MCQ Anatomy-thorax-Abdo-Pelvis

MCQs in
Anatomy
An aid to revision and self assessment
Chapter I : Thorax
Questions
Thoracic Wall and Diaphragm
The Thoracic Cavity
Superior Mediastinum
Anterior Mediastinum
Middle Mediastinum
Posterior Mediastinum
Lungs and Pleurae
Answers and Explanations
Chapter 2 : Abdomen
Questions
Anterior Abdominal Wall
Vessels and Nerves of the Gut
Abdominal cavity and the peritoneum
Development of the Gut
Gastrointestinal Tract
Liver and Biliary System, Pancreas and Spleen
Posterior Abdominal Wall
Kidneys, Ureters and Suprarenal glands
Chapter 3 : Pelvis and Perineum

Questions
Pelvic Cavity and joints
Rectum and anal canal
Urinary bladder, urethra and ureters in the pelvis
Male Reproductive Organs
Female Reproductive Organs
Pelvic vessels and nerves
Perineum
Thorax
Thoracic Wall and Diaphragm
1. Intercostal nerves
A. are the ventral rami of thoracic spinal nerves
B. lie deep to the internal intercostal muscles
C. supply the parietal pleura
D. lie above the intercostal vessels in the costal groove
E. cross in front of the internal thoracic artery near the sternum
2. Regarding intercostal nerves

A. The anterior primary ramus of the twelfth thoracic nerve is the subcostal
nerve
B. The 7th intercostal nerve is a typical spinal nerve
C. They lie in the subcostal groove
D. The 4th intercostal nerve supplies only the thoracic wall
E. The 2nd has a supply to the skin of the axilla
3. Regarding intercostal arteries

A. All posterior intercostal arteries arise from the descending aorta
B. They lie superior to the vein and nerve in the costal groove
C. All anterior intercostal arteries arise from the internal thoracic artery
D. Posterior intercostal arteries supply the spinal cord
E. The right third posterior intercostal artery gives off the right bronchial
artery
4. External intercostal muscle

A. is innervated by the posterior ramus of the thoracic spinal nerve
B. is derived from the paraxial mesoderm
C. extends as far forwards as the costochondral junction
D. has an attachment to the neck of the respective rib
E. has fibres directed downwards and backwards
5. Internal thoracic artery

A. arises from the first part of the subclavian artery
B. supplies the upper six intercostal spaces
C. supplies the thymus
D. gives off the superior epigastric artery
E. terminates in the 5th intercostal space
6. Regarding intercostal spaces
A. External intercostal muscle has fibres directed downwards and forwards
B. Neurovascular bundle runs between the internal and innermost
intercostal muscle layers
C. Each intercostal space is supplied by two anterior intercostal arteries
D. Posterior intercostal arteries supplying the first two spaces arise from
the descending aorta
E. All anterior intercostal veins drain into the internal thoracic vein
7. The first rib

A. Its head articulates with the body of first thoracic vertebra
B. Its neck is related to the sympathetic trunk
C. The inner border gives attachment to the suprapleural membrane
D. Has a groove for the subclavian vein on its inferior surface
E. Articulates with the manubriosternal angle
8. Branches of the internal thoracic artery are

A. pericardiacophrenic artery
B. posterior intercostal artery
C. superior epigastric artery
D. musculophrenic artery
E. superior intercostal artery
9. Primary cartilaginous joints are

A. manubriosternal joint
B. sternoclavicular joint
C. costochondral joint
D. first sternocostal joint
E. costotransverse joint
10. Regarding thoracic vertebrae

A. The first thoracic vertebra has a complete facet for the 1st rib
B. They have thick bifid spines
C. Transverse process articulates with the neck of the corresponding rib
D. The articulation between two vertebral bodies is synovial
E. An inferior costal facet is absent on T9 vertebra
11. Regarding the inlet of the thorax

A. The lateral boundary is formed by the inner surface of the first rib and
its costal cartilage
B. Manubrium sterni forms the anterior boundary
C. Posterior boundary is formed by the lower border of T4 vertebra
D. Brachiocephalic artery passes through it
E. Vertebral artery passes through it
12. The aortic opening in the diaphragm

A. lies anterior to the body of tenth thoracic vertebra
B. lies between the crura of the diaphragm
C. transmits the sympathetic trunk
D. transmits the vagus nerve
E. transmits the azygos vein
13. The thoracic sympathetic trunk

A. is present in the posterior mediastinum
B. has ganglia most of which lie anterior to the heads of ribs
C. passes into the abdomen behind the lateral arcuate ligament
D. sends postganglionic fibres to the cardiac plexus
E. sends preganglionic fibres to the greater splanchnic nerve
14. The diaphragm is developed from the

A. ventral mesentery of oesophagus
B. dorsal mesentery of oesophagus
C. pleuroperitoneal membrane
D. pleuropericardial membrane
E. septum transversum
15. Derivatives of the septum transversum include

A. lesser omentum
B. Kupffer cells
C. ligamentum teres
D. falciform ligament
E. central tendon of the diaphragm
16. The oesophageal opening in the diaphragm

A. is at the tenth thoracic vertebral level
B. is surrounded by a sling of fibres from right crus
C. lies in the central tendon of the diaphragm
D. transmits branches of the right gastric artery
E. transmits the right phrenic nerve
17. Regarding the diaphragm
A. The level of the diaphragm is higher in the supine position than in the
standing position
B. The right dome reaches the upper border of the 5th rib
C. The central tendon lies at the level of the xiphisternal joint
D. The hemiazygos vein passes through the right crus
E. The sympathetic trunk passes behind the medial arcuate ligament
18. Regarding the arcuate ligaments of the diaphragm

A. The medial arcuate ligament is a thickening of lumbar fascia
B. The medial arcuate ligament has an attachment to the body of first
lumbar vertebra
C. The lateral arcuate ligament is the thickening of the fascia of quadratus
lumborum muscle
D. The lateral arcuate ligament extends from transverse process of L1
vertebra to the 12th rib
E. Crura develops from the dorsal mesentery of the oesophagus
19. The superior vena cava

A. is formed by the right anterior cardinal and right common cardinal veins
B. is formed behind the manubrium sterni
C. opens into the right atrium behind the 3rd costal cartilage
D. receives the hemi azygos vein
E. lies in the superior mediastinum
20. Regarding the superior mediastinum

A. Its anterior boundary is formed by the body of the sternum
B. The arch of the aorta lies within it
C. The prevertebral fascial layer is present within it
D. It is separated from the inferior mediastinum by a plane passing
through the third costal cartilage
E. It contains the thymus
21. The thoracic duct

A. commences at twelfth thoracic vertebral level
B. passes through the aortic opening of the diaphragm
C. lies along the left margin of the oesophagus in the superior
mediastinum
D. crosses from right to left side at the fourth thoracic vertebral level
E. drains lymph from the right upper limb
22. Regarding the arch of the aorta

A. It commences at the level of the sternal angle
B. It is developed from the third left aortic arch
C. Left vagus nerve lies anterior to it
D. It forms the cervical constriction of the oesophagus
E. A cardinal sign in the coarctation of aorta is diminished femoral pulse
23. The ascending aorta

A. is an elastic artery
B. is developed from the fourth left aortic arch
C. lies posterior to the root of the pulmonary trunk
D. is covered by the fibrous pericardium at its commencement
E. is stenosed in tetralogy of Fallot
24. The trachea

A. commences at the inferior border of the cricoid cartilage
B. contains incomplete rings of hyaline cartilage
C. is lined by a simple columnar epithelium
D. bifurcates at the level of sternal angle
E. lies in the posterior mediastinum
25. Structures present in a cross section of the thorax at the upper border of
the fourth thoracic vertebra include
A. arch of aorta
B. superior vena cava
C. left atrium
D. left vagus nerve
E. right atrium
26. The trachea

A. is about 10 cm in length
B. lies in the midline through out its course
C. is supplied by the inferior thyroid arteries
D. has an epithelium derived from the endoderm of the foregut
E. is supplied by the recurrent laryngeal nerves
27. The pulmonary trunk

A. lies within the pericardial sac
B. divides at the fourth thoracic vertebral level
C. lies posterior to the transverse sinus
D. is stenosed in Fallot’s tetralogy
E. is developed from the truncus arteriosus
28. The left main bronchus

A. is wider than the right principal bronchus
B. is longer than the right principal bronchus
C. is developed from the tracheo-bronchial diverticulum
D. divides into two lobar bronchi
E. has the root of the pulmonary trunk anterior to it
29. At the sternal angle

A. the first rib articulates with sternum
B. the aortic arch ends
C. the trachea bifurcates
D. the azygos vein enters the superior vena cava
E. the inferior boundary of the superior medisatinum is demarcated
30. Regarding the development of the venous system

A. Azygos vein is developed from the right supracardinal vein
B. Left brachiocephalic vein is developed from the left supracardinal vein
C. The inferior vena cava has a part developed from the right subcardinal
vein
D. Right renal vein is developed from the subcardinal anastomosis
E. Common iliac vein is developed from the sacrocardinal anastomosis
31. Veins draining into the right brachiocephalic vein include

A. vertebral
B. inferior thyroid
C. middle thyroid
D. external jugular
E. internal thoracic
32. Structures found in both superior and posterior mediastina are

A. oesophagus
B. trachea
C. thoracic aorta
D. phrenic nerves
E. vagi
Anterior mediastinum
33. The thymus

A. lies in the anterior mediastinum
B. is developed from the 3rd branchial pouch
C. has lymphoid follicles
D. involutes after puberty
E. is supplied by the inferior thyroid artery
34. The thymus

A. is the only structure lying in the anterior mediastinum
B. has a blood supply from the internal thoracic artery
C. regresses soon after birth
D. contains Hassall’s corpuscles
E. lies in front of the left brachiocephalic vein
Middle mediastinum
35. In the foetal circulation mixing of oxygenated and deoxygenated blood

occurs in the
A. left atrium
B. left ventricle
C. right atrium
D. right ventricle
E. liver
36. Embryonic structures that contribute to the inter-atrial septum include

A. septum primum
B. septum spurium
C. septum secondum
D. left valve of sinus venosus
E. right valve of sinus venosus
37. Ligaments that have foetal vessels of origin include

A. median umbilical ligament
B. ligamentum teres
C. ligamentum venosum
D. medial umbilical ligaments
E. gastrosplenic ligament
38. The right atrium

A. forms the right border of the heart
B. has a smooth part derived from the right horn of sinus venosus
C. has the sinuatrial node in its wall
D. has the crista terminalis separating the smooth and rough parts
E. receives the coronary sinus
39. The ductus arteriosus

A. represents the distal portion of the left sixth aortic arch
B. is functionally closed shortly after birth
C. connects the pulmonary vein to the aortic arch
D. is present as the ligamentum arteriosum at birth
E. shunts blood from the pulmonary trunk to the aorta before birth
40. The right coronary artery

A. arises from the anterior aortic sinus
B. supplies blood to the sinu-atrial node
C. is accompanied by the great cardiac vein
D. causes an infarction at the apex of the heart if occluded
E. gives off the circumflex branch
41. The left atrium

A. forms the major part of the left border of the heart
B. lies behind the right atrium
C. has the oblique sinus posterior to it
D. lies anterior to the oesophagus
E. receives the four pulmonary veins
42. Regarding the development of the heart

A. The secondary septum completely divides the atrium
B. The septum spurium contributes to the formation of the interatrial
septum
C. The pulmonary arteries develop from the right horn of sinus
venosus
D. The right valve of sinus venosus gives rise to the valve of the inferior
vena cava
E. The smooth part of the right atrium is developed from the left horn of
sinus venosus
43. The descending thoracic aorta

A. begins at the level of the lower border of the fourth thoracic vertebra
B. lies in the posterior mediastinum
C. gives off the pericardiacophrenic artery
D. passes through the diaphragm at the tenth thoracic vertebral level
E. gives off branches to supply the middle third of the oesophagus
44. The azygos vein

A. is formed by the union of right subcostal and right ascending lumbar
veins
B. passes through the oesophageal opening
C. arches over the root of the right lung
D. receives the superior intercostal vein
E. drains directly into the right atrium
45. Branches arising from the descending thoracic aorta are

A. third right posterior intercostal artery
B. musculophrenic artery
C. superior phrenic artery
D. superior intercostal artery
E. bronchial arteries
46. Regarding the thoracic part of the oesophagus

