2005 Final examination, ANHB 2212. MCQs 1 to 15.

 

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1   Tissues / organs which develop from the endoderm include :    
         
  A. Epithelium lining the oesophagus.    
  B. Parenchyma of the liver.     
  C. Visceral peritoneum.    
  D. A and B.    
  E. A, B and C.    
         

This question is similar to some which appeared in the CA tests and has been discussed at length.

         
2   The serous membranes of the body    
         
  A.  include the lining of the digestive tube.    
  B. are kept moist by secretions of glands.    
  C. develop from the endoderm.    
  D. are formed by a simple columnar epithelium.    
  E. allow easy movement of the organs they cover.    
         

Serous membranes are linings of parts of coelomic cavities (pleura, peritoneum and pericardium).
They have no glands.
Embryologically they are the walls of coelomic cavity, therefore mesodermal in origin (coelomic cavity appears by the splitting of the lateral plate mesoderm!)
They are lined by simple squamous epithelium.
The main function of the watery fluid they produce is to facilitate movement of organs.

         
         
3   In the thoracic vertebral column    
         
  A. the orientation of the articular facets allows axial rotation.    
  B. a secondary curvature develops when a child begins to stand.    
  C. has a wide range of flexion.    
  D. transverse processes are thin compared to those in the lumbar vertebrae.    
  E. the vertebral canal is triangular.    

The articular facets of the thoracic column are best suited for rotation, as they are flat and located on an arc of a circle. In the cervical column they slope down, so rotation is accompanied by some tilting. The curved facets in lumbar vertebrae in fact prevent rotation.
Secondary curvatures appear in the cervical and lumbar column. The thoracic column retains its primary curvature.
The thoracic column does not have much of other movements due to the semi-rigid rib cage.
Thoracic transverse processes need to form joints with the tubercles of ribs, they are fairly strong. Lumbar processes are thin.
Thoracic canal is circular and narrow. Cervical and lumbar canals are triangular.
This question can be easily answered if you have seen the bones in the lab!

         
         
4   Papillary muscles of the heart    
         
  A. cause opening and closing of heart valves.    
  B. stabilise the A-V valves during ventricular contraction.    
  C. stabilise the aortic and pulmonary valves.    
  D. are present in the rough part of the right atrium.    
  E. are made of Purkinje fibres.    

Valves open and close due to pressure differences! Muscles have nothing to do with actually moving the valves.
Yes, the papillary muscles stabilise the AV valves and prevent them being blown back into the atria.
Papillary muscles are not attached to the outflow valves (aortic and pulmonary). These valves are anchored by smaller, firm rings.
D. This is a common point of confusion, beware! Muscles in the rough part of the atrium are pectinate muscle (look like a comb).
E. Again, do not confuse between papillary and pectinate!

         
5   The sinus venosus    
         
  A. is at the cranial end of the primitive heart tube.    
  B. gives rise to the pulmonary veins.    
  C.  forms a part of the right atrium.    
  D. is the passage between the embryonic right and left atria.    
  E. is seen as the ligamentum venosum after birth.    

One look at the PowerPoint picture will tell you that the sinus venosus is at the caudal (tail) end of the embryo!
It gives rise to a part of the right atrium and the coronary sinus (main vein of the heart).
'D' is obviously wrong, but surprisingly some students though it was correct!
'E' : Do not fall for the similarity between 'venosus' and 'venosum'. It is ductus venosus that becomes the ligamentum venosum, not sinus venosus!

         
6   The abdominal part of the oesophagus :    
         
  A. has a lining of simple columnar epithelium.    
  B. develops from the foregut.    
  C. has a thickening of circular muscle which acts as a sphincter.    
  D. enters the abdomen through an opening in the central tendon of the diaphragm.    
  E. A, B and C are correct.    

Oesophagus is a site of friction, and no secretion or absorption. It has stratified squamous epithelium all throughout.
Yes, like the stomach. However, only the abdominal part receives blood from the coeliac artery.
'C' is an important concept. A sphincter is a thickening of circular muscle, but at the lower end of the oesophagus (between it and the stomach), there is no significant thickening of muscle. This is unlike any other sphincter in the body.
The oesophagus passes through muscular fibres of the diaphragm. In fact this diaphragmatic muscle contributes to the sphincteric mechanism of the oesophagus. (The IVC passes through the central tendon).

         
7   Regarding the development of the digestive system :    
         
  A. The inferior mesenteric artery supplies blood to the hindgut.    
  B. The junction between foregut and midgut is at the pyloric sphincter.    
  C. The ascending colon develops from the hindgut.    
  D. Hindgut extends as far as the end of the sigmoid colon.    
  E. All of the above are correct.    

Coeliac : foregut. Superior mesenteric : midgut. Inferior mesenteric : hindgut.
'B' :
Common mistake, just because the stomach ends there. The junction is in the middle of the duodenum, where the bile duct and pancreatic duct open.
'C". Another common mistake
is thinking that the small intestine develops from the midgut, the colon from the hindgut. The junction betrween midgut and hindgut is towards the left end of the transverse colon.
The hindgut extends all the way down to the anal canal, except the terminal (half-an-inch or so) anal canal.

