1.
Which of the following lobes of the liver is between the gallbladder and the round ligament?
Correct Answer
A. Quadrate Lobe
Explanation
o Quadrate (anterior): b/w gallbladder & round ligament; functionally related to L lobe
o Caudate (posterior): b/w IVC, ligamentum venosum & porta hepatis; functionally separate from R & L lobes
2.
Which of the following is a fibrous remnant of fetal shunt that delivers blood from the umbilical vein to the IVC?
Correct Answer
D. Ligamentum Venosum
Explanation
The ligamentum venosum is a fibrous remnant of the fetal shunt known as the ductus venosus. This structure connects the umbilical vein to the inferior vena cava (IVC) in the developing fetus, allowing oxygenated blood from the placenta to bypass the liver and enter the systemic circulation. After birth, the ductus venosus closes and becomes the ligamentum venosum. The falciform ligament attaches the liver to the anterior abdominal wall, the coronary ligament connects the liver to the diaphragm, and the triangular ligament is a part of the liver's visceral peritoneum.
3.
The portal triad is enclosed by which of the following?
Correct Answer
A. Hepatoduodenal Ligament
Explanation
Hepatoduodenal ligament: encloses portal triad
Hepatogastric ligament: contains common hepatic a
4.
Which of the following is a fissure of the liver that is between the quadrate and caudate lobes and contains hepatic ducts, hepatic arteries, portal vein branches, hepatic nerves and lymphatic vessels?
Correct Answer
C. Porta Hepatis
Explanation
The correct answer is Porta Hepatis. The porta hepatis is a fissure of the liver that is located between the quadrate and caudate lobes. It contains important structures such as the hepatic ducts, hepatic arteries, portal vein branches, hepatic nerves, and lymphatic vessels. These structures play a crucial role in the functioning and blood supply of the liver.
5.
What two vessels provide the liver with 25% and 75% of the livers blood respectively?
Correct Answer
A. Proper Hepatic Artery and Hepatic Portal Vein
Explanation
Hepatic Vein drains the blood from the liver.
25% of the livers blood enters through the Proper Hepatic Artery
75% of the livers blood enters through the Hepatic Portal Vein
6.
The Hepatic Portal Vein carries blood from all of the following except?
Correct Answer
A. Liver
Explanation
The Hepatic Portal Vein carries blood to the liver, not from. The Hepatic Vein carries blood from the liver.
Branches of the Hepatic Portal Vein include Superior Mesenteric Vein, Inferior Mesenteric Vein which is a branch of the Splenic Vein, the gastric veins, etc.
7.
Which of the following lymphatics does not drain into the Thoracic Duct through the Celiac Nodes?
Correct Answer
A. Deep LympHatics of Liver
Explanation
The Deep lymphatics do drain into the thoracic duct, but by way of the IVC then to the Posterior Mediastinal Nodes.
8.
The common bile duct and the pancreatic duct drain where?
Correct Answer
A. 2nd Part of Duodenum
Explanation
• Secreted into 2nd part of duodenum, where it emulsifies fat for
later absorption
9.
While in your surgery rotation, you and your attending are performing biliary surgery. The attending asks you to find the Hepatocystic Triangle (of Calot). Which of the following would not be one of the landmarks that you would point to when showing him the triangle?
Correct Answer
D. Bile Duct
Explanation
The hepatocystic triangle (of Calot) is an important reference area for biliary surgery
It is bounded by the common hepatic duct, the cystic duct & the hepatic a
The cystic a arises w/in the triangle
10.
A patient comes into your ER with nausea, vomiting and pain in the abdomin and between the shoulder blades. You decide to do a test for Murphy's Sign. Which of the following are you testing for?
Correct Answer
A. Gallstones
Explanation
Murphy’s Sign
Ask patient to breathe out, then gently place a hand below the R costal margin at the mid-clavicular line
Ask patient to breathe in (abdominal contents are pushed downward as lungs expand & diaphragm moves down)
If patient stops breathing in & winces w/ a ‘catch’ in breath, test is POSITIVE
b/c gallbladder comes in contact w/ fingers as it moves down
Gallstone Attack-intense pain in RUQ, nausea, vomiting
Referred pain b/w shoulder blades or below R scapula (T3-5)
Jaundice (if bile is obstructed)
Risk factors – age, obesity, female & rapid weight loss
11.
Which part of the pancreas is not retroperitoneal?
Correct Answer
D. Tail
Explanation
The tail of the pancreas is not retroperitoneal. The pancreas is an organ located in the abdominal cavity, behind the stomach. It is partially retroperitoneal, meaning that it is situated behind the peritoneum (the membrane that lines the abdominal cavity), but the tail extends away from the peritoneum and lies anterior to the left kidney. Therefore, the tail is not considered retroperitoneal.
12.
Which of the following is the artery that brings blood to the pancreas and is a branch of the Superior Mesenteric Artery?
Correct Answer
A. Inferior Pancreaticoduodenal Artery
Explanation
The correct answer is Inferior Pancreaticoduodenal Artery. This artery brings blood to the pancreas and is a branch of the Superior Mesenteric Artery.
13.
Which of the following supplies blood to the pancreas, but is not a branch of the Splenic Artery?
Correct Answer
E. Anterior Superior Pancreaticoduodenal A.
Explanation
All the others are branches of the Splenic that give blood to the Pancreas.
14.
A patient has pancreatic cancer accompanied by jaundice. Which part of the pancreas is most likely the site of the tumor?
Correct Answer
A. Head
Explanation
A tumor in the head of the pancreas can cause obstruction of the bile duct. This obstruction can lead to jaundice.
Also, 60% of pancreatic cancer tumors are found in the head of the pancreas.
15.
Which part of the spleen contains the 1. venous sinus and 2. lymphatic nodules and diffuse lymphatic tissue respectively?
Correct Answer
A. Red Pulp and White Pulp
Explanation
Red Pulp: Removes and destroys expended RBC's and platelets, recycling iron. Filters Blood.
White Pulp: Produces Lymphocytes (WBC's), macrophages and antibodies.
16.
A patient has been rushed to your ER after being involved in a car accident. The patient is holding his lower left ribs and complaining of immense pain. You suspect that he has broken his ribs. Suddenly, he starts to go into shock. After performing a quick ultrasound, you find hemoperitoneum (blood in the abdominal cavity). You suspect which of the following?
Correct Answer
C. Ruptured Spleen
Explanation
Ruptured Spleen:
o Trauma to LUQ
o Fractured rib may rupture spleen
o Sudden increase in intra-abdominal pressure
o Large amounts of blood leak into abdominal cavity shock & even death
o Splenectomy
o Monitor the patient to see if bleeding stops by itself & allow spleen to heal on its own
17.
Which nerves give a sympathetic stimulation to the stomach, liver, pancreas, small intestine and a portion of the colon?
Correct Answer
A. Thoracic Splanchnic Nerves
Explanation
Thoracic Splanchnic Nerves: T5-T12 Sympathetic Response