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NBME 18 Answers

nbme18/Block 4/Question#29 (14.8 difficulty score)
65 yo man, cancer of the cecum
Ileocolic → superior mesenteric → portal → right hepatic branch of the portal🔍

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submitted by itsalwayslupus(27),

I have seen some anatomy questions or wrong answer explanations on UWorld about the colic veins, so I think the drainage of all of them are fair game. From those questions, The right colic drains the ascending colon and the middle colic drains the transverse and upper part of descending. Therefore I knew to cross out anything with middle or right colic, because those wouldn't drain the cecum. Next, like the other comment said, we have to know that the cecum is part of the midgut, which is drained by the SMV, which only leaves you with the ileocolic --> superior mesenteric answer choice.

submitted by lilyo(69),

Anyone have an idea on how to approach this question?

gdupgrant  So the thing i think they tried to catch people on was that the SMV Joins with the splenic to become the portal vein and the IMV feeds into the splenic vein. And they want you to know that cecum is midgut, so drained by the SMV. so my approach was automatically eliminate any answer that included IMV or Splenic vein and that left me with only Ileocolic → superior mesenteric → portal → right hepatic branch of the portal +15  

submitted by mumenrider4ever(37),

"The ileocolic vein is located within the digestive tract. It receives blood from the appendicular vein, and it drains oxygen-depleted blood from the ileum in the small intestine and the cecum and colon, parts of the large intestine.

From there, this deoxygenated blood flows to the superior mesenteric vein, which joins with the hepatic portal vein."