GI Anatomy Lecture Exam 2024 PDF

OS 206: Human body and mind 5 Exam 1 |GI Anatomy February 25, 2024 B. Hepatic acinus REMINDERS...

OS 206: Human body and mind 5 Exam 1 |GI Anatomy February 25, 2024 B. Hepatic acinus REMINDERS C. Portal lobule This GCash was only based on the memory of participating D. Portal triad students, so some questions may be incomplete or paraphrased. Blind memorization of GCash is highly discouraged. This is only meant to give you an idea of the nature and type of questions that may appear in future exams. This should NOT replace actually studying the lecture materials. DO NOT SHARE OR REPRODUCE THIS DOCUMENT IN ANY WAY OUTSIDE OF THE GCASH SYSTEM. Failure to do so will result in permanent eviction from the system. HOW TO USE GCASH Answer the unanswered GCash first. Check your answers through the consolidated answer key. For a more thorough explanation of the answers, go through the detailed answer key at the last page of the GCash. → IMPORTANT: If feedback was not given for a particular exam, please note that the indicated answers and 5. What does the pointed structure do? explanations are only based on the judgment and A. Decrease in hemoglobin for bile production knowledge of the GCash system and may be incorrect. B. Increase in surface area for bile absorption C. Facilitates contraction of gallbladder and secretion of bile EXAM DETAILS D. Allows peristalsis for movement of ingested materials across the Number of Items: GI tract Time: Lecturers: 6. Which structure is not found in the specimen below: Feedback: Given/NOT given QUESTIONS Important reminders Do NOT boldface the correct answers in this part Ensure that questions and options do NOT get cut off the next column or page TOPIC 1 TITLE 1. A 15 y/o male comes to the clinic due to abdominal discomfort. On physical examination, he was noted to have yellowish discoloration of the sclera and skin. After a series of tests, he was found to have hepatitis A. Which of the following functions of the liver is affected by A. Striated duct his condition? B. Intercalated duct A. Modification of structure and function of many hormones C. Serous acinus B. Bilirubin metabolism D. Excretory duct C. Degradation of drugs, toxins, and other proteins foreign to the body 7. Once the saliva reached the excretory duct, which of the following will be D. Storage of glucose as glycogen its expected composition: A. Low sodium, high potassium 2. Which of the following are pale staining cells located in the acinus B. High sodium, low potassium and continuous with the intercalated duct of the exocrine pancreas? C. More mucousy than watery A. Serous demilune D. Contains lipase, amylase, carboxypeptidase B. Ito cell C. Centroacinar cell 8. The dark staining cells found in the hepatic sinusoids with intracellular D. Paneth cell debris are known as? A. Ito cells B. Mall cells 3. Which is responsible for the formation of bile? C. Kupffer cells A. Sinusoidal epithelium D. Hemapoeitic cells B. Ito cell C. Kupffer cell 9. Which of the following cells have multiple spindle-shaped with D. Hepatocyte contractile properties that empty the contents of the acinus? A. Submandibular cells 4. Which arrangement of the liver is based on the degree of oxygenation a B. Mucous cells specific area receives? C. Serous demilunes A. Classical lobule E0# TG# 1 of 25  D. Myoepithelial cell 10. Which of the following are features of the gallbladder? 19. You are a doctor to the barrios, and a patient presented with pain in A. The mucosa is lined by tall simple columnar epithelium the right lower quadrant. You diagnosed it as acute appendicitis and B. The muscular mucosa is notably absent decided to operate on the patient. Upon closing the surgical site, C. It has numerous deep mucosal folds called Rokitansky-Aschoff which layer will you not encounter? sinuses A. Internal oblique D. All of the above B. External oblique C. Anterior rectus sheath 11. Patient RRV was brought to PGH due to a vehicular accident. The D. Posterior rectus sheath attending physician noted that he has no sensation in his clavicle and he is unable to flex his elbow. As part of the emergency team, what is 20. The thoracoabdominal nerves can be found in between which the most life threatening situation that you should look out for? muscles? A. Altered sensorium A. Internal oblique and external oblique B. Low blood pressure (hypotension) B. Transversus abdominis and internal oblique C. Hyperglycemia C. Rectus abdominis and external oblique D. Respiratory arrest D. Internal oblique and transversalis fascia 21. A 23-year old man was sent to the emergency room following a car 12. If a mass is found along the diaphragmatic hiatus at the spinal level crash. During the crash, he was wearing his seatbelt. CT scans of T10, which of the following will most likely the patient will present? showed that he had a retroperitoneal hematoma. Injury to which of the A. Problem in swallowing following organs is the LEAST LIKELY source of bleeding? B. Hypertension A. Kidney C. Low heart rate B. Duodenum D. Tachycardia C. Liver D. Pancreas 13. What is the surface of the liver superior to the foramen of Winslow? A. Right lobe 22. A 53 year-old male was diagnosed with a duodenal mass on B. Caudate lobe endoscopy. If the initial symptom of the patient was jaundice, in which C. Quadrate lobe segment of the duodenum was the mass likely located? D. Left Lobe A. Superior B. Descending 14. What is the direction of internal oblique muscle? C. Inferior A. Inferomedial D. Ascending B. Superomedial C. Horizontal 23. A 35-yr old female complained of epigastric pain after meals. D. Vertical Diagnosed with peptic ulcer, which segment of the duodenum is most likely affected? 15. A surgeon wanted to drain blood from the femoral vein, but he A. Superior punctured/damaged the femoral artery instead. What structure is most B. Descending likely affected? C. Inferior A. Deep circumflex D. Ascending B. Inferior epigastric C. Subcostal 24. A mass that erodes the anterior wall of the 3rd segment of the D. Superior epigastric duodenum may encroach upon which vessels? A. Aorta and IVC 16. During your LU7 days, you remember when you enjoyed yourself B. Celiac trunk and portal vein the previous night and arrived late in the operating room the next day C. Inferior mesenteric artery and vein to assist a surgical resident. Giving you the silent treatment, the D. Superior mesenteric artery and vein resident did not brief you on the case. You noticed that the area being operated on is the groin. You also heard from the nurse that the patient 25. Duodenal atresia in radiographic imaging is seen as: had a “luslos”. The small bowel of the patient had protruded from the A. Apple core sign abdomen lateral to major vessels that the resident was careful not to B. Double bubble sign injure. Because you studied OS 206 well during LU3, you know that the C. Seagull sign patient had a case of: D. Rovsing sign A. Direct hernia B. Indirect hernia 26. Ligation of what artery LEAST LIKELY leads to infarction of pancreas: 17. What structure divides the abdominal cavity into a supracolic and A. Celiac Trunk infracolic region? B. Inferior Mesenteric Artery A. Omentum C. Splenic Artery B. Transverse Mesocolon D. Superior Mesenteric Artery C. Epiploic Foramen D. Hepatoduodenal Ligament 27. A 59-year-old male with jaundice has a pancreatic mass on imaging. In which part of the pancreas is the mass most likely located? 18. The conjoint tendon is formed by the aponeurosis of the transversus abdominis and what other muscle? A. Head A. Internal Oblique B. Neck B. Transversalis C. Tail C. External Oblique D. Body D. Rectus Abdominis Course Code Title of Exam 2 of 25  37. Proximal part 28. The possibility of injury to the pancreas should be considered in 38. Middle part patients with traumatic fractures involving which vertebrae? 