Stanford University SURG 203 Anatomy
(Macroscopic, Embryology and Histology) –
Stanford Medical School Anatomy Study Guide,
Original Practice Questions & Answers, SURG 203
Exam Preparation, Comprehensive Clinical
Anatomy Review, Gross Anatomy, Macroscopic
Anatomy, Embryology, Histology, Developmental
Anatomy, Medical Imaging, Dissection, Thorax,
Abdomen, Pelvis, Back, Upper & Lower Limbs, Head
& Neck & Clinical Anatomy
Question 1: Which of the following anatomical relationships correctly
describes the position of the right kidney relative to the peritoneum and
adjacent structures?
A. It is primarily an intraperitoneal organ suspended by the mesentery of the ascending
colon.
B. It lies anterior to the quadratus lumborum muscle and is covered by peritoneum only
on its anteromedial aspect.
C. It is a retroperitoneal structure located posterior to the duodenum and the right colic
flexure.
D. It is positioned inferior to the suprarenal gland and anterolateral to the inferior vena
cava.
CORRECT ANSWER: C. It is a retroperitoneal structure located posterior to the
duodenum and the right colic flexure.
Rationale: The right kidney is a retroperitoneal organ. Its anterior surface is related to
the right lobe of the liver, the descending part of the duodenum (which crosses its
medial border), and the right colic flexure. It lies on the psoas major and quadratus
lumborum muscles, not anterolateral to the IVC, and is not an intraperitoneal organ.
Question 2: During the embryonic development of the female reproductive
tract, failure of the caudal portions of the paramesonephric ducts to fuse
properly most likely results in which of the following congenital anomalies?
A. Uterus didelphys
B. Agenesis of the vagina
C. Bicornuate uterus
D. Unicornuate uterus
CORRECT ANSWER: C. Bicornuate uterus
Rationale: A bicornuate uterus results from incomplete fusion of the caudal
paramesonephric (Müllerian) ducts. Uterus didelphys results from a complete failure of
fusion. Vaginal agenesis is associated with Mayer-Rokitansky-Küster-Hauser syndrome
,(failure of duct development). A unicornuate uterus results from failure of development
of one of the ducts.
Question 3: A histology slide of the esophagus reveals a stratified squamous
epithelium that transitions abruptly at the gastroesophageal junction. Which
of the following best describes the junctional epithelium found in the stomach
at this site?
A. Non-keratinized stratified squamous epithelium with gastric pits
B. Simple columnar epithelium with deep branching gastric glands
C. Pseudostratified columnar epithelium with goblet cells
D. Transitional epithelium with prominent dome cells
CORRECT ANSWER: B. Simple columnar epithelium with deep branching
gastric glands
Rationale: The stomach is lined by a simple columnar epithelium that invaginates to
form gastric pits and glands. At the gastroesophageal junction, the stratified squamous
epithelium of the esophagus abruptly changes to the simple columnar epithelium of the
stomach.
Question 4: Which of the following structures is derived from the fourth
pharyngeal arch and innervated by the superior laryngeal branch of the vagus
nerve (CN X)?
A. Stylopharyngeus muscle
B. Cricothyroid muscle
C. Levator veli palatini muscle
D. All intrinsic muscles of the larynx
CORRECT ANSWER: B. Cricothyroid muscle
Rationale: The cricothyroid muscle is derived from the mesenchyme of the fourth
pharyngeal arch and is innervated by the superior laryngeal nerve (branch of CN X). The
stylopharyngeus is derived from the third arch and innervated by CN IX. The intrinsic
laryngeal muscles (except cricothyroid) are derived from the sixth arch and innervated
by the recurrent laryngeal nerve. Levator veli palatini is derived from the fourth arch but
is innervated by the pharyngeal plexus (CN X).
Question 5: In a gross anatomy dissection of the mediastinum, a structure is
identified posterior to the pericardium, anterior to the esophagus, and superior
to the tracheal bifurcation. Which structure is most likely being observed?
