Abdomen Flashcards
Upon initial reading doctor D mentioned that the abdominal radiograph shows essentially normal abdominal plain radiograph. What is the normal diameter of cecum?
a. < 9 CM
b. < 3 CM
c. < 12 CM
d. < 6 CM
a. < 9cm
Which structure is obstructed in the portal triad in case of Choledocholithiases?
a. Right hepatic artery
b. Portal vein
c. Cystic duct
d. Common bile duct
d. Common bile duct
Doctor X requested for a contrast study of the upper Gastrointestinal series which revealed a narrowing at the level of cricopharyngeus muscle. What could be the cause of this narrowing?
a. Diverticula
b. Inflammation
c. Physiologic
d. Neoplasm
c. Physiologic
What is the most dependent portion of the abdominal cavity in a supine patient?
a. Hepatorenal fossa
b. Left subphrenic space
c. Subhepatic space
d. Right subphrenic space
a. Hepatorenal fossa
Couinaud segments defines the anatomy of the liver in case of surgical interventions. Which segment is involve if the lesion is located in the right anterior inferior subsegment of the liver?
a. VIII
b. VII
c. VI
d. V
d. V
This structure is an identifying feature of a small intestinal loop.
a. Valvulae conniventes
b. Taenia Coli
c. Appendices epiploicae
d. Haustrations
a. Valvulae conniventes
All are the things to look for in a plain film of the abdomen except?
a. GAS PATTERN
b. EXTRALUMINAL AIR
c. SUBCUTANEOUS TISSUE
d. CALCIFICATIONS
c. SUBCUTANEOUS TISSUE
On CT and barium studies this structure appears to be feathery pattern with more prominent valvulae coniventes, a wider lumen and a thicker wall.
a. Ileum
b. Cecum
c. Duodenum
d. Jejunum
d. Jejunum
What structure of the large intestine forms a redundant loop of variable length from the distal descending colon in the left iliac fossa to the rectum?
a. Sigmoid colon
b. Transverse colon
c. Descending colon
d. Ascending colon
a. Sigmoid colon
What structure separates the anterior portion from the posterior portion of the liver in the Couinauds segments?
a. Right hepatic vein
b. Middle hepatic vein
c. Left hepatic vein
d. Falciform ligament
a. Right hepatic vein
What structure separates the gastrohepatic recess of the left subphrenic space from the lesser sac?
a. LESSER OMENTUM
b. GREATER OMENTUM
c. GREATER SAC
d. FORAMEN OF WINSLOW
a. LESSER OMENTUM
For ambulatory patients, air fluid levelling is better appreciated in what abdominal view?
a. AP upright
b. PA upright
c. Lateral decubitus
d. AP supine
a. AP upright
Which portion of the duodenum has an opening on its posteromedial aspect for the pancreatic and common bile ducts?
a. Second
b. Third
c. Fourth
d. First
a. Second
All are indication for examination of abdomen radiography except?
a. Abnormal intraabdominal masses
b. Ascites
c. Radiolucent foreign bodies in the GI tract
d. Pneumoperitoneum
c. Radiolucent foreign bodies in the GI tract
What is the primary imaging modality for comprehensive evaluation of the abdomen including abdominal organs, peritoneal cavity and retroperitoneum?
a. FLUOROSCOPY
b. CT SCAN
c. RADIOGRAPH
d. ULTRASOUND
d. ULTRASOUND
What is the gold standard for kidney stones detection?
a. CT stonogram
b. Ultrasound
c. Plain Radiograph
a. CT stonogram
Maximum enhancement of the liver
during a MDCT contrast study is attained
during the _____
a. Portovenous phase
b. Early Arterial Phase
c. Late Arterial Phase
d. Delayed Phase
a. Portovenous phase
Which of the following imaging modality is not used in assessing the biliary tree?
