1. Which of the following is NOT a function of the peritoneum?
a) Protection of abdominal organs
b) Absorption of nutrients
c) Production of ascitic fluid in normal conditions
d) Supporting blood vessels and nerves
Solution: (c) is correct.
The peritoneum does NOT normally produce ascitic fluid. The peritoneum is a serous membrane that lines the abdominal cavity and covers abdominal organs. Its main functions include protecting organs, supporting blood vessels and nerves, and allowing frictionless movement between organs. Ascitic fluid accumulation is pathological and occurs in various disease conditions.
2. The portal vein is formed by the union of:
a) Splenic vein and superior mesenteric vein
b) Inferior mesenteric vein and splenic vein
c) Superior and inferior mesenteric veins
d) Gastric and splenic veins
Solution: (a) is correct. The portal vein is formed by the union of the splenic vein and superior mesenteric vein behind the neck of the pancreas. This is clinically significant because portal vein hypertension can affect blood flow from these vessels, leading to various complications like esophageal varices.
3. Which layer of the GI tract contains the nerve plexuses?
a) Mucosa
b) Submucosa
c) Muscularis externa
d) Both b and c
Solution: (d) is correct. The GI tract has two major nerve plexuses: Meissner’s plexus in the submucosa and Auerbach’s plexus in the muscularis externa. These plexuses are part of the enteric nervous system and regulate GI motility and secretion.
4. The appendix is typically located at:
a) McBurney’s point
b) Right hypochondrium
c) Left iliac fossa
d) Umbilical region
Solution: (a) is correct. McBurney’s point is located approximately 1/3 of the distance from the anterior superior iliac spine to the umbilicus. This is a crucial landmark for nurses during abdominal assessment, particularly when evaluating appendicitis.
5. Which sphincter is NOT under voluntary control?
a) External anal sphincter
b) Internal anal sphincter
c) External urethral sphincter
d) All are under voluntary control
Solution: (b) is correct. The internal anal sphincter is composed of smooth muscle and is under involuntary control (autonomic nervous system). This is important for maintaining continence at rest, while the external sphincter (skeletal muscle) provides voluntary control.
6. The stomach is divided into all of the following regions EXCEPT:
a) Fundus
b) Body
c) Duodenum
d) Pylorus
Solution: (c) is correct. The duodenum is the first part of the small intestine, not a region of the stomach. The main regions of the stomach are the cardia, fundus, body, and pylorus. Understanding these anatomical divisions is crucial for identifying the location of gastric pathologies.
7. Which structure connects the liver to the duodenum?
a) Pancreatic duct
b) Common bile duct
c) Cystic duct
d) Hepatic duct
Solution: (b) is correct. The common bile duct connects the liver to the duodenum, joining with the pancreatic duct to form the ampulla of Vater. This is crucial for understanding biliary disorders and pancreatic conditions.
8. The arterial supply to the stomach is derived from:
a) Superior mesenteric artery only
b) Celiac trunk only
c) Both celiac trunk and superior mesenteric artery
d) Inferior mesenteric artery
Solution: (b) is correct. The stomach receives its blood supply primarily from branches of the celiac trunk (left gastric, right gastric, and short gastric arteries). This knowledge is essential for understanding gastric bleeding and surgical procedures.
9. Which part of the small intestine has Brunner’s glands?
a) Jejunum
b) Ileum
c) Duodenum
d) All of the above
Solution: (c) is correct. Brunner’s glands are found exclusively in the duodenum. They secrete alkaline mucus that helps neutralize stomach acid and protect the duodenal mucosa.
10. The hepatic portal vein carries blood from:
a) Heart to liver
b) Liver to heart
c) GI tract to liver
d) Liver to GI tract
Solution: (c) is correct. The hepatic portal vein carries nutrient-rich blood from the GI tract to the liver for processing. This is crucial for understanding drug metabolism and nutrition absorption.
11. Peyer’s patches are predominantly found in the:
a) Stomach
b) Duodenum
c) Jejunum
d) Ileum
Solution: (d) is correct. Peyer’s patches are aggregated lymphoid follicles found primarily in the ileum. They are part of the gut-associated lymphoid tissue (GALT) and play a crucial role in immune surveillance.
12. The gallbladder is located in which fossa of the liver?
a) Right
b) Left
c) Quadrate
d) Caudate
Solution: (a) is correct. The gallbladder is located in the right fossa of the liver’s visceral surface. This anatomical relationship is important when assessing right upper quadrant pain.
