ENDO Index

QUESTION SET I.  Concentric tissue layers of the GI tract.

Point to an answer.  Green color and bold indicates "CORRECT."  Red color and italics indicates "Wrong answer."  (NOTE:  In cases where all of the responses are correct, only "all of the above" will be indicated as correct.)

X.  Sample question.
     a.  wrong answer.
     b.  wrong answer.
     c.  CORRECT answer.
     d.  wrong answer.
     e.  wrong answer.

1. The term mucosa (mucous membrane) means:
     a.  a nonkeratinized stratified squamous epithelium.
     b.  an epithelium which contains mucus-secreting goblet cells.
     c.  a body surface onto which mucous glands secrete their product.
     d.  the lining of the GI tract.
     e.  the moist surface of any hollow organ that communicates with the outside world.

2. Every mucosa consists of:
     a.  a simple epithelium.
     b.  a stratified epithelium.
     c.  a surface epithelium together with associated glands.
     d.  a surface epithelial layer, with or without glands, together with an underlying layer of loose connective tissue.
     e.  a surface epithelial layer, with or without glands, together with an underlying layer of loose connective tissue, and a layer of smooth muscle.

3. The connective tissue layer of a mucous membrane is named:
     a.  the submucosa.
     b.  subcutaneous tissue.
     c.  the papillary layer.
     d.  the reticular layer.
     e.  lamina propria.

4. Lamina propria typically differs from ordinary loose connective tissue by including:
     a.  abundant adipose tissue.
     b.  mucous glands.
     c.  numerous white blood cells.
     d.  serous glands.
     e.  densely interwoven collagen fibers.

5. Besides loose connective tissue with numerous lymphocytes, lamina propria may contain:
     a.  a network of capillaries.
     b.  some nerve and smooth muscle fibers.
     c.  lymph vessels.
     d.  lymph nodules.
     e.  all of the above.

6. Lamina propria differs from dermis by having:
     a.  more adipocytes.
     b.  more densely packed collagen fibers.
     c.  more lymphocytes.
     d.  fewer capillaries.
     e.  fewer macrophages and mast cells.

7. The epithelium lining the entire GI tract is:
     a.  stratified squamous, nonkeratinized, for protection.
     b.  simple squamous, for rapid diffusion across the epithelium.
     c.  simple columnar, for secretion and active absorption.
     d.  simple cuboidal, like that of most other tubular structures.
     e.  regionally specialized for regionally localized functions.

8. Along most of the GI tract (except for the oral cavity and lower anal canal), the basal boundary of the mucosa is marked by:
     a.  a thin and often inconspicuous layer of smooth muscle, the muscularis mucosae.
     b.  a thick layer of smooth muscle.
     c.  the myenteric plexus.
     d.  fibrous connective tissue of serosa or adventitia.
     e.  the mesothelium.

9. The layer of tissue beneath the mucosa is called the:
     a.  hypodermis.
     b.  muscularis externa.
     c.  serosa.
     d.  submucosa.
     e.  adventitia.

10. Submucosa of the digestive tract consists primarily of:
     a.  loose fibrous connective tissue.
     b.  adipose connective tissue.
     c.  dense fibrous connective tissue.
     d.  connective tissue with interwoven bundles of smooth muscle.
     e.  lymphatic tissue.

11. The submucosa differs from lamina propria by having:
     a.  fewer white blood cells.
     b.  less lymphatic tissue.
     c.  larger blood vessels.
     d.  thicker and more prominent collagen fibers.
     e.  all of the above.

12. Which of the following occurs within the submucosa in most regions of the GI tract:
     a.  several layers of smooth muscle.
     b.  nerves and parasympathetic ganglia of the submucosal (Meissner’s) plexus.
     c.  the myenteric (Auerbach’s) plexus.
     d.  relatively few blood vessels.
     e.  numerous lymph nodules.

13. In most regions of the GI tract (exceptions are oral cavity and stomach), smooth muscle fibers of the muscularis are arranged into:
     a.  inner circular and outer longitudinal layers.
     b.  outer circular and inner longitudinal layers.
     c.  circular and longitudinal layers whose relative position varies from region to region.
     d.  an interwoven meshwork of circular and longitudinal muscle fibers.
     e.  bundles aligned along three mutually perpendicular directions.

14. The myenteric (Auerbach’s) plexus is located:
     a.  just beneath the epithelium of the mucosa, in lamina propria.
     b.  within lamina propria, adjacent to the muscularis mucosae.
     c.  in submucosa.
     d.  between the layers of smooth muscle in the muscularis.
     e.  in serosa and/or adventitia.

15. The myenteric (Auerbach’s) plexus does not contain:
     a.  postganglionic axons from sympathetic ganglia.
     b.  postganglionic axons from parasympathetic ganglia.
     c.  nerve cell bodies in sympathetic ganglia.
     d.  nerve cell bodies in parasympathetic ganglia.
     e.  preganglionic parasympathetic axons.

16. For an organ lying within a body cavity, the tissue which forms the deepest layer (i.e., farthest from the inner core or lumen of the organ) is called the:
     a.  mucosa.
     b.  serosa.
     c.  stroma.
     d.  parenchyma.
     e.  adventitia.

17. For an organ embedded within the body wall, the tissue which forms the deepest layer (i.e., farthest from the inner core or lumen of the organ) is called the:
     a.  mucosa.
     b.  serosa.
     c.  stroma.
     d.  parenchyma.
     e.  adventitia.

18. Adventitia consists of:
     a.  surface epithelium.
     b.  adipose connective tissue.
     c.  ordinary connective tissue.
     d.  lymphatic connective tissue.
     e.  muscle tissue.

19. The serosal surface exposed to a body cavity consists of:
     a.  endothelium.
     b.  stroma.
     c.  mesentery.
     d.  mesothelium.
     e.  parenchyma.

20. Mesothelium consists of:
     a.  stratified squamous epithelium.
     b.  simple squamous epithelium.
     c.  simple cuboidal epithelium.
     d.  simple columnar epithelium.
     e.  stratified cuboidal epithelium.