a. Ultrasound
b. MRI
c. Plain radiograph
d. CT scan
c. Plain radiograph
In Couinaud classification of liver anatomy, segment VIII corresponds to
a. Right anterior inferior subsegment
b. Right posterior inferior subsegment
c. Right anterior superior subsegment
d. Right posterior superior subsegment
c. Right anterior superior subsegment
The union of the right and left hepatic duct give rise to your:
a. Cystic duct
b. Common hepatic duct
c. Celiac duct
d. Common bile duct
b. Common hepatic duct
In this sequence of the MRI, the normal
liver is of slightly higher signal intensity than
the spleen
a. T3 weighted Mr
b. T2 weighted MR
c. T4 weighted MR
d. T1 weighted MR
d. T1 weighted MR
This has a characteristic “tadpole”
appearance at the junction of the body and
neck of the pancreas which helps to identify
the gland on transverse imaging in the
midline.
a. Splenic vein
b. Superior mesenteric artery
c. Splenic artery
d. Superior mesenteric vein
a. Splenic vein
Which is true regarding the MRI findings
of a normal spleen?
a. The spleen signal intensity is lower than
hepatic parenchyma of T1WIs and higher
than liver parenchyma on T2WIs
b. The spleen signal intensity is higher than
hepatic parenchyma of T1Wis and higher
than the liver parenchyma on T2Wis
c. The spleen signal intensity is higher than
hepatic parenchyma of T1WIs and lower
than the liver parenchyma on T2Wis
d. The spleen signal intensity is lower than
hepatic parenchyma of T1Wis and lower
than liver parenchyma of T2Wis
a. The spleen signal intensity is lower than
hepatic parenchyma of T1WIs and higher
than liver parenchyma on T2WIs
The esophageal hiatus is at what level of
the diaphragm
a. T10
b. T6
c. T8
d. T12
a. T10
This muscle forms part of the posterior wall
of the pelvis which arises on either side of the
anterior sacrum and pass laterally through
the greater sciatic foramen to insert into the
greater trochanter of femur.
a. Obturator internus
b. Iliacus
c. Psoas
d. Piriformis
d. Piriformis
These are the anterior branches of the
abdominal aorta EXCEPT:
a. Celiac artery
b. Inferior mesenteric artery
c. Inferior phrenic artery
d. Superior mesenteric artery
c. Inferior phrenic artery
This artery supplies the liver, stomach, pancreas and spleen.
a. Inferior phrenic artery
b. Superior mesenteric artery
c. Inferior mesenteric artery
d. Celiac artery
d. Celiac artery
Blind pouch of the large bowel proximal to ileocecal valve
a. Rectum
b. Sigmoid
c. Cecum
d. Jejunum
c. Cecum
Approximately how long is the cecum?
a. 6cm
b. 8cm
c. 7 cm
d. 10cm
a. 6cm
Runs from the hepatic flexure across the midline to the splenic flexure intraperitoneally
a. Transverse colon
b. Descending colon
c. Ascending colon
d. Sigmoid colon
a. Transverse colon
Penetrates the peritoneum at the level
of S2-S4 to continue as a retroperitoneal
rectum
a. Anal canal
b. Cecum
c. Sigmoid colon
d. Descending colon
c. Sigmoid colon
These are the detailed pattern of the
gastric mucosa and the hallmark of normal
is regularity of the pattern in all areas in
which it is visualized.
a. Pyloric canal
b. Areae gastricae
c. Rugae
d. Muscularis mucosae
b. Areae gastricae
What part of the duodenum is covered
by visceral peritoneum?
a. Ascending part
b. Duodenal cap/bulb
c. Descending part
d. Transverse part
b. Duodenal cap/bulb
Structure that arises from the
convergence of the taenia colon on the
posteromedial wall of the cecum
a. Rectum
b. Appendix
c. Anal canal
d. Peritoneal tag
b. Appendix
Which of the following describes the left
adrenal gland?
a. Anterior to the splenic vein and medial to
diaphragmatic crus
b. Posterior to the splenic vein and medial
to diaphragmatic crus
c. Posterior to the splenic vein and lateral to
diaphragmatic crus
d. Anterior to the splenic vein and lateral to
diaphragmatic crus
c. Posterior to the splenic vein and lateral to
diaphragmatic crus
All of the following is true regarding
adrenal glands EXCEPT
a. Composed of the body, medial and lateral
limbs
b. Retroperitoneal
c. Enclosed within the perirenal fascia and
in the same compartment with the kidney
d. Outer cortex from mesoderm and inner
medulla (10% of the weight of the gland)
from the neural crest
c. Enclosed within the perirenal fascia and
in the same compartment with the kidney
These are flattened bands of incomplete longitudinal muscle layer of the
colon.
