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  • Question 1 - You are reviewing a patient who is complaining of pain and numbness to...

    Correct

    • 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.

    • This question is part of the following fields:

      • Anatomy
      13.6
      Seconds

  • Question 2 - Regarding the rectus sheath which of the following statements are true? ...

    Correct

    • Regarding the rectus sheath which of the following statements are true?

      Your Answer: Above the arcuate line the internal oblique divides into two lamellae

      Explanation:

      The rectus sheath is formed by the aponeurosis of the internal and external oblique muscles and the transversus abdominus muscle. The internal oblique divides into two lamellae and encloses the rectus muscle. Anteriorly it fuses with the aponeurosis of the external oblique and posteriorly with that of the transverus abdominus. Below the arcuate line the aponeurosis of all the flat muscles lies anteriorly and posteriorly it is only enclosed by the transveralis fascia.

    • This question is part of the following fields:

      • Anatomy
      12.3
      Seconds

  • Question 3 - Regarding lymph drainage of the lower vagina where does the majority of lymph...

    Correct

    • Regarding lymph drainage of the lower vagina where does the majority of lymph drain to?

      Your Answer: Inguinal nodes

      Explanation:

      The lower vagina drains to the inguinal nodes where as the upper vagina drains to the internal and external iliacs

    • This question is part of the following fields:

      • Anatomy
      6.4
      Seconds

  • Question 4 - What is the anterior boundary of the pelvic outlet? ...

    Correct

    • What is the anterior boundary of the pelvic outlet?

      Your 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

    • This question is part of the following fields:

      • Anatomy
      43
      Seconds

  • Question 5 - During the filling phase of micturition. At what bladder volume is the first...

    Correct

    • During the filling phase of micturition. At what bladder volume is the first urge to void felt?

      Your Answer: 150ml

      Explanation:

      Micturition is defined as a process of expelling urine from the body. It is caused by the reflex contraction of detrusor muscle. Urinary bladder is a hollow muscular organ which can store 400-600ml of urine until it is expelled from the body. The first urge to urinate is felt when the bladder is filled with around 150ml of urine. The reflex action is initiated when the stretch receptors located in the bladder wall are stimulated. The afferent fibres pass to the pelvic splanchnic nerves to the 2nd, 3rd, and 4th sacral segments and some pass through the hypogastric plexus to the first and second lumbar segments of the spinal cord. Efferent pathways from the 2nd, 3rd, and 4th sacral segments leave the cords and through the splanchnic nerves and inferior hypogastric plexus supplies the smooth muscle of the bladder i.e. detrusor muscle. Detrusor muscle contracts and the sphincters are relaxed.

    • This question is part of the following fields:

      • Anatomy
      5.5
      Seconds

  • Question 6 - What is the average anteroposterior distance of the female pelvic outlet? ...

    Incorrect

    • What is the average anteroposterior distance of the female pelvic outlet?

      Your Answer: 9 cm

      Correct Answer: 13 cm

      Explanation:

      The pelvic outlet is bounded in front by the lower margin of the symphysis pubis, on each side by the descending ramus of the pubic bone, the ischial tuberosity and the sacrotuberous ligament, and posteriorly by the last piece of the sacrum. The AP diameter of the pelvic outlet is 13.5 cm and the transverse diameter is 11 cm.

    • This question is part of the following fields:

      • Anatomy
      5.2
      Seconds

  • Question 7 - Sensory supply to the clitoris is via branches of which nerve? ...

    Correct

    • Sensory supply to the clitoris is via branches of which nerve?

      Your Answer: Pudendal nerve

      Explanation:

      The Pudendal nerve divides into inferior rectal, perineal and dorsal nerve of the clitoris (or penis in males). The dorsal nerve of clitoris supplies sensory innervation to the clitoris. The perineal branch supplies sensory innervation to the skin of the labia majora and minora and the vestibule.

    • This question is part of the following fields:

      • Anatomy
      11.6
      Seconds

  • Question 8 - Bladder neck closure and relaxation of the bladder is mediated by? ...

