BIO 350 Exam 2

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A 35-year-old alcoholic man came to the clinic with pain at the right upper abdominal quadrant. Based on your anatomical knowledge, which of the following could be a possible origin of his pain?

Liver
Duodenum
Pancreas
Gall bladder
a, b and c
All of the above
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Terms in this set (95)
A 35-year-old alcoholic man came to the clinic with pain at the right upper abdominal quadrant. Based on your anatomical knowledge, which of the following could be a possible origin of his pain?

Liver
Duodenum
Pancreas
Gall bladder
a, b and c
All of the above
All of the above
He mentioned that the pain is increase with food intake and relieved by vomiting. He lost 20 pounds in the last 2 months. On examination, he looked pale, with yellow coloration of the skin and conjunctiva of the eye. The yellow coloration of skin could be due to

Excessive vomiting and loss of nutrient
Excess bilirubin pigments in the circulation
Excess bile salts and deficiency of cholesterol metabolism
Excess red blood cells formation
Excessive bilirubin pigments in the circulation
A defect in which of the following anatomical structures is highly likely to be associated with yellow coloration in this patient?

Pancreatic blood vessels
Main pancreatic duct
Accessory pancreatic ducts
Common bile duct
Common bile duct
Which of the following is highly likely to explain vomiting in this patient?


Excessive appetite
Duodenal obstruction
Dysphagia
Esophagitis
Duodenal obstruction
Laboratory tests revealed elevated liver enzymes; serum amylase and alkaline phosphatase levels. Ultrasound showed abnormal pancreatic mass and hospital admission was done. Based on your anatomical knowledge and patient history above, which of the following parts of the pancreas the mass was highly likely located in this patient?

Head
Body
Tail
Head
At the hospital he had an episode of vomiting that was bright red with massive blood. Complete physical examination was done by the gastroenterologist that revealed enlarged fluid filed abdomen and dilated veins radiated from the umbilicus. Palpitation revealed enlarged spleen. Diagnosis was made as pancreatic (tumor) with portal hypertension. Based on the anatomical knowledge, where the portal vein is located?


Anterior to superior mesenteric artery
Anterior to neck of pancreas
At the tail of the pancreas
At the hepatoduodenal ligament
At the hepatoduodenal ligament
What are the major veins that join and form portal vein?

Right gastric vein and short gastric veins
Superior gasto-omental vein and celiac vein
Splenic vein and superior mesenteric vein
Inferior epigastric and inferior gastro-omental vein
Splenic vein and superior mesenteric vein
The cause of vomiting blood in this patient could be due to


Rupture esophageal varices
Anastomoses between left gastric vein and azyous vein
Anastomose of portal vein and superior and inferior epigastric veins
a and b
a and c
All of the above
Rupture esophageal varices
Anastomoses between left gastric vien and azyous vein
The cause of dilated veins around umbilicus in this patient could be due to

Rupture esophageal varices
Anastomoses between left gastric vein and azyous
Anastomose between portal vein and superior and inferior epigastric veins
a and b
a and c
All of the above
Anastomoses between portal vein and superior and inferior epigastric veins
Dilated veins radiated from the umbilicus are called