21. The mesentery and lining of the peritoneal cavity, like the outermost layer of the digestive tract, consist of:
     a.  a mucous membrane, or mucosa.
     b.  a serous membrane, or serosa.
     c.  a submucous membrane, or submucosa.
     d.  an endothelial membrane, or endothelium.
     e.  a plasma membrane.

QUESTION SET II.  Special features of the GI tract.

Point to an answer.  Green color and bold indicates "CORRECT."  Red color and italics indicates "Wrong answer."  (NOTE:  In cases where all of the responses are correct, only "all of the above" will be indicated as correct.)

X.  Sample question.
     a.  wrong answer.
     b.  wrong answer.
     c.  CORRECT answer.
     d.  wrong answer.
     e.  wrong answer.

22. Tonsils consist of:
     a.  ordinary connective tissue with many vascular sinusoids.
     b.  adipose connective tissue.
     c.  serous glandular tissue with vascular sinusoids.
     d.  mucous glandular tissue and stroma.
     e.  lymphatic connective tissue with epithelially lined crypts.

23. Tonsils occur in each of the following sites EXCEPT:
     a.  in the soft palate.
     b.  in the pharynx.
     c.  in the posterior tongue.
     d.  in the esophagus.

24. The crypts of lingual and palatine tonsils are lined by:
     a.  simple squamous epithelium.
     b.  stratified squamous, keratinized epithelium.
     c.  stratified squamous, nonkeratinized epithelium.
     d.  simple cuboidal epithelium.
     e.  ciliated pseudostratified columnar epithelium.

25. The crypts of pharyngeal tonsils are lined by:
     a.  simple squamous epithelium.
     b.  stratified squamous, keratinized epithelium.
     c.  stratified squamous, nonkeratinized epithelium.
     d.  simple cuboidal epithelium.
     e.  ciliated pseudostratified columnar epithelium.

26. The epithelium lining tonsillar crypts may be obscured by numerous cells migrating through it. These cells are:
     a.  neutrophils.
     b.  lymphocytes.
     c.  mast cells.
     d.  macrophages.
     e.  fibroblasts.

27. Lymphocytes proliferate in relatively permanent sites in connective tissue which contain germinal centers surrounded by dense concentrations of incoming and outgoing cells. These sites are called:
     a.  sinusoids.
     b.  crypts.
     c.  villi.
     d.  lymph nodules.
     e.  lymph nodes.

28. The germinal centers of lymph nodules function as sites where:
     a.  previous inflammation has not yet been resolved.
     b.  worn out lymphocytes are replaced.
     c.  lymphocytes are secreted across mucous membranes.
     d.  antigens are secreted into blood.
     e.  activated lymphocytes proliferate.

29. In the digestive system, lymph nodules occur:
     a.  concentrated in the tonsils.
     b.  concentrated in the appendix.
     c.  scattered in lamina propria throughout the GI tract.
     d.  concentrated in Peyer’s patches.
     e.  all of the above.

30. The papillae covering most of the top surface of the human tongue (the tips of these papillae are whitish in life) are called:
     a.  tonsils.
     b.  fungiform papillae.
     c.  filiform papillae.
     d.  circumvallate papillae.
     e.  dermal papillae.

31. The whitish tips of filiform papillae consist of:
     a.  keratinized epithelial tissue.
     b.  collagen.
     c.  mucous.
     d.  taste buds.
     e.  goblet cells.

32. Taste buds occur most commonly:
     a.  on the tips of filiform papillae.
     b.  on the sides of fungiform and circumvallate papillae.
     c.  in the crypts of lingual tonsils.
     d.  only on the tip of the tongue.
     e.  anywhere in the stratified squamous epithelium of the tongue.

33. Tubular invaginations (crypts, pits or glands) occurring within the mucosa (embedded in lamina propria), are not characteristic of the:
     a.  esophagus
     b.  stomach
     c.  duodenum
     d.  ileum and jejunum
     e.  colon

34. Submucosal glands occur in the submucosa of the:
     a.  esophagus.
     b.  stomach.
     c.  jejunum.
     d.  ileum.
     e.  colon.

35. Submucosal glands also occur in the:
     a.  duodenum.
     b.  ileum.
     c.  jejunum.
     d.  appendix.
     e.  colon.

36. Folds in the mucosa of the stomach are called:
     a.  rugae.
     b.  plicae.
     c.  villi.
     d.  pits.
     e.  crypts.

37. Permanent folds in the wall of the intestine, containing a core of submucosa, are called:
     a.  rugae.
     b.  plicae.
     c.  villi.
     d.  pits.
     e.  crypts.

38. Microscopic finger-like projections of the intestinal mucosa are called intestinal:
     a.  rugae.
     b.  plicae.
     c.  villi.
     d.  pits.
     e.  crypts.

39. Microscopic indentations in the epithelial surface of the stomach are called gastric:
     a.  rugae.
     b.  plicae.
     c.  villi.
     d.  pits.
     e.  crypts.

40. Simple tubular glands within the mucosa of the small or large intestine are called intestinal:
     a.  rugae.
     b.  plicae.
     c.  villi.
     d.  pits.
     e.  crypts.

41. Lymphatic vessels within intestinal villi, which transport lipids to the circulatory system, are called:
     a.  capillaries.
     b.  ductules.
     c.  canaliculi.
     d.  lacteals.
     e.  crypts.

42. Taenia coli are:
     a.  discrete bands of longitudinal muscle along the large intestine.
     b.  crypts or mucosal glands of the large intestine.
     c.  submucosal glands of the large intestine.
     d.  Compact regions of lymphoid tissue in the intestine.
     e.  sites of mucosal folding into the lumen of the large intestine.

QUESTION SET III.  Regional differences along the GI tract.

Point to an answer.  Green color and bold indicates "CORRECT."  Red color and italics indicates "Wrong answer."  (NOTE:  In cases where all of the responses are correct, only "all of the above" will be indicated as correct.)

