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Anatomy 2

The document presents a series of clinical scenarios involving patients with abdominal issues, focusing on the anatomical relationships of various structures in the pancreas and surrounding areas. Each scenario includes multiple-choice questions regarding which structures are likely to be affected by tumors or injuries. The questions cover topics such as vascular compression, organ blood supply, and anatomical constrictions in the esophagus.

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Mustafa Abdullah
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9 views5 pages

Anatomy 2

The document presents a series of clinical scenarios involving patients with abdominal issues, focusing on the anatomical relationships of various structures in the pancreas and surrounding areas. Each scenario includes multiple-choice questions regarding which structures are likely to be affected by tumors or injuries. The questions cover topics such as vascular compression, organ blood supply, and anatomical constrictions in the esophagus.

Uploaded by

Mustafa Abdullah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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TBL

Multiple Choice Question

A 54-year-old man comes to a hospita lwith abdominal pain, jaundice, loss


of appetite ,and weight loss. On examination of his radiograms and CT
scans, a physician finds a slowly growing tumor in the uncinate
process of the pancreas. Which of the following structures is most likely
compressed by this tumor?
(A) Main pancreatic duct
(B) Splenic artery
(C) Portal vein
(D) Superior mesenteric artery
(E) Superior pancreaticoduodenal artery
A 43-year-old woman is admitted to a hospital because of deep abdominal
pain in her epigastric region. On examination, it is observed that a
retroperitoneal infection erodes an artery that runs along the superior
border of the pancreas. Which of the following arteries is likely injured?
(A) Right gastric artery
(B) Left gastroepiploic artery
(C) Splenic artery
(D) Gastroduodenal artery
(E) Dorsal pancreatic artery

A 58-year-old man is admitted to a hospital with severe abdominal pain,


nausea, and vomiting resulting in dehydration Emergency CT scan reveals
a tumor located between the celiac trunk and the superior mesenteric
artery. Which of the following structures is likely compressed by this
tumor?
(A) Fundus of the stomach
(B) Neck of the pancreas
(C) Transverse colon
(D) Hepatopancreatic ampulla
(E) Duodenojejunal junction
A radiograph of a 32-year-old woman reveals a perforation in the posterior
wall of the stomach in which the gastric contents have spilled into the
lesser sac. The general surgeon has opened the lienogastric (gastrosplenic)
ligament to reach the lesser sac and notes erosion of the ulcer into an
artery. Which of the following vessels is most likely involved?
(A) Splenic artery
(B) Gastroduodenal artery
(C) Left gastric artery
(D) Right gastric artery
(E) Left gastroepiploic artery

A 48-year-old man is admitted to the hospital with severe abdominal pain.


Radiologic examination reveals a tumor in the tail of the pancreas. A
diagnostic arteriogram shows that the tumor has compromised the blood
supply to another organ. Which of the following organs is most likely to
have its blood supply compromised by this tumor?
A. Duodenum
B. Gallbladder
C. Kidney
D. Liver
E. Spleen

A 16-year-old boy with a ruptured spleen comes to the emergency


department for splenectomy. Soon after ligation of the splenic artery just
distal to its origin, a surgical resident observes that the patient is healing
normally. Normal blood flow would occur in which of the following
arteries?
(A) Short gastric arteries
(B) Dorsal pancreatic artery
(C) Inferior pancreaticoduodenal artery
(D) Left gastroepiploic artery
(E) Artery in the lienorenal ligament

A 45-year-old woman is admitted to the emergency department with a


complaint of severe abdominal pain. CT scan and MRI examinations
reveal a tumor of the head of the pancreas involving the uncinate process.
Which of the following vessels is most likely to be occluded?
A. Common hepatic artery
B. Cystic artery and vein
C. Superior mesenteric artery
D. Inferior mesenteric artery
E. Portal vein

A 42-year-old woman is admitted to the hospital after a traumatic landing


while skydiving. Radiographic examination reveals a ruptured spleen. An
emergency splenectomy is performed. Which of the following peritoneal
structures must be carefully manipulated to prevent intraperitoneal
bleeding?
A. Coronary ligament
B. Gastrocolic ligament
C. Splenorenal ligament
D. Phrenocolic ligament
E. Falciform ligament

A major vessel appears to be nearly occluded in a 42-year-old male patient


diagnosed with ductular adenocarcinoma. A CT scan examination has
clearly demonstrated the tumor is at the neck of the pancreas.
Which of the following vessels would be the most likely to be obstructed?
A. Inferior mesenteric vein
B. Portal vein
C. Celiac trunk
D. Posterior superior pancreaticoduodenal artery
E. Greater pancreatic artery

A 10-year-old boy is imaged following an injury while camping. A


laceration of the body of the pancreas is seen with hemorrhage around the
vessel traveling along the superior border of the pancreas. Which vessel is
this?
A. Superior mesenteric artery
B. Portal vein
C. Left gastric artery
D. Splenic artery
E. Left gastro-omental artery

A 52-year-old man with a long history of alcoholic cirrhosis complained of


severe dysphagia and retrosternal “burning” pain. During esophagoscopy,
the endoscopist advanced the endoscope until its tip reached the
esophageal hiatus of the diaphragm. At which of the following vertebral
levels did the tip of the endoscope most likely end?
A. T7
B. T8
C. T10
D. T11
E. T12

A 49-year-old man presents with acute abdominal pain and jaundice


resulting from a tumor at the head of the pancreas. The tumor will most
likely obstruct which of the following structures?
A. Bile duct
B. Common hepatic duct
C. Left hepatic duct
D. Cystic duct
E. Right hepatic duct

A 35-year-old female who was brought into the emergency department for
a drug overdose require insertion of a nasogastric tube and administration
of activated charcoal. What are the three sites in the esophagus where one
should anticipate resistance due to compression on the organ?
A. A t the aortic arch, the cricopharyngeal constriction,
and the diaphragmatic constriction
B. T he cardiac constriction, the cricoid cartilage
constriction, and the thoracic duct
C. T he pulmonary constriction, cricothyroid constriction,
and the azygos arch
D. T he cardiac constriction, the azygos arch, the
pulmonary trunk
E. T he cricopharyngeal constriction, cricothyroid
constriction, thymus gland

32-year-old female is admitted to the hospital in a comatose state. Physical


examination reveals that the patient suffers from anorexia nervosa. A
nasogastric tube is ordered to be inserted. What is the last site at which
resistance would be expected as the tube passes from the nose to the
stomach?
A. Pharyngoesophageal junction
B. Level of the superior thoracic aperture
C. Posterior to the aortic arch
D. Posterior to the left main bronchus
E. Esophageal hiatus of the diaphragm

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