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DMS > Exam 3 Multiple Choice > Flashcards

Exam 3 Multiple Choice Flashcards

1
Q

A small part of the ______ of the pancreas is enclosed in peritoneum.
a. tail
b. body
c. neck
d. head

A

D: head
Most of the pancreas is retroperitoneal; however, a small portion of the head is surrounded by peritoneum.

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2
Q

The portal vein is formed
a. posterior to the neck of the pancreas.
b. anterior to the neck of the pancreas.
c. posterior to the head of the pancreas.
d. anterior to the head of the pancreas.

A

ANS: A
The portal vein is formed by the union of the splenic and superior mesenteric veins posterior to the neck of the pancreas.

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3
Q

The length of the pancreas is
a. 3 to 5 cm.
b. 8 to 10 cm.
c. 12 to 18 cm.
d. 15 to 20 cm.

A

ANS: C
The length of the pancreas ranges from 12 to 18 cm.

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4
Q

Which statement best describes the anteroposterior dimensions of the pancreas?
a. The head is 1 to 2 cm; the neck is 0.5 to 1 cm; the body is 2 to 3 cm; and the tail is 1 to 2 cm.
b. The head is 2 to 3 cm; the neck is 0.5 to 1 cm; the body is 3 to 3.5 cm; and the tail is 3 to 4 cm.
c. The head is 2 to 3 cm; the neck is 0.5 to 1 cm; the body is 2 to 3 cm; and the tail is 1 to 2 cm.
d. The head is 2 to 3 cm; the neck is 1.5 to 2.5 cm; the body is 2 to 3 cm; and the tail is 1 to 2 cm.

A

ANS: D
The anteroposterior measurements of the head, neck, body, and tail of the pancreas vary widely. The size ranges are: head, 2 to 3 cm; neck, 1.5 to 2.5 cm; body, 2 to 3 cm; and tail, 1 to 2 cm.

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5
Q

The head of the pancreas lies
a. to the right of the SMV, in the C-loop of the duodenum, and anterior to the IVC.
b. to the right of the SMV, in the C-loop of the duodenum, and posterior to the IVC.
c. to the left of the SMV, outside the C-loop of the duodenum, and anterior to the IVC.
d. to the left of the SMV, in the C-loop of the duodenum, and anterior to the IVC.

A

ANS: A
The head of the pancreas lies to the right of the superior mesenteric vein, cradled in the C-loop of the duodenum, and anterior to the IVC.

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6
Q

Which statement describes the structures closely related to the head of the pancreas?
a.The common bile duct (CBD) is posterolateral, and the gastroduodenal artery (GDA) is posterolateral.
b.The common bile duct is anterolateral, and the gastroduodenal artery is posterolateral.
c.The common bile duct is posterolateral, and the gastroduodenal artery is anterolateral.
d.The common bile duct is anterolateral, and the gastroduodenal artery is anterolateral.

A

ANS: C
The CBD is in the posterolateral portion, and the GDA is more anterolateral. In addition, the CBD courses inferomedially, running behind the first part of the duodenum on its way to the head of the pancreas, where it meets the main pancreatic duct.

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7
Q

The gastroduodenal artery divides into
a. lateral and medial superior pancreaticoduodenal branches.
b. proper and common hepatic arteries.
c. anterior and posterior superior pancreaticoduodenal branches.
d. anterior and posterior portasplenic arteries.

A

ANS: C
The GDA is the first branch of the CHA, which originates from the celiac axis. It courses along the anterior aspect of the head just to the right of the neck, where it divides into the anterior and posterior superior pancreaticoduodenal branches, supplying blood to the head of the pancreas and the duodenum.