13. Which structure is NOT retroperitoneal?
a) Duodenum (second part)
b) Jejunum
c) Ascending colon
d) Descending colon
Solution: (b) is correct. The jejunum is intraperitoneal, while the others listed are retroperitoneal. This anatomical relationship affects how infections and inflammations spread in the abdomen.
14. The main function of the muscularis mucosae is:
a) Absorption
b) Local movement of mucosa
c) Peristalsis
d) Secretion
Solution: (b) is correct. The muscularis mucosae causes local movement of the mucosa, creating small folds that increase surface area for absorption.
15. Which sphincter prevents gastroesophageal reflux?
a) Pyloric sphincter
b) Lower esophageal sphincter
c) Upper esophageal sphincter
d) Cardiac sphincter
Solution: (b) is correct. The lower esophageal sphincter (LES) prevents gastroesophageal reflux. Its dysfunction can lead to GERD, a common condition nurses encounter.
16. The pancreas is:
a) Entirely retroperitoneal
b) Entirely intraperitoneal
c) Partially retroperitoneal
d) Within the peritoneal cavity
Solution: (c) is correct. The pancreas is partially retroperitoneal, with only its tail being intraperitoneal. This affects the spread of pancreatic inflammation and fluid collections.
17. Which part of the colon has appendices epiploicae?
a) Cecum only
b) Ascending colon only
c) Sigmoid colon only
d) All parts except the rectum
Solution: (d) is correct. Appendices epiploicae are small fatty projections found along the entire colon except the rectum. They can become inflamed or twisted, causing localized pain.
18. The arterial supply to the rectum comes from:
a) Superior mesenteric artery only
b) Inferior mesenteric artery only
c) Internal iliac artery only
d) Multiple sources including inferior mesenteric and internal iliac arteries
Solution: (d) is correct. The rectum receives blood supply from multiple sources, including the superior rectal (from inferior mesenteric), middle rectal, and inferior rectal arteries (from internal iliac).
19. Which structure is NOT found in the porta hepatis?
a) Hepatic artery
b) Portal vein
c) Hepatic veins
d) Common bile duct
Solution: (c) is correct. Hepatic veins drain directly into the inferior vena cava and are not found in the porta hepatis. The porta hepatis contains the hepatic artery, portal vein, and common bile duct.
20. The gastroesophageal junction is typically located at:
a) T10 vertebral level
b) T12 vertebral level
c) L1 vertebral level
d) L2 vertebral level
Solution: (b) is correct. The gastroesophageal junction is typically located at the T12 vertebral level. This is an important anatomical landmark for procedures and understanding thoracoabdominal conditions.
21. Which of the following ligaments contains the ligamentum teres?
a) Coronary ligament
b) Falciform ligament
c) Triangular ligament
d) Hepatoduodenal ligament
Solution: (b) is correct. The falciform ligament is a broad, thin fold of peritoneum that connects the liver to the anterior abdominal wall and diaphragm. The ligamentum teres (obliterated umbilical vein) runs along the free edge of the falciform ligament. This is clinically significant as it can serve as a pathway for collateral circulation in portal hypertension.
22. The functional units of the liver are called:
a) Hepatic acini
b) Liver lobules
c) Portal triads
d) Both a and b
Solution: (d) is correct. The liver has two functional unit concepts:
– Classic hepatic lobules: Hexagonal units with central veins at the center
– Hepatic acini: Diamond-shaped units between two central veins, divided into zones 1, 2, and 3
Understanding these units is crucial for comprehending liver pathology and drug metabolism patterns.
23. Which of the following vessels carries oxygenated blood to the liver?
a) Portal vein
b) Hepatic vein
c) Hepatic artery
d) Central vein
Solution: (c) is correct. The hepatic artery, a branch of the celiac trunk, carries oxygenated blood to the liver (about 25% of liver blood supply). The portal vein carries nutrient-rich but partially deoxygenated blood (75% of liver blood supply) from the digestive organs and spleen.
24. Which structure is NOT found in the portal triad?
a) Hepatic artery branch
b) Portal vein branch
c) Bile duct
d) Hepatic vein branch
Solution: (d) is correct. The portal triad contains:
– Branch of hepatic artery
– Branch of portal vein
– Bile duct
Hepatic veins are not part of the portal triad but drain into the inferior vena cava.
25. The bare area of the liver is:
a) Directly attached to the diaphragm
b) Covered by peritoneum
c) Part of the caudate lobe
d) Located on the visceral surface
Solution: (a) is correct. The bare area of the liver is a region on its posterior surface that is directly attached to the diaphragm without intervening peritoneum. This area is bounded by the reflexion of peritoneum forming the coronary ligament.
