Practice Quiz - Duodenum, Pancreas, Liver, & Gallbladder
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  1. Which organ becomes retroperitoneal during rotation of the gut tube?
    Duodenum
    Kidney
    Spleen
    Stomach
    Transverse Colon
  2. A 40 year-old male with a long history of duodenal ulcer problems was brought in for emergency surgery to control severe hemorrhage into the peritoneal cavity. The surgeons found that erosion by the ulcer of a vessel passing behind the first part of the duodenum was the source of the hemorrhage. Which of the following vessels passes behind the first part of the duodenum and would need to be clamped off to control the bleeding?
    coronary vein
    gastroduodenal artery
    inferior pancreatoduodenal arcade
    proper hepatic artery
    splenic vein
  3. During a cholecystectomy (removal of the gall bladder), the surgical resident accidentally jabbed a sharp instrument into the area immediately posterior to the epiploic foramen (its posterior boundary). He was horrified to see the surgical field immediately fill with blood, the source which he knew was the:
    aorta
    inferior vena cava
    portal vein
    right renal artery
    superior mesenteric vein
  4. The division between the true right and left lobes (internal lobes) of the liver may be visualized on the outside of the liver as a plane passing through the:
    gallbladder fossa and round ligament of liver
    falciform ligament and ligamentum venosum
    gallbladder fossa and inferior vena cava
    falciform ligament and right hepatic vein
    gallbladder fossa and right triangular ligament
  5. Orally ingested contrast medium opacifies all of the following structures except the:
    colon
    duodenum
    esophagus
    gall bladder
    stomach
  6. To stop hemorrhaging from a ruptured spleen, it was necessary to temporarily ligate the splenic artery near the celiac trunk. The blood supply to which structure is least likely to be affected by the ligation?
    Duodenum
    Greater omentum
    Body of pancreas
    Tail of pancreas
    Stomach
  7. A 50-year-old female patient with severe jaundice was diagnosed with pancreatic cancer. You suspect that the tumor is located in which portion of the pancreas?
    Head
    Neck
    Body
    Tail
    Uncinate process
  8. A patient was admitted with symptoms of bowel obstruction. Further examination revealed that the obstruction was caused by the nutcracker-like compression of the bowel between the superior mesenteric artery and the aorta. The compressed bowel is most likely the:
    Duodenum
    Jejunum
    Ileum
    Ascending colon
    Transverse colon
  9. A medical student was asked to identify a small specimen taken for pathological examination from a surgically removed duodenum. The student noted that the specimen revealed a thin wall and no circular folds. The specimen is from which segment?
    Superior
    Descending
    Horizontal
    Ascending
  10. You are observing a laparoscopic cholecystectomy. The surgeon states that he is next going to expose the cystic artery in order to staple across it. He asks you where he should look for it. You reply, "In the triangle of Calot." What stuctures form this triangle and are the keys to finding the artery?
    Common hepatic duct, liver and cystic duct
    Cystic duct, right hepatic artery and right hepatic duct
    Gall bladder, liver and common bile duct
    Left hepatic duct, liver and cystic duct
    Right branch of portal vein, liver and common bile duct
  11. Upon endoscopic examination of a 65-year-old man who had a history of a chronic duodenal ulcer, it was found that the ulcer had been eroding the posterior wall of the first part of the duodenum. If erosion perforates the wall, the gastric expellant of high acidity would endanger the structures in its vicinity. Which is least likely to be endangered?
    Common bile duct
    Gastroduodenal artery
    Main pancreatic duct
    Portal vein
  12. A 58-year-old patient was diagnosed with a severe case of portal hypertension due to alcoholic cirrhosis of the liver. It was determined that a bypass between the vessels of the portal and caval systems was necessary. The plan most likely to be successful is:
    Coronary vein to right gastro-omental vein
    Left colic vein to sigmoidal vein
    Inferior mesenteric vein to splenic vein
    Splenic vein to left renal vein
    Superior rectal vein to inferior rectal vein
  13. A radiological examination of a patient revealed a large tumor in the quadrate lobe of the liver. During the surgical removal of the tumor, one of the vessels that needs to be clamped to effectively control bleeding is the:
    Left hepatic artery
    Right hepatic artery
  14. A patient was admitted with symptoms of an upper bowel obstruction. Upon CT examination, it was found that the third (transverse) portion of the duodenum was compressed by a large vessel causing the obstruction. The vessel involved is most likely to be the:
    inferior mesenteric artery
    superior mesenteric artery
    inferior mesenteric vein
    portal vein
    splenic vein
  15. An ulcer near the pyloroduodenal junction perforated and eroded a large artery immediately posterior to the duodenum. The ligation of the eroded vessel at its origin would LEAST affect the arterial supply to the:
    First part of the duodenum
    Second part of the duodenum
    Greater curvature of the stomach
    Head of the pancreas
    Tail of the pancreas
  16. A patient was diagnosed with pancreatitis due to a reflux of bile into the pancreatic duct caused by a gallstone. The stone is likely to be lodged at the:
    Common bile duct
    Common hepatic duct
    Cystic duct
    Hepatopancreatic ampulla
  17. The blockage of a main bile duct in the quadrate lobe will likely cause reduced flow of bile secretion in the:
    Left hepatic duct
    Right hepatic duct
  18. Regarding the 2nd portion of the duodenum, all are correct EXCEPT:
    It is crossed by the transverse colon.
    It is thin walled and circular folds are absent in its interior.
    It has the opening for the common bile duct and pancreatic duct on its posteromedial wall.
    It is secondarily retroperitoneal.
    It is supplied by both the gastroduodenal and superior mesenteric arteries.
  19. A Kocher manuever dissects in the avascular plane behind which organ that becomes retroperitoneal during rotation of the gut?
    Duodenum
    Kidney
    Spleen
    Suprarenal gland
    Transverse colon
  20. The inferior mesenteric vein usually joins which vein?
    Inferior vena cava
    Left renal
    Portal
    Splenic
    Superior mesenteric
  21. A surgeon needs to construct a bypass between the veins of the portal and caval systems to circumvent insufficient drainage through the natural portacaval anastomoses. Which plan is likely to be successful?
    Coronary vein to right gastroepiploic vein
    Inferior mesenteric vein to splenic vein
    Left colic vein to middle colic vein
    Splenic vein to left renal vein
    Superior mesenteric vein to splenic vein
  22. A patient with jaundice was diagnosed with cancer of the head of the pancreas. Which structure was compressed by the tumor?
    Common bile duct
    Common hepatic duct
    Cystic duct
    Left hepatic duct
    Right hepatic duct
  23. The structure that traverses the space between the aorta and first part of the superior mesenteric artery and is vulnerable to the nutcracker-like compression by these two vessels is the:
    Duodenum
    Jejunum
    Pancreas
    Splenic vein
    Transverse colon
  24. A 60-year-old patient who has had a chronic ulcer of the duodenum for many years was admitted to the hospital with signs of a severe internal hemorrhage. The ulcer perforated the posterior wall of the first portion of the duodenum and eroded an artery in that position. The damaged artery was:
    Cystic
    Gastroduodenal
    Hepatic
    Left gastric