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What structures are derived from the dorsal part of the dorsal mesogastrium? A) Stomach and spleen B) Liver and gallbladder C) Aorta and lesser omentum D) Parietal peritoneum and falciform ligament E) Lesser sac and gastrosplenic ligament
A) Stomach and spleen Explanation: The dorsal part of the dorsal mesogastrium gives rise to the stomach and spleen, which are key components in the development of the foregut.
What happens to the position of the appendix as the cecum grows after birth? A) It moves to the right B) It remains unchanged C) It moves to the left D) It detaches completely E) It becomes longer
C) It moves to the left Explanation: As the cecum grows, the apex of the cecum and the base of the appendix are pushed towards the left, resulting in the base of the appendix being attached to the posteromedial wall of the cecum near the ileocecal junction.
1/109
p.7
Foregut, Midgut, and Hindgut Differentiation

What structures are derived from the dorsal part of the dorsal mesogastrium?
A) Stomach and spleen
B) Liver and gallbladder
C) Aorta and lesser omentum
D) Parietal peritoneum and falciform ligament
E) Lesser sac and gastrosplenic ligament

A) Stomach and spleen
Explanation: The dorsal part of the dorsal mesogastrium gives rise to the stomach and spleen, which are key components in the development of the foregut.

p.11
Cecum Development

What happens to the position of the appendix as the cecum grows after birth?
A) It moves to the right
B) It remains unchanged
C) It moves to the left
D) It detaches completely
E) It becomes longer

C) It moves to the left
Explanation: As the cecum grows, the apex of the cecum and the base of the appendix are pushed towards the left, resulting in the base of the appendix being attached to the posteromedial wall of the cecum near the ileocecal junction.

p.2
Primitive Gut Formation

What are the three main parts of the primitive gut?
A) Foregut, Midgut, Hindgut
B) Upper gut, Middle gut, Lower gut
C) Anterior gut, Posterior gut, Lateral gut
D) Proximal gut, Distal gut, Central gut
E) Cranial gut, Caudal gut, Lateral gut

A) Foregut, Midgut, Hindgut
Explanation: The text identifies the three main parts of the primitive gut as the foregut, midgut, and hindgut, which are essential for understanding the development of the digestive tract.

p.2
Foregut, Midgut, and Hindgut Differentiation

What is the significance of the anterior intestinal portal?
A) It marks the end of the esophagus
B) It corresponds with the termination of the bile duct in the duodenum
C) It is the junction between the foregut and midgut
D) It indicates the beginning of the hindgut
E) It is the site of the gallbladder

C) It corresponds with the termination of the bile duct in the duodenum
Explanation: The anterior intestinal portal is the junction between the foregut and midgut, and its position in the adult gut corresponds with the termination of the bile duct in the second part of the duodenum.

p.6
Stomach Development and Rotation

What is the function of the greater omentum?
A) It connects the spleen to the stomach
B) It forms a space behind the stomach
C) It serves as an apron-like fold of peritoneum
D) It connects the stomach to the posterior abdominal wall
E) It forms the gastric glands

C) It serves as an apron-like fold of peritoneum
Explanation: The greater omentum is described as a large apron-like fold of peritoneum that extends from the greater curvature of the stomach, playing a significant role in the anatomy of the digestive tract.

p.15
Development of the Digestive Tract

What is the origin of the lower half of the anal canal?
A) Mesodermal
B) Ectodermal
C) Endodermal
D) Epithelial
E) Neural

C) Endodermal
Explanation: The lower half of the anal canal is endodermal in origin and develops from the anal pit known as the proctodeum.

p.1
Development of the Digestive Tract

Which part of the gut is derived from the dorsal part of the endodermal yolk sac?
A) Foregut
B) Midgut
C) Hindgut
D) All parts of the gastrointestinal tract
E) Both foregut and hindgut

D) All parts of the gastrointestinal tract
Explanation: The primitive gut, which develops from the dorsal part of the endodermal yolk sac, forms the endothelial lining of all parts of the gastrointestinal tract, except for parts derived from ectoderm.

p.2
Arterial Supply of the Gut

Which artery supplies the foregut?
A) Inferior mesenteric artery
B) Celiac trunk
C) Superior mesenteric artery
D) Dorsal aorta
E) Renal artery

B) Celiac trunk
Explanation: The celiac trunk is specifically mentioned as the artery that supplies the foregut, making it crucial for understanding the vascularization of this part of the digestive tract.

p.5
Stomach Development and Rotation

What happens to the left vagus nerve during stomach rotation?
A) It supplies the pyloric end
B) It supplies the posterior surface
C) It supplies the anterior surface
D) It becomes non-functional
E) It supplies the cardiac end

C) It supplies the anterior surface
Explanation: Due to the stomach's rotation, the left vagus nerve, which initially supplied the left surface, now supplies the anterior surface of the stomach.

p.3
Foregut, Midgut, and Hindgut Differentiation

What is the primary function of the tracheoesophageal septum?
A) To separate the foregut into stomach and duodenum
B) To divide the foregut into the esophagus and trachea
C) To form the respiratory system
D) To create the laryngotracheal groove
E) To connect the esophagus to the stomach

B) To divide the foregut into the esophagus and trachea
Explanation: The tracheoesophageal septum plays a crucial role in separating the foregut into the esophagus and trachea, which is essential for proper respiratory and digestive function.

p.2
Development of the Digestive Tract

What is the role of the splanchnopleuric mesoderm in gut development?
A) It forms the mucosal layer
B) It contributes to the muscular coat
C) It develops into the serosa coat
D) It is responsible for the formation of the gut lumen
E) It does not play a role in gut development

B) It contributes to the muscular coat
Explanation: The splanchnopleuric mesoderm is involved in forming the muscular coat of the gut, which is essential for the movement and function of the digestive tract.

p.10
Primitive Gut Formation

Which structure is referred to as the 'cecal bud' in the context of midgut development?
A) A segment of the stomach
B) An embryonic structure that develops into the cecum
C) A part of the descending colon
D) The appendix
E) The transverse colon

B) An embryonic structure that develops into the cecum
Explanation: The cecal bud is an embryonic structure that ultimately develops into the cecum, highlighting its importance in gut formation.

