hllj/quesmed huggingface dataset:
Which of the following is a major branch of the labelled structure?

[lightgallery]

Options:
explanation: It is the superior rectal artery which is the third and final main branch of the inferior mesenteric artery. The superior rectal then communicates with the middle and inferior rectal arteries which are found within the rectum itself at the level of S3.
name: Inferior rectal artery
label: c
answer: no
explanation: This arises from the superior mesenteric artery to supply the ascending colon.
name: Right colic artery
label: b
answer: no
explanation: This is the first branch of the inferior mesenteric artery (IMA) and supplies the distal 1/3 of the transverse colon and the descending colon. It anastomoses with the sigmoid arteries, another main branch of the IMA which also supply the descending colon.
name: Left colic artery
label: a
answer: yes
explanation: This arises from the superior mesenteric artery to supply the transverse colon.
name: Middle colic artery
label: e
answer: no
explanation: Though this is formed by the left colic and sigmoid branches of the inferior mesenteric artery (IMA), it is not a major branch of the IMA as it forms an anastomoses with several other branches including those of the superior mesenteric artery.
name: Marginal artery of Drummond
label: d
answer: no

Correct answer: a
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: Arising at the level of T12 from the abdominal aorta, its branches supply the foregut: the stomach, liver, gallbladder, pancreas, spleen and first half of the duodenum.
name: Coeliac trunk
label: b
answer: no
explanation: This arises at L1 and its branches supply the midgut which spans from the second half of the duodenum to the first two thirds of the transverse colon.
name: Superior mesenteric artery
label: a
answer: yes
explanation: This is also known as the descending aorta and terminates at the level of T12 at the aortic hiatus of the diaphragm where it becomes the abdominal aorta.
name: Thoracic aorta
label: d
answer: no
explanation: This is the first part of the aorta arising from the base of the left ventricle of the heart. It gives rise to the coronary arteries.
name: Ascending aorta
label: e
answer: no
explanation: This arises at the level of L3 and supplies the hindgut which starts at the remaining 1/3 of the transverse colon and ends at the rectum.
name: Inferior mesenteric artery
label: c
answer: no

Correct answer: a
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: This is the visceral peritoneum that covers the outer part of the stomach. Here we are looking inside the stomach.
name: Serosa
label: b
answer: no
explanation: These are folds of mucosa and submucosa which look wrinkled and are seen macroscopically. This helps to increase the surface area of the stomach and the rugae flatten out when the stomach is full.
name: Rugae
label: a
answer: yes
explanation: This is the outermost layer of the stomach and is made of three layers of smooth muscle.
name: Muscularis externa
label: e
answer: no
explanation: This is more likely to be the body of the stomach. The pylorus connects the end of the stomach to the first part of the duodenum.
name: Pylorus
label: d
answer: no
explanation: These are more likely to be seen microscopically and are found at the end of gastric pits (located at the surface of the simple columnar epithelium of the mucosa).
name: Gastric glands
label: c
answer: no

Correct answer: a
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: This has a similar route to the greater curvature but is the medial and shorter border of the stomach.
name: Lesser curvature
label: b
answer: no
explanation: This is the lateral and longer border of the stomach which extends from the gastric cardia (where the oesophagus meets the fundus) to the angular notch (where the pylorus begins).
name: Greater curvature
label: a
answer: yes
explanation: This is a double fold of peritoneum which arises at the greater curvature of the stomach and attaches to the transverse colon. This is particularly important for peritoneal infections as it wraps around the site of infection to prevent spread and therefore peritonitis.
name: Greater omentum
label: c
answer: no
explanation: This is a double fold of peritoneum which arises at the lesser curvature of the stomach and attaches the stomach to the liver.
name: Lesser omentum
label: d
answer: no
explanation: This is the superior part of the stomach, found above the cardiac orifice. It can expand when the stomach is full and contains gas.
name: Fundus of stomach
label: e
answer: no

Correct answer: a
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: This is the outermost muscle of the abdomen with its fibres runnning inferomedially. It originates at the 5-12 ribs and inserts onto the iliac crest and pubic tubercle where it forms part of the inguinal ligament.
name: External oblique
label: a
answer: yes
explanation: This is the deepest muscle of the abdomen with fibres that run transversely.The transversalis fascia is found deep to this and becomes the thoracolumbar fascia.
name: Transversus abdominis
label: d
answer: no
explanation: This is found in the midline where it is separated by a white strip down the middle known as the linea alba. This muscle is identified by its unique tendinous intersections which is white and found transversely across the muscle in segments.
name: Rectus abdominis
label: b
answer: no
explanation: This lies deep to the external oblique with its fibres running superiomedially. It therefore originates where the external oblique inserts at the inguinal ligament, iliac crest and thoracolumbar fascia and inserts at ribs 10-12.
name: Internal oblique
label: c
answer: no
explanation: This is a muscle of the thorax rather than the abdomen. It originates from the lateral parts of ribs 1-8 and inserts onto the medial aspect of the scapula.
name: Serratus anterior
label: e
answer: no

Correct answer: a
Which of the following is not true of the muscle pointed to by the arrow?