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8
Q

Which statement best describes the locations of the neck, body, and tail of the pancreas?
a. The neck lies posterior to the porta splenic confluence; the body lies anterior to the SMA; and the tail lies just to the left of the aorta.
b. The neck lies anterior to the porta-splenic confluence; the body lies anterior to the SMA; and the tail lies just to the left of the aorta.
c. The neck lies posterior to the porta-splenic confluence; the body lies posterior to the SMA; and the tail lies just to the right of the aorta.
d. The neck lies anterior to the porta-splenic confluence; the body lies posterior to the SMA; and the tail lies just to the left of the aorta.

A

ANS: B
The neck of the pancreas lies anterior to the porta-splenic confluence; the body lies anterior to the SMA and SV; and the tail lies left lateral to the pancreas body and aorta.

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9
Q

The tail of the pancreas
a. lies between the stomach anteriorly and left kidney posteriorly and extends to the splenic hilum.
b. lies between the stomach posteriorly and left kidney anteriorly and extends to the lateral aspect of the spleen.
c. lies with the stomach and left kidney posterior and extends to the lateral aspect of the spleen.
d. lies with the stomach and left kidney anterior and extends to the hilum of the spleen.

A

ANS: A
The tail of the pancreas generally begins just to the left of the spine and extends to the hilum of the spleen. It lies between the stomach anteriorly and the left kidney posteriorly. The SV courses along its posterior superior surface. Usually the tail lies even with the body, but in some cases it may be at a lower or even higher level.

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10
Q

Arterial flow to the head, body, and tail of the pancreas is through the
a. suprapancreatic, pancreatic, and prepancreatic arteries.
b. suprapancreatic, pancreatic, and caudal pancreatic arteries.
c. prepancreatic, pancreatic, and prehilar arteries.
d. pancreaticoduodenal and splenic arteries.

A

ANS: D
The arterial supply of the pancreas includes blood from the pancreaticoduodenal arteries (branches of the gastroduodenal artery and superior mesenteric artery) and branches of the splenic artery. The superior and inferior pancreaticoduodenal arteries supply a portion of the duodenum and along with the pancreatic arcades—the vascular connections between the hepatic, splenic, and superior mesenteric arteries—supply the head of the pancreas. The pancreatic branches of the splenic artery supply the body and tail of the pancreas with blood.

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11
Q

The length, depth, and diameter of a normal adult kidney are

a. 9 to 12 cm, 2.5 to 4 cm, and 4 to 6 cm, respectively.
b. 8 to 10 cm, 1.5 to 3 cm, and 2 to 4 cm, respectively.
c. 9 to 12 cm, 4 to 6 cm, and 2.5 to 4 cm, respectively.
d. None of these

A

ANS: A
The normal adult kidney is approximately 9 to 12 cm long, 2.5 to 4 cm in depth, and 4 to 6 cm in diameter.

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12
Q

The length, depth, and diameter of a normal neonatal kidney are
a.2 to 3 cm, 1.5 to 2.5 cm, and 3.3 to 5 cm, respectively.
b.4 to 6 cm, 2 to 2.5 cm, and 2 to 3 cm, respectively.
c.3.5 to 5 cm, 1.5 to 2.5 cm, and 2 to 3 cm, respectively.
d.0.5 to 1 cm, 1.5 to 2.5 cm, and 2 to 3 cm, respectively.

A

ANS: C
The neonatal kidney is 3.5 to 5 cm long, 1.5 to 2.5 cm in depth, and 2 to 3 cm in diameter. The pediatric kidney is proportionately larger than the adult kidney and may extend inferiorly to the iliac crest.

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13
Q

The adult male and female urethras measure, respectively,
a.10 cm and 2.5 cm.
b.20 cm and 4 cm.
c.15 cm and 2.5 cm.
d.20 cm and 5.5 cm.

A

ANS: B
The male urethra is 20 cm long; the female urethra is considerably shorter, approximately 3.5 cm in length.

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14
Q

The adult ureter is _____ cm long
a.10 to 15
b.15 to 20
c.20 to 25
d.28 to 34

A

ANS: D
The ureters are hollow, narrow tubes that range in length from 28 to 34 cm. The diameter is 6 mm.