A. It lies posterior to the left bronchus
B. It lies anterior to the thoracic duct
C. Its wall is composed of smooth muscle along its entire length
D. Venous blood from the thoracic part drains into azygos vein
E. The right pulmonary artery is anterior to it
47. The oesophagus

A. is lined by the stratified squamous non keratininsed epithelium
B. is constricted by the right bronchus
C. lies posterior to the pericardium and the left atrium
D. passes through both superior and posterior mediastina
E. has an arterial supply from the left gastric artery
48. The right phrenic nerve

A. lies in the superior mediastinum
B. has the superior vena cava on its medial side
C. is posterior to the thoracic duct
D. passes through the caval opening in the diaphragm
E. supplies the fibrous pericardium
Lungs and Pleurae
49. The right lung

A. has its inferior lobe below and behind the oblique fissure
B. has four structures in the hilum
C. has five bronchopulmonary segments in its lower lobe
D. has the arch of the aorta related to its mediastinal surface
E. is supplied by two bronchial arteries
50. The parietal pleura

A. extends superiorly up to the neck of the first rib
B. is attached to the mediastinal surface of the fibous pericardium
C. is developed from the splanchnic mesoderm
D. forms the pulmonary ligament
E. forms the costo diaphragmatic recess
51. Regarding the bronchopulmonary segments

A. There are eight bronchopulmonary segments in each lung
B. Each segment is pyramidal in shape with the base towards the hilum
C. Each segment is supplied by a lobar bronchus
D. It is the smallest part of the lung that could be removed surgically
E. They are supplied by end arteries
52. Regarding the pleura

A. The cervical pleura extends above the clavicle
B. The parietal layer is separated from the thoracic wall by the
endothoracic fascia
C. The parietal and visceral pleurae are continuous around the root of the
lung
D. The visceral pleura extends into the depths of the interlobar fissures of
the lung
E. The visceral pleura is sensitive to pain
Thorax : Answers and Explanations
Thoracic wall and diaphragm