[lightgallery]

Options:
explanation: The iliacus muscle is a major hip flexor. The hamstrings (biceps femoris, semimembranosus, semitendinosus muscles) and the gluteus maximus muscle are responsible for extension at the hip joint.
name: It is important for flexion of the thigh and lateral rotation of the trunk
label: b
answer: no
explanation: The main blood supply of the iliacus muscle is the iliolumbar artery however it does receive branches from the deep circumflex (arising from the external iliac), obturator and femoral arteries (arising from the internal iliac).
name: It receives its blood supply from the iliolumbar artery, a branch of the internal iliac artery
label: d
answer: no
explanation: The iliacus can be distinctly identified as a triangular muscle that fans across the upper 2/3rds of the iliac fossa and joins the psoas major tendon before inserting onto the femur.
name: It arises from the iliac fossa and inserts onto the lesser trochanter of the femur
label: c
answer: no
explanation: The iliacus muscle is found on the posterior abdominal wall. Other muscles found here include the posterior aspect of the diaphragm, quadratus lumborum and psoas minor.
name: It joins with the psoas major muscle to form the iliopsoas muscle
label: e
answer: no
explanation: The iliacus muscle is innervated by the femoral nerve which also arises from L2-L4.
name: It is innervated by the obturator nerve, arising from L2-L4
label: a
answer: yes

Correct answer: a
Which of the following is true about the muscle to which the arrow is pointing to?

[lightgallery]

Options:
explanation: This describes the blood supply of the rectus abdominis muscle which is a key part of the anterior abdominal wall. The quadratus lumborum is a muscle of the posterior abdominal wall. It receives its blood supply from the paired subcostal arteries, lumbar and iliolumbar arteries.
name: It receives its blood supply from the superior and inferior epigastric arteries
label: d
answer: no
explanation: This describes the psoas major muscle. The quadratus lumborum originates from the iliac crest and iliolumbar ligament and inserts onto the inferior border of the 12th rib.
name: It originates from the transverse processes and vertebral bodies of T12-L5 and inserts onto the lesser trochanter of the femur
label: c
answer: no
explanation: Although it is mainly the external intercostal muscles and the diaphragm that contract to elevate the rib during inspiration, the quadratus lumborum has an important role in stabilisation of the 12th rib on both sides so that the diaphragm contracts efficiently.
name: It is important as it fixes the 12th rib during inspiration
label: a
answer: yes
explanation: Whilst the quadratus lumborum is important for lateral flexion of the trunk, it also plays a role in extension of the trunk. Additionally it is the psoas minor which is only found in some and therefore provides weak flexion of the trunk.
name: It is found in only 40% of the population and is important for lateral flexion of the trunk
label: e
answer: no
explanation: This describes the innervation to the diaphragm. The quadratus lumborum receives its innervation from the anterior rami of the T12 and L1-L4 muscles.
name: It receives its innervation from the phrenic nerve which arises from C3-C5
label: b
answer: no

Correct answer: a
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: The right and left common iliac veins form the IVC at the level of L5 (not to be confused with the common iliac arteries which bifurcate at the level of L4). The IVC then leaves at the level of T8 through the diaphragm to drain into the right atrium of the heart.
name: Common iliac vein
label: d
answer: no
explanation: The vessel the arrow is pointing to in the image is the ovarian vein which is a tributary of the IVC. The IVC is a much bigger vessel and lies medial to the ovarian vein.
name: Inferior vena cava (IVC)
label: e
answer: no
explanation: This is another tributary of the IVC but drains the liver at T8. Here we are looking at the level of L2, below the kidneys.
name: Hepatic vein
label: c
answer: no
explanation: This drains directly into the IVC at the level of L2, unlike the left gonadal (ovarian/testicular vein) which first drains into the left renal vein (which then drains directly into the IVC).
name: Ovarian vein
label: a
answer: yes
explanation: This also drains into the IVC but is seen more clearly higher up at the hilum of the right kidney at the level of L1.
name: Renal vein
label: b
answer: no

Correct answer: a
Into which of the following structures does the vessel pointed to by the arrow drain into?

