Renal Supraren Anat Abdom Art MCQ's

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Renal Supraren Anat Abdom Art MCQ

Questions and Answers
  • 1. 

    A patient with renal colic is in extreme pain until, due to the action of peristaltic contractions in the upper ureter, the renal stone passes. Parasympathetic (vagal) fibers that innervate the upper ureter pass through the

    • A.

      Renal plexus

    • B.

      Superior mesenteric plexus

    • C.

      Inferior mesenteric plexus

    • D.

      Superior hypogastric plexus

    • E.

      Inferior hypog-astric plexus

    Correct Answer
    A. Renal plexus
    Explanation
    The renal plexus contains parasympathetic (vagal) fibers that innervate the upper ureter. These fibers are responsible for the peristaltic contractions that help the renal stone to pass, providing relief from the extreme pain experienced in renal colic.

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  • 2. 

    Afferent arterioles branch off directly from which of the following vessels in the kidney?

    • A.

      Renal artery

    • B.

      Stellate vein

    • C.

      Interlobular artery

    • D.

      Arcuate artery

    • E.

      Interlobar artery

    Correct Answer
    C. Interlobular artery
    Explanation
    The correct answer is the Interlobular artery. Afferent arterioles branch off directly from the Interlobular artery in the kidney. The Interlobular artery is responsible for supplying blood to the renal cortex and is located between the arcuate artery and the interlobar artery.

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  • 3. 

    The left kidney

    • A.

      Medial side is related to the duodenum.

    • B.

      Is an intraperitoneal organ

    • C.

      Is found normally at level of L3-L5.

    • D.

      Lies posterior to the tail of the pancreas

    • E.

      Lies antero-medial to the psoas major muscle.

    Correct Answer
    D. Lies posterior to the tail of the pancreas
    Explanation
    The left kidney lies posterior to the tail of the pancreas. This means that the left kidney is positioned behind the tail of the pancreas in the abdominal cavity.

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  • 4. 

    Which of the following statements is INCORRECT? The renal arteries:

    • A.

      Originate directly from the abdominal aorta

    • B.

      Provide blood to the adrenal glands

    • C.

      Are main blood supply to kidneys

    • D.

      Usually form four to five segmental end arteries

    • E.

      Freely anastomose with one another

    Correct Answer
    E. Freely anastomose with one another
    Explanation
    The renal arteries do not freely anastomose with one another. An anastomosis is a connection or communication between two blood vessels. However, the renal arteries do not typically form direct connections with each other. Instead, they branch off from the abdominal aorta and provide blood supply to the kidneys.

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  • 5. 

    Which of the following DOES NOT ACCURATELY describe the renal veins?

    • A.

      The left renal vein passes anterior to the abdominal aorta

    • B.

      The right renal vein is longest

    • C.

      Each vein drains into the IVC

    • D.

      The renal veins lie anterior to the renal arteries

    • E.

      Left renal vein receives left supra-renal vein

    Correct Answer
    B. The right renal vein is longest
    Explanation
    The given statement that the right renal vein is longest accurately describes the renal veins. The renal veins drain blood from the kidneys into the inferior vena cava (IVC), and the right renal vein is typically longer than the left renal vein due to the position of the IVC being slightly to the right of the midline. Therefore, the right renal vein being the longest is a correct characteristic of the renal veins.

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  • 6. 

    Which of the following structures is located at the corticomedullary junction of the kidney?

    • A.

      Renal artery

    • B.

      Afferent arteriole

    • C.

      Interlobular artery

    • D.

      Arcuate artery

    • E.

      Interlobar artery

    Correct Answer
    D. Arcuate artery
    Explanation
    The arcuate artery is located at the corticomedullary junction of the kidney. It is a branch of the interlobular artery and runs along the boundary between the renal cortex and medulla. It gives rise to the interlobular arteries, which supply blood to the renal cortex. The other options mentioned are also arteries in the kidney, but they are not specifically located at the corticomedullary junction.

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  • 7. 