         
8   Regarding the liver :    
         
  A. It develops in the lesser omentum.    
  B. Hepatic veins enter it at the porta hepatis.    
  C. Bile ducts have a branching pattern similar to hepatic veins.    
  D. A and C are correct.    
  E.  A, B and C are correct.    

The liver develops in the ventral mesogastrium, part of which becomes the lesser omentum. If this seems difficult, consider the other options : 'A' is still the best of the lot!
B and C : Common errors. Hepatic veins leave the liver, NOT at the porta hepatis. At the porta hepatis we find hepatic artery, portal vein (which brings blood from GIT to the liver) and the bile ducts. These structures have an almost identical branching pattern within the liver. This excludes D and E as well.

         
9   In the development of the human urogenital systems    
         
  A. The pronephros functions as kidneys for a short period.    
  B. The mesonephric duct gives rise to a part of the male reproductive tract.    
  C. The ureter develops from the paramesonephric duct.    
  D. Metanephric tissue gives rise to the calyces.    
  E. Kidneys are nonfunctional before birth.    
         

Note the stem of the question carefully : it refers to the human system. In mammals, the pronephros is non-functional.
'B' : Remember "m for m". The mesonephric duct gives rise to the duct of the male system.
The paramesonephric duct is exclusively for the female system.
About the kidney, in a nutshell, the metanephros gives rise to the "secretory" part of the nephron, the ureteric bud and its branching gives rise to the transport ducts which include the ureters, the pelvis of the kidney and the calyces.
'E'. Once again, a thought provoking, HD kind of question! The placenta does the job of excretion of wastes for the foetus. However, the foetus continuously swallows amniotic fluid, and the excess fluid in the body is filtered out by the kidney!

         
10   Regarding the kidneys    
         
  A.  They are located in the iliac regions of the abdomen.    
  B. The right kidney is at a higher level than the left.    
  C. The left renal vein is longer than the right.    
  D. The right kidney is related to the stomach.    
  E. None of the above is correct.    

A : No, they are much higher! Remember, the transpyloric plane cuts across the kidneys.
B : The massive liver keeps the right kidney at a slightly lower level.
C : The IVC is on the right side, so obviously the right renal vein has a shorter distance to travel. The left vein must cross the midline.
D : Most of the stomach is on the left side of the midline!

         
         
11   Regarding contrast media in conventional X-ray imaging :    
         
  A. Barium chloride solution is used to study blood vessels.    
  B. The medium used to study the urinary system is given by mouth.    
  C. The medium used to study the urinary system contains radioactive iodine.    
  D. Contrast media outline the cavities they fill.    
  E. Contrast media are NOT used in the female reproductive tract.    

A : No! Barium is used only in the digestive tube. That too, as insoluble barium sulphate. Most liquid media in conventional contrast imaging are iodine based.
It would take too long for a medium to be absorbed through the digestive tube and reach the kidneys! What we need in the urinary system is a single rapid dose of the medium to be excreted by the kidney. Commonly the medium is injected into a vein. Remember, the process is called intravenous urography.
Contrast media are radio-opaque (opaque to X-rays),
NOT radioactive.
And yes, they create contrast between the cavity and the surrounding tissues.
They are used! See the hysterosalpingogram picture on the lab questions pages. Remember, contrast media are not radioactive!

Have you seen the PowerPoint linked to the imaging pages of this section? If not, here is the link! :
General Introduction, Chest X Rays.

         
12   Muscles which cover the gaps in the bony pelvis include:    
         
  A. Obturator internus.    
  B. Obturator externus.    
  C. Piriformis.    
  D. Levator ani.    
  E. All of the above.    

Simple....?!

         
13   The urinary bladder    
         
  A. is completely covered by peritoneum.    
  B. has an external sphincter formed by the pelvic diaphragm.    
  C. is between the uterus and the rectum in the female.    
  D. rises into the abdomen when it is full of urine.    
  E. All of the above are true.    

It is covered by peritoneum only at the top and part of the posterior surface.
B : No! It is called the urogenital diaphragm and this is below the pelvic diaphragm.
C : A simple mental image of the female pelvis should explain this! The uterus is between the bladder and the rectum.
D : Indeed it does. The peritoneum is very loosely attached to the abdominal wall. The bladder can rise as high as the umbilicus.

         
14   Regarding the anal canal, all of the following are true EXCEPT :    
         
  A. Its lower part develops from the hindgut.    
  B. Its external sphincter is made of skeletal muscle.    
  C. It is a site of porta-systemic anastomoses.    
  D. The puborectalis muscle maintains the angle between the rectum and the anal canal.    
  E. It is NOT covered by peritoneum.    

Beware : "Except"!
Its upper part develops from the hindgut, the lower part is ectodermal.
Internal sphincter is smooth, external is skeletal muscle.
Portasystemic anastomoses - yes! Discussed elsewhere.
D : Yes, the rectum passes forward along the curve of the sacrum, the anal canal is directed backwards.
The peritoneal covering stops at the rectum.

 

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