Intermediate Appendix Quiz

Q1. Which arterial feature makes the appendix vulnerable to ischemia if its main artery is obstructed?

• Its blood supply comes directly from the portal vein
• Its principal artery has limited collateral supply
• It has no arterial supply
• It receives blood only from the inferior mesenteric artery

Q2. Where does lymph from the appendix primarily drain before reaching superior mesenteric nodes?

• Superficial inguinal nodes
• Ileocolic lymph nodes
• Axillary nodes
• Inferior mesenteric nodes

Q3. Which autonomic plexus provides sympathetic pathways associated with the appendix?

• Cardiac plexus
• Inferior hypogastric plexus only
• Brachial plexus
• Superior mesenteric plexus

Q4. Which nerve provides parasympathetic innervation to the appendix?

• Pudendal nerve
• Phrenic nerve
• Pelvic splanchnic nerves
• Vagus nerve

Q5. Early visceral pain from appendiceal inflammation is classically referred to which region?

• Perineum
• Left shoulder
• Posterior thigh
• Periumbilical region

Q6. Which spinal cord level is classically associated with early referred pain from the appendix?

• T2
• T10
• C2
• S4

Q7. Why can later appendicitis produce more localized pain in the right lower quadrant?

• The appendix develops new cutaneous nerves
• Irritation of the parietal peritoneum activates somatic sensory fibers
• Vagal fibers become somatic motor fibers
• The appendicular artery directly stimulates the skin

Q8. What is McBurney point used to approximate clinically?

• The left colic flexure
• The region of the appendiceal base
• The pylorus
• The splenic hilum

Q9. Which feature explains why the tip of the appendix may lie in different anatomical locations?

• The cecum is fixed inside the thorax
• The base migrates freely around the colon
• The appendix has no peritoneal attachment
• The distal appendix is mobile

Q10. What is the relationship between the taeniae coli and the appendiceal base?

• The taeniae are absent from the cecum
• Only one taenia reaches the cecum
• All three taeniae coli converge at the base
• The taeniae terminate at the ileocecal valve