Abdomen and pelvis: portal vein: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Abdomen and pelvis: portal vein

Sample item

A 60-year-old man has an adenocarcinoma at the neck of the pancreas. CT shows involvement of a confluence of veins immediately behind the neck. Which veins join at this site to form the portal vein?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Superior mesenteric vein and splenic vein

The portal vein is formed at about the level of L1 to L2 behind the neck of the pancreas by the union of the superior mesenteric and splenic veins. The inferior mesenteric vein drains into the splenic vein or the superior mesenteric vein. Involvement of this confluence affects resectability of pancreatic tumours.

Option by option

  • A. Superior mesenteric vein and inferior mesenteric vein

    The two mesenteric veins do not unite directly to form the portal vein.

  • B. Inferior mesenteric vein and splenic vein

    The inferior mesenteric vein drains into the splenic vein (or the superior mesenteric vein) and does not itself form the portal vein.

  • C. Superior mesenteric vein and splenic vein (correct)

    Correct. The superior mesenteric and splenic veins unite behind the neck of the pancreas.

  • D. Right and left hepatic veins

    The hepatic veins drain the liver into the inferior vena cava, not the portal system.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, Superior mesenteric vein and splenic vein. The portal vein is formed at about the level of L1 to L2 behind the neck of the pancreas by the union of the superior mesenteric and splenic veins.

Why is "Superior mesenteric vein and inferior mesenteric vein" not the answer?

The two mesenteric veins do not unite directly to form the portal vein.

Why is "Inferior mesenteric vein and splenic vein" not the answer?

The inferior mesenteric vein drains into the splenic vein (or the superior mesenteric vein) and does not itself form the portal vein.

Why is "Right and left hepatic veins" not the answer?

The hepatic veins drain the liver into the inferior vena cava, not the portal system.

What concept does this question test?

It tests Abdomen and pelvis: portal vein in Anatomy. The inferior mesenteric vein drains into the splenic vein or the superior mesenteric vein. Involvement of this confluence affects resectability of pancreatic tumours.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdomen and pelvis: portal vein?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.