-
Question 1
Correct
-
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.
-
This question is part of the following fields:
- Anatomy
-
-
Question 2
Correct
-
Regarding the pelvic outlet, what structure marks the posterior boundary?
Your Answer: Tip of the coccyx
Explanation:The bony pelvis is made up of a girdle with a central canal. The rim that surrounds the upper opening of the canal is called the pelvic inlet, while the lower rim is the called the pelvic outlet. The pelvic outlet is diamond-shaped and is bounded posteriorly by the tip of the sacrum, and anteriorly by the pubic symphysis, with its lateral boundaries being the ischial tuberosities and the sacrotuberous ligament.
-
This question is part of the following fields:
- Anatomy
-
-
Question 3
Incorrect
-
Question 4
Correct
-
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.
-
This question is part of the following fields:
- Anatomy
-
-
Question 5
Correct
-
Which of the following muscles is NOT a constituent of the pelvic floor (diaphragm)?
Your Answer: Piriformis
Explanation:The pelvic floor or diaphragm is composed of Coccygeus and Levator Ani. Levitator Ani is composed of 3 muscles: puborectalis, pubococcygeus and iliococcygeal. Although Piriformis assists in closing the posterior pelvic outlet it is not considered a component of the pelvic floor
-
This question is part of the following fields:
- Anatomy
-
-
Question 6
Correct
-
The femoral triangle is bounded superiorly by which of the following structures?
Your Answer: Inguinal ligament
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.
-
This question is part of the following fields:
- Anatomy
-
-
Question 7
Correct
-
What is the inferior border of the deep perineal pouch?
Your Answer: Perineal membrane
Explanation:The perineal membrane is a tough fascial sheet that attaches to the sides of the urogenital triangle. it forms the inferior border of the deep pouch which lies between this and the levator ani and the superior border of the superficial pouch.
-
This question is part of the following fields:
- Anatomy
-
-
Question 8
Incorrect
-
Regarding the round ligament, it leaves the pelvis via which structure?
Your Answer: Superficial inguinal ring
Correct Answer: Deep inguinal ring
Explanation:The round ligament is a band of fibromuscular connective tissue attached to the cornua of the uterus, near the attachment of the ovaries. On each side of the body, the ligament exits the pelvis through the deep inguinal ring, travels through the inguinal canal and enters the labia majora where its fibres terminate at the mons pubis. It is also important to know the embryological origins of the round ligament from the gubernaculum.
-
This question is part of the following fields:
- Anatomy
-
-
Question 9
Correct
-
The main support of the uterus is provided by:
Your Answer: The cardinal ligament
Explanation:The cardinal ligament (or Mackenrodt’s ligament, lateral or transverse cervical ligament) is a major ligament of the uterus. It is located at the base of the broad ligament of the uterus. It attaches the cervix to the lateral pelvic wall by its attachment to the Obturator fascia of the Obturator internus muscle, and is continuous externally with the fibrous tissue that surrounds the pelvic blood vessels. It thus provides support to the uterus.
-
This question is part of the following fields:
- Anatomy
-
-
Question 10
Incorrect
-
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 2
Correct Answer: Grade 3
Explanation:Pelvic organ prolapse is a common condition amongst ageing women where a weakness in the pelvic support structures of the pelvic floor allows pelvic viscera to descend.
The Pelvic Organ Prolapse Quantification system (POP-Q) is useful for describing and staging the severity of the pelvic organ prolapse.
Grade 1: the most distal portion of the prolapse is more than 1 cm above the level of the hymen
Grade 2: the most distal portion of the prolapse is 1 cm or less proximal or distal to the hymenal plane
Grade 3: the most distal portion of the prolapse protrudes more than 1 cm below the hymen but protrudes no farther than 2 cm less than the total vaginal length (for example, not all of the vagina has prolapsed)
Grade 4: vaginal eversion complete -
This question is part of the following fields:
- Anatomy
-
-
Question 11
Incorrect
-
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.
-
This question is part of the following fields:
- Anatomy
-
-
Question 12
Incorrect
-
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: Perineal
Correct Answer: Ilioinguinal
Explanation:This describes the sensory area supplied by the ilioinguinal nerve. This is a potential complication with pelvic surgery.
-
This question is part of the following fields:
- Anatomy
-
-
Question 13
Incorrect
-
If the presenting part of the foetus is the large fontanel, this presentation is known as?
Your Answer: Brow
Correct 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
-
-
Question 14
Correct
-
Pelvic ligaments can change at term resulting in?
Your Answer: Enlargement of the pelvic cavity
Explanation:The pelvis is supported by a variety of ligaments. At term, these ligaments allow for variation in its structure such that the overall size of the pelvic cavity is increased in order to accommodate the upcoming foetus into the cavity.
-
This question is part of the following fields:
- Anatomy
-
-
Question 15
Correct
-
Question 16
Correct
-
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 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
-
-
Question 17
Correct
-
What is the anatomical landmark used for gauging the station of the fetal head during labour?
Your 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.
-
This question is part of the following fields:
- Anatomy
-
-
Question 18
Incorrect
-
Bladder contraction during voiding (micturating) is mediated via innervation of which of the following pathways?
Your Answer: Sympathetic fibres from S2,S3,S4 nerve roots
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.
-
This question is part of the following fields:
- Anatomy
-
-
Question 19
Correct
-
Regarding the pubic symphysis, what type of joint is it
Your 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.
-
This question is part of the following fields:
- Anatomy
-
-
Question 20
Incorrect
-
The inguinal canal is reinforced posteriorly by which structure?
Your Answer: External oblique aponeurosis
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
-
This question is part of the following fields:
- Anatomy
-
-
Question 21
Correct
-
Question 22
Incorrect
-
Which of the following nerves passes through the inguinal canal?
Your Answer: Inferior hypogastric
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.
-
This question is part of the following fields:
- Anatomy
-
-
Question 23
Correct
-
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
-
-
Question 24
Correct
-
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.
-
This question is part of the following fields:
- Anatomy
-
-
Question 25
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
-
-
Question 26
Correct
-
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.
-
This question is part of the following fields:
- Anatomy
-
-
Question 27
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
-
-
Question 28
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
-
-
Question 29
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
-
-
Question 30
Correct
-
Regarding the uterine artery which of the following statements are FALSE?
Your Answer: It crosses the Ureter posteriorly
Explanation:The Uterine artery typically arises from the anterior branch of the internal iliac artery. It crosses the ureter ANTERIORLY. It is the primary source of arterial supply to the uterus and its branches anastomose with branches of the ovarian and vaginal arteries.
-
This question is part of the following fields:
- Anatomy
-
00
Correct
00
Incorrect
00
:
00
:
00
Session Time
00
:
00
Average Question Time (
Mins)