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Question 1
Correct
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The arcuate line forms part of the border of the pelvic brim. Where is it located?
Your Answer: Ilium
Explanation:The arcuate line is a smooth rounded border on the internal surface of the ilium just inferior to the iliac fossa. It forms the boundary of the pelvic inlet.
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This question is part of the following fields:
- Anatomy
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Question 2
Correct
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Which of the following structures does the broad ligament contain?
Your Answer: Uterine artery
Explanation:The broad ligament is one of the secondary supporting structures of the uterus which attaches the lateral portion of the uterus to the pelvic sidewall. The broad ligament primarily serves a protective layer for important structures including the fallopian tubes, the ovaries, the ovarian arteries, and the uterine arteries, the round and ovarian ligaments, and the infundibulopelvic ligaments.
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This question is part of the following fields:
- Anatomy
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Question 3
Incorrect
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Which of the following muscles does NOT receive innervation from the pudendal nerve?
Your Answer: External urethral sphincter
Correct Answer: Internal anal sphincter
Explanation:The internal anal sphincter is innervated by pelvic splanchnic nerves
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This question is part of the following fields:
- Anatomy
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Question 4
Incorrect
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A patient present to the clinic with a 1 day history of vaginal prolapse. Upon examination, the vagina is 1.5 cm below the vaginal plane. What grade is the prolapse according to the POP-Q classification?
Your Answer: Grade 1
Correct Answer: Grade 3
Explanation:Pelvic organ prolapse is a common condition amongst ageing women where a weakness in the pelvic support structures of the pelvic floor allows pelvic viscera to descend.
The Pelvic Organ Prolapse Quantification system (POP-Q) is useful for describing and staging the severity of the pelvic organ prolapse.
Grade 1: the most distal portion of the prolapse is more than 1 cm above the level of the hymen
Grade 2: the most distal portion of the prolapse is 1 cm or less proximal or distal to the hymenal plane
Grade 3: the most distal portion of the prolapse protrudes more than 1 cm below the hymen but protrudes no farther than 2 cm less than the total vaginal length (for example, not all of the vagina has prolapsed)
Grade 4: vaginal eversion complete -
This question is part of the following fields:
- Anatomy
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Question 5
Incorrect
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What is the inferior border of the deep perineal pouch?
Your Answer: Superior fascia of the urogenital diaphragm
Correct Answer: Perineal membrane
Explanation:The perineal membrane is a tough fascial sheet that attaches to the sides of the urogenital triangle. it forms the inferior border of the deep pouch which lies between this and the levator ani and the superior border of the superficial pouch.
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This question is part of the following fields:
- Anatomy
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Question 6
Correct
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What is the anatomical landmark used for gauging the station of the fetal head during labour?
Your Answer: Ischial Spine
Explanation:The ischial spines and palpable through the vagina and are used as landmarks to assess the decent of the fetal head from the cervix. It also serves as a landmark for giving the pudendal block.
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This question is part of the following fields:
- Anatomy
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Question 7
Incorrect
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The inguinal canal is reinforced posteriorly by which structure?
Your Answer: Inguinal ligament
Correct Answer: Conjoint tendon
Explanation:The Inguinal Canal
– Anterior wall: formed by the external oblique aponeurosis throughout the length of the canal; its lateral part is reinforced by muscle fibres of the internal oblique.
– Posterior wall: formed by the transversalis fascia; its medial part is reinforced by pubic attachments of the internal oblique and transversus abdominis aponeuroses that frequently merge to variable extents into a common tendon—the inguinal falx (conjoint tendon)—and the reflected inguinal ligament.
– Roof: formed laterally by the transversalis fascia, centrally by musculo-aponeurotic arches of the internal oblique and transversus abdominis, and medially by the medial crus of the external oblique aponeurosis.