    During resection of the right suprarenal gland, the surgeon accidentally lacerated a vessel after he thought he had ligated all the vessels to the gland. The bleeding is profuse and pulsatile. His resident checked the anatomy of the ligated vessels and found the middle suprarenal artery and the inferior renal artery neatly tied off. The renal artery is intact. Which vessel needs to be clamped to stop the bleeding without causing too much collateral ischemia?

    • A.

      Right renal vein

    • B.

      Aorta

    • C.

      Right renal artery

    • D.

      Right inferior phrenic artery

    • E.

      Superior mesenteric artery

    Correct Answer
    D. Right inferior phrenic artery
    Explanation
    The right inferior phrenic artery needs to be clamped to stop the bleeding without causing too much collateral ischemia. This is because the right suprarenal gland receives its blood supply from the superior, middle, and inferior suprarenal arteries, as well as the right inferior phrenic artery. Since the middle suprarenal artery and the inferior renal artery have already been ligated, clamping the right inferior phrenic artery would effectively stop the bleeding without compromising the blood supply to other important structures in the area.

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  • 8. 

    All of the following statements about the right renal artery are correct EXCEPT it

    • A.

      Passes posterior to the inferior vena cava

    • B.

      Provides branches to the right adrenal gland

    • C.

      Provides branches to the right ureter

    • D.

      Arises from the aorta at vertebral level L2

    • E.

      Gives rise to the right gonadal artery

    Correct Answer
    E. Gives rise to the right gonadal artery
    Explanation
    The right renal artery does not give rise to the right gonadal artery. The right gonadal artery typically arises from the abdominal aorta, separate from the renal artery.

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  • 9. 

    In order to avoid ischemia induced necrosis of the sigmoid colon in a colonectomy procedure, the surgeon had to understand the circulation around the critical point of Sudek. Which two arteries provide the weak anastomosis around this area?

    • A.

      Left Colic and Marginal artery (of Drummond)

    • B.

      Marginal artery of Drummond and Inferior mesenteric

    • C.

      Sigmoid and superior rectal arteries

    • D.

      Inferior rectal and internal pudendal

    • E.

      Internal pudendal and Superior mesenteric

    Correct Answer
    C. Sigmoid and superior rectal arteries
    Explanation
    The correct answer is Sigmoid and superior rectal arteries. These two arteries provide a weak anastomosis around the critical point of Sudek, which is important in preventing ischemia induced necrosis of the sigmoid colon during a colonectomy procedure. By understanding the circulation around this area, the surgeon can ensure proper blood supply to the sigmoid colon and prevent complications.

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  • 10. 

    A 27-year-old man is brought to the emergency department after a car accident. He is unresponsive because he has lost a large amount of blood. The source of the blood loss is soon determined to be the patient's damaged celiac artery. In addition to foregut structures, which of the following patient's organs may not be receiving adequate amounts of blood supply due to this injury?

    • A.

      Kidneys

    • B.

      Midgut

    • C.

      Spleen

    • D.

      Hindgut

    • E.

      Testicles

    Correct Answer
    C. Spleen
    Explanation
    The damaged celiac artery would result in inadequate blood supply to the spleen. The celiac artery is responsible for supplying blood to various organs in the abdomen, including the spleen. Since the patient has lost a large amount of blood, it is likely that the damaged artery is causing reduced blood flow to the spleen, leading to inadequate blood supply to this organ.

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  • 11. 

    A large tumor mass impinges on the splenic artery and its branches. Branches of which of the following arteries would most likely be affected by the pressure on the splenic artery?

    • A.

      Left gastric

    • B.

      Short gastric

    • C.

      Left gastroepiploic

    • D.

      Right gastric

    • E.

      Right gastroepiploic

    Correct Answer
    B. Short gastric
    Explanation
    The short gastric arteries are the branches of the splenic artery that supply blood to the fundus and upper part of the greater curvature of the stomach. In this scenario, the large tumor mass is impinging on the splenic artery and its branches. Therefore, it is most likely that the short gastric arteries, being branches of the splenic artery, would be affected by the pressure on the splenic artery.

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  • 12. 