[lightgallery]

Options:
explanation: The left adrenal vein does ultimately drain into the IVC but first drains into the left renal vein.
name: Inferior vena cava
label: d
answer: no
explanation: The adrenal glands are situated on top of the kidneys and are therefore also known as the suprarenal glands. The adrenal veins are also called the suprarenal veins. Additionally, this is the left suprarenal vein not the right.
name: Right suprarenal vein
label: b
answer: no
explanation: This is the structure to which the arrow is pointing to. This receives the venous drainage from the left adrenal gland.
name: Left adrenal vein
label: c
answer: no
explanation: This does not exist. The veins are either supraRENAL or adrenal as explained above.
name: Left supraadrenal vein
label: e
answer: no
explanation: The left adrenal vein drains first into the left renal vein which drains into the IVC unlike the right adrenal vein which drains directly into the IVC. The left renal vein is 3x longer than the right so carries the drainage of many left sided vessels including the gonadal and inferior phrenic veins.
name: Left renal vein
label: a
answer: yes

Correct answer: a
Which of the following is true about the labelled structure?

[lightgallery]

Options:
explanation: This correctly describes the oesophagus. The openings of the different vessels in the diaphragm can be remembered via the following:
inferior VENA CAVA (8 letters)= T8
oesophagus (10 letters) = T10
abdominal aorta (longest number of letters and there is no T14)= T12
name: This enters the abdomen at the level of the hiatus at T10
label: d
answer: no
explanation: This describes the superior vena cava. The arrow is pointing to the inferior vena cava which is formed by the common iliac veins at the level of T8.
name: It is formed by the right and left brachiocephalic veins at the level of T4
label: b
answer: no
explanation: This is correct. The IVC also receives drainage from the hepatic vein so if the hepatic portal vein which carries blood from the intestines is occluded then this bypasses the liver and drains straight into the IVC.
name: Occlusion of this vessel causes opening of collateral vessels to the superior vena cava
label: a
answer: yes
explanation: The ascending aorta arises here and becomes the descending part of the thoracic aorta before entering the abdomen at the level of T12 to become the abdominal aorta. It is found on the left side rather than the right side.
name: This arises from the aortic orifice at the base of the left ventricle
label: e
answer: no
explanation: This describes the abdominal aorta which lies medial to the inferior vena cava.
name: It arises at the level of T12 at the aortic hiatus and terminates at the level of L4 as the common iliac arteries
label: c
answer: no

Correct answer: a
Which of the following is not true about the labelled structure?

[lightgallery]

Options:
explanation: The common bile duct joins with the pancreatic duct to form the ampulla of vater that opens onto the major duodenal ampulla in the second part of the duodenum.
name: Bile is released into the second part of the duodenum via the ampulla of vater
label: c
answer: no
explanation: Calot's triad is formed by the cystic duct, hepatic duct and inferior border of the liver. It is a space which contains the cystic artery. It is important to identify the cystic artery and ligate during a cholecystectomy (removal of the gallbladder) as it may contain smaller branches supplying the liver and associated structures.
name: Calot's triad is formed by the cystic vein, hepatic duct and cystic duct
label: a
answer: yes
explanation: The intestine releases CKK in response to fats, this along with vagal parasympathetic innervation causes the gallbladder to contract. The sphincter of oddi which controls the major duodenal ampulla, relaxes when CKK is present.
name: It responds to cholecystokinin (CKK) that helps it to contract and release bile
label: b
answer: no
explanation: Bile leaves the liver via the common hepatic duct and is stored in the gallbladder before being released into the cystic duct and entering the common bile duct and ampulla of vater to the duodenum.
name: Bile first enters the cystic duct upon leaving this structure
label: d
answer: no
explanation: This is true, the gallbladder is supplied by the cystic artery which is a branch of the right hepatic artery.
name: It is supplied by the cystic artery
label: e
answer: no

Correct answer: a
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: The jejuneum becomes the ileum at no clear anatomical point however the jejuneum is much larger with longer vasa recta and less complicated vasculature so the change can be seen macroscopically. The ileum ends at the ileocaecal junction where it becomes the caecum.
name: Ileum
label: e
answer: no
explanation: The descending part is the second part of the duodenum and from here the the duodenum becomes retroperitoneal. The third and fourth parts are the inferior and ascending parts of the duodenum, respectively. Together, the four parts create a c shape around the pancreas.
name: Descending part of the duodenum
label: b
answer: no
explanation: This is also known as the first part of the duodenum and is intraperitoneal. It is found in close proximity to the head of the pancreas. It is also connected to the liver by the hepatoduodenal ligament.
name: Superior part of the duodenum
label: a
answer: yes
explanation: This marks the point at which the ascending part of the duodenum becomes the jejuneum. Here the duodenum is held by the suspensory ligament of treitz which marks the change between the upper and lower gastrointestinal tract.
name: Duodenojejunal flexure
label: c
answer: no
explanation: This is found between the duodenum and ileum and is intraperitoneal unlike the duodenum.
name: Jejuneum
label: d
answer: no

