of the uterus Uterosacral ligament

 Which of the following does not conduct spermatozoa? Ampulla of the ductus deferens Duct of the seminal vesicle Epididymis Prostatic Urethra

During the course of surgery for benign prostatic hypertrophy (benign enlargement of the prostate tissue which occludes the prostatic urethra) an electrical cutting device is inserted into the penile, then prostatic urethra, to remove the hypertrophic tissue. The posterior wall of the prostatic urethra is by necessity removed as well. Which part of the male seminal tract may also be partially removed? duct of seminal vesicle ductus deferens ejaculatory duct fossa navicularis seminiferous tubule

 A 27-year-old woman is examined by her gynecologist. Upon rectal examination, a firm structure, directly in front of the rectum in the midline, is palpated through the anterior wall of the rectum. This structure is the: bladder body of uterus cervix of uterus pubic symphysis vagina

 The most inferior extent of the peritoneal cavity in the female is the: Pararectal fossa Paravesical fossa Rectouterine pouch Rectovesical pouch Vesicouterine pouch

 The prostate gland: Contains upper, middle and lower lobes Encircles the urethra Is well imaged radiologically using an intravenous urogram Is extraperitoneal B and D

 A 64-year-old woman was diagnosed as having carcinoma of the distal gastrointestinal tract. At surgery, lymph nodes from the sacral, internal iliac and inguinal lymph node groups were removed and sent to pathology for study. Only the superificial inguinal nodes contained cancerous cells. In which part of the GI tract was the tumor localized? cutaneous portion of anal canal distal rectum mucosal zone of anal canal pectinate line of anal canal proximal rectum

 Structures within the lower gastrointestinal tract specialized for physical support of fecal material are the: Transverse rectal folds Circular folds Anal valves Anal columns

 A malignant tumor in the cutaneous zone of the anal canal would most likely metastasize (spread) to which group of lymph nodes? Inferior mesenteric Pararectal Sacral Superficial inguinal

 Which of these features of the anal canal serves to indicate the point where the mucosal covering of the gastrointestinal tract ends and a skin-like covering begins? Mucosal zone White line Transitional zone Pectinate line

 The expanded region of the lower rectum, where fecal matter is retained, is known as the: Anal columns Anal sinuses Ampulla Transverse folds

 During a vasectomy, the ductus deferens is ligated in the superior part of the scrotum. Two months following this sterilization procedure, the subsequent ejaculate contains: Prostatic fluid only Seminal fluid and prostatic fluid Sperm only Sperm and seminal fluid Sperm, seminal fluid, and prostatic fluid

 During a hysterectomy, the uterine vessels are ligated. However, the patient's uterus continues to bleed. The most likely source of blood still supplying the uterus is from which artery? Inferior vesical Internal pudendal Middle rectal Ovarian Superior vesical

 A female patient is found to have an ectopic (tubal) pregnancy (embryo develops in the uterine tube). In order to gain access to the peritoneal cavity endoscopically to remove the embryo, the instrument can be passed into the vagina and through the: anterior fornix cervix posterior fornix retropubic space vesicouterine pouch

 An elderly male patient presents with dysuria and urgency. You suspect benign prostatic hypertrophy which has caused an enlargement of the: interureteric crest prostatic utricle seminal colliculus sphincter urethrae uvula

 During a hysterectomy and an oophorectomy, the uterine and ovarian vessels must be ligated. These vessels can be found in which ligaments? Broad and ovarian Broad and suspensory Round and ovarian Round and suspensory Suspensory and ovarian

 A female patient comes to your office with lower abdominal pain. She missed her last menses and her pregnancy test is positive. Ultrasound imaging reveals a cyst-like structure in the right uterine tube which you feel may be a tubal pregnancy. In order to confirm your diagnosis and to remove the tubal embryo, you can gain access to the patient's lower pelvic cavity by passing a culdoscope through the vagina and the: vesicouterine pouch posterior fornix cervix isthmus ampulla

 An elderly patient notices red blood in his stool. As part of his examination, you insert a proctoscope (sigmoidoscope) through his anal canal. As you pass the scope superiorly through the rectum, the most prominent features to be seen are: longitudinal muscle bands tenia coli transverse rectal folds rectovesical pouches haustra

 An elderly patient is having difficulty in voiding (urinating). He complains that after voiding, he still feels as though he needs "to go" again. You suspect that this patient suffers from benign prostatic hypertrophy, which has caused enlargement of the __________ of the bladder. seminal colliculus interureteric crest ampulla trigone uvula

 During a hysterectomy, care must be taken in ligation of the uterine vessels because they cross the _________ superiorly. ureter round ligament of the uterus ovarian artery lumbosacral trunk inferior hypogastric plexus

 The prostate gland: encircles the urethra is well imaged using an intravenous urogram is partially intraperitoneal contains upper, middle and lower lobes

 The part of the broad ligament giving attachment and support to the uterine tube is the: mesometrium mesovarium mesosalpinx round ligament

