Advanced Superior Mesenteric Artery Quiz

Q1. What is the anatomical basis of superior mesenteric artery syndrome?

• Compression of the stomach between the renal arteries
• Compression of the appendix by the SMA
• Compression of the sigmoid colon by the celiac trunk
• Compression of the third part of the duodenum between the SMA and aorta

Q2. Which vascular compression can occur when the left renal vein is compressed between the SMA and aorta?

• Thoracic outlet syndrome
• Median arcuate ligament syndrome
• May-Thurner syndrome
• Anterior nutcracker syndrome

Q3. Why is acute proximal SMA occlusion particularly dangerous?

• It interrupts only abdominal wall supply
• It can compromise a large territory of midgut bowel
• It affects only the spleen
• It blocks only venous drainage

Q4. Which collateral pathway directly links SMA and celiac arterial territories around the pancreatic head?

• Renal segmental arteries
• Pancreaticoduodenal arcades
• Sigmoid arcades
• Short gastric arteries only

Q5. Which collateral pathway can connect SMA and IMA territories more centrally when prominent?

• Arcus senilis
• Arc of Riolan
• Circle of Willis
• Plantar arch

Q6. Which sequence correctly traces arterial blood from the abdominal aorta to the terminal ileum?

• Aorta, SMA, ileocolic artery, terminal ileal branches
• Aorta, renal artery, gonadal artery, terminal ileum
• Aorta, IMA, left colic artery, terminal ileum
• Aorta, celiac trunk, splenic artery, terminal ileum

Q7. Why is the relationship between the SMA and SMV important during pancreatic and mesenteric surgery?

• Their close relationship forms a major surgical vascular landmark
• They have no relationship to the pancreas
• They are always separated by the spleen
• They lie within the urinary bladder wall

Q8. Which embryologic event explains the central role of the SMA in intestinal rotation?

• The foregut rotates around the IMA
• The stomach rotates around the renal artery
• The midgut rotates around the SMA axis
• The hindgut rotates around the celiac trunk

Q9. Why can malrotation alter the expected relationship of bowel and mesenteric vessels?

• It eliminates the SMA
• Abnormal midgut rotation changes bowel and mesenteric vascular relationships
• It converts the SMA into a vein
• It affects only splenic position

Q10. Which statement best summarizes the surgical significance of the SMA?

• It has no important collateral connections
• It is a minor branch confined to the spleen
• It supplies only the abdominal wall
• It is a major midgut vascular axis whose anatomy determines bowel perfusion