q bank q - step1mom

[ArchivalUser]

33>A 52-year-old female presents with groin pain . Physical examination
reveals a bulge in the groin area immediately inferior to the inguinal
canal. The physician suspects that the patient has a femoral hernia
containing a loop of small intestine. Which of the following structures
is located immediately medial to the hernia sac?
A. Femoral artery
B. Femoral nerve
C. Femoral vein
D. Inferior epigastric artery
E. Lacunar ligament

[ArchivalUser]

E...

[ArchivalUser]

33>The correct answer is E. A femoral hernia exits the abdominal cavity through the femoral ring to enter the femoral canal. The femoral ring is bounded medially by the lacunar ligament. Compression of the herniated intestine against the sharp edge of the lacunar ligament may cause strangulation of the intestine. The other borders of the inguinal ring are the inguinal ligament anteriorly, the pubis posteriorly, and the femoral vein laterally.
The femoral artery (choice A) is within the femoral sheath along with the femoral hernia, but is lateral to the femoral vein, which separates the artery from the hernia.
The femoral nerve (choice B) is not inside of the femoral sheath, but is lateral to the sheath.
The femoral vein (choice C) is lateral to the femoral canal within the femoral sheath.
The inferior epigastric artery (choice D) is not related to a femoral hernia. This artery is on the anterior abdominal wall and passes immediately medial to the deep inguinal ring. Indirect inguinal hernias pass lateral to this artery and direct inguinal hernias pass medial to this artery.