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Question 1
Incorrect
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What is the anatomical landmark used for gauging the station of the fetal head during labour?
Your Answer: Sacrotuberous ligament
Correct Answer: Ischial Spine
Explanation:The ischial spine is the anatomical landmark for assessing the station of the fetal head and also placing pudendal nerve blocks. (the pudendal nerve runs posterior to the ischial spine). The ischial spine can be palpated approximately 8cm into the vagina, at 4 and 8 o’clock.
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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 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 3
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 4
Correct
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Question 5
Correct
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All of the following are features of the female bony pelvis, except?
Your Answer: It is funnel shaped
Explanation:The female bony pelvis is larger, broader and more of a funnel shape. The inlet is larger and oval in shape and the sides of the female pelvis are wider apart.
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This question is part of the following fields:
- Anatomy
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Question 6
Correct
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What are the branches of the pudendal nerves in women?
Your Answer: Perineal, inferior anal and dorsal nerve of clitoris
Explanation:The pudendal nerve provides sensory and motor innervation to regions of the anus, the perineum, the labia and the clitoris in women. The nerve is formed from the ventral rami of the S2-S4 sacral spinal nerves. The nerve is paired, each innervating the left and the right side of the body. The nerve gives the following branches in females: the inferior anal nerve, the perineal nerve and the dorsal nerve of the clitoris.
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This question is part of the following fields:
- Anatomy
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Question 7
Correct
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The ovarian artery is a branch of the:
Your Answer: Aorta
Explanation:The ovarian artery is an artery that supplies oxygenated blood to the ovary in females. It arises from the abdominal aorta below the renal artery. It can be found in the suspensory ligament of the ovary, anterior to the ovarian vein and ureter.
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This question is part of the following fields:
- Anatomy
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Question 8
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 9
Correct
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Which one of the following muscles is the most important muscle forming the pelvic floor?
Your Answer: Levator ani
Explanation:Levator ani muscle is composed of three different muscles i.e. iliococcygeus, pubococcygeus and the puborectalis muscle. It is the main muscle that supports the organs of the pelvic cavity.
Bulbocavernosus and Ischiocavernosus muscles are located in-between the anus and scrotum and play an important role in sexual response in males.
Superficial and deep transverse perineal muscles are located in the perinium and pass in front of the anus. -
This question is part of the following fields:
- Anatomy
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Question 10
Correct
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Question 11
Incorrect
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The femoral triangle contains all of the following structures EXCEPT which one?
Your Answer: Deep inguinal lymph nodes
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 12
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 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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Bladder neck closure and relaxation of the bladder is mediated by?
Your Answer: Sympathetic Fibres S2,S3,S4
Correct Answer: Sympathetic Fibres L1,L2
Explanation:The neck of the bladder is surrounded by the internal sphincter. It is supplied by the sympathetic and parasympathetic nerves of the splanchnic nerve. Parasympathetic stimulation causes the detrusor muscle to contract and the internal urethral sphincter to relax. It Is predominantly by the parasympathetic nerves S2-S4. Relaxation of the bladder is caused by inhibiting the sacral parasympathetic preganglionic neurons and exciting the lumbar sympathetic preganglionic neurons. Remember SYMPATHETIC is for STORAGE and PARASYMPATHETIC is for PEEING.
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This question is part of the following fields:
- Anatomy
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Question 15
Correct
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The uterine vein drains where?
Your 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 16
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 17
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 18
Correct
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In which one of the following positions does hyperextension of the fetal head occur?
Your 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
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 20
Correct
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The testicular arteries are branches of what?
Your 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 21
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 22
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 23
Incorrect
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The inferior 1/3 of the rectum is principally supplied by which artery?
Your Answer: Superior 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 24
Incorrect
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Question 25
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 26
Correct
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At what angle is the plane of the pelvic inlet to the anatomical horizontal plane?
Your 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 27
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 approximately a quarter of the thickness through the external anal sphincter. How would you classify this tear?
Your Answer: 3c
Correct Answer: 3a
Explanation:1. First-degree trauma corresponds to lacerations of the skin/vaginal epithelium alone.
2. Second-degree tears involve perineal muscles and therefore include episiotomies.
3. Third-degree extensions involve any part of the anal sphincter complex (external and internal sphincters):
i Less than 50 per cent of the external anal
sphincter is torn.
ii More than 50 per cent of the external anal
sphincter is torn.
iii Tear involves the internal anal sphincter
(usually there is complete disruption of the
external sphincter).
4. Fourth-degree tears involve injury to the anal sphincter complex extending into the rectal mucosa. -
This question is part of the following fields:
- Anatomy
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Question 28
Correct
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Question 29
Incorrect
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Which one of the following measurements is usually taken during clinical exam of the pelvis?
Your Answer: Bi-ischial diameter
Correct 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 30
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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