Anatomy

Question 1

The whole of the pancreas is a retroperitoneal structure, T/F?

Answer 1

False. Pancreas except for the tail.

The tail is an intraperitoneal structure.

Question 2

What part of the Duodenum is intraperitoneal?

Answer 2

The 1st part.

Question 3

Falciform ligament contains ___ & ___

Answer 3

Ligamentum teres hepatis (a derivative of fetal umbilical vein)

Patent paraumbilical veins

Question 4

The Portal triad is contained in what ligament?

Answer 4

Hepatoduodenal

Question 5

Constituent of the Portal triad

Answer 5

(From Left to right)
Common bile duct
Portal vein
Proper hepatic artery

Question 6

Derivatives of Ventral mesentery are ___ & ___

Answer 6

Falciform ligament and Lesser omentum

Question 7

The Pringle maneuver involves

Answer 7

Compression of the hepatoduodenal ligament manually or with a vascular clamp in the omental foramen to control bleeding from hepatic inflow source

Question 8

The pancreatic tail is contained in which ligament?

Answer 8

Splenorenal ligament

Question 9

Ulcers are in the mucosa only, T/F?

Answer 9

False.

Question 10

Erosions can extend into the submucosa, inner or outer muscular layer, T/F?

Answer 10

False.

Question 11

Basal electric rhythm(slow waves) originates in ____ cells?

Answer 11

Interstitial cells of Cajal

Question 12

The frequency of basal electric rhythm is greatest in what part of the GIT?

Answer 12

Duodenum

Question 13

What third of the esophagus has striated muscles in it’s histology

Answer 13

Upper 1/3

Question 14

What epithelium lines the esophagus?

Answer 14

Nonkeratinized stratified squamous epithelium

Question 15

Defensins, lysozyme, and TNF are secreted by which cells in the duodenum

Answer 15

Paneth cells

Question 16

There is the presence of villi in the colon histology, T/F?

Answer 16

False.
No villi

Question 17

Brunner glands are found where?

Answer 17

In the submucosa of the duodenum

Question 18

Bifurcation of the abdominal aorta is at which Vertebra?

Answer 18

L4

Question 19

Watershed regions of the colon (which are susceptible to colonic ischemia) are___ & ___

Answer 19

Splenic flexure
Rectosigmoid junction

Question 20

What is Nutcracker syndrome

Answer 20

Compression of the left renal vein between the SMA and aorta.

Question 21

Clinical presentations of Nutcracker syndrome are _____, _____, & ____

Answer 21

Abdominal(flank) pain
Gross hematuria (from rupture of thin-walled varicosities)
Left-sided varicocele

Question 22

Superior mesenteric artery syndrome is characterized by

Answer 22

• intermittent intestinal obstruction symptoms
• primarily postprandial pain
• when the SMA and the aorta compress the transverse(3rd) portion of the duodenum

Question 23

Superior mesenteric artery syndrome typically occurs in conditions associated with ______

Answer 23

Diminished mesenteric fat (e.g., low body weight/ malnutrition)

Question 24

Inferior Mesenteric artery branches off the aorta at what vertebra level?

Answer 24

L3

Question 25

Branches of the Celiac trunk are Hint: 3

Answer 25

Common hepatic artery Splenic artery Left gastric artery

Question 26

Treatment of Portal hypertension is via

Answer 26

Transjugular Intrahepatic Portosystemic Shunt (TIPS) between the portal vein and hepatic vein - this relieves portal hypertension by shunting blood to the systemic circulation, bypassing the liver

Question 27

Can TIPS precipitate hepatic encephalopathy?

Answer 27

Yes, due to a decrease in the clearance of ammonia from shunting

Question 28

Mention the sites of Portosystemic anastomoses and their clinical sign when there is a portal hypertension

Answer 28

1. Esophagus - Esophageal varices 2. Umbilicus - Caput medusae 3. Rectum - Anorectal varies

Question 29

Inferior mesenteric vein drains into ____

Answer 29

Splenic vein

Question 30

Internal hemorrhoids are painful, T/F?