p.13
Midgut Loop Rotation and Fixation

What is the consequence of reversed rotation of the midgut loop?
A) The cecum is located below the liver
B) The transverse colon passes behind the duodenum
C) The small intestine is obstructed
D) The appendix is removed
E) The large intestine occupies the right side of the abdomen

B) The transverse colon passes behind the duodenum
Explanation: In reversed rotation, the midgut loop rotates clockwise instead of anticlockwise, resulting in the transverse colon passing behind the duodenum and lying behind the superior mesenteric artery.

p.1
Primitive Gut Formation

What separates the cranial end of the foregut from the stomodeum?
A) Cloacal membrane
B) Buccopharyngeal membrane
C) Vitellointestinal duct
D) Proctodeum
E) Amniotic cavity

B) Buccopharyngeal membrane
Explanation: The cranial end of the foregut is separated from the stomodeum by the buccopharyngeal membrane, which plays a crucial role in the early development of the digestive tract.

p.1
Primitive Gut Formation

What is the significance of the vitellointestinal duct?
A) It connects the foregut to the proctodeum
B) It allows communication between the primitive gut and the yolk sac
C) It separates the midgut from the hindgut
D) It forms the cloacal membrane
E) It is responsible for the muscular layer of the gut

B) It allows communication between the primitive gut and the yolk sac
Explanation: The vitellointestinal duct facilitates the communication between the primitive gut and the remaining yolk sac, which is crucial during early development.

p.18
Congenital Anomalies of the Esophagus

What is the fate of the vitellointestinal duct by the tenth week of intrauterine life (IUL)?
A) It doubles in size
B) It becomes a permanent structure
C) It completely obliterates
D) It forms a fistula
E) It develops into the umbilical cord

C) It completely obliterates
Explanation: The vitellointestinal duct, also known as the omphaloenteric tract, normally completely obliterates by the tenth week of intrauterine life, which is a crucial developmental milestone.

p.5
Stomach Development and Rotation

How do the cephalic and caudal ends of the stomach move during rotation?
A) Both move to the left
B) Cardiac end moves to the left and slightly downward; pyloric end moves to the right and slightly upward
C) Both move to the right
D) Cardiac end moves upward; pyloric end moves downward
E) Both remain in the midline

B) Cardiac end moves to the left and slightly downward; pyloric end moves to the right and slightly upward
Explanation: The rotation of the stomach causes the cardiac end to shift left and downward while the pyloric end moves right and upward, altering their original midline positions.

p.7
Stomach Development and Rotation

What is the significance of the clockwise rotation of the stomach?
A) It causes the stomach to grow larger
B) It allows the duodenal loop to fall on the right side
C) It affects the blood supply to the liver
D) It changes the shape of the spleen
E) It has no significant effect

B) It allows the duodenal loop to fall on the right side
Explanation: The clockwise rotation of the stomach to the left results in the duodenal loop falling on the right side, which is an important aspect of the anatomical positioning of the digestive organs.

p.5
Stomach Development and Rotation

What does the dorsal mesogastrium extend from?
A) Lesser curvature to the liver
B) Greater curvature to the posterior abdominal wall
C) Cardiac end to the pyloric end
D) Anterior abdominal wall to the liver
E) Septum transversum to the anterior wall

B) Greater curvature to the posterior abdominal wall
Explanation: The dorsal mesogastrium initially extends from the greater curvature of the stomach to the posterior abdominal wall, playing a role in the stomach's positioning and support.

p.14
Fixation of Midgut Derivatives

What happens to the dorsal mesentery during the rotation of the midgut loop?
A) It disappears completely
B) It twists around the superior mesenteric artery
C) It becomes longer
D) It fuses with the stomach
E) It shifts to the left side of the abdomen

B) It twists around the superior mesenteric artery
Explanation: During the rotation of the midgut loop, the dorsal mesentery twists around the superior mesenteric artery, which is a significant developmental change.

p.8
Arterial Supply of the Gut

Which artery supplies the proximal half of the duodenum?
A) Superior mesenteric artery
B) Celiac trunk
C) Inferior mesenteric artery
D) Renal artery
E) Hepatic artery

B) Celiac trunk
Explanation: The proximal half of the duodenum develops from the foregut and is supplied by the celiac trunk, which is critical for understanding its blood supply.

p.18
Congenital Anomalies of the Esophagus

What is Meckel’s diverticulum?
A) A type of congenital hernia
B) A remnant of the vitellointestinal duct
C) A form of intestinal obstruction
D) A type of umbilical cord anomaly
E) A developmental defect of the stomach

B) A remnant of the vitellointestinal duct
Explanation: Meckel’s diverticulum is a small diverticulum that persists in about 2% of cases where a remnant of the vitellointestinal duct remains after the normal obliteration process.

p.8
Development of the Digestive Tract

What does the postarterial segment of the midgut loop develop into?
A) Distal half of duodenum
B) Jejunum
C) Cecum
D) Ascending colon
E) Proximal two-thirds of the transverse colon

C) Cecum
Explanation: The postarterial segment of the midgut loop gives rise to the terminal part of the ileum, cecum, appendix, ascending colon, and proximal two-thirds of the transverse colon.

p.4
Congenital Anomalies of the Esophagus

What is the survival rate after surgical correction of esophageal atresia?
A) 50%
B) 70%
C) 85%
D) 90%
E) 95%

C) 85%
Explanation: The surgical correction of esophageal atresia has an 85% survival rate, indicating a relatively high success rate for this congenital anomaly.

p.3
Clinical Correlations and Anomalies in Gut Development

What is a common clinical condition associated with esophageal atresia?
A) Oligohydramnios
B) Polyhydramnios
C) Hyperemesis gravidarum
D) Placenta previa
E) Ectopic pregnancy

B) Polyhydramnios
Explanation: In esophageal atresia, the fetus is unable to swallow amniotic fluid, leading to an abnormal increase in amniotic fluid known as polyhydramnios.

p.16
Congenital Anomalies of the Esophagus

What is the clinical condition known as imperforate anus?
A) A condition where the gut fails to communicate with the exterior
B) A type of intestinal infection
C) A condition where the gut is overly mobile
D) A type of bowel obstruction
E) A condition where the gut is too narrow

A) A condition where the gut fails to communicate with the exterior
Explanation: Imperforate anus is a clinical condition where the lower part of the gastrointestinal tract does not connect to the exterior, leading to various complications.

