NBME 24 Superior rectal vein (NBME Answers)

need help with your account or subscription? click here to email us (or see the contact page)

search for anything ⋅ score predictor (“predict me!”)

NBME 24 Answers

nbme24/Block 4/Question#50 (reveal difficulty score)
A 47-year-old man comes to the physician ...
Superior rectal vein 🔍 / 📺 / 🌳 / 📖
tags: anatomy FA18p360 FA19p359

+9 upvote downvote
submitted by ∗m-ice(370)

get full access to all content ⋅ pick a username

This patient shows signs of cirrhosis, which is likely associated with portal hypertension. Portal hypertension will cause increased pressure in all veins draining into the portal vein, and can cause bulging of these veins at areas where they meet those that drain to the vena cava. One area is the rectum and anus, where the superior rectal vein (from the portal system) meets up with the middle and inferior rectal veins (which drain to the caval system). Increased pressure in the superior rectal vein will cause hemorrhoids at this location.

get full access to all content ⋅ pick a username

+5 upvote downvote
submitted by ∗ihavenolife(81)

get full access to all content ⋅ pick a username

Pg 360 First Aid 2019

Internal Hemorrhoids

-Visceral innervation (no pain felt), Superior rectal a., Superior rectal vein (drains to IMV), Internal iliac lymph nodes

versus

External Hemorrhoids

-Somatic innervation (they hurt), Inferior rectal a., Inferior rectal vein (drains to internal pudendal vein), Superficial inguinal lymph nodes

get full access to all content ⋅ pick a username

kateinwonderland Above pectinate -V:sup. rectal v -> inf. mesenteric v. -> splenic v. -> portal v -internal iliac LN Below pectinate -V:inf. rectal v -> internal pudendal v->internal iliac v->common iliac v->IVC -superficial inguinal LN (FA 2018 p360) +3

sherry Venous drainage above pectinate, most to the portal vein, some to internal iliac v via middle rectal vein. I think the real solid key here is that the clinical vignette suggests hepatic cirrhosis. +1

moxomonkey internal hemorroids are not related to portal hypertension https://www.ncbi.nlm.nih.gov › pmc › articles › PMC4691702 also FA 383 anorectal varices are. now if you check FA it say Pg 359 First Aid 2019 Anorectal varices Superior rectal ↔ middle and inferior rectal all of them include in the answers options so? +1

Must-See Comments from nbme24

seagull on Intestinal mucosa
tissue creep on Ask the roommate not to smoke in the apartment
drdoom on Adenosine
seagull on Increased serum testosterone concentration
atstillisafraud on Lamins
niboonsh on Only cookies are independently associated ...
atstillisafraud on Scar formation
lamhtu on Decreased adherence
drachenx on Damage to the rectovaginal septum
drdoom on Intestinal mucosa
azibird on Coronavirus
lsmarshall on Organic acid metabolism disorder
sympathetikey on Inhalant abuse
tea-cats-biscuits on Eosinophils