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15
Q

The kidneys are composed mainly of two distinct areas: the
a. corpuscle and proximal and distal convoluted tubules.
b. parenchyma and sinus.
c. renal loops and medulla.
d. medullary and renal pyramids.

A

ANS: B
The kidney is composed of two distinct areas; the peripheral parenchyma and central sinus.

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16
Q

The process of nephron function, in correct order, is
a. filtration, tubular secretion, and tubular reabsorption.
b. filtration, tubular reabsorption, and tubular secretion.
c. tubular reabsorption, filtration, and tubular secretion.
d. tubular secretion, filtration, and tubular reabsorption.

A

ANS: B
Filtration takes place in the glomerulus and is the first step in urine formation. Tubular reabsorption is the process by which substances in the plasma solute that are useful to the body are reabsorbed into the bloodstream. Tubular secretion is the process through which waste substances, including ammonia, drugs, hydrogen, and potassium, are secreted in the distal convoluted tubules.

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17
Q

Where is ADH produced?
a. Adrenal cortex
b. Kidney
c. Juxtaglomerular apparatus
d. Posterior pituitary gland

A

ANS: D
ADH, which increases blood volume, is produced in the posterior pituitary gland.

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18
Q

Where is aldosterone produced?
a. Adrenal cortex
b. Kidney
c. Juxtaglomerular apparatus
d. Posterior pituitary gland

A

ANS: A
Aldosterone, which increases blood volume, is produced in the adrenal cortex.

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19
Q

Where is erythropoietin produced?
a. Adrenal cortex
b. Kidney
c. Juxtaglomerular apparatus
d. Posterior pituitary gland

A

ANS: B
Erythropoietin, which increases the production of red blood cells, is produced by the kidney.

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20
Q

Where is renin produced?
a. Adrenal cortex
b. Kidney
c. Juxtaglomerular apparatus
d. Posterior pituitary gland

A

ANS: C
Renin, which increases the systemic blood pressure, is produced by the juxtaglomerular apparatus.

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21
Q

What is the echogenicity of the renal capsule?
a. High level echoes
b. Medium level echoes
c. Low level echoes

A

ANS: A
The renal capsule appears as a thin, highly reflective line visualized along the periphery of the kidney; it is hyperechohic relative to adjacent renal cortex.

22
Q

What is the echogenicity of the renal cortex?
a. High level echoes
b. Medium level echoes
c. Low level echoes

A

ANS: B
The renal cortex demonstrates a medium- to low-level echo texture.

23
Q

What is the echogenicity of the renal pyramids?
a. High level echoes
b. Medium level echoes
c. Low level echoes

A

ANS: C
Anechoic pyramids have a distinctive and readily identifiable appearance; their echo-free presentation is in sharp contrast to the highly echogenic sinus and medium-gray cortex.

24
Q

What is the echogenicity of the renal sinus?
a. High level echoes
b. Medium level echoes
c. Low level echoes

A

ANS: A
The sinus is markedly echogenic due to the dense fat and fibrous tissue it contains.

25
Q

What is the echogenicity of the urinary bladder wall?
a. High level echoes
b. Medium level echoes
c. Low level echoes

A

ANS: A
The distended bladder wall appears as a smooth, bright outline that is hyperechoic relative to the anechoic, urine-filled lumen.

26
Q

Which of the following structures are anterior to the right kidney?
a. Psoas major muscle
b. Diaphragm
c. Right lobe of the liver
d. Pancreas tail

A

ANS: C
Structures anterior to the right kidney are the right adrenal gland, right lobe of the liver, second part of the duodenum, hepatic flexure of the colon, and jejunum of the small bowel.

27
Q

Which of the following structures are anterior to the left kidney?
a. Psoas major muscle
b. 11th and 12th ribs
c. Diaphragm
d. Spleen

A

ANS: D
Structures anterior to the left kidney are the tail of the pancreas, left adrenal gland, spleen, jejunum, stomach, and splenic flexure of the colon.