p.4
Congenital Anomalies of the Esophagus

What is the characteristic finding on a barium swallow for achalasia cardia?
A) Widening of the esophagus
B) Pencil-shaped narrowing (bird beak deformity)
C) Complete blockage of the esophagus
D) Presence of air bubbles
E) Normal esophageal shape

B) Pencil-shaped narrowing (bird beak deformity)
Explanation: In achalasia cardia, a barium swallow reveals a pencil-shaped narrowing of the lower part of the esophagus, known as bird beak deformity, due to failure of relaxation of the musculature.

p.9
Arterial Supply of the Gut

What artery supplies all parts derived from the midgut?
A) Inferior mesenteric artery
B) Celiac trunk
C) Superior mesenteric artery
D) Renal artery
E) Aorta

C) Superior mesenteric artery
Explanation: The superior mesenteric artery is responsible for supplying all parts derived from the midgut, highlighting its crucial role in the vascularization of this region during development.

p.4
Stomach Development and Rotation

How does the stomach rotate during development?
A) Only around a longitudinal axis
B) Only around an anteroposterior axis
C) Twice, around both longitudinal and anteroposterior axes
D) It does not rotate
E) It rotates randomly

C) Twice, around both longitudinal and anteroposterior axes
Explanation: The stomach rotates twice during development: first around its longitudinal axis and then around its anteroposterior axis, which contributes to its final shape and position.

p.11
Cecum Development

Which type of cecum is most common in adults?
A) Conical type
B) Infantile type
C) Normal type
D) Exaggerated type
E) Fetal type

C) Normal type
Explanation: The normal type of cecum is the most prevalent in adults, accounting for 80-90% of cases, indicating its typical anatomical presentation.

p.1
Primitive Gut Formation

What is the role of the cloacal membrane in gut development?
A) It connects the foregut to the yolk sac
B) It separates the hindgut from the proctodeum
C) It forms the lining of the stomach
D) It connects the midgut to the foregut
E) It is involved in the formation of the amniotic cavity

B) It separates the hindgut from the proctodeum
Explanation: The cloacal membrane separates the caudal end of the hindgut from the proctodeum, and its rupture allows communication with the exterior.

p.1
Development of the Digestive Tract

What regulates the regional differentiation of the primitive gut?
A) Hox and ParaHox genes, and sonic hedgehog (SHH) signals
B) Estrogen and testosterone
C) Insulin and glucagon
D) Vitamin D and calcium
E) Nerve growth factor and brain-derived neurotrophic factor

A) Hox and ParaHox genes, and sonic hedgehog (SHH) signals
Explanation: The molecular regulation of regional differentiation of the primitive gut is primarily controlled by Hox and ParaHox genes, along with sonic hedgehog (SHH) signaling.

p.3
Congenital Anomalies of the Esophagus

What condition is characterized by the failure of recanalization of the developing esophagus?
A) Esophageal atresia
B) Polyhydramnios
C) Tracheoesophageal fistula
D) Gastroesophageal reflux
E) Duodenal atresia

A) Esophageal atresia
Explanation: Esophageal atresia occurs due to the failure of recanalization of the developing esophagus, often leading to associated conditions like tracheoesophageal fistula.

p.4
Congenital Anomalies of the Esophagus

What is a common clinical presentation of tracheoesophageal fistula?
A) Difficulty in swallowing
B) Vomiting every feed
C) Severe chest pain
D) Persistent cough
E) Abdominal bloating

B) Vomiting every feed
Explanation: Tracheoesophageal fistula typically presents with an infant vomiting every feed, and the presence of air in the stomach is a diagnostic sign.

p.16
Congenital Anomalies of the Esophagus

Which type of imperforate anus involves a bulging anal membrane?
A) Stenosed anal canal
B) Solid mass of ectodermal cells
C) Minor form with anal membrane failure to breakdown
D) Gap between upper and lower anal canal
E) Rectal atresia

C) Minor form with anal membrane failure to breakdown
Explanation: In this minor form of imperforate anus, the anal membrane develops normally but fails to break down, causing a bulging effect due to accumulated contents.

p.16
Congenital Anomalies of the Esophagus

What is a common association with rectal fistulae?
A) Stenosis of the anal canal
B) Imperforate anus
C) Volvulus
D) Situs inversus
E) Ischemic necrosis

B) Imperforate anus
Explanation: Rectal fistulae are frequently seen in association with imperforate anus, indicating a connection between these two conditions.

p.14
Development of Rectum

What is the cloaca in the context of hindgut development?
A) A part of the stomach
B) A dilated part of the hindgut distal to the allantois
C) The upper part of the anal canal
D) The urinary bladder
E) A section of the small intestine

B) A dilated part of the hindgut distal to the allantois
Explanation: The cloaca is the terminal dilated part of the hindgut, which is divided by the urorectal septum into the primitive urogenital sinus and the primitive rectum.

p.9
Midgut Loop Rotation and Fixation

What occurs during the third week of intrauterine life (IUL) concerning the midgut?
A) The midgut loops shrink
B) The midgut loop elongates rapidly
C) The midgut loops become fully formed
D) The midgut becomes completely vascularized
E) The midgut loops rotate 180°

B) The midgut loop elongates rapidly
Explanation: During the third week of IUL, the midgut loop undergoes rapid elongation, particularly in its prearterial segment, which is significant for subsequent developmental processes.

p.11
Congenital Anomalies of the Esophagus

What is exomphalos or omphalocele?
A) A type of cecal anomaly
B) A failure of the small intestine to return to the abdominal cavity
C) A congenital heart defect
D) An abnormality in the formation of the appendix
E) A type of intestinal obstruction

B) A failure of the small intestine to return to the abdominal cavity
Explanation: Exomphalos or omphalocele is a congenital anomaly resulting from the failure of the small intestine coils to return to the abdominal cavity during the sixth to tenth week of intrauterine life.

p.7
Foregut, Midgut, and Hindgut Differentiation

Which part of the duodenum is derived from the foregut?
A) Third part
B) Fourth part
C) First part
D) Second part
E) Common bile duct

C) First part
Explanation: The first part of the duodenum is derived from the foregut, while the second part up to the opening of the common bile duct is also derived from the foregut.

