MCQs of Peritoneal Cavity & Intestines
- Which of the following veins does not run a course parallel to the artery of the same name?
superficial circumflex iliac
- The presence of which feature (also obvious on a radiograph with barium contrast) distinguishes small from large bowel?
Circular folds of the mucosa
Circular smooth muscle layer in the wall
Longitudinal smooth muscle layer in the wall
- Occlusion of the inferior mesenteric artery is seldom symptomatic because its territory may be supplied by branches of the:
- During exploratory abdominal surgery on a 55-year-old male complaining of right lower quadrant pain, the surgeon initially sees no appendix but knows that he can quickly locate it by
looking at the confluence of the teniae coli
palpating the ileocecal valve and looking just above it
following the course of the right colic artery
removing the right layer of the mesentery of the jejunoileum
palpating and inspecting the pelvic brim
- During development of the gut:
the sigmoid colon is retroperitoneal
the inferior mesenteric artery is the axis for rotation of the midgut loop
the stomach rotates around its longitudinal axis causing the ventral border to become the greater curvature
the liver is non-functional
none of the above
- Meckel’s diverticulum:
is an abnormal persistance of the urachus
is a site of ectopic pancreatic tissue
is caused by a failure of the midgut loop to return to the abdominal cavity
is an abnormal connection of the midgut to the duodenum
is associated with polyhydramnios
- Visceral pain is often referred to a site on the body wall (where the patient “feels” it) that is innervated by the same spinal cord segment that innervates the visceral organ involved. Pain of appendicitis is often first felt around the umbilicus, indicating that the appendix receives its sympathetic (and thus visceral afferents) from which spinal cord segment?
- A surgical maneuver which takes advantage of the avascular plane of fusion fascia can be applied to mobilize all of the organs below, except the:
- A surgeon performing an appendectomy was unable to identify the base of the appendix due to massive adhesions in the peritoneal cavity. Eventually she identified the cecum and was able to localize the base of the appendix. What anatomical structure(s) on the cecum would she have used to find the base of the appendix?
- The spleen normally does not descend below the costal margin. However, it pushes downward and medially when pathologically enlarged. What structure limits the straight vertical downward movement?
Left colic flexure
Left suprarenal gland
Ligament of Treitz
- During the surgical repair of a hiatal hernia, the celiac branch of the posterior vagal trunk was severed accidentally. The damage to this nerve would affect the muscular movements, as well as some secretory activities, of the gastrointestinal tract (GI). Which segment is least likely to be affected by the nerve damage?
- A 70-year-old man with cancer of the ascending colon was admitted to the hospital for tumor removal. The surgeon may perform any of these surgical procedures EXCEPT:
an incision in the left lower quadrant to access the tumor.
examination of the superior mesenteric lymph nodes for possible metastasis.
ligation of the relevant branches of the superior mesenteric artery.
mobilization of the concerned intestinal segment by freeing its fusion fascia.
protect the peritoneum from possible fecal contamination.
- A 60-year-old woman arrived at the emergency room complaining of acute abdominal pain. She was diagnosed with ischemic bowel resulting from an obstruction of one or more branches of the inferior mesenteric artery. Which of the following is most likely NOT to be seriously affected by the ischemia?
- A surgeon has decided to perform a segmental resection of the descending colon on a 70-year-old man with intestinal cancer. In principle, any of these surgical procedures might be necessary EXCEPT:
An extended left lower quadrant incision to approach the descending colon.
Examining the sacral lymph nodes for possible enlargement.
Ligation of the relevant left colic artery branches.
Mobilizing the concerned intestinal segment by freeing its fusion fascia.
Protecting the peritoneum from possible fecal contamination.
- As the bowel is exposed, the surgeon says in amazement, “This is a loop of large bowel!” Which characteristic(s) would identify it specifically as large bowel?
C and D
- The anastomotic artery running along the border of the large intestine is called the:
- The inferior mesenteric artery is often occluded by atherosclerosis without symptoms; its normal area of distribution therefore must be supplied by collateral blood flow between which arteries?
Ileocolic and right colic
Left and middle colic
Left colic and sigmoidal
Right and middle colic
Sigmoidal and superior rectal
- The artery of the midgut is the: