COMSAE PHASE 1 ABDOMINAL ANATOMY
PRACTICE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
Question 1
A 54-year-old man undergoes imaging for intermittent right upper-
quadrant abdominal pain. The radiologist identifies a structure located
posterior to the stomach and extending from the duodenum toward the
spleen. The structure is retroperitoneal except for its tail, which reaches
the splenic hilum within a peritoneal ligament. Which anatomical
relationship most accurately describes this organ?
A. The pancreas lies entirely intraperitoneally within the greater
omentum
B. The pancreas lies anterior to the stomach and drains directly into the
splenic vein through its entire length
C. The pancreas is primarily retroperitoneal, with its tail extending into
the splenorenal ligament
D. The pancreas is suspended from the liver by the hepatoduodenal
ligament
E. The pancreas is located entirely within the lesser sac and is
completely surrounded by peritoneum
Answer: C. The pancreas is primarily retroperitoneal, with its tail
extending into the splenorenal ligament
1
,Rationale: The pancreas is secondarily retroperitoneal except for its
tail, which extends toward the splenic hilum within the splenorenal
ligament. The head lies within the C-shaped curve of the duodenum,
while the body crosses the posterior abdominal wall and the tail
approaches the spleen. This anatomical arrangement is clinically
important during pancreatic and splenic surgery.
Question 2
A 62-year-old woman has a mass involving the head of the pancreas.
Imaging demonstrates obstruction of a tubular structure immediately
posterior to the pancreatic neck. Which vessel is most likely
compressed?
A. Inferior mesenteric vein
B. Superior mesenteric vein
C. Left renal vein
D. Inferior vena cava
E. Splenic artery
Answer: B. Superior mesenteric vein
Rationale: The portal vein is formed posterior to the neck of the
pancreas by union of the superior mesenteric and splenic veins. The
superior mesenteric vein ascends posterior to the pancreatic neck
before joining the splenic vein. A pancreatic-head mass can therefore
compromise the portal venous system.
Question 3
During an abdominal operation, a surgeon identifies the celiac trunk
arising from the anterior aspect of the abdominal aorta. Which
combination represents the three classic branches of the celiac trunk?
2
,A. Left gastric, splenic, and common hepatic arteries
B. Superior mesenteric, inferior mesenteric, and splenic arteries
C. Right gastric, left gastric, and gastroduodenal arteries
D. Common hepatic, superior mesenteric, and left gastric arteries
E. Splenic, inferior mesenteric, and common hepatic arteries
Answer: A. Left gastric, splenic, and common hepatic arteries
Rationale: The celiac trunk is an unpaired anterior branch of the
abdominal aorta that supplies derivatives of the foregut. Its three
major branches are the left gastric artery, splenic artery, and common
hepatic artery. The superior and inferior mesenteric arteries arise
separately from the aorta.
Question 4
A patient undergoes lymph-node evaluation for a gastric carcinoma
involving the greater curvature. Which arterial branch is most directly
associated with the greater curvature of the stomach?
A. Left gastric artery
B. Right gastric artery
C. Short gastric arteries
D. Right gastro-omental artery
E. Superior pancreaticoduodenal artery
Answer: D. Right gastro-omental artery
Rationale: The greater curvature receives blood from the right and left
gastro-omental arteries, which anastomose within the greater
omentum. The short gastric arteries supply the fundus, while the right
and left gastric arteries run along the lesser curvature.
Question 5
3
, A surgeon performs a procedure involving the lesser omentum. The
surgeon identifies a free edge containing the portal triad. Which
structure is NOT normally contained within the hepatoduodenal
ligament?
A. Proper hepatic artery
B. Portal vein
C. Common bile duct
D. Hepatic artery
E. Inferior vena cava
Answer: E. Inferior vena cava
Rationale: The hepatoduodenal ligament forms the free edge of the
lesser omentum and contains the portal triad: the common bile duct,
proper hepatic artery, and portal vein. The inferior vena cava lies
posterior to the omental bursa and is not part of the portal triad.
Question 6
A trauma patient has severe hemorrhage from an injury involving the
porta hepatis. The surgeon temporarily compresses the hepatoduodenal
ligament to reduce hepatic bleeding. Which vessels are being
compressed by this maneuver?
A. Hepatic veins and inferior vena cava
B. Portal vein and hepatic artery
C. Splenic vein and superior mesenteric artery
D. Celiac trunk and inferior vena cava
E. Superior mesenteric vein and renal artery
Answer: B. Portal vein and hepatic artery
Rationale: Compression of the hepatoduodenal ligament, known as
the Pringle maneuver, temporarily reduces hepatic inflow by
compressing the proper hepatic artery and portal vein. Hepatic veins
4
PRACTICE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
Question 1
A 54-year-old man undergoes imaging for intermittent right upper-
quadrant abdominal pain. The radiologist identifies a structure located
posterior to the stomach and extending from the duodenum toward the
spleen. The structure is retroperitoneal except for its tail, which reaches
the splenic hilum within a peritoneal ligament. Which anatomical
relationship most accurately describes this organ?
