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  • Question 1 - A patient is about to undergo a pudendal nerve block after vaginal delivery...

    Incorrect

    • 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: L5, S1 and S2

      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.

    • This question is part of the following fields:

      • Anatomy
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  • Question 2 - Which of the following statements regarding the vaginal artery is typically TRUE? ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Anatomy
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  • Question 3 - You see a patient who is 32 weeks pregnant. She complains of tingling...

    Incorrect

    • 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:

      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.

    • This question is part of the following fields:

      • Anatomy
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  • Question 4 - Which of the following arteries branches directly from the aorta? ...

    Incorrect

    • Which of the following arteries branches directly from the aorta?

      Your Answer:

      Correct Answer: Ovarian

      Explanation:

      The uterine and vaginal arteries branch from the internal iliac artery. The ovarian artery branches direct from the aorta.

    • This question is part of the following fields:

      • Anatomy
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  • Question 5 - The femoral triangle is bounded superiorly by which of the following structures? ...

    Incorrect

    • The femoral triangle is bounded superiorly by which of the following structures?

      Your Answer:

      Correct 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 6 - You are asked to assess a patients perineal tear following labour by vaginal...

    Incorrect

    • 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:

      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.

    • This question is part of the following fields:

      • Anatomy
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  • Question 7 - The ovarian artery is a branch of the: ...

    Incorrect

    • The ovarian artery is a branch of the:

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
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  • Question 8 - The pelvis includes which of the following bones: ...

    Incorrect

    • The pelvis includes which of the following bones:

      Your Answer:

      Correct 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
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  • Question 9 - What is the anterior boundary of the pelvic outlet? ...

    Incorrect

    • What is the anterior boundary of the pelvic outlet?

      Your Answer:

      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

    • This question is part of the following fields:

      • Anatomy
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  • Question 10 - Which of the following leaves the pelvis via the greater sciatic foramen? ...

    Incorrect

    • Which of the following leaves the pelvis via the greater sciatic foramen?

      Your Answer:

      Correct Answer: Pudendal Nerve

      Explanation:

      The pudendal nerve is formed by sacral nerve roots S2, S3 and S4 almost immediately as they exit the spinal foramina. The pudendal nerve exits the pelvis via the greater sciatic foramen, travels behind the sacrospinous ligament before re-entering the pelvis via the lesser sciatic foramen. It is an important nerve to be aware of as it supplies sensation to the genitalia and can also be damaged/compressed at a number of places along its course. Image sourced from Wikipedia

    • This question is part of the following fields:

      • Anatomy
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  • Question 11 - At the time of delivery, if there is a laceration of perineal body...

    Incorrect

    • 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:

      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.

    • This question is part of the following fields:

      • Anatomy
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  • Question 12 - Regarding lymph drainage of the fallopian tubes where does the majority of lymph...

    Incorrect

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

      Your Answer:

      Correct 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
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  • Question 13 - If the presenting part of the foetus is the large fontanel, this presentation...

    Incorrect

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

      Your Answer:

      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
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  • Question 14 - The superficial inguinal ring is an aperture in which structure? ...

    Incorrect

    • The superficial inguinal ring is an aperture in which structure?

      Your Answer:

      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

    • This question is part of the following fields:

      • Anatomy
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  • Question 15 - The normal lining of the fallopian tube is: ...

    Incorrect

    • The normal lining of the fallopian tube is:

      Your Answer:

      Correct Answer: Columnar epithelium with cilia

      Explanation:

      The Fallopian tubes, also known as, uterine tubes, and salpinges, are two very fine tubes lined with ciliated columnar epithelia, leading from the ovaries of female mammals into the uterus, via the uterotubal junction.

    • This question is part of the following fields:

      • Anatomy
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  • Question 16 - The juxtaglomerular apparatus (JGA) lies within which part of the kidney? ...

    Incorrect

    • The juxtaglomerular apparatus (JGA) lies within which part of the kidney?

      Your Answer:

      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

    • This question is part of the following fields:

      • Anatomy
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  • Question 17 - Regarding the Pituitary gland which of the following statements is true? ...

    Incorrect

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

      Your Answer:

      Correct 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
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  • Question 18 - The ascending colon drains into the superior mesenteric vein (SMV). What vein does...

    Incorrect

    • The ascending colon drains into the superior mesenteric vein (SMV). What vein does the SMV drain into?

      Your Answer:

      Correct Answer: Hepatic portal vein

      Explanation:

      The superior mesenteric vein joins the splenic vein to form the hepatic portal vein.

    • This question is part of the following fields:

      • Anatomy
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  • Question 19 - The inferior 1/3 of the rectum is principally supplied by which artery? ...

    Incorrect

    • The inferior 1/3 of the rectum is principally supplied by which artery?

      Your Answer:

      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.

    • This question is part of the following fields:

      • Anatomy
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  • Question 20 - The femoral triangle is bounded medially by which of the following structures? ...

    Incorrect

    • The femoral triangle is bounded medially by which of the following structures?

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
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  • 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:

      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 22 - The rectus sheath is formed by which of the following? ...

    Incorrect

    • The rectus sheath is formed by which of the following?

      Your Answer:

      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.

    • This question is part of the following fields:

      • Anatomy
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  • Question 23 - Regarding the round ligament, it leaves the pelvis via which structure? ...

    Incorrect

    • Regarding the round ligament, it leaves the pelvis via which structure?

      Your Answer:

      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
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  • Question 24 - Regarding the female breast how many lobes does the typical breast contain? ...

    Incorrect

    • Regarding the female breast how many lobes does the typical breast contain?

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
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  • Question 25 - Sensory supply to the clitoris is via branches of which nerve? ...

    Incorrect

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

      Your Answer:

      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.

    • This question is part of the following fields:

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

    Incorrect

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

      Your Answer:

      Correct 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
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  • Question 27 - How many seminiferous tubules would you typically expect to find in a testicular...

    Incorrect

    • How many seminiferous tubules would you typically expect to find in a testicular lobule?

      Your Answer:

      Correct Answer: 2

      Explanation:

      There are between 250 and 400 lobules in each testis. The lobule is a structural unit of the testis with each lobule contained in one of the intervals between fibrous septa which extend between the mediastinum testis and the tunica albuginea. Each lobule contains 1 to 3 seminiferous tubules.

    • This question is part of the following fields:

      • Anatomy
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  • Question 28 - During the filling phase of micturition. At what bladder volume is the first...

    Incorrect

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

      Your Answer:

      Correct 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
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  • Question 29 - Which cell type of the testis secrete inhibin? ...

    Incorrect

    • Which cell type of the testis secrete inhibin?

      Your Answer:

      Correct Answer: Sertoli cells

      Explanation:

      Summary points of the two key testicular cell types:
      1. Sertoli Cells = Secrete Inhibin. Forms blood-testis barrier. Have FSH receptors
      2. Leydig Cells = Secrete testosterone. Have LH receptors

    • This question is part of the following fields:

      • Anatomy
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  • Question 30 - The testis receive innervation from which spinal segment ...

    Incorrect

    • The testis receive innervation from which spinal segment

      Your Answer:

      Correct Answer: T10

      Explanation:

      The T10 spinal segment provides the sympathetic nerve fibres that innervate the testes

    • This question is part of the following fields:

      • Anatomy
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