p.5
Stomach Development and Rotation

What is the first movement of the stomach during its development?
A) It moves downward
B) It rotates 90° clockwise around its longitudinal axis
C) It expands laterally
D) It rotates 180° counterclockwise
E) It shifts to the right

B) It rotates 90° clockwise around its longitudinal axis
Explanation: The stomach first rotates 90° clockwise around its longitudinal axis, resulting in the repositioning of its surfaces and altering the nerve supply to those surfaces.

p.7
Hindgut Development and Anomalies

What happens to the mesoduodenum during development?
A) It becomes part of the stomach
B) It is absorbed and becomes retroperitoneal
C) It forms the common bile duct
D) It develops into the spleen
E) It remains as a mesentery

B) It is absorbed and becomes retroperitoneal
Explanation: The mesoduodenum is absorbed during development and eventually becomes retroperitoneal, indicating a change in its anatomical position and function.

p.6
Duodenum Development and Disorders

Which part of the duodenum develops from the foregut?
A) Distal half
B) First and second parts
C) Third part
D) Fourth part
E) Entire duodenum

B) First and second parts
Explanation: The first and second parts of the duodenum, up to the opening of the common bile duct, are derived from the foregut, while the distal half comes from the midgut, indicating the dual origin of the duodenum.

p.14
Fixation of Midgut Derivatives

What is the role of the dorsal mesentery in the midgut loop?
A) It connects the midgut to the stomach
B) It attaches to the posterior abdominal wall in the midline
C) It forms the lining of the small intestine
D) It supports the liver
E) It is responsible for nutrient absorption

B) It attaches to the posterior abdominal wall in the midline
Explanation: The dorsal mesentery (mesentery proper) is crucial as it connects the midgut loop to the posterior abdominal wall, providing support during the development of the digestive tract.

p.4
Stomach Development and Rotation

What is the initial appearance of the stomach during development?
A) A tubular structure
B) A fusiform dilatation of the foregut
C) A solid mass
D) A spherical shape
E) A flat structure

B) A fusiform dilatation of the foregut
Explanation: The stomach appears as a fusiform dilatation of the foregut distal to the esophagus during the fourth week of intrauterine life, marking an important stage in its development.

p.14
Development of Anal Canal

From which two sources does the anal canal develop?
A) Hindgut and stomach
B) Proctodeum and cloaca
C) Hindgut and proctodeum
D) Urogenital sinus and rectum
E) Cloaca and mesentery

C) Hindgut and proctodeum
Explanation: The anal canal develops from both the hindgut and the proctodeum, with the upper half being endodermal in origin from the primitive rectum.

p.10
Foregut, Midgut, and Hindgut Differentiation

Which of the following structures is NOT part of the midgut as described in the text?
A) Cecum
B) Appendix
C) Transverse colon
D) Stomach
E) Ascending colon

D) Stomach
Explanation: The stomach is not considered part of the midgut; it is part of the foregut, while the other options are components of the midgut.

p.15
Development of the Digestive Tract

What separates the two parts of the anal canal during early development?
A) Anal orifice
B) Anal membrane
C) Pectinate line
D) Myenteric plexus
E) Proctodeum

B) Anal membrane
Explanation: Initially, the two parts of the anal canal are separated by the anal membrane, which later ruptures to allow communication between the two parts.

p.11
Cecum Development

What shape does the cecum take at birth?
A) Quadrate
B) Conical
C) Cylindrical
D) Oval
E) Irregular

B) Conical
Explanation: At birth, the cecum is described as having a conical shape, which later changes as it grows and develops in the infant.

p.8
Duodenum Development and Disorders

What causes duodenal stenosis?
A) Complete recanalization of the duodenum
B) Incomplete recanalization of the duodenum
C) Overgrowth of endodermal cells
D) Failure of the mesoduodenum to develop
E) Abnormal blood supply from the celiac trunk

B) Incomplete recanalization of the duodenum
Explanation: Duodenal stenosis occurs due to incomplete recanalization of the duodenum, resulting in a narrow lumen that can lead to partial obstruction.

p.6
Histogenesis of the Stomach

From which embryonic layer do the gastric glands of the stomach develop?
A) Ectoderm
B) Mesoderm
C) Endoderm
D) Splanchnic mesoderm
E) Neural crest

C) Endoderm
Explanation: The epithelial lining and gastric glands of the stomach are derived from the endoderm of the primitive foregut, highlighting their embryonic origin.

p.18
Congenital Anomalies of the Esophagus

What is a common confusion among students regarding exomphalos?
A) It is confused with Meckel’s diverticulum
B) It is confused with congenital umbilical hernia
C) It is confused with intestinal atresia
D) It is confused with gastroschisis
E) It is confused with duodenal obstruction

B) It is confused with congenital umbilical hernia
Explanation: Students often confuse exomphalos with congenital umbilical hernia, highlighting the need for clear differentiation between these two congenital anomalies.

p.13
Congenital Anomalies of the Esophagus

What is a vitelline (umbilical) fistula?
A) A connection between the stomach and the umbilicus
B) A failure of the vitellointestinal duct to obliterate completely
C) A type of hernia
D) An abnormal connection between the small and large intestine
E) A cyst formed from the vitellointestinal duct

B) A failure of the vitellointestinal duct to obliterate completely
Explanation: A vitelline fistula occurs when the vitellointestinal duct fails to obliterate along its entire length, resulting in a communication between the ileum and the umbilicus, allowing ileal contents to discharge through the umbilicus.

p.4
Congenital Anomalies of the Esophagus

What happens in a short esophagus condition?
A) The esophagus elongates excessively
B) The stomach is pulled up into the diaphragm
C) The esophagus develops normally
D) The esophagus becomes wider
E) The stomach is displaced laterally

B) The stomach is pulled up into the diaphragm
Explanation: In short esophagus, the esophagus fails to elongate during development, causing the stomach to be pulled up into the esophageal hiatus of the diaphragm, which can lead to congenital hiatal hernia.

p.16
Congenital Anomalies of the Esophagus

What is volvulus?
A) A condition where the gut is overly mobile
B) A type of rectal fistula
C) A congenital anomaly of the esophagus
D) A condition where the intestine twists along its mesentery
E) A type of stenosis

D) A condition where the intestine twists along its mesentery
Explanation: Volvulus occurs when a portion of the intestine twists around its mesentery, potentially compromising blood supply and leading to ischemic necrosis if not corrected in time.

