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Histology Testbank: Hepatobiliary System 2a

Instructions: For each histology question, pick the one best answer. This histology test bank is also useful for the histology questions on the USMLE (USMLE step 1).

1.
What is the opening of the pancreatic duct into the duodenum?
a. Rokitansky-Aschoff sinuses
b. Ducts of Luschka
c. Duct of Wirsung
d. Ampulla of Vater
e. Sphincter of Oddi

Answer: d

Rokitansky-Aschoff sinuses are divertiuclae of the mucosa of the gallbladder. The small bile ducts which connect between the cystic duct and liver are the ducts of Luschka The duct of Wirsung is the pancreatic duct. The opening of the pancreatic duct into the duodenum is at the ampulla of Vater. The valves which regulates the flow of bile into the small intestine is the sphincter of Oddi.

2.
Which of the following is the exocrine portion of the pancreas?
a. Islets of Langerhans
b. Alpha cells
c. Beta cells
d. Delta cells
e. Acini

Answer: e

The pancreas is both an endocrine and exocrine organ.

The endocrine portion of the pancreas is housed in the islets of Langerhans. Within the islets, there are several cell types. The alpha cells secrete glucagon. The beta cells secrete insulin. The delta cells secrete somatostain. The gamma cells secrete pancreatic polypeptide.

The acini is the exocrine portion of the pancreas

3.
Which of the following clotting factors is NOT produced in the liver?
a. Factor I
b. Factor II
c. Factor IV
d. Factor IX
e. Factor X

Answer: c

The liver performs many, many functions. Estimates range at over 500 different functions for the liver.

The liver makes clotting Factors I, II, VII, IX, and X. Fibrinogen is Factor I. Prothrombin is Factor II. Factor IV is calcium, which is not produced in the liver.

Histology hint: If ever asked where a process occurs, and you absolutely have no idea, make an educated guess of the liver.---Sarah Bellham

4.
In what structure does blood run through between the hepatocytes?
a. Hepatic artery
b. Portal triad
c. Central vein
d. Portal vein
e. Sinusoids

Answer: e

Hepatocytes are the liver cells. They are arranged to form a liver lobule, which is the functional unit of the liver. The liver lobule is a hexagonal shaped structure. At the angles of the liver lobule are portal triads. The portal triad is composed of a branch of the hepatic artery, portal vein, and bile duct. In the middle of the liver lobule is a central vein. Hepatic sinusoids run between the hepatocytes.

5.
What is the space called that is located at the portal canal between the hepatocytes and connective tissue?
a. Space of Disse
b. Space of Mall
c. Vacuole
d. Lacuna
e. Howship's lacuna

The space of Disse is in the liver. The space of Disse is also called the perisinosoidal space. It is the space between the liver sinusoids and the hepatocytes.

The space of Mall is also in the liver. The space of Mall is located at the portal canal and is the region between the connective tissue and the liver parenchymal cells. It is the site where lymph is formed within the liver.

A vacuole is a small clear space within an individual cell.

A lacuna is a small space or depression. The space that the chondrocyte rests in is a lacuna.

Howship's lacuna is seen in bone. Howship's lacuna is a space seen underneath an osteoclast.

6.
What layer is NOT found in the gallbladder?
a. Mucosa
b. Muscularis mucosa
c. Muscularis
d. Adventita
e. Serosa

Answer: b

The gallbladder is comprised of three layers: mucosa, muscularis, and adventita or serosa. Serosa is found on the free surface of the gallbladder. The mucosa is simple columnar epithelium and lamina propria. There is no muscularis in the mucosa of the gallbladder.

7.
What cell type makes up the mucosa of the gallbladder?
a. Simple squamous epithelium
b. Simple cuboidal epithelium
c. Simple columnar epithelium
d. Stratified squamous epithelium
e. Transitional epithelium

Answer: c

The mucosa of the gallbladder is made of simple columnar epithelium.

8.
What is the classification of the pancreas?
a. Mixed
b. Endocrine
c. Exocrine
d. Both endocrine and exocrine
e. None of the above

Answer: d

The pancreas is both an endocrine and exocrine organ.

The endocrine portion of the pancreas is housed in the islets of Langerhans. Within the islets, there are several cell types. The alpha cells secrete glucagon. The beta cells secrete insulin. The delta cells secrete somatostain. The gamma cells secrete pancreatic polypeptide.

The acini is the exocrine portion of the pancreas.

9.
Which cell is a hepatic macrophage?
a. Kupffer cells
b. Histiocyte
c. Dust cell
d. Langerhans cell
e. Microglia

Answer: a

Macrophages are mononuclear phagocytes. Many tissues have resident (fixed) macrophages. Fixed macrophages are given a unique name, depending on the tissue that they are located in. Kupffer cells are the hepatic macrophages. Histiocytes are macrophages seen in connective tissue. Dust cells are alveolar macrophage found in the respiratory tract. Langerhans cells are macrophages seen in the skin. Microglia are the central nervous system macrophages.

10.
Where in the pancreas are islets of Langerhans most numerous?
a. Head
b. Body
c. Tail
d. Evenly distributed
e. Depends on the individual

Answer: c

Islets of Langerhans are most numerous in the tail of the pancreas.