X.  Sample question.
     a.  wrong answer.
     b.  wrong answer.
     c.  CORRECT answer.
     d.  wrong answer.
     e.  wrong answer.

43. Choose the best description of the esophagus.
     a.  Nonkeratinized stratified squamous epithelium; relatively unspecialized lamina propria; submucosa with scattered mucous glands.
     b.  Keratinized stratified squamous epithelium; relatively unspecialized lamina propria; submucosa with scattered serous glands.
     c.  Nonkeratinized stratified squamous epithelium; lamina propria with numerous lymph nodules; submucosa with scattered mucous glands.
     d.  Keratinized stratified squamous epithelium; lamina propria with numerous lymph nodules; are submucosa with scattered mucous glands.
     e.  Keratinized stratified squamous epithelium; relatively unspecialized lamina propria; submucosa with scattered mucous glands.

44. Choose the best description of the duodenum.
     a.  Mucosa with crypts and villi; epithelium with scattered goblet cells; lamina propria with occasional lymph nodules; submucosa unspecialized.
     b.  Mucosa with crypts but no villi; epithelium with scattered goblet cells; lamina propria with occasional lymph nodules; submucosa unspecialized.
     c.  Mucosa with both crypts and villi; epithelium with scattered goblet cells; lamina propria with occasional lymph nodules; submucosa with mucous glands.
     d.  Mucosa with both crypts and villi; epithelium with scattered goblet cells; lamina propria packed with mucous glands; submucosa with numerous lymph nodules.
     e.  Mucosa with crypts but no villi; epithelium with scattered goblet cells; lamina propria with occasional lymph nodules; submucosa with mucous glands.

45. Which of the following epithelial types is most closely associated with active absorption at a mucosal surface, as in small intestine and colon?
     a.  simple squamous
     b.  stratified squamous
     c.  simple columnar
     d.  stratified columnar
     e.  stratified cuboidal

46. Which of the following epithelial types is most closely associated with active secretion at a mucosal surface, as in the stomach lining?
     a.  simple squamous
     b.  stratified squamous
     c.  simple columnar
     d.  stratified columnar
     e.  stratified cuboidal

47. Choose the best description of the fundic stomach.
     a.  Mucosa without villi, but thick and densely packed with tubular glands containing several distinct cell types; epithelium apparently consisting of a single cell type lining surface and pits; lamina propria with numerous lymph nodules.
     b.  Mucosa without villi, but thick and densely packed with tubular glands containing several distinct cell types; epithelium apparently consisting of a single cell type lining surface and pits; lamina propria inconspicuous.
     c.  Mucosa with villi, thick and densely packed with tubular glands containing several distinct cell types; epithelium apparently consisting of a single cell type lining surface and pits; lamina propria inconspicuous.
     d.  Mucosa with villi, thick and densely packed with tubular glands containing several distinct cell types; epithelium with scattered goblet cells lining surface and pits; lamina propria inconspicuous.
     e.  Mucosa with villi, thick and densely packed with tubular glands containing several distinct cell types; epithelium with scattered goblet cells lining surface and pits; lamina propria with numerous lymph nodules.

48. Choose the best description of the jejunum.
     a.  Mucosa with both crypts and villi; epithelium with scattered goblet cells; lamina propria with occasional lymph nodules; submucosa unspecialized.
     b.  Mucosa with crypts but no villi; epithelium with scattered goblet cells; lamina propria with occasional lymph nodules; submucosa unspecialized.
     c.  Mucosa with both crypts and villi; epithelium with scattered goblet cells; lamina propria with occasional lymph nodules; submucosa with mucous glands.
     d.  Mucosa with both crypts and villi; epithelium uniform, without goblet cells; lamina propria with occasional lymph nodules; submucosa with numerous lymph nodules.
     e.  Mucosa with crypts but no villi; epithelium uniform, without goblet cells; lamina propria with occasional lymph nodules; submucosa with mucous glands.

49. Choose the best description of the ileum.
     a.  Mucosa with both crypts and villi; epithelium uniform, without goblet cells; lamina propria with occasional conspicuous clusters of lymph nodules; submucosa unspecialized.
     b.  Mucosa with crypts but no villi; epithelium with scattered goblet cells; lamina propria with occasional conspicuous clusters of lymph nodules; submucosa unspecialized.
     c.  Mucosa with both crypts and villi; epithelium with scattered goblet cells; lamina propria with occasional conspicuous clusters of lymph nodules; submucosa with mucous glands.
     d.  Mucosa with both crypts and villi; epithelium with scattered goblet cells; lamina propria with occasional conspicuous clusters of lymph nodules; submucosa unspecialized.
     e.  Mucosa with both crypts and villi; epithelium with scattered goblet cells; lamina propria with lymph nodules relatively uncommon; submucosa with mucous glands.

50. Choose the best description of the colon.
     a.  Mucosa with villi and short tubular invaginations; epithelium with many goblet cells; lamina propria with occasional lymph nodules; submucosa unspecialized.
     b.  Mucosa with short tubular invaginations but no villi; epithelium consisting entirely of goblet cells; lamina propria with occasional lymph nodules; submucosa unspecialized.
     c.  Mucosa with villi and short tubular invaginations; epithelium consisting entirely of goblet cells; lamina propria with occasional lymph nodules; submucosa unspecialized.
     d.  Mucosa thick, with many tubular glands consisting of several distinct secretory cell types; epithelium with many goblet cells; lamina propria inconspicuous; submucosa unspecialized.
     e.  Mucosa with short tubular invaginations but no villi; epithelium with many goblet cells; lamina propria with occasional lymph nodules; submucosa unspecialized.

