MCQs for Peritoneal cavity & viscera

1. Which ligament attaches the liver to the anterior (ventral) abdominal wall?
– Falciform ligament

2. The gastrocolic ligament is part of?
– the greater omentum

3. The peritoneum consists of what two layers?
– parietal peritoneum and visceral peritoneum (investing visceral organs)

4. Name four types of peritoneal relationships with the viscera (e.g., how they are covered)
– Intraperitoneal, retroperitoneal, subperitoneal, secondarily peritoneal

5. What mnemonic can be used to remember the retroperitoneal organs?

6. Name two types of peritoneal formations.
– Mesentary, peritoneal ligament (e.g., falciform ligament)

7. What ligament contains the portal triad?
– Hepatoduodenal ligament

8. What ligament conencts the liver to the stomach?
– Gastrohepatic ligament

9. Name the three greater omentum ligaments.
– Gastrophrenic, gastrosplenic, gastrocolic

10. What is a common digestive disease which involves the formation of pouches (diverticula) within the bowel wall?
– Diverticulitis

11. After reaching the esophagogastic junction what orifice does injested matter enter?
– cardial orifice of stomach

12. At what level of the vertibrae does food pass through the elliptical esophaheal hiatus?
– T10

13. What type muscle layers are seen in the esophagus?
– external logitudianl, internal circular

14. What plexus would you find around the left gastric artery and left inferior phrenic artery?
– Periarterial plexus

15. What nerves stem from the vagal trunks lateral to the esophagus?
– Anterior and posterior gastric nerves.

16. What nerve stems from the right thoracic sympathetic trunk?
– Thoracic splanchnic nerve

17. What condition is the tissue lining the esophagus replaced by tissue that is similar to the intestinal lining?
 – Barrett’s esophagus

18. What are the three muscle layers of the stomach?
– (outer) longitudinal, (inner) circular, (innermost) oblique

19. What do we call the double layer of peritoneum that extends from the stomach and liver, and duodenum and liver?
– Lesser omentum

20. The two layers of lesser omentum wrap around the stomach and leave the greater
curvature of the stomach as what?
– greater omentum

21. The stomach bed is formed by which structures forming the posterior wall of the omental bursa?
– left dome of diaphragm, spleen, left kidney and suprarenal gland, spletic artery, pancreas, transverse mesocolon and colon.

22. For the stomach, most of the blood is supplied by what type of connections?
– anastomoses

23. The left gastric artery of the stomach stems from where?
– celiac trunk

24. The right gastric artery of the stomach stems from where?
– Common hepatic artery

25. The right gastroepiploic (gastro-omental) artery of the stomach stems from where?
– proper hepatic or gastroduodenal arteries

26. The left gastroepiploic artery stems from where?
– Splenic artery

27. The short gastric arteries of the stomach stem from where?
– Distal splenic artery

28. What are the two main branches coming off the celiac trunk of the stomach?
– Common hepatic artery, and splenic artery

29. The right and left gastric veins of the stomach drain into the what?
– Portal vein

30. The right gastroepiploic vein drains into the what?
– Superior mesenteric vein

31. What is the path of drainage of the short gastric veins and left gastroepiploic veins?
– They drain into the splenic vein, then the SMV (superior mesenteric vein), then the portal vein

32. Which parts of the duodenum are retroperitoneal?
– Parts 2-4

33. What is the position of the first part of the duodenum?
– Anterolateral to the body of L1

34. Name the four parts of the duodenum.
– superior, descending, horizontal, ascending

35. The celiac trunk comes off what artery? At what level?
– Abdominal aorta, at level of the lesser curvature of the stomach

36. What is the suspensory ligament of the duodenum? In what section can it be found?
– The ligament of Treitz, ascending 4th part

37. What is the name of your study partner?
– Moji

38. In which part of the duodenum do the bile duct and main pancreatic ducts via the
hepatopancreatic ampulla enter the posteriormedial wall?
– Descending 2nd part

39. Which part of the duodenum crosses anterior to the IVC and aorta, and posterior to the
SMA, and SMV at the level of the L3 vertebra?
– Horizontal 3rd part

40. What attaches the jejunum and the ileum to the posterior abdominal wall?
– Mesentary

41. How is the origin of the mesentary directed?
– obliquely, inferiorly, and to the right

42. The root of the mesentary extends from the duodenojejunal junction on the left side
of the L2 vertebra to what junction, and to which side of the sacroiliac joint?
– Ileocolic junction, to right sacroiliac joint

43. Which parts does the mesentary cross?
– Ascending and horizontal parts of the duodenum, abdominal aorta, inferior vena cava,
right ureter, right psoas major muscle, and right testicular or ovarian vessel.

