E.noneofthese9. Which ofthe following structures could not be seen when looking directly into the oral cavity?A.dorsum of the tongueB.uvulaC. palatine tonsilD.epiglottisE.papilla of parotid duct10. Which of the following is NOT found within the hepatoduodenal ligament?A.Portal veinB.FibroblastsC.Main pancreatic ductD.Properhepatic arteryE.Postganglionic sympathetic nerve fibers11. The stomach:A.Is the first part ofthe alimentary canalB.Hasa smooth interior surfacelinedbystratified squamous epitheliumC.Receives the esophagus at its fundusD.Is normally covered by peritoneum on its posterior surfaceE..Lies anteriortoboththe omental bursa andthegreater omentum12. In a surgical approach to the stomach, upon opening the abdominal cavity, what peritonealspecialization(s) would you expect to encounter in the upper right quadrant?Median umbilical ligamentA.B.IFalciformligamentC.Conjoint tendonD.Greater omentumE.BothBandDarecorrect13. The liver:A..Usually cannot be palpated belowthecostal margin ina healthy personB.Is an exocrine gland that secretes erythropoietinC.Has a porta hepatis from which the common bile duct exitsD.Is innervated by the vagus nerve,but lacks a sympathetic nerve supplyE.Has superficial and deep lymphatics, some ofwhich drain towardthe diaphragm and thorax14. The gall bladder:A.Wheninflamedordistendedmayreferpaintotheright shoulderregionB.Is lodged in the porta hepatis of the liverC.Is retroperitonealD.Is an exocrine gland that produces and secrets bileE.Contactstheanteriorabdominal wall ontheleftsideofthefalciformligament15. The celiac trunk:Normally has four main branchesA.B.Usually is at the level of the esophageal hiatusIs located in the splenorenal ligamentC.D.Has a branch, the splenic artery that supplies the body and tail of the pancreasE.Has branches which usually supply the suprarenal glands16. Which of the following statements about the portal system is FALSE?Its tributaries lack valvesA..B.It begins in capillaries and ends in hepatic sinusoidsC.It usually drains only the alimentary canalD.Itcarriesdeoxygenated blood16
16 E. none of these 9. Which of the following structures could not be seen when looking directly into the oral cavity? A. dorsum of the tongue B. uvula C. palatine tonsil D. epiglottis E. papilla of parotid duct 10. Which of the following is NOT found within the hepatoduodenal ligament? A. Portal vein B. Fibroblasts C. Main pancreatic duct D. Proper hepatic artery E. Postganglionic sympathetic nerve fibers 11. The stomach: A. Is the first part of the alimentary canal B. Has a smooth interior surface lined by stratified squamous epithelium C. Receives the esophagus at its fundus D. Is normally covered by peritoneum on its posterior surface E. Lies anterior to both the omental bursa and the greater omentum 12. In a surgical approach to the stomach, upon opening the abdominal cavity, what peritoneal specialization(s) would you expect to encounter in the upper right quadrant? A. Median umbilical ligament B. Falciform ligament C. Conjoint tendon D. Greater omentum E. Both B and D are correct 13. The liver: A. Usually cannot be palpated below the costal margin in a healthy person B. Is an exocrine gland that secretes erythropoietin C. Has a porta hepatis from which the common bile duct exits D. Is innervated by the vagus nerve, but lacks a sympathetic nerve supply E. Has superficial and deep lymphatics, some of which drain toward the diaphragm and thorax 14. The gall bladder: A. When inflamed or distended may refer pain to the right shoulder region B. Is lodged in the porta hepatis of the liver C. Is retroperitoneal D. Is an exocrine gland that produces and secrets bile E. Contacts the anterior abdominal wall on the left side of the falciform ligament 15. The celiac trunk: A. Normally has four main branches B. Usually is at the level of the esophageal hiatus C. Is located in the splenorenal ligament D. Has a branch, the splenic artery that supplies the body and tail of the pancreas E. Has branches which usually supply the suprarenal glands 16. Which of the following statements about the portal system is FALSE? A. Its tributaries lack valves B. It begins in capillaries and ends in hepatic sinusoids C. It usually drains only the alimentary canal D. It carries deoxygenated blood
