ARDMS ABDOMEN BOARD PREP EXAM Questions With 100% Correct Answers Verified Updated 2024 GR, Exams of Nursing

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ARDMS ABDOMEN BOARD PREP EXAM Questions

With 100% Correct Answers Verified Updated 2024

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3 layers of Aorta - Correct Answer-Tunica Intima, Tunica Media, Tunica Adventitia What is the tunica intima made of - Correct Answer- endothelial cells (inner layer) What is the tunica media made of - Correct Answer-muscle, thicker and more organized layer in arteries (middle layer) What is the tunica adventitia made of - Correct Answer- epithelial cells (outer layer) Where does the aorta arise from - Correct Answer-Left ventricle Where is the aorta located - Correct Answer-Anterior and to the left of the spine and left of the IVC (most posterior abdominal vessel)

Name the paired branches of aorta - Correct Answer- Suprarenal arteries, renal arteries, gonadal arteries, lumbar arteries, and common iliac arteries Name the unpaired branches of the aorta - Correct Answer- celiac axis (common hepatic artery, splenic artery, and left gastric artery), SMA, IMA, median sacral artery Name the anterior branches of the aorta - Correct Answer- celiac axis, SMA, IMA, gonadal arteries, and median sacral artery Name the lateral branches of aorta - Correct Answer- suprarenal arteries, renal arteries, and common iliac arteries Where do the common iliac arteries bifurcate - Correct Answer-L3- 4 Average normal proximal measurement of aorta - Correct Answer-2.0 - 2.6 cm

Average normal mid measurement of aorta - Correct Answer- 1.6 - 2.4 cm Average normal distal measurement of aorta - Correct Answer-1.1 - 2.0 cm Normal measurement of iliac arteries - Correct Answer-0.6 - 1.4 cm What is the most common type of AAA - Correct Answer- fusiform What is the most common location of AAA - Correct Answer- infrarenal Where does aortic dissection most commonly occur - Correct Answer-ascending aorta and arch What is the most common cause of aortic stenosis - Correct Answer-atherosclerosis

Where does retroperitoneal fibrosis most commonly occur at - Correct Answer-aortic bifurcation and below What is the most common location of splanchnic artery aneurysm - Correct Answer-splenic artery Where does the IVC and SVC empty - Correct Answer-right atrium What are the tributaries of the IVC - Correct Answer-CIV, lumbar veins, gonadal veins, renal veins, suprarenal veins, hepatic veins What is the most common variation of IVC anatomy - Correct Answer-duplicated IVC What is a transposed IVC - Correct Answer-IVC on left side of abdomen and crosses anterior to aorta What is an interrupted IVC - Correct Answer-congenital anomaly where IVC doesn't extend the entire way to the right atrium

Dilated hemiazygos and azygos veins indicate what - Correct Answer-interrupted IVC, IVC obstruction, and IVC overload What is the largest soft tissue organ - Correct Answer-liver The liver is encapsulated by - Correct Answer-Glisson capsule Bare areas of the liver - Correct Answer-portion of liver not covered by peritoneum/capsule. Fluid cannot accumulate here because liver is indirect contact with diaphragm What are the bare areas of the liver - Correct Answer-GB fossa, porta hepatis, and superior surface to the right of IVC Where is the porta hepatis located - Correct Answer-liver hilum on the inferior surface of liver What is the porta hepatis bordered by - Correct Answer-GB fossa and lig teres What is the portal triad - Correct Answer-portal vein, hepatic artery, bile duct

What is contained in the extrahepatic portal triad - Correct Answer-MPV, proper hepatic artery, and CBD What forms the right boundary of the caudate lobe - Correct Answer-GB fossa What is the normal size of the liver - Correct Answer-13.5 - 15.5 cm What is the normal size of the pediatric liver - Correct Answer- Normal liver should not extend more than 1 cm below the costal margin What separates the right and left lobes of the liver - Correct Answer-main lobar fissure Right lobe of the liver is ___x the size of left lobe - Correct Answer-6x The medial left lobe of liver was formerly called the - Correct Answer-quadrate lobe