a. Appendices epiploicae
b. Taenia coli
c. Haustra
d. Valvulae conivent
b. Taenia coli
Kidneys are located within the cone of ___, surrounded by the fat of the perirenal space.
a. Camper’s fascia
b. Gerota fascia (Renal fascia)
c. Transversalis fascia
b. Gerota fascia (Renal fascia)
Which imaging modality uses routine abdominal films consisting of supine and upright views.
a. Ultrasound
b. Plain Radiograph
c. Fluoroscopy
b. Plain Radiograph
Abdomen is composed primarily of __?
a. soft tissue
b. fats
c. tumor cells
a. Soft tissue
The difference in density between
solid and liquid is not distinguishable on a plain radiograph.
a. True
b. False
a. True
It is a layer of fat density underlying the muscle
lateral to the abdominal wall
a. Camper’s fascia
b. Transversalis fascia
c. Flank stripe (properitoneal fat stripe)
c. Flank stripe (properitoneal fat stripe)
What fluoroscopic procedure is performed for assessing the biliary tree with the use of contrast material?
a. Lithiotripsy
b. T-tube cholangiogram
c. MR Cholangiography
b. T-tube cholangiogram
Which abdominal imaging modality is used for inspection of the mucosal surface of the esophagus, stomach and duodenum?
a. Ultrasound
b. Contrast studies
c. Fluoroscopy
d. Plain radiograph
b. Contrast studies
Which abdominal imaging modality is used to provide comprehensive evaluation of the abdomen, including the peritoneal cavity, retroperitoneal compartments, abdominal and pelvic organs, blood vessels, and lymph nodes
a. Ultrasound
b. Plain radiograph
c. CT and MRI
c. CT and MRI
____ used as a screening method for patients with abdominal symptoms and suspected diffuse or focal liver disease.
a. MRI
b. Ultrasound
c. Plain radiograph
b. Ultrasound
This structure is a double layer of peritoneum that hangs from the greater curvature of the stomach and descends in front of the abdominal viscera, separating the bowels from the anterior abdominal wall.
a. Lesser omentum
b. Mesentery
c. Greater omentum
d. Lesser sac
c. Greater omentum
This structure separates the gastrohepatic
recess of the left subphrenic space from the lesser sac.
a. Lesser omentum
b. Lesser sac
c. Hepatorenal fossa
a. Lesser omentum
This is a space that communicates freely
with the left subhepatic space, but it is separated from the right subphrenic space by the falciform ligament and from the left paracolic gutter by the phrenicocolic ligament
a. Left subphrenic space
b. Lesser sac
c. Lesser omentum
a. Left subphrenic space
Color flow and spectral Doppler are
used to assess hepatic vessels and ___?
a. hepatic parenchyma
b. tumor vascularity
c. parasites
b. tumor vascularity
The eight Couinaud segments have “shared” vascular inflow, outflow, and
biliary drainage and can each be resected without damaging the remaining
segments.
a. True
b. False
b. False
In a CT scan, density of normal liver parenchyma is equal to or __ than the density of normal spleen parenchyma on unenhanced images.
a. greater
b. lesser
a. greater
The union of the right and left hepatic ducts can be seen in the __ ?
a. bile duct
b. porta hepatis
c. cystic duct
b. porta hepatis
What is this tongue-shaped organ, approximately 12 to 15 cm in length?
a. Liver
b. Pancreas
c. Gallbladder
d. Stomach
b. Pancreas
What are the three primary imaging modalities for pancreas?
a. CT, MRI, Plain radiograph
b. Ultrasound, MRI, Plain radiograph
c. CT, Ultrasound, MRI
c. CT, Ultrasound, MRI
Upper GI series of patient XY revealed a focal
protrusion into the lumen of the proximal duodenum causing narrowing and obstruction. Which of the following is the most probable cause?
a. Ulceration
b. Neoplastic
c. Inflammatory
d. Diverticulum
b. Neoplastic
The following are true about the scout film EXCEPT?
a. Taken without any contrast material
b. Consists of several films with patient
in the upright or supine position
c. Also called the plain film
d. First step in imaging the abdomen
b. Consists of several films with patient
in the upright or supine position
The following are indications for abdominal
imaging EXCEPT?