    Incorrect

    • 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:

      Remember SYMPATHETIC is STORAGE PARASYMPATHETIC is PEEING

    • This question is part of the following fields:

      • Anatomy
      8.8
      Seconds

  • Question 9 - You see a patient who is 32 weeks pregnant. She complains of tingling...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Anatomy
      16.4
      Seconds

  • Question 10 - The roof of the femoral triangle is formed by which structure? ...

    Incorrect

    • The roof of the femoral triangle is formed by which structure?

      Your Answer: Transversalis fascia

      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
      16.6
      Seconds

  • Question 11 - You are reviewing a patient who is complaining of pain and numbness to...

    Incorrect

    • 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: L1-L3

      Correct Answer: L1

      Explanation:

      Ilioinguinal nerve injury is one of the most common nerve injuries associated with pelvic surgery.

    • This question is part of the following fields:

      • Anatomy
      16.5
      Seconds

  • Question 12 - If the presenting part of the foetus is the large fontanel, this presentation...

    Correct

    • If the presenting part of the foetus is the large fontanel, this presentation is known as?

      Your Answer: Sinciput

      Explanation:

      Sinciput means the head is neither flexed nor extended. It is the area between forehead and crown and in this case the anterior fontanel is the presenting part.

    • This question is part of the following fields:

      • Anatomy
      2124.1
      Seconds

  • Question 13 - A patient is about to undergo a pudendal nerve block after vaginal delivery...

    Correct

    • 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.

    • This question is part of the following fields:

      • Anatomy
      10.9
      Seconds

  • Question 14 - All of the following anatomical features of the pelvis favour a vaginal delivery,...

    Correct

    • 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.

    • This question is part of the following fields:

      • Anatomy
      86.7
      Seconds

  • Question 15 - The round ligament develops from which structure? ...

    Correct

    • The round ligament develops from which structure?

      Your Answer: Gubernaculum

      Explanation:

      The round ligament is a remnant of the gubernaculum in females. In males it persists as the scrotal ligament.

    • This question is part of the following fields:

      • Anatomy
      25.5
      Seconds

  • Question 16 - The pelvis includes which of the following bones: ...

    Correct

    • The pelvis includes which of the following bones:

      Your Answer: Ilium, ischium, pubis, sacrum & coccyx

      Explanation:

      The pelvic skeleton is formed posteriorly (in the area of the back), by the sacrum and the coccyx and laterally and anteriorly (forward and to the sides), by a pair of hip bones. Each hip bone consists of 3 sections, ilium, ischium, and pubis.

    • This question is part of the following fields:

      • Anatomy
      13.6
      Seconds

  • Question 17 - Which spinal segment is the lumbar plexus derived from? ...

    Correct

    • Which spinal segment is the lumbar plexus derived from?

      Your Answer: T12-L4

      Explanation:

      The lumbar plexus is formed via contributions from the T12-L4 spinal cord segment. The plexus is responsible for the motor and sensory innervation of portions of the lower extremities and some parts of the lower abdomen and pelvis. Nerves arising from the plexus include the Iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, femoral nerve, obturator, and nerve to the lumbosacral trunk.

    • This question is part of the following fields:

      • Anatomy
      12.8
      Seconds

  • Question 18 - Regarding lymph drainage of the fallopian tubes where does the majority of lymph...

    Correct

    • Regarding lymph drainage of the fallopian tubes where does the majority of lymph drain to?

      Your 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.

    • This question is part of the following fields:

      • Anatomy
      9.3
      Seconds

  • Question 19 - The joint between the two pubic bones is called the: ...

    Correct

    • The joint between the two pubic bones is called the:

      Your Answer: Pubis symphysis

      Explanation:

      The pubic symphysis or symphysis pubis is the midline cartilaginous joint (secondary cartilaginous) uniting the superior rami of the left and right pubic bones. It is located anterior to the urinary bladder and superior to it.

    • This question is part of the following fields:

      • Anatomy
      5.4
      Seconds

  • Question 20 - You see a patient who is 32 weeks pregnant. She complains of tingling...

    Correct

    • 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: 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
      1276.5
      Seconds

  • Question 21 - After a vaginal delivery, a patient suffers a perineal tear. On examination the...

    Incorrect

    • 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: 4th

      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
      9.2
      Seconds

  • Question 22 - Which of the following muscles does NOT receive innervation from the pudendal nerve?...