A. Azygos vein
B. Left recurrent laryngeal nerve
,C. Right pulmonary artery
D. Arch of the azygos vein
CORRECT ANSWER: A. Azygos vein
Rationale: The azygos vein arches over the right main bronchus and the right pulmonary
artery to enter the superior vena cava. It is located in the posterior mediastinum,
posterior to the pericardium and anterior to the esophagus. The left recurrent laryngeal
nerve loops under the aortic arch, not in this specific location.
Question 6: Which histological feature is most characteristic of the proximal
convoluted tubule (PCT) in the kidney, enabling its function of active
reabsorption?
A. Tall columnar cells with a prominent brush border and abundant mitochondria
B. Low cuboidal cells with a smooth luminal surface and short microvilli
C. Simple squamous epithelium with a fenestrated endothelium
D. Stratified cuboidal epithelium with tight junctions and sparse organelles
CORRECT ANSWER: A. Tall columnar cells with a prominent brush border and
abundant mitochondria
Rationale: PCT cells are cuboidal to columnar with a well-developed brush border
(microvilli) to increase surface area and numerous mitochondria to provide ATP for
active transport of Na+, glucose, and amino acids.
Question 7: A patient presents with a fracture of the surgical neck of the
humerus. Which nerve is at greatest risk of injury, potentially resulting in
deltoid muscle paralysis?
A. Radial nerve
B. Ulnar nerve
C. Axillary nerve
D. Musculocutaneous nerve
CORRECT ANSWER: C. Axillary nerve
Rationale: The axillary nerve passes posteriorly through the quadrangular space and
wraps around the surgical neck of the humerus. Fractures in this area frequently injure
this nerve, leading to weakness or paralysis of the deltoid muscle and loss of sensation
over the lower deltoid.
Question 8: During embryogenesis, the primitive gut tube is divided into
foregut, midgut, and hindgut. Which of the following structures is derived
from the endoderm of the foregut?
, A. The ascending colon
B. The urinary bladder
C. The liver and biliary apparatus
D. The appendix
CORRECT ANSWER: C. The liver and biliary apparatus
Rationale: The liver, gallbladder, and biliary ducts develop as an endodermal outgrowth
from the ventral wall of the foregut (duodenum). The ascending colon and appendix are
derived from the midgut. The urinary bladder is derived from the urogenital sinus
(endoderm of the hindgut).
Question 9: In histological cross-section, the trachea is identified by which of
the following characteristic features?
A. C-shaped rings of hyaline cartilage, a pseudostratified ciliated columnar epithelium,
and a muscularis mucosa
B. Complete rings of elastic cartilage, a simple squamous epithelium, and prominent
serous glands
C. Irregular plates of hyaline cartilage, a stratified squamous epithelium, and a lack of
submucosal glands
D. C-shaped rings of elastic cartilage, a ciliated cuboidal epithelium, and a prominent
adventitia
CORRECT ANSWER: A. C-shaped rings of hyaline cartilage, a pseudostratified
ciliated columnar epithelium, and a muscularis mucosa
Rationale: The trachea features C-shaped rings of hyaline cartilage (open posteriorly), a
pseudostratified ciliated columnar epithelium (respiratory epithelium), and a distinct
muscularis mucosa. The posterior gap is bridged by the trachealis muscle.
Question 10: A medical student palpates the anterior abdominal wall and
locates the deep inguinal ring. This opening in the transversalis fascia
corresponds anatomically to which of the following landmarks?