Where is the caudate lobe located - Correct Answer-between IVC and medial left lobe, occupies posterior surface of the liver What do the triangular ligaments do of the liver - Correct Answer-Right and left, attaches superior liver to diaphragm, located at medial and lateral edges of bare area What is the coronary ligament of the liver - Correct Answer- right and left suspend the posterior superior surface of the liver from diaphragm, lateral margins form the triangular ligaments What is the falciform ligament of the liver - Correct Answer- attaches anterior surface to abdominal wall from diaphragm to umbilicus What is the ligamentum teres - Correct Answer-separates medial and lateral left lobes, remnant of umbilical vein What is the ligamentum teres also called - Correct Answer- Round Ligament

What is the ligamentum Venosum - Correct Answer-remnant of ductus venosus from fetal circulation, thin echogenic line anterior to the caudate lobe, separates caudate lobe from left lobe medial segment What is the hepatoduodenal ligament - Correct Answer- peritoneal folds at the porta hepatis that surround the portal vein, bile duct, and hepatic artery What is the main lobar fissure - Correct Answer-divides right and left lobes, connects the GB and IVC fossa What is the Couinaud's Liver Segments - Correct Answer- method for liver lesion localization and surgical planning, divides liver into 8 functional segments The right and left lobes of liver are separated by imaginary line from GB fossa to IVC called - Correct Answer-the Rex- Cantlie line The right lobe is segmented into - Correct Answer-2 anterior and 2 posterior lobes

The left lobe is segmented into - Correct Answer-2 medial and 2 lateral segments Name the 8 Couinaud's Liver Segments - Correct Answer-1. Caudate

2. Left lateral superior segment
3. Left lateral inferior segment 4a. Left medial superior segment 4b. Left medial inferior segment
4. Right anterior inferior segment
5. Right posterior inferior segment
6. Right posterior superior segment
7. Right anterior superior segment What is the right branch of the celiac axis - Correct Answer- common hepatic artery What does the common hepatic artery supply - Correct Answer-liver, GB, stomach

What percent of blood does the common hepatic artery carry into the liver - Correct Answer-20% What percent of blood does the main portal vein carry into the liver - Correct Answer-80% What does the gastroduodenal artery supply - Correct Answer-pancreas and stomach What does the proper hepatic artery supply - Correct Answer- liver and GB What is the RI of the hepatic artery - Correct Answer-low resistance, .55 -. What does the portal venous system drain - Correct Answer- blood from the digestive tract and delivers it to the liver for filtration The IMV joins the splenic vein near the - Correct Answer-tail of the pancreas

What is the portal confluence - Correct Answer-confluence of SMV and splenic vein posterior to the head of pancreas What does the MPV drain - Correct Answer-GI tract and sends blood to liver for filtration The hepatic veins divide the liver into - Correct Answer-lobes (intersegmental veins) What is the normal pressure in the portal vein - Correct Answer- 5 - 10 mmHg A normal portal vein will ___________ in diameter by more than 20% with deep inspiration - Correct Answer-increase What is the normal diameter of the MPV - Correct Answer-< 13 mm What is the normal velocity of the MPV - Correct Answer- 15 - 20 m/s

The splenic vein courses ______________ to the pancreas where it meets with the ___ - Correct Answer-posterior where it meets with the IMV After the splenic vein joins the IMV, it then joins the ___ to form the main portal vein ____________ to the neck of the pancreas - Correct Answer-SMV to form the MPV posterior to neck of the pancreas What does the splenic vein drain - Correct Answer-stomach, spleen, pancreas Where does the SMV originate - Correct Answer-at the mesentery The SMV joins the ______ vein posterior to the neck of the pancreas to form ___ - Correct Answer-splenic vein posterior to the neck of the pancreas to form the MPV What does the SMV drain - Correct Answer-small intestine and proximal colon Where does the IMV arise from - Correct Answer-colon

The IMV ascends to the left of the ____ - Correct Answer-IMA The IMV joins _________ vein posterior to body of pancreas - Correct Answer-splenic vein posterior to body of pancreas What does the IMV drain - Correct Answer-distal colon Where do the hepatic veins enter IVC - Correct Answer-just below the diaphragm The hepatic veins drain blood from the ________ and return it to the heart - Correct Answer-liver What is the most common variation in hepatic vein anatomy - Correct Answer-an accessory right hepatic vein What is the direction of flow in the hepatic veins - Correct Answer-hepatofugal What are the functional unit of the liver? - Correct Answer- lobules which are composed of hepatocytes