39. Retroduodenal part A. Right hepatic artery A. 10-11 B. Cystic artery B. L1-L2 C. Posterior superior pancreaticoduodenal artery C. L2-L3 D. S2-S3 40. Which part of the stomach lies posterior to the left 6th rib in the MCL? 29. [reworded] If you were to investigate and probe the major duodenal A. Cardia papilla, what pancreatic duct would you cannulate? B. Fundus A. Rotor C. Body B. Vater D. Pylorus C. Santorini D. Wirsung 41. Which of the following are rudimentary in humans? A. Filiform papillae 30. Thrombosis or blockage/narrowing of the portal vein would lead to B. Foliate papillae the enlargement of which organ? C. Fungiform papillae A. Small intestine D. Circumvallate papillae B. Spleen C. Liver 42. What specific layer in the gastrointestinal tract can you see dense D. Kidney or loose connective tissue, nerve plexus, and in some segments, glands? 31. RVV 42/F was stabbed on the right side, along the 9th rib while A. Mucosa walking along Pedro Gil. All of the following structures are affected B. Serosa EXCEPT: C. Muscularis externa A. Caudate lobe D. Submucosa B. Right lobe of the liver C. Right kidney 43. Which of the following is characterized by a stratified squamous D. Gallbladder epithelium? A. Esophagus 32. 65/M was brought to the ER because of severe abdominal pain, B. Stomach specifically in the RUQ and epigastric area. Upon examination, the C. Ileum patient has fever and jaundice. Two months prior, the patient was D. Colon diagnosed and treated for gallstones. A. Gallbladder stone obstruction in the bile duct 44. Which of the following is characterized with simple columnar B. Gallbladder stone obstruction in the cystic duct epithelium abundant in goblet cells? C. Gallbladder was inflamed A. Esophagus B. Stomach 33. A 72/M was admitted to the hospital due to hematemesis. On C. Ileum physical examination, an engorged blood vessel on his abdomen was D. Colon noted. What is this condition? A. Cholelithiasis 45. Which of the following is characterized by an inner oblique muscle B. Choledocholithiasis layer? C. Portal hypertension A. Duodenum D. Perforated gastric ulcer B. Esophagus C. Stomach 34. Which part of the stomach lies posterior to the left 6th rib in the D. Colon MCL? A. Cardia 46. Brunner glands are a characteristic of which of the following? B. Fundus A. Duodenum C. Body B. Esophagus D. Pylorus C. Stomach D. Colon 35. Bile can easily be diverted into the gallbladder when the distal end of the bile duct is closed by the hepatopancreatic sphincter because 47. In Hirschsprung's disease, the ganglion cells of the large intestine of: fail to develop, especially the Auerbach plexus. The expected clinical A. The spiral valve helps keep the cystic duct closed presentation of this patient is: B. The spiral valve helps keep the cystic duct open A. Bright red blood in stool C. The spiral valve helps keep the hepatopancreatic duct open B. Constipation D. The spiral valve helps keep the cystic duct closed C. Diarrhea and Flatulence D. Intestinal malabsorption 36. Parasympathetic stimulation causes which of the following: A. Contraction of the gallbladder 48. Patient who undergoes gastrectomy or removal of the whole B. Constriction of the hepatopancreatic ampulla stomach because of cancer must be given which of the following C. AOTA vitamin supplements? D. NOTA A. Cobalamin B. Riboflavin For numbers 37-39, match the blood supply of the cystic duct: C. Pyridoxine Course Code Title of Exam 3 of 25  D. Thiamine 58. Cecile is 38 weeks pregnant and is about to deliver vaginally. There was no anesthesiologist available so her OB offered her a pudendal 49. Secretion of hydrochloric acid is a function of which cell? block. What should Cecile expect? A. Chief Cell A. She will feel numb and will not feel contractions B. Paneth Cell B. Her contractions will not be affected C. Enteroendocrine Cell C. Her contractions will be reduced D. Parietal Cell D. She will still feel contractions but her perineum will feel numb 50. This cell is found at the base of intestinal crypts and are 59. Obstetrician on duty asked you to assist in giving a pudendal characterized by eosinophilic granules, which have a protective block. Once you have palpated the ischial spine, you should move: function. A. 1 cm inferior and lateral A. Chief Cell B. 1 cm inferior and medial B. Enteroendocrine Cell C. 1 cm superior and medial C. Paneth Cell D. 1 cm superior and lateral D. Parietal Cell 60. Pelvic floor muscle that forms the lateral wall of the pelvis and is an 51. You are at duty in the ER and there is a patient that comes in with a external rotator of the thigh? motor vehicular accident. Upon examination, it was discovered that the A. Coccygeus patient has a traumatic injury piercing through the greater sciatic B. Obturator internus foramen. What structures may be damaged? C. Piriformis A. Superior gluteal, inferior gluteal, internal pudendal arteries D. Iliococcygeus B. Obturator nerve, pudendal nerve, inferior gluteal arteries C. Superior gluteal, obturator, internal pudendal arteries 61. Which branch of the internal iliac artery passes posteriorly through D. Popliteal nerve, anterior gluteal, external pudendal arteries the lumbosacral trunk and S1? A. Iliolumbar 52. Gemma underwent pelvic surgery for an ovarian malignancy. After B. Inferior gluteal the procedure, she complained of numbness on the medial aspect of C. Lateral sacral the thigh. Damage to which nerve may have caused this? D. Superior gluteal A. Inferior gluteal nerve B. Obturator nerve 62. Which artery passes between S2 and S3? C. Pudendal nerve A. Iliolumbar D. Femoral nerve B. Inferior gluteal C. Lateral sacral 53. The measurement between the superior pubic symphysis and the D. Superior gluteal sacral promontory is which of the following? A. Bi-ischial diameter 63. Jessa came to your clinic complaining of severe vulvular pain. After B. Diagonal conjugate performing the physical exam you observed a 2cm carbuncle on her C. True conjugate right vulva. Which of the group of nodes would you expect to be tender D. Bituberous diameter and swollen? A. Inguinal nodes 54. Which of the following is the only anteroposterior plane in the B. Sacral nodes pelvic inlet that can be measured clinically during a pelvic C. Pudendal nodes examination? D. External Iliac nodes A. Obstetric conjugate B. Diagonal conjugate 64. Which of the following does the right ovarian vein drain into? C. True conjugate A. External Iliac vein D. Bispinous diameter B. Internal Iliac vein C. Right renal vein 55. Part of the Visceral Pelvic Fascia that functions as the major D. IVC support to the uterus? A. Uterosacral Ligament 65. A 25 year old female complained of severe pain in the hypogastric B. Mackenrodt ligament region. Upon probing, it was noted that she has her menstruation. C. Broad Ligament What layer is responsible for the pain? D. Round Ligament A. Perimetrium B. Endometrium 56. The Distance of which structures is the smallest dimension in the C. Myometrium pelvis D. AOTA A. Ischial Tuberosity B. Symphysis Pubis 66. What layer is sloughed off during menstruation? C. Sacral Promontory A. Perimetrium D. Ischial Spine B. Endometrium C. Myometrium 57. Assessment of pelvic outlet involves the identification of which D. AOTA landmark? A. Ischial tuberosities 67. Maturation of sperm happens in which structure? B. Sacral promontory A. Seminiferous tubules C. Symphysis pubis B. Vas deferens D. Ischial spines C. Epididymis D. Testes Course Code Title of Exam 4 of 25  78. Removing a growth from the posterior portion of the labia minora, a 68. The duct each seminal vesicle along with the vas deferens combine physician must anesthetize a branch from which of the following in the prostate to form what