Med Oradea - Anatomy II - Digestive System - Small Intestine And Abdominal Wall

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Med Oradea - Anatomy II - Digestive System - Small Intestine And Abdominal Wall - Quiz

Med Oradea - Anatomy II - Digestive System - Small Intestine (Duodenum, Jejunum, and Ileum) and Abdominal Wall


Questions and Answers
  • 1. 

    The duodenum:

    • A.

      Has 4 parts

    • B.

      The first and third parts are retroperitoneal

    • C.

      Is situated in the supramezocolic space

    • D.

      Is fixed

    • E.

      Is shaped like a horseshoe with the opening to the left

    Correct Answer(s)
    A. Has 4 parts
    C. Is situated in the supramezocolic space
    D. Is fixed
    Explanation
    Only the first part of the duodenum is retroperitoneal. It is shaped like a horseshoe, but the concavity is oriented upwards

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  • 2. 

    The duodenum:

    • A.

      The duodenal bulb runs from the duodenopiloric incisure to the gallbladder

    • B.

      Has an upper, lower, and duodenojejunal flexure

    • C.

      Presents vertical folds on the interior

    • D.

      The greater duodenal papilla opens in the Vater's ampoule

    • E.

      Has relationships in its 3rd and 4th part with the root of the mezenterum in front (and the transverse colon)

    Correct Answer(s)
    A. The duodenal bulb runs from the duodenopiloric incisure to the gallbladder
    B. Has an upper, lower, and duodenojejunal flexure
    D. The greater duodenal papilla opens in the Vater's ampoule
    E. Has relationships in its 3rd and 4th part with the root of the mezenterum in front (and the transverse colon)
    Explanation
    The interior of the duodenum has circular folds

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  • 3. 

    The internal configuration of the duodenum:

    • A.

      The greater duodenal papilla is in the lower part of a vertical fold

    • B.

      Vertical fold is determined by the Wirsung duct

    • C.

      The pancreatic duct unites with the Santonini duct

    • D.

      Intestinal villi are present at the distal part

    Correct Answer(s)
    A. The greater duodenal papilla is in the lower part of a vertical fold
    D. Intestinal villi are present at the distal part
    Explanation
    There is a single vertical fold in the duodenum that is determined by the coledoc duct. In the lower part of the fold, there is the greater duodenal papilla, containing Vater's ampoule. The coledoc and pancreatic (Wirsung's) ducts open here.

    The lesser duodenal papilla is above the greater - the accessory pancreatic duct (Santonini) opens here

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  • 4. 

    The duodenum:

    • A.

      Presents 4 coats: serous membrane, muscular membrane, submucous, and mucous

    • B.

      Brunner glands are duodenal glands between the submucous and muscular membrane

    • C.

      Only the second, third, and fourth parts are retroperitoneal

    • D.

      The peritoneal membrane forms lunate folds (duodenal fossas) in the fourth part

    • E.

      The duodenal fossas are called the superior duodenal, inferior duodenal, retroduodenal, and duodeno-jejunal

    Correct Answer(s)
    A. Presents 4 coats: serous membrane, muscular membrane, submucous, and mucous
    B. Brunner glands are duodenal glands between the submucous and muscular membrane
    C. Only the second, third, and fourth parts are retroperitoneal
    D. The peritoneal membrane forms lunate folds (duodenal fossas) in the fourth part
    Explanation
    There are 6 duodenal fosses: Superior duodenal, inferior duodenal, superior (venous) paraduodenal, inferior (arterial) paraduodenal, superior duodenal-jejunal, and superior retroduodenal.

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  • 5. 

    Regarding some relationships:

    • A.

      The liver is in front of the first and second part of the duodenum

    • B.

      The second part of the duodenum has relations behind with the coledoc duct, portal vein, and gastroduodenal artery

    • C.

      The liver is above the second part of the duodenum

    • D.

      Below the first part of the duodenum there is the pancreas, which is also medial to the second part

    • E.

      The inferior vena cava is behind the second and third parts of the duodenum

    Correct Answer(s)
    A. The liver is in front of the first and second part of the duodenum
    D. Below the first part of the duodenum there is the pancreas, which is also medial to the second part
    E. The inferior vena cava is behind the second and third parts of the duodenum
    Explanation
    Gastroduodenal artery should be a cue as to why option B is wrong - the first part of the duodenum has relationships with the coleduc duct (remember greater duodenal papilla), portal vein, and gastroduodenal artery.

    The liver is in front and above the first part of the duodenum, and in front and lateral of the second part

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  • 6. 

    The duodenum has relations with:

    • A.

      In its first part, the pancreas below and the liver to the left

    • B.

      In its second part, the liver and ascending colon, laterally

    • C.

      In its third part, the aorta and uterus, behind

    • D.

      In its third part, mesenteric vessels in front

    • E.

      In its fourt part, the left kidney behind and laterally

    Correct Answer(s)
    B. In its second part, the liver and ascending colon, laterally
    D. In its third part, mesenteric vessels in front
    E. In its fourt part, the left kidney behind and laterally
    Explanation
    The first part has relations with the pancreas below and the liver above and in front

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  • 7. 