A. The pancreas lies entirely intraperitoneally within the greater
omentum
B. The pancreas lies anterior to the stomach and drains directly into the
splenic vein through its entire length
C. The pancreas is primarily retroperitoneal, with its tail extending into
the splenorenal ligament
D. The pancreas is suspended from the liver by the hepatoduodenal
ligament
E. The pancreas is located entirely within the lesser sac and is
completely surrounded by peritoneum
Answer: C. The pancreas is primarily retroperitoneal, with its tail
extending into the splenorenal ligament
1
,Rationale: The pancreas is secondarily retroperitoneal except for its
tail, which extends toward the splenic hilum within the splenorenal
ligament. The head lies within the C-shaped curve of the duodenum,
while the body crosses the posterior abdominal wall and the tail
approaches the spleen. This anatomical arrangement is clinically
important during pancreatic and splenic surgery.
Question 2
A 62-year-old woman has a mass involving the head of the pancreas.
Imaging demonstrates obstruction of a tubular structure immediately
posterior to the pancreatic neck. Which vessel is most likely
compressed?
A. Inferior mesenteric vein
B. Superior mesenteric vein
C. Left renal vein
D. Inferior vena cava
E. Splenic artery
Answer: B. Superior mesenteric vein
Rationale: The portal vein is formed posterior to the neck of the
pancreas by union of the superior mesenteric and splenic veins. The
superior mesenteric vein ascends posterior to the pancreatic neck
before joining the splenic vein. A pancreatic-head mass can therefore
compromise the portal venous system.
Question 3
During an abdominal operation, a surgeon identifies the celiac trunk
arising from the anterior aspect of the abdominal aorta. Which
combination represents the three classic branches of the celiac trunk?
2
,A. Left gastric, splenic, and common hepatic arteries
B. Superior mesenteric, inferior mesenteric, and splenic arteries
C. Right gastric, left gastric, and gastroduodenal arteries
D. Common hepatic, superior mesenteric, and left gastric arteries
E. Splenic, inferior mesenteric, and common hepatic arteries
Answer: A. Left gastric, splenic, and common hepatic arteries
Rationale: The celiac trunk is an unpaired anterior branch of the
abdominal aorta that supplies derivatives of the foregut. Its three
major branches are the left gastric artery, splenic artery, and common
hepatic artery. The superior and inferior mesenteric arteries arise
separately from the aorta.
Question 4
A patient undergoes lymph-node evaluation for a gastric carcinoma
involving the greater curvature. Which arterial branch is most directly
associated with the greater curvature of the stomach?
A. Left gastric artery
B. Right gastric artery
C. Short gastric arteries
D. Right gastro-omental artery
E. Superior pancreaticoduodenal artery
Answer: D. Right gastro-omental artery
Rationale: The greater curvature receives blood from the right and left
gastro-omental arteries, which anastomose within the greater
omentum. The short gastric arteries supply the fundus, while the right
and left gastric arteries run along the lesser curvature.
Question 5
3
, A surgeon performs a procedure involving the lesser omentum. The
surgeon identifies a free edge containing the portal triad. Which
structure is NOT normally contained within the hepatoduodenal
ligament?
A. Proper hepatic artery
B. Portal vein
C. Common bile duct
D. Hepatic artery
E. Inferior vena cava
Answer: E. Inferior vena cava
Rationale: The hepatoduodenal ligament forms the free edge of the
lesser omentum and contains the portal triad: the common bile duct,
proper hepatic artery, and portal vein. The inferior vena cava lies
posterior to the omental bursa and is not part of the portal triad.
Question 6
A trauma patient has severe hemorrhage from an injury involving the
porta hepatis. The surgeon temporarily compresses the hepatoduodenal
ligament to reduce hepatic bleeding. Which vessels are being
compressed by this maneuver?
A. Hepatic veins and inferior vena cava
B. Portal vein and hepatic artery
C. Splenic vein and superior mesenteric artery
D. Celiac trunk and inferior vena cava
E. Superior mesenteric vein and renal artery
Answer: B. Portal vein and hepatic artery
Rationale: Compression of the hepatoduodenal ligament, known as
the Pringle maneuver, temporarily reduces hepatic inflow by
compressing the proper hepatic artery and portal vein. Hepatic veins
4
