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Question 1
Correct
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Which of the following is contained within the deep perineal pouch?
Your 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 2
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 3
Correct
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The rectus sheath is formed by which of the following?
Your 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 4
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 5
Correct
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The roof of the femoral triangle is formed by which structure?
Your 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 6
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 7
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 8
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 9
Correct
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A patient undergoes oophorectomy and the ovarian veins are ligated. Which vein does the left ovary drain into?
Your Answer: Left renal
Explanation:When it comes to questions on venous drainage the ovarian vein is likely to be a common question given its varied drainage depending on laterality. 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 10
Incorrect
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Which of the following takes part in the arterial supply of the ovary?
Your Answer: Ureteric arteries
Correct 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 11
Incorrect
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The arcuate line forms part of the border of the pelvic brim. Where is it located?
Your Answer: Ischium
Correct Answer: Ilium
Explanation:Arcuate means ‘bow shaped’ and there are different arcuate lines in anatomical terms. Regarding the pelvic brim this is composed of the arcuate line of the ilium, pectineal line and prominences of sacrum and pubic symphysis (as demonstrated in the images below). As can be seen the arcuate line is a smooth rounded border on the internal surface of the ilium inferior to the iliac fossa and Iliacus. Image sourced from Wikipedia Note: The pelvic 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 12
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: 1st
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 13
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 14
Incorrect
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Sensory supply to the clitoris is via branches of which nerve?
Your Answer: Superior rectal
Correct Answer: Pudendal nerve
Explanation:The pudenal nerves has three branches, namely the inferior rectal, perineal and the dorsal nerve of the clitoris. The perineal nerve has two branches: The superficial perineal nerve gives rise to posterior scrotal or labial (cutaneous) branches, and the deep perineal nerve supplies the muscles of the deep and superficial perineal pouches, the skin of the vestibule, and the mucosa of the inferior most part of the vagina. The inferior rectal nerve communicates with the posterior scrotal or labial and perineal nerves. The dorsal nerve of the penis or clitoris is the primary sensory nerve serving the male or female organ, especially the sensitive glans at the distal end.
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This question is part of the following fields:
- Anatomy
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Question 15
Correct
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The roof of the femoral triangle is formed by which structure?
Your Answer: Fascia lata
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 (cribriform fascia at the saphenous opening) Trasversalis fascia forms part of the roof of the inguinal canal
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This question is part of the following fields:
- Anatomy
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Question 16
Incorrect
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Question 17
Incorrect
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Regarding lymph drainage of the ovary where does the majority of lymph drain to?
Your Answer: internal iliac lymph nodes
Correct Answer: para-aortic nodes
Explanation:The Ovaries lymph drains primarily to the lateral para-aortic lymph nodes
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This question is part of the following fields:
- Anatomy
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Question 18
Incorrect
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In which one of the following positions does hyperextension of the fetal head occur?
Your Answer: A hydrocephalic baby
Correct Answer: Face presentation
Explanation:Face presentation is the abnormal position of the fetal head in labour. In this position the neck is hyperextended.
Vertex position is the normal presentation of the foetus for delivery, in which the head is flexed and the position of the chin is towards the chest. -
This question is part of the following fields:
- Anatomy
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Question 19
Incorrect
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Uterine Cervix:
Your Answer: Can be dilated with dilators without the need of anaesthesia
Correct Answer: Is the portion of the uterus below the isthmus
Explanation:The uterus is divisible into two portions. The portion above the isthmus is termed the body, and that below, the cervix. The uterine cervix is the narrow inferior segment of the uterus, which projects into the vaginal cavity. It is a fibromuscular organ lined by a mucous membrane and measures approximately 3cm in length and 2.5cm in diameter. The cervix is continuous at its superior margins with the body of the uterus and at its inferior margins with the vagina.
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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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The lower part of the rectum is supplied by the middle rectal artery. What is the middle rectal artery a branch of?
Your Answer: Internal pudendal artery
Correct Answer: Internal iliac artery
Explanation:The middle rectal artery arises from the anterior division of the internal iliac artery.
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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 the uterine artery which of the following statements are TRUE?
Your Answer: It arises from the vaginal artery
Correct Answer: It arises from the internal iliac artery
Explanation:The uterine artery arises from the internal iliac artery, in particular the anterior division of the internal iliac artery. Some older texts refer to the internal iliac as the hypogastric artery. The vaginal artery typically arises as its own branch of the internal iliac artery. The ovarian arteries are branches of the aorta
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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 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 24
Incorrect
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Bladder neck closure and relaxation of the bladder is mediated by?
Your Answer: Parasympathetic Fibres T11,L1,L2
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 25
Correct
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Which of the following statements regarding the Vaginal artery is typically TRUE?
