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Question 1
Correct
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Regarding the urinary bladder, what type of epithelium lines it?
Your Answer: Transitional
Explanation:The urinary bladder, and most of the urinary structures are lined by epithelium called the urothelium, or the transitional epithelium. This stratified lining is divided into three parts, an apical layer, an intermediate layer and a basal layer. The transitional epithelium is available to stretch to accommodate the increased volume when the bladder is distended, without structural damage.
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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 rectus sheath is formed by which of the following?
Your Answer: External oblique and rectus abdominus 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 3
Incorrect
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What is the anterior boundary of the pelvic outlet?
Your Answer: pubic tubercle
Correct Answer: pubic arch
Explanation:The pelvic outlet is bounded anteriorly by the inferior border of the pubic arch, posteriorly by the sacrotuberous ligament and the tip of the coccyx and laterally by the ischial tuberosities.
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This question is part of the following fields:
- Anatomy
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Question 4
Incorrect
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Which of the following nerves passes through the inguinal canal?
Your Answer: Pudendal 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 5
Correct
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Question 6
Incorrect
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What is the anatomical landmark used for gauging the station of the fetal head during labour?
Your Answer: Pubic symphysis
Correct 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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Which of the following muscles does NOT receive innervation from the pudendal nerve?
Your Answer: External anal sphincter
Correct Answer: Internal anal sphincter
Explanation:The internal anal sphincter is innervated by the splanchnic nerves. Sympathetic nerve supply from the inferior hypogastric plexus (for contraction) and parasympathetic supply from nervi erigentes (for relaxation).
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This question is part of the following fields:
- Anatomy
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Question 8
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 9
Incorrect
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The femoral triangle contains all of the following structures EXCEPT which one?
Your Answer: Saphenofemoral Junction
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 10
Incorrect
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The ascending colon drains into the superior mesenteric vein (SMV). What vein does the SMV drain into?
Your Answer: Inferior vena cava
Correct Answer: Hepatic portal vein
Explanation:The superior mesenteric vein joins the splenic vein to form the hepatic portal vein.
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This question is part of the following fields:
- Anatomy
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Question 11
Incorrect
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You are reviewing a patient who is complaining of pain and numbness to the right anterior aspect of her labia following abdominal hysterectomy. You suspect ilioinguinal nerve injury. What spinal segment is the ilioinguinal nerve derived from?
Your Answer: T12-L4
Correct Answer: L1
Explanation:Ilioinguinal nerve injury is one of the most common nerve injuries associated with pelvic surgery.
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This question is part of the following fields:
- Anatomy
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Question 12
Incorrect
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Sensory supply to the clitoris is via branches of which nerve?
Your Answer: Inferior rectal
Correct 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 13
Incorrect
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After a vaginal delivery, a patient suffers a perineal tear. On examination the laceration involves the external anal sphincter and has partially torn the internal anal sphincter. Which of the following classifies this tear?
Your Answer: 3b
Correct Answer: 3c
Explanation:During childbearing the vagina and perineum are prone to lacerations that may involve the skin or can extend into the anal sphincter complex. It is important to be able to identify obstetric and anal sphincter injuries to provide adequate care and prevent complications. In the classification of obstetric tears according to RCOG guidelines:
First degree tear: injury to the perineal skin and/or the vaginal mucosa
Second degree tears: Injury to perineum involving perineal muscles but not the anal sphincter.
Third-degree tear: Injury to perineum involving the anal sphincter complex:
Grade 3a tear: Less than 50% of external anal sphincter (EAS) thickness torn.
Grade 3b tear: More than 50% of EAS thickness torn.
Grade 3c tear: Both EAS and internal anal sphincter (IAS) torn.
Fourth-degree tear: Injury to perineum involving the anal sphincter complex (EAS and IAS)
and anorectal mucosa. -
This question is part of the following fields:
- Anatomy
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Question 14
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 15
Correct
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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 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 16
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 17
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: Femoral 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 18
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 of longitudinal smooth muscle
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 19
Incorrect
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Regarding the foetus, which one of the following statements is true?
Your Answer: The anterior fontanelle is usually closed by the time of labour
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 20
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 21
Incorrect
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Question 22
Incorrect
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Which of the following takes part in the arterial supply of the ovary?
Your Answer: Vaginal 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 23
Incorrect
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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: Genitofemoral
Correct 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 24
Incorrect
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The juxtaglomerular apparatus (JGA) lies within which part of the kidney?