– Floor: formed laterally by the iliopubic tract, centrally by gutter formed by the infolded inguinal ligament, and medially by the lacunar ligament. -
This question is part of the following fields:
- Anatomy
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Question 8
Incorrect
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Regarding the structure of the detrusor muscle. Which of the following is true?
Your Answer: The detrusor is a single layer consisting of both circular and longitudinal muscle fibres
Correct Answer: The detrusor is divided into 3 layers consisting of inner and outer layers of longitudinal smooth muscle with a middle circular smooth muscle layer
Explanation:The urinary bladder is composed of the transitional epithelium, followed by the lamina propria made up of the fibroelastic connective tissue. The muscularis layer covers the lamina propria which is made up of three poorly defined layers of smooth muscles; the inner longitudinal, middle circular and the outer longitudinal layer. The bladder is covered on the superior surface and the lateral surface by the peritoneum.
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This question is part of the following fields:
- Anatomy
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Question 9
Incorrect
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Which of the following leaves the pelvis via the greater sciatic foramen?
Your Answer: Obturator Nerve
Correct Answer: Pudendal Nerve
Explanation:The pudendal nerve is formed by sacral nerve roots S2, S3 and S4 almost immediately as they exit the spinal foramina. The pudendal nerve exits the pelvis via the greater sciatic foramen, travels behind the sacrospinous ligament before re-entering the pelvis via the lesser sciatic foramen. It is an important nerve to be aware of as it supplies sensation to the genitalia and can also be damaged/compressed at a number of places along its course. Image sourced from Wikipedia
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This question is part of the following fields:
- Anatomy
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Question 10
Incorrect
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Sertoli cells contain receptors to which hormone?
Your Answer: Inhibin
Correct Answer: FSH
Explanation:Sertoli cells contain receptors for FSH. In response to this Sertoli cells synthesize inhibin, androgen binding proteins and anti Mullerian hormone all which are connected to the reproduction cycle.
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This question is part of the following fields:
- Anatomy
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Question 11
Correct
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The femoral triangle is bounded superiorly by which of the following structures?
Your Answer: Inguinal ligament
Explanation:The femoral triangle is bounded superiorly by the inguinal ligament which forms the base of the triangle, medially by the lateral border of the adductor longus and laterally by the sartorius muscle.
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This question is part of the following fields:
- Anatomy
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Question 12
Correct
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You see a patient who is 32 weeks pregnant. She complains of tingling to the right buttock and shooting pain down the leg. You suspect Piriformis syndrome. Regarding Piriformis which of the following statements are true?
Your Answer: Insertion is onto the greater trochanter
Explanation:Nerve Supply: L5 to S2 via Nerve to Piriformis
Origin: Sacrum
Insertion: Greater trochanter
Action: External rotation of hip
Blood Supply: Superior and Inferior gluteal arteries and lateral sacral arteries -
This question is part of the following fields:
- Anatomy
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Question 13
Correct
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A patient undergoes surgery for a vaginal vault prolapse. After surgery she complains of numbness and groin pain. You assess her and find the numb area is the anterior aspect of the labia. Which nerve has likely been damaged during surgery?
Your Answer: Ilioinguinal
Explanation:This describes the sensory area supplied by the ilioinguinal nerve. This is a potential complication with pelvic surgery.
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This question is part of the following fields:
- Anatomy
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Question 14
Incorrect
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Which of the following statements regarding the vaginal artery is typically TRUE?
Your Answer: It arises from the Uterine artery
Correct Answer: It arises from the Internal iliac artery
Explanation:The vaginal artery is the homolog to the inferior vesical artery in males. In most of the cases it arises from the internal iliac artery.
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This question is part of the following fields:
- Anatomy
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Question 15
Correct
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Which of the following leaves the pelvis via the greater sciatic foramen?
Your Answer: Pudendal Nerve
Explanation:The pudendal nerve arises from the S2-S4 nerve roots and it lies medial to the internal pudendal artery while exiting the pelvis via the greater sciatic foramen. It curves around the sacrospinous ligament and re-enters the pelvis via the lesser sciatic foramen and from there it runs medial to the ischial tuberosity over the obturator internus in the pudendal canal to the deep perineal pouch.