1. A. True – The intercostal nerves are the ventral rami of T1 – T11 spinal
nerves
B. True - In the intercostal space the nerve lies in the subcostal groove
between the internal intercostal muscle and innermost
intercostal muscles
C. True – The collateral branch arising near the angle of the rib supplies
the muscles of that space. It also supplies the parietal pleura
and the parietal peritoneum in the case of the lower nerves
D. False – In the costal groove the nerve lies below the intercostal
vessels. The order from above downwards is vein, artery and
nerve
E. True
2.
A. True
B. False – The 3rd to 6th intercostal nerves supply only the thoracic wall
and are called typical nerves. The 7th to 11th nerves supply the
abdominal wall in addition to the intercostal spaces
C. True
D. True – It is a typical intercostal nerve
E. True – The lateral cutaneous branch of the 2nd intercostal nerve
crosses the axilla to the medial side of the arm as the
intercostobrachial nerve and supplies the skin of the
axilla . Not infrequently the lateral cutaneous nerve of
the 3rd intercostal nerve also supplies the skin of the axilla
3.
A. False – The 3rd -11th arteries arise from the descending aorta. The 1st
and 2nd arise from the superior intercostal artery which is a
branch of the costocervical trunk
B. False – In the costal groove the artery is accompanied by the vein and
nerve. The relationship from above downwards being vein-
artery-nerve
C. False - The upper six arise from the internal thoracic artery and the
7th to 9th arise from the musculophrenic artery
D. True – The dorsal branch which supplies the muscles and skin at the
back gives off a spinal branch which supplies the spinal cord
and vertebrae.
E. True
4.
A. False – The intercostal muscles are innervated by the corresponding
intercostal nerve.
The intercostal nerves are the anterior rami of first 11
thoracic spinal nerves. The anterior ramus of the twelfth
thoracic nerve lies in the abdomen and runs forward in the
abdominal wall as the subcostal nerve
B. True – Although the ribs develop from sclerotome the intercostal
muscles develop from the somatic mesoderm (body wall
muscles)
C. True – The muscle extends as far forwards as the costochondral
junction and continues as the anterior intercostal membrane
D. False – It is attached to the tubercle of the rib
E. False – The fibres of the external intercostal muscle are directed
downwards and forwards. The fibres of the internal
intercostal muscle are directed downwards and backwards
5.
A. True – It is the second branch that arises from the inferior aspect of
the first part of the subclavian artery
B. True - It gives off two anterior intercostals to each of the upper six
intercostal spaces
C. True - It supplies the thymus via mediastinal branches
D. True – The artery terminates in the 6th intercostal space by dividing
into superior epigastric and musculophrenic artery
E. False
6.
A. True - The fibres of the external intercostal muscle are directed
downwards and forwards. The fibres of the internal intercostal
muscle are directed downwards and backwards
B. False - The intercostal nerves and vessels (neurovascular bundle) run
between the intermediate and innermost layers of muscles
C. True - Each intercostal space contains a large single posterior
intercostal artery (branches of the descending thoracic aorta)
and two small anterior intercostal arteries (branches of the
internal thoracic artery)
D. False –They arise from the superior intercostal artery. Others arise
from the descending aorta
E. False - The upper six drain into the internal thoracic vein and the 7th -
9th spaces drain into the musculophrenic vein
7.
A. True
B. True – Anteriorly the neck is related from medial to lateral to the
sympathetic chain, the first posterior intercostal vein, the
superior intercostal artery and the first thoracic nerve
C. True
D. False –The groove for the subclavian vein is on its superior surface
anterior to the scalene tubercle. The groove behind the
tubercle lodges the subclavian artery
E. False – It articulates with the manubrium sterni. The 2nd rib
articulates at the manubriosternal angle
8.
A. True – Branches of the internal thoracic artery include : two anterior
intercostal arteries to each space, pericardiacophrenic artery,
mediastinal branches, perforating branches, superior epigastric
artery, musculophrenic artery
B. False – Posterior intercostal arteries are 11 in number. 1-2 arise from the
superior intercostal artery and 3-11 arise from the descending
aorta.
C. True
D. True
E. False - The superior intercostal artery is a branch of the costocervical trunk
which comes off from the second part of the subclavian artery. The
first and second posterior intercostal arteries arise from it
9.
A. False – The manubriosternal joint is a symphyseal joint. The joint
between the body of the sternum and the xiphoid process
(xiphisternal joint) is another symphysis.
B. False – It is a synovial joint
C. True – The anterior end of each rib makes a a primary cartilaginous
joint with its costal cartilage (costochondral joint)
D. True – The first costal cartilage articulates with the sternum at a
primary cartilaginous joint. The other six costal cartilages (2nd
to 7th ) articulate with the sternum at synovial joints
E. False – It is a synovial joint
10.
A. True – Except the first, tenth, eleventh and twelfth vertebrae all
others have demi facets to articulate with the respective ribs
B. False – This is not a feature of thoracic vertebrae. Bifid spines are
found in some of the cervical vertebrae (2nd to 6th)
C. True
D. False – The articulation between two vertebral bodies (the
intervertebral disc), is a symphyseal or secondary
cartilaginous
E. True – The tenth, eleventh and twelfth vertebrae have only single
facets on each side of their bodies for articulation with the
numerically corresponding ribs. The tenth rib has only a single
facet on the head for articulation with the body of the tenth
thoracic vertebra. It has no articulation with the vertebra
above. Hence T9 vertebra has no inferior costal facet.
11.
A. True
B. True
C. False – The posterior boundary is formed by the superior surface of
the body of the first thoracic vertebra
D. True
E. False – The vertebral artery (right and left) arise from the first
part of the subclavian artery. The vertebral artery enters the
foramen transversarium of the sixth cervical vertebra. It does
not pass through the inlet of the thorax
12.
A. False – The aortic opening lies anterior to the body of the twelfth
thoracic vertebra
B. True - It lies between the left and right crura which form the
median arcuate ligamnet
C. True – The sympathetic trunk passes behind the medial arcuate
ligament
D. False - It transmits the aorta with azygos vein to the right and the
thoracic duct between them
E. True
13.
A. False – The thoracic sympathetic trunk lies posterior to the
costovertebral pleura. Hence it is not a content of the
posterior mediastinum
B. True – It has about 12 ganglia, most of which lie anterior to the
heads of ribs. The stellate ganglion (the fused first thoracic
ganglion and the inferior cervical ganglion) lies anterior to the
neck of the first rib while the lowest three ganglia lie lateral
to the corresponding vertebral bodies
C. False – It passes into the abdomen behind the medial arcuate
ligament which is the thickening of the psoas fascia. The
subcostal nerve and vessels pass behind the lateral arcuate
ligament which is the thickening of the quadratus lumborum
fascia
D. True – Postganglionic sympathetic fibres pass to the cardiac and
pulmonary plexuses, trachea, oesophagus, thoracic aorta and
its branches, and to each thoracic spinal nerves
E. True – Preganglionic sympathetic fibres are present in the greater
spanchnic nerve which receives branches from the fifth to
ninth thoracic sympathetic ganglia
14.
A. False – The diaphragm is developed from four embryonic structures
namely, the septum transversum, left and right
pleuroperitoneal membranes, dorsal mesentery of the
oesophagus and left and right lateral body wall muscles
originating from the lower six intercostal region
B. True
C. True
D. False
E. True
15.
A. True – Derivatives of the septum transversum include the central
tendon of the diaphragm, falciform ligament, lesser omentum,
coronary ligaments of the liver, connective tissue and Kupffer
cells of the liver and connective tissue of the gall bladder
B. True
C. False
D. True
E. True
16.
A. True
B. True – lies within a sling of muscle fibres originating from the right
crus
C. False – It lies in the muscular part of the diaphragm. The inferior vena
cava passes through the central tendon
D. False – It transmits the oesophageal branches of the left gastric
artery
E. False – It transmits the oesophagus, right and left vagus nerves,
oesophageal branches of left gastric artery and lymphatics
from the lower part of the oesophagus
17.
A. True
B. True – The right dome reaches as high as the upper border of the
fifth rib whereas the left reaches the lower border of the fifth
rib
C. True
D. False – The hemiazygos vein passes through the left crus
E. True – The sympathetic trunk passes behind the medial arcuate
ligament which is the thickening of the psoas fascia. The
subcostal nerve and vessels pass through the lateral arcuate
ligament which is the thickening of the fascia of the quadratus
lumborum muscle
18.
A. False – The medial arcuate ligament is the thickened upper margin of
the fascia covering the anterior surface of the psoas muscle
The lateral arcuate ligament is the thickened upper margin of
the fascia covering the anterior surface of the quadratus
lumborum muscle
B. False – The medial arcuate ligament extends from the body of the
second lumbar vertebra to the transverse process of first
lumbar vertebra
C. True
D. True
E. True
19.
A. True
B. False – It is formed behind the right first costal cartilage by the union
of right and left brachiocephalic veins
C. True
D. False - Its tributaries are azygos vein, mediastinal and pericardial
veins
E. True – Its upper part lies in the superior mediastinum. The lower part
lies in the anterior mediastinum
20.
A. False – The anterior boundary is formed by the manubrium as the
lower boundary of the superior mediastinum is at T4 level
(manubriosternal joint)
B. True – The commencement and the termination of the arch of the
aorta is at the T4 level (manubriosternal junction). Therefore
the arch of the aorta is above this level lying in the superior
mediastinum
C. True - The prevertebral fascial layer passes in front of the vertebral
bodies into the superior mediastinum and is attached to the
body of the fourth thoracic vertebra
D. False – It is separated from the inferior mediastinum by an imaginary
plane passing through the sternal angle anteriorly and the
lower border of the body of the fourth thoracic vertebra
posteriorly
E. True – Contents of the superior mediastinum include the thymus,
large veins, large arteries, trachea, oesophagus, thoracic duct
and sympathetic trunks
21.
A. True – The thoracic duct commences as a continuation of cisterna
chili at the lower border of the twelfth thoracic vertebra
B. True – It passes through the aortic opening of the diaphragm
between the right crus of diaphragm and abdominal aorta
C. True – In the posterior mediastinum the thoracic duct passes
upwards in front of T12 to T5 vertebrae and lies between the
azygos vein and descending aorta. It crosses from right to left
side behind the oesophagus at T5 vertebral level. Next it
passes in the superior mediastinum along the left margin of
the oesophagus to the neck
D. False – It crosses from right to left side at the fifth thoracic vertebral
level
E. False – It drains right and left lower limbs, viscera and walls of the
abdomen and pelvis, left half of the thorax, left half of the
head and neck and left upper limb. The right lymphatic duct
drains the right upper limb
22.
A. True – The arch of the aorta commences at the level of the sternal
angle (T4 level). It passes upwards and backwards forming
an arch in the superior mediastinum. It then passes
downwards to the left of the midline to reach the level of the
fourth thoracic vertebra and continues as the descending
aorta
B. False - The third left aortic arch gives rise to the left internal carotid
artery. The arch of the aorta is developed from the fourth left
aortic arch
C. True – Both the left vagus and left phrenic nerves lie anterior to the
arch of the aorta
D. False - There are four constrictions in the oesophagus. The first is at
the cricopharyngeal sphincter (ie. 6 inches (15cm) away from
incisor teeth). This is called the cervical constriction. The
second is at the crossing of the arch of the aorta (ie 9 inches
(22.5 cm) from the incisor teeth). The third is at where it is
crossed by the left bronchus (ie. 11 inches (27.5 cm) from the
incisor teeth). The fourth is at where is passes through
the diaphragm ( 16 inches (40 cm) from the incisor teeth)
E. True – The pulsation in the femoral arteries of both lower limbs can
be absent or diminished in coarctation of aorta. A collateral
circulation helps to compensate the diminished blood flow
23.
A. True – Arteries close to the heart are elastic arteries
B. False – The ascending aorta is developed from the truncus arteriosus.
A spiral septum forms within the truncus arteriosus which
separates the truncus into the pulmonary trunk and
ascending aorta.
The fourth left aortic arch gives rise to the arch of the aorta
C. True
D. True – The fibrous pericardium invests the commencement of great
vessels
E. False – The abnormalities present in tetralogy of Fallot are , high
ventricular septal defect, an overriding aorta, pulmonary
stenosis and right ventricular hypertrophy
24.
A. True – The trachea is the continuation of the larynx and it
commences in the neck below the cricoid cartilage at the level
of the sixth cervical vertebra
B. True – Its wall contains 16-20 incomplete rings of hyaline cartilage
C. False – It is lined by a pseudostratified columnar ciliated epithelium
with goblet cells which is the respiratory epithelium
D. True – It bifurcates into the two main bronchi at the level of the
sternal angle (T4-T5 vertebral level)
E. False – It lies in the superior mediastinum and bifurcates at the level
of the lower border of the fourth thoracic vertebra which is
the lower boundary of the superior mediastinum
25.
A. True – Structures present in a cross section of the thorax at the upper
border of T4 vertebral level include the arch of the aorta, left
and right lungs and pleura, superior vena cava, trachea,
oesophagus, azygos vein, left superior intercostal vein, vagi
and right and left phrenic nerves
B. True
C. False
D. True
E. False
26.
A. True
B. False – It lies in the midline over most of its length but near the lower
end it deviates slightly to the right
C. True – Branches from the inferior thyroid and bronchial arteries form
an anastomotic network in the tracheal wall
D. True – Apart from the epithelium, the other structures (cartilage,
muscle etc) are derived from the splanchnic mesoderm
E. True – It receives a parasympathetic supply through vagi and
recurrent laryngeal nerves, and sympathetic fibres from the
upper ganglia of the sympathetic trunk to smooth muscles and
blood vessels
27.
A. True – The fibrous pericardium blends with the wall of the pulmonary
trunk up to its division and thus it lies in the pericardial sac
B. False – The pulmonary trunk divides at the fifth thoracic vertebral
level
C. False – The pulmonary trunk lies anterior to the transverse sinus
D. True – The abnormalities present in the tetralogy of Fallot are high
ventricular septal defect, an overriding aorta, pulmonary
stenosis and right ventricular hypertrophy
E. True – The truncus arteriosus is divided into the pulmonary artery
and ascending aorta by the formation of a spiral septum
within it.
28.
A. False – The left principal bronchus is narrower, longer and more
horizontal than the right principal bronchus
B. True
C. True – The lung develops as an outgrowth (diverticulum) from the
ventral aspect of the foregut which gives rise to all parts of
the bronchial tree ie. the trachea, principal bronchi, tertiary
bronchi, bronchioles and alveoli. This diverticulum is called
the tracheo-bronchial diverticulum
D. True – The left principal bronchus divides into two lobar bronchi
and the right principal bronchus into three lobar bronchi
E. True – The immediate relation of the left principal bronchus is the
pulmonary trunk. The arch of the aorta lies superior to the
left principal bronchus.
29.
A. False – The sternal angle is the junction of the manubrium and the
body of the sternum. It is located at the level where the
second costal cartilage articulates with the sternum. At this
level lies the bifurcation of the trachea, origin and
termination of the aortic arch and the opening of the azygos
vein into the superior vena cava. It marks the end of the arch
of the aorta and the beginning of the descending aorta. It