Your 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 26
Correct
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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 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 27
Incorrect
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Which of the following muscles is NOT a constituent of the pelvic floor (diaphragm)?
Your Answer: Iliococcygeal
Correct 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 28
Incorrect
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Under which one of the following conditions is the pelvic inlet felt to be contracted?
Your Answer: The transverse diameter is only 10 cm
Correct Answer:
Explanation:Contracted pelvis occurs when one or more of its diameters is reduced so that it interferes with the normal mechanism of labour. A transverse diameter below 11 cm will result in difficult delivery of the foetus and C-section will be the better option in that case
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This question is part of the following fields:
- Anatomy
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Question 29
Incorrect
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Which of the following nerves passes through the inguinal canal?
Your Answer: Pelvic splanchnic nerves
Correct Answer: Ilioinguinal nerve
Explanation:The contents of the inguinal canal is the ilioinguinal nerves, the round ligament of uterus in the females and the spermatic cord with its contents in males.
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This question is part of the following fields:
- Anatomy
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Question 30
Correct
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Presence of which one of the following features at term makes spontaneous delivery incompatible?
Your Answer: Mentum posterior
Explanation:When face presentation is diagnosed, around 60% of cases are in the mentum anterior position, 25% are mentum posterior and 15% are mentum transverse; most malpositions rotate spontaneously into mentum anterior. A vaginal birth at term is possible only if the foetus is in the mentum anterior position.
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This question is part of the following fields:
- Anatomy
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Question 31
Incorrect
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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: Perineal
Correct 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 32
Incorrect
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The juxtaglomerular apparatus (JGA) lies within which part of the kidney?
Your Answer: Minor Calyces
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 33
Incorrect
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Which one of the following statements regarding the fetal head is true?
Your Answer: Can be delivered vaginally in persistent brow presentation
Correct 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 34
Incorrect
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The external anal sphincter is innervated by which nerves?
Your Answer: Superior rectal
Correct Answer: Inferior rectal
Explanation:The external anal sphincter is innervated by the inferior rectal branch of the pudendal nerve (S2-4) while the internal anal sphincter is innervated by autonomic nerves.
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This question is part of the following fields:
- Anatomy
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Question 35
Incorrect
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The superficial inguinal ring is an aperture in which structure?
Your Answer: Conjoint tendon
Correct Answer: Aponeurosis external oblique
Explanation:The superficial ring is the exit to the inguinal canal. It is a triangular aperture in the aponeurosis of external oblique. The conjoint tendon reinforces the ring posteriorly
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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
Incorrect
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Which of the following is true about the origin of the ovarian artery?
Your Answer: It arises from the External iliac artery
Correct 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 38
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 39
Incorrect
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Which of the following structures does the broad ligament contain?
Your Answer: Vaginal artery
Correct 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 40
Incorrect
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What is the anterior boundary of the pelvic outlet?
Your Answer: sacrotuberous ligaments
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 41
Incorrect
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Regarding lymph drainage of the ovary where does the majority of lymph drain to?
Your Answer: Mesenteric nodes
Correct Answer: para-aortic nodes
Explanation:Majority of the lymph from the ovaries drain into the para-aortic lymph nodes.
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This question is part of the following fields:
- Anatomy
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Question 42
Incorrect
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Regarding the foetus, which one of the following statements is true?
Your Answer: The coronal suture lies between the two parietal bones
Correct Answer: Fetal lie describes the long axis of the foetus to the long axis of the mother
Explanation:Fetal lie describes the relationship of the long axis of the foetus with respect to the long axis of the mother.
Coronal suture is the transverse suture separating the parietal bone from the frontal bone.
Umbilical cord is composed of two arteries and one vein. the vein carries the oxygenated blood, whereas the arteries contain the deoxygenated blood.
At the time of birth, the anterior fontanelle is open and appears as a soft jelly like structure. -
This question is part of the following fields:
- Anatomy
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Question 43
Correct
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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: 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 44
Incorrect
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The inguinal canal is reinforced posteriorly by which structure?
Your Answer: Internal oblique fibres
Correct Answer: Conjoint tendon
Explanation:The Conjoint tendon AKA Inguinal falx reinforces the posterior wall of the inguinal canal. The inguinal and lacunar ligaments are 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
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This question is part of the following fields:
- Anatomy
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Question 45
Incorrect
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Question 46
Incorrect
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Which of the following statements regarding the vaginal artery is typically TRUE?
Your Answer:
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 47
Incorrect
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At what angle is the plane of the pelvic inlet to the anatomical horizontal plane?
Your Answer:
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 48
Incorrect
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Question 49
Incorrect
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Question 50
Incorrect
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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:
Correct 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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SESSION STATS - PERFORMANCE PER SPECIALTY