structures? A. Ejaculatory duct A. Genitofemoral B. Seminal vesicle B. Pudendal C. Prostatic urethra C. Pelvic splanchnic D. Membranous urethra D. Vagus 69. Which among the following is NOT a function of the seminal 79. An obstetrician does a median episiotomy. While doing so, the glands? perineal body was cut. What structures are most likely affected? A. Neutralize acidic urine A. Bulbospongiosus and transverse perineal B. Lubricate the distal urethra B. Internal urethral sphincter and external anal sphincter C. Helps in preparing for the passage of sperm C. Vaginal mucosa and transverse perineal D. Helps in sperm transport D. External anal sphincter and obturator internus 70. The following are accessory glands of the male reproductive 80. Which of the following does not pass throughout the pelvic system except? diaphragm or urogenital diaphragm? A. Testes A. Vagina B. Bulbourethral B. Penile urethra C. Prostate C. Anal Canal D. Cowper’s Glands D. Uterus 71. Prostatic secretions do not join the seminal fluid until the 81. True of the external anal sphincter ejaculatory duct terminates at the prostatic urethra. A. Thickening of muscle A. TRUE B. It is innervated by the inferior rectal nerve B. FALSE C. It surrounds the upper 2/3 of the anal canal D. It is an involuntary sphincter 72. The spermatic cord arise from the following except: A. Tranversus abdominis 82. Which of the following is true about the radiological anatomy of the B. Transversalis fascia stomach? C. Internal oblique A. The cardia receives the esophagus via the gastroesophageal D. External oblique junction B. The body is the main central region which contains parietal 73. Which of the following is supplied by the perineal branch of the cells that functions for secretion of gastric acid pudendal nerve? C. The pylorus-antrum is the lower section of the stomach that A. External anal sphincter facilitates emptying of the stomach into the small intestine, B. Internal anal sphincter located on the right of the midline at the level of L1 C. Labia minora D. All of the above D. Clitoris 83. Which of the following is NOT TRUE about radiologic anatomy of 74. Which association is correct? the liver? A. Glans penis : Corpus spongiosum A. Segment 1 is the caudate lobe that extends between the B. Bulb : Corpus cavernosa ligamentum venosum and IVC. C. Membranous urethra : Superficial perineal space B. 2/3 of the liver's blood supply comes from the portal vein D. Pudendal cleft : Labia minora while 1/3 comes from hepatic artery. C. The (R) hepatic vein separates the anterior (segment 5 and 8) 75. TRUE of the deep perineal space: from the posterior segment (6 & 7) Couinaud segments. E. It is the membranous layer of the peritoneum D. The left portal vein divides the liver into medial and lateral F. It is continuous with Scarpa’s fascia in the lower abdominal segments. wall G. It is attached to the tensor fascia lata 84. The common bile duct drains into which of the following H. It is invested with the superficial perineal muscles structures? A. 2nd portion of the duodenum 76. A male swimmer hit his groin with a diving board. This caused a B. 3rd portion of the duodenum rupture in his penile urethra. Where would blood and urine possibly C. 1st portion of the duodenum accumulate? D. Gallbladder I. Paravesical fossa J. Lower abdominal wall 85. Which of the following is true of radiologic examination of pancreas K. Deep perineal pouch true? L. Lateral thigh A. The head of the pancreas is enveloped by the 3rd segment of the duodenum forming the D-loop 77. You are examining a young boy brought to the ER with bleeding B. The pancreatic neck, body, and tail are ventral to the splenic from his penis. The blood primary branches from which of the arteries vein C. The pancreas has no anatomical relation to the splenic artery A. Superior gluteal D. The head is in front of the left kidney B. Internal pudendal C. External pudendal 86. Which of the following is true of radiologic examination of the D. Femoral jejunum? A. The diameter of the jejunum is normally less than 3.0cm Course Code Title of Exam 5 of 25  B. There are prominent valvulae conniventes and feather-like 92. The transverse colon can be used to replace a diseased folds in the mucosa esophagus after ingestion of corrosive material. But this is only C. It is 2/5ths the length of the entire small intestine possible with a very patent Marginal Artery of Drummond. This artery D. All of the above are true can be based on this vascular pedicle: A. Ilioiliac artery B. Middle colic artery 87. Which of the following is not true about the colon. C. Meandering artery of Moskowitz A. Not less than 6 cm in radiographic imaging D. Left colic artery B. Splenic flexure is a bend between the transverse and the E. Arc of Riolan descending colon C. The nerves in the S2-S4 region plays an important role in the 93. Which divides the greater sac to supracolic and infracolic innervation of muscles in the colon compartments? A. Transverse Mesocolon 88. What is not included in the acute abdominal series radiograph? B. Gastrocolic Ligament A. Supine C. Greater Omentum B. Right lateral decubitus D. Lesser Omentum C. Upright D. Prone 94. The clinical presentation of the condition shown in the image includes lower GI hemorrhage, abdominal pain, and nausea. It is also 89. Which of the following is TRUE about normal bowel gas characterized to be approximately 2 inches in length and may also pattern? present with bleeding. What is the pathophysiology of this condition? A. Large bowel gas is often always present in the rectum and sigmoid B. Around 2-3 loops of non-distended small bowel loops are seen on a normal abdominal radiograph C. Stomach demonstrates air-filled level on upright radiographs D. All of the statements are true 90. In a patient with a “closed” esophagus as a result of corrosive ingestion, oral feeding becomes a problem. To surgically correct this, the transverse colon is usually used to replace the diseased esophagus. To be able to do this, the marginal arteries have to be A. Patency of the vitellointestinal duct patent and this artery serving as its main vascular pedicle. B. Incomplete transection of the omphalomesenteric duct C. Persistence of the vitelline duct A. Right colic artery D. Weakness of the abdominal muscles in the area B. Ileocolic artery C. Arc of Riolan 95. Refer to the image below. What is the second site of perforation if D. Middle colic artery the obstruction is at the area pointed by the red arrow? E. Superior mesenteric artery 91. The image below shows the “bent inner tube sign” of volvulus and is an urgent surgical problem that needs to be addressed immediately. This condition is due to the twisting of a segment of the colon on itself. Which of the following gives rise to this condition? A. A B. B C. C D. D A. Redundant colon with wide mesentery 96. You are a resident assisting a colorectal fellow in a rectal surgery. B. Redundant colon with narrow mesentery While the fellow was mobilizing the rectum, you noticed that blood was C. Long segment of colon with long mesentery flooding the operative field fast. What did the fellow remove? D. Long segment of colon with short mesentery A. Waldeyer’s fascia E. All of the above conditions can give rise to volvulus B. Denonvillier’s fascia C. Rectosigmoid fascia Course Code Title of Exam 6 of 25  D. Lateral stalk 103. In the process of developing the primordial gut the following processes are included. Which of these is the last step? 97. In an Axial MRI, the v-shaped seagull sign represents what A. Retraction and return of gut structure that is usually found 11 cm from the anal verge? B. Elongation of gut tube A. Rectosigmoid junction C. Counterclockwise rotation B. Anterior peritoneal reflection D. Descent of cecum C. Lateral