28
Q

Which of the following structures are posterior to the kidneys?
a. Diaphragm
b. Psoas muscle
c. Quadratus lumborum muscle
d. all of these

A

ANS: D
Posterior to both kidneys are the diaphragm, psoas muscle, transversus muscle, and quadratus lumborum muscle.

29
Q

Which of the following is the correct order of the arterial blood supply to the kidney?
a.Renal artery, segmental artery, interlobar artery, arcuate artery, interlobular artery
b.Renal artery, interlobar artery, segmental artery, arcuate artery, interlobular artery
c.Renal artery, segmental artery, interlobular artery, arcuate artery, interlobar artery
d.Renal artery, interlobular artery, segmental artery, arcuate artery, interlobar artery

A

ANS: A
Blood reaches the nephron by entering the kidney through the renal artery, a branch of the aorta. The renal artery branches into five segments to supply each one of the apical, superior, middle, inferior and posterior renal segments. The segmental arteries then branch into one lobar artery for each renal pyramid and these form interlobar arteries, which travel between the renal pyramids. The interlobar arteries branch into arcuate arteries, located at the base of the renal pyramids. From the arcuate arteries, the interlobular arteries travel into the renal cortex.

30
Q

Which of the following laboratory values measure how well the kidneys remove waste and excess fluid from the blood?
a. Blood urea nitrogen
b. Creatinine
c. Glomerular filtration rate
d. Specific gravity

A

ANS: C
Glomerular filtration rate measures how well the kidneys remove waste and excess fluid from the blood. Normal GFR is 90mL/min; lower values may indicate disease.

31
Q

Elevation of this laboratory may indicate renal disease.
a. Creatinine
b. Glomerlular filtration rate
c. Aldosterone
d. Serum cortisol

A

ANS: A
Creatinine is used to assess renal function and measure the kidney’s ability to get rid of waste. Normal creatinine is 1.1 mg/dL and elevation of this value may indicate renal disease.

32
Q

The splenic artery arises from the
a. superior mesenteric artery.
b. common hepatic artery.
c. celiac artery.
d. proper hepatic artery.

A

ANS: C
The splenic artery (SPA) is one of three vessels that arise from the celiac artery (CA) (the other two branches are the left gastric artery and the common hepatic artery). The diameter of the SPA as it arises from the CA has been estimated to be 5.6 mm.

33
Q

Which artery is a branch of the splenic artery?
a. Left gastric artery
b. Short gastric artery
c. Right gastroepiploic artery
d. Inferior mesenteric artery

A

ANS: B
The short gastric artery arises from the splenic artery and supplies the superior portion of the greater curvature of the stomach.

34
Q

At the hilum, the splenic artery branches into
a. two to four lobular arteries.
b. four to six lobular arteries.
c. two to four lobar arteries.
d. four to six lobar arteries.

A

ANS: C
The splenic artery branches into two to four lobar arteries after entering the splenic hilum; these splenic artery branches further divide into lobular arteries.

35
Q

The primary component of the white pulp is
a. Malpighian corpuscles.
b. epithelial cells.
c. red and pink pulp.
d. splenic cords.

A

ANS: A
The spleen is composed of red and white pulp. The white pulp consists of lymphatic tissue that surrounds and follows the smaller splenic arteries. The primary components of this portion of the spleen are the Malpighian corpuscles.

36
Q

The average volume of the adult spleen is about
a. 50 mL.
b. 200 mL.
c. 400 mL.
d. 600 mL.

A

ANS: B
The average splenic volume in an adult is approximately 200 mL. Volumes as low as 60 mL and as high as 350 mL have been reported in normal adults.

37
Q

The normal splenic index is approximately
a. 51 to 153 cm3.
b. 155 to 450 cm3.
c. 450 to 750 cm3.
d. 107 to 314 cm3.