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This question is part of the following fields:
- Anatomy
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Question 16
Incorrect
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During the filling phase of micturition. At what bladder volume is the first urge to void felt?
Your Answer: 50ml
Correct Answer: 150ml
Explanation:The normal functional bladder capacity is around 400-600ml. First urge to void is typically felt when the bladder is approximately 150ml full.
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This question is part of the following fields:
- Anatomy
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Question 17
Correct
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The pelvis includes which of the following bones:
Your Answer: Ilium, ischium, pubis, sacrum & coccyx
Explanation:The pelvic skeleton is formed posteriorly (in the area of the back), by the sacrum and the coccyx and laterally and anteriorly (forward and to the sides), by a pair of hip bones. Each hip bone consists of 3 sections, ilium, ischium, and pubis.
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This question is part of the following fields:
- Anatomy
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Question 18
Incorrect
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Regarding molding of the fetal head, which one is true?
Your Answer: Does not happen when the maternal pelvis is adequate
Correct Answer: Does NOT have time to occur in breech delivery
Explanation:Molding allows the skull bones of the fetal head some mobility during the normal delivery of foetus as the skull changes its shape to accommodate passage through the mothers pelvis. However this does not occur in breach delivery where the skull is in circular shape. Babies born breech typically have craniofacial and limb deformations resulting from their in utero position. These babies characteristically have a long, narrow head, (“dolichocephaly” or “type 1”), with a prominent occipital shelf, redundant skin over the neck, overlapping lambdoidal sutures, and an indentation below their ears (from shoulder compression).
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This question is part of the following fields:
- Anatomy
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Question 19
Correct
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Regarding the female breast how many lobes does the typical breast contain?
Your Answer: 15-20
Explanation:The basic components of the mammary gland are the alveoli. These are lined with milk-secreting cuboidal cells surrounded by myoepithelial cells. The alveoli join to form groups known as lobules. The lobules form lobes. Each lobe has a lactiferous duct that drains into openings in the nipple. Each breast typically contains 15-20 lobes.
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This question is part of the following fields:
- Anatomy
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Question 20
Incorrect
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The median umbilical ligament is a remnant of what structure?
Your Answer: Paraumbilical Veins
Correct Answer: Urachus
Explanation:MEDIAL umbilical ligament = remnant fetal umbilical arteries
MEDIAN umbilical ligament = remnant of urachus -
This question is part of the following fields:
- Anatomy
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Question 21
Incorrect
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Bladder neck closure and relaxation of the bladder is mediated by?
Your Answer: Sympathetic Fibres S2,S3,S4
Correct Answer: Sympathetic Fibres L1,L2
Explanation:The neck of the bladder is surrounded by the internal sphincter. It is supplied by the sympathetic and parasympathetic nerves of the splanchnic nerve. Parasympathetic stimulation causes the detrusor muscle to contract and the internal urethral sphincter to relax. It Is predominantly by the parasympathetic nerves S2-S4. Relaxation of the bladder is caused by inhibiting the sacral parasympathetic preganglionic neurons and exciting the lumbar sympathetic preganglionic neurons. Remember SYMPATHETIC is for STORAGE and PARASYMPATHETIC is for PEEING.
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This question is part of the following fields:
- Anatomy
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Question 22
Incorrect
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A patient attends clinic with a vaginal prolapse. On examination the vaginal prolapse is visible 1.5cm above the plane of the hymen. According to the POPQ classification what grade is this prolapse?
Your Answer: Grade 3
Correct Answer: Grade 1
Explanation:This is a grade 1 prolapse
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This question is part of the following fields:
- Anatomy
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Question 23
Incorrect
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What are the branches of the pudendal nerves in females?
