Abdomen and pelvis: 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

Sample item

A patient with cirrhosis and ascites has bleeding oesophageal varices, but no caput medusae. A shunt from bowel to the posterior abdominal wall veins is suspected. These veins connect retroperitoneal portal tributaries to which systemic veins?

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

The answer and the reasoning

C. Renal, lumbar and phrenic veins (veins of Retzius)

Veins of Retzius connect the colonic tributaries of the portal system, where they are retroperitoneal, with the renal, lumbar and phrenic veins. Paraumbilical anastomoses cause caput medusae, and oesophageal and rectal ones produce varices.

Option by option

  • A. Middle and inferior rectal veins

    Rectal veins form the anorectal portosystemic anastomosis.

  • B. Superior and inferior epigastric veins

    Epigastric veins join the paraumbilical anastomosis causing caput medusae.

  • C. Renal, lumbar and phrenic veins (veins of Retzius) (correct)

    Correct. Retzius veins connect retroperitoneal colon veins with renal, lumbar and phrenic veins.

  • D. Azygos and hemiazygos only via oesophageal veins

    The oesophageal route is a separate anastomosis between left gastric and azygos veins.

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, Renal, lumbar and phrenic veins (veins of Retzius). Veins of Retzius connect the colonic tributaries of the portal system, where they are retroperitoneal, with the renal, lumbar and phrenic veins.

Why is "Middle and inferior rectal veins" not the answer?

Rectal veins form the anorectal portosystemic anastomosis.

Why is "Superior and inferior epigastric veins" not the answer?

Epigastric veins join the paraumbilical anastomosis causing caput medusae.

Why is "Azygos and hemiazygos only via oesophageal veins" not the answer?

The oesophageal route is a separate anastomosis between left gastric and azygos veins.

What concept does this question test?

It tests Abdomen and pelvis in Anatomy. Paraumbilical anastomoses cause caput medusae, and oesophageal and rectal ones produce varices.

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?

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.