Your Answer: Major 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 25
Incorrect
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Which of the following terms best describes the pelvic type of small posterior sagittal diameter, convergent sidewalls, prominent ischial spines, and narrow pubic arch?
Your Answer: Anthropoid
Correct Answer: Android
Explanation:There are four types pelvic shapes:
1) Android pelvis: it has a larger inlet and smaller outlet along with small posterior sagittal diameter, prominent ischial spines and has a two finger arch.
2) Gynecoid pelvis: it has a transverse or nearly a circular ellipse and it is the most favourable for delivery.
3) Anthropoid pelvis: the brim is an anteroposterior ellipse.
4) Platypelloid pelvis: in this type the pelvic brim is kidney shape -
This question is part of the following fields:
- Anatomy
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Question 26
Incorrect
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Which of the following is contained within the deep perineal pouch?
Your Answer: Superficial transverse perineal muscle
Correct Answer: Proximal portion of urethra
Explanation:The proximal portion of urethra in females or membranous urethra in males is in the deep perineal pouch
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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 pubic symphysis, what type of joint is it
Your Answer: Synovial
Correct Answer: Secondary Cartilaginous
Explanation:The pubic symphysis is a cartilaginous joint. The cartilaginous joints are divided further into primary and secondary joints. The primary joint is called the synchondrosis. It articulates with the pubis of the other side.
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This question is part of the following fields:
- Anatomy
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Question 28
Incorrect
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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: Arterial supply is primarily via the medial sacral artery
Correct 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 29
Incorrect
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Which of the following is contained within the deep perineal pouch?
Your Answer: Fatty layer superficial fascia
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 30
Incorrect
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Regarding lymph drainage of the ovary where does the majority of lymph drain to?
Your Answer: Inguinal 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 31
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: Fifth 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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Question 32
Correct
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Question 33
Correct
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If your patient is 8 weeks pregnant which one of the following USS measurements is most useful?
Your Answer: Crown rump length
Explanation:Fetal crown-rump length (CRL) is recommended over last menstrual period for estimating GA when measured in early pregnancy i.e. before 9 to 13+6 weeks.
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This question is part of the following fields:
- Anatomy
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Question 34
Incorrect
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Which of the following structures does the broad ligament contain?
Your Answer: Sacrospinous ligament
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 35
Incorrect
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Question 36
Correct
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Question 37
Incorrect
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The uterine vein drains where?
Your Answer: Inferior vena cava
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 38
Incorrect
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Which of the following statements regarding the vaginal artery is typically TRUE?
Your Answer: It arises from the Abdominal Aorta
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 39
Incorrect
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The roof of the femoral triangle is formed by which structure?
Your Answer: Sartorius
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 40
Correct
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Question 41
Correct
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Question 42
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: Genitofemoral
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 43
Incorrect
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Regarding the uterine artery which of the following statements are TRUE?
Your Answer: It arises from the external ilia 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 44
Correct
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Bladder neck closure and relaxation of the bladder is mediated by?
Your 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 45
Incorrect
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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: Nerve supply is via S2 to S4
Correct Answer: Insertion is onto the greater trochanter
Explanation:The proximal attachment of the piriformis muscles is from the anterior surface of sacrum and it attaches distally to the superior border of the greater trochanter of the femur. It is innervated by the anterior rami of S1 and S2.
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This question is part of the following fields:
- Anatomy
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Question 46
Incorrect
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Regarding lymph drainage of the lower vagina where does the majority of lymph drain to?
Your Answer: Lumbar nodes
Correct Answer: Inguinal nodes
Explanation:Lymphatic vessels from the vagina drain from the parts of the vagina as follows:
• Superior part: to the internal and external iliac lymph nodes.
• Middle part: to the internal iliac lymph nodes.
• Inferior part: to the sacral and common iliac nodes. -
This question is part of the following fields:
- Anatomy
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Question 47
Incorrect
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During vertex presentation, the position is determined by relationship of which part of the fetal vertex to the mother's pelvis?
Your Answer: Acromion
Correct Answer: Occiput
Explanation:A cephalic presentation is the one where head of the foetus enters the pelvic cavity at the time of delivery. The commonest form of cephalic presentation is the vertex presentation in which the occiput of the foetus enters the birth canal.
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This question is part of the following fields:
- Anatomy
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Question 48
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: L2-L4
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 49
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 2
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 50
Incorrect
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Bladder contraction during voiding (micturating) is mediated via innervation of which of the following pathways?
Your Answer:
Correct 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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SESSION STATS - PERFORMANCE PER SPECIALTY