ligament E. Fixation to the posterior abdominal wall D. Parietal Pelvic Fascia E. Presacral fascia 104. The normal length of the small intestine is about 3-5 meters. A short bowel syndrome will occur if there is a loss of ___ of the total 98. We normally squat when we move our bowel, this position aids in length of the small intestine. the defecation process. What anatomical change happens with this A. 1/4 position and what promotes the defecation process? B. 1/3 A. The anorectal angle becomes wider C. 1/2 B. The abdominal wall becomes compressed against the hips D. 2/3 C. The puborectalis muscle contracts more E. 3/4 D. Intraabdominal pressure increases E. The external sphincter relaxes 105. When dancing the swing, the posterior abdominal wall muscles used for lateral flexion and extension of the lumbar spine; hip flexion; 99. The most important muscle which maintains our fecal continence: and lateral rotation and stabilization of the spine and pelvis are: A. Superficial external anal sphincter A. Psoas B. Deep external anal sphincter B. Iliacus C. Internal anal sphincter C. Quadratus Lumborum D. Puborectalis D. Iliopsoas and Quadratus Lumborum E. Pubococcygeus E. C only 100. After a successful rectal cancer surgery, the patient observed that 106. Which of the following is not a collateral circulation of the inferior whenever he feels the urge to move his bowel, he finds it difficult to vena cava if it is cut infrarenal/below the kidneys? keep his stool from coming out before he reaches the toilet. What may A. Superior and inferior mesenteric veins have been injured during the procedure? B. Thoracoepigastric and superficial epigastric veins A. Lumbosacral trunk C. Ascending lumbar veins B. Hypogastric nerves D. Azygous and hemi-azygous vein C. Sympathetic trunk D. Puborectalis muscle 107. Blunt trauma towards areas in the retroperitoneum may not E. Nervi reigentes require exploration or surgery except if trauma is in which zone? A. Centromedial 101. This fluid collection is not usually seen in the retroperitoneal B. Lateral space: C. Pelvic D. Perirenal A. Enteric E. Pararenal B. Hemorrhagic C. Biliary 108. Most common location of retroperitoneal hemorrhage: D. Urinary A. Zone 1 E. Gastric B. Zone 2 C. Zone 3 102. What is the basic pathology of this: D. Zone 4 109. A suspected retroperitoneal hemorrhage following a blunt abdominal trauma. What is the digital imaging of choice? A. Ultrasound B. CT C. MRI D. Plain abdominal x ray 110. Posterior abdominal hernia just above the iliac crest. A. Petit Triangle B. Grynfeltt-Lesshaft Triangle C. Superior Lumbar D. Inferior Lumbar E. A&D F. B&C CONSOLIDATED ANSWER KEY A. Lymphatic hyperplasia 1 B 21 C 41 B 61 C 81 B B. Obstruction in the lumen of the structure involved C. Dependent position in relation to terminal ileum and cecum 2 C 22 B 42 D 62 B 82 D D. Idiopathic or unknown Course Code Title of Exam 7 of 25 3 D 23 A 43 A 63 A 83 C 4 B 24 D 44 D 64 D 84 A 5 C 25 B 45 C 65 C 85 B 6 B 26 B 46 A 66 B 86 B 7 A 27 A 47 B 67 C 87 A 8 C 28 C 48 A 68 A 88 B 9 D 29 D 49 D 69 A 89 D 10 D 30 B 50 A 70 A 90 D 11 A 31 C 51 B 71 A 91 B 12 B 32 A 52 B 72 A 92 B 13 B 33 C 53 C 73 C 93 A 14 B 34 B 54 B 74 A 94 C 15 A 35 E 55 B 75 B 95 B 16 B 36 A 56 D 76 C 96 A 17 B 37 B 57 A 77 B 97 B 18 A 38 A 58 D 78 B 98 A 19 D 39 C 59 B 79 C 99 C 20 B 40 B 60 B 80 B 100 D 101 E 102 B 103 E 104 D 105 D 106 A 107 A 108 C 109 B 101 F Course Code Title of Exam 8 of 25  ANSWER KEY WITH RATIONALE Question Answer Rationale B Options A, C, and D are incorrect because those liver functions are not 1. A 15 y/o male comes to the clinic due to abdominal directly related to the jaundice exhibited by the patient. discomfort. On physical examination, he was noted to Option B is the best/correct answer because patients will exhibit have yellowish discoloration of the sclera and skin. After jaundice when there is a problem with the metabolism of bilirubin. a series of tests, he was found to have hepatitis A. Which of the following functions of the liver is affected by his condition? A. Modification of structure and function of many hormones B. Bilirubin metabolism C. Degradation of drugs, toxins, and other proteins foreign to the body D. Storage of glucose as glycogen 2. Which of the following are pale staining cells C Option A is incorrect because serous demilunes are found in salivary located in the acinus and continuous with the glands intercalated duct of the exocrine pancreas? Option B is incorrect because Ito cells are found in liver A. Serous demilune Option C is the correct answer because centroacinar cells are B. Ito cell pale-staining cells specific to the pancreas, which line the lumen of C. Centroacinar cell the acinus and add large amounts of bicarbonate to the secretions D. Paneth cell (alkaline) Option D is incorrect because Paneth cells are found in crypts of Lieberkuhn in small intestines D Hepatocytes are responsible for the formation of bile. Bile is produced by the 3. Which is responsible for the formation of bile? liver and then stored in the gallbladder before being released into the small A. Sinusoidal epithelium intestine to aid in digestion. [Hundt, Melanie, et al. “Physiology, Bile Secretion.” PubMed, StatPearls Publishing, B. Ito cell 2021, www.ncbi.nlm.nih.gov/books/NBK470209/#:~:text=Bile%20is%20produced%20by%20hepatocytes.] C. Kupffer cell D. Hepatocyte B The hepatic acinus is a functional unit of the liver that describes the 4. Which arrangement of the liver is based on the degree of arrangement of liver cells based on oxygen supply. oxygenation a specific area receives? The classical lobule is an anatomical unit of the liver defined by the terminal branches of the hepatic artery and portal vein radiating outward from the A. Classical lobule central vein. The portal lobule is another anatomical unit of the liver defined B. Hepatic acinus by the portal triad at its center and the terminal branches of the portal vein C. Portal lobule at its periphery. The portal triad refers to the structural components of the D. Portal triad liver located at the corners of the lobules and consists of the hepatic artery, portal vein, and bile duct. C This structure is a smooth muscle layer of gallbladder that facilitates the contraction of gallbladder which expels the stored bile into the digestive system. 5. What does the pointed structure do? A. Decrease in hemoglobin for bile production B. Increase in surface area for bile absorption C. Facilitates contraction of gallbladder and secretion of bile D. Allows peristalsis for movement of ingested materials across the GI tract 6. Which structure is not found in the specimen below: B Intercalated ducts are not usually seen in a salivary gland specimen as they are located deep within the glandular tissue and may collapse during tissue preparation. Course Code Title of Exam 9 of 25  A. Striated duct B. Intercalated duct C. Serous acinus D. Excretory duct A Option A is correct because saliva is hypotonic compared to blood 7. Once the saliva reaches the excretory duct, which of the plasma containing high amounts of K+ and HCO3-, and low amounts following will be its expected composition: of Na+. [Samplex 2026] A. Low sodium, high potassium Option B is incorrect because saliva should have low sodium and high B. High sodium, low potassium potassium after reaching the excretory duct. C. More mucousy than watery Option C is incorrect because the saliva mentioned is saliva in general D. Contains lipase, amylase, carboxypeptidase (parotid gland: watery; submandibular and sublingual: mucousy/viscous) → Option D is incorrect because saliva does not contain carboxypeptidases. 