51. Which of the following epithelial types is most closely associated with passive protection, without specialization for either secretion or absorption, as in the esophagus and anal canal?
     a.  simple squamous
     b.  stratified squamous
     c.  simple columnar
     d.  stratified columnar
     e.  stratified cuboidal

52. Which of the following regions of the GI tract is not characterized by simple columnar epithelium on the mucosal surface?
     a.  stomach
     b.  small intestine
     c.  appendix
     d.  large intestine
     e.  anal canal

53. Choose the best description of the appendix.
     a.  Mucosa with short tubular invaginations but no villi; epithelium lacking goblet cells; lamina propria packed with lymphoid tissue containing numerous germinal centers.
     b.  Mucosa lacking both tubular invaginations and villi; epithelium with many goblet cells; lamina propria unspecialized, without lymphoid tissue.
     c.  Mucosa lacking both tubular invaginations and villi; epithelium lacking goblet cells; lamina propria packed with lymphoid tissue containing numerous germinal centers.
     d.  Mucosa with short tubular invaginations but no villi; epithelium with many goblet cells; lamina propria unspecialized, without lymphoid tissue.
     e.  Mucosa with short tubular invaginations but no villi; epithelium with many goblet cells; lamina propria packed with lymphoid tissue containing numerous germinal centers.

54. Choose the best description of the gall bladder. (If you haven’t learned gall bladder yet, choose the answer which does not match any region of the GI tract proper.)
     a.  Mucosa with evaginations resembling villi (actually wrinkles), but no crypts; simple columnar epithelium consisting of a single absorptive cell type, without goblet cells; lamina propria unspecialized; no muscularis mucosa.
     b.  Mucosa with short tubular invaginations but no villi; epithelium with many goblet cells; lamina propria with occasional lymph nodules; submucosa unspecialized.
     c.  Nonkeratinized stratified-squamous epithelium; lamina propria unspecialized; distinct muscularis mucosa; submucosa with scattered mucous glands.
     d.  Mucosa without villi, but thick and densely packed with tubular glands containing several distinct cell types; epithelium apparently consisting of a single cell type lining surface and pits; lamina propria inconspicuous.
     e.  Mucosa with short tubular invaginations but no villi; epithelium with many goblet cells; lamina propria packed with lymphoid tissue containing numerous germinal centers.

55. Which of the following regions of the GI tract is characterized by simple columnar epithelium on the mucosal surface which apparently consists of a single cell type, without goblet cells?
     a.  esophagus
     b.  stomach
     c.  small intestine
     d.  large intestine
     e.  appendix

56. In which of the following regions of the GI tract does the highest proportion of goblet cells occur in the surface epithelium of the mucosa?
     a.  stomach
     b.  duodenum
     c.  jejunum
     d.  ileum
     e.  large intestine

57. Which of the following regions of the GI tract is characterized by short tubular invaginations (crypts or pits) which are not lined by dividing, differentiating cells?
     a.  esophagus
     b.  stomach
     c.  duodenum
     d.  jejunum
     e.  ileum

58. Which of the following regions of the GI tract is characterized by numerous short tubular invaginations but no villi?
     a.  duodenum
     b.  jejunum
     c.  ileum
     d.  colon
     e.  anal canal

59. Which of the following regions of the GI tract is characterized by stratified squamous epithelium?
     a.  duodenum
     b.  jejunum
     c.  ileum
     d.  colon
     e.  anal canal

60. Which of the following regions of the GI tract is characterized by villi?
     a.  esophagus
     b.  stomach
     c.  small intestine
     d.  large intestine
     e.  appendix

61. Which of the following regions of the GI tract is characterized by permanent folds (plica)?
     a.  esophagus
     b.  stomach
     c.  small intestine
     d.  large intestine
     e.  appendix

62. Which of the following regions of the GI tract is characterized by a thick mucosa densely packed with tubular glands containing a variety of cell types?
     a.  esophagus
     b.  stomach
     c.  small intestine
     d.  large intestine
     e.  appendix

63. In which of the following regions of the GI tract does the mucosa most closely resemble that of the colon, but with more lymphoid tissue?
     a.  stomach
     b.  duodenum
     c.  jejunum
     d.  ileum
     e.  appendix

64. In which region(s) of the GI tract are there tubular mucous glands in the mucosa?
     a.  upper esophagus
     b.  cardiac and pyloric stomach
     c.  duodenum
     d.  ileum
     e.  appendix

65. In which region of the GI tract is the longitudinal muscle of the muscularis arranged into distinct longitudinal bundles (taenia)?
     a.  stomach
     b.  duodenum
     c.  jejunum
     d.  ileum
     e.  colon

QUESTI0N SET IV.  Glands associated with the GI tract.

Point to an answer.  Green color and bold indicates "CORRECT."  Red color and italics indicates "Wrong answer."  (NOTE:  In cases where all of the responses are correct, only "all of the above" will be indicated as correct.)

X.  Sample question.
     a.  wrong answer.
     b.  wrong answer.
     c.  CORRECT answer.
     d.  wrong answer.
     e.  wrong answer.

66. Glandular ducts are typically lined by which type of epithelium?
     a.  simple squamous epithelium
     b.  stratified squamous, keratinized epithelium
     c.  stratified squamous, non-keratinized epithelium
     d.  simple cuboidal, simple columnar, or stratified cuboidal epithelium
     e.  any of the above

67. Ducts may be distinguished from secretory tissue because cells lining ducts:
     a.  form a stratified epithelium.
     b.  have nuclei located basally rather than apically.
     c.  are usually much larger than secretory cells.
     d.  lack apical vesicles and other evidence of cell specialization for synthesizing and storing secretory product.
     e.  are usually more intensely stained with H&E than secretory cells.

68. The parotid gland is a:
     a.  serous gland, secreting a watery solution of enzymes and immunoglobulins but not mucus.
     b.  mucous gland, secreting mucus but not digestive enzymes.
     c.  mixed gland, producing both serous and mucous secretions.

69. The submandibular and sublingual glands are:
     a.  serous glands, secreting a watery solution of enzymes and immunoglobulins but not mucus.
     b.  mucous glands, secreting mucus but not digestive enzymes.
     c.  mixed glands, producing both serous and mucous secretions.

70. Minor salivary glands are mixed, secreting mainly mucus but also some serous product. Minor salivary glands are found:
     a.  in the cheeks (buccal glands).
     b.  in the lips (labial glands).
     c.  in the soft palate (palatine glands).
     d.  in the tongue (lingual glands).
     e.  all of the above.