E.Ithas clinicallyimportantanatomoseswiththesystemicvenous system17.Which of thefollowing isTRUEconcerning theduodenum?A.,ItiscompletelyretroperitonealB.Its 2nd part is anterior to the hepatic flexureC.Its 3rd part is anterior to the path of the superior mesenteric arteryD.Its3rd part crosses anteriorto thebodyof thefirst lumbar vertebraE..Its junction with thejejunum is stabilized by afibromuscular band18. Select the FALSE statement from the following list:The greater curvature ofthe stomach normally is in contact with the hilum ofthe spleenA.B.Thehepaticflexureof the large intestinenormallyis in contact withtheliverC.The ileum normally contacts the inferior surface of the diaphragmD.Thegallbladder isfound deepto thelateralmargin ofthe right rectus abdominis at itssuperior endE.Thetransverse colon normallycontactsboththejejunumand theileum19.The inferiormesenteric artery:A.Hasonlyretroperitoneal branchesB..Carries a plexus ofvagal nervefibers along its surfaceC.BranchesfromtheaortaposteriortotheneckofthepancreasD.Has a right colic branch that courses anterior to the inferior vena cavaE..Gives rise to sigmoidal and superiorrectal arteries20.The large intestine:A..Has a right (hepatic) flexure that is normally higher than the left (splenic) flexureB..Has a mesentery suspending onlythe transverse colonC.Can befound in all fourabdominal quadrantsD.Is longer than the small intestineE.Has numerousplicae on its innersurface21.The appendix:A.Lacks an outer longitudinal muscle layerB.Lies in the retroperitoneal space at McBurney's pointC..Has lymphatic drainage into the inferior mesentericnodesD.Typically receives its blood supply from an intestinal branch of the superior mesentericarteryE.Has its own mesenteryand its own artery22.One way to distinguish the jejunum from the ileum is that:A.Its external surface is characterized by haustraB.It containsfewer epiploicappendagesthantheileumC.It lies in the left upper quadrantD.It lies intraperitoneal while the ileum lies retroperitonealE.It is linedby stratified squamous epithelium23.The blood supply to the gastrointestinal organs:A.Is constant in its patternB.In the adult, always courses between layers of mesenteryC.Rarely contains vasa rectaD.CommonlyformanastomoticconnectionsE.All of the above24. The pancreas:A.Receives its only arterial supply from the splenic arteryB.Has an uncinate process located posterior to the course ofthe superior mesenteric arteryC.Becomes intraperitoneal atthehepatoduodenal ligament17
17 E. It has clinically important anatomoses with the systemic venous system 17. Which of the following is TRUE concerning the duodenum? A. It is completely retroperitoneal B. Its 2nd part is anterior to the hepatic flexure C. Its 3rd part is anterior to the path of the superior mesenteric artery D. Its 3rd part crosses anterior to the body of the first lumbar vertebra E. Its junction with the jejunum is stabilized by a fibromuscular band 18. Select the FALSE statement from the following list: A. The greater curvature of the stomach normally is in contact with the hilum of the spleen B. The hepatic flexure of the large intestine normally is in contact with the liver C. The ileum normally contacts the inferior surface of the diaphragm D. The gall bladder is found deep to the lateral margin of the right rectus abdominis at its superior end E. The transverse colon normally contacts both the jejunum and the ileum 19. The inferior mesenteric artery: A. Has only retroperitoneal branches B. Carries a plexus of vagal nerve fibers along its surface C. Branches from the aorta posterior to the neck of the pancreas D. Has a right colic branch that courses anterior to the inferior vena cava E. Gives rise to sigmoidal and superior rectal arteries 20. The large intestine: A. Has a right (hepatic) flexure that is normally higher than the left (splenic) flexure B. Has a mesentery suspending only the transverse colon C. Can be found in all four abdominal quadrants D. Is longer than the small intestine E. Has numerous plicae on its inner surface 21. The appendix: A. Lacks an outer longitudinal muscle layer B. Lies in the retroperitoneal space at McBurney's point C. Has lymphatic drainage into the inferior mesenteric nodes D. Typically receives its blood supply from an intestinal branch of the superior mesenteric artery E. Has its own mesentery and its own artery 22. One way to distinguish the jejunum from the ileum is that: A. Its external surface is characterized by haustra B. It contains fewer epiploic appendages than the ileum C. It lies in the left upper quadrant D. It lies intraperitoneal while the ileum lies retroperitoneal E. It is lined by stratified squamous epithelium 23. The blood supply to the gastrointestinal organs: A. Is constant in its pattern B. In the adult, always courses between layers of mesentery C. Rarely contains vasa recta D. Commonly form anastomotic connections E. All of the above 24. The pancreas: A. Receives its only arterial supply from the splenic artery B. Has an uncinate process located posterior to the course of the superior mesenteric artery C. Becomes intraperitoneal at the hepatoduodenal ligament
