A 65-Year-Old Man Comes to the Emergency Department Due to Severe

question 194

Multiple Choice

A 65-year-old man comes to the emergency department due to severe lower abdominal pain and nausea.  He also has not been able to urinate for the past 24 hours.  The patient has a history of hypertension and benign prostatic hyperplasia.  On examination, a large mass is palpable in the suprapubic area.  Multiple attempts at urethral catheterization are unsuccessful, and an ultrasound-guided midline suprapubic cystostomy is planned.  Besides the bladder wall, which of the following structures is most likely to be penetrated by the trocar and cannula during the procedure?

• A)Anterior abdominal aponeurosis
• B)Parietal peritoneum
• C)Perineal membrane
• D)Ureter
• E)Visceral peritoneum

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