    Incorrect

    • Which of the following muscles does NOT receive innervation from the pudendal nerve?

      Your Answer: Levator ani

      Correct Answer: Internal anal sphincter

      Explanation:

      The internal anal sphincter is innervated by pelvic splanchnic nerves

    • This question is part of the following fields:

      • Anatomy
      9.9
      Seconds

  • Question 23 - Which structure reinforces the inguinal canal anterolaterally? ...

    Correct

    • Which structure reinforces the inguinal canal anterolaterally?

      Your Answer: Internal oblique

      Explanation:

      The anatomy of the inguinal canal is of surgical importance. In the male, the inguinal canal carries the spermatic cord, ilioinguinal nerve and important blood vessels, while in females the inguinal canal holds the round ligament, ilioinguinal nerve and blood vessels. The floor of the inguinal canal is made of the inguinal ligament (a thickened portion of the inguinal ligament), while the posterior wall is made of the transversalis muscle. The anterior wall is made of the external oblique aponeurosis, and the roof is made up of fibres of the internal oblique, transversus abdominis and its aponeurosis, and the conjoint tendon. This means that the anterolateral support structure of the inguinal canal would be the fibres of the internal oblique.

    • This question is part of the following fields:

      • Anatomy
      5.2
      Seconds

  • Question 24 - From which of the following spinal segments do both the internal and external...

    Incorrect

    • From which of the following spinal segments do both the internal and external anal sphincters receive their innervation?

      Your Answer: S1

      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.

    • This question is part of the following fields:

      • Anatomy
      11.6
      Seconds

  • Question 25 - Uterine Cervix: ...

    Correct

    • Uterine Cervix:

      Your 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.

    • This question is part of the following fields:

      • Anatomy
      19
      Seconds

  • Question 26 - A patient undergoes oophorectomy and the ovarian veins are ligated. Which vein does...

    Correct

    • A patient undergoes oophorectomy and the ovarian veins are ligated. Which vein does the left ovary drain into?

      Your Answer: Left renal

      Explanation:

      The right ovarian vein ascends and enters the inferior vena cava and the left ovarian vein drains into the longer left renal vein.

    • This question is part of the following fields:

      • Anatomy
      5.6
      Seconds

  • Question 27 - Regarding the Pituitary gland which of the following statements is true? ...

    Correct

    • Regarding the Pituitary gland which of the following statements is true?

      Your Answer: It is surrounded by the sella turcica

      Explanation:

      The Sella turcica is composed of three parts:
      1. The tuberculum sellae (horn of saddle): a variable slight to prominent median elevation forming the posterior
      boundary of the prechiasmatic sulcus and the anterior boundary of the hypophysial fossa.
      2. The hypophysial fossa (pituitary fossa): a median depression (seat of saddle) in the body of the sphenoid that accommodates the pituitary gland (L. hypophysis).
      3. The dorsum sellae (back of saddle): a square plate of bone projecting superiorly from the body of the sphenoid.
      It forms the posterior boundary of the Sella turcica, and its prominent superolateral angles make up the posterior clinoid processes.

    • This question is part of the following fields:

      • Anatomy
      9.1
      Seconds

  • Question 28 - A patient present to the clinic with a 1 day history of vaginal...

    Correct

    • 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
      46.1
      Seconds

  • Question 29 - Which of the following is true about the origin of the ovarian artery?...

    Correct

    • Which of the following is true about the origin of the ovarian artery?

      Your Answer: It arises from the Abdominal Aorta

      Explanation:

      The ovarian arteries are considered the main blood supply for the ovaries. The ovarian arteries usually arise from the lateral aspect of the abdominal artery, though in some instances they may arise from the renal or iliac arteries.

    • This question is part of the following fields:

      • Anatomy
      7.7
      Seconds

  • Question 30 - The lower part of the rectum is supplied by the middle rectal artery....

    Incorrect

    • The lower part of the rectum is supplied by the middle rectal artery. What is the middle rectal artery a branch of?

      Your Answer: Inferior mesenteric artery

      Correct Answer: Internal iliac artery

      Explanation:

      The middle rectal artery arises from the anterior division of the internal iliac artery.

    • This question is part of the following fields:

      • Anatomy
      14.5
      Seconds

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