demarcates the inferior boundary of the superior
mediastinum
B. True
C. True
D. True
E. True
30.
A. True - The azygos system of veins develop from the left and right
supra cardinal veins and supra cardinal anastomosis. Left
supra cardinal vein and supra cardinal anastomosis give rise
to the hemiazygos vein and the right supracardinal vein gives
rise to the azygos vein
B. False – The left brachiocephalic vein develops from the left anterior
cardinal vein and anterior cardinal anastomosis
C. True – The inferior vana cava develops from several embryonic
veins. From above downwards it develops from the right
vitelline vein (later becomes the right hapatocardiac channel),
right subcardinal vein, right sacrocardinal vein and
sacrocardinal anastomosis
D. False – The right renal vein has no embryonic vein of origin. The
subcardinal anastomosis gives rise to the left renal vein.
E. True
31.
A. True – Both right and left brachiocephalic veins receive vertebral,
inferior thyroid and internal thoracic veins (tributaries
corresponding to the branches of the first part of the
subclavian artery). In addition the left brachiocephalic vein
receives the superior intercostal vein
B. True
C. False – The middle thyroid vein drains into the internal jugular vein
D. False – The external jugular vein drains into the subclavian vein
E. True
32.
A. True – The superior mediastinum contains the thymic remnants,
internal thoracic arteries and veins, brachiocephalic veins,
upper half of the superior vena cava, the aortic arch, the
braciocephalic artery, left common carotid artery, subclavian
arteries, the left superior intercostal vein, the vagus, cardiac,
phrenic, and left recurrent laryngeal nerves, the trachea,
oesophagus, the superficial part of the cardiac plexus and
thoracic duct.
The posterior mediastinum contains the oesophagus, thoracic
aorta, azygos, hemiazygos and accessory azygos veins, the
vagus and splanchnic nerves, thoracic duct and the posterior
mediastinal lymph nodes. Hence the structures contained in
both mediastina are the oesophagus, vagi and thoracic duct
B. False – The trachea ends and bifurcates into left and right bronchi at
the sternal angle – the lower limit of the superior
mediastinum
C. False – The thoracic aorta which is the continuation of the arch of the
aorta begins at the level of the sternal angle and is located in
the posterior mediastinum
D. False – The phrenic nerves pass through the superior mediastinum
and the middle mediastinum only
E. True
Anterior mediastinum
33.
A. True – The thymus lies in both the superior and anterior mediastina.
B. True – It develops from the ventral wing of the third branchial pouch
C. False – The thymus consists of lymphoid cells arranged in lobes and
lobules
D. True– It is large and active during infancy and childhood and remains
active up to puberty after which it involutes
E. True – The inferior thyroid artery and branches of the internal
thoracic artery supply the thymus
34.
A. False – The anterior mediastinum contains the thymus (or its
remnants), a few lymph nodes and branches of the internal
thoracic vessels
B. True - The inferior thyroid artery and branches of the internal
thoracic artery supply the thymus
C. False – It is largest in the early part of life up to adolescence,
although its activity continues into old age
D. True – Some of the epithelial cells become thymic (Hassall’s)
corpuscles and the others form an epithelial network
E. False – The thymus lies in front of the upper pericardium and great
vessels
Middle mediastinum
35.
A. True – Mixing of oxygenated blood from the inferior vena cava via
the foramen ovale and deoxygenated blood from the
pulmonary veins occur in the left atrium
B. False – Left ventricle receives oxygenated blood from the left atrium
and no deoxygenated blood enters into it
C. True – Mixing of oxygenated blood from the inferior vena cava and
deoxygenated blood from the superior vena cava occurs in
the right atrium
D. False - The right ventricle receives deoxygenated blood from the
superior vena cava (via the right atrium) and no oxygenated
blood enters into it
E. True – Oxygenated blood entering the liver via the left umbilical vein
(from the placenta) mixes with the deoxygenated blood from
the portal vein
36.
A. True – The interatrial septum is developed from the septum primum,
septum secundum, septum spurium and the left valve of sinus
venosus. The right valve of sinus venosus gives rise to the
crista terminalis and valves of the coronary sinus and inferior
vena cava
B. True
C. True
D. True
E. False
37.
A. False – The median umbilical ligament is the urachus (a derivative of
distal urogenital sinus) which is not a foetal vessel
B. True – The ligamentum teres is the obliterated left umbilical vein
which carries oxygenated blood from the placenta to the
foetus during foetal life
C. True – The ligamentum venosum is the obliterated ductus venosus
which shunts oxygenated blood from the left umbilical vein to
the right hepatocardiac channel which will be the post hepatic
part of the inferior vena cava
D. True – The left and right umbilical arteries which carry deoxygenated
blood from the foetus to the placenta form the medial
umbilical ligaments (distal part) and the superior vescical
arteries (proximal part)
E. False – The gastrosplenic ligament is a derivative of the dorsal
mesentery of the stomach and hence is not a foetal vessel
38.
A. True - The right border of the heart is formed by the right atrium, the
left border by the left atrium and left ventricle. The lower
border or base is formed by the left and right ventricles. The
upper border is related to the ascending aorta, pulmonary
trunk and superior vena cava
B. True - The right atrium has a smooth part and a rough part
separated by the crista. The smooth part is derivedfrom the
absorbed right horn of the sinus venosus and sinus venosus.
The rough part is the right side of the primitive common
atrium from the right horn of the sinus venosus
C. True – Both the sinuatrial and atrioventricular nodes are located in
the wall of the right atrium
D. False – The crista terminalis is developed from the upper part of the
right valve of sinus venosus and separates the smooth and
rough parts of the right atrium
E. True – The right atrium receives the superior vena cava, inferior vena
cava and the coronary sinus
39.
A. True – It represents the distal portion of the of the left sixth aortic
arch and connects the left pulmonary artery to the aortic arch
closer to the commencement of the descending aorta
B. True – It is functionally closed shortly after birth; however, its
structural closure takes place after several months
C. False – It connects the pulmonary artery to the aortic arch
D. True – At birth, with the pulmonary circulation, the release of
Bradykinin leads to the contraction of ductus arteriosus. It
gradually becomes a ligament
E. True – It shunts blood from the pulmonary trunk to the aortic arch
before birth, by passing the pulmonary circulation
40.
A. True – Arising from the anterior aortic sinus on the right side of the
pulmonary trunk the artery passes between the right auricle
and the pulmonary trunk and descends in the anterior
atrioventricular groove
B. True – The artery to the SA node supplies the SA node and right and
left atrioventricular bundles
C. False – It accompanies the small cardiac vein in the anterior
interventricular groove and accompanies the coronary sinus
in the right posterior coronary sulcus.
The great cardiac vein passes in the anterior interventricular
groove along with the anterior interventricular artery, a
branch of the left coronary artery
D. False – The apex of the heart receives blood from the anterior
interventricular branch of the left coronary artery and not by
a branch of the right coronary artery
E. False – The branches arising from the right coronary artery are conus
artery, SA nodal artery, marginal artery, AV nodal artery and
posterior interventricular branch.
The circumflex artery is a branch of the left coronary artery
41.
A. False – The left border of the heart is formed mostly (4/5ths) by the
left ventricle, with the auricle of the left atrium forming the
uppermost part (1/5th ).
B. True - The left atrium forms the posterior surface (base) of the heart
and lies behind the right atrium
C. True – The oblique sinus lies posterior to the left atrium and the
transverse sinus lies anterior to the left atrium
D. True – Its posterior relations are the oesophagus and descending
thoracic aorta
E. True – The four pulmonary veins, two on each side on its posterior wall
open in to the left atrium. These veins do not have valves
42.
A. False - The common atrium is separated by the interatrial septum which in
developed from four embryonic parts. They are the septum
primum, septum secondum, septum spurium and the left value of
sinus venosus.
B. True
C. False - The pulmonary arteries develop from the proximal part of the sixth
aortic arches on left and right sides. The right horn of sinus venosus
along with the sinus venosus gets absorbed into the right side of
the common atrium giving rise to the smooth part of the right
atrium.
D. True - Upper half of the right valve of sinus venosus gives rise to the
crista terminals and from the lower half develops the valves
of the coronary sinus and inferior vena cava.
E. False- Smooth part of the right atrium is developed from the sinus
venosus and its right horn. The coronary sinus develops from the
left horn of sinus venosus.
43.
A. True – The descending thoracic aorta is the continuation of the arch
of the aorta. The arch ends at the fourth thoracic vertebral
level and the descending aorta begins at this level
B. True
C. False –The pericardiacophrenic artery arises from the internal
thoracic artery
D. False – It passes through the diaphragm at T12 vertebral level
E. True – The upper part of the oesophagus (the cervical part) is
supplied by branches of the inferior thyroid arteries. The
middle part (the thoracic part) is supplied by oesophageal
branches of the descending thoracic aorta and bronchial
arteries. The lower part is supplied by the oesophageal
branches of the left gastric artery
44.
A. True
B. False – It enters the thorax by passing through the aortic opening of
the diaphragm
C. True - It ascends upto the 4th thoracic vertebral level and arches
forwards over the root of the right lung and ends by opening
into the superior vena cava
D. True – Its tributaries are superior intercostal vein formed by 2nd, 3rd,
4th posterior intercostal veins, 5th 11th posterior intercostal
veins, hemiazygos and accessory hemiazygos, oesophageal,
pericardial and mediastinal veins, and the right bronchial vein.
E. False – The azygos vein drains into the superior vena cava. The right
atrium receives the superior vena cava, inferior vena cava and
the coronary sinus.
45.
A. True – The descending aorta gives off nine pairs of posterior
intercostal arteries (for 3rd -11th spaces), a pair of subcostal
arteries, bronchial arteries, oesophageal vessels, pericardial
branches and superior phrenic arteries
B. False – The musculophrenic artery is a terminal branch of the internal
thoracic artery
C. True
D. False – The superior intercostal artery is a descending branch of the
costocervical trunk which comes off from the second part of
the subclavian artery
E. True
46.
A. True – The anterior relations of the thoracic part of the oesophagus
from above downwards are: the trachea and the left
recurrent laryngeal nerve; the left principal bronchus and the
right pulmonary artery; and the pericardium which separates
it from the left atrium
B. True – The thoracic part of the oesophagus lies anterior to the bodies
of the thoracic vertebrae, thoracic duct, azygos vein, right
posterior intercostal arteries and at the lower end the
descending thoracic aorta
C. False – The muscularis externa of the oesophagus in the upper third
is composed of skeletal muscle; the middle third is composed
of both skeletal and smooth muscle; and the lower third is
composed of smooth muscle
D. True – The veins from the upper third drain into the inferior thyroid
veins, from the middle third into the azygos veins and from
the lower third into the left gastric vein, a tributary of the
portal vein
E. True – Just below the bifurcation of the trachea in the posterior
mediastinum the oesophagus is crossed anteriorly by the left
main bronchus and the right pulmonary artery
47.
A. True
B. False – The oesophagus has three anatomic constrictions. The first is
pharyngo-oesophageal junction, the second is where aortic
arch and left bronchus cross its anterior surface, and third
occurs where the oesophagus passes through the diaphragm
C. True – It lies posterior to the trachea and the left recurrent laryngeal
nerve; the left principal bronchus and the right pulmonary
artery; and the pericardium which separates it from the left
atrium
D. True
E. True – The upper third of the oesophagus is supplied by the inferior
thyroid artery, the middle third by branches from the
descending thoracic aorta, and the lower third by branches
from the left gastric artery
48.
A. True – Nerves lying in the superior mediastinum are : phrenic, vagus
and cardiac nerves, and left recurrent laryngeal nerve
B. True – The right brachiocephalic vein, superior vena cava, the
pericardium over the right atrium and the inferior cava lie on
its medial side
C. False – The right phrenic is not related to the thoracic duct
D. True – Its terminal branches pass through the caval opening in the
central tendon to supply the undersurface of the diaphragm
E. True – The phrenic nerve supplies the mediastinal pleura, fibrous
pericardium, parietal layer of the serous pericardium
Lungs and Pleurae
49.
A. True – The right lung has three lobes. The inferior lobe is below and
behind the oblique fissure. The part of right lung in front and
above the oblique fissure is subdivided in to the superior lobe
and middle lobe by the horizontal fissure. The left lung has
two lobes, superior and inferior, sparated by the oblique
fissure
B. False – The right lung has five structure in the hilum, namely the two
pulmonary veins, one pulmonary artery, upper lobar
bronchus and right principal bronchus. The left has four
structures in the hilum, namely the two pulmonary veins, one
pulmonary artery and the left principal bronchus
C. True – It has three, two and five bronchopulmonary segements in
the upper, middle and lower lobes respectively
D. False – The arch of the aorta is related to the mediastinal surface of
the left lung. The azygos vein is related to the mediastinal
surface of the right lung
E. False – It is supplied by a single bronchial artery
50.
A. True – The parietal pleura is attached to the inferior surface of the
suprapeural membrane and extends up to the neck of the first
rib
B. True
C. False – The parietal pleura is developed from the somatic mesoderm
and the visceral pleura from the visceral (splanchnic)
mesoderm
D. True – From the mediastinal layer of the parietal a cuff of membrane
surrounds the hilum of the lung (the root of lung) which forms
the pulmonary ligament inferiorly and continues with the
visceral pleura.
E. True – The parietal pleura lines the inner surface of the thoracic wall
(rib cage, vertebrae and diaphragm). The recess formed by the
parietal pleura inferiorly between the ribs and the diaphragm
is the costo diaphragmatic recess.
51.
A. False – There are ten bronchpulmonary segments in each lung and
each of the ten bronchopulmonary segments have ten
segmental bronchi
B. False – Each bronchopulmonary segment is pyramidal in shape with
the base towards the lung surface and apex towards the
hilum
C. False – Each segment is supplied by a segmental brochuus. Lobar
bronchi supply the lobes of the lung (two lobar bronchi in the
left lung and three lobar bronchi in the right lung)
D. True – It is the smallest part of the lung that could be surgically
removed with minimal bleeding and damage
E. True – This is important because if this artery gets blocked that part
will become an infarct
52.
A. True – The cervical pleura extends up into the neck above the clavicle
up to the level of the neck of the first rib, lining the
undersurface of suprapleural membrane. It reaches a level 1-
1.5 inches (2.5 – 4 cm) above the medial third of the clavicle
B. True – The parietal layer of pleura lines the thoracic wall. Loose
areolar tissue separates it from the endothoracic fascia which
is an extrapleural sheet of fascia that lines the thoracic wall
C. True – The two layers are continuous with one another by means of
a cuff of pleura that surrounds the structures entering and
leaving the lung at the hilum of each lung. This pleura extends
for a distance below the hilum froming a double layered fold
called the pulmonary ligament
D. True
E. False – It is sensitive to stretch, but is insensitive to common
sensations such as pain and touch. The parietal pleura is
sensitive to pain, temperature and pressure
Abdomen
Anterior Abdominal Wall
53. The transpyloric plane