Esophageal varices
Caput medusae
Hemorrhoids
Caput medusae
This patient might also complain of Coughing blood Bloody urine Bloody fecesBloody fecesWhat would be a possible cause of the enlarged spleen in this patient? Increase blood flow in splenic vein that leads to splenic congestion Decrease blood flow in splenic artery that leads to ischemic spleen Pressure of the pancreatic tumor at the hilum of the spleen Increase blood flow in the left gastric veinIncrease blood flow in splenic vein that leads to splenic congestionA 35-year-old man came to emergency room with sever excruciating pain in the left flank and inguinal regions. A urine sample was positive for blood. While waiting at the hospital the pain moved into the anterior and medial aspect of the left thigh and the pubic region. X ray indicates possible caculus in the lower left quadrant. The initial pain in the flank and inguinal region result from a nephrolith is due to visceral afferent fiber that travel via Greater splanchnic nerve Parasympathetic innervation T11-L2 nerves Vagus nerveT11-L2 nervesThe subsequent renal colic referred to medial and anterior aspect of the thigh and pubic region is the result of afferent fibers which travel via Greater splanchnic nerve T12 and lesser splanchnic nerve L1-2 Vagus nerveL1-2The patient was admitted for possible surgery. Under general anesthesia, the peritoneal cavity was opened by incision of skin, fascia and musculature of the anterior abdominal wall from the iliac crest to pubis above and parallel to left inguinal ligament. All of the following layers are affected in anterior abdominal wall incision except Deep fascia Renal fascia Scarpa's fascia Transversalis fasciaRenal fasciaThe surgeon mobilized the descending colon from the posterior abdominal wall, moving them into the midline. The ureter was visible; the stone was palpated and removed through a small longitudinal incision. Care was taken to preserve the blood supply to the ureter, which is obtained from all of the following vessels except Renal artery Gonadal artery Iliac artery Inferior mesenteric arteryInferior mesenteric arteryThe surgeon noticed that the blood supply to the kidney is normal. All o f the following statements concerning blood supply in the vicinity of the kidney are correct except Left suprarenal artery only originates from the left renal artery Left suprarenal vein usually drains into the left renal vein Right adrenal vein drains directly to IVC Left renal vein drains directly to IVCLeft suprarenal artery only originates from the left renal arteryThe abdominal incision was closed in layers. As a result of the location and direction of the incision, healing might be expected to be accompanied by Increase tendency to retract the fibers Tend to have large gap Minimal scar formation Prominent scarMinimal scar formationWhich of the following concerning the ureter is correct It descend anterior to psoas muscle It originate at the renal papilla It is posterior to iliac vessels It opens into the superior surface of the bladderIt descend anterior to psoas muscleInterruption of blood supply of the lower segment of the ureter is associated with systemic hypertensionFalseLeft gastro-omental arteries arise from Superior mesenteric artery Splenic artery Celiac trunkSplenic arteryPeritoneum is consists of Transversalis fascia and a parietal layer Transversalis fascia, a visceral layer and a parietal layer Parietal layer, a visceral layer and a fatty layer in between Parietal layer and a visceral layerParietal layer and a visceral layerPyloric sphincter is located between Stomach and esophagus Stomach and duodenum Stomach and diaphragm Stomach and liverStomach and duodenumStomach is divided into Cardia, body and pylorus Fundus, body and pylorus Cardia, fundus and pylorus Cardia, fundus, body and pylorusCardia, fundus, body, and pylorusWhich of the following abdominal muscles is the most superficial? Internal oblique External oblique Transverse abdominisExternal obliqueRugae is mucosal fold found in Esophagus Stomach Duodenum LiverStomachRight gastric artery is A direct branch of abdominal aorta A direct branch of celiac trunk A direct branch of common hepatic arteryA direct branch of common hepatic arteryHepato-pancreatic duct is opened at Pylorus Descending portion of the duodenum Transverse portion of the duodenum Ascending portion of the duodenumDescending portion of the duodenumTransversalis fascia is located between Transverse abdominis muscle and internal oblique Transverse abdominis muscle and peritoneum Dermis and external oblique muscleTransverse abdominis muscle and peritoneumSuperior mesenteric artery Crosses the superior portion of the duodenum Runs along the greater curvature of the stomach Crosses the transverse portion of the duodenum Runs along the cardia of the stomachCrosses the transverse portion of the duodenumFalciform ligament found Between stomach and liver Between liver and anterior