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  • Question 1 - You are asked to assess a patients perineal tear following labour by vaginal...

    Correct

    • 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: 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
      39.1
      Seconds

  • Question 2 - 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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      Seconds

  • Question 3 - Regarding the uterine artery which of the following statements are FALSE? ...

    Incorrect

    • Regarding the uterine artery which of the following statements are FALSE?

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 4 - Regarding the foetus, which one of the following statements is true? ...

    Incorrect

    • Regarding the foetus, which one of the following statements is true?

      Your Answer:

      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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      Seconds

  • Question 5 - 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:

      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 6 - The arcuate line forms part of the border of the pelvic brim. Where...

    Incorrect

    • The arcuate line forms part of the border of the pelvic brim. Where is it located?

      Your Answer:

      Correct Answer: Ilium

      Explanation:

      Arcuate means ‘bow shaped’ and there are different arcuate lines in anatomical terms. Regarding the pelvic brim this is composed of the arcuate line of the ilium, pectineal line and prominences of sacrum and pubic symphysis (as demonstrated in the images below). As can be seen the arcuate line is a smooth rounded border on the internal surface of the ilium inferior to the iliac fossa and Iliacus. Image sourced from Wikipedia Note: The pelvic 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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      Seconds

  • Question 7 - 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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      Seconds

  • Question 8 - A patient undergoes surgery for a vaginal vault prolapse. After surgery she complains...

    Incorrect

    • 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:

      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
      0
      Seconds

  • Question 9 - The typical female breast contains how many lobes? ...

    Incorrect

    • The typical female breast contains how many lobes?

      Your Answer:

      Correct Answer: 15-20

      Explanation:

      The female breast is made of about 15 to 20 individual lobes. The lobules each consists of alveoli which drain into a single lactiferous duct. The ductal system leads to lactiferous sinuses and collecting ducts which expel milk from openings in the nipple.

    • This question is part of the following fields:

      • Anatomy
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      Seconds

  • Question 10 - At what angle is the plane of the pelvic inlet to the anatomical...

    Incorrect

    • At what angle is the plane of the pelvic inlet to the anatomical horizontal plane?

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
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      Seconds

  • Question 11 - 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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      Seconds

  • Question 12 - 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 right ovary drain into?

      Your Answer:

      Correct 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
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      Seconds

  • Question 13 - Pelvic ligaments can change at term resulting in? ...

    Incorrect

    • Pelvic ligaments can change at term resulting in?

      Your Answer:

      Correct 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
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      Seconds

  • Question 14 - Uterine Cervix: ...

    Incorrect

    • Uterine Cervix:

      Your Answer:

      Correct 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
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      Seconds

  • Question 15 - 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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      Seconds

  • Question 16 - Under which one of the following conditions is the pelvic inlet felt to...

    Incorrect

    • Under which one of the following conditions is the pelvic inlet felt to be contracted?

      Your Answer:

      Correct Answer:

      Explanation:

      Contracted pelvis occurs when one or more of its diameters is reduced so that it interferes with the normal mechanism of labour. A transverse diameter below 11 cm will result in difficult delivery of the foetus and C-section will be the better option in that case

    • This question is part of the following fields:

      • Anatomy
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      Seconds

  • Question 17 - 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 proximal medial thigh following abdominal hysterectomy. You suspect genitofemoral nerve injury. What spinal segment(s) is the genitofemoral nerve derived from?

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 18 - Which of the following terms best describes the pelvic type of small posterior...

    Incorrect

    • 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:

      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
      0
      Seconds

  • Question 19 - Which one of the following dimensions relates to the greatest diameter of the...

    Incorrect

    • Which one of the following dimensions relates to the greatest diameter of the fetal head?

      Your Answer:

      Correct Answer: Occipitomental

      Explanation:

      Occipitomental diameter is the greatest diameter of the fetal scalp and runs from chin to the prominent portion on the occiput. It measure about 12.5cm in diameter.

    • This question is part of the following fields:

      • Anatomy
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      Seconds

  • Question 20 - 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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      Seconds

  • Question 21 - The inguinal canal is reinforced posteriorly by which structure? ...

    Incorrect

    • The inguinal canal is reinforced posteriorly by which structure?

      Your Answer:

      Correct Answer: Conjoint tendon

      Explanation:

      The Inguinal Canal
      – Anterior wall: formed by the external oblique aponeurosis throughout the length of the canal; its lateral part is reinforced by muscle fibres of the internal oblique.
      – Posterior wall: formed by the transversalis fascia; its medial part is reinforced by pubic attachments of the internal oblique and transversus abdominis aponeuroses that frequently merge to variable extents into a common tendon—the inguinal falx (conjoint tendon)—and the reflected inguinal ligament.
      – Roof: formed laterally by the transversalis fascia, centrally by musculo-aponeurotic arches of the internal oblique and transversus abdominis, and medially by the medial crus of the external oblique aponeurosis.
      – Floor: formed laterally by the iliopubic tract, centrally by gutter formed by the infolded inguinal ligament, and medially by the lacunar ligament.