a. Diverticula
b. Intraabdominal masses
c. Radiopaque foreign bodies
d. Pneumothorax
d. Pneumothorax
Among the basic radiologic densities, which
is the most attenuating?
a. Air
b. Bone
c. Metal
d. Soft tissue
c. Metal
Which of the following is TRUE regarding ultrasound of the pancreas?
a. All of the above
b. Characteristic “tadpole” appearance at the junction of body and tail
c. Anterior to the splenic vein on ultrasound
d. Seen even when obscured by colonic
and gastric gas
c. Anterior to the splenic vein on ultrasound
The cystic duct courses posteriorly and inferiorly from the gallbladder to join the
common hepatic duct to form the ____
a. Common bile duct
b. Right hepatic duct
c. Left hepatic duct
d. Biliary radicals
a. Common bile duct
What structure separates the superior portion
from the inferior portion of the liver in the
Couinauds segments?
a. Middle hepatic vein
b. Right hepatic vein
c. Portal plane
d. Left hepatic vein
c. Portal plane
Which of the following parts of the large
intestine is INTRAPERITONEAL in location?
a. Transverse colon
b. Rectum
c. Descending colon
d. Ascending colon
a. Transverse colon
Which of the following is TRUE about the
ultrasound of the spleen?
a. Measures less than 10 cm on its long axis
b. Similar echogenicity to that of the liver or higher
c. Accessory spleens cannot be appreciated on ultrasound
d. Heterogenous appearance
b. Similar echogenicity to that of the liver or higher
Doctor AB requested for an abdominal
radiograph. Which of the following is NOT a
view of the abdomen?
a. Lateral decubitus
b. AP upright
c. AP supine
d. PA upright
d. PA upright
How many functionally dependent segments does the Couinaud classification divides the liver?
A. 6
B. 7
C. 8
D. 9
C. 8
Which of the following segments of the liver is NOT in the left lobe?
A. Segment III
B. Segment IVa
C. Segment IVb
D. Segment V
D. Segment V
What is the normal diameter of the extrahepatic bile ducts?
a. Not more than 2-3 mm in internal diameter
b. Not more than 4-3 mm in internal diameter
c. Not more than 6-7 mm in internal diameter
d. Not more than 9-10 mm in internal diameter
c. Not more than 6-7 mm in internal diameter
The ducts of the left hepatic lobe position is more ____ than those of the right hepatic lobe.
A. Anterior
B. Inferior
C. Posterior
D. Superior
A. Anterior
What is the normal measurement thickness of the gallbladder wall?
A. less than 10 mm
B. less than 3mm
C. less than 6 mm
D. less than 8 mm
B. less than 3mm
What is the normal length of the spleen?
A. 15-18 cm
B. 8-9 cm
C. 10-12 cm
D. 12-15 cm
D. 12-15 cm
In CT scan, as a result of its oblique position the tail of the pancreas is visible near what structure?
A. Left lobe of the liver
B. Right kidney
C. Splenic hilum
D. Transverse colon
C. Splenic hilum
What is the normal average thickness of the spleen dimension in adult measures?
A. 1 to 2 cm
B. 2 to 3 cm
C. 3 to 4 cm
D. 5 to 6 cm
C. 3 to 4 cm
What structure occupies the left upper quadrant of the abdomen, just below the
diaphragm and posterior and lateral to the stomach?
A. Appendix
B. Inferior vena cava
C. Right adrenal gland
D. Spleen
D. Spleen
CT scan is used as a modality, a normal spleen density is ___ to the density of normal a liver?
A. Echogenic
B. Hyperintese
C. Less than
D. More than
C. Less than
What part of the duodenum is lateral to the head of the pancreas?
A. Ascending
B. Descending
C. Superior
D. Transverse
B. Descending
What structure runs from the hepatic flexure across the midline to the splenic flexure intraperitoneally?
A. Ascending colon
B. Descending colon
C. Sigmoid colon
D. Transverse colon
D. Transverse colon
Which is of the following is/are NOT a true characteristic of a right adrenal gland?