    Regarding duodenal relationships

    • A.

      The gastroduodenal artery is a branch of the common hepatic

    • B.

      The fourth part of the duodenum has the stomach above and the aorta behind and medially

    • C.

      The aorta is behind the second part of the duodenum

    • D.

      The left kidney is lateral to the 3rd (transverse) and 4th (ascending) part of the duodenum

    • E.

      The stomach is above the 3rd and 4th part of the duodenum

    Correct Answer(s)
    A. The gastroduodenal artery is a branch of the common hepatic
    B. The fourth part of the duodenum has the stomach above and the aorta behind and medially
    Explanation
    The aorta is behind of the third and fourth parts of the duodenum

    The 3rd part is indeed transverse and the 4th part ascending, but in fact the left kidney only has relations with the 4th part (at least directly)

    The stomach is above the 4th part of the duodenum, and the pancreas is above the 3rd part

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  • 8. 

    Vascularization:

    • A.

      The veins of the duodenum go to the portal vein

    • B.

      The duodenum is supplied by the gastroduodenal and superior mesenteric arteries

    • C.

      The superior pancreaticoduodenal artery is from the superior mesenteric artery

    • D.

      The inferior pancreaticoduodenal artery is from the superior mesenteric artery

    Correct Answer(s)
    A. The veins of the duodenum go to the portal vein
    B. The duodenum is supplied by the gastroduodenal and superior mesenteric arteries
    D. The inferior pancreaticoduodenal artery is from the superior mesenteric artery
    Explanation
    C should be clearly incorrect, since the superior mesenteric artery is a branch of the abdominal aorta lower than the celiac trunk (which ultimately gives off the gastroduodenal artery). Remember that the gastroduodenal artery supplies the part of the duodenum near the pylorus, and gives off the superior pancreaticoduodenal further out

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  • 9. 

    The duodenum:

    • A.

      Lymph drains to the hepatic and celiac lymph nodes

    • B.

      Parasympathetic innervation is from the celiac ganglia

    • C.

      Innervation is partly from thoracic splanchnic nerves

    • D.

      Thoracic splanchnic nerves are parasympathetic nerves which is why they don't synapse in the paravertebral ganglia

    Correct Answer(s)
    A. LympH drains to the hepatic and celiac lympH nodes
    C. Innervation is partly from thoracic splanchnic nerves
    Explanation
    If you know that the vagus supplies the parasympathetic innervation, then you know that B is wrong. Sympathetic innervation comes from the celiac ganglia (aka solar plexus, and from thoracic splanchnic nerves)

    D is not really covered in our course, but it's there to help you remember the sympathetic innervation. The thoracic splanchnic nerves are sympathetic nerves, not parasympathetic. But the part about the paravertebral ganglia is true, and that's why these nerves are unusual- they synapse in the celiac ganglia which is what provides sympathetic innervation to the duodenum.

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  • 10. 

    The small intestine:

    • A.

      Jejunum is fixed, ileum is mobile

    • B.

      Occasionally is partially outside the inframezocolic space

    • C.

      Jejunum and ileum don't have clearly defined limits, but jejunum is about 3/5 and ileum 2/5

    • D.

      Compared to the ileum, jejunum has more circular folds, is bigger, has more blood vessels, and is stronger

    • E.

      Peyer patches are found in the ileum and are lymphatic formations

    Correct Answer(s)
    D. Compared to the ileum, jejunum has more circular folds, is bigger, has more blood vessels, and is stronger
    E. Peyer patches are found in the ileum and are lympHatic formations
    Explanation
    Jejunum and ileum are both mobile, duodenum is the fixed part

    B is kind of a trick question, to help you remember- the duodenum is in the supramezocolic space, but the jejunum and ileum are in the inframezocolic. So it's not occasional- it's all the time.

    B is backwards - the ileum is 60%, the jejunum is 40%

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  • 11. 

    Jejunum and ileum:

    • A.

      Together have transversal folds, but only the ileum has vertical folds

    • B.

      In front is the greater omentum

    • C.

      The omentum is also called the epiploon

    • D.

      Behind is the retroperitoneal space and posterior abdominal wall

    • E.

      Below is the bladder, rectum, and uterus (in women)

    Correct Answer(s)
    B. In front is the greater omentum
    C. The omentum is also called the epiploon
    D. Behind is the retroperitoneal space and posterior abdominal wall
    E. Below is the bladder, rectum, and uterus (in women)
    Explanation
    A is wrong- the jejunum has transversal folds and the ileum has vertical

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  • 12. 

    Regarding the small intestine:

    • A.

      The ascending and descending colon is lateral

    • B.

      Jejunum and ileum are connected to the posterior abdominal wall by a mesentery

    • C.

      This mesentery has an anterior (right) and posterior (left) surface

    • D.

      The mesentery has an intestinal border behind and a parietal border in front

    • E.