    • This question is part of the following fields:

      • Anatomy
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      Seconds

  • Question 22 - Which of the following is true about the origin of the ovarian artery?...

    Incorrect

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

      Your Answer:

      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.

    • This question is part of the following fields:

      • Anatomy
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      Seconds

  • Question 23 - 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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      Seconds

  • Question 24 - The joint between the two pubic bones is called the: ...

    Incorrect

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

      Your Answer:

      Correct 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
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      Seconds

  • Question 25 - Which of the following muscles is NOT a constituent of the pelvic floor...

    Incorrect

    • Which of the following muscles is NOT a constituent of the pelvic floor (diaphragm)?

      Your Answer:

      Correct 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
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      Seconds

  • Question 26 - Which of the following structures does the broad ligament contain? ...

    Incorrect

    • Which of the following structures does the broad ligament contain?

      Your Answer:

      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.

    • This question is part of the following fields:

      • Anatomy
      0
      Seconds

  • Question 27 - 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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      Seconds

  • Question 28 - Which of the following is contained within the deep perineal pouch? ...

    Incorrect

    • Which of the following is contained within the deep perineal pouch?

      Your Answer:

      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.

    • This question is part of the following fields:

      • Anatomy
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      Seconds

  • Question 29 - What is the inferior border of the deep perineal pouch? ...

    Incorrect

    • What is the inferior border of the deep perineal pouch?

      Your Answer:

      Correct 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
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  • Question 30 - The ureters receive autonomic supply from which spinal segments? ...

    Incorrect

    • The ureters receive autonomic supply from which spinal segments?

      Your Answer:

      Correct Answer: T11-L2

      Explanation:

      The ureters receive innervation by a number of nerve plexuses. The nerves supplying the ureters originate from spinal segments T11 to L2. When you think about ureteric colic giving classic ‘loin to groin’ pain it is because the pain is referred to these dermatomes.

    • This question is part of the following fields:

      • Anatomy
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  • Question 31 - 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 32 - Regarding lymph drainage of the lower vagina where does the majority of lymph...

    Incorrect

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

      Your Answer:

      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 33 - 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 34 - The broad ligament contains which of the following structures? ...

    Incorrect

    • The broad ligament contains which of the following structures?

      Your Answer:

      Correct Answer: Uterine artery

      Explanation:

      The contents of the broad ligament:
      Fallopian tubes
      Ovarian artery
      Uterine artery
      Ovarian ligament
      Round ligament of uterus

    • This question is part of the following fields:

      • Anatomy
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      Seconds

  • Question 35 - The median umbilical ligament is a remnant of what structure? ...

    Incorrect

    • The median umbilical ligament is a remnant of what structure?

      Your Answer:

      Correct Answer: Urachus

      Explanation:

      The median umbilical ligament is the remnant of the Urachus.

    • This question is part of the following fields:

      • Anatomy
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      Seconds

  • Question 36 - 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
      0
      Seconds

  • Question 37 - Leydig cells contain receptors to which hormone? ...

    Incorrect

    • Leydig cells contain receptors to which hormone?

      Your Answer:

      Correct Answer: LH

      Explanation:

      The Leydig cells contain receptors to the luteinizing hormone which in turn is responsible for the production of testosterone. This circulates in the body predominantly bound to transport proteins and to a lesser extent to albumin.

    • This question is part of the following fields:

      • Anatomy
      0
      Seconds

  • Question 38 - 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:

      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
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      Seconds

  • Question 39 - What is the inferior border of the deep perineal pouch? ...

    Incorrect

    • What is the inferior border of the deep perineal pouch?

      Your Answer:

      Correct Answer: Perineal membrane

      Explanation:

      The perineal membrane (also known as the inferior fascia of the urogenital diaphragm) separates the deep and superficial perineal pouches i.e. it is the inferior border of the deep pouch and superior border of the superficial pouch. The deep perineal pouch is the space therefore between superior and inferior layers of the urogenital diaphragm The superior fascia of the urogenital diaphragm is the superior border

    • This question is part of the following fields:

      • Anatomy
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  • Question 40 - If your patient is 8 weeks pregnant which one of the following USS...

    Incorrect

    • If your patient is 8 weeks pregnant which one of the following USS measurements is most useful?

      Your Answer:

      Correct 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
      0
      Seconds

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