D.Has its head in contact withthe hilus of the rightkidneyE.Is usuallylocated atthelevel of theL4vertebra25.Thececum:A.Exhibits a complete longitudinal muscle layerB.Has a lumen characterized by the opening of the vermiform appendixC.Issuspended onthetransversemesocolonD.Is in the left iliac fossaE.Receives itsmainarterial supplyfromthemiddlecolicartery26.Whichof thefollowing statements about the internal iliac systemof arteries isFALSE?Theposteriordivision of the internal iliac arterygives rise toparietal branches onlyA.:B.The anterior division ofthe internal iliac artery gives rise to the umbilical arteryC.Theuterine andvaginal arteriesmaybranchfroma commontrunkD.The internal pudendal artery exits the pelvis by passing through the lesser sciatic foramenE.The inferior vesical artery supplies boththebladder and theprostategland in the male27. Which of the following statements about the rectum is FALSE?A.:The lower third of therectum is entirely retroperitonealBy digital examination of the rectum in the male, the prostate can be palpated through theB.anterior wall oftherectumC.The inner surfaceof the rectum has three transverse rectal folds on the posteriorwallD.Themusclelayers of thewall of therectumare under control oftheautonomicnervoussystemE.Veins in the wall of the rectum form a clinically important communication between theportalandcavalvenoussystems28.Concerning theanal sphincters:The internal anal sphincter is a thickened portion of the inner longitudinal layer of smoothA.muscleoftheanal canalB.The superficial portion of the external anal sphincter is innervated by inferior rectalbranches ofthepudendal nerveC.The deep portion ofthe external anal sphincter isfusiform in structureD.The subcutaneous portion of the external anal sphincter is the largest portion of theexternal anal sphincterE.The puborectalis muscle does not usually contact any of the anal sphincters29.Concerning the rectum:There are two right and one left transverse rectal foldsA.B.Peritoneum surrounds the upper halfC.The inferior hypogastric plexus lies on its lateral surfaceD.The inferior rectal veins are tributary to the inferior mesenteric veinE.Sacral splanchnic nerves innervatethe smoothmuscle of its wall30.Apatient was diagnosed with bleeding ulcer ofthe lesser curvature of the stomach.Which arteryis most likely involved?A.,GastroduodenalB.Left gastricC.Left gastro-omental (epiploic)D.Right gastro-omental (epiploic)E.Shortgastrics31.Which is a derivative of the dorsal mesogastrium?Falciform ligamentA..B..Hepatoduodenal ligamentC.Hepatogastric ligamentD.Greater omentum18
18 D. Has its head in contact with the hilus of the right kidney E. Is usually located at the level of the L4 vertebra 25. The cecum: A. Exhibits a complete longitudinal muscle layer B. Has a lumen characterized by the opening of the vermiform appendix C. Is suspended on the transverse mesocolon D. Is in the left iliac fossa E. Receives its main arterial supply from the middle colic artery 26. Which of the following statements about the internal iliac system of arteries is FALSE? A. The posterior division of the internal iliac artery gives rise to parietal branches only B. The anterior division of the internal iliac artery gives rise to the umbilical artery C. The uterine and vaginal arteries may branch from a common trunk D. The internal pudendal artery exits the pelvis by passing through the lesser sciatic foramen E. The inferior vesical artery supplies both the bladder and the prostate gland in the male 27. Which of the following statements about the rectum is FALSE? A. The lower third of the rectum is entirely retroperitoneal B. By digital examination of the rectum in the male, the prostate can be palpated through the anterior wall of the rectum C. The inner surface of the rectum has three transverse rectal folds on the posterior wall D. The muscle layers of the wall of the rectum are under control of the autonomic nervous system E. Veins in the wall of the rectum form a clinically important communication between the portal and caval venous systems 28. Concerning the anal sphincters: A. The internal anal sphincter is a thickened portion of the inner longitudinal layer of smooth muscle of the anal canal B. The superficial portion of the external anal sphincter is innervated by inferior rectal branches of the pudendal nerve C. The deep portion of the external anal sphincter is fusiform in structure D. The subcutaneous portion of the external anal sphincter is the largest portion of the external anal sphincter E. The puborectalis muscle does not usually contact any of the anal sphincters 29. Concerning the rectum: A. There are two right and one left transverse rectal folds B. Peritoneum surrounds the upper half C. The inferior hypogastric plexus lies on its lateral surface D. The inferior rectal veins are tributary to the inferior mesenteric vein E. Sacral splanchnic nerves innervate the smooth muscle of its wall 30. A patient was diagnosed with bleeding ulcer of the lesser curvature of the stomach. Which artery is most likely involved? A. Gastroduodenal B. Left gastric C. Left gastro-omental (epiploic) D. Right gastro-omental (epiploic) E. Short gastrics 31. Which is a derivative of the dorsal mesogastrium? A. Falciform ligament B. Hepatoduodenal ligament C. Hepatogastric ligament D. Greater omentum