44. Considering the jejunum and ileum together, which is longer?
– The ileum is about 3/5 of the lengh.

45. Considering the jejunum and ileum, which has peyer’s patches and is thin-walled, and less
– Ileum

46. What trunk extends into the common hepatic artery?
– Celiac

47. What artery supplies the jejunal arteries, arterial arcades, ileal arteries, and vasa recta (straight) arteries?

48. What external features distinguish the large intestine from the small intestine?
– Tenia coli, Haustra, Omental appendicies, Caliber (diameter)

49. At what points does the colon take sharp turns – at corner of transverse, and descending colon?
– right colic flexure, left colic flexure

50. Which part of the colon is almost entirely enveloped by peritoneum and can be lifted freely (has no mesentary)?
– Cecum

51. Appendix extends from where to where?
– Posteriormedial aspect of the cecum inferior to the ileocecal junction

52. McBurney’s point is 1/3 of the way along the oblique line joining what to what?
– right anterior superior iliac spine to the umbilicus

53. Vague pain (not well localized) in periumbilical region as afferent fibers enter the spinal cord at T10 make you think of? (irritation of parietal peritoneum lining posterior abdominal wall)
– Appendicitis

54. What extends from hepatic flexure on the right to splenic flexure on the left, attached to posterior abdominal wall by its mesentary – largest most mobile section of the colon?
– Transverse colon

55. What two sections of the colon are secondarily retroperitoneal?
– Ascending and descending

56. Descending and sigmoid colon is supplied by which arteries?
– Branches of inferior mesenteric artery IMA, inferior mesenteric vein IMV, left colic, superior sigmoid

57. Ascending colon is supplied by which arteries?
superior mesenteric artery SMA/SVA, iliocolic and right colic

58. Ischemia of right colic artery would affect what part of colon?
– Ascending colon

59. The spleen is entirely intraperitoneal except where?
– The hilum (where splenic arteries and veins leave)

60. The spleen contacts the posterior wall of the stomach, and is connected to its greater
curvature by what ligament? And what ligament connects it to the kidney?
– Gastrosplenic ligament, splenorenal ligament

61. What is the largest branch of the celiac trunk?
– Splenic artery (runs along the superior border of the pancreas)

62. The splenic vein is joined by what vein (near head of the pancreas)? It then unites with what vein to join the portal vein?
– Inferior mesenteric vein, superior mesenteric vein

63. The body of the pancreas crosses the body of L2 and the aorta, and continues from the neck and lies to the left of what artery and vein?
– Superior mesenteric artery and vein

63. The tail of the pancreas is mobile, and passes through where?
– Splenorenal ligament, and splenic vessels

64. Describe the position of the pancreatic duct.
– begins in the tail of the pancreas and runs through the parenchyma (substance) of the
gland to the head, where it turns inferiorly and merges with the bile duct

65. Describe the position of the bile duct.
– Unites with the pancreatic duct to form a short, dilated hepatopancreatic ampulla which
opens into the descending part of the duodenum at the summit of the major duodenal papilla.

66. What does arteries and veins does the head of the pancreas overlie?
– IVC, left and right renal veins and right renal artery.

67. The neck of the pancreas overlies which vessels?
– Overlies superior mesenteric vessels. It is adjacent to the pylorus of the stomach.
The superior mesenteric vein (SMV) joins the splenic vein to form the
portal vein posterior to the neck.

68. Describe the lymphatic drainage of the liver.
– Drain mainly to the hepatic nodes at the porta hepatis. From hepatic nodes → celiac nodes
→ cisterna chyli

69. Describe the lymphatic drainage of the hepatic veins of the liver.
Formed by union of central veins, drain directly into the IVC inferior to diaphragm

70. What are the two ligaments on the liver which are fetal remnants?
–  The round ligament (ligamentum teres) is the occluded remains of the fetal umbilical vein.
The ligamentum venosum is the fibrous remnant of the fetal ductus venosus

71. Name the four lobes of the liver.
– Left, right, caudate, quadrate

72. What ducts precede the common bile duct?
Cystic duct connects to common hepatic duct to form the common bile duct
73. Obstructive jaundice is a problem with what duct?
– Common hepatic duct

74. What is the artery of the gall bladder?
– cystic artery from right hepatic artery
75. Describe the cystic veins.
– Veins draining neck and biliary ducts empty into portal vein. Veins draining the body and 
fundus drain directly into the liver.
76. Lymph from gall bladder drains where?
– to hepatic nodes
77. Describe the innervation of the gall bladder.
– Sympathetic from celiac plexus, Parasympathetic from vagus, Sensory from right phrenic
78. The cystic artery runs into which artery?
– Common hepatic artery
79. Clinically, gallstones can be found where?
– Common bile duct, pancreatic duct (leading to pancreatitis)
80. Which artery goes around the pancreas and duodenum?
– Superior pancreaticoduodenal artery
81. Are you tired?
– Yes

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