p.4
Stomach Development and Rotation

What causes the greater curvature of the stomach?
A) Growth of the ventral border
B) Equal growth of both borders
C) Differential growth of the dorsal border
D) Absence of mesentery
E) Incomplete rotation

C) Differential growth of the dorsal border
Explanation: The greater curvature of the stomach is formed by the differential growth of the dorsal border, which grows more than the ventral border, leading to the characteristic shape of the stomach.

p.5
Stomach Development and Rotation

What marks the longitudinal axis of the stomach?
A) Line connecting the duodenum and esophagus
B) Line connecting the cardiac and pyloric ends of the stomach
C) Line connecting the anterior and posterior surfaces
D) Line connecting the greater and lesser curvatures
E) Line connecting the left and right vagus nerves

B) Line connecting the cardiac and pyloric ends of the stomach
Explanation: The longitudinal axis of the stomach is defined by the line connecting the cardiac and pyloric ends, which is crucial for understanding the stomach's rotation and orientation.

p.2
Development of the Digestive Tract

What does the esophagus develop from?
A) The part of the midgut
B) The part of the hindgut
C) The part of the foregut between the pharynx and the stomach
D) The dorsal mesentery
E) The yolk sac

C) The part of the foregut between the pharynx and the stomach
Explanation: The esophagus develops from the foregut, specifically from the section located between the pharynx and the stomach, highlighting its embryological origin.

p.10
Arterial Supply of the Gut

What artery supplies the proximal segment of the digestive tract mentioned in the text?
A) Inferior mesenteric artery
B) Celiac trunk
C) Superior mesenteric artery
D) Renal artery
E) Gastric artery

C) Superior mesenteric artery
Explanation: The superior mesenteric artery is specifically mentioned as supplying the proximal segment of the digestive tract, indicating its crucial role in arterial supply.

p.16
Midgut Loop Rotation and Fixation

What happens to the mesentery of the duodenum after gut rotation?
A) It becomes highly mobile
B) It fuses with the posterior abdominal wall
C) It remains unchanged
D) It develops into a volvulus
E) It becomes part of the rectum

B) It fuses with the posterior abdominal wall
Explanation: After the rotation of the gut, the mesentery of the duodenum (except for the first inch) fuses with the parietal peritoneum lining the posterior abdominal wall, becoming retroperitoneal.

p.9
Congenital Anomalies of the Esophagus

What is the physiological umbilical hernia?
A) A condition where the intestines are permanently outside the abdominal cavity
B) Herniation of intestinal loops through the umbilical opening
C) A type of congenital anomaly
D) A hernia that occurs only in adults
E) A hernia that does not require treatment

B) Herniation of intestinal loops through the umbilical opening
Explanation: The physiological umbilical hernia refers to the temporary herniation of intestinal loops through the umbilical opening during the sixth week of IUL, which is a normal developmental process.

p.9
Midgut Loop Rotation and Fixation

How many degrees does the midgut loop rotate during its return to the abdominal cavity?
A) 180°
B) 90°
C) 360°
D) 270°
E) 45°

D) 270°
Explanation: The midgut loop undergoes a total rotation of 270° during its return to the abdominal cavity, consisting of three 90° anticlockwise rotations, which is essential for establishing the definitive relationships of the intestine.

p.12
Congenital Anomalies of the Esophagus

What characterizes a congenital umbilical hernia?
A) Herniation of abdominal viscera through a closed umbilicus
B) Herniation of abdominal viscera through a weak umbilical opening
C) Herniation of abdominal viscera through the diaphragm
D) Herniation of abdominal viscera through the inguinal canal
E) Herniation of abdominal viscera through the thoracic cavity

B) Herniation of abdominal viscera through a weak umbilical opening
Explanation: A congenital umbilical hernia occurs when abdominal contents protrude through a poorly closed umbilicus, leading to a clinical presentation of a protrusion in the linea alba.

p.17
Foregut, Midgut, and Hindgut Differentiation

What embryological basis explains the innervation of the stomach by the vagus nerves?
A) They originate from the same spinal segment
B) They innervate the stomach before rotation
C) They are derived from the same embryonic layer
D) They cross over during development
E) They are influenced by the position of the liver

B) They innervate the stomach before rotation
Explanation: Initially, the left and right vagus nerves innervate the left and right sides of the stomach, respectively. Following a 90° clockwise rotation, these sides become the anterior and posterior surfaces, leading to their respective innervation.

p.6
Stomach Development and Rotation

What structure forms from the part of the dorsal mesogastrium extending from the greater curvature of the stomach to the spleen?
A) Greater omentum
B) Gastrosplenic ligament
C) Lienorenal ligament
D) Lesser omentum
E) Omental bursa

B) Gastrosplenic ligament
Explanation: The part of the dorsal mesogastrium that extends from the greater curvature of the stomach to the spleen forms the gastrosplenic ligament, which is an important anatomical structure in the digestive tract.

p.4
Congenital Anomalies of the Esophagus

What causes esophageal stenosis?
A) Incomplete esophageal recanalization and vascular abnormalities
B) Excessive growth of the esophagus
C) Overproduction of mucus
D) Infection in the esophagus
E) Genetic mutations

A) Incomplete esophageal recanalization and vascular abnormalities
Explanation: Esophageal stenosis is caused by incomplete recanalization of the esophagus and vascular abnormalities, leading to a narrowed lumen, particularly in the lower third of the esophagus.

p.14
Development of Hindgut Derivatives

Which part of the colon develops from the hindgut?
A) Ascending colon
B) Right two-thirds of transverse colon
C) Left one-third of transverse colon
D) Sigmoid colon
E) Cecum

D) Sigmoid colon
Explanation: The sigmoid colon, along with the descending colon and rectum, develops from the hindgut, highlighting the differentiation of the gastrointestinal tract.

p.13
Congenital Anomalies of the Esophagus

What happens in the case of a vitelline cyst?
A) The entire vitellointestinal duct is absent
B) The small intestine is obstructed
C) The middle part of the vitellointestinal duct persists
D) The cecum is located below the liver
E) The appendix is removed

C) The middle part of the vitellointestinal duct persists
Explanation: A vitelline cyst forms when the small middle part of the vitellointestinal duct fails to obliterate, leading to the formation of a cyst.