abdominal wall Between liver and diaphragm Between liver and duodenumBetween liver and anterior abdominal wallSuperior mesenteric artery supplies all of the following structure except Stomach Duodenum Cecum Transverse colonStomachCommon bile duct is formed by Cystic duct and right hepatic duct Cystic duct and pancreatic duct Cystic duct and common hepatic ductCystic duct and common hepatic ductDuodenum is continuous with ------ at the midline Ascending colon Descending colon Jejunum IleumJejunumSpleen is An organ of hematopoiesis in fetus Located in the epigastric region of the abdomen Avascular organ A retro-peritoneum organAn organ of hematopoiesis in fetusInferior mesenteric artery supplies Duodenum Jejunum Ileum Descending colonDescending colonLigamentum teres (round ligament) Is an obliterated umbilical vein Connect the umbilical vein into IVC in infant Connect the superior pole of the liver to diaphragmIs an obliterated umbilical veinWhich of the following regarding the main pancreatic duct is not true Secretes pancreatic enzymes into portal circulation Joins the common bile duct Drains pancreatic enzymes to the duodenumSecretes pancreatic enzymes into portal circulationWhich of the following regarding liver is not true Consist of four anatomical lobs Covered completely with peritoneum Connected to diaphragm by coronary ligament Gets its blood supply via portal vein and hepatic arteryCovered completely with peritoneumAppendix is a projection extended from the Transverse colon Sigmoid colon Rectum CecumCecumCollecting ducts collects the well formed urine and terminate at Renal cortex Renal column Renal papilla Renal pelvisRenal papillaRenal pyramids Are located in the renal cortex The base of the pyramids are toward the hilum The apex of each pyramid is called renal papilla Are located in the outer part of each kidney toward its outer surfaceThe apex of each pyramid is called renal papillaThe ureter Lies anterior to sacrum Lies posterior to psoas muscle Lies posterior to common iliac vesselsLies anterior to sacrumAdrenal glands At the inferior border of each kidney Secrete hormones directly into blood circulation Have ducts that drain its hormones into renal pelvisSecrete hormones directly into blood circulationLeft supra-renal vein drains into Common iliac vein IVC Left renal veinLeft renal veinRenal arteries arise from Descending thoracic aorta Abdominal aorta Common iliac arteriesAbdominal aortaAbdominal aorta is Posterior to the vertebral column Anterior to jejunum Left to IVC Lateral to the kidneyLeft to IVCRenal hilum Is located at the lateral border of the kidney It contains renal pyramids It contains renal vessels It contains the collecting ductsIt contains renal vesselsUreter connected inferiorly to Kidney Renal pelvis Urinary bladder Common iliac veinsUrinary bladderRenal columns are Extension of renal cortex into the renal medulla Extension of renal medulla into renal cortex Connection of the collecting ducts into minor calycesExtension of renal cortex into the renal medullaAnterior abdominal wall (abdominal muscles and fascia) is well developed with complete wall layersFalseWhich of the following is incorrect pertaining to the rectus abdominis muscle or rectus sheath? Which of the following is incorrect pertaining to the rectus abdominis muscle or rectus sheath? A. The linea alba lies in the midline between the two rectus muscles B. The attachments (tendinous insertions) between the muscle and the anterior layer of sheath account for the abdominal bulge evident when muscular individuals tense this muscle C. Rectus abdominus is the main flexor muscle of the trunk D. The muscle runs diagonally and inserted into iliac crest and ASISD. The muscle runs diagonally and inserted into iliac crest and ASISThe muscles of the anterior abdominal wall assist in all of the following activities except: Inspiration Defecation Sneezing Vomiting ParturitionInspiration70-years-old man with chronic bronchitis and persistent cough. He told his physician that he has swelling and pain in his right groin. Swelling increase with cough. Direct hernia was diagnosed. Which of the followings is incorrect regarding direct hernia A. Swelling is usually descends into scrotum B. Swelling is located medial to inferior epigastric vessels C. Swelling is highly likely due to passage of abdominal viscera through superficial inguinal ring D. Direct hernia is highly likely due to defect in the external oblique muscleA. Swelling is usually descends into scrotumWhich of the followings concerning superficial inguinal ring is correct A. It is formed by rectus sheath B. It is formed by aponeurosis of internal oblique muscle C. It is formed by external oblique muscle aponeurosis D. It is formed by transversalis fasciaC. It is formed by external oblique muscle aponeurosisWhich of the followings concerning deep inguinal ring is incorrect A. It is formed by interruption of transvesalis fascia B. Abdominal structure