TA Review Questions

Question 1

Which of the following structures never had a mesentery?

a) ascending colon
b) descending colon
c) duodenum
d) kidney
e) pancreas

Answer 1

d) kidney

all the others are secondarily retroperitoneal

Question 2

Patient with GERDs and a weak right crus muscle may develop this form of hernia. Strangulation is NOT a concern.

a) Paraesophageal hernia
b) Sliding hernia

Answer 2

b) Sliding hernia

Question 3

Patient has gastric mucosa in the esophagus above the lower esophageal sphincter. What might the patient have? How did come about?

Answer 3

Barrett’s esophagus .
Repeated acid reflux/GERD – stomach mucosa more protective against acid than stratified squamous, but can lead to cancer.

Question 4

What is the landmark that divides the foregut and midgut? (midway of 2nd part of duodenum)

Answer 4

Major duodenal papilla/hepatopancreatic ampulla (of Vater)

Question 5

The secondary/accessary pancreatic duct is derived from…

a) Dorsal bud of the pancreas
b) Ventral bud of the pancreas

Answer 5

a) Dorsal bud

the ventral bud forms the main duct, which fuses with the common bile duct

Question 6

Falciform ligament is part of which?

a) Dorsal mesentery
b) Ventral mesentery

Answer 6

b) Ventral mesentery

Question 7

After birth, the umbilical vein degenerates to form the…

a) Medial umbilical fold
b) Falciform ligament
c) Ligamentum teres hepatis
d) Ligamentum venosum

Answer 7

c) Ligamentum teres hepatis

Question 8

Papillary process of the liver exist in which area?

a) Left lobe
b) Caudate lobe
c) Quadrate lobe
d) Right lobe

Answer 8

b) Caudate lobe

Question 9

What landmark attaches to the beginning (cap) of the duodenum? What attaches to the end? Hint: 2 ligaments

Answer 9

Beginning: Hepatoduodenal ligament
End: Ligament of Treitz

Question 10

Plicae circulares are most concentrated where?

a) Proximal jejunum
b) Distal jejunum
c) Proximal ileum
d) Distal ileum
e) Small intestine throughout

Answer 10

a) Proximal jejunum

Question 11

Highest # of arcades are found?
Longer vasa recta are found?
a) Proximal jejunum
b) Distal jejunum
c) Proximal ileum 
d) Distal ileum
e) Small intestine throughout

Answer 11

Highest # of arcades are found? Distal ileum

Longer vasa recta are found? Proximal jejunum

Question 12

Baby has symptoms of bilious vomiting. Explain the pathology.

Answer 12

1) Superior mesentery syndrome = compression of 3rd part of duodenum => dilate 1st and 2nd part + bile backup into vomit
** SMA can also compress renal vein **
2) Annular pancreas
X-ray: pancreas wraps around 2nd part of duodenum