A. Transects the body through L1 vertebra
B. Is midway between the xiphisternum and the pubic symphysis
C. Crosses through the neck of the pancreas
D. Marks the level of termination of the spinal cord
E. Cuts through the neck of the gall bladder
54. Regarding the anterior abdominal wall

A. Skin around the umbilicus is supplied by the 10th thoracic spinal nerve
B. The transpyloric plane marks the level of the hila of the kidneys
C. The intertubercular plane lies at the level of the pubic tubercles
D. The subcostal plane is at the L3 vertebral level
E. Nerves of the anterior abdominal wall lie between the internal oblique
and external oblique muscles
55. At the transpyloric plane

A. the common iliac artery commences
B. the superior mesenteric artery arises from the aorta
C. the splenic vein joins the superior mesenteric vein to form the portal
vein
D. the neck of the pancreas is located
E. the inferior vena cava commenses
56. The inguinal canal

A. commences at the superficial inguinal ring
B. has an anterior wall formed by the external oblique aponeurosis
assisted laterally by the internal oblique muscle
C. has the floor formed by the inguinal ligament
D. has the posterior wall reinforced in its medial third by the conjoint
tendon
E. transmits the round ligament in the female
57. The superficial inguinal ring

A. is oval shaped
B. is a defect in the superficial fascia
C. lies immediately above and lateral to the pubic tubercle
D. has crura giving attachment to external spermatic fascia
E. transmits the ilioinguinal nerve
58. Regarding the inguinal canal

A. It lies above the lateral part of the inguinal ligament
B. Its deep ring lies half an inch above the mid inguinal point
C. The lacunar ligament forms the floor medially
D. It transmits the genitofemoral nerve
E. Its roof is formed by the fibres of internal oblique and transversus
abdominis muscles
59. The inguinal canal

A. is 1.5 cm long
B. has the ilioinguinal nerve entering through the deep ring
C. has part of its floor formed by the lacunar ligament
D. has fascia transversalis along the whole length of the posterior wall
E. has the inferior epigastric artery medial to its deep ring
60. The rectus abdominis muscle

A. arises from the pubic symphysis and pubic crest
B. inserts on to the 9th rib
C. is enclosed in the aponeurosis of the internal oblique muscle between
the umbilicus and costal margin
D. has a tendinous intersection at the level of the umbilicus
E. is supplied by the iliohypogastric nerve
61. The external oblique muscle
A. has fibres interdigitating with fibres of latissimus dorsi
B. has an attachment to the anterior half of the iliac crest
C. has the superficial inguinal ring in its aponeurosis
D. contributes to the formation of the conjoint tendon
E. has its lower border forming the roof of the inguinal canal
62. Regarding the rectus sheath

A. The anterior layer above the level of the costal margin is formed by the
external oblique aponeurosis
B. The posterior layer above the level of the costal margin formed by the
internal oblique aponeurosis
C. The subcostal nerve supplies it
D. The anterior layer above the pubic symphysis is formed by the fusion of
aponeuroses of external and internal oblique and transversus
abdominis muscles
E. The posterior layer above the pubic symphysis is formed by the
aponeurosis of the transversus abdominis muscle
63. The anterior abdominal wall is supplied by the

A. eighth posterior intercostal artery
B. superior epigastric artery
C. inferior epigastric artery
D. tenth posterior intercostal artery
E. musculophrenic artery
64. Nerves that supply the muscles of the anterior abdominal wall include
A. sixth intercostal nerve
B. subcostal nerve
C. ilioinguinal nerve
D. iliohypogastric nerve
E. lateral femoral cutaneous nerve
65. Components of the spermatic cord include

A. ilioinguinal nerve
B. vas deferens
C. genitofemoral nerve
D. appendix testis
E. testicular artery
66. Regarding vertebral levels

A. The portal vein commences at theL1 vertebral level
B. Bifurcation of the descending aorta is at the S1 level
C. Oesophageal opening in the diaphragm is at the T12 vertebral level
D. Bifurcation of the trachea is at the T6 vertebral level
E. The lower limit of the prevertebral fascia is at the T4 vertebral level
67. The coeliac trunk

A. is the artery of the foregut
B. arises at the 10th thoracic vertebral level
C. gives off the splenic artery
D. supplies the entire oesophagus
E. lies behind the peritoneum of the lesser sac
68. The superior mesenteric artery

A. arises at the level of the transpyloric plane
B. lies behind the body of the pancreas
C. supplies the pancreas
D. lies anterior to the left renal vein
E. supplies the caecum
69. Branches arising from the superior mesenteric artery include

A. ileocolic
B. left colic
C. right gastric
D. gastroduodenal
E. inferior pancreaticoduodenal
70. The inferior mesenteric artery

A. arises at the L3 vertebral level
B. crosses the pelvic brim at the bifurcation of the left common iliac artery
C. supplies the descending colon
D. descends into the pelvis as the superior rectal artery
E. gives off the right colic artery
71. The portal vein

A. is formed behind the neck of the pancreas
B. lies in front of the inferior vena cava
C. receives right and left gastric veins
D. ascends in the greater omentum
E. lies anterior to the bile duct
72. Porto-systemic anastomoses occur at the

