Abdomen: duodenum: 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: duodenum

Sample item

A thin young woman after rapid weight loss has postprandial epigastric pain and bilious vomiting relieved by lying prone or in the knee-chest position. The compression is of the third part of the duodenum. Which anatomical relation explains this?

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

The answer and the reasoning

B. It crosses between the superior mesenteric artery in front and the aorta behind

The third part of the duodenum crosses the midline anterior to the aorta and IVC and posterior to the superior mesenteric vessels. Loss of the retroperitoneal fat pad reduces the aortomesenteric angle, so the artery compresses the duodenum, causing superior mesenteric artery syndrome.

Option by option

  • A. It lies between the inferior vena cava and the right kidney only

    Its relations include the IVC and aorta, but the key is the SMA anterior to it.

  • B. It crosses between the superior mesenteric artery in front and the aorta behind (correct)

    Correct. The duodenum is trapped between the SMA anteriorly and the aorta posteriorly.

  • C. It lies anterior to the pancreatic head and the portal vein

    The pancreatic head lies in the C-loop of the duodenum, and the portal vein is not related in this manner.

  • D. It lies anterior to the superior mesenteric vessels

    It passes behind, not in front of, the superior mesenteric vessels.

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 B, It crosses between the superior mesenteric artery in front and the aorta behind. The third part of the duodenum crosses the midline anterior to the aorta and IVC and posterior to the superior mesenteric vessels.

Why is "It lies between the inferior vena cava and the right kidney only" not the answer?

Its relations include the IVC and aorta, but the key is the SMA anterior to it.

Why is "It lies anterior to the pancreatic head and the portal vein" not the answer?

The pancreatic head lies in the C-loop of the duodenum, and the portal vein is not related in this manner.

Why is "It lies anterior to the superior mesenteric vessels" not the answer?

It passes behind, not in front of, the superior mesenteric vessels.

What concept does this question test?

It tests Abdomen: duodenum in Anatomy. Loss of the retroperitoneal fat pad reduces the aortomesenteric angle, so the artery compresses the duodenum, causing superior mesenteric artery syndrome.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: duodenum?

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.