A. Less consistent in location
B. Posterior to inferior vena cava, medial to the right lobe of the liver,
C. Lower and more medial to the spine than the left
D. V-shaped lateral to the right diaphragmatic
A. Less consistent in location
Which is included as a common indication of intravenous urography?
A. All of the choices
B. Check for anatomical variants or congenital anomalies
C. Detect and localize ureteric obstruction
D. Normal function of the kidneys
A. All of the choices
Which of the following is the anterior branch of the abdominal aorta at the level of L3?
A. Celiac artery
B. Inferior mesenteric artery
C. Middle sacral artery
D. Superior mesenteric artery
B. Inferior mesenteric artery
Which of the following is NOT a primary imaging modality used in the evaluation of the pancreas?
A. CT scan
B. MRI
C. Ultrasound
D. X-ray
D. Xray
What is the screening method used for suspected diffuse or focal liver disease?
A. CT scan
B. Fluoroscopy
C. Radiograph
D. Ultrasound
D. Ultrasound
What level of the thoracic vertebra does the inferior vena cava pierces the central tendon of the diaphragm?
A. T6
B. T8
C. T10
D. T12
B. T8
What ligament separates the left subphrenic space and left paracolic gutter?
A. Cystic ligament
B. Falciform ligament
C. Ligament of Treitz
D. Phrenicocolic ligament
D. Phrenicocolic ligament
Which of the following is correct about the urinary bladder?
A. As it fills, it becomes ovoid and rises into the abdomen, stripping the loose peritoneum of the anterior abdominal wall and displaces the bowel inferiorly.
B. Intraperitoneal structure
C. It has a triangular shaped base posteriorly
D. Pyramidal muscular organ when distended
C. It has a triangular shaped base posteriorly
What structure marks the transition to the small bowel and is the highest part of the fourth part of the duodenum?
A. Falciform ligament
B. Ligament of Treitz
C. Pancreatic duct
D. Splenic vein
B. Ligament of Treitz
- Which of the following statements is TRUE about the liver?
A. Following bolus IV contrast administration, the normal parenchymal enhancement is less than that of the spleen during the arterial phase and equal to or greater than that of the spleen during the portal venous phase.
B. On T2WIs, the normal liver is greater than or equal to the spleen in signal strength, and most lesions appear as low- intensity foci.
C. The density of normal liver parenchyma is equal to or lesser than the density of normal spleen parenchyma on unenhanced images.
D. Vessels and bile ducts of the liver are particularly well seen on x-ray studies.
A. Following bolus IV contrast administration, the normal parenchymal enhancement is less than that of the spleen during the arterial phase and equal to or greater than that of the spleen during the portal venous phase.
The right subphrenic and subhepatic spaces communicate freely with the pelvic peritoneal cavity via what structure?
A. Hepatorenal recess
B. Left paracolic gutter
C. Right paracolic gutter
D. Splenorenal recess
A. Hepatorenal recess
What vein/s drain direct to the inferior vena cava?
A. Lateral phrenic veins
B. Left adrenal vein
C. Left gonadal vein
D. Right gonadal vein
D. Right gonadal vein
What specific abdominal organ is very well seen in MRI because of the surrounding fat, which is iso or slightly hypointense compared to liver in both T1 and T2 weighted
images?
A. Adrenal gland
B. Gallbladder
C. Pancreas
D. Spleen
A. Adrenal gland
What artery supplies the liver, stomach, pancreas and spleen?
A. Celiac artery
B. Inferior mesenteric artery
C. Inferior phrenic artery
D. Superior mesenteric artery
A. Celiac artery
Which of the following is NOT included in the ureteral anatomical constrictions?
A. Pelvic brim
B. Proximal ureter
C. Ureteropelvic junction
D. Ureterovesical junction
B. Proximal ureter
Which of the following is the deepest muscle that forms the anterior abdominal wall?