8. The dark staining cells found in the hepatic sinusoids C Option A is incorrect because Ito cells are hepatic stellate cell for storage with intracellular debris are known as? of vitamin A [T06-P12] A. Ito cells Option B is incorrect because Mall cells are proteolipid with a B. Mall cells membrane-tetra-spanning structure [Rubio-Ramos et al., 2022; C. Kupffer cells https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995265/ ] D. Hemapoeitic cells Option C is correct because Kupffer cells are macrophages of the liver found along the hepatic sinusoids [T06-P11] Option D is incorrect because the hematopoietic cells including HSCs are found in the liver parenchyma [Lewis et al., 2021, https://stemcellres.biomedcentral.com/articles/10.1186/s13287-021-02189-w#:~:text=Early%20hematopoiesis%20in%20the The liver also serves as a site of hematopoiesis only during %20fetal,1). gestation [T06-P11]. source: https://histology.siu.edu/erg/GI166b.htm 9. Which of the following cells have multiple D Myoepithelial cells of the intercalated ducts are more spindle-shaped and spindle-shaped with contractile properties that empty the with fewer processes contents of the acinus? → Ultrastructurally very similar to that of smooth muscle cells A. Submandibular cells Functions of Myoepithelial Cells: B. Mucous cells → Support secretory cells C. Serous demilunes → Contract and widen the diameter of the intercalated ducts D. Myoepithelial cell → Contraction may aid in the rupture of acinar cells of epithelial origin [T06-P03-04] 10. Which of the following are features of the gallbladder? D All choices are features of the gallbladder[2026 Ayuda]. A. The mucosa is lined by tall simple columnar epithelium B. The muscular mucosa is notably absent C. It has numerous deep mucosal folds called Rokitansky-Aschoff sinuses D. All of the above Course Code Title of Exam 10 of 25 11. Patient RRV was brought to PGH due to a vehicular D Options A,B,C are incorrect because while altered sensorium, low blood accident. The attending physician noted that he has no pressure (hypotension), and hyperglycemia can be serious conditions, they sensation in his clavicle and he is unable to flex his are not necessarily the most immediate life-threatening concerns in this elbow. As part of the emergency team, what is the most scenario. life threatening situation that you should look out for? Option D is correct because respiratory arrest, on the other hand, is a A. altered sensorium critical emergency that requires immediate intervention. Traumatic B. low blood pressure (hypotension) injuries, especially those involving the upper body and cervical region, C. hyperglycemia can potentially affect the respiratory muscles or compromise the D. Respiratory arrest airway, leading to respiratory failure. 12. If a mass is found along the diaphragmatic hiatus at A Option A is correct because the diaphragmatic hiatus at T10 is the the spinal level of T10, which of the following will most esophageal hiatus. Thus, a mass found in this hiatus will most likely likely the patient will present? present a problem in swallowing. A. Problem in swallowing B. Hypertension C. Low heart rate D. Tachycardia 13. What is the surface of the liver superior to the foramen B Option B is the correct answer because the foramen of Winslow is defined of Winslow? superiorly by the caudate lobe of the liver and dorsally by the inferior vena A. Right lobe cava. The inferior portion is defined by the duodenum, with the B. Caudate lobe hepatoduodenal ligament serving as the ventral border (Thomas & Fossen, C. Quadrate lobe 2022). D. Left Lobe 14. What is the direction of internal oblique muscle? B The fibers of the internal oblique muscle are superomedial in direction as A. Inferomedial opposed to the inferomedial fibers (Option A) of the external oblique.[T01-P05] B. Superomedial The transversus abdominis is the one with horizontally oriented fibers C. Horizontal (Option C), while the rectus abdominis is vertically oriented (Option D. Vertical D).[T01-P05] 15. A surgeon wanted to drain blood from the femoral A Option A is the correct answer because the deep circumflex artery vein, but he punctured/damaged the femoral artery originates from the external iliac artery just before the latter continues as instead. What structure is most likely affected? the femoral artery when it passes the inguinal ligament. A. Deep circumflex The inferior epigastric artery (option B) also arises from the external iliac B. Inferior epigastric artery. However, the deep circumflex artery (1) courses closer to the C. Subcostal femoral artery, (2) receives anastomosis from branches of the femoral D. Superior epigastric artery, and (3) actually arises from the femoral artery in 42% of cases. Hence, it is more likely to be the artery affected[Thrall, 2016]. The subcostal arteries (Option C) arise from the thoracic aorta and course along the 12th rib. The superior epigastric artery (Option D) is a branch of the internal thoracic artery that supplies the skin of the abdomen. 16. During your LU7 days, you remember when you B Option B is the correct answer because in indirect hernias, entry is lateral enjoyed yourself the previous night and arrived late in to the inferior epigastric vessels.[T01-P10] the operating room the next day to assist a surgical Option A is incorrect because in direct hernias, entry is medial to the resident. Giving you the silent treatment, the resident inferior epigastric vessels.[T01-P10] did not brief you on the case. You noticed that the area being operated on is the groin. You also heard from the nurse that the patient had a “luslos”. The small bowel of the patient had protruded from the abdomen lateral to major vessels that the resident was careful not to injure. Because you studied OS 206 well during LU3, you know that the patient had a case of: A. Direct hernia B. Indirect hernia 17. What structure divides the abdominal cavity into a B The transverse mesocolon, which attaches the transverse colon to the supracolic and infracolic region? posterior wall of the abdomen, subdivides the peritoneal cavity into A. Omentum supracolic and infracolic compartments located above and below the B. Transverse Mesocolon transverse colon and its mesocolon[Sharma et al., 2017]. C. Epiploic Foramen D. Hepatoduodenal Ligament Sharma, M., Madambath, J. G., Somani, P., Pathak, A., Rameshbabu, C. S., Bansal, R.,... & Patil, A. (2017). Endoscopic ultrasound of peritoneal spaces. Endoscopic Ultrasound, 6(2), 90. 18. The conjoint tendon is formed by the aponeurosis of A The conjoint tendon is important in the integrity of inguinal canal by enforcing the transversus abdominis and what other muscle? the weak areas to avoid hernia. It is formed by the both internal oblique A. Internal Oblique and transversus abdominus muscles. [T01-P05] B. Transversalis Course Code Title of Exam 11 of 25  C. External Oblique D. Rectus Abdominis 19. You are a doctor to the barrios, and a patient D The arcuate line is located about midway between the umbilicus and pubic presented with pain in the right lower quadrant. You symphysis and represents the inferior portion of the posterior rectus sheath. diagnosed it as acute appendicitis and decided to Therefore, below the arcuate line, only an anterior layer of the rectus sheath operate on the patient. Upon closing the surgical site, exists, and there is no posterior layer of the rectus sheath. which layer will you not encounter? A. Internal oblique B. External oblique C. Anterior rectus sheath D. Posterior rectus sheath 20. The thoracoabdominal nerves can be found in B The thoracoabdominal nerves travel within a neurovascular plane between the between which muscles? transversus abdominis and internal oblique muscles before piercing the A. Internal oblique and external oblique posterior rectus sheath[T01-P05]. B. Transversus abdominis and internal oblique C. Rectus abdominis and external oblique D. Internal oblique and transversalis fascia 21. A 23-year old man was sent to the emergency room C Option C is the correct answer because it is the only organ not found in the following a car crash. During the crash, he was wearing retroperitoneal area. his seatbelt. CT scans showed that he had a Recall the mnemonic, SADPUCKER: retroperitoneal hematoma. Injury to which of the → S = Suprarenal (adrenal) Glands following organs is the LEAST LIKELY source of → A = Aorta/IVC bleeding? → D = Duodenum (except the proximal 2cm, the duodenal cap) A. Kidney → P = Pancreas (except the tail) B. Duodenum → U = Ureters C. Liver → C = Colon (ascending and descending parts) D. Pancreas → K = Kidneys → E = Esophagus → R = Rectum 22. A 53 year-old male was diagnosed with a duodenal B Option B is the correct answer because the bile ducts empty to the mass on endoscopy. If the initial symptom of the patient duodenum at the major duodenal papilla of the descending segment. A was jaundice, in which segment of the duodenum was mass in the descending segment may block the secretion of bile, which the mass likely located? may manifest as jaundice due to the backflow of bile.