71. Tissue from which of the following is often poorly preserved in autopsy specimens, because it self-destructs soon after death due to post-mortem release of its stored secretory product of proteolytic enzymes?
     a.  submaxillary and sublingual glands
     b.  esophageal glands
     c.  duodenal (Brunner’s) glands
     d.  parotid glands.
     e.  pancreas

72. The parotid gland and the pancreas are both compound acinar glands, served by a branching duct system. Morphological differences between parotid and pancreas include which of the following?
     a.  Islets of endocrine tissue occur in the pancreas but not the parotid.
     b.  Adipocytes are scattered commonly through the stroma of the parotid but not that of the pancreas.
     c.  Centroacinar cells (initial duct cells appearing within acini) occur in most pancreatic acini but not those of parotid.
     d.  all of the above.

73. Esophageal glands are located:
     a.  in the mucosa.
     b.  in the submucosa.
     c.  in the serosa.
     d.  in the adventitia.
     e.  deep to the wall of the esophagus proper.

74. Gastric glands are located:
     a.  in the mucosa of the stomach.
     b.  in the submucosa of the stomach.
     c.  in the serosa of the stomach.
     d.  deep to the stomach wall proper.
     e.  more than one of the above.

75. Duodenal (Brunner’s) glands are located:
     a.  in the mucosa of the duodenum.
     b.  in the submucosa of the duodenum.
     c.  in the adventitia of the posterior duodenal wall.
     d.  deep to the wall of the duodenum.
     e.  more than one of the above.

76. The pancreas is located:
     a.  in the mucosa of the small intestine.
     b.  in the submucosa of the small intestine.
     c.  in the serosa of the small intestine.
     d.  deep to the wall of the small intestine proper.

77. Intestinal crypts of Lieberkühn are located:
     a.  in the mucosa of the small intestine.
     b.  in the submucosa of the small intestine.
     c.  in the serosa of the small intestine.
     d.  deep to the wall of the small intestine proper.
     e.  more than one of the above.

78. All of the following are primarily mucous-secreting glands EXCEPT:
     a.  esophageal glands.
     b.  cardiac glands.
     c.  fundic glands.
     d.  pyloric glands.
     e.  duodenal (Brunner’s) glands.

79. Which of the following lacks clearly differentiated ducts (i.e., consists almost entirely of secretory cells)?
     a.  minor salivary glands
     b.  parotid gland
     c.  esophageal glands
     d.  gastric glands
     e.  pancreas

80. Which of the following “glands” is primarily a protected site for mitotic activity rather than a tissue specialized for secretion?
     a.  parotid salivary glands.
     b.  esophageal glands.
     c.  gastric (fundic) glands.
     d.  duodenal (Brunner’s) glands.
     e.  intestinal crypts (of Lieberkühn).

81. Which of the dimensions is about 1–2 millimeters? (Think about actual sizes as you can see them in gross lab and with your unaided eye on microscope slides, and also the sizes of familiar cells like the RBC. Remember, having a reasonable intuition about size can help you notice many significant departures from normal or expected structure.)
     a.  The thickness of the stomach wall (all layers).
     b.  The thickness of the gastric mucosa.
     c.  The height of the stomach’s surface epithelial cells.
     d.  The diameter of a parietal cell.
     e.  The length of microvilli.

82. The length of intestinal villi is about:
     a.  10–20 millimeters.
     b.  0.5–1.0 millimeters.
     c.  20–50 microns.
     d.  1–2 microns.
     e.  50–100 nanometers.

83. The length of microvilli is about:
     a.  10–20 millimeters.
     b.  0.5–1.0 millimeters.
     c.  20–50 microns.
     d.  1–2 microns.
     e.  50–100 nanometers.

84. The principal secretory product for cells of Brunner’s (duodenal) glands is:
     a.  acid mucus.
     b.  alkaline mucus.
     c.  proteolytic and other digestive enzymes.
     d.  lysosomal enzymes.
     e.  any one of several duodenal hormones.

QUESTION SET V.  Specialized cell types of the GI tract.

Point to an answer.  Green color and bold indicates "CORRECT."  Red color and italics indicates "Wrong answer."  (NOTE:  In cases where all of the responses are correct, only "all of the above" will be indicated as correct.)

X.  Sample question.
     a.  wrong answer.
     b.  wrong answer.
     c.  CORRECT answer.
     d.  wrong answer.
     e.  wrong answer.

85. Which of the following is characteristic of mucus-secreting cells?
     a.  polarized cytoplasm, with distinct apical and basal regions
     b.  rough endoplasmic reticulum in basal cytoplasm
     c.  supranuclear Golgi apparatus
     d.  large, mucus-containing vesicles occupying apical cytoplasm
     e.  all of the above

86. Which the following stains is used to demonstrate mucus (as well as basement membranes and glycogen)?
     a.  hematoxylin
     b.  eosin
     c.  periodic acid Schiff (PAS)
     d.  Golgi silver
     e.  Mucus can only be stained immunohistochemically.

87. In H&E stained tissue sections, the mucus-containing secretory vesicles in mucous cells typically appear:
     a.  red or pink.
     b.  blue or purple.
     c.  yellow or brown.
     d.  black.
     e.  clear or only weakly stained.

88. Which of the following is characteristic of serous (enzyme-secreting) cells?
     a.  polarized cytoplasm, with distinct apical and basal regions
     b.  extensive rough endoplasmic reticulum in basal cytoplasm
     c.  supranuclear Golgi apparatus
     d.  zymogen vesicles occupying apical cytoplasm
     e.  all of the above

89. In H&E stained tissue sections, the basal cytoplasm in enzyme-secreting (serous) cells typically appears:
     a.  red or pink.
     b.  blue or purple.
     c.  yellow or brown.
     d.  black.
     e.  clear or only weakly stained.

90. Contractile epithelial cells which, under autonomic neural control, help expel product from glandular acini and ducts are called:
     a.  myoepithelial cells.
     b.  mucous cells.
     c.  interlobular duct cells.
     d.  intralobular duct cells.
     e.  enteroendocrine cells.

