Advanced Fundus of the Stomach Quiz

Q1. Why can the short gastric arteries be vulnerable during surgical mobilization of the gastric fundus from the spleen?

• They lie entirely within the pelvic cavity
• They arise from the inferior mesenteric artery
• They traverse the gastrosplenic ligament between the spleen and fundus
• They pass through the hepatoduodenal ligament

Q2. Which relationship explains the appearance of a subdiaphragmatic gastric air bubble on an upright radiograph?

• The fundus lies below the pelvic brim
• The fundus is fixed behind the right kidney
• The fundus lies inside the lesser omentum
• The fundus lies beneath the left hemidiaphragm and is the highest gastric region

Q3. Which structures are important posterior relations of the fundus through the lesser sac?

• Thyroid gland, trachea, and heart
• Urinary bladder, prostate, and seminal vesicles
• Spleen, left kidney, left suprarenal gland, and pancreas
• Cecum, appendix, and right ovary only

Q4. How does embryonic stomach rotation help establish the adult orientation of the fundus?

• Midgut rotation alone creates the fundus
• Rotation and differential growth of the dorsal gastric wall contribute to adult fundic orientation
• The fundus forms by fusion with the spleen
• The fundus develops from the cloaca

Q5. Which statement best describes sympathetic innervation of the fundus?

• Pelvic splanchnic nerves provide its sympathetic supply
• Thoracic splanchnic fibers synapse in celiac ganglia before postganglionic fibers follow gastric arteries
• The pudendal nerve supplies fundic smooth muscle
• The vagus nerve carries sympathetic fibers

Q6. Why can visceral pain from the fundus be perceived in the epigastric region?

• The fundus has only somatic sensory innervation
• The femoral nerve carries gastric visceral pain
• Foregut visceral afferents project to upper thoracic spinal levels associated with the epigastrium
• All fundic sensation travels through sacral nerves

Q7. Which vascular fact is most important when considering collateral supply to the fundus?

• The fundus is supplied by a single terminal branch of the inferior mesenteric artery
• The portal vein provides its arterial supply
• Fundic supply includes short gastric and neighboring gastric arterial branches with variable collateral overlap
• The fundus has no arterial anastomoses

Q8. How does lymph from the fundus typically reach the celiac nodal group?

• Directly through axillary nodes
• Through pancreaticosplenic nodes along splenic vessels toward celiac nodes
• Through inferior mesenteric nodes to internal iliac nodes
• Through popliteal nodes to inguinal nodes

Q9. Which developmental mesentery gives rise to the gastrosplenic ligament associated with the fundus?

• Ventral mesentery of the hindgut
• Sigmoid mesocolon
• Dorsal mesogastrium
• Mesoappendix

Q10. Which statement best integrates the anatomy of the gastric fundus?

• It is a retroperitoneal midgut segment supplied by the superior mesenteric artery
• It is a hindgut structure innervated mainly by pelvic splanchnic nerves
• It is a dome-shaped intraperitoneal foregut region with diaphragmatic and splenic relations, fundic glands, short gastric vessels, celiac lymphatic pathways, and vagal-autonomic innervation
• It is an extraperitoneal pelvic organ without autonomic innervation