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Question 1
Incorrect
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The juxtaglomerular apparatus (JGA) lies within which part of the kidney?
Your Answer: Renal Medulla
Correct 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 2
Incorrect
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The inguinal canal is reinforced posteriorly by which structure?
Your Answer: External oblique aponeurosis
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 3
Incorrect
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The round ligament develops from which structure?
Your Answer: Medial umbilical ligament
Correct Answer: Gubernaculum
Explanation:The round ligament is a remnant of the gubernaculum in females. In 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 4
Correct
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Which of the following muscles is NOT a constituent of the pelvic floor (diaphragm)?
Your Answer: Piriformis
Explanation:The pelvic floor or diaphragm is composed of Coccygeus and Levator Ani. Levitator Ani is composed of 3 muscles: puborectalis, pubococcygeus and iliococcygeal. Although Piriformis assists in closing the posterior pelvic outlet it is not considered a component of the pelvic floor
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This question is part of the following fields:
- Anatomy
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Question 5
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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Question 6
Correct
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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: 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 7
Incorrect
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Which of the following is contained within the deep perineal pouch?
Your Answer: Ischiocavernosus muscle
Correct Answer: Proximal portion of urethra
Explanation:The deep perineal pouch contains the external urethral sphincter, proximal urethra in females and membranous urethra in males, deep transverse perineal muscles and the glands of cowper.
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This question is part of the following fields:
- Anatomy
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Question 8
Incorrect
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From which of the following spinal segments do both the internal and external anal sphincters receive their innervation?
Your Answer: S2
Correct Answer: S4
Explanation:The anal sphincters are responsible for closing the anal canal to the passage of faeces and flatus. The smooth muscle of the involuntary internal sphincter sustains contraction to prevent the leakage of faeces between bowel movements and is innervated by the pelvic splanchnic nerves, which are a branch of the spinal segment 4. The external sphincter is made up of skeletal muscle and can therefore contract and relax voluntarily. Its innervation comes from the inferior rectal branch of the pudendal nerve, and the perineal branch of S4 nerve roots.
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This question is part of the following fields:
- Anatomy
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Question 9
Incorrect
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The inguinal canal is reinforced anterolaterally by which structure?
Your Answer: Aponeurosis external oblique
Correct Answer: Internal oblique
Explanation:The Conjoint tendon AKA Inguinal falx reinforces the posterior wall of the inguinal canal. The inguinal ligament is part of the floor.
The aponeurosis of external oblique is the major component of the anterior wall with fibres of internal oblique reinforcing the lateral part -
This question is part of the following fields:
- Anatomy
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Question 10
Correct
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Question 11
Correct
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The juxtaglomerular apparatus (JGA) lies within which part of the kidney?
Your Answer: Renal Cortex
Explanation:The juxtaglomerular apparatus is the main site for the production of renin. It plays an important role in the regulation of the blood pressure. These structures are mainly located in the cortex of the kidneys.
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This question is part of the following fields:
- Anatomy
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Question 12
Correct
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All of the following anatomical features of the pelvis favour a vaginal delivery, except?
Your 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 13
Correct
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Which of the following arteries branches directly from the aorta?
Your Answer: Ovarian
Explanation:The ovarian artery takes its origin directly from the aorta. While the uterine and the vaginal arteries are all branches of the internal iliac artery.
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This question is part of the following fields:
- Anatomy
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Question 14
Correct
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Regarding molding of the fetal head, which one is true?
Your 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 15
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 16
Correct
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The femoral triangle is bounded superiorly by which of the following structures?
Your Answer: Inguinal ligament
Explanation:Boundaries of the Femoral Triangle:
Superior: Inguinal ligament
Medial: Medial border of the adductor longus
Lateral: Medial border of the sartorius
Floor: Pectineus, Adductor longus and Iliopsoas muscles
Roof: Fascia Lata -
This question is part of the following fields:
- Anatomy
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Question 17
Correct
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A patient is about to undergo a pudendal nerve block after vaginal delivery to repair an episiotomy. Which spinal segments form the pudendal nerve?
Your Answer: S2, S3 and S4
Explanation:The pudendal nerve provides sensory 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. Pudendal nerve blocks are indicated for analgesia of the second stage of labour, repair of an episiotomy or perineal laceration, and for minor surgeries of the lower vagina and perineum.
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This question is part of the following fields:
- Anatomy
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Question 18
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 19
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 20
Correct
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Question 21
Incorrect
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Sertoli cells contain receptors to which hormone?
Your Answer: Testosterone
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 22
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 23
Correct
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The vulva is mainly supplied by which one of the following vessels?
Your Answer: Pudendal artery
Explanation:Vulva is defined by the area which is located outside the female vagina and comprises of the labia majora, labia minora, clitoris, mons pubis and Bartholin glands. It is supplied by the vestibula branch of pudental artery.
Inferior hemorrhoidal artery supplies the lower part of the rectum.
Femoral artery is the continuation of external iliac artery and supplies most of the leg. -
This question is part of the following fields:
- Anatomy
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Question 24
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 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 25
Correct
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Which cell type of the testis secrete inhibin?
Your Answer: Sertoli cells
Explanation:Summary points of the two key testicular cell types:
1. Sertoli Cells = Secrete Inhibin. Forms blood-testis barrier. Have FSH receptors
2. Leydig Cells = Secrete testosterone. Have LH receptors -
This question is part of the following fields:
- Anatomy
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Question 26
Incorrect
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Regarding the structure of the detrusor muscle. Which of the following is true?
Your Answer: The detrusor is divided into 2 layers consisting of an inner longitudinal smooth muscle layer and outer circular smooth muscle layer
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 27
Incorrect
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Regarding the round ligament, it leaves the pelvis via which structure?
Your Answer: Superficial inguinal ring
Correct Answer: Deep inguinal ring
Explanation:The round ligament is a band of fibromuscular connective tissue attached to the cornua of the uterus, near the attachment of the ovaries. On each side of the body, the ligament exits the pelvis through the deep inguinal ring, travels through the inguinal canal and enters the labia majora where its fibres terminate at the mons pubis. It is also important to know the embryological origins of the round ligament from the gubernaculum.
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This question is part of the following fields:
- Anatomy
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Question 28
Correct
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Which of the following takes part in the arterial supply of the ovary?
Your Answer: Uterine arteries
Explanation:The ovarian arteries, arising from the abdominal aorta and the ascending uterine arteries which are branches of the internal iliac artery all supply the ovaries. They terminate by bifurcating into the ovarian and tubal branches and anastomose with the contralateral branches providing a collateral circulation.
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This question is part of the following fields:
- Anatomy
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Question 29
Incorrect
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Question 30
Incorrect
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Lymph drainage from the bladder is via which nodes?
Your Answer: Internal and Common iliac nodes only
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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