91. The epithelial cells lining striated intralobular ducts:
     a.  are usually simple cuboidal or columnar cells.
     b.  have relatively eosinophilic cytoplasm containing numerous mitochondria.
     c.  have basal cell membranes extensively folded to increase the surface that contains active ion pump molecules.
     d.  are specialized for concentrating secretory products in the duct lumen.
     e.  All of the above.

92. Cells which secrete HCl into the stomach are called:
     a.  goblet cells.
     b.  chief (zymogenic) cells.
     c.  parietal (oxyntic) cells.
     d.  enterocytes.
     e.  Paneth cells.

93. Cells which secrete pepsinogen into the stomach are called:
     a.  goblet cells.
     b.  chief (zymogenic) cells.
     c.  parietal (oxyntic) cells.
     d.  Kupffer cells.
     e.  Paneth cells.

94. Enteroendocrine cells, an inconspicuous but important epithelial cell type, occur:
     a.  only in the stomach (especially its pyloric region).
     b.  only in the small intestine.
     c.  only in the colon.
     d.  only in the gall bladder.
     e.  mainly in the stomach (especially its pyloric region) and in the small intestine, but also elsewhere along the GI tract (and also along respiratory passages).

95. Which of the following cell types is characterized by a large nucleus (sometimes two nuclei) surrounded by prominent eosinophilic cytoplasm containing very many mitochondria and an intracellular canaliculus?
     a.  gastric chief cells
     b.  gastric parietal cells
     c.  enteroendocrine cells
     d.  Paneth cells
     e.  Kupffer cells

96. Which of the following cell types is characterized by secretory vesicles concentrated in basal cytoplasm, near the basement membrane?
     a.  gastric chief cells
     b.  gastric parietal cells
     c.  enteroendocrine cells
     d.  Paneth cells
     e.  gastric surface mucous cells

97. Which of the following cell types is characterized by extensive basal rough endoplasmic reticulum, a supranuclear Golgi apparatus and apical zymogen vesicles?
     a.  gastric chief cells
     b.  gastric parietal cells
     c.  enteroendocrine cells
     d.  gastric surface mucous cells
     e.  gastric mucous neck cells

98. Which of the following cells is most directly responsible for protecting the stomach mucosa from attack by acid and proteolytic enzymes?
     a.  gastric chief cells
     b.  gastric parietal cells
     c.  enteroendocrine cells
     d.  Paneth cells
     e.  gastric surface mucous cells

99. Which of the following cell types is characterized by extensive basal rough endoplasmic reticulum, a supranuclear Golgi apparatus and apical zymogen vesicles?
     a.  pancreatic acinar cell
     b.  Brunner’s gland cell
     c.  intestinal goblet cell
     d.  intestinal absorptive cell (enterocyte)
     e.  centroacinar cell

100. The principal function for intestinal goblet cells is:
     a.  secreting digestive enzyme.
     b.  secreting one of several various hormones.
     c.  secreting mucus.
     d.  absorbing nutrients.
     e.  mitotic activity for continuing replacement of surface epithelium.

101. The principal function for most surface epithelial cells in the small intestine (enterocytes) is:
     a.  secreting digestive enzyme.
     b.  secreting one of several various hormones.
     c.  secreting mucus.
     d.  absorbing nutrients.
     e.  mitotic activity for continuing replacement of surface epithelium.

102. The principal function for intestinal enteroendocrine cells is:
     a.  secreting digestive enzyme.
     b.  secreting one of several various hormones.
     c.  secreting mucus.
     d.  absorbing nutrients.
     e.  mitotic activity for continuing replacement of surface epithelium.

103. The principal function for cells lining the sides of intestinal crypts of Lieberkühn is:
     a.  secreting digestive enzyme.
     b.  secreting one of several various hormones.
     c.  secreting mucus.
     d.  absorbing nutrients.
     e.  supplying replacement cells for epithelium of villi.

104. The principal secretory product for the Paneth cells clustered at the ends of intestinal crypts is:
     a.  mucus.
     b.  pepsinogen.
     c.  trypsinogen.
     d.  any one of several intestinal hormones.
     e.  lysosomal enzymes.

105. The principal secretory product for the epithelial cells forming pancreatic islets (of Langerhans) is:
     a.  mucus.
     b.  pepsinogen.
     c.  trypsinogen.
     d.  any one of several islet hormones.
     e.  lysosomal enzymes.

106. The principal secretory product for the pancreatic acinar cells is:
     a.  acid mucus.
     b.  alkaline mucus.
     c.  proteolytic and other digestive enzymes.
     d.  any one of several acinar hormones.
     e.  lysosomal enzymes.

107. The principal secretory product for cells of Brunner’s (duodenal) glands is:
     a.  acid mucus.
     b.  alkaline mucus.
     c.  proteolytic and other digestive enzymes.
     d.  any one of several acinar hormones.
     e.  lysosomal enzymes.

108. Undifferentiated, mitotically active epithelial cells which can replace or regenerate the epithelial lining of the small intestine are located:
     a.  at the tips of villi.
     b.  along the entire villous surface.
     c.  in the lamina propria.
     d.  along the wall of intestinal crypts.
     e.  at the ends (bottoms) of intestinal crypts.

109. Undifferentiated, mitotically active epithelial cells which can replace or regenerate the epithelial lining of the stomach are located:
     a.  among mucous cells of the gastric surface.
     b.  along the sides of gastric pits.
     c.  in the lamina propria.
     d.  in the neck region of gastric glands.
     e.  at the deep ends (bottoms) of gastric glands.

110. Columnar cells which extend across the thickness of a stratified squamous epithelium, and which have apical microvilli and basal synaptic vesicles associated with afferent nerve endings, are characteristic of:
     a.  taste buds in the tongue.
     b.  lingual and palatine tonsils.
     c.  the upper third of the esophagus.
     d.  the lower third of the esophagus.
     e.  the anal canal.