Your Answer: Perineal, ilioinguinal and dorsal clitoral
Correct Answer: Perineal, inferior rectal and dorsal nerve of clitoris
Explanation:The pudendal nerve provides sensory and motor innervation to regions of the anus, the perineum, the labia and the clitoris in women. The nerve is formed from the ventral rami of the S2-S4 sacral spinal nerves. The nerve is paired, each innervating the left and the right side of the body. The nerve gives the following branches in females: the inferior anal nerve, the perineal nerve and the dorsal nerve of the clitoris.
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This question is part of the following fields:
- Anatomy
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Question 24
Incorrect
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The round ligament develops from which structure?
Your Answer: Medial umbilical ligament
Correct Answer: Gubernaculum
Explanation:The round ligament develops from the lower end of the gubernaculum in females. In the males it persists as the scrotal ligament.
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This question is part of the following fields:
- Anatomy
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Question 25
Incorrect
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Which one of the following dimensions relates to the greatest diameter of the fetal head?
Your Answer: Suboccipit bregmatic
Correct Answer: Occipitomental
Explanation:Occipitomental diameter is the greatest diameter of the fetal scalp and runs from chin to the prominent portion on the occiput. It measure about 12.5cm in diameter.
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This question is part of the following fields:
- Anatomy
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Question 26
Correct
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The arterial blood supply to the bladder is via branches of which artery?
Your Answer: Internal Iliac
Explanation:The bladder is supplied by branches of the internal iliac artery, including the superior vesical artery, branches of the gluteal and obturator arteries and the inferior vesical artery in males and the vaginal and the uterine arteries in females.
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This question is part of the following fields:
- Anatomy
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Question 27
Incorrect
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The roof of the femoral triangle is formed by which structure?
Your Answer: Femoral sheath
Correct Answer: Fascia lata
Explanation:The femoral triangle is bounded:
– Superiorly by the inguinal ligament that forms the base of the femoral triangle.
– Medially by the lateral border of the adductor longus.
– Laterally by the sartorius; the apex of the femoral triangle is formed where the borders of the sartorius and the adductor muscles meet.
– The floor of the femoral triangle is formed by the iliopsoas laterally and the pectineus muscle medially.
– The roof of the femoral triangle is formed by the fascia lata and cribriform
fascia, subcutaneous tissue, and skin. -
This question is part of the following fields:
- Anatomy
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Question 28
Incorrect
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What is the anterior boundary of the pelvic outlet?
Your Answer: ischial tuberosity
Correct Answer: pubic arch
Explanation:Pelvic Outlet Boundaries Anteriorly: Pubic arch Laterally: Ischial tuberosities Posterolaterally: Inferior margin of the sacrotuberous ligament Posteriorly: Tip of the coccyx Note: The pelvis outlet is also called the inferior aperture. The pelvic brim is the superior aperture
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This question is part of the following fields:
- Anatomy
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Question 29
Incorrect
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The inferior 1/3 of the rectum is principally supplied by which artery?
Your Answer: Inferior rectal artery
Correct Answer: Middle rectal artery
Explanation:Remember the inferior rectal artery supplies the anus. The middle rectal artery is the principle supply to the lower 1/3 rectum. The rectal arteries do form an anastomosis.
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This question is part of the following fields:
- Anatomy
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Question 30
Incorrect
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At the time of delivery, if there is a laceration of perineal body but not the anal sphincter, this type of laceration is classified as?
Your Answer: First degree
Correct Answer: Second degree
Explanation:Perineal tears are common at the time of child birth. First degree perineal laceration means that the wound is so small that it doesn’t require any stitches and usually heals on its own. 2nd degree means that skin and smooth muscles are both torn. 3rd degree tear means that the tear is beyond the perineal muscles and the muscles surrounding the anal canal, while in 4th degree, the perineal tear goes through the anal sphincter up to the rectum.
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This question is part of the following fields:
- Anatomy
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