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Question 1
Incorrect
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Bladder neck closure and relaxation of the bladder is mediated by?
Your Answer: Parasympathetic 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 2
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 3
Correct
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Leydig cells contain receptors to which hormone?
Your Answer: LH
Explanation:The Leydig cells contain receptors to the luteinizing hormone which in turn is responsible for the production of testosterone. This circulates in the body predominantly bound to transport proteins and to a lesser extent to albumin.
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This question is part of the following fields:
- Anatomy
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Question 4
Correct
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Pelvic ligaments can change at term resulting in?
Your Answer: Enlargement of the pelvic cavity
Explanation:The pelvis is supported by a variety of ligaments. At term, these ligaments allow for variation in its structure such that the overall size of the pelvic cavity is increased in order to accommodate the upcoming foetus into the cavity.
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This question is part of the following fields:
- Anatomy
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Question 5
Incorrect
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Regarding lymph drainage of the fallopian tubes where does the majority of lymph drain to?
Your Answer: Internal iliac nodes
Correct Answer: Para-aortic nodes
Explanation:Lymphatic vessels from the ovaries, joined by vessels from the uterine tubes and most from the fundus of the uterus, follow the ovarian veins as they ascend to the right and left lumbar (caval/aortic) lymph nodes.
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This question is part of the following fields:
- Anatomy
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Question 6
Correct
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Regarding the pelvic outlet, what structure marks the posterior boundary?
Your Answer: Tip of the coccyx
Explanation:The bony pelvis is made up of a girdle with a central canal. The rim that surrounds the upper opening of the canal is called the pelvic inlet, while the lower rim is the called the pelvic outlet. The pelvic outlet is diamond-shaped and is bounded posteriorly by the tip of the sacrum, and anteriorly by the pubic symphysis, with its lateral boundaries being the ischial tuberosities and the sacrotuberous ligament.
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This question is part of the following fields:
- Anatomy
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Question 7
Incorrect
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You are asked to assess a patients perineal tear following labour by vaginal delivery. You note a laceration that extends through the vaginal mucosa into the perineal muscle and fascia. The external anal sphincter appears to be in tact. How would you classify this tear?
Your Answer: 3rd type A
Correct Answer: 2nd
Explanation:If the external anal sphincter is in tact then this is a 1st or 2nd degree tear. As the perineal muscles are involved this is 2nd degree tear.
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This question is part of the following fields:
- Anatomy
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Question 8
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, like the Uterine artery is typically a branch of the Internal Iliac artery. It can sometimes arise as a branch of the Uterine artery so it is important to read the question (if the stem stated it CAN arise from the Uterine artery then that would be true)
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This question is part of the following fields:
- Anatomy
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Question 9
Correct
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Which one of the following statements regarding the fetal head is true?
Your Answer: Considered to be engaged when the biparietal diameter passes the level of the pelvic inlet
Explanation:The fetal head is engaged when the head of the foetus or the presenting part enters the pelvic inlet or pelvic brim. It usually occurs at 38 weeks of gestation.
The Spalding sign refers to the overlapping of the fetal skull bones caused by collapse of the fetal brain. It appears usually a week or more after fetal death in utero.
In brow presentation the scalp is deflexed as the foetus is looking upward. Normally the head is inflexed such that the chin is touching the chest. -
This question is part of the following fields:
- Anatomy
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Question 10
Incorrect
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The rectus sheath is formed by which of the following?
Your Answer: Rectus abdominus and pyramidalis aponeuroses
Correct Answer: aponeuroses of transversus abdominis, external and internal oblique
Explanation:The rectus sheath is formed by the decussation and interweaving of the aponeuroses of the fl at abdominal muscles. The external oblique aponeurosis contributes to the anterior wall of the sheath throughout its length. The superior two thirds of the internal oblique aponeurosis splits into two layers (laminae) at the lateral border of the rectus abdominis; one lamina passing anterior to the muscle and the other passing posterior to it. The anterior lamina joins the aponeurosis of the external oblique to form the anterior layer of the rectus sheath. The posterior lamina joins the aponeurosis of the transversus abdominis to form the posterior layer of the rectus sheath.
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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 medially by which of the following structures?
Your Answer: Adductor longus
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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Regarding lymph drainage of the breast where does the majority of lymph drain to?
Your Answer: Axillary nodes
Explanation:Lymphatic drainage of the breast.