p.16
Congenital Anomalies of the Esophagus

What is situs inversus?
A) A condition where organs are transposed to the opposite side
B) A type of bowel obstruction
C) A condition where the gut is too narrow
D) A type of rectal atresia
E) A condition affecting only the stomach

A) A condition where organs are transposed to the opposite side
Explanation: Situs inversus is characterized by all abdominal and thoracic viscera being laterally transposed, such as the appendix and duodenum lying on the left side.

p.13
Congenital Anomalies of the Esophagus

What is a subhepatic cecum and appendix?
A) A condition where the cecum is located above the liver
B) A congenital anomaly where the cecum remains below the liver
C) A type of hernia
D) An inflammation of the gallbladder
E) A normal anatomical position of the cecum

B) A congenital anomaly where the cecum remains below the liver
Explanation: Subhepatic cecum and appendix occur when the cecum does not descend properly and remains permanently below the liver, which can lead to misdiagnosis during appendicitis.

p.17
Congenital Anomalies of the Esophagus

What is the commonest congenital anomaly of the intestine?
A) Esophageal atresia
B) Duodenal atresia
C) Meckel’s diverticulum
D) Intestinal malrotation
E) Hirschsprung's disease

C) Meckel’s diverticulum
Explanation: Meckel’s diverticulum is recognized as the most common congenital anomaly of the intestine, resulting from incomplete closure of the omphalomesenteric duct.

p.12
Congenital Anomalies of the Esophagus

What is the prognosis for a congenital umbilical hernia?
A) Poor prognosis, requiring immediate surgery
B) Good prognosis, usually reducing on its own
C) No prognosis, as it is always fatal
D) Poor prognosis, with a high mortality rate
E) Uncertain prognosis, varies by individual

B) Good prognosis, usually reducing on its own
Explanation: Congenital umbilical hernias typically reduce on their own within 2–3 years of life, and surgical intervention is only necessary if the hernia persists beyond this age.

p.17
Congenital Anomalies of the Esophagus

What is the name of the sinus tract that communicates with the distal part of the ileum in a newborn with a swollen umbilicus?
A) Umbilical hernia
B) Meckel's diverticulum
C) Vitelline duct fistula
D) Omphalocele
E) Gastroschisis

C) Vitelline duct fistula
Explanation: The persistent discharge from the umbilicus and the fluoroscopy findings indicate a vitelline duct fistula, which results from the failure of the vitelline duct to close during development.

p.7
Development of the Digestive Tract

What is the role of the mesoduodenum in duodenal development?
A) It forms the gallbladder
B) It connects the duodenal loop to the posterior abdominal wall
C) It forms the lesser omentum
D) It becomes the falciform ligament
E) It supports the spleen

B) It connects the duodenal loop to the posterior abdominal wall
Explanation: The mesoduodenum serves as the mesentery that connects the developing duodenal loop to the posterior abdominal wall, playing a crucial role in its support and positioning.

p.3
Primitive Gut Formation

Which of the following is a derivative of the foregut?
A) Cecum
B) Ascending colon
C) Esophagus
D) Descending colon
E) Rectum

C) Esophagus
Explanation: The foregut gives rise to several structures, including the esophagus, making it a key derivative of this part of the primitive gut.

p.3
Development of the Digestive Tract

What causes the elongation of the esophagus during development?
A) Formation of the stomach
B) Descent of the diaphragm
C) Growth of the liver
D) Development of the pancreas
E) Fusion of the pharyngeal pouches

B) Descent of the diaphragm
Explanation: The elongation of the esophagus is attributed to the descent of the diaphragm, along with the formation of the neck and the descent of the heart and lungs.

p.10
Midgut Loop Rotation and Fixation

What is the sequence of rotation of the midgut loop as described in the text?
A) 90° clockwise, then 180° anticlockwise
B) 90° anticlockwise, then 180° anticlockwise
C) 180° clockwise, then 90° anticlockwise
D) 90° clockwise, then 90° anticlockwise
E) No rotation occurs

B) 90° anticlockwise, then 180° anticlockwise
Explanation: The midgut loop undergoes a 90° anticlockwise rotation followed by a 180° anticlockwise rotation as it is withdrawn into the abdominal cavity, which is crucial for proper gut positioning.

p.10
Hindgut Development and Anomalies

What happens to the cecum during midgut development?
A) It remains in the same position
B) It descends later in development
C) It rotates 90° clockwise
D) It forms before the stomach
E) It becomes part of the duodenum

B) It descends later in development
Explanation: The text indicates that the descent of the cecum occurs later in the development process, which is an important aspect of gut anatomy.

p.17
Midgut Loop Rotation and Fixation

What is the primary role of gut rotation during development?
A) To increase the length of the intestine
B) To help in the retraction of herniated loops of intestine into the abdominal cavity
C) To establish the blood supply to the gut
D) To form the mesentery
E) To create the digestive enzymes

B) To help in the retraction of herniated loops of intestine into the abdominal cavity
Explanation: The rotation of the gut plays a crucial role in retracting herniated loops back into the abdominal cavity and establishing the definitive relationships of various parts of the intestine.

p.12
Congenital Anomalies of the Esophagus

What distinguishes omphalocele from congenital umbilical hernia?
A) Omphalocele has a good prognosis
B) Congenital umbilical hernia is covered by Wharton’s jelly
C) Omphalocele involves physiological herniation
D) Congenital umbilical hernia has a genetic basis
E) Omphalocele occurs through a weak umbilical opening

C) Omphalocele involves physiological herniation
Explanation: Omphalocele is characterized by herniation of bowel loops through the umbilical opening as a normal developmental event, which fails to return to the abdominal cavity, unlike congenital umbilical hernia.

p.12
Congenital Anomalies of the Esophagus

What is a key feature of gastroschisis?
A) It occurs through a weak umbilical opening
B) It involves herniation lateral to the umbilicus
C) It is covered by Wharton’s jelly
D) It has a genetic basis
E) It is a result of physiological herniation

B) It involves herniation lateral to the umbilicus
Explanation: Gastroschisis is characterized by a linear defect in the anterior abdominal wall through which abdominal contents herniate out, typically occurring to the right of the umbilicus.

