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Anatomy · Abdomen and pelvis: psoas abscess
Sample itemA 30-year-old man with tuberculosis of the lumbar spine has a fluctuant swelling in the right femoral triangle. Along which fascial sheath did the pus track from the vertebrae?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Psoas sheath
Pus from lumbar vertebral tuberculosis enters the fascia covering psoas major and tracks along it under the inguinal ligament to the femoral triangle, sometimes pointing near the lesser trochanter. The psoas sheath is attached to the lumbar vertebrae, so it carries infection from the spine to the thigh.
Option by option
A. Psoas sheath (correct)
Correct. The psoas sheath extends from the vertebral bodies to the thigh.
B. Femoral sheath
The femoral sheath is the funnel of fascia round the femoral vessels below the inguinal ligament, and does not extend up to the spine.
C. Posterior layer of thoracolumbar fascia
This layer encloses the erector spinae and tracks pus to the lumbar triangle, not to the femoral triangle.
D. Rectus sheath
The rectus sheath encloses the rectus abdominis in the anterior abdominal wall.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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