    Portal hypertension is defined by a hepatic venous pressure gradient (HVPG) greater than 5 mmHg. It is usually caused by an increase in resistance in the portal-hepatic vascular bed due to obstruction to flow, which is related to cirrhosis in the vast majority of patients. Which of the following veins would contribute for by passing this obstruction?

    • A.

      Right gastric and esophageal veins

    • B.

      Left gastric and esophageal veins

    • C.

      Middle rectal and inferior rectal veins

    • D.

      Superior rectal and sigmoidal veins

    • E.

      Left gastromental and Splenic vein

    Correct Answer
    B. Left gastric and esophageal veins
    Explanation
    The left gastric and esophageal veins would contribute to bypassing the obstruction in portal hypertension. These veins form collateral vessels that allow blood to flow from the portal vein to the systemic circulation, bypassing the liver. This is known as portosystemic collateral circulation and helps to alleviate the increased pressure in the portal-hepatic vascular bed caused by the obstruction.

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  • 13. 

    A 53-year-old woman was admitted to the hospital because of shortness of breath. On the second hospital day, the patient had sudden onset of steady low-back pain without radiation accompanied by nausea and vomiting. Physical examination revealed mild tenderness in the left flank. You noticed blood in the urine drainage bags. A Contrast- enhanced CT scan was done and you observe a renal infract on the posterior aspect of the right kidney. A blockage of which of the following artery can cause the above findings?

    • A.

      Superior segmental, anterosuperior segmental, inferior segmental

    • B.

      Superior segmental, posterior segmental, inferior segmental

    • C.

      Superior segmental, anteroinferior segmental, inferior segmental

    • D.

      Anterosuperior segmental, posterior segmental, anteroinferior segmental

    • E.

      Anterosuperior segmental, anterior segmental, anteroinferior segmental

    Correct Answer
    B. Superior segmental, posterior segmental, inferior segmental
    Explanation
    A blockage of the superior segmental artery, posterior segmental artery, or inferior segmental artery can cause the symptoms described. The patient's sudden onset of low-back pain without radiation, accompanied by nausea and vomiting, suggests a possible kidney infarct. The presence of blood in the urine drainage bags further supports this diagnosis. The renal infarct is likely caused by a blockage in the arteries supplying the affected areas of the kidney. Therefore, the correct answer is Superior segmental, posterior segmental, inferior segmental.

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  • 14. 

    A 71-year-old male presented to a chiropractic clinic with subacute low back pain. While the pain appeared to be mechanical in nature, radiographic evaluation revealed an abdominal aortic aneurysm, which required the patient to have vascular surgery. Which of the following statements concerning the abdominal aorta is correct?

    • A.

      The aorta enters the abdomen in front of the T12 vertebra

    • B.

      The aorta lies on the right side of the inferior vena cava.

    • C.

      The superior suprarenal arteries are direct braches from the aorta.

    • D.

      From the aorta's posterior surface arise the inferior mesenteric arteries

    • E.

      The aorta bifurcates into the two common iliac arteries in front of L3 vertebra

    Correct Answer
    A. The aorta enters the abdomen in front of the T12 vertebra
    Explanation
    The correct answer is "The aorta enters the abdomen in front of the T12 vertebra." This is because the aorta passes through the diaphragm and enters the abdomen at the level of the T12 vertebra. This is an anatomical fact that is important for understanding the location and course of the abdominal aorta in relation to other structures in the abdomen.

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  • 15. 

    A plasticized kidney was stolen from the Seattle exhibit "Bodies...The Exhibition", only to be recovered recently. Police interviewed the 26-year-old suspect from Tacoma. The police were not able to confirm if it was the same kidney. They ask you to identify the kidney. You say that it is a…

    • A.

      Right kidney lying on the posterior surface

    • B.

      Left kidney lying on the posterior surface

    • C.

      Right kidney lying on the anterior surface

    • D.

      Left kidney lying on the anterior surface

    • E.

      Right kidney lying on the medial surface

    Correct Answer
    A. Right kidney lying on the posterior surface
    Explanation
    Ureter is inferior to artery and vein. it is also posterior. Therefore this must be a right kidney, lying on its posterior surface.

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