111. Which of the following connective tissue cell types is not typical of lamina propria?
     a.  lymphocyte
     b.  fibroblast
     c.  macrophage
     d.  mast cell
     e.  adipocyte

112. The mucosal surface of the stomach is protected from digestion by:
     a.  stratified squamous epithelial cells.
     b.  surface mucous cells.
     c.  chief cells.
     d.  parietal cells.
     e.  alkaline secretions from Brunner’s glands.

113. Absorptive epithelial cells of the small intestine (enterocytes) are characterized by:
     a.  apical brush border composed of microvilli.
     b.  a glycocalyx containing various digestive enzymes.
     c.  junctional complexes (terminal bars), which include tight junctions that separate apical from lateral cell membranes.
     d.  cytoplasm with a supranuclear Golgi apparatus, many mitochondria, lysosomes, and extensive smooth and rough endoplasmic reticulum.
     e.  all of the above.

114. Goblet cells in the intestine differ from enterocytes by having:
     a.  a more basally located nucleus.
     b.  fewer microvilli.
     c.  large vacuoles of mucus that stain poorly with routine acidic and basic dyes (like H&E).
     d.  a shape which is narrow basally and broad apically.
     e.  all of the above.

115. The basal basophilia of serous (enzyme-secreting) cells results from the presence in basal cytoplasm of:
     a.  extensive rough endoplasmic reticulum.
     b.  extensive smooth endoplasmic reticulum.
     c.  extensive Golgi apparatus.
     d.  many mitochondria.
     e.  numerous folds of the plasma membrane.

116. Which of the following is not a distinguishing characteristic of a parasympathetic neuron cell body in a ganglion of Meissner’s or Auerbach’s plexus?
     a.  relatively large diameter
     b.  round, large, euchromatic nucleus
     c.  prominent, single nucleolus
     d.  cytoplasmic acidophilia
     e.  location in submucosa or between circular and longitudinal layers of muscularis

117. Most lymphocytes in the GI tract (and elsewhere) can be recognized by their:
     a.  relatively small size.
     b.  round heterochromatic nuclei.
     c.  proportionately small (inconspicuous) cytoplasmic volume, compared with the nucleus.
     d.  location in connective tissue, often clustered near blood vessels or epithelial tissue.
     e.  all of the above.

118. Plasma cells differ from other lymphocytes by having:
     a.  a greater volume of basophilic cytoplasm (associated with rough ER for antibody production).
     b.  heterochromatin arranged in a radial, “spoke-wheel” pattern around the nucleus.
     c.  cytoplasm forming a lopsided or eccentric bulge on one side of the cell.
     d.  all of the above.

119. With H&E stain, many columnar epithelial cells display a weakly stained region in the cytoplasm above the nucleus. This pale supranuclear region represents the location of the:
     a.  vesicles containing stored mucus.
     b.  chylomicrons.
     c.  Golgi apparatus.
     d.  microvilli.
     e.  mitochondria.

120. The cytoplasm of gastric parietal cells stains pink with H&E because:
     a.  the cytoplasm is highly acidic.
     b.  the cytoplasm is highly basic.
     c.  the secretory vesicles are highly acidic.
     d.  the numerous mitochondria, needed for the highly energetic H+/Cl- ion pump, are acidophilic.

121. Intensely basophilic bodies in the epithelial lining of intestinal crypts, usually located toward the apical end of the columnar cells, represent:
     a.  mucus vesicles.
     b.  ribosomes.
     c.  chylomicrons.
     d.  lipofuscin granules.
     e.  condensed chromatin of mitotic figures.

QUESTION SET VI.  Liver.

Point to an answer.  Green color and bold indicates "CORRECT."  Red color and italics indicates "Wrong answer."  (NOTE:  In cases where all of the responses are correct, only "all of the above" will be indicated as correct.)

X.  Sample question.
     a.  wrong answer.
     b.  wrong answer.
     c.  CORRECT answer.
     d.  wrong answer.
     e.  wrong answer.

122. The structural unit of liver tissue, centered around a central vein with branches of the hepatic artery, portal vein and bile duct at the corners, is called a:
     a.  liver acinus.
     b.  portal triad, tract or canal.
     c.  classical or hepatic lobule.
     d.  hepatic cord.
     e.  biliary tract.

123. The hepatic lobule can also be defined as a region of hepatic tissue that is served by a single:
     a.  portal vein.
     b.  central vein.
     c.  bile duct.
     d.  hepatic artery.
     e.  sinusoid.

124. The tissue region located at the corners of a classical liver lobule, containing branches of portal vein, hepatic artery and bile duct all enveloped in connective tissue, is called a:
     a.  liver acinus.
     b.  portal triad, tract or canal.
     c.  classical or hepatic lobule.
     d.  hepatic cord.
     e.  biliary tract.

125. A functional unit of liver tissue served by a single terminal branch of the hepatic artery, including all the hepatic cords leading toward central veins on both sides of this arteriole, is called a:
     a.  liver acinus.
     b.  portal triad, tract or canal.
     c.  classical or hepatic lobule.
     d.  sinusoid.
     e.  biliary tract.

126. Cirrhosis, or liver scarring in which functional hepatic tissue is replaced by connective tissue, can be recognized by:
     a.  a greater than normal amount of connective tissue in the liver.
     b.  continuous strands of connective tissue extending between portal areas.
     c.  multiple bile ducts embedded in large portal areas (where the intervening hepatic parenchyma has disappeared).
     d.  by using a trichrome stain, which highlights collagen.
     e.  by all of the above.

127. The vessel which brings venous blood from the intestine and spleen into the liver, with branches in each portal area, is the:
     a.  hepatic artery.
     b.  portal vein.
     c.  central vein.
     d.  sinusoid.
     e.  bile duct.

128. The vessel which brings oxygenated, arterial blood from the heart into the liver, with branches in each portal area, is the:
     a.  hepatic artery.
     b.  portal vein.
     c.  central vein.
     d.  sinusoid.
     e.  bile duct.