A

ANS: D
The normal splenic index is 107 to 314 cm3.

38
Q

The removal of nuclei from old red blood cells without damage to the cells is called
a. culling.
b. sampling.
c. pitting.
d. pulping

A

ANS: C
Pitting is the removal of nuclei from old red blood cells without damaging the cells.

39
Q

The most abundant pigment released by the spleen during red blood cell removal is
a. hemosiderin.
b. hemoglobin.
c. heme.
d. bilirubin.

A

ANS: A
The most abundant pigment released is hemosiderin

40
Q

The component of the spleen that is responsible for immune functions is
a. red pulp.
b. white pulp.
c. hilum.
d. Kupffer cells.

A

ANS: B
In the white pulp, lymphocytes and monocytes are continually produced and are active in ingesting and digesting harmful pathogens that enter the bloodstream.

41
Q

The oxygen-carrying and iron-containing pigment of red blood cells is
a. red pulp.
b. hemosiderin.
c. hemoglobin.
d. heme.

A

ANS: C
Hemoglobin is the oxygen-carrying and iron-containing pigment of red blood cells.

42
Q

The echogenicity of the spleen can be described as
a. anechoic.
b. low-level echoes.
c. medium-level echoes.
d. high-level echoes.

A

ANS: C
The normal spleen demonstrates a medium-level echo pattern similar to or slightly more echogenic that of the normal liver parenchyma.

43
Q

The removal of abnormal red blood cells is called
a. culling.
b. sampling.
c. pitting.
d. pulping.

A

ANS: A
Pitting, the removal of nuclei from old red blood cells without damaging the cells, and culling, the removal of abnormal red blood cells, occur.

44
Q

The echogenicity of the liver can be described as
a. anechoic.
b. low-level echoes.
c. medium-level echoes.
d. high-level echoes.

A

ANS: C
The normal liver parenchyma demonstrates a medium-level echo pattern.

45
Q

Which of the following breathing technique would be used to move the spleen inferiorly away from the bony thorax alleviating rib shadows?
a. Deep inspiration
b. Expiration
c. Shallow inspiration
d. Varied breathing technique with each patient

A

ANS: A
Deep inspirations depress the diaphragm and moves the spleen inferiorly away from the bony thorax, alleviating shadows from the ribs and bowel gas.

46
Q

The echogenicity of the splenic calcifications can be described as
a. anechoic.
b. low-level echoes.
c. medium-level echoes.
d. high-level echoes.

A

ANS: D
Bright reflections may be seen throughout the spleen that represent calcifications of small arterial walls or calcified granulomatous inclusions.

47
Q

The percentage of red blood cells per volume of blood is termed
a. bacteremia.
b. leukocytosis.
c. hemoglobin.
d. hematocrit.

A

ANS: D
The hematocrit reading indicates the percentage of red blood cells per volume of blood. Normal values for men are 40% to 54%; for women, 37% to 47%.

48
Q

Which of the following is indicative of an infection in the blood?
a. Bacteremia
b. Leukocytosis
c. Leukopenia
d. Hematocrit

A

ANS: B
OBJ: Describe the associated physicians, diagnostic tests, and laboratory values relevant to the normal spleen.

49
Q

An abnormal decrease in the number of circulating platelets is termed
a. bacteremia.
b. leukocytosis.
c. leukopenia.
d. thrombocytopenia.

A

ANS: D
Thrombocytopenia is an abnormal decrease in the number of circulating platelets. The normal range is 150,000 to 350,000 per mm3.

50
Q

Which of the following diagnostic imaging modalities involves intravenous injection of radionuclides to “tag” specific cells?
a. Ultrasound
b. Nuclear medicine
c. Computed axial tomography
d. Magnetic resonance imaging

A

ANS: B
Nuclear medicine involves intravenous injection of radionuclides to create diagnostic images. The radionuclides “tag” specific cells, so that the resulting image is specific to the area of interest.

DMS (5 decks)

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