 Which structure is NOT found within the true pelvis? Femoral nerve Hypogastric nerve Internal pudendal artery Obturator artery Pelvic splanchnic nerves

 A structure which takes the form of a hood anterosuperior to the clitoris: Frenulum of the clitoris Labia majora Labia minora Prepuce

 A structure which is homologous to the male scrotum: Labia minora Labia majora Glans Shaft of corpus cavernosum

 Which skeletal feature would you consider to be most characteristic of the female pelvis? Subpubic angle of 90 degrees or greater Marked anterior curvature of the sacrum Tendency to vertical orientation of the iliac bones Prominent medial projection of the ischial spines

 You are observing a doctor perform an abdominal hysterectomy. He notes that it is vital to protect the ureter which is found in the base of the: mesometrium mesovarium mesosalpinx round ligament of the uterus suspensory ligament of the ovary

 A female patient is found to have an ectopic (tubal) pregnancy. In order to gain access to the peritoneal cavity endoscopically to remove the tubal embryo, the instrument can be passed through the posterior fornix of the vagina piercing into the: external os internal os rectouterine pouch rectovesical pouch vesicouterine pouch

 The male pelvis tends to differ from the female pelvis in that the male pelvis often has a: larger pelvic inlet smaller subpubic angle straighter sacral curvature larger pelvic outlet rounder pelvic inlet

 The rectouterine pouch is the lowest extent of the female peritoneal cavity. At its lowest, it provides a coat of peritoneum to a portion of the: urinary bladder urethra uterine cervix vagina

 In a CT scan of the pelvis, the uterus is located: posterior to the bladder and rectum posterior to the bladder and anterior to the rectum anterior to the bladder and rectum anterior to the bladder and posterior to the rectum

 What bony landmark on the lateral pelvic wall may be used as a reference for localizing female pelvic anatomy or pain phenomena? Coccyx Ischial spine Ischial tuberosity Obturator canal Pectineal line

 Which statement about the pelvic floor is NOT correct? Along with the pelvic brim, it defines the true pelvic cavity It is a funnel-shaped skeletal muscle It is referred to as the pelvic diaphragm It is tensed during defecation It projects into the anal triangle

Following pregnancy and delivery, a 32-year-old woman continued to have problems with urinary incontinence which developed during pregnancy. Her obstetrician counseled her to strengthen the muscle bordering the vagina and urethra, increasing its tone and exerting pressure on the urethra. This physical therapy was soon adequate to restore urinary continence. What muscle was strengthened? Coccygeus Ischiocavernosus Obturator Internus Piriformis Puborectalis

 Preganglionic parasympathetic nerve fibers within the pelvic (inferior hypogastric) plexus arise from S2, 3, 4 and enter the plexus via: gray rami communicantes hypogastric nerves pelvic splanchnic nerves sacral splanchnic nerves white rami communicantes

 While performing a hysterectomy, the resident must ligate the uterine artery. To avoid iatrogenic injury to the ureters, she must be aware that the ureter passes ___________ the artery at the level of the ______________. Over; cervix Over; fundus of uterus Over; pelvic brim Under; cervix Under; pelvic brim

 After giving birth, a patient complains of urinary stress incontinence characterized by dribbling of urine with an increase in intra-abdominal pressure. Her physician suspects injury to the pelvic floor during delivery which may have altered the position of the neck of bladder and the urethra. Which muscle was most likely damaged during the vaginal delivery? Bulbospongiosus Coccygeus Levator ani Obturator internus Piriformis

 A caudal epidural block is a form of regional anesthetic used in childbirth. Within the sacral canal, the anesthetic agent bathes the sacral spinal nerve roots which would anesthetize all of the following nerves except: Pelvic splanchnics Pudendal S2 dorsal root Sacral splanchnics S2 ventral primary ramus

 After giving birth, a patient complains of dribbling of urine while coughing, sneezing, or laughing. Which muscle was most likely damaged during the vaginal delivery? Coccygeus Levator ani Obturator internus Piriformis Transverse perineal

 A patient presents complaining of blood-stained stools and the inability to completely empty his rectum. He also has pain along the back of his thigh and weakness of the posterior thigh muscles. Digital examination reveals a tumor in the posterolateral wall of the rectum. Pressure on what nerve plexus could cause the pain in his lower limb? Inferior hypogastric Inferior mesenteric Lumbar Sacral Superior hypogastric

 In a patient with rectal cancer located in the wall of the ampulla, you find that the cancer has spread to the muscle immediately lateral to the ampulla. This muscle is the: Piriformus Obturator internus Levator ani Sphincter urethrae Bulbospongeosis

 Blood supply to the superior portions of the bladder typically arises from the ____________ arteries. Umbilical Middle rectal Obturator Inferior gluteal Uterine

