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  • Question 1 - Regarding the structure of the detrusor muscle. Which of the following is true?...

    Incorrect

    • Regarding the structure of the detrusor muscle. Which of the following is true?

      Your Answer: The detrusor is a single layer of circular smooth muscle

      Correct Answer: The detrusor is divided into 3 layers consisting of inner and outer layers of longitudinal smooth muscle with a middle circular smooth muscle layer

      Explanation:

      The urinary bladder is composed of the transitional epithelium, followed by the lamina propria made up of the fibroelastic connective tissue. The muscularis layer covers the lamina propria which is made up of three poorly defined layers of smooth muscles; the inner longitudinal, middle circular and the outer longitudinal layer. The bladder is covered on the superior surface and the lateral surface by the peritoneum.

    • This question is part of the following fields:

      • Anatomy
      20.5
      Seconds

  • Question 2 - Which two nerves provide the primary cutaneous sensory innervation to the labia majora?...

    Incorrect

    • Which two nerves provide the primary cutaneous sensory innervation to the labia majora?

      Your Answer: Pudendal and perineal

      Correct Answer: Ilioinguinal and pudendal

      Explanation:

      The Pudendal provides cutaneous innervation to the posterior external genitalia via one of its terminal branches called the perineal nerve (this further branches into the posterior labial nerves or posterior scrotal nerve in men). The ilioinguinal nerve provides anterior sensation via the anterior labial nerves (anterior scrotal nerve in men). The genital branch of the genitofemoral nerve contributes some fibres to the skin of the mons pubis and labia majora in females. The posterior cutaneous nerve of thigh sometimes overlaps sensory areas.

    • This question is part of the following fields:

      • Anatomy
      6.1
      Seconds

  • Question 3 - All of the following are features of the female bony pelvis, except? ...

    Incorrect

    • All of the following are features of the female bony pelvis, except?

      Your Answer: Has a pubic angle greater than 90 degrees

      Correct 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
      72.6
      Seconds

  • Question 4 - 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: Femur length

      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
      12.3
      Seconds

  • Question 5 - Which of the following muscles does NOT receive innervation from the pudendal nerve?...

    Correct

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

      Your Answer: Internal anal sphincter

      Explanation:

      The internal anal sphincter is innervated by pelvic splanchnic nerves

    • This question is part of the following fields:

      • Anatomy
      29.4
      Seconds

  • Question 6 - 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:

      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.

    • This question is part of the following fields:

      • Anatomy
      4.6
      Seconds

  • Question 7 - 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: Fatty layer superficial fascia

      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
      10.9
      Seconds

  • Question 8 - 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 juxtaglomerular apparatus is the main site for the production of renin. It plays an important role in the regulation of the blood pressure. These structures are mainly located in the cortex of the kidneys.

    • This question is part of the following fields:

      • Anatomy
      0
      Seconds

  • Question 9 - 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
      0
      Seconds

  • Question 10 - 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
      0
      Seconds

  • Question 11 - 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 proximal portion of urethra in females or membranous urethra in males is in the deep perineal pouch

    • This question is part of the following fields:

      • Anatomy
      0
      Seconds

  • Question 12 - A patient present to the clinic with a 1 day history of vaginal...

    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:

      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
      0
      Seconds

  • Question 13 - 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
      0
      Seconds

  • Question 14 - Bladder contraction during voiding (micturating) is mediated via innervation of which of the...

    Incorrect

    • Bladder contraction during voiding (micturating) is mediated via innervation of which of the following pathways?

      Your Answer:

      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
      0
      Seconds

  • Question 15 - 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:

      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
      0
      Seconds

  • Question 16 - Regarding the uterine artery which of the following statements are TRUE? ...

    Incorrect

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

      Your Answer:

      Correct Answer: It arises from the internal iliac artery

      Explanation:

      The uterine artery arises from the internal iliac artery, in particular the anterior division of the internal iliac artery. Some older texts refer to the internal iliac as the hypogastric artery. The vaginal artery typically arises as its own branch of the internal iliac artery. The ovarian arteries are branches of the aorta

    • This question is part of the following fields:

      • Anatomy
      0
      Seconds

  • Question 17 - 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
      0
      Seconds

  • Question 18 - 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
      0
      Seconds

  • Question 19 - The testicular arteries are branches of what? ...

    Incorrect

    • The testicular arteries are branches of what?

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
      0
      Seconds

  • Question 20 - The inguinal canal is reinforced anterolaterally by which structure? ...

    Incorrect

    • The inguinal canal is reinforced anterolaterally by which structure?

      Your Answer:

      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
      0
      Seconds

  • Question 21 - A patient attends clinic with a vaginal prolapse. On examination the vaginal prolapse...

    Incorrect

    • 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:

      Correct Answer: Grade 1

      Explanation:

      This is a grade 1 prolapse

    • This question is part of the following fields:

      • Anatomy
      0
      Seconds

  • Question 22 - 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:

      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
      0
      Seconds

  • Question 23 - 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
      0
      Seconds

  • Question 24 - 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 25 - 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:

      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
      0
      Seconds

  • Question 26 - 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
      0
      Seconds

  • Question 27 - Regarding the pelvic outlet, what structure marks the posterior boundary? ...

    Incorrect

    • Regarding the pelvic outlet, what structure marks the posterior boundary?

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 28 - Regarding lymph drainage of the ovary where does the majority of lymph drain...

    Incorrect

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

      Your Answer:

      Correct Answer: para-aortic nodes

      Explanation:

      Majority of the lymph from the ovaries drain into the para-aortic lymph nodes.

    • This question is part of the following fields:

      • Anatomy
      0
      Seconds

  • Question 29 - 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
      0
      Seconds

  • Question 30 - 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
      0
      Seconds

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