passing through it are usually medial to the inguinal vessels C. Contents passing through it are more likely to go to the scrotumB. Abdominal structure passing through it are usually medial to the inguinal vesselsProtrusion of fat or abdominal viscera through an opening is known as herniaTrueAnterior abdominal wall is a well developed and complete wall supported by abdominal muscles and fasciaFalseNatural opening/s or defects are found in anterior abdominal wall layers; either in abdominal fascia and/or external muscle layer of the abdomenTrueWhich of the following is incorrect pertaining to the umbilicus? A. Underlying the umbilicus is the umbilical ring B. The umbilicus is in the L1 dermatome C. Deep lymphatic vessels below the umbilicus drain to para-aortic nodesB. The umbilicus is in the L1 dermatomeWhich of the followings regarding abdominal part of the esophagus is incorrect A. Parasympathetic innervation is via vagus B. Blood supply is via celiac trunk C. Venous drainage is via portal vein D. Help in the absorption of nutrientsD. Help in the absorption of nutrientsWhich of the following is incorrect pertaining to the esophagus? A. Typically it joins with the stomach at the T11 level B. Hiatus hernia could be associated with heartburn C. Esophageal venous drainage is through both systemic and portal circulation D. It is innervated by the vagal trunks and lesser splanchnic nervesD. It is innervated by the vagal trunks and lesser splanchnic nervesInflammation of the esophagus could be identified as pain around ______regions except; A. Umbilicus B. Nipple C. Epigastric region D. MediastinumA. UmbilicusDysfunction of parasympathetic pathway at the level of myenteric and meissner plexuses in the wall of esophagus may result in A. Dysphagia B. Esophageal varices C. Hiatus herniaA. DysphagiaWhich does not describe the stomach? A.Has no smooth muscle layer B.Makes HCl C.Digest the ingested food D.Help vitamin B12 absorptionA.Has no smooth muscle layerWhich of the following is correct pertaining to the stomach? A. Parasympathetic increase gastric secretion and motility B. Has end arteries that pass at greater and lesser curvatures C. Pyloric stenosis is a congenital disorder associated with gastric reflux and heart burn D. Cardiac notch is between fundus and pylorisA. Parasympathetic increase gastric secretion and motilityA direct branch of celiac artery includes A. Right gastric artery B. Right gastroomental artery C. Left gastric artery D. Superior mesenteric arteryC. Left gastric arteryPerforated ulcer was seen at the pylorus. Which of the following arteries are likely to be injured A Left gastric artery B Left gastro-omenal artery C Right gastric artery D Right gastro-omenal artery E A and B F C and DF C and D35-year-old previously healthy woman has sudden abdominal pain and massive vomiting. Upon asking her she said that she had lost 150 Ib within 3 weeks. Which of the following is highly likely to be the reason for her symptoms? A Pyloric stenosis due to pyloric sphincter hypertrophy B Duodenoum obstruction due to pressure of Superior mesenteric vessels C Gastro-esophageal reflux and peptic ulcerationB Duodenoum obstruction due to pressure of Superior mesenteric vesselsa 5-week-old male who presents to the emergency department (ED) with his parents. The parents report a several day history of vomiting, despite changing his formula. The mother states he is always hungry and vomits after nearly every bottle. He has had no fever, or diarrhea. Which of the following is highly likely to be the reason for her symptoms? A Pyloric stenosis due to pyloric sphincter hypertrophy B Duodenoum obstruction due to pressure of Superior mesenteric vessels C Gastro-esophageal reflux and peptic ulcerationA Pyloric stenosis due to pyloric sphincter hypertrophyPortal vein enters the liver at ______________ of the visceral surfacePorta hepatisAn incision should be made in the membrane between stomach and liver. To avoid excessive bleeding from portal triad and blood vessels of lesser curvature, the incision should go through A Falciform ligament B Gastrohepatic ligament C Hepatoduodenal ligament D Greather omentumB Gastrohepatic ligamentBile is synthesized viaLiver40-year-old woman complaining of abdominal pain associated with gall bladder inflammation. Biliary pain is referred to which dermatome? A Skin segment innervated by T5 B Skin segment innervated by T12 C Skin segment innervated by L1 D Skin segment innervated by C 8A Skin segment innervated by T5A minor stone stuck at the hepato-pancreatic ampulla. Which of the following could happen as a consequence A Cholecystitis B Pyloric obstruction C Gastric acid reflux D Pancreatitis E b&d F a&c G a&dG a&d30-year-old man brought to emergency department following car accident. He had massive pain on the left side and holding his hand over his lower ribs. His blood pressure was extremely low. Radiography revealed fractured 10 and 11 ribs. Which