[T03-P02] A. Superior B. Descending C. Inferior D. Ascending 23. A 35-yr old female complained of epigastric pain A Superior portion is most prone to ulcers as it is the closest to the stomach. after meals. Diagnosed with peptic ulcer, which segment [E01-T03] of the duodenum is most likely affected? A. Superior B. Descending C. Inferior D. Ascending 24. A mass that erodes the anterior wall of the 3rd D segment of the duodenum may encroach upon which The third segment of the duodenum is closely related to the superior mesenteric vessels? vessels anatomically. Therefore, a mass eroding the anterior wall of this segment is likely to encroach upon the superior mesenteric artery and vein A. Aorta and IVC B. Celiac trunk and portal vein C. Inferior mesenteric artery and vein D. Superior mesenteric artery and vein 25. Duodenal atresia in radiographic imaging is seen as: B Presence of two air-filled bubbles or distended segments in the upper abdomen A. Apple core sign (double bubble sign) is indicative of duodenal atresia. B. Double bubble sign C. Seagull sign First bubble - dilated stomach D. Rovsing sign Second bubble - dilated proximal duodenum 26. Ligation of what artery LEAST LIKELY leads to B Option B is not a vessel supplying the pancreas. infarction of pancreas: The splenic artery (a branch of the celiac trunk) and the superior mesenteric A. Celiac Trunk artery supply the pancreas B. Inferior Mesenteric Artery C. Splenic Artery Course Code Title of Exam 12 of 25  D. Superior Mesenteric Artery 27.. A 59-year-old male with jaundice has a pancreatic E mass on imaging. In which part of the pancreas is the A mass located in the head of the pancreas blocks the bile duct, leading mass most likely located? to a buildup of bile in the liver. This causes jaundice, as experienced by the patient [Hopkins Medicine]. E. Head F. Neck G. Tail H. Body 28. The possibility of injury to the pancreas should be F Option F is the correct answer because the pancreas is overlying and considered in patients with traumatic fractures involving transversely crossing the bodies of L1 and L2 vertebra.[Moore, p.488] which vertebrae? E. 10-11 F. L1-L2 G. L2-L3 H. S2-S3 29. If you were to investigate and probe the major D Option D is the correct answer because the Major Pancreatic Duct (of Wirsung) duodenal papilla, what pancreatic duct would you empties into the ampulla of Vater or major duodenal papilla. The cannulate? Minor/Accessory Pancreatic Duct (of Santorini) empties into the minor duodenal A. Rotor papilla.[T03-P6] B. Vater C. Santorini D. Wirsung 30. Thrombosis of the portal vein would lead to the B Option B is the correct answer because the Spleen is supplied by the splenic enlargement of which organ? vein which joins the superior mesenteric vein to become the portal vein. Thus, A. Small intestine thrombosis of the portal vein would likely lead to the enlargement of the Spleen B. Spleen (Splenomegaly)[T03-P17] C. Liver D. Kidney 31. RVV 42/F was stabbed on the right side, along the C Option C is the correct answer because the superior parts of the kidneys lie 9th rib while walking along Pedro Gil. All of the following deep to the 11th and 12th ribs. The liver is found within the levels of the structures are affected EXCEPT: 7th–11th right ribs at the mid-axillary line and crosses the midline to the left A. Caudate lobe nipple. The gallbladder is found in the inferior Border of the liver at the tip of the B. Right lobe of the liver 9th costal cartilage of the MCL.[SGD02-P01,P06] C. Right kidney D. Gallbladder 32. 65/M was brought to the ER because of severe A Option A is the correct answer because gallstones may block the common bile abdominal pain, specifically in the RUQ and epigastric duct, resulting in choledocholithiasis which then results in jaundice and liver area. Upon examination, the patient has fever and damage.[T02-P10] jaundice. Two months prior, the patient was diagnosed and treated for gallstones. A. Gallbladder stone obstruction in the bile duct B. Gallbladder stone obstruction in the cystic duct C. Gallbladder was inflamed 33. A 72/M was admitted to the hospital due to C During portal hypertension, the splenic vein enlarges due to the backflow of hematemesis. On physical examination, an engorged blood from the portal vein [2026 Ayuda] blood vessel on his abdomen was noted. What is this condition? A. Cholelithiasis B. Choledocholithiasis C. Portal hypertension D. Perforated gastric ulcer 34. Which part of the stomach lies posterior to the left B The fundus is the dilated superior part of the stomach related to the left 6th rib in the MCL? dome of diaphragm superior to it and limited inferiorly by horizontal plane A. Cardia of cardial orifice. In a supine position, it lies posterior to the left 6th rib in B. Fundus the plane of the MCL. Hence, B is the correct answer [E01-SGD01, p. 3] C. Body D. Pylorus Course Code Title of Exam 13 of 25 35. Bile can easily be diverted into the gallbladder when B The spiral fold helps keep the cystic duct open; thus, bile can easily be the distal end of the bile duct is closed by the diverted into the gallbladder when the distal end of the bile duct is closed by hepatopancreatic sphincter because of: the sphincter of the bile duct and/or hepatopancreatic sphincter, or bile can A. The spiral valve helps keep the cystic duct pass the duodenum as the gallbladder contracts. The spiral fold also offers closed additional resistance to sudden dumping of bile when the sphincters are B. The spiral valve helps keep the cystic duct closed, and intra-abdominal pressure is suddenly increased, as during a open sneeze or cough. [Moore, p. 503] C. The spiral valve helps keep the hepatopancreatic duct open D. The spiral valve helps keep the cystic duct closed 36. Parasympathetic stimulation causes which of the A Parasympathetic innervation of the vagus stimulates contraction of the following: gallbladder and RELAXATION of the hepatopancreatic ampulla [E01-T02, p. 10] A. Contraction of the gallbladder Thus, A is the correct answer B. Constriction of the hepatopancreatic ampulla C. AOTA D. NOTA For numbers 37-39, match the blood supply of the According to Dr. Dumlao’s lecture[T02-P09], the arterial supply of the cystic cystic duct: duct includes: B → Cystic artery: proximal part of the duct 37. Proximal part → Right hepatic artery: middle part of the duct A. Right hepatic artery → Posterior superior pancreaticoduodenal artery and gastroduodenal B. Cystic artery artery: retroduodenal part of the duct C. Posterior superior pancreaticoduodenal artery Thus, Option B is the correct answer 38. Middle part A According to Dr. Dumlao’s lecture[T02-P09], the arterial supply of the cystic A. Right hepatic artery duct includes: B. Cystic artery → Cystic artery: proximal part of the duct C. Posterior superior pancreaticoduodenal artery → Right hepatic artery: middle part of the duct → Posterior superior pancreaticoduodenal artery and gastroduodenal artery: retroduodenal part of the duct Thus, Option A is the correct answer 39. Retroduodenal part C According to Dr. Dumlao’s lecture[T02-P09], the arterial supply of the cystic A. Right hepatic artery duct includes: B. Cystic artery → Cystic artery: proximal part of the duct C. Posterior superior pancreaticoduodenal artery → Right hepatic artery: middle part of the duct → Posterior superior pancreaticoduodenal artery and gastroduodenal artery: retroduodenal part of the duct Thus, Option C is the correct answer 40. Which part of the stomach lies posterior to the left B Option B is the correct answer because in supine position, fundus lies 6th rib in the MCL? posterior to the 6th left rib in the plane of MCL.