E.Lesseromentum32.Duringafull workupona2-month-old infant withahistoryof intermittentgastrointestinalpain and vomiting,physicians discovered that the cause was lack of emptying ofthe stomach.Theyimmediately suspected that the cause was a spasmotic contraction of which of the following partsof the stomach?A.cardiacnotchB.fundusC.lesser curvatureD.pylorusE.rugae33.Inordertodoa vagotomy(sectionofvagal nervetrunks)to reducethesecretion of acidbycellsofthe stomachmucosa inpatients withpeptic ulcers,oneneedstocutthegastricbranchesand retainvagal innervation to other abdominal organs. Where would a surgeon look for these branches inrelation to the stomach?A.alongthegastroepiploicvesselsB.alongthegreatercurvatureC..along the lesser curvatureD.in thebaseof theomental apronE.in the gastrocolic ligament34.Whileperforminga splenectomy(removalofthespleen)followinganautomobileaccident,thesurgeons wereespecially attentiveto locate and preservethetail ofthe pancreas which is closelyassociated with the spleen.This they found in theA.gastrocolic ligamentB.gastrospenic ligamentC.phrenicocolic ligamentD.splenorenal ligamentE.transversemesocolon35. Which of the following structures does not lie at least partially in the retroperitoneum?A.adrenal glandB. duodenumC.kidneyD.pancreasE.spleen36. Which ligament is a derivative of the dorsal mesogastrium?A.CoronaryB.FalciformC.HepatoduodenalD.HepatogastricE.Gastrocolic37.A60-year-old male executive who had a history ofa chronic duodenal ulcer was admitted tothe ER exhibiting signs of a severe internal hemorrhage.He was quickly diagnosed with perforationof the posterior wall of thefirst part oftheduodenum and erosion of an arterybehind it by the gastricexpellent.Theartery is most likelythe:A..CommonhepaticB. GastroduodenalC.LeftgastricD.Proper hepaticE.Superior mesenteric38.An ulcer near the pyloroduodenal junction perforated and eroded a large artery immediatelyposterior to theduodenum.Theligation of the eroded vessel at its originwould LEASTaffect the19
19 E. Lesser omentum 32. During a full workup on a 2-month-old infant with a history of intermittent gastrointestinal pain and vomiting, physicians discovered that the cause was lack of emptying of the stomach. They immediately suspected that the cause was a spasmotic contraction of which of the following parts of the stomach? A. cardiac notch B. fundus C. lesser curvature D. pylorus E. rugae 33. In order to do a vagotomy (section of vagal nerve trunks) to reduce the secretion of acid by cells of the stomach mucosa in patients with peptic ulcers, one needs to cut the gastric branches and retain vagal innervation to other abdominal organs. Where would a surgeon look for these branches in relation to the stomach? A. along the gastroepiploic vessels B. along the greater curvature C. along the lesser curvature D. in the base of the omental apron E. in the gastrocolic ligament 34. While performing a splenectomy (removal of the spleen) following an automobile accident, the surgeons were especially attentive to locate and preserve the tail of the pancreas which is closely associated with the spleen. This they found in the: A. gastrocolic ligament B. gastrospenic ligament C. phrenicocolic ligament D. splenorenal ligament E. transverse mesocolon 35. Which of the following structures does not lie at least partially in the retroperitoneum? A. adrenal gland B. duodenum C. kidney D. pancreas E. spleen 36. Which ligament is a derivative of the dorsal mesogastrium? A. Coronary B. Falciform C. Hepatoduodenal D. Hepatogastric E. Gastrocolic 37. A 60-year-old male executive who had a history of a chronic duodenal ulcer was admitted to the ER exhibiting signs of a severe internal hemorrhage. He was quickly diagnosed with perforation of the posterior wall of the first part of the duodenum and erosion of an artery behind it by the gastric expellent. The artery is most likely the: A. Common hepatic B. Gastroduodenal C. Left gastric D. Proper hepatic E. Superior mesenteric 38. An ulcer near the pyloroduodenal junction perforated and eroded a large artery immediately posterior to the duodenum. The ligation of the eroded vessel at its origin would LEAST affect the