of the following organs is more likely to be affected A Liver B Pancreas C Spleen D StomachC SpleenA 65-year-old woman suffering severe lacerations of the spleen and must have that organ removed. In dissecting at the hilum of the spleen during the splenectomy, the surgeon must be careful to avoid damaging which of the following parts of the pancreas? A Head B Body C Tail D Uncinate processC TailCarcinoma of head of pancreas may be associated with to A Obstruction of common bile duct B Jaundice C Obstruction of portal vein D Portal hypertension E None of the above F All of the aboveF All of the aboveColon has the following character A Plicae circularis B Microvilli C Epiploic appendagesC Epiploic appendagesAppendix is innervated byT10-T11Intussusception A Is twisting of the small intestinal loops B Is herniation of small intestinal viscera through anterior abdominal wall opening C Herniation of small intestinal into large intestineC Herniation of small intestinal into large intestineSplenic flexure is formed between A Cecum and transverse colon B Transverse and descending colon C Ascending and transverse colonB Transverse and descending colonA 21-year-old man received a penetrating knife wound in the abdomen and was successful to injure both the superior mesenteric artery and the vagus nerve. Which portion of the colon would most likely be impaired by this injury? A Ascending and transverse colons B Ascending and descending colons C Transverse and sigmoid colons D Descending and sigmoid colons E Transverse and descending colonsA Ascending and transverse colonsA 55-year-old man has a 90% occlusion of the inferior mesenteric artery due to atherosclerotic plaque formation at the origin of the vessel. Which of the following is the most likely outcome of this condition? A Blood flow to the descending colon is affected B Blood flow to the pancreas is affected C Blood flow to the ilium is affected D Blood flow to the sigmoid colon is normalA Blood flow to the descending colon is affectedAll of the following structures refer pain to epigastric region via greater splanchnic nerve except A Abdominal esophagus B Descending duodenum C Gall bladder D IleumD IleumIlium is supplied bySuperior mesenteric arteryVagotomy is a surgical procedure that involves removing part of or resection of the vagus nerve. This procedure might help in the following condition A Diverticulosis B Recurrent peptic (gastric) ulcers C Recurrent diverticulitisB Recurrent peptic (gastric) ulcersRenal pyramids are A Dilated part located at the junction of the ureter to kidney B Found in the renal cortex C Found in the renal medulla D Enter the kidney at the hilumC Found in the renal medullaEvaluation of a 22-year-old man in the emergency room reveals a gunshot wound to the right lumbar region. The right kidney is shattered, necessitating piecemeal removal of that organ. In surgical dissection of the kidney, which of the following structures is most likely to be found attached at the hilum? A Renal pyramids B Renal pelvis C Suprarenal gland D Tail of the pancreasB Renal pelvis50 year old man had experience of three episodes of painful passing kidney stones. These episodes were explained by lodged stones trying to pass through the normal constrictions of the ureter. Based on your anatomical knowledge, which of the following is a site where the kidney stones may be held up? A At the junction of renal pelvis and ureter B At the bifurcation of common iliac vessels C When the ureter enter the bladder D All of the above E None of the aboveD All of the aboveWhich of the following is incorrect pertaining to the kidneys? A Liver, duodenum, and ascending colon are located anteriorly to the right kidney B Stomach, spleen, pancreas, jejunum, and descending colon are located anteriorly to the left kidney C The renal pelvis is the junction between the renal artery and the renal hilum D Both kidneys are retroperitonealC The renal pelvis is the junction between the renal artery and the renal hilumThe suprarenal glands: A Are typically each drained by one vein B Are each supplied by one artery that arises from the abdominal aorta C Are each supplied by one artery that arises from a renal arteryA Are typically each drained by one veinThe inferior vena cava: A Enter the thorax through caval opening B Receives the left testicular vein C Is to the left of abdominal aorta D It receive the lymphatic drainage from the thoracic ductA Enter the thorax through caval openingAll of the following are direct branches of abdominal aorta except A Celiac artery B Superior mesenteric artery C Renal arteries D Inferior epigastric artery E Inferior mesenteric arteryD Inferior epigastric arteryAll of the following may lead to high blood pressure except; A Occlusion of Low blood flow to renal artery B Occlusion of inferior mesenteric artery C Hydronephrosis or renal failure D Supra renal gland tumor E PheochromocytomaB Occlusion of inferior mesenteric artery