A. Iliacus
B. Psoas
C. Quadratus lumborum
D. Transversus abdominis
D. Transversus abdominis
Which view of the abdomen best confirms the presence of intraperitoneal air in ambulatory patients?
a. AP upright
b. AP supine
c. Lateral Decubitus
d. Crosstable lateral
a. AP upright
Which procedure is best used for visualization of the esophagus, stomach and small intestine?
a. Barium Enema
b. Upper GI series
c. ERCP
d. Ultrasound
b. Upper GI series
Which of the following is the most dependent portion of the abdominal cavity in an upright
patient?
a. Right paracolic gutter
b. Morrison’s pouch
c. Perisplenic space
d. Pouch of Douglas
d. Pouch of Douglas
Which of the following is the most dependent portion of the abdominal cavity in a supine
patient?
a. Right paracolic gutter
b. Morrison’s pouch
c. Perisplenic space
d. Pouch of Douglas
b. Morrison’s pouch
Which of the following statements regarding abdominal compartments is FALSE?
a. The right subphrenic and subhepatic spaces communicate freely with the pelvic peritoneal cavity via the right paracolic gutter
b. The right subphrenic spaces is separated from the left subphrenic space by the falciform ligament
c. The left subphrenic space communicates freely with the left subhepatic space
d. The left subphrenic space communicates freely with the left paracolic gutter
d. The left subphrenic space communicates freely with the left paracolic gutter
According to Couinaud classification system, which of the following divides the liver into the
right and left lobe?
a. Right hepatic vein
b. Left hepatic vein
c. Portal vein
d. Middle hepatic vein
d. Middle hepatic vein
According to Couinaud classification system, which of the following divides the liver into upper and lower segments?
a. Right hepatic Vein
b. Hepatic artery
c. Middle hepatic vein
d. Portal vein
d. Portal vein
Which blood vessel supplies majority of the liver?
a. Hepatic artery
b. Portal vein
c. Celiac artery
d. Superior mesenteric artery
b. Portal vein
What imaging procedure produces excellent images of the biliary and pancreatic systems?
a. ERCP
b. MRCP
c. CT scan
d. Ultrasound
b. MRCP
The neck, body and tail of the pancreas lie ventral to which structure?
a. Splenic vein
b. Superior mesenteric vein
c. Portal vein
d. Inferior mesenteric vein
a. Splenic vein
Spleen is size of a __?
a. Stone
b. Fist
c. Palm
b. Fist
In what CT phase does the spleen shows palisading pattern of enhancement?
a. Arterial
b. Portovenous
c. Delayed
d. Nephrogenic
a. Arterial
Which procedure allows the good visualization of the mucosal outline of the large intestine?
a. Barium Enema
b. Upper GI series
c. ERCP
d. Ultrasound
a. Barium Enema
What part of the stomach is referred to as the gastroesophageal junction?
a. Body
b. Fundus
c. Cardia
d. Antrum
c. Cardia
Which part of the stomach comprises the distal 1/3 of the stomach?
a. Body
b. Fundus
c. Cardia
d. Antrum
d. Antrum
Which segment of the duodenum is canalized by the pancreatic and common bile ducts?
a. first
b. second
c. third
d. fourth
b. second
What is the normal diameter of appendix in ultrasound and CT scan?
a. <6cm
b. 5-7 cm
c. 7-9cm
d. >1.0 cm
a. <6cm
What is normal caliber of the small bowel lumen?
a. 9 cm
b. 5 cm
c. 4 cm
d. <3cm
d. <3cm
What is the most common anatomic location of the appendix?
a. Pelvic
b. Retrocecal
c. Ileocecal
d. ascending colon
b. Retrocecal
The following locations are normal physiologic narrowings of the ureter EXCEPT for:
a. ureteropelvic junction
b. as it crosses the iliac vessels
c. ureterovesical junction
d. vesicourethral junction
d. vesicourethral junction
What structure connects the liver to the anterior abdominal wall?
a. falciform ligament
b. coronary ligament
c. gastrophrenic ligament
d. gastrosplenic ligament
a. falciform ligament
Which of the following is not a branch of the celiac artery?
a. common hepatic artery
b. splenic artery
c. right gastric artery
d. left gastric artery
c. right gastric artery
Which paired muscles arise from the upper part of the iliac fossa?
a. psoas muscle
b. iliacus muscle
c. quadratus lumborum
d. transversus abdominis
b. Iliacus muscle
At what level does the aorta pass through the diaphragm?
a. T6
b. T8
c. T10
d. T12
d. T12
The following vessels are anterior branches of the abdominal aorta, EXCEPT:
a. renal artery
b. celiac artery
c. superior mesenteric artery
d. inferior mesenteric artery
a. renal artery