The lateral two thirds of the breast drains into the axillary lymph nodes. This constitute about 75% of the lymphatic drainage of the breast. The medial third of the breast drains into the parasternal lymph nodes and these communicate with the ipsilateral lymph nodes from the opposite breast. The superior part of the breast drains into the infraclavicular lymph nodes and inferior part drains into the diaphragmatic lymph nodes. -
This question is part of the following fields:
- Anatomy
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Question 13
Correct
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Bladder contraction during voiding (micturating) is mediated via innervation of which of the following pathways?
Your Answer: Parasympathetic fibres from S2,S3,S4 nerve roots
Explanation:Detrusor contraction is via Parasympathetic innervation of pelvic splanchnic nerves (S2-4). This also causes relaxation of the internal urethral sphincter Note contraction and relaxation of the external urethral sphincter is under somatic control.
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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 structure reinforces the inguinal canal anterolaterally?
Your Answer: Conjoint tendon
Correct Answer: Internal oblique
Explanation:The anatomy of the inguinal canal is of surgical importance. In the male, the inguinal canal carries the spermatic cord, ilioinguinal nerve and important blood vessels, while in females the inguinal canal holds the round ligament, ilioinguinal nerve and blood vessels. The floor of the inguinal canal is made of the inguinal ligament (a thickened portion of the inguinal ligament), while the posterior wall is made of the transversalis muscle. The anterior wall is made of the external oblique aponeurosis, and the roof is made up of fibres of the internal oblique, transversus abdominis and its aponeurosis, and the conjoint tendon. This means that the anterolateral support structure of the inguinal canal would be the fibres of the internal oblique.
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This question is part of the following fields:
- Anatomy
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Question 15
Incorrect
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At what angle is the plane of the pelvic inlet to the anatomical horizontal plane?
Your Answer: 45
Correct Answer: 60
Explanation:The female pelvic inlet tilts at an inclination that is about 60 degrees from the anatomical horizontal plane. This tilt is maintained by muscles and fascia. The pelvic outlet slopes at an angle of 15 degrees.
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This question is part of the following fields:
- Anatomy
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Question 16
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 17
Incorrect
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During the filling phase of micturition. At what bladder volume is the first urge to void felt?
Your Answer: 300ml
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 18
Correct
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Which one of the following measurements is usually taken during clinical exam of the pelvis?
Your Answer: Shape of the pubic arch
Explanation:During pelvimetry, the shape of the pubic arch is usually examined. It helps in determining the outcome of the type of fetal delivery.
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This question is part of the following fields:
- Anatomy
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Question 19
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 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 20
Correct
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How many seminiferous tubules would you typically expect to find in a testicular lobule?
Your Answer: 2
Explanation:There are between 250 and 400 lobules in each testis. The lobule is a structural unit of the testis with each lobule contained in one of the intervals between fibrous septa which extend between the mediastinum testis and the tunica albuginea. Each lobule contains 1 to 3 seminiferous tubules.
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This question is part of the following fields:
- Anatomy
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Question 21
Incorrect
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Question 22
Incorrect
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The uterine vein drains where?
Your Answer: Renal vein
Correct Answer: Internal iliac vein
Explanation:The venous drainage of the uterus is via the uterine veins which form a plexus passing below the artery within the base of the broad ligament communicating with the rectal and the vesical venous plexus before draining into the internal iliac veins.
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This question is part of the following fields:
- Anatomy
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Question 23
Correct
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The juxtaglomerular apparatus (JGA) lies within which part of the kidney?
Your Answer: Renal Cortex
Explanation:The substructures of the nephrons are mainly located within the cortex. The JGA sits next to the glomerulus in the cortex (click on the magnifying glass of the image to see the arrangement). They play an important role in blood pressure homeostasis as the juxtaglomerular cells produce renin. The descending and ascending limbs of the loop of Henle and collecting ducts have sections within both the cortex and medulla
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This question is part of the following fields:
- Anatomy
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Question 24
Correct
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Sensory supply to the clitoris is via branches of which nerve?
Your Answer: Pudendal nerve
Explanation:The Pudendal nerve divides into inferior rectal, perineal and dorsal nerve of the clitoris (or penis in males). The dorsal nerve of clitoris supplies sensory innervation to the clitoris. The perineal branch supplies sensory innervation to the skin of the labia majora and minora and the vestibule.
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This question is part of the following fields:
- Anatomy
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Question 25
Incorrect
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The femoral triangle contains all of the following structures EXCEPT which one?
Your Answer: Femoral nerve
Correct Answer: Genital branch of the genitofemoral nerve
Explanation:The contents of the femoral triangles are femoral nerve, artery and the vein. Along with the femoral sheath and lymphatics.