A. upper end of oesophagus
B. area around the umbilicus
C. anal canal
D. hilum of the spleen
E. transverse colon
73. The splenic vein

A. lies below the splenic artery
B. is derived from the left umbilical vein
C. ends behind the neck of the pancreas
D. receives short gastric veins
E. receives the right gastric vein
74. Regarding the blood supply of the gut

A. Left gastric artery supplies the lesser curvature of the stomach
B. Short gastric arteries supply the pyloric region of the stomach
C. Right colic artery supplies the ascending colon
D. Right gastric artery supplies the first part of the duodenum
E. Left colic artery supplies the proximal 1/3 of the transverse colon
75. Derivatives of the vitelline veins include

A. portal vein
B. inferior mesenteric vein
C. splenic vein
D. superior mesenteric vein
E. inferior vena cava
76. Regarding the coeliac plexus
A. It lies around the origin of the coeliac trunk
B. The greater splanchnic nerve carries postganglionic sympathetic fibres
to the plexus
C. Both vagi contribute fibres to the plexus
D. The coeliac plexus contributes fibres to the renal plexus
E. The adrenal medulla receives preganglionic sympathetic fibres from the
splanchnic nerves via the plexus
77. Regarding vertebral levels

A. Coeliac trunk arises at the tenth thoracic vertebral level
B. Superior mesenteric artery arises at the twelfth thoracic vertebral level
C. Inferior mesenteric artery arises at the third lumbar vertebral level
D. The abdominal aorta divides into right and left common iliac arteries at
the fourth lumbar vertebral level
E. The common iliac artery divides at the level of the second sacral
vertebral level
Abdominal cavity and the peritoneum
78. Which of the following is/are retroperitoneal

A. Ureter
B. Head of the pancreas
C. Ascending colon
D. Appendix
E. Spleen
79. Derivatives of the dorsal mesentery (dorsal mesogastrium) include

A. lienorenal ligament
B. spleen
C. falciform ligament
D. lesser omentum
E. greater omentum
80. Regarding the epiploic foramen

A. Its lower boundary is the second part of the duodenum
B. Its upper boundary is the caudate process of the liver
C. Its posterior boundary is the superior mesenteric vein
D. Its anterior boundary is the free margin of the lesser omentum
E. The right subhepatic space communicates with the lesser sac via the
epiploic foramen
81. The lesser omentum

A. extends between the stomach and the liver
B. is attached to the greater curvature of the stomach
C. extends into the fissure for the ligamentum teres
D. forms the anterior boundary of the epiploic foramen
E. is developed from the ventral mesentery
82. Regarding the sigmoid mesocolon

A. It has two limbs diverging from each other at the common iliac
bifurcation
B. Its lateral limb passes forwards along the pelvic brim
C. Its medial limb reaches the midline in front of the first sacral vertebra
D. It is derived from the dorsal mesentery
E. It is formed by the parietal layer of the peritoneum
83. Which of the following ligaments originate from foetal vessels

A. Ligamentum teres
B. Gastrosplenic ligament
C. Ligamentum venosum
D. Median umbilical ligament
E. Medial umbilical ligament
Development of the Gut
84. Regarding the rotation of the gut

A. The stomach rotates in an anticlockwise direction
B. The duodenum rotates 90° clockwise
C. Mid gut loop rotates 90° anticlockwise at 6th week intra uterine life
D. Mid gut rotation is complete at 10th week intra uterine life
E. Physiological umbilical herniation occurs after completion of mid gut
rotation
85. Which of the following cells is/are mesodermal
A. Kupffer cells
B. APUD cells
C. Paneth cells
D. cells of the zona glomerulosa
E. hepatocytes
86. Abnormalities associated with a malrotation of the gut include

A. biliary atresia
B. Hirschprungs disease
C. annular pancreas
D. imperforate anus
E. vitelline fistula
Gastrointestinal Tract
87. The greater curvature of the stomach is supplied by the

A. left gastric artery
B. right gastric artery
C. short gastric arteries
D. left gastroepiploic artery
E. right gastroepiploic artery
88. Regarding the stomach

A. It receives all its arterial supply from the coeliac trunk
B. It is completely invested by the peritoneum
C. The lymph is drained to the celiac lymph nodes
D. It is lined by the stratified squamous non keratinizing epithelium
E. The lesser sac lies posterior to the stomach
89. Structures forming the stomach bed include

A. Left kidney
B. Splenic artery
C. Body of the pancreas
D. Superior mesenteric artery
E. Lesser sac
90. First part of the duodenum
A. lies on the transpyloric plane
B. is supplied by the celiac trunk
C. is anterior to the bile duct
D. is posterior to the gastroduodenal artery
E. is developed from the midgut
91. The jejunum differs from the ileum in having

A. a thicker wall
B. longer vasa recta
C. Peyer’s patches
D. more arterial arcades
E. broader windows
92. The caecum

A. is completely covered by the peritoneum
B. lies over the iliacus and psoas muscles
C. has taeniae coli
D. is supplied by the inferior mesenteric artery
E. has the lateral cutaneous nerve of the thigh anterior to it
93. The second part of the duodenum

A. is covered in front with the peritoneum
B. runs in front of the hilum of the right kidney
C. is supplied by superior pancreaticoduodenal artery
D. is developed entirely from the foregut
E. has the bile duct opening in to its anterior wall
94. Meckel’s diverticulum

A. is found 2 feet distal to the ileocaecal junction
B. arises from the mesenteric surface of the ileum
C. is a persistent remnant of the vitellointestinal duct
D. contains renal and suprarenal tissue
E. occurs in about 20% of the population
95. Posterior relations of the 1st part of the duodenum include

A. bile duct
B. gall bladder
C. gastroduodenal artery
D. portal vein
E. neck of the pancreas
96. The ascending colon
A. is retroperitoneal
B. is a derivative of the hindgut
C. extends upwards to the splenic flexure
D. lies on the iliac fascia
E. is related to the anterior surface of the right kidney
97. Regarding the appendix

A. It is a derivative of the midgut
B. The position of its base is constant in relation to the caecum
C. It has its own mesentery
D. It is supplied by the inferior mesenteric artery
E. It has taenia coli
98. Regarding the appendix

A. It develops at the 4th week IUL
B. It is lined by a simple cuboidal epithelium
C. It is supplied by an end artery
D. Its surface projection is the tip of the right 9th costal cartilage
E. Its commonest position is retrocaecal

99. The caudate lobe of the liver
A. lies between the fissure for the ligamentum teres and gall bladder
B. is connected to the right lobe by the caudate process
C. forms the upper boundary of the foramen of Winslow
D. belongs to the left and right morphological lobes of the liver
E. is enclosed by the peritoneum
100. Regarding the bile duct

A. It is formed by the union of left and right hepatic ducts
B. Its lining is endodermal in origin
C. Its upper third lies in the free edge of the lesser omentum
D. It passes between the second part of the duodenum and head
of pancreas
E. It lies behind the right renal vein
101. The pancreas

A. has its neck in front of the commencement of the portal vein
B. has its tail related to the hilum of the kidney
C. consists of cells derived from neuroectoderm
D. is retroperitoneal
E. has its tail lying within the gastrosplenic ligament
102. Organs related to the visceral surface of the spleen include

A. Left kidney
B. left colic flexure
C. Stomach
D. Tail of the pancreas
E. Greater omentum
103. Organs related to the visceral surface of the liver include

A. Stomach
B. Duodenum
C. Hepatic flexure of the colon
D. Right kidney
E. Pancreas
104. Regarding the pancreas

A. Its head lies anterior to the commencement of the portal vein
B. The uncinate process extends behind the superior mesenteric
vessels
C. Annular pancreas causes duodenal obstruction
D. It is supplied by branches of the superior mesenteric artery
E. The tail passes in the lienorenal ligament
105. The spleen

A. Is developed from the dorsal mesogastrium
B. Has a notch in its anterior border
C. Lies beneath the 7th and 9th ribs
D. Has a lower pole extending upto the midaxillary line
E. Is supplied by vessels passing in the gastrosplenic ligament
Posterior Abdominal Wall

106. The abdominal aorta
A. passes through the diaphragm tenth thoracic vertebral level
B. terminates at the fifth lumbar vertebral level
C. gives off branches supplying the gut from its anterior aspect
D. has a longer course than the inferior vena cava in the abdomen
E. is accompanied by thoracic duct at the aortic opening
107. Paired branches of the abdominal aorta include

A. gonadal arteries
B. hepatic arteries
C. subcostal arteries
D. lumbar ateries
E. inferior phrenic arteries
108. The inferior vena cava
A. is formed at the fourth lumbar vertebral level
B. grooves the bare area of the liver
C. passes through the tendinous part of the diaphragm
D. receives the right suprarenal vein
E. has its post hepatic part derived from the left vitelline vein
109. Regarding the inferior vena cava

A. It passes through the diaphragm at the tenth thoracic vertebral level
B. It has a valve at its termination
C. Its post hepatic part is derived from the right supracardinal vein
D. It receives the hepatic vein
E. Both gonadal veins drain into it
110. Tributaries of the inferior vena cava include

A. left fourth lumbar vein
B. left gonadal vein
C. right renal vein
D. left suprarenal vein
E. right inferior phrenic vein
111. The right renal artery

A. arises from the aorta at the second lumbar vertebral level
B. lies anterior to the right crus of the diaphragm
C. passes anterior to the inferior vena cava
D. supplies the ureter
E. gives off the right gonadal artery
112. The left renal vein

A. lies posterior to the left renal artery
B. is longer than the right renal vein
C. is developed from the subcardinal anastomosis
D. enters the inferior vena cava at second lumbar vertebral level
E. receives the left gonadal vein
113. Regarding the lumbar plexus

A. It lies within the psoas major muscle
B. It is formed by the dorsal rami of upper four lumbar nerves
C. It has branches supplying the skin
D. The femoral nerve emerges from the medial border of the psoas
muscle
E. It gives off the pudendal nerve
114. The genitofemoral nerve

A. descends on the quadratus lumborum muscle
B. is a branch of the femoral nerve
C. has its genital branch passing though the inguinal canal
D. supplies the cremaster muscle
E. has motor and sensory components
115. The ilioinguinal nerve

A. contains fibres arising from first and second lumbar segments
B. emerges from the lateral border of the psoas muscle
C. lies within the inguinal canal
D. supplies the skin of the scrotum
E. is entirely sensory
116. The ovarian artery
A. arises from the abdominal aorta just above the origin of renal
artery
B. lies on the psoas major muscle
C. crosses in front of the ureter
D. on the right side crosses in front of the inferior vena cava
E. supplies the ureter
Kidneys, Ureters and Suprarenal glands

117. The ureter
A. passes down on the psoas major muscle
B. has a narrowing at the pelviureteric junction
C. lies anterior to the gonadal vessels
D. crosses the bifurcation of the common iliac artery anteriorly
E. is developed from the paramesonephric duct
118. Regarding the right ureter

A. It is retroperitoneal
B. It is crossed by the right ileocolic vessels
C. It receives an arterial supply from the renal arteries
D. The projection of the ureter on a radiograph is opposite the tips of the
transverse processes of upper lumbar vertebrae
E. It lies behind the fourth part of the duodenum
119. Regarding the suprarenal glands

A. They are symmetrical in shape
B. They are enclosed in renal fascia
C. Each gland is drained by three veins
D. The inferior vena cava is an anterior relation of the right suprarenal
gland
E. The medulla is developed from endoderm
120. Regarding the suprarenal glands

A. The anterior surface of the left gland is in contact with the bare area of
the liver
B. The left gland lies on the left crus of the diaphragm
C. Suprarenal arteries arise from the renal arteries
D. Cells of the zona glomerulosa develop from the neural crest cells
E. They receive preganglionic sympathetic fibres via the splanchnic
nerves
121. Regarding the relations of the kidneys

A. The costodiaphragmatic recess of the pleura is at risk in the lumbar
approach to the kidney
B. The right kidney rests on the twelfth rib
C. Iliohpogastric and ilioinguinal nerves are related posteriorly
D. The hilum of the left kidney is related to the pancreas
E. The hila of both kidneys lie at the subcostal plane
122. The anterior relations of the right kidney include

A. liver
B. second part of the duodenum
C. head of pancreas
D. hepatic flexure of colon
E. subcostal vessels
123. Derivatives of the metanephric blastema include