[T02-P11] A. Cardia Option A is incorrect because in supine position, cardia lies posterior to the B. Fundus 6th left costal cartilage.[T02-P11] C. Body Option C and D is incorrect because the body and the pylorus are inferior D. Pylorus to the 6th rib.[T02-P11] 41. Which of the following are rudimentary in humans? B Option B is the correct answer because the foliate papillae is rudimentary A. Filiform papillae in humans.[T05-P03] B. Foliate papillae C. Fungiform papillae D. Circumvallate papillae 42. What specific layer in the gastrointestinal tract can D Option D is the correct answer because the submucosa contains dense you see dense or loose connective tissue, nerve plexus, connective tissue with larger blood and lymphatic vessels, fibers and and in some segments, glands? nerves. It may also contain glands and significant lymphoid tissue (primary A. Mucosa or secondary follicles).[T05-P02] B. Serosa C. Muscularis externa D. Submucosa 43. Which of the following is characterized by a stratified A Option A is the correct answer because all the other choices are lined squamous epithelium? instead with simple columnar epithelium. The esophagus has A. Esophagus non-keratinized stratified squamous epitheulium in order to serve as B. Stomach protection from mechanical stress.[T05-P04] C. Ileum D. Colon Course Code Title of Exam 14 of 25 44. Which of the following is characterized with simple D Option A is incorrect because the mucosa consists of non-keratinized columnar epithelium abundant in goblet cells? stratified squamous epithelium.[T05-P04] A. Esophagus Option B is incorrect because, although the stomach’s mucosa is B. Stomach composed of simple columnar epithelium, it has no goblet cells.[T05-P05] C. Ileum Option C is incorrect because, although the villi in the ileum are covered in D. Colon simple columnar epithelium, the goblet cells are not as abundant as the colon.[T05-P07] Option D is the correct answer because the tubular glands of the colon consist of simple columnar epithelium, and the mucosa of the colon also contains more goblet cells than any other part of the GI tract.[T05-P11] 45. Which of the following is characterized by an inner C Only the stomach is characterized by an inner oblique muscle layer located in the oblique muscle layer? muscularis externa.[T05-P06] A. Duodenum B. Esophagus C. Stomach D. Colon 46. Brunner glands are a characteristic of which of the A Brunner’s glands are pale staining compound tubulo-alveolar, secrete alkaline following? mucus and epidermal growth factor, and are only found in the duodenum.[T06-P09] A. Duodenum B. Esophagus C. Stomach D. Colon 47. In Hirschsprung's disease, the ganglion cells of the B Hirschprung’s disease entails the absence of ganglia in a segment of the large intestine fail to develop, especially the Auerbach rectum/colon. This leads to no peristalsis and thus obstruction. [T04-P10] plexus. The expected clinical presentation of this patient is: A. Bright red blood in stool B. Constipation C. Diarrhea and Flatulence D. Intestinal malabsorption 48. Patient who undergoes gastrectomy or removal of A Patients who undergo gastrectomy are prone to Vitamin B12 (Cobalamin) the whole stomach because of cancer must be given deficiency because the stomach secretes an intrinsic factor that binds and which of the following vitamin supplements? helps in absorption of the said vitamin.[T05-P05] A. Cobalamin B. Riboflavin C. Pyridoxine D. Thiamine 49. Secretion of hydrochloric acid is a function of which D Parietal cells, also known as oxyntic cells, secretes gastric acid cell? (hydrochloric acid) to maintain the acidity of the stomach for food A. Chief Cell digestion. [T05-P05] B. Paneth Cell A. Chief Cells - secrete pepsinogen C. Enteroendocrine Cell B. Paneth Cells - secrete bacterial lysozyme D. Parietal Cell C. Enteroendocrine Cells - secrete peptides with specific functions 50. This cell is found at the base of intestinal crypts and C Paneth cells are found at the base of crypts and are distinguished by their are characterized by eosinophilic granules, which have a prominent eosinophilic apical granules (reddish-orange). They function for protective function. defense or protection. [T05-P08] A. Chief Cell A. Chief Cells - condensed, basally-located nuclei and strongly basophilic B. Enteroendocrine Cell granular cytoplasm C. Paneth Cell B. Enteroendocrine Cells - Not readily identifiable with H&E stain D. Parietal Cell D. Parietal Cells - Large rounded cells with an extensive eosinophilic cytoplasm and a centrally located nucleus 51. You are at duty in the ER and there is a patient that A The superior gluteal, inferior gluteal, and internal pudendal arteries leave comes in with a motor vehicular accident. Upon the pelvis through the greater sciatic foramen. [T11-P09] examination, it was discovered that the patient has a traumatic injury piercing through the greater sciatic foramen. What structures may be damaged? A. Superior gluteal, inferior gluteal, internal pudendal arteries B. Obturator nerve, pudendal nerve, inferior gluteal arteries Course Code Title of Exam 15 of 25  C. Superior gluteal, obturator, internal pudendal arteries D. Popliteal nerve, anterior gluteal, external pudendal arteries 52. Gemma underwent pelvic surgery for an ovarian B The obturator nerve leaves the pelvis via the obturator foramen, and malignancy. After the procedure, she complained of supplies the adductor muscles and overlying skin of the medial thigh. numbness on the medial aspect of the thigh. Damage to [T11-P05] which nerve may have caused this? A. Inferior gluteal nerve B. Obturator nerve C. Pudendal nerve D. Femoral nerve 53. The measurement between the superior pubic C True Conjugate is the AP distance between sacral promontory and upper symphysis and the sacral promontory is which of the border of pubic symphysis. [T10-P04] following? A. Bi-ischial diameter - distance between the left and right ischial spines. A. Bi-ischial diameter B. Diagonal Conjugate - AP distance between sacral promontory and lower B. Diagonal conjugate border of pubic symphysis C. True conjugate D. Bituberous diameter - distance between the two ischial tuberosities D. Bituberous diameter 54. Which of the following is the only anteroposterior B Diagonal conjugate is the distance between the inferior border of the pubic plane in the pelvic inlet that can be measured clinically symphysis up to the sacral promontory. It can be measured clinically. It is during a pelvic examination? measured by palpating the sacral promontory with the tip of the middle A. Obstetric conjugate finger, using the other hand to mark the level of the inferior margin of the B. Diagonal conjugate pubic symphysis on the examining hand. [T10-P05] C. True conjugate D. Bispinous diameter 55. Part of the Visceral Pelvic Fascia that functions as B From 2027 Trans E01-T09 (p. 13) the major support to the uterus? The MacKenrodt’s Ligament is the main passive support of the uterus. E. Uterosacral Ligament F. Mackenrodt ligament (Based on 2027 GCash; Feedback was GIVEN) G. Broad Ligament H. Round Ligament 56. The Distance of which structures is the smallest D The ischial spine constitutes the smallest dimension (narrowest diameter) in dimension in the pelvis the pelvis and represents the pelvic midplane. A. Ischial Tuberosity B. Symphysis Pubis C. Sacral Promontory D. Ischial Spine 57. Assessment of pelvic outlet involves the A The pelvic outlet is found at the level of the ischial tuberosities.