129. The vessel which drains bile from the liver, with branches in each portal area, is the:
     a.  hepatic artery.
     b.  portal vein.
     c.  central vein.
     d.  sinusoid.
     e.  bile duct.

130. The vessel which drains venous blood from the center of each classical lobule is the:
     a.  hepatic artery.
     b.  portal vein.
     c.  central vein.
     d.  sinusoid.
     e.  bile duct.

131. A hepatic cord is:
     a.  another name for a branch of the portal vein.
     b.  the tough connective tissue surrounding a portal triad.
     c.  a row of adjacent hepatocytes within a liver lobule.
     d.  a branch of the bile duct.
     e.  a nerve within the liver.

132. A vascular passageway between adjacent hepatic cords is called a:
     a.  hepatic artery.
     b.  portal vein.
     c.  central vein.
     d.  sinusoid.
     e.  bile duct.

133. The term liver parenchyma refers to:
     a.  hepatocytes.
     b.  portal veins and hepatic arteries.
     c.  bile ducts.
     d.  stored glycogen.
     e.  connective tissue in the liver.

134. Hepatic sinusoids are lined by:
     a.  nothing; they are free spaces between hepatic cords.
     b.  stratified squamous epithelium.
     c.  endothelium, like any other vascular channel.
     d.  simple cuboidal epithelium.
     e.  simple columnar epithelium.

135. The endothelium lining hepatic sinusoids is:
     a.  continuous.
     b.  fenestrated.
     c.  open-ended.
     d.  impermeable to large molecules.
     e.  nonexistent.

136. What fluid flows within hepatic sinusoids?
     a.  bile
     b.  lymph
     c.  venous blood from intestine and spleen
     d.  arterial blood from hepatic artery
     e.  mixed arterial and venous blood

137. Between liver sinusoidal endothelium and the basal surfaces of hepatocytes is the:
     a.  bile canaliculus.
     b.  space of Disse.
     c.  sinusoidal lumen.
     d.  portal canal.
     e.  central vein.

138. The basal surface of hepatocytes is bathed by blood plasma as it flows freely through:
     a.  bile canaliculi.
     b.  portal canals.
     c.  the space of Disse.
     d.  the central veins.
     e.  the portal veins.

139. Blood cells (both RBCs and leukocytes) are retained by the sinusoidal endothelium and do not normally enter the:
     a.  hepatic artery.
     b.  lumen of hepatic sinusoids.
     c.  space of Disse.
     d.  central veins.
     e.  portal veins.

140. A tiny passage between adjacent hepatocytes, lying entirely within a hepatic cord, is called a:
     a.  bile canaliculus.
     b.  space of Disse.
     c.  sinusoidal lumen.
     d.  portal canal.
     e.  central vein.

141. Kupffer cells are most similar to:
     a.  lymphocytes.
     b.  hepatocytes.
     c.  neutrophils.
     d.  macrophages.
     e.  bile canaliculi.

142. Kupffer cells are found most commonly within the:
     a.  gall bladder.
     b.  portal canals.
     c.  hepatic sinusoids.
     d.  central vein.
     e.  bile ducts.

143. Hepatocyte function includes all of the following EXCEPT:
     a.  drug detoxification.
     b.  protein synthesis.
     c.  gluconeogenesis.
     d.  urea formation by deamination of amino acids.
     e.  breakdown of hemoglobin.

144. Macrophages in the spleen and Kupffer cells in the liver perform which of the following functions?
     a.  drug detoxification
     b.  antibody secretion
     c.  mass storage of glycogen
     d.  exocrine secretion
     e.  breakdown of hemoglobin

145. Hepatocytes are:
     a.  lymphoid tissue.
     b.  epithelial tissue.
     c.  muscle tissue.
     d.  adipose tissue.
     e.  nervous tissue.

146. The shape of hepatocytes is best described as:
     a.  cuboidal.
     b.  columnar.
     c.  squamous.
     d.  fusiform.
     e.  stellate, with many branches.

147. Hepatocytes are characterized by:
     a.  round nuclei (occasionally paired).
     b.  plentiful rough and smooth endoplasmic reticulum.
     c.  many mitochondria.
     d.  numerous lysosomes.
     e.  all of the above.

148. In normal, H&E stained material, the cytoplasm of hepatocytes appears:
     a.  unstained.
     b.  deep pink.
     c.  dark blue or purple.
     d.  yellow, brown or black.
     e.  green or sky blue.

149. Endocrine secretory products of hepatocytes include all of the following EXCEPT:
     a.  glucose (from glycogen).
     b.  serum albumin.
     c.  prothrombin.
     d.  conjugated bilirubin and bile acids.
     e.  fibrinogen.

150. Exocrine secretory products of hepatocytes include which of the following?
     a.  glucose (from glycogen)
     b.  serum albumin
     c.  prothrombin
     d.  conjugated bilirubin and bile acids
     e.  fibrinogen

151. Fat-storing stellate cells (Ito cells) in the space of Disse are noted for storing:
     a.  glycogen.
     b.  glucose.
     c.  albumin.
     d.  vitamin A.
     e.  all of the above.

152. Hepatocytes synthesize:
     a.  glycogen.
     b.  cholesterol.
     c.  albumin.
     d.  glucose.
     e.  all of the above.

153. The gall bladder is best understood as a specialized region of:
     a.  a lymph node.
     b.  a duct.
     c.  adipose tissue.
     d.  hepatocyte parenchyma.
     e.  a sympathetic ganglion.

154. Like the small intestine, the gall bladder:
     a.  is lined by columnar cells with a brush border of microvilli.
     b.  has goblet cells in the mucosal epithelium.
     c.  has crypts with Paneth cells at the bottom.
     d.  has villi with lacteals in the core.
     e.  has a distinct muscularis mucosa, and is further surrounded by two distinct layers of circular and longitudinal muscle.

155. Although the gall bladder lining superficially resembles the mucosa of the small intestine, the gall bladder lacks:
     a.  an epithelial lining.
     b.  columnar cells.
     c.  microvilli.
     d.  lamina propria.
     e.  a muscularis mucosa, crypts, villi, and goblet cells.