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This question is part of the following fields:
- Anatomy
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Question 26
Correct
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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: 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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Question 27
Correct
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The inferior 1/3 of the rectum is principally supplied by which artery?
Your 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 28
Correct
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The normal lining of the fallopian tube is:
Your Answer: Columnar epithelium with cilia
Explanation:The Fallopian tubes, also known as, uterine tubes, and salpinges, are two very fine tubes lined with ciliated columnar epithelia, leading from the ovaries of female mammals into the uterus, via the uterotubal junction.
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This question is part of the following fields:
- Anatomy
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Question 29
Incorrect
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A patient who is 36 weeks pregnant comes to see you as she has developed tingling to the right lateral thigh over the past 3 weeks. On examination there are no skin changes and no muscle weakness. What is the likely diagnosis?
Your Answer: Pudendal nerve entrapment
Correct Answer: Meralgia Paraesthetica
Explanation:Raised pressure with the pelvis can cause a number of nerve entrapment syndromes. This is entrapment of the lateral cutaneous nerve of the thigh (or lateral femoral cutaneous nerve) also known as Meralgia Paraesthetica. Pregnancy is a risk factor. Shingles can effect this nerve but the rash would usually present itself within 14days.
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This question is part of the following fields:
- Anatomy
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Question 30
Correct
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The inguinal canal is reinforced posteriorly by which structure?
Your 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 31
Correct
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The typical female breast contains how many lobes?
Your Answer: 15-20
Explanation:The female breast is made of about 15 to 20 individual lobes. The lobules each consists of alveoli which drain into a single lactiferous duct. The ductal system leads to lactiferous sinuses and collecting ducts which expel milk from openings in the nipple.
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This question is part of the following fields:
- Anatomy
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Question 32
Incorrect
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The arterial blood supply to the bladder is via branches of which artery?
Your Answer: Internal pudendal
Correct 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 33
Correct
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A patient undergoes surgery for a vaginal vault prolapse. After surgery she complains of numbness of the anterior aspect of the labia. Which nerve has likely been damaged during surgery?
Your Answer: Ilioinguinal
Explanation:The anterior aspect of the vulva (mons pubis, anterior labia) is supplied by derivatives of the lumbar plexus: the anterior labial nerves, derived from the
ilio-inguinal nerve, and the genital branch of the genitofemoral nerve.
The posterior aspect of the vulva is supplied by derivatives of the sacral plexus: the perineal branch of the posterior cutaneous nerve of the thigh laterally, and the pudendal nerve centrally. -
This question is part of the following fields:
- Anatomy
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Question 34
Incorrect
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All of the following anatomical features of the pelvis favour a vaginal delivery, except?
Your Answer: Subpubic arch accepts 2 fingers
Correct Answer: Obstetric conjugate is less than 10 cm
Explanation:For the foetus to pass through the vagina, the obstetric conjugate should be 11cm or greater. If the diameter is less than 10 cm then its better to perform C-section as the labour might not progress. All the other options favour a normal vaginal delivery.
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This question is part of the following fields:
- Anatomy
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Question 35
Incorrect
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Which of the following statements regarding the vaginal artery is typically TRUE?
Your Answer: It arises from the External iliac 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 36
Correct
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Question 37
Correct
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Which two nerves provide the primary cutaneous sensory innervation to the labia majora?
Your Answer: Ilioinguinal and pudendal
Explanation:The Pudendal provides cutaneous innervation to the posterior external genitalia via one of its terminal branches called the perineal nerve (this further branches into the posterior labial nerves or posterior scrotal nerve in men). The ilioinguinal nerve provides anterior sensation via the anterior labial nerves (anterior scrotal nerve in men). The genital branch of the genitofemoral nerve contributes some fibres to the skin of the mons pubis and labia majora in females. The posterior cutaneous nerve of thigh sometimes overlaps sensory areas.
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This question is part of the following fields:
- Anatomy
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Question 38
Incorrect
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The testicular arteries are branches of what?
Your Answer: Internal iliac
Correct Answer: Aorta
Explanation:The testicular artery arises from the aorta and supplies the testis and the epididymis. The testis is supplied by 3 arteries.: Testicular artery, cremasteric artery that arises from the inferior hypogastric artery and the artery to the vas deferens from the internal iliac artery.
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This question is part of the following fields:
- Anatomy
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Question 39
Correct
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Regarding the structure of the detrusor muscle. Which of the following is true?
Your 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 40
Correct
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Which of the following is true about the origin of the ovarian artery?