A. ureter
B. minor calyces
C. Bowmans capsule
D. distal convoluted tubule
E. collecting ducts
124. The adrenal cortex

A. has cells secreting androgens
B. is developed from the intermediate mesoderm
C. is supplied by the preganglionic sympathetic fibres
D. has cells having an abundance of smooth endoplasmic reticulum
E. has a rich reticulin fibre network
Abdomen : Answers and Explanations

53.
A. True – The plane passes through the lower border of the L1 vertebra
B. False – The plane lies midway between the jugular notch (upper
border of the manubrium) and symphysis pubis
C. False – The plane passes through the head, neck and body of the
pancreas
D. True – The spinal cord ends at L1 vertebral level
E. True – It cuts each costal margin at the tip of the ninth costal
cartilage, which is at the lateral border of the rectus
abdominis; deep to this point on the right side lies the fundus
of the gall bladder
54.
A. True– Dermatomes over the xiphoid process is T7, over the umbilicus is T10
and over the pubis – L1
B. True - The hila of the kidneys lie at this plane, the right just
below and the left just above it
C. False – Intertubercular plane passes through the tubercles of iliac
crests and body of L5 vertebra
D. True – The subcostal plane passes through the lower border of the
10th costal cartilage and body of L3 vertebra
E. False – Nerves of the anterior abdominal wall lie between internal
oblique and transversus abdominis muscle
55.
A. False – The abdominal aorta divides into the two common iliac
arteries at the level of the body of L4 vertebra
B. True - Thesuperior mesenteric artery arises from the aorta at the
level of the lower border of the body of L1 vertebra
C. True - The commencement of the portal vein is just behind the neck
of the pancreas
D. True
E. False – The inferior vena cava begins opposite the L5 vertebral level
by the confluence of the two common iliac veins behind the
right common iliac artery
56.
A. False - The inguinal canal is an oblique passage through the lower
part of the anterior abdominal wall which commences at the
deep inguinal ring and ends at the superficial inguinal ring
B. True – The anterior wall along its entire length of the canal is formed
by the aponeurosis of the external oblique muscle. It is
reinforced in its lateral third by the internal oblique
C. True – The floor or the inferior wall is formed by the inrolled
inferior edge of the inguinal ligament (the aponeurosis of the
external oblique) reinforced medially by the lacunar ligament
D. True – The posterior wall is formed along its entire length by the
fascia transversalis. It is reinforced in its medial third by the
conjoint tendon
E. True– It transmits the round ligament of the uterus and the
ilioinguinal nerve in the female and the spermatic cord and
ilioinguinal nerve in the male
57.
A. False – It is a triangular defect or aperture in the aponeurosis of the
external oblique muscle
B. False
C. True
D. True - Margins of the ring are called the crura (lateral and medial)
and give attachment to external spermatic fascia
E. True - It transmits the round ligament of the uterus and the
ilioinguinal nerve in the female and the spermatic cord and
ilioinguinal nerve in the male
58.
A. False - The inguinal canal is an oblique intermuscular slit about 4 cm
long lying above the medial part of the inguinal ligament
B. True – The deep ring lies about 1.25 cm (1 inch) above the midpoint
of the inguinal ligament which is an opening in the
transversalis fascia
C. True - The floor is the inrolled lower edge of the inguinal ligament
reinforced medially by the lacunar ligament
D. False – The inguinal canal transmits the spermatic cord and
ilioinguinal nerve in the male and the round ligament of
uterus and ilioinguinal nerve in the female. The genitofemoral
nerve is formed in the psoas major muscle and emerges
on its anterior surface and runs down along the muscle,
pierces the psoas fascia and divides into the genital and
femoral branches. The genital branch passes through the
deep ring, enters the inguinal canal and supplies the
cremaster muscle, spermatic fascia, tunica vaginalis and
scrotal skin
E. True – The roof is formed by the lower edges of the internal
oblique and transversus abdominis muscles
59.
A. False – It is 1.5 inches (4 cm) long
B. False – The ilioinguinal nerve enters the canal by piercing the lower
border of the internal oblique muscle and emerges through
the superficial inguinal ring
C. True – The floor is formed by the inrolled lower border of the
inguinal ligament and reinforced medially by the lacunar
ligament
D. True – The posterior wall is formed along its entire length by fascia
transversalis. It is reinforced on its medial third by the
conjoint tendon
E. True – Related to it medially are the inferior epigastric vessels,
which pass upward from the external iliac vessels
60.
A. True – It arises by two heads: a medial from in front of the pubic
symphysis and a lateral from the pubic crest
B. False – The muscle is inserted on to the front of the 5th to 7th costal
cartilages
C. True – Between the umbilicus and costal margin, the aponeurosis of
the internal oblique splits into anterior and posterior layers to
enclose the rectus abdominis muscle
D. True – Typically three tendinous intersections are found in the
muscle, one at the umbilicus, one at the xiphisternum, and
one between these two
E. False – The rectus muscle and external obique muscle are both
supplied by the lower intercostal and subcostal nerves (T7-
T12). The internal oblique and transversus abdominis are also
supplied by the same nerves but with the addition of the
iliohypogastric and ilioinguinal nerves (L1)
61.
A. True – The muscle arises by eight digitations, one from each of
the lower eight ribs. The lower four slips interdigitate with
the costal fibres of latissimus dorsi and the upper four
with the digitations of the sarratus anterior
B. True – The muscle has a free posterior border which extends
from the twelfth rib to its insertion into the anterior half
of the outer lip of the iliac crest
C. True - Above and lateral to the pubic tubercle is the superficial
inguinal ring in the aponeurosis of the external oblique
muscle
D. False – Muscles contributing to the formation of the conjoint
tendon are the internal oblique and the transversus
abdominis
E. False – Its lower border forms the inguinal ligament. The inguinal
ligament forms the floor of the inguinal canal. The roof of
the canal is formed by arching fibres of internal oblique
and transversus abdominis
62.
A. True
B. False – The posterior layer above the level of the costal margin
has no rectus sheath. The rectus muscle rests directly on
the fifth, sixth and seventh costal cartilages
C. True – Seventh to eleventh intercostal nerves and subcostal
nerve (12th thoracic nerve) supply it
D. True
E. False – The posterior layer above the pubic symphysis is deficient
and the rectus muscle rests directly on the fascia
transversalis
63.
A. False – The anterior abdominal wall is supplied by the superior
epigastric and musculophrenic arteries (branches of internal
throracic artery), tenth and eleventh posterior intercostal
arteries (branches of thoracic aorta), subcostal artery,
inferior epigastric artery and deep circumflex iliac artery
(branches of the external iliac artery) and lumbar arteries
(dorsal branches of abdominal aorta)
B. True
C. True
D. True
E. True
64.
A. False – Rectus abdominis and external oblique muscles are supplied
by the lower intercostals (T7-T12) and subcostal (T12) nerves;
the internal oblique and transversus abdominis by the lower
intercostals, subcostal, iliohypogastric and ilioinguinal nerves
and the lowest fibres of the internal oblique and transversus
abdominis by the first lumbar fibres.
B. True
C. True
D. True
E. False
65.
A. False – The spermatic cord has three coverings and six constituents.
They are the internal spermatic fascia, cremasteric fascia and
muscle, external spermatic fascia, ductus deferns, testicular
artery with the artery to the ducts and cremasteric artery,
pampiniform plexus of veins, lymphatics, genital branch of the
genitofemoral nerve and processus vaginalis.
The ilioinguinal nerve passes down deep to the external
oblique muscle and emerges on the front of the spermatic
cord through the superficial inguinal ring.
B. True
C. True
D. False - The appendix testis is a small cystic part attached to the upper
pole of testis which is a remnant of the paramesonephric duct
E. True
66.
A. True - The portal vein commences behind the neck of pancreas
by the union of the splenic vein and superior mesenteric vein
at the first lumbar vertebral level
B. False – Bifurcation of the descending aorta is at the fourth lumbar
vertebral level
C. False – Oesophageal opening in the diaphragm is at the tenth
thoracic vertebral level. The inferior vena caval opening is
at the eighth thoracic vertebral level and the aortic opening
is at the twelfth thoracic vertebral level
D. False – Bifurcation of the trachea is at the fourth thoracic vertebral
level which is at the level of the manubriosternal joint (angle
of Louis)
E. True – The prevertebral fascia extends from the base of the skull
to the fourth thoracic vertebral level
67.
A. True – It is the artery of the distal part of the foregut and supplies
the gastrointestinal tract from the lower one third of the
oesophagus down to the duodenum as far as the opening of
the bile duct. It supplies the liver, spleen and pancreas
which are foregut derivatives
B. False – It arises at the 12th thoracic vertebral level
C. True – Its three branches are the left gastric, splenic and
common hepatic arteries
D. False – The derivatives of the distal part of the foregut including the
liver, pancreas and spleen are supplied by the coeliac trunk.
The upper part of the oesophagus is supplied by the inferior
thyroid arteries; middle part by the oesophageal branches of
the aorta and bronchial arteries; and the lower part by the
oesophageal branches of the left gastric artery
E. True – The three branches from the coeliac trunk are given off at the
upper border of the pancreas behind the peritoneum of the
posterior wall of the upper sac
68.
A. True – It arises from the abdominal aorta a centimeter below the
origin of the celiac trunk at the L1 vertebral level
B. True - After airsing from the aorta the superior mesenteric artery is
directed downwards behind the body of the pancreas and
splenic vein
C. False – It is the artery of the mid gut and supplies the gut from
the duodenal papilla up to the junction between the proximal
two-thirds and distal one-third of the transverse colon.
The pancreas is supplied mainly by the splenic artery, a branch
of the coeliac trunk (neck, body and tail). Superior and inferior
pancreaticoduodenal arteries supply the head of pancreas
D. True – It lies anterior to the left renal vein, uncinate process of
the pancreas and the third part of the duodenum, in that
order from above downwards
E. True – The ileocolic artery is a branch of the superior mesenteric
artery. The inferior branch of the ileocolic artery gives off the
anterior and posterior caecal arteries to supply the caecum.
69.
A. True – Branches arising from the superior mesenteric artery are
inferior pancreaticoduodenal, ileocolic, right colic, middle
colic, jejunal and ileal arteries
B. False – The left colic is a branch of the inferior mesenteric artery
C. False – The right gastric artery is a branch of the common hepatic
artery which arises from the coeliac trunk
D. False – The gastroduodenal artery is a branch of the common hepatic
artery which arises from the coeliac trunk
E. True
70.
A. True – It arises from the aorta behind the inferior border of the third
part of the duodenum at the third lumbar vertebral level (3-4
cm above the bifurcation of the aorta)
B. True – It crosses the pelvic brim at the bifurcation of the left
common iliac vessels over the sacroiliac joint and converges
towards the ureter and lie at the apex of the attachment of
the sigmoid mesocolon
C. True – It supplies the distal third of the transverse colon, left colic
Flexure (splenic flexure), the descending colon, the sigmoid
colon, the rectum, and the anal canal above the pectinate line
D. True – The terminal branch of the inferior mesenteric artery is the
superior rectal artery which anastomoses with the last
branch of the sigmoid arteries
E. False – Its branches are the left colic, sigmoid and superior rectal
arteries. The right colic artery is a branch of the superior
mesenteric artery
71.
A. True - The portal vein is formed by the union of splenic vein (which
also receives the inferior mesenteric vein) with
the superior mesenteric vein, behind the neck of the
pancreas at the 1st lumbar vertebral level
B. True – It lies in front of the inferior vena cava behind the neck of
the pancreas and the first part of the duodenum. By
entering between the two layers of the lesser omentum it
loses contact with the inferior vena cava
C. True – Tributaries of the portal vein are the right and left gastric
veins, superior pancreaticoduodenal veins, cystic veins
and paraumbilical veins
D. False – it ascends in the free edge of the lesser omentum
E. False – The portal vein runs upwards in the free edge of the lesser
omentum which forms the anterior boundary of the epiploic
foramen lying behind the bile duct and the hepatic artery
72.
A. False – The following are the four common sites of porto-
systemic anastomoses:
(i) At the lower end of the oesophagus (oesophageal or
gastric varices) the oesophageal branches of the left gastric
vein (portal tributary) anastomoses with oesophageal veins
that drain into azygos and accessory azygos veins
(ii) Anorectal region – superior rectal veins (portal tributary)
anastomose with the middle and inferior rectal veins
(systemic tributaries) that drain into internal iliac and
pudendal veins
(iii) Around the umbilicus – the left branch of the portal vein
anastomoses with the superficial veins (superior and inferior
epigastric) of the anterior abdominal wall (systemic
tributaries) through paraumbilical veins that accompany the
ligamentum teres
In portal obstruction the veins around the umbilicus distend.
The distended veins radiate from the umbilicus giving rise to
caput medusae
(iv) In the bare area of liver – the right branch of the portal
vein in the bare area anastomoses with the retroperitoneal
veins that drain into lumbar, azygos and hemiazygos veins
B. True
C. True
D. False
E. False
73.
A. True – The vein leaves the hilum of the spleen and passes in the
lienorenal ligament lying below the splenic artery
B. False – The splenic vein has no foetal vessel of origin. The left
umbilical vein which is the main source of oxygenated blood
to the foetus becomes the ligamentum teres after birth
C. True – It unites with the superior mesenteric vein behind the
neck of the pancreas (at the first lumbar vertebral level) to
form the portal vein
D. True – It receives short gastric, left gastroepiploic, inferior
mesenteric and pancreatic veins
E. False - The right gastric vein passes along the lesser curvature to the
pylorus of the stomach and empties into the portal vein
74.
A. True – The lesser curvature of the stomach is supplied by the left
and right gastric arteries
B. False – Short gastric arteries (about six branches) are branches
from the splenic artery that supply the fundus and upper
part of the greater curvature of the stomach. The pyloric
region of the stomach is supplied by the gastroduodenal
artery, right gastroepiploic artery and supraduodenal artery
C. True – The ascending colon is supplied by the ileocolic, right
colic and middle colic arteries, which are branches of the
superior mesenteric artery
D. True – The first 2 cm of the duodenum receives blood from the
hepatic, gastroduodenal, supraduodenal, right gastric and
right gastroepiploic arteries
E. False - The middle colic artery, a branch of the superior mesenteric
artery supplies the proximal 1/3 of the transverse colon.
The left colic artery supplies the descending colon
75.
A. True – Left and right vitelline veins and vitelline anastomosis give
rise to superior mesenteric vein, portal vein and post hepatic
inferior vena cava. The inferior mesenteric and splenic veins
do not have a foetal vessel of origin
B. False
C. False
D. True
E. True
76.
A. True – It lies around the origin of the coeliac trunk above the
upper border of the pancreas
B. False – The greater and lesser splanchnic nerves carry preganglionic
sympathetic fibres. They pierce the crura of the diaphragm
and enter the two large coeliac ganglia
C. True
D. True – Fibres from the plexus supply all abdominal viscera, renal
ganglion and plexus, testes and ovaries
E. True – Preganglionic fibres from the greater splanchnic nerve
pass without relay to the cells of the suprarenal medulla
77.
A. False – The coeliac trunk arises from the abdominal aorta between
the crura of the diaphragm a little below the median
arcuate ligament at the twelfth thoracic vertebral level
B. False – The superior mesenteric artery arises from the aorta a
centimeter below the coeliac trunk at the first lumbar
vertebral level
C. True – The inferior mesenteric artery arises from the aorta
behind the inferior border of the third part of the
duodenum at the third lumbar vertebral level
D. True – The abdominal aorta passes behind the median arcuate
ligament at the twelfth thoracic vertebral level and
passes downwards behind the peritoneum on the bodies
of lumbar vertebrae with the left sympathetic trunk at its
left margin. At the fourth lumbar vertebral level it divides
into the two common iliac arteries
E. False – The common iliac arteries divide into internal and
external iliac arteries at the fifth lumbar vertebral level
(at the disc between the 5th lumbar vertebra and the
sacrum) in front of the sacroiliac joint
78.
A. False – Although the kidney is retroperitoneal, the ureter lies on
the posterior abdominal wall in front of the muscles
B. True – The pancreas after development fuses with the posterior
abdominal wall and becomes secondarily retroperitoneal
C. True – During development the descending colon has a dorsal
mesentery which will fuse with the posterior abdominal
wall and becomes retroperitoneal
D. False – The appendix has a mesentery called the mesoappendix
and is not retroperitoneal
E. False– The spleen develops in the dorsal mesentery and is
attached to the posterior abdominal wall by the
lienorenal ligament
79.
A. True – Derivatives of the dorsal mesentery include the greater
omentum, gastrosplenic ligament, spleen and the
lienorenal ligament. The lesser omentum and falciform
ligament develops from the ventral mesentery (ventral
mesogastrium)
B. True
C. False
D. False
E. True
80.
A. False – Its lower boundary is the first part of the duodenum
B. True
C. False – The posterior boundary is the inferior vena cava covered
by the parietal peritoneum of the posterior abdominal
wall
D. True – The free margin of the lesser omentum contains between
its two peritoneal layers the portal vein and anterior to it
the hepatic artery and bile duct
E. True – Left (lesser sac) and righr subhepatic spaces communicate
with each other via the epiploic foramen
81.
A. True – The two layers of peritoneum that extend between the
liver and the lesser curvature of the stomach constitute
the lesser omentum. This is part of the ventral mesogastrium
B. False – It is attached to the lesser curvature of the stomach. The
greater omentum is attached to the greater curvature of the
stomach.
C. False – The attachment of the lesser omentum to the liver is L-
shaped. It is attached to the fissure for the ligamentum
venosum and the porta hapatis
D. True – Anteriorly the foramen is bounded by the right free
margin of the lesser omentum containing between its two
peritoneal layers the portal vein, hepatic artery and bile duct.
E. True - The ventral mesentery (or septum transversum) gives rise to
the lesser omentum, falciform ligament, central tendon of
diaphragm, connective tissue of the liver, Kupffer cells and
coronary ligaments
82.
A. True – The sigmoid mesocolon has an inverted ‘V’ shape with
two limbs diverging from each other at the bifurcation of
the common iliac vessels, on the pelvic brim over the left
sacroiliac joint
B. True – The lateral limb passes forward along the pelvic brim
C. False – The medial limb slopes down to the hollow of the sacrum,
reaches the midline in front of the third sacral vertebra
(at the commencement of the rectum)
D. True – There is no ventral mesentery in relation to the sigmoid
colon
E. False – The sigmoid mesocolon is a double fold of visceral layer of
peritoneum suspended from the sigmoid colon.
83.
A. True - The left umbilical vein that carries oxygenated blood from
the placenta to the foetus becomes the ligamentum teres
after birth
B. False – The gastrosplenic ligament is derived from the dorsal
mesogastrium and extends from the stomach to the
spleen
C. True - Ligamentum venosum carries oxygenated blood coming
from the left umbilical vein to the right hepatocardiac vein
during foetal life. It becomes ligamentous after birth with
the cessation of blood entering via the left umbilical vein
D. False – The median umbilical ligament is the distal part of the
urogenital sinus (earlier the allantoic diverticulum) which
forms the urachus. It becomes ligamentous at birth. It
is attached to the anterior wall of the urinary bladder
E. True – The medial umbilical ligaments are the obliterated distal
parts of the left and right umbilical arteries. The umbilical
arteries carry deoxygenated blood from the foetus to the
placenta during foetal life. The proximal part of the
umbilical arteries become the superior vesical arteries
84.
A. False – The stomach rotates 90° in a clockwise direction
B. False – The duodenum does not rotate during development
C. True- The midgut rotates 90° anticlockwise at the 6th week
intrauterine life and completes its rotation at the 10th week
intrauterine life by rotating another 180° anticlockwise
D. True
E. False – Physiological umbilical herniation occurs between 6th to
10th week intrauterine life and the rotation occurs during
this period
85.
A. True – Kupffer cells are the macrophage cells in the liver. These
cells are derived from the septum transversum which is
the ventral mesogastrium. Hence they develop from
mesoderm
B. False – APUD cells are neuroendocrine cells of the gut wall. These
cells are developed from the neural crest cells
C. False – Paneth cells are present in the intestinal mucosa and
hence derived from the endoderm
D. True – Zona glomerulosa cells are present in the adrenal
cortex.The adrenal cortex is developed from the
intermediate mesoderm and therefore the cells of the zona
glomerulosa are mesodermal in origin. The adrenal medullary
cells are neural crest in origin
E. False – The liver develops from the hepatic diverticulum from the
foregut endoderm. Therefore the hepatocytes (liver
parenchymal cells) are derived from the endoderm
86.
A. False – Biliary atresia occurs due to the non canalization of the bile
duct.
B. Fasle - Hirschprungs disease is due to the absence of nerve plexus
(parasympathetic nerve cells) which develops from neural
crests.
C. True – During the rotation of the mid gut, the two pancreatic
buds (dorsal and ventral) fuse together in an abnormal
way giving rise to a ring of pancreatic tissue around the
duodenum, called the annular pancreas
D. False – An imperforate anus occurs due to the non rupture of the
anal membrane
E. False – A vitelline fistula occurs due to the persistence of the
vitello-intestinal duct which connects the ileum with the
umbilicus
87.
A. False – The greater curvature of the stomach is supplied by the
short gastric, left and right gastroepiploic arteries
The lesser curvature is supplied by the left and right
gastric arteries
B. False
C. True
D. True
E. True
88.
A. True – The stomach is a derivative of the foregut and its artery of
supply is the coeliac trunk and therefore it is supplied
by branches of the coeliac trunk.
B. True– The stomach has a dorsal and a ventral mesentery
(mesogastrium). Hence it is completely covered by the
peritoneum
C. True
D. False – The epithelium lining the stomach is simple columnar
epithelium. This epithelium forms gastric glandsof the gut.
The stratified squamous epithelium is present in the oral
cavity, oesophagus and the lower third of the anal canal
E. True – The peritoneum of the anterior wall of the lesser sac covers
the posterior wall of the stomach and the stomach bed is
covered by the posterior wall of the lesser sac
89.
A. True – Behind the stomach are a group of structures comprising
the stomach bed. Structures forming the stomach bed
include the lesser sac, left crus and the dome of the
diaphragm, splenic artery, body of the pancreas, transverse
mesocolon, upper part of left kidney, left suprarenal gland,
spleen and left colic flexure
B. True
C. True
D. False
E. True
90.
A. True – The duodenum makes a C-shaped loop round the head of
the pancreas, which is opposite the body of L2 vertebra.
The first part lies at the level of L1 vertebra (at the
transpyloric plane), the second on the right side of L2
vertebra, the third crosses in front of L3 vertebra, and the
fourth is on the left of L2 vertebra
B. True – The foregut is supplied by the coeliac trunk. The first part and
the second part of the duodenum upto the duodenal papilla is
derived from the foregut and hence supplied by branches of
the coeliac trunk
C. True – It lies in front of the gastroduodenal artery, bile duct and
portal vein
D. False – The lesser sac, bile duct, gastroduodenal artery, portal
vein and inferior vena cava are posterior relations of the
first part of the duodenum
E. False – It is a derivative of the foregut
91.
A. True – The jejunum has a larger diameter and a thicker wall than the
ileum.
B. True – It has longer vasa recta or straight arteries
C. False –Peyer’s patches or aggregations of lymphoid follicles are
present in the ileum
D. False – The jejunum has less prominent arterial arcades or
anastomotic loops in its mesentery compared to the
ileum
E. False – The jejunum has high narrow windows between the
straight arteries running to its wall whereas the ileum has
low broad windows
92.
A. True – It is situated in the right iliac fossa and is completely
covered by the peritoneum
B. True – It lies on the right iliac fosaa on the fascia over the iliacus and
psoas muscle and femoral and lateral femoral cutaneous
nerves
C. True – As in the rest of the colon the longitudinal muscle layer is
concentrated into three flat bands called taeniae coli which
converge on to the base of the appendix
D. False – It is supplied by branches of the ileocolic artery (anterior
and posterior caecal arteries) which is a branch of the
superior mesenteric artery. The inferior mesenteric artery
supplies the derivatives of the hindgut (from distal 1/3 of the
colon to upper part of anal canal)
E. False - The femoral and lateral cutaneous nerve of the thigh lie
posterior to the caecum
93.
A. True – Also it is crossed by the attachment of the transverse
mesocolon
B. True
C. True – It is supplied by the superior pancreaticoduodenal artery
which is a branch of the gastroduodenal artery. Also it receives
branches from the inferior pancreaticoduodenal artery, a
branch of the superior mesenteric artery
D. False – The foregut gives rise to the duodenum proximal to the
entrance of bile duct (duodenal papilla) and the midgut gives
rise to the duodenum distal to the entrance of the bile duct.
Hence the second part of the duodenum is developed from
both the foregut and the midgut
E. Fasle – Its posteromedial wall receives the common opening of
the bile duct and the pancreatic duct at the
hepatopancreatic ampulla that opens on the summit of
the major duodenal papilla
94.
A. False – Meckel’s diverticulum, a finger-like pouch of the ileum is
located 2 feet proximal to the ileoceacal junction
B. False – It arises from the antimesenteric border of the ileum
C. True - It is a persistent remnant of the yolk sac (vitelline duct)
and may be connected to the umbilicus via a fibrous cord
or fistula
D. False – It may contain gastric, liver or pancreatic mucosal tissue
E. False – It occurs in about 2% of the population
95.
A. True – Posterior to the 1st part of the duodenum, the
gastroduodenal artery, bile duct and portal vein are found
and behind these structures lies the inferior vena cava
B. False - The gall bladder lies anterior to the first part of the duodenum
(duodenal cap)
C. True
D. True
E. False – The pancreas is not a posterior relation of any of the parts of
the duodenum. The head of the pancreas is moulded into the
‘C’ shaped concavity of the duodenum and completely fills it
96.
A. True – Of the four parts of the colon, transverse and sigmoid
parts are suspended by mesenteries but the ascending and
descending colon are plastered on to the posterior
abdominal wall and covered by the peritoneum only on the
anterior surface thus making it retroperitoneal
B. False – The ascending colon and the proximal two-thirds of the
transverse colon are derivatives of the midgut. The distal one-
third of the transverse colon, descending colon, sigmoid colon
and proximal part of the rectum are derivatives of the
hindgut.
C. False – The ascending colon extends upwards from the ileocaecal
junction to the right colic flexure (hepatic flexure)
D. True – It lies on both the iliac fascia and the anterior layer of lumbar
fascia
E. True – The right colic (hepatic) flexure is related to the inferolateral
part of the anterior surface of the right kidney
97.
A. True – The derivatives of the midgut include the duodenum (distal
duodenal papilla), jejunum, ileum, caecum, appendix ,
ascending colon and the proximal 2/3 of the transverse colon
B. True – In relation to the abdominal wall its base is situated one-
third of the way up the line joining the right anterior ileac
spine to the umbilicus (McBurney’s point) and the position of
the base is constant in relation to the caecum although it may
lie in a variety of positions
C. True – It has its own short mesentery named the mesoappendix
D. False – It is supplied by the appendicular artery which is a branch
of the inferior division of the ileocaecal artery. This is an end
artery
E. False – The three taenia coli of the caecum merge to a point at the
base of the appendix. Therfore taenia coli are not present in
the appendix
98.
A. False – Although organogenesis of most of the organs commences
at the 4th week intrauterine life, the appendix is an exception.
It develops at the 10th week intrauterine life
B. False – The appendix is a part of the large intestine. Therefore
the epithelium that lines it is the simple columnar
epithelium
C. True – The appendix is supplied by the appendicular artery
which is a branch of the inferior division of the ileocaecal
artery. The appendicular artery may be thrombosed in
appendicitis which may lead to ischaemic necrosis of the
appendix as there is no collateral circulation
D. False – As the position of the appendix is variable there is no
definitive surface projection. The surface projection of the
fundus of the gall bladder is the tip of the right ninth
costal cartilage
E. True – Althought the commonest position of the appendix is
retrocaecal, it can be in other positions such as pelvic,
retroileal and retrocolic

