Abdomen and pelvis: replaced right hepatic artery: 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: replaced right hepatic artery

Sample item

While performing a pancreaticoduodenectomy, a surgeon palpates an arterial pulsation behind the portal vein in the hepatoduodenal ligament, separate from the hepatic artery proper in front. Which vessel is most likely responsible?

AReplaced left hepatic artery from the left gastric arteryBReplaced right hepatic artery from the superior mesenteric arteryCCystic artery arising from the right hepatic arteryDGastroduodenal artery arising from the common hepatic artery

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

The answer and the reasoning

B. Replaced right hepatic artery from the superior mesenteric artery

A replaced right hepatic artery arises from the superior mesenteric artery in a minority of people. It ascends behind the head of the pancreas and portal vein in the hepatoduodenal ligament, and must be identified before dividing structures in pancreatic or biliary surgery.

Option by option

A. Replaced left hepatic artery from the left gastric artery
A replaced left hepatic artery runs in the gastrohepatic part of the lesser omentum, to the left of the portal vein.
B. Replaced right hepatic artery from the superior mesenteric artery (correct)
Correct. A replaced right hepatic artery arises from the superior mesenteric artery and runs behind the portal vein.
C. Cystic artery arising from the right hepatic artery
The cystic artery is small and runs to the gallbladder in the hepatocystic triangle.
D. Gastroduodenal artery arising from the common hepatic artery
The gastroduodenal artery descends behind the first part of the duodenum and is not found behind the portal vein.

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.

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, Replaced right hepatic artery from the superior mesenteric artery. A replaced right hepatic artery arises from the superior mesenteric artery in a minority of people.

Why is "Replaced left hepatic artery from the left gastric artery" not the answer?

A replaced left hepatic artery runs in the gastrohepatic part of the lesser omentum, to the left of the portal vein.

Why is "Cystic artery arising from the right hepatic artery" not the answer?

The cystic artery is small and runs to the gallbladder in the hepatocystic triangle.

Why is "Gastroduodenal artery arising from the common hepatic artery" not the answer?

The gastroduodenal artery descends behind the first part of the duodenum and is not found behind the portal vein.

What concept does this question test?

It tests Abdomen and pelvis: replaced right hepatic artery in Anatomy. It ascends behind the head of the pancreas and portal vein in the hepatoduodenal ligament, and must be identified before dividing structures in pancreatic or biliary surgery.

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 and pelvis: replaced right hepatic artery?

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.