p.15
Development of the Digestive Tract

What is represented by the pectinate line in adults?
A) Site of anal membrane
B) Site of anal pit
C) Site of myenteric plexus
D) Site of rectal dilation
E) Site of peristalsis

A) Site of anal membrane
Explanation: The pectinate line in adults represents the site where the anal membrane was located during development.

p.11
Arterial Supply of the Gut

What is the primary artery supplying the postarterial segment of the midgut loop?
A) Inferior mesenteric artery
B) Renal artery
C) Superior mesenteric artery
D) Celiac trunk
E) Aorta

C) Superior mesenteric artery
Explanation: The postarterial segment of the midgut loop is primarily supplied by the superior mesenteric artery, which plays a crucial role in the vascularization of the midgut.

p.8
Duodenum Development and Disorders

What is the clinical sign associated with duodenal atresia?
A) Double bubble sign
B) Triple bubble sign
C) Single bubble sign
D) No visible signs on X-ray
E) Shadowing of the liver

A) Double bubble sign
Explanation: The 'double bubble sign' seen in X-ray or ultrasound indicates duodenal atresia, which occurs due to the failure of recanalization of the duodenum.

p.1
Arterial Supply of the Gut

Which arteries remain after the ventral branches of the dorsal aorta disappear?
A) Celiac artery, superior mesenteric artery, inferior mesenteric artery
B) Carotid artery, subclavian artery, renal artery
C) Femoral artery, popliteal artery, tibial artery
D) Aorta, pulmonary artery, coronary artery
E) Brachial artery, radial artery, ulnar artery

A) Celiac artery, superior mesenteric artery, inferior mesenteric artery
Explanation: After the disappearance of most ventral branches of the dorsal aorta, only the celiac artery (foregut), superior mesenteric artery (midgut), and inferior mesenteric artery (hindgut) remain.

p.5
Stomach Development and Rotation

What structure is formed from the ventral mesogastrium during liver development?
A) Lesser omentum
B) Greater omentum
C) Falciform ligament
D) Dorsal mesogastrium
E) Mesenteric root

A) Lesser omentum
Explanation: The ventral mesogastrium is divided into two parts during liver development, with the part extending from the stomach to the liver becoming the lesser omentum.

p.14
Development of Transverse Colon

What supplies the right two-thirds of the transverse colon?
A) Inferior mesenteric artery
B) Celiac trunk
C) Superior mesenteric artery
D) Renal artery
E) Hepatic artery

C) Superior mesenteric artery
Explanation: The right two-thirds of the transverse colon is supplied by the superior mesenteric artery, which is associated with the midgut development.

p.13
Midgut Loop Rotation and Fixation

What characterizes the nonrotation anomaly of the midgut loop?
A) The cecum is located above the stomach
B) The large intestine occupies the left side of the abdominal cavity
C) The small intestine is on the left side
D) The midgut loop rotates 360 degrees
E) The appendix is located on the left side

B) The large intestine occupies the left side of the abdominal cavity
Explanation: In the nonrotation anomaly, the midgut loop fails to rotate, resulting in the large intestine occupying the left side of the abdominal cavity while the small intestine occupies the right side.

p.9
Development of the Digestive Tract

What does the cecal bud develop into?
A) Only the appendix
B) Only the cecum
C) Cecum and appendix
D) Ascending colon
E) Transverse colon

C) Cecum and appendix
Explanation: The cecal bud, which appears in the postarterial segment of the midgut loop, develops into the cecum and appendix, with the proximal part forming the cecum and the distal part forming the appendix.

p.9
Midgut Loop Rotation and Fixation

What happens to the jejunum and ileum during the midgut rotation?
A) They become part of the ascending colon
B) They pass behind the superior mesenteric artery
C) They remain in the umbilical region
D) They do not rotate
E) They form the cecal bud

B) They pass behind the superior mesenteric artery
Explanation: During the second 90° anticlockwise rotation, the coils of jejunum and ileum pass behind the superior mesenteric artery, which is an important step in the rotation process.

p.17
Congenital Anomalies of the Esophagus

What is the probable diagnosis for a newborn with a shiny mass protruding from the umbilicus?
A) Umbilical hernia
B) Omphalocele
C) Gastroschisis
D) Meckel's diverticulum
E) Intestinal malrotation

B) Omphalocele
Explanation: The description of a shiny mass covered by a thin membrane suggests an omphalocele, which occurs when abdominal contents herniate through the umbilical ring.

p.8
Duodenum Development and Disorders

What is the significance of the mesoduodenum in relation to the duodenum?
A) It disappears completely during development
B) It persists only in the distal half of the duodenum
C) It persists in relation to a small portion adjoining the pylorus
D) It is responsible for the development of the cecum
E) It connects the duodenum to the liver

C) It persists in relation to a small portion adjoining the pylorus
Explanation: The mesoduodenum is noted for its persistence in relation to a small portion of the duodenum that is adjacent to the pylorus, which is important for understanding its anatomical relationships.

p.6
Congenital Anomalies of the Esophagus

What condition is characterized by hypertrophy of the circular muscle layer at the pylorus?
A) Duodenal atresia
B) Congenital hypertrophic pyloric stenosis
C) Gastroesophageal reflux
D) Intestinal malrotation
E) Meckel's diverticulum

B) Congenital hypertrophic pyloric stenosis
Explanation: Congenital hypertrophic pyloric stenosis occurs due to the hypertrophy of the circular muscle layer at the pylorus, leading to obstruction and significant clinical symptoms in newborns.

p.18
Congenital Anomalies of the Esophagus

What is exomphalos (omphalocele)?
A) A type of intestinal obstruction
B) A congenital anomaly where the intestine fails to return to the abdominal cavity
C) A remnant of the vitellointestinal duct
D) A form of congenital hernia
E) A developmental defect of the liver

B) A congenital anomaly where the intestine fails to return to the abdominal cavity
Explanation: Exomphalos, also known as omphalocele, occurs when the intestine fails to return to the abdominal cavity during the tenth week of intrauterine life, leading to a significant congenital anomaly.

p.18
Congenital Anomalies of the Esophagus

What happens to the membrane covering exomphalos when exposed to air?
A) It becomes transparent
B) It remains shiny
C) It rapidly loses its shiny appearance
D) It thickens and becomes fibrous
E) It turns into a solid mass