      Jejunum and ileum present circular folds in their mucous layer

    Correct Answer(s)
    A. The ascending and descending colon is lateral
    B. Jejunum and ileum are connected to the posterior abdominal wall by a mesentery
    C. This mesentery has an anterior (right) and posterior (left) surface
    E. Jejunum and ileum present circular folds in their mucous layer
    Explanation
    D should be pretty clearly incorrect- if the mesentery connects the small intestine to the posterior abdominal wall (which it does), then it can't have relations with the intestines behind- so the intestinal border is in front, the parietal border is behind.

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  • 13. 

    Jejunum and ileum:

    • A.

      Present intestinal villi

    • B.

      Have 4 layers: serous, muscular, submucous, and mucous

    • C.

      The muscular layer is composed of an external circular layer and an internal longitudinal layer

    • D.

      The mucous layer has peyer patches in the ileum

    Correct Answer(s)
    A. Present intestinal villi
    B. Have 4 layers: serous, muscular, submucous, and mucous
    D. The mucous layer has peyer patches in the ileum
    Explanation
    C is backwards - the internal muscular layer is exterior, the circular muscular layer is interior

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  • 14. 

    The jejunum and ileum

    • A.

      Receive blood from the superior mesenteric artery (a branch of the aorta) and the superior colic artery

    • B.

      The upper mesenteric vein drains them

    • C.

      Lymph goes to apical nodes and from there to cisterna chyli

    • D.

      Celiac and mesenteric plexuses supply innervation

    Correct Answer(s)
    B. The upper mesenteric vein drains them
    D. Celiac and mesenteric plexuses supply innervation
    Explanation
    A is wrong- the superior mesenteric is correct but the superior colic is made up

    Lymph is collected from the intestinal villi (which have lymphatic formations) and then drains to mesenteric lymph nodes and from there goes to cisterna chyli or pecquet. Apical nodes are in the thorax around the pectoral area.

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  • 15. 

    The jejun and ileum:

    • A.

      Receive innervation from the vagus nerve via the celiac plexus

    • B.

      The celiac plexus continues to the superior mesenteric plexus which surrounds the superior mesenteric artery

    • C.

      The vagus nerve joins the superior mesenteric plexus

    • D.

      The superior mesenteric plexus comes from the celiac plexus

    Correct Answer(s)
    B. The celiac plexus continues to the superior mesenteric plexus which surrounds the superior mesenteric artery
    C. The vagus nerve joins the superior mesenteric plexus
    D. The superior mesenteric plexus comes from the celiac plexus
    Explanation
    Innervation of the jejunum and ileum is as follows: thoracic splanchnic nerves (sympathetic) arrive in the celiac plexus. Fibers leave the celiac plexus and are accompanied by the vagus (parasympathetic) nerve to form the superior mesenteric plexus, which distributes innervation to the jejunum and ileum

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  • 16. 

    The anterior abdominal wall:

    • A.

      Is limited in the upper part by the costal arches and xiphoid process

    • B.

      Is limited in the lower part by a line connecting the inferior limit of the iliac crests

    • C.

      When divided into the system of 9 regions, the vertical lines are mid-axillary and the horizontal lines are bicostal and bicrestal

    • D.

      The bicrestal line connects the anterior end of the iliac fossa

    • E.

      The left hypochondriac region is in the second row

    Correct Answer(s)
    A. Is limited in the upper part by the costal arches and xipHoid process
    B. Is limited in the lower part by a line connecting the inferior limit of the iliac crests
    Explanation
    The anterior abdominal wall is divisible into 9 compartments by a pair of vertical, midclavicular lines, an upper (bicostal) horizontal line, and a lower (bicrestal) horizontal line. The bicrestal line connects the anterior ends of the iliac crests

    The second row has the right and left colic regions and the ombilical region in the center

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  • 17. 

    When dividing the anterior abdominal wall into 9 segments:

    • A.

      The third row has the right and left iliac fossa

    • B.

      The hypogastric region is in the first row

    • C.

      The right and left epigastric regions are in the second row

    • D.

      The umbilical region is in the second row

    Correct Answer(s)
    A. The third row has the right and left iliac fossa
    D. The umbilical region is in the second row
    Explanation
    The first row: Right and left hypochondriac and epigastric (in the center)
    The second row: Right and left colic, with the umbliical in the center
    The third row: Right and left iliac fossa with the hypogastric in the center

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  • 18. 

    The small intestine:

    • A.

      Serous coat is a visceral peritoneal membrane

    • B.

      Muscular coat has external longitudinal fibers

    • C.

      Has intestinal villi but these are absent in the first part of the duodenum and last part of ileum

    • D.

      Celiac plexus provides sympathetic innervation from the solar plexus

    Correct Answer(s)
    A. Serous coat is a visceral peritoneal membrane
    B. Muscular coat has external longitudinal fibers
    C. Has intestinal villi but these are absent in the first part of the duodenum and last part of ileum
    Explanation
    Celiac plexus is just another name for solar plexus. But it does provide sympathetic innervation

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jun 02, 2011
    Quiz Created by
    Medoradea
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