Correct answer: a
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: This marks the point at which the sigmoid colon becomes the rectum at the level of S3.
name: Rectosigmoidal junction
label: c
answer: no
explanation: This is where the colon begins, where the ileum becomes the caecum which then becomes the ascending colon which runs to the hepatic flexure.
name: Ileocaecal junction
label: d
answer: no
explanation: This is the start of the transverse colon but more specifically is the hepatic flexure.
name: Tranverse colon
label: e
answer: no
explanation: This is where the transverse colon becomes the descending colon as it bends at a right angle away and inferior to the spleen. It is the left colic flexure.
name: Splenic flexure
label: b
answer: no
explanation: This is where the ascending colon becomes the transverse colon as it bends at a right angle close to the liver. It is therefore also known as the right colic flexure.
name: Hepatic flexure
label: a
answer: yes

Correct answer: a
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: These are tall, circular folds of mucosa found in the jejuneum. In the ileum they are smaller. Confusingly, these folds are also known as valves of Kerckring or plicae circularis. These help to increase the surface area for reabsorption.
name: Valvulae conniventes
label: a
answer: yes
explanation: This is found characteristically in the duodenum, in the submucosa. They produce mucosa to protect the duodenum from damage due to gastric acid.
name: Brunner's glands
label: d
answer: no
explanation: These are intestinal glands that extend into the lamina propria, with Paneth cells located at the base of the crypts (although their function is unclear - perhaps antimicrobial).
name: Crypts of Lieberkuhn
label: c
answer: no
explanation: The jejuneal and ileal arteries anastomose to form loops called arcades which terminate as the vasa recta (straight arteries). In the jejuneum there are fewer arcades but longer vasa recta as compared to the ileum.
name: Vasa recta
label: e
answer: no
explanation: This is gut associated lymphoid tissue found characteristically in the ileum in the lamina propria of the mucosa. Here we are looking at the jejuneum. These would also be difficult to see macroscopically.
name: Peyer's patches
label: b
answer: no

Correct answer: a
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: The arrowed structure is closer to the aorta than the IVC so must be the LEFT adrenal gland.
name: Right adrenal gland
label: a
answer: no
explanation: This is a layer of the adrenal cortex which would be difficult to see macroscopically or at least without a cross section. This layer secretes glucocorticoids such as cortisol which is the body's stress hormone and stimulates glucose release.
name: Zona fasciculata
label: d
answer: no
explanation: This is the fat protecting the kidneys and is found closest to the kidney as compared to paranephric fat which is found outside the renal fascia. Therefore it is the perinephric fat which separates the adrenal glands (which are found in Gerato's fascia) from the kidneys.
name: Perinephric fat
label: c
answer: no
explanation: This is a posterior view of the renal structures. The aorta is the more rounded looking structure which sits ont he left side of the midline and the IVC is the more flattened looking structure on right side. Therefore, the arrowed structure which sits on the left side of the picture, above the kidney must be the left adrenal gland.
name: Left adrenal gland
label: b
answer: yes
explanation: This is another layer of the adrenal cortex, again difficult to see. It is responsible for production of sex hormones such as testosterone.
name: Zona reticularis
label: e
answer: no

Correct answer: b
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: This is best seen posteriorly and is a remnant of the ductus venosus which in utero allows oxygenated blood in the umbilical veins to bypass the liver to go to the IVC.
name: Ligamentum venosum
label: e
answer: no
explanation: This primarily attaches the superior surface of the liver to the inferior surface of the diaphragm. However it has anterior and posterior folds which create the bare area of the liver (where there is no peritoneum).
name: Coronary ligament
label: b
answer: no
explanation: This divides the liver into its left and right lobes and attaches the anterior surface of the liver to the anterior abdominal wall.
name: Falciform ligament
label: a
answer: yes
explanation: This is a remnant of the foetal umbilical vein seen in the free edge of the falciform ligament. It is also called the round ligament of the liver.
name: Ligamentum teres
label: c
answer: no
explanation: The right and left triangular ligaments are continuous with the coronary ligaments reaching to the upper corners of the liver.
name: Triangular ligament
label: d
answer: no

Correct answer: a
Identify the structure labelled by the arrow in the image below.

[lightgallery]

Options:
explanation: The caecum is the start of the colon and becomes the ascending colon (the straight part of the colon distal to the arrow).
name: Ascending colon
label: c
answer: no
explanation: The rectum is also a distal part of the colon which cannot be seen here and arises from the sigmoid colon at the level of S3 before terminating as the anal canal.
name: Rectum
label: e
answer: no
explanation: The image shows two distinct points: one at which the ileum joins the caecum and the other at which the vermiform appendix is formed. This helps us to identify the structure as the caecum.
name: Caecum
label: a
answer: yes
explanation: The ileum is the end of the small intestine and meets the caecum at the ileocaecal junction.
name: Ileum
label: b
answer: no
explanation: This cannot be seen in the image as it is found after the splenic flexure and is the more distal part of the colon.
name: Descending colon
label: d
answer: no

Correct answer: a