arterial supply to theA.FirstpartoftheduodenumB.Secondpartof theduodenumC.Greatercurvatureof the stomachD.Head of the pancreasE.Tailofthepancreas39.You are observing an operation to remove the left suprarenal gland.To expose thegland thesurgeonmobilizesthedescendingcolonbycuttingalong itslateral attachmenttothebodywall anddissecting medialward in the fusion fascia behind it. Suddenly the operative field is filled with blood.Thesurgeonrealizeshehasfailedtocutamesentericattachmentbetweentheleftcolicflexureandanotherorgan.Asaresultofthetraction,thesurfaceoftheorgantore.Whichorganwasinjured?7DuodenumB.KidneyC.LiverD.SpleenE.Suprarenal gland40.Apatientwasadmittedwithsymptomsofanupperbowel obstruction.UponCT examination,itwas found that thethird (transverse)portion of the duodenum was compressed by a large vesselcausingthe obstruction.The vessel involved is most likelytobe the:A.inferior mesenteric arteryB.superior mesenteric arteryC..inferior mesenteric veinD.portal veinE.splenicvein41.During emergency surgery,it was found that a chronicgastric ulcerhad perforated theposteriorwall of the stomach and eroded a large artery running immediately posterior to the stomach. Theartery is the:A.:GastroduodenalB.Common hepaticC.Left gastroepiploicD.SplenicE.Superior mesenteric42.Regarding the2nd portion of the duodenum, all are correctEXCEPT:A.Itis crossed bythetransverse colon.B.It is thin walled and circular folds are absent in its interiorC.It has the opening for the common bile duct and pancreatic duct on its posteromedial wall.D.It is secondarily retroperitonealE.It is supplied by both thegastroduodenal and superiormesenteric arteries43. In order to approach the area posterior to the stomach, a surgeon decided to go through the lesseromentum.Before incisingthemesenteryshewas careful tofind andpreservea nervelying intheupper portion of the hepatogastric ligament, i.e., theA,Celiacbranchoftheanteriorvagal trunkB.Celiac branch of the posterior vagal trunkGreater splanchnic branch to the right suprarenal glandC.D.Hepatic branch of the anterior vagal trunkE..Hepatic branch oftheposterior vagal trunk44.Which of the following is NOT in contact with the spleen?A.ColonB.DiaphragmC.DuodenumD.Pancreas20
20 arterial supply to the: A. First part of the duodenum B. Second part of the duodenum C. Greater curvature of the stomach D. Head of the pancreas E. Tail of the pancreas 39. You are observing an operation to remove the left suprarenal gland. To expose the gland the surgeon mobilizes the descending colon by cutting along its lateral attachment to the body wall and dissecting medialward in the fusion fascia behind it. Suddenly the operative field is filled with blood. The surgeon realizes he has failed to cut a mesenteric attachment between the left colic flexure and another organ. As a result of the traction, the surface of the organ tore. Which organ was injured? A. Duodenum B. Kidney C. Liver D. Spleen E. Suprarenal gland 40. A patient was admitted with symptoms of an upper bowel obstruction. Upon CT examination, it was found that the third (transverse) portion of the duodenum was compressed by a large vessel causing the obstruction. The vessel involved is most likely to be the: A. inferior mesenteric artery B. superior mesenteric artery C. inferior mesenteric vein D. portal vein E. splenic vein 41. During emergency surgery, it was found that a chronic gastric ulcer had perforated the posterior wall of the stomach and eroded a large artery running immediately posterior to the stomach. The artery is the: A. Gastroduodenal B. Common hepatic C. Left gastroepiploic D. Splenic E. Superior mesenteric 42. Regarding the 2nd portion of the duodenum, all are correct EXCEPT: A. It is crossed by the transverse colon. B. It is thin walled and circular folds are absent in its interior. C. It has the opening for the common bile duct and pancreatic duct on its posteromedial wall. D. It is secondarily retroperitoneal. E. It is supplied by both the gastroduodenal and superior mesenteric arteries. 43. In order to approach the area posterior to the stomach, a surgeon decided to go through the lesser omentum. Before incising the mesentery she was careful to find and preserve a nerve lying in the upper portion of the hepatogastric ligament, i.e., the A. Celiac branch of the anterior vagal trunk B. Celiac branch of the posterior vagal trunk C. Greater splanchnic branch to the right suprarenal gland D. Hepatic branch of the anterior vagal trunk E. Hepatic branch of the posterior vagal trunk 44. Which of the following is NOT in contact with the spleen? A. Colon B. Diaphragm C. Duodenum D. Pancreas