The portal triad tracts course _____________ to the lobules of liver tissue - Correct Answer-adjacent What do the hepatocytes surround - Correct Answer- periphery of veins What do the hepatocytes do - Correct Answer-synthesize, metabolize, and excrete compounds What do the walls of the sinusoids contain - Correct Answer- endothelial and Kupffer cells that phagocytize bacteria and foreign material What are the functions of the liver - Correct Answer-1. metabolism of digestive products

2. storage of vitamins, iron, glycogen, fat, amino acids
3. detoxification
4. bile production and excretion
5. albumin and globulin formation
6. lymph production

What causes an increase in LFT's - Correct Answer-acquired and inherited liver disease (hepatitis, fatty liver, hemochromatosis, Wilson disease) The liver contains higher levels of ___ than ___ - Correct Answer-ALT than AST Changes in the ___ levels are more specific to liver disease - Correct Answer-ALT Elevation of AST levels indicate? - Correct Answer-NON hepatic issues (because AST is found in other organs) Where is Aspartate Aminotransferase present - Correct Answer-liver, kidneys, skeletal muscle, heart muscle, and brain AST increases with - Correct Answer-acute hepatitis, cirrhosis, metastasis, and Reye Syndrome AST is mildly increased with - Correct Answer-fatty changes

AST is NOT elevated with - Correct Answer-isolated biliary obstruction Causes for increased AST with normal ALT include - Correct Answer-myocardial infarction, CHF, muscle injury, CNS disease, other NON hepatic disorders What is Alanine Aminotransferase necessary for - Correct Answer-energy production ALT is released into blood with ______ _____ damage - Correct Answer-liver cell ALT is used to evaluate the level of - Correct Answer-jaundice and monitor hepatitis and cirrhosis ALT is increased with - Correct Answer-hepatitis, cirrhosis, liver tumors, biliary obstruction, and Reye syndrome Where is alkaline phosphatase found - Correct Answer-liver, bone, and placenta

Alkaline phosphatase is normally excreted with - Correct Answer-bile Increased Alkaline Phosphatase (ALP) indicates - Correct Answer-biliary obstruction from tumors, cholelithiasis, or biliary atresia If ALP is elevated alone then the cause may be - Correct Answer-related to bone disease, pregnancy, or hyperparathyroidism Where is Gamma-glutamyl transpeptidase normally found - Correct Answer-liver cells and biliary epithelium What is the most sensitive indicator for alcoholism? - Correct Answer-Gamma-glutamyl transpeptidase (GGTP) Marked increase of GGTP indicates - Correct Answer-liver disease and post hepatic biliary obstruction Moderate increase of GGTP is seen with - Correct Answer-liver damage due to alcohol, drugs, and chemotherapy

Increased GGTP + ALP = - Correct Answer-biliary obstruction Increased GGTP + ALT = - Correct Answer-hepatocellular disease What is the best way to differentiate hepatic jaundice from obstructive jaundice - Correct Answer-measure the CBD Hepatic jaundice is caused by ___________ disease - Correct Answer-liver Obstructive jaundice is caused by _____________ obstruction

• Correct Answer-biliary What is pre hepatic jaundice caused by - Correct Answer- hepatocellular disease (destruction of hepatocytes) What is hepatic jaundice caused by - Correct Answer- hemolytic disease (abnormally functioning liver cells, unable to conjugate bilirubin)

What is post hepatic jaundice caused by - Correct Answer- mechanical obstruction of the biliary tree What are the relative echogenicities in the abdomen from hyperechoic to hypoechoic - Correct Answer-renal sinus > pancreas > liver > spleen > renal parenchyma What is agenesis of liver - Correct Answer-absence of liver formation What are accessory fissures of the liver - Correct Answer-rare, caused by infolding of the peritoneum What is partial situs inversus - Correct Answer-abdomen contents reversed, liver LUQ What is complete situs inversus - Correct Answer-chest and abdomen contents reversed, liver LUQ and heart in right chest What is Reidel's lobe - Correct Answer-extension of right lobe below the lower pole of right kidney (right lobe large, left lobe is normal size)