[T10-P05] identification of which landmark? The sacral promontory is the posterior boundary of the pelvic inlet while the A. Ischial tuberosities symphysis pubis is its anterior boundary.[T10-P04] B. Sacral promontory → The plane of the pelvic inlet runs from the superior border of the C. Symphysis pubis symphysis pubis to the sacral promontory. D. Ischial spines The pelvic midplane is found at the level of the ischial spines.[T10-P06] 58. Cecile is 38 weeks pregnant and is about to deliver D The patient will not feel anything in the perineum but will feel pain above vaginally. There was no anesthesiologist available so her the perineum. Hence, the patient will still feel the uterine contractions in the OB offered her a pudendal block. What should Cecile upper part of the vagina, body of the uterus, and cervix.[T11-P3] expect? A. She will feel numb and will not feel contractions B. Her contractions will not be affected C. Her contractions will be reduced D. She will still feel contractions but her perineum will feel numb 59. Obstetrician on duty asked you to assist in giving a B A pudendal nerve block aims to block the nerve as it exits the lesser sciatic pudendal block. Once you have palpated the ischial foramen for a less painful childbirth. It is administered by: spine, you should move: 1. Palpating the ischial spine with 2 fingers of the non-dominant hand A. 1 cm inferior and lateral transvaginally inserted B. 1 cm inferior and medial 2. Pierce the buttocks with a syringe 1 cm inferior and medial to C. 1 cm superior and medial palpated area D. 1 cm superior and lateral 3. Aspirate to ensure blood vessels are avoided, then inject local anesthesia https://www.ncbi.nlm.nih.gov/books/NBK551518/ Course Code Title of Exam 16 of 25 60. Pelvic floor muscle that forms the lateral wall of the B A and D are wrong because the coccygeus and iliococcygeus muscles pelvis and is an external rotator of the thigh? form the floor of the pelvis, not lateral A. Coccygeus C is wrong because the piriformis forms the posterosuperior wall of the B. Obturator internus pelvis, not lateral C. Piriformis B is correct because the obturator internus forms the lateral wall of the D. Iliococcygeus pelvis and acts as an external or lateral rotator of the thigh [Moore] 61. Which branch of the internal iliac artery passes C Taken from Trans E01-T11 p. 7 posteriorly through the lumbosacral trunk and S1? A. Iliolumbar The internal iliac artery is a major blood vessel that supplies blood to various B. Inferior gluteal structures in the pelvis. One of its branches is the lateral sacral artery, which C. Lateral sacral arises from the posterior division of the internal iliac artery. D. Superior gluteal 62. Which artery passes between S2 and S3? B Taken from Trans E01-T11 p. 8 A. Iliolumbar B. Inferior gluteal The inferior gluteal artery passes posteriorly between the sacral nerves C. Lateral sacral (usually S2 and S3) D. Superior gluteal 63. Jessa came to your clinic complaining of severe A Taken from Trans E01-T11 p. 12 vulvular pain. After performing the physical exam you observed a 2cm carbuncle on her right vulva. Which of The inguinal nodes would likely be tender and swollen because they drain the group of nodes would you expect to be tender and lymphatic fluid from the external genitalia, including the vulva, so inflammation swollen? or infection in that area can cause them to be tender and swollen as they A. Inguinal nodes work to filter and remove the pathogens or inflammatory substances. B. Sacral nodes C. Pudendal nodes D. External Iliac nodes 64. Which of the following does the right ovarian vein D Taken from Trans E01-T12 p. 7 drain into? A. External Iliac vein The right ovarian vein drains upward into the IVC as seen in the figure below. B. Internal Iliac vein C. Right renal vein D. IVC 65. A 25 year old female complained of severe pain in C From 2028 Trans E01-T12 (p. 9): the hypogastric region. Upon probing, it was noted that she has her menstruation. What layer is responsible for During menstruation, contractions of the myometrium may the pain? produce dysmenorrhea or cramping A. Perimetrium B. Endometrium C. Myometrium D. AOTA 66. What layer is sloughed off during menstruation? B From 2028 Trans E01-T12 (p. 9): A. Perimetrium Course Code Title of Exam 17 of 25  B. Endometrium Endometrium is the inner mucous coat of the uterine wall; if conception does C. Myometrium NOT occur, inner surface of the coat is shed during menstruation. D. AOTA 67. Maturation of sperm happens in which structure? C [OS 206]-E01-T12-Male and Female Internal Genitalia p. 2 A. Seminiferous tubules B. Vas deferens The epididymis also plays an essential role in maturation of sperm C. Epididymis D. Testes 68. The duct each seminal vesicle along with the vas A [OS 206]-E01-T12-Male and Female Internal Genitalia p. 4 deferens combine in the prostate to form what structures? A. Ejaculatory duct the ejaculatory duct consists of sllender tubes that arise by the union of the B. Seminal vesicle ducts of the seminal glands and ductus deferens C. Prostatic urethra D. Membranous urethra 69. Which among the following is NOT a function of the A [OS 206]-E01-T12-Male and Female Internal Genitalia p. 4 seminal glands? A. Neutralize acidic urine The function listed that is NOT associated with the seminal glands is B. Lubricate the distal urethra "Neutralize acidic urine." The seminal glands primarily contribute to seminal C. Helps in preparing for the passage of sperm fluid production, which helps in lubricating the distal urethra, preparing for D. Helps in sperm transport the passage of sperm, and aiding in sperm transport. Neutralizing acidic urine is a function typically associated with other components of the male reproductive system, such as the prostate gland. 70. The following are accessory glands of the male A “The accessory glands of the male reproductive system are the seminal reproductive system except? vesicles, prostate gland, and the bulbourethral glands. These glands A. Testes secrete fluids that enter the urethra.” B. Bulbourethral C. Prostate Source: https://training.seer.cancer.gov/anatomy/reproductive/male/ D. Cowper’s Glands glands.html: 71. Prostatic secretions do not join the seminal fluid until A Pathway of Sperm Cells During Ejaculation[EO1-T12] the ejaculatory duct terminated at the prostatic urethra. Seminiferous tubules > Straight tubules > Rete testis > WEfferent ductules > A. TRUE Epididymis > Ductus deferens > Duct of seminal gland > Ejaculatory duct > B. FALSE Prostatic urethra > Intermediate part of urethra/membranous urethra > Spongy urethra > External urethral orifice 72. The spermatic cord arise from the following except: A Table below shows the fate of the abdominal layers in the testis[EO1-T13]: A. Tranversus abdominis B. Transversalis fascia C. Internal oblique D. External oblique 73. Which of the following is supplied by the perineal C The pudendal nerve has 3 terminal branches: the dorsal nerve to the branch of the pudendal nerve? penis/clitoris, the perineal branch, and the inferior