Answer 30

False. Painless b/c they receive visceral innervation

Question 31

Lymphatic drainage of the rectum above the pectinate line is to ___ Lymph node

Answer 31

Iliac LN

Question 32

External hemorrhoids are painful, T/F?

Answer 32

True. B/c they receive somatic innervation via the Pudendal nerve [S2-S4]

Question 33

Lymphatic drainage of the rectum below the pectinate line is to ___ lymph node

Answer 33

Superficial inguinal LN

Question 34

Tear in the anoderm below the pectinate line is ___

Answer 34

Anal fissure

Question 35

The apical surface of the hepatocytes faces the ____ while the basolateral surface faces the _____

Answer 35

Bile canaliculi Sinusoids

Question 36

Which cells in the liver are responsible for hepatic fibrosis?

Answer 36

Hepatic stellate (Ito) cells

Question 37

Role of Hepatic stellate (Ito) cells [in the space of Disse] when; - quiescent - activated

Answer 37

When quiescent- store Vitamin A When activated - produce extracellular matrix

Question 38

Which zone of the functional unit of the liver (hexagonal lobule) is affected first by Viral hepatitis?

Answer 38

Zone I (Periportal zone)

Question 39

Which zone of the functional unit of the liver (hexagonal lobule) is affected first by ischemia (least oxygenated)

Answer 39

Zone III ( Pericentral or Centrilobular zone)

Question 40

Which zone of the functional unit of the liver (hexagonal lobule) is most resistant to circulatory compromise?

Answer 40

Zone I (Periportal zone) Means best oxygenated.

Question 41

Which zone of the functional unit of the liver (hexagonal lobule) is the site for alcoholic hepatitis?

Answer 41

Zone III (Pericentral or Centrilobular zone)

Question 42

Which zone of the functional unit of the liver (hexagonal lobule) is affected by Yellow fever?

Answer 42

Zone II (Intermediate zone)

Question 43

High concentration of Cytochrome P-450 is seen in which zone of the functional unit of the liver (hexagonal lobule)

Answer 43

Zone III

Question 44

Which zone of the functional unit of the liver (hexagonal lobule) is most sensitive to metabolic toxins (e.g., ethanol, acetaminophen, CCl4, halothane, rifampin)?

Answer 44

Zone III

Question 45

Which zone of the functional unit of the liver (hexagonal lobule) is affected by ingested toxins (e.g., cocaine)?

Answer 45

Zone I (Periportal zone)

Question 46

An enlarged gallbladder with painless jaundice being positive is what sign that can be elicited during P/E?

Answer 46

Courvoisier sign

Question 47

Courvoisier sign is positive in what condition?

Answer 47

Obstruction of the common bile duct by tumors that arise in the head of the pancreas

Question 48

Double duct sign is seen in what condition?

Answer 48

Hall stone blocking the confluence of the common bile and pancreatic ducts at the ampulla of Vater causing both cholangitis and pancreatitis, respectively.

Question 49

Content of the Femoral triangle from lateral to medial

Answer 49

Femoral Nerve, artery, vein

Question 50

The femoral sheath contains the femoral Nerve, T/F?

Answer 50

False.

Question 51

The site of protrusion of the indirect hernia is at ____

Answer 51

The Deep (internal) inguinal ring

Question 52

What is Hernia

Answer 52

Protrusion of peritoneum through an opening, usually at a site of weakness

Question 53

The Most common type of Hiatal hernia is

Answer 53

Sliding hiatal hernia

Question 54

The two types of Hiatal hernia

Answer 54

Sliding Paraesophageal

Question 55

Which type of hiatal hernia is associated with GERD?

Answer 55

Sliding

Question 56

Direct inguinal hernia is covered by all 3 layers of spermatic fascia, T/F?

Answer 56

False. Covered by external operatic fascia.

Question 57

Indirect inguinal hernia is covered by all 3 layers of operatic fascia, T/F?

Answer 57

True.

Question 58

The inguinal triangle is also called ______ Boundaries are?

Answer 58

Hesselbach triangle