Colon And Rectum: Appendicitis
Appendix, colon and rectum
- 1.What is the blind sac that is in the RLQ below the ileocecal valve?
- A.
Cecum
- B.
Appendix
- C.
Transverse colon
- D.
Ascending colon
- 2.The __________ extends from the rectosigmoid junction to the anal canal and is composed of insensitive columnar epithelium.
- A.
Anal Canal
- B.
Rectum
- C.
Colon
- D.
Large bowel
- 3.The _____________ is 3-4 cm long, starts at the dentate line, is supported by the internal and external anal sphincters, and composed of sensitive squamous epithelium.
- A.
Rectum
- B.
Anal Canal
- C.
Colon
- D.
Anal sphincter canal
- 4.What 3 major branches of the aorta supply blood to the intestines?
- A.
Celiac artery, superior mesenteric artery, inferior mesenteric artery
- B.
Celiac artery, superior mesenteric artery, and right and left gastric artery
- C.
Superior mesenteric artery, inferior mesenteric artery, and internal and external iliac arteries
- D.
Common iliac artery, superior mesenteric artery, inferior mesenteric arteries
- 5.What 3 arteries supply the anorectum? (click all that apply)
- A.
Superior rectal artery
- B.
Middle rectal artery
- C.
Inferior rectal artery
- D.
Inferior mesenteric artery and its branches
- E.
Superior mesenteric artery and its branches
- 6.The celiac artery supplies blood to which part of the GI tract?
- A.
Duodenum
- B.
Jejunum
- C.
Small intestine and proximal colon
- D.
Mid-transverse colon to rectum
- E.
Cecum
- 7.The superior mesenteric artery supplies blood to which part of the GI tract?
- A.
Small intestine (other than duodenum) and proximal colon
- B.
Mid-transverse colon to rectum
- C.
Duodenum
- D.
Cecum
- E.
Rectum only
- 8.The inferior mesenteric artery supplies blood to which part of the GI tract?
- A.
Mid-transverse colon to rectum
- B.
Colon and anal canal
- C.
Descending colon and rectum
- D.
Colon and rectum
- E.
Colon, cecum, and rectum
- 9.The superior rectal artery supplies blood to which part of the GI tract?
- A.
The rectum
- B.
The upper and middle rectum
- C.
Lower rectum
- D.
Anal sphincters and rectum
- E.
Anal sphincters only
- 10.The middle rectal artery supplies blood to which part of the rectum?
- A.
The lower rectum
- B.
The middle rectum
- C.
The anal sphincters
- D.
Upper and middle rectum
- 11.The inferior rectal artery supplies blood to which part of the rectum?
- A.
The internal and external anal sphincters
- B.
The lower rectum
- C.
The uppper, middle, and lower rectum
- D.
The external sphincter only
- E.
The internal sphincter only
- 12.What vein carries venous blood from the intestines to the liver?
- A.
Portal vein
- B.
Iliac veins
- C.
Middle colic vein
- D.
Inferior mesenteric vein
- E.
Superior mesenteric vein
- 13.What part of the colon propels retrograde waves of contraction to allow the cecum to retain liquid feces and act as a 'fermenting vat'?
- A.
Mid-transverse colon
- B.
Entire transverse colon
- C.
Ascending colon
- D.
Descending colon
- E.
Ileum
- 14.What stimulates the contraction of propulsive waves that move stool distally from the cecum?
- A.
Distention of the colonic wall
- B.
Distention of the small intestinal wall
- C.
The fermenting vat located in the cecum
- D.
Distention of the cecum wall
- 15.During the rectoanal inhibitory reflex, the internal sphincter ________ allowing the contents into the anal canal, then the external sphincter ____________ and contents are pushed back into the rectum. This occurs up to 7 times daily.
- A.
Relaxes, relaxes
- B.
Contracts, contracts
- C.
Relaxes, contracts
- D.
Contracts, relaxes
- 16.What type of tissue is the appendix made up of?
- A.
Lymphatic
- B.
Connective
- C.
Fibrinous
- D.
Intestinal mucosa
- 17.What is the primary cause of appendicitis?
- A.
Obstruction of the lumen between the cecum and appendix
- B.
Inflammation due to an immune response
- C.
Constipation
- D.
Overuse of antibiotics
- 18.What best explains what happens to the appendix when it is obstructed?
- A.
The inflamed tissue becomes infected and dies from lack of blood supply and eventually bursts
- B.
The inflamed tissue dies from lack of blood supply causing the appendix to burst
- C.
The obstruction causes pressure to build up and eventually causes the appendix to burst
- D.
The obstruction hardens the appendix eventually causing it to burst
- 19.What are some possible causes of an obstructed appendix?
- A.
Inflammatory bowel disease, infection, fecal stasis, calcium salts or undigested fiber- fecaliths, parasites, fb, and neoplasms
- B.
Infection, fecal stasis, calcium salts or undigested fiber-fecaliths, parasites, FB, and neoplasms, diarrhea
- C.
Fecal stasis, fecaliths, FB, gastric ulcer, infection, calcium salts or undigested fiber- fecaliths, parasites,and neoplasms
- D.
Suppositories, FB, neoplams, undigested fiber and calcium salts, calcium salts or undigested fiber-fecaliths, infection, fecal stasis, parasites
- 20.A patient presents with periumbilical pain that moves to the RLQ over 24 hrs. the pain is exacerbated by walking, coughing, or a car ride. The patient presents with nausea, vomiting, and a low grade fever of less than 38C or 100.4. What is the suspected diagnosis?
- A.
Acute appendicitis
- B.
Ovarian cyst
- C.
Volvulus
- D.
Acute pancreatitis
- E.
Acute cholecystitis
- 21.While examining a patient with suspected appendicitis, you would expect to find pain (with or without) gaurding, (with or without) rebound tenderness, pain (with or without) passive flexion of R hip, pain (with or without) passive flexion of L hip, and a postitive or negative obturator sign?
- A.
Pain: with gaurding, with rebound tenderness, with passive flexion of R hip, without passive flexion of L hip, and a positive obturator sign
- B.
Pain: without gaurding, with rebound tenderness, with passive flexion of R hip, without passive flexion of L hip, and a postivie obturator sign
- C.
Pain: without gaurding, with rebound tenderness, with passive flexion of R hip, with passive flexion of L hip, and a positive obturator sign
- D.
Pain: with gaurding, with rebound tenderness, with passive flexion of R hip, with passive flexion of L hip, and a positive obturator sign
- 22.Name 4 (positive) findings on a physical exam of someone has acute appendicitis
- 23.What are diagnostic features of acute appendicitis? click all that apply
- A.
Low grade fever less than 100.4F/38C
- B.
Moderate leukocytosis (10,000-20,000)
- C.
Ultrasound
- D.
CT (with contrast depending on body habitus)
- E.
CT (helpful if perforation is suspected to diagnose periappendiceal abscess)
- 24.During defecation, movement of feces into the rectum initiates (click all that apply)
- A.
Rectoanal inhibitory reflex
- B.
Voluntary relaxation of the pelvic floor and external sphincter mechanism
- C.
Voluntary increase in intra-abdominal pressure
- D.
Voluntary contraction of external sphincter
- 25.What percentage of people have appendicitis in their lifetime?
- A.
10%
- B.
20%
- C.
30%
- D.
50%
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