 The pelvic splanchnic nerves primarily carry ____________ to the _____________ plexus. Preganglionic parasympathetics--superior hypogastric Preganglionic parasympathetics--inferior hypogastric Postganglionic parasympathetics--superior hypogastric Postganglionic sympathetics--superior hypogastric Postganglionic sympathetics--superior hypogastric

 The arcus tendineus levator ani is a thickening of fascia of the: Coccygeus Obturator externus Obturator internus Piriformis

 The sacral outflow of the parasympathetic (craniosacral) system enters the pelvic plexus via: Hypogastric nerves Pelvic splanchnic nerves Pudendal nerves Sacral splanchnic nerves

 The boundaries of the perineum include all the following except: Ischiopubic rami Ischial tuberosity Tip of the coccyx Sacrotuberal ligament Sacrospinal ligament

 A condensation of fibrous tissue in the female located at the center of the posterior border of the perineal membrane is the: Frenulum Posterior labial commissure Perineal body Anococcygeal ligament Pubovesical ligament

 The artery which supplies blood to the major erectile body in both the male and female is the: Artery of the bulb Dorsal artery of the penis/clitoris Deep artery of the penis/clitoris Posterior labial/scrotal artery Superficial external pudendal artery

 The vestibular bulbs/bulb of the corpus spongiosum are firmly attached to the: Perineal membrane Superior pubic rami Ischiopubic rami Pubic symphysis Ischial tuberosities

 The part of the male reproductive tract which carries only semen within the prostate gland is the: Prostatic urethra Membranous urethra Seminal vesicle Ductus deferens Ejaculatory duct

 Which of the following developmental processes is least likely to be involved in the differentiation of male external genitalia from the indifferent state? Descent of the gonads into the labio-scrotal folds Fusion of the urogenital folds Elongation of the phallus Formation of new erectile bodies

 An intrahepatic blockage of the portal venous outflow may cause intestinal blood to drain via portal-systemic anastomoses into the: Superior gluteal vein Middle rectal vein Splenic vein Renal vein Inferior phrenic vein

 The perineum is bounded by all of the following skeletal elements except: coccyx ischiopubic ramus spine of ischium symphysis pubis

 A 6 mo. old male was brought to the pediatric clinic by his parents because of leakage of urine from the ventral surface of his penis. This congenital condition, hypospadias, is due to incomplete ventral closure of a component of the penis. Which of the below structures would be partially open for urine to take such a course? Shaft of corpus cavernosum Membranous urethra Glans Shaft of corpus spongiosum

 During childbirth a bilateral pudendal nerve block may be performed to provide anesthesia to the majority of the perineum and the lower one fourth of the vagina. To do this an anesthetic agent is injected near the pudendal nerve as it passes from the pelvic cavity to the perineum. The physician inserts a finger into the vagina and presses laterally to palpate what landmark? Arcus tendineus levator ani Coccyx Ischial spine Lateral fornix Obturator foramen

 During a vaginal delivery, a surgeon performed median episiotomy in which he cut too far (i.e., through the perineal body into the structure immediately posterior). Which perineal structure did he cut? Bulbospongiosis muscle External anal sphincter muscle Ischiocavernosis muscle Sacrospinous ligament Sphincter urethrae

 During a prostatectomy, the surgeon attempts to protect the prostatic plexus of nerves which contains nerve fibers that innervate penile tissue to cause erection. From which nerves do these fibers originate? Deep perineal Dorsal nerve of the penis Genitofemoral Pelvic splanchnics Pudendal

 If the venous drainage of the anal canal above the pectinate line is impaired in a patient with portal hypertension, there may be an increase in blood flow downward to the systemic venous system via anastomoses with the inferior rectal vein, which is a tributary of the: External iliac Inferior gluteal Inferior mesenteric Internal iliac Internal pudendal

 A patient complains of a boil located on her labia majora. Lymphatic spread of the infection would most likely enlarge which nodes? Lumbar nodes Sacral nodes External iliac nodes Superficial inguinal nodes Internal iliac nodes

 A 58-year-old patient was diagnosed with a severe case of portal hypertension due to alcoholic cirrhosis of the liver. It was determined that a bypass between the vessels of the portal and caval systems was necessary. The plan most likely to be successful is: Coronary vein to right gastro-omental vein Left colic vein to sigmoidal vein Inferior mesenteric vein to splenic vein Splenic vein to left renal vein Superior rectal vein to inferior rectal vein

 A 67-year-old man develops portal hypertension caused by cirrhosis of the liver. Collateral venous circulation begins to develop to enable blood to bypass the liver. In which of the following tributaries of the portal vein will there be an increased retrograde flow of venous blood? A. Azygous vein B. Hepatic vein C. Inferior rectal vein D. Left gastric vein E. Superficial epigastric vein

 A 54-year-old male has developed cirrhosis, with obstruction of the portal circulation within the liver. Portal blood could still be conveyed to the caval system via which of the following? A. Azygos and hemiazygos veins B. Gonadal veins C. Internal iliac veins D. Splenic vein E. Vesical venous plexus