A. The midpoint of the inguinal ligament
B. A point superior to the pubic tubercle
C. A point halfway between the anterior superior iliac spine and the pubic tubercle
D. The superficial inguinal ring
CORRECT ANSWER: C. A point halfway between the anterior superior iliac
spine and the pubic tubercle
Rationale: The deep inguinal ring is a defect in the transversalis fascia located laterally
to the inferior epigastric vessels, approximately midway between the anterior superior
(Macroscopic, Embryology and Histology) –
Stanford Medical School Anatomy Study Guide,
Original Practice Questions & Answers, SURG 203
Exam Preparation, Comprehensive Clinical
Anatomy Review, Gross Anatomy, Macroscopic
Anatomy, Embryology, Histology, Developmental
Anatomy, Medical Imaging, Dissection, Thorax,
Abdomen, Pelvis, Back, Upper & Lower Limbs, Head
& Neck & Clinical Anatomy
Question 1: Which of the following anatomical relationships correctly
describes the position of the right kidney relative to the peritoneum and
adjacent structures?
A. It is primarily an intraperitoneal organ suspended by the mesentery of the ascending
colon.
B. It lies anterior to the quadratus lumborum muscle and is covered by peritoneum only
on its anteromedial aspect.
C. It is a retroperitoneal structure located posterior to the duodenum and the right colic
flexure.
D. It is positioned inferior to the suprarenal gland and anterolateral to the inferior vena
cava.
CORRECT ANSWER: C. It is a retroperitoneal structure located posterior to the
duodenum and the right colic flexure.
Rationale: The right kidney is a retroperitoneal organ. Its anterior surface is related to
the right lobe of the liver, the descending part of the duodenum (which crosses its
medial border), and the right colic flexure. It lies on the psoas major and quadratus
lumborum muscles, not anterolateral to the IVC, and is not an intraperitoneal organ.
Question 2: During the embryonic development of the female reproductive
tract, failure of the caudal portions of the paramesonephric ducts to fuse
properly most likely results in which of the following congenital anomalies?
A. Uterus didelphys
B. Agenesis of the vagina
C. Bicornuate uterus
D. Unicornuate uterus
CORRECT ANSWER: C. Bicornuate uterus
Rationale: A bicornuate uterus results from incomplete fusion of the caudal
paramesonephric (Müllerian) ducts. Uterus didelphys results from a complete failure of
fusion. Vaginal agenesis is associated with Mayer-Rokitansky-Küster-Hauser syndrome
,(failure of duct development). A unicornuate uterus results from failure of development
of one of the ducts.
Question 3: A histology slide of the esophagus reveals a stratified squamous
epithelium that transitions abruptly at the gastroesophageal junction. Which
of the following best describes the junctional epithelium found in the stomach
at this site?
A. Non-keratinized stratified squamous epithelium with gastric pits
B. Simple columnar epithelium with deep branching gastric glands
C. Pseudostratified columnar epithelium with goblet cells
D. Transitional epithelium with prominent dome cells
CORRECT ANSWER: B. Simple columnar epithelium with deep branching
gastric glands
Rationale: The stomach is lined by a simple columnar epithelium that invaginates to
form gastric pits and glands. At the gastroesophageal junction, the stratified squamous
epithelium of the esophagus abruptly changes to the simple columnar epithelium of the
stomach.
Question 4: Which of the following structures is derived from the fourth
pharyngeal arch and innervated by the superior laryngeal branch of the vagus
nerve (CN X)?
A. Stylopharyngeus muscle
B. Cricothyroid muscle
C. Levator veli palatini muscle
D. All intrinsic muscles of the larynx
CORRECT ANSWER: B. Cricothyroid muscle
Rationale: The cricothyroid muscle is derived from the mesenchyme of the fourth
pharyngeal arch and is innervated by the superior laryngeal nerve (branch of CN X). The
stylopharyngeus is derived from the third arch and innervated by CN IX. The intrinsic
laryngeal muscles (except cricothyroid) are derived from the sixth arch and innervated
by the recurrent laryngeal nerve. Levator veli palatini is derived from the fourth arch but
is innervated by the pharyngeal plexus (CN X).
Question 5: In a gross anatomy dissection of the mediastinum, a structure is
identified posterior to the pericardium, anterior to the esophagus, and superior
to the tracheal bifurcation. Which structure is most likely being observed?