C) It rapidly loses its shiny appearance
Explanation: Once the transparent membrane covering exomphalos is exposed to air, it quickly loses its shiny appearance and becomes thicker, eventually getting covered with an opaque fibrinous exudate.

p.3
Hindgut Development and Anomalies

Which part of the esophagus has striated musculature?
A) Upper one-third
B) Middle one-third
C) Lower one-third
D) Entire esophagus
E) None of the above

A) Upper one-third
Explanation: The upper one-third of the esophagus is characterized by striated musculature, while the middle has mixed musculature and the lower has smooth musculature.

p.13
Midgut Loop Rotation and Fixation

What occurs during partial rotation of the midgut loop?
A) The cecum is located below the liver
B) The first 180° of rotation occurs normally
C) The entire loop rotates 360 degrees
D) The appendix is located on the left side
E) The midgut loop does not rotate at all

B) The first 180° of rotation occurs normally
Explanation: In partial rotation, the first 180° of rotation occurs normally, but the last 90° does not, causing the cecum and appendix to be located just below the pylorus of the stomach instead of the right side.

p.17
Congenital Anomalies of the Esophagus

What is the most important confirmatory sign of esophageal atresia?
A) Vomiting bile
B) Continuous pouring of saliva from mouth
C) Abdominal distention
D) Lack of bowel movement
E) Cyanosis

B) Continuous pouring of saliva from mouth
Explanation: The continuous pouring of saliva from the mouth is a key sign indicating esophageal atresia, as it suggests that the saliva cannot pass into the stomach.

p.17
Midgut Loop Rotation and Fixation

How many degrees does the midgut rotate during its return to the abdominal cavity?
A) 90°
B) 180°
C) 270°
D) 360°
E) 45°

C) 270°
Explanation: The midgut undergoes a total anticlockwise rotation of 270° during its return to the abdominal cavity, which is essential for proper intestinal positioning.

p.12
Congenital Anomalies of the Esophagus

What happens to a congenital umbilical hernia during crying or coughing?
A) It decreases in size
B) It remains unchanged
C) It increases in size
D) It becomes irreducible
E) It disappears completely

C) It increases in size
Explanation: The size of a congenital umbilical hernia increases during crying, coughing, and straining due to increased abdominal pressure, which can exacerbate the herniation.

p.17
Duodenum Development and Disorders

What is the most probable diagnosis for a newborn with bile in vomitus and marked distention in the epigastric region?
A) Intestinal obstruction
B) Duodenal atresia
C) Pyloric stenosis
D) Gastroesophageal reflux
E) Meckel’s diverticulum

B) Duodenal atresia
Explanation: The symptoms of bile in the vomitus and epigastric distention suggest duodenal atresia, which is caused by incomplete recanalization of the duodenum during development.

p.12
Congenital Anomalies of the Esophagus

What is Meckel’s diverticulum?
A) A type of congenital umbilical hernia
B) A small part of the vitellointestinal duct that persists
C) A defect in the abdominal wall
D) A type of omphalocele
E) A fibrous cord connecting to the umbilicus

B) A small part of the vitellointestinal duct that persists
Explanation: Meckel’s diverticulum is formed when a small part of the vitellointestinal duct near the midgut (ileum) persists, leading to a diverticulum that can cause various complications.

p.15
Congenital Anomalies of the Esophagus

What is the primary cause of congenital megacolon?
A) Excessive peristalsis
B) Failure of neural crest cell migration
C) Infection in the colon
D) Genetic mutation
E) Dietary factors

B) Failure of neural crest cell migration
Explanation: Congenital megacolon is produced due to the failure of migration of neural crest cells in the wall of the affected segment of the colon, leading to the absence of peristalsis.

p.12
Congenital Anomalies of the Esophagus

What occurs when part of the vitellointestinal duct near the umbilicus persists?
A) Gastroschisis
B) Meckel’s diverticulum
C) Umbilical sinus
D) Congenital umbilical hernia
E) Omphalocele

C) Umbilical sinus
Explanation: An umbilical sinus occurs when part of the vitellointestinal duct near the umbilicus fails to close, leading to a communication with the umbilicus.

p.15
Congenital Anomalies of the Esophagus

What is congenital megacolon also known as?
A) Anal stenosis
B) Hirschsprung’s disease
C) Anal fissure
D) Rectal prolapse
E) Colonic atresia

B) Hirschsprung’s disease
Explanation: Congenital megacolon is clinically referred to as Hirschsprung’s disease, characterized by a dilated segment of the colon due to the absence of autonomic parasympathetic ganglia.

p.15
Congenital Anomalies of the Esophagus

Which segment of the colon is most commonly affected by congenital megacolon?
A) Ascending colon
B) Transverse colon
C) Sigmoid colon or rectum
D) Descending colon
E) Cecum

C) Sigmoid colon or rectum
Explanation: Congenital megacolon is commonly seen in the sigmoid colon or rectum, where the affected segment lacks autonomic ganglia.

p.15
Nerve Supply of the Gut

What type of nerve supply is associated with the lower half of the anal canal?
A) Autonomic
B) Somatic
C) Sympathetic
D) Parasympathetic
E) Central

B) Somatic
Explanation: The lower half of the anal canal has a somatic nerve supply, contrasting with the autonomic supply of the upper half.

p.15
Clinical Correlations and Anomalies in Gut Development

What are the clinical presentations of congenital megacolon?
A) Diarrhea and dehydration
B) Loss of peristalsis, fecal retention, and abdominal distension
C) Constipation and weight loss
D) Nausea and vomiting
E) Fever and abdominal pain

B) Loss of peristalsis, fecal retention, and abdominal distension
Explanation: Clinically, congenital megacolon presents with loss of peristalsis, fecal retention, and abdominal distension due to the obstruction caused by the affected segment.

p.15
Arterial Supply of the Gut

What is the main difference in arterial supply between the upper and lower halves of the anal canal?
A) Both receive blood from the same artery
B) Upper half receives blood from the inferior rectal artery
C) Lower half receives blood from the superior rectal artery
D) Upper half receives blood from the superior rectal artery
E) Lower half receives blood from the portal vein

D) Upper half receives blood from the superior rectal artery
Explanation: The upper half of the anal canal is supplied by the superior rectal artery, while the lower half is supplied by the inferior rectal artery.

Study Smarter, Not Harder
Study Smarter, Not Harder