Reidel's lobe is more common in _________ - Correct Answer- women Sonographic appearance of Reidel's lobe - Correct Answer- right lobe extends below lower pole of right kidney, can extend medially, NORMAL echotexture What is the normal transverse measurement of the GB - Correct Answer-< 5 cm Where is the GB fossa located? - Correct Answer-posterior inferior surface of right lobe of liver What does the main lobar fissure connect - Correct Answer- right portal vein to GB neck What artery supplies the GB - Correct Answer-cystic artery (originates from right hepatic artery) What vein is the GB drained by? - Correct Answer-cystic vein into the right portal vein

Name the layers of the GB wall - Correct Answer-Mucosa (inner), muscle (middle), serosa (outer) Normal GB wall measurement - Correct Answer-< 3 mm What is increased GB wall thickness seen with? - Correct Answer-itis (cholecystitis, hepatitis, pancreatitis) Duct of Luschka - Correct Answer-located within GB wall, bile thickening occurs here What are the smallest and most proximal component of the collecting system? - Correct Answer-bile canaliculi Cystic Duct of GB - Correct Answer-carries bile to and from the GB What regulates flow in the cystic duct of the GB? - Correct Answer-spiral valves of Heister Common Hepatic duct of GB - Correct Answer-located anterior to the split of the MPV, measures 4 mm or less

Cystic duct + CHD = - Correct Answer-CBD What part of the CBD dilates first with any type of distal obstruction? - Correct Answer-Mid segment (located just out of the liver) Where is the distal portion of the CBD located? - Correct Answer-head of the pancreas The CBD courses posterior to the 1st segment of the duodenum to meet the duct of __________________ - Correct Answer-Duct of Wirsung (posterior to the pancreas head) The Duct of Wirsung connects the _____________ __ __________ at the duodenum - Correct Answer-Ampulla of Vater What controls the flow of bile and pancreatic fluid through the Ampulla of Vater? - Correct Answer-The Sphincter of Oddi What measurement of the CBD is considered dilated with GB present? - Correct Answer-> 8 mm

What measurement of the CBD is considered dilated in patients without GB/ - Correct Answer-> 12 mm What is the normal wall thickness of the CBD? - Correct Answer-At 2 mm or less Bile is excreted by the - Correct Answer-liver Bile contains - Correct Answer-bilirubin, biliverdin, bile salt, acids and cholesterol What system breaks down red blood cells to release bilirubin from hemoglobin? - Correct Answer-Reticuloendothelial System (RES) Bilirubin + albumin = - Correct Answer-unconjugated bilirubin Liver breaks down unconjugated bilirubin to remove the ______________ - Correct Answer-bilirubin bilirubin + gluconoride = - Correct Answer-conjugated bilirubin

Jaundice - Correct Answer-NOT a disease, result of abnormalities of liver and/or ductal system. Abnormal bilirubin metabolism and excretion Jaundice is related to - Correct Answer-increased red blood cell destruction, hepatocellular disease and biliary obstruction Hyperbilirubinemia can cause - Correct Answer-yellowing of the sclera of the eyes and fingernails beds, dark colored urine and pale stools Hemolytic Jaundice - Correct Answer-RBC destruction occurs rapidly, seen with anemia Hepatic Jaundice - Correct Answer-Liver disease reduces its ability to process conjugated bilirubin (hepatitis and cirrhosis) Obstructive Jaundice - Correct Answer-obstruction of the biliary tree increases bilirubin in blood and urine Jaundice + dilated intrahepatic ducts = - Correct Answer- obstructive cause

Jaundice + normal intrahepatic ducts = - Correct Answer-non- obstructive cause Cholescintigraphy / HIDA Scan - Correct Answer-Nuclear medicine exam that evaluates the GB function and ejection fraction. Cholecystokinin administered to cause the GB to contract and relax the Sphincter of Oddi What is the most accurate exam for evaluating acute cholecystitis? - Correct Answer-Cholescintigraphy / HIDA Scan Oral Cholecystogram - Correct Answer-Radiopaque oral contrast given. Excreted by the liver and concentrated in the GB which extracts water, thus concentrating the excreted substance T-tube Cholangiogram - Correct Answer-fluoroscopy procedure, demonstrates bile ducts when x-ray dye is injected into a T-tube in the abdomen