A. Azygos vein
B. Left recurrent laryngeal nerve
,C. Right pulmonary artery
D. Arch of the azygos vein
CORRECT ANSWER: A. Azygos vein
Rationale: The azygos vein arches over the right main bronchus and the right pulmonary
artery to enter the superior vena cava. It is located in the posterior mediastinum,
posterior to the pericardium and anterior to the esophagus. The left recurrent laryngeal
nerve loops under the aortic arch, not in this specific location.
Question 6: Which histological feature is most characteristic of the proximal
convoluted tubule (PCT) in the kidney, enabling its function of active
reabsorption?
A. Tall columnar cells with a prominent brush border and abundant mitochondria
B. Low cuboidal cells with a smooth luminal surface and short microvilli
C. Simple squamous epithelium with a fenestrated endothelium
D. Stratified cuboidal epithelium with tight junctions and sparse organelles
CORRECT ANSWER: A. Tall columnar cells with a prominent brush border and
abundant mitochondria
Rationale: PCT cells are cuboidal to columnar with a well-developed brush border
(microvilli) to increase surface area and numerous mitochondria to provide ATP for
active transport of Na+, glucose, and amino acids.
Question 7: A patient presents with a fracture of the surgical neck of the
humerus. Which nerve is at greatest risk of injury, potentially resulting in
deltoid muscle paralysis?
A. Radial nerve
B. Ulnar nerve
C. Axillary nerve
D. Musculocutaneous nerve
CORRECT ANSWER: C. Axillary nerve
Rationale: The axillary nerve passes posteriorly through the quadrangular space and
wraps around the surgical neck of the humerus. Fractures in this area frequently injure
this nerve, leading to weakness or paralysis of the deltoid muscle and loss of sensation
over the lower deltoid.
Question 8: During embryogenesis, the primitive gut tube is divided into
foregut, midgut, and hindgut. Which of the following structures is derived
from the endoderm of the foregut?
, A. The ascending colon
B. The urinary bladder
C. The liver and biliary apparatus
D. The appendix
CORRECT ANSWER: C. The liver and biliary apparatus
Rationale: The liver, gallbladder, and biliary ducts develop as an endodermal outgrowth
from the ventral wall of the foregut (duodenum). The ascending colon and appendix are
derived from the midgut. The urinary bladder is derived from the urogenital sinus
(endoderm of the hindgut).
Question 9: In histological cross-section, the trachea is identified by which of
the following characteristic features?
A. C-shaped rings of hyaline cartilage, a pseudostratified ciliated columnar epithelium,
and a muscularis mucosa
B. Complete rings of elastic cartilage, a simple squamous epithelium, and prominent
serous glands
C. Irregular plates of hyaline cartilage, a stratified squamous epithelium, and a lack of
submucosal glands
D. C-shaped rings of elastic cartilage, a ciliated cuboidal epithelium, and a prominent
adventitia
CORRECT ANSWER: A. C-shaped rings of hyaline cartilage, a pseudostratified
ciliated columnar epithelium, and a muscularis mucosa
Rationale: The trachea features C-shaped rings of hyaline cartilage (open posteriorly), a
pseudostratified ciliated columnar epithelium (respiratory epithelium), and a distinct
muscularis mucosa. The posterior gap is bridged by the trachealis muscle.
Question 10: A medical student palpates the anterior abdominal wall and
locates the deep inguinal ring. This opening in the transversalis fascia
corresponds anatomically to which of the following landmarks?
A. The midpoint of the inguinal ligament
B. A point superior to the pubic tubercle
C. A point halfway between the anterior superior iliac spine and the pubic tubercle
D. The superficial inguinal ring
CORRECT ANSWER: C. A point halfway between the anterior superior iliac
spine and the pubic tubercle
Rationale: The deep inguinal ring is a defect in the transversalis fascia located laterally
to the inferior epigastric vessels, approximately midway between the anterior superior