Your Answer: It arises from the Abdominal Aorta
Explanation:The ovarian arteries are considered the main blood supply for the ovaries. The ovarian arteries usually arise from the lateral aspect of the abdominal artery, though in some instances they may arise from the renal or iliac arteries.
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This question is part of the following fields:
- Anatomy
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Question 41
Correct
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During the filling phase of micturition. At what bladder volume is the first urge to void felt?
Your Answer: 150ml
Explanation:Micturition is defined as a process of expelling urine from the body. It is caused by the reflex contraction of detrusor muscle. Urinary bladder is a hollow muscular organ which can store 400-600ml of urine until it is expelled from the body. The first urge to urinate is felt when the bladder is filled with around 150ml of urine. The reflex action is initiated when the stretch receptors located in the bladder wall are stimulated. The afferent fibres pass to the pelvic splanchnic nerves to the 2nd, 3rd, and 4th sacral segments and some pass through the hypogastric plexus to the first and second lumbar segments of the spinal cord. Efferent pathways from the 2nd, 3rd, and 4th sacral segments leave the cords and through the splanchnic nerves and inferior hypogastric plexus supplies the smooth muscle of the bladder i.e. detrusor muscle. Detrusor muscle contracts and the sphincters are relaxed.
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This question is part of the following fields:
- Anatomy
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Question 42
Incorrect
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What is the inferior border of the deep perineal pouch?
Your Answer: Sphincter urethrae
Correct Answer: Perineal membrane
Explanation:The perineal membrane (also known as the inferior fascia of the urogenital diaphragm) separates the deep and superficial perineal pouches i.e. it is the inferior border of the deep pouch and superior border of the superficial pouch. The deep perineal pouch is the space therefore between superior and inferior layers of the urogenital diaphragm The superior fascia of the urogenital diaphragm is the superior border
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This question is part of the following fields:
- Anatomy
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Question 43
Correct
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Regarding the rectus sheath which of the following statements are true?
Your Answer: Above the arcuate line the internal oblique divides into two lamellae
Explanation:The rectus sheath is formed by the aponeurosis of the internal and external oblique muscles and the transversus abdominus muscle. The internal oblique divides into two lamellae and encloses the rectus muscle. Anteriorly it fuses with the aponeurosis of the external oblique and posteriorly with that of the transverus abdominus. Below the arcuate line the aponeurosis of all the flat muscles lies anteriorly and posteriorly it is only enclosed by the transveralis fascia.
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This question is part of the following fields:
- Anatomy
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Question 44
Incorrect
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The ureters receive autonomic supply from which spinal segments?
Your Answer: S1-S3
Correct Answer: T11-L2
Explanation:The ureters receive innervation by a number of nerve plexuses. The nerves supplying the ureters originate from spinal segments T11 to L2. When you think about ureteric colic giving classic ‘loin to groin’ pain it is because the pain is referred to these dermatomes.
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This question is part of the following fields:
- Anatomy
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Question 45
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 46
Incorrect
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You are reviewing a patient who is complaining of pain and numbness to the proximal medial thigh following abdominal hysterectomy. You suspect genitofemoral nerve injury. What spinal segment(s) is the genitofemoral nerve derived from?
Your Answer: T12,L1
Correct Answer: L1,L2
Explanation:The genitofemoral nerves takes its origin from the L1 and L2 spinal segments.
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This question is part of the following fields:
- Anatomy
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Question 47
Incorrect
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Lymph drainage from the bladder is via which nodes?
Your Answer: Para-aortic nodes
Correct Answer: External, Internal and Common iliac nodes
Explanation:Lymphatic drainage of the bladder is to the common iliac nodes via the internal iliac nodes.
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This question is part of the following fields:
- Anatomy
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Question 48
Correct
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A patient undergoes oophorectomy and the ovarian veins are ligated. Which vein does the right ovary drain into?
Your Answer: Inferior vena cava
Explanation:The right ovarian vein travels through the suspensory ligament of the ovary and generally joins the inferior vena cava whereas the left ovarian vein drains into the left renal vein.
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This question is part of the following fields:
- Anatomy
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Question 49
Incorrect
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The ureter is lined by what type of epithelium?
Your Answer: Simple Cuboidal
Correct Answer: Transitional
Explanation:Ureters are muscular tubes that run from the kidneys to the urinary bladder. It is lined by transitional epithelium.
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This question is part of the following fields:
- Anatomy
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Question 50
Correct
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What is the inferior border of the deep perineal pouch?
Your 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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SESSION STATS - PERFORMANCE PER SPECIALTY