99.
A. False – The caudate lobe lies between the fissure for the ligamentum
venosum and the inferior vena cava. The quadrate lobe lies
between the fissure for the ligamentum teres and gall
bladder
B. True
C. False – It is the caudate lobe that forms the upper boundary of the
foramen of Winslow
D. True – The anatomical division of lobes is different from the
morphological division of lobes.The morphological division
lies to the right of the gross anatomical plane and therefore
the quadrate lobe is part of the left morphological lobe of the
liver while the caudate lobe belongs partly to the left and
partly to the right morphological lobes of the liver
E. True – The liver is enclosed by the peritoneum except the bare area
which is demarcated by the peritoneal reflections as the
coronary ligaments
100.
A. False – The bile duct is formed by the union of the common hepatic
duct and cystic duct. Left and right hepatic ducts unite to
form the common hepatic duct
B. True – The proximal part of the hepatic diverticulum that grows from
the ventral aspect of the foregut gives rise to the bile duct
and gallbladder. Hence its lining is similar to the gut lining
which is developing from endoderm
C. True – The bile duct has three parts. The upper third lies in the free
edge of the lesser omentum. The middle third is behind the
first part of the duodenum and the lower third lies in a
groove between the back of the head of the pancreas and
the second part of the duodenum
D. True – The lower third of the bile duct passes between the second
part of the duodenum and head of the pancreas
E. False – The bile duct lies in front of the right renal vein
101.
A. True – The portal vein commences at the first lumbar vertebral level
(ie. behind the neck of the pancreas) by the union of the
splenic vein and superior mesenteric vein
B. False – The tail of the pancreas is related to the hilum of the spleen.
The body of the pancreas is related to the hilum of the left
kidney
C. True – The islets of Langerhans (the endocrine part) are developed
from the neural crest cells (neuroectoderm)
D. True
E. False – The tail of the pancreas lies within the lienorenal ligament
which is the part of the dorsal mesentery extending between
the greater curvature of the stomach and spleen
102.
A. True – Organs related to the visceral surface include the left kidney,
stomach, tail of the pancreas and left colic flexure
B. True
C. True
D. True
E. False – The greater omentum is attached to the greater curvature of
the stomach and is connected to the gastrosplenic ligament
which extends from the stomach to the spleen
103.
A. True - The visceral surface is related, with peritoneum intervening, to
the stomach, duodenum, hepatic flexure of the colon and the
right kidney, and these organs may leave impressions on the
liver surface
B. True
C. True
D. True
E. False
104.
A. False – The head of pancreas is moulded to the C-shaped concavity of
the duodenum. It lies over the inferior vena cava and the right
and left renal veins at the second lumbar vertebral level.
The neck of the pancreas lies in front of the commencement
of the portal vein
B. True – The uncinate process arises from the lower part of
the posterior surface of the pancreas as a hook shaped
extension which passes upwards and to the left behind the
superior mesenteric vessels
C. True – An annular pancreas forms due to a defective fusion of the
dorsal and ventral pancreatic buds. Pancreatic tissue is
formed around the duodenum giving rise to an annular
pancreas leading to obstruction of the duodenum
D. True – It is supplied by branches of the superior mesenteric and
coeliac arteries
E. True – The tail of the pancreas extends forwards and to the left from
the anterior surface of the left kidney along with the splenic
vessels and lymphatics and lie within the lienorenal ligament
to reach the hilum of the spleen
105.
A. True – It develops at the 6th week intra uterine life as a condensation
in the dorsal mesogastrium. Other structures derived from
the dorsal mesogastrium include the greater omentum,
lienorenal ligament and gastrosplenic ligament
B. True – When enlarged the spleen may extend beyond the left costal
margin and the palpable spleen is identified by the notch on
its anterior border
C. False – It lies just beneath the left half of the diaphragm between the
9th and 11th ribs.
D. True - Its long axis lies along the shaft of the tenth rib and its lower
pole extends forwards as far as the mid axillary line
E. False – It is supplied by the splenic artery which passes in the
lienorenal ligament extending from the spleen to the kidney
106.
A. False – It passes through the diaphragm at the twelfth thoracic
vertebral level. The oesophagus passes through the
diaphragm at the tenth thoracic vertebral level
B. False – It ends by dividing into the two common iliac arteries at the
fourth lumbar vertebral level
C. True – The main branches of the abdominal aorta fall into three
types: single ventral arteries to the gut and its derivatives
(coeliac, superior and inferior mesenteric), paired branches to
other viscera (suprarenal, renal and gonadal arteries) and
paired branches to the abdominal wall (inferior phrenic and
lumbar arteries).
In addition, a small posterior branch, the median sacral artery
leaves the aorta a little above its bifurcation.
D. False – The inferior vena cava has a longer course in the abdomen
than the abdominal aorta. The abdominal aorta extends from
the twelfth thoracic vertebral level to the fifth lumbar
vertebral level while the inferior vena cava extends from the
fifth lumbar vertebral level to the eighth thoracic vertebral
level
E. True – The thoracic duct passes through the aortic opening of the
diaphragm at the twelfth thoracic vertebral level while lying
between the aorta and the azygos vein
107.
A. True - Paired branch of the abdominal aorta include suprarenal, renal
and gonadal arteries to visceral structures; inferior phrenic and
lumbar arteries to the abdominal wall.
There are four paired lumbar arteries arising from the
abdominal aorta opposite the bodies of upper four lumbar
vertebrae. Inferior phrenic arteries are the first branches of the
abdominal aorta.
Hepatic arteries arise from the coeliac trunk. Subcostal arteries
although paired, arise from the lowest part of the thoracic
aorta and enter the abdomen behind the lateral arcuate
ligaments.
B. False
C. False
D. True
E. True
108.
A. False – It is formed at the fifth lumbar vertebral level by the
confluence of the two common iliac veins behind the right
common iliac artery
B. True
C. True – It passes upwards on to the right of the aorta, grooves the
bare area of the liver and pierces the tendinous part of the
diaphragm at the eighth thoracic vertebral level
D. True – The left suprarenal vein enters the left renal vein while the
right suprarenal vein enters the posterior aspect of the
inferior vena cava behind the bare area of the liver
E. False – Its post hepatic part is derived from the proximal part of the
right vitelline vein. The left vitelline vein disappears after
contributing to a small part of the portal vein
109.
A. False - The inferior vena cava passes through the diaphragm at the
eighth thoracic vertebral level. At the 10th and 12th thoracic
vertebral levels the oesophagus and aorta pass through the
diaphragm
B. True – There is a valve at the termination of the inferior vena cava
which is nonfunctional. It is developed from the right valve of
the sinus venosus
C. False – The post hepatic part of the inferior vena cava (IVC) is
developed from the right hepatocardiac channel (ie. the
proximal part of the right vitelline vein). The renal part of the
IVC is developed from the right subcardinal vein and the
pelvic part from the right sacrocardinal vein
D. True – From above downwards the IVC receives hepatic veins,
inferior phrenic veins, right suprarenal vein, right and left
renal veins, right and left 3rd and 4th lumbar veins and
right testicular or ovarian vein (gonadal vein).
E. False
110.
A. True – The tributaries of the inferior vena cava include left and right
third and fourth lumbar veins, right gonadal vein, left and right
renal veins, right suprarenal vein, left and right inferior
phrenic veins and hepatic veins. The left gonadal vein and the
left suprarenal vein drain into the left renal vein
B. False
C. True
D. False
E. True
111.
A. True – The right and left renal arteries arise from the aorta at the
second lumbar vertebral level just below the origin of the
superior mesenteric artery
B. True - The right renal artery crosses the right crus of diaphragm
and psoas muscle behind the inferior vena cava and the
right renal vein
C. False
D. True – It gives off the ureteric and suprarenal branches
E. False- Both gonadal arteries (testicular and ovarian) arise from
the front of the aorta below the renal arteries but well
above origin of the inferior mesenteric artery
112.
A. False – The left renal vein lies in front of the left renal artery
B. True - The left renal vein is about 3 times as long as the right
renal vein
C. True – The left renal vein has a foetal veinl of origin which is the
subcardinal anastomosis. The right renal vein has no
foetal vessel of origin
D. True – The left renal vein joins the inferior vena cava at a right
angle at the second lumbar vertebral level
E. True – It receives the left suprarenal vein and left gonadal vein
and sometimes the left inferior phrenic vein. The right
renal vein usually drains only the right kidney
113.
A. True – The anterior primary rami of the upper four lumbar nerves
contribute to form the lumbar plexus in the substance of
psoas major muscle
B. False – It is formed by the anterior rami of the upper four lumbar
nerves
C. True – The plexus supplies the lower abdominal wall and mainly
supply the skin and muscles of the lower limb
D. False – The femoral nerve emerges from the lateral border of the
psoas muscle and crosses the iliac fossa between the psoas
and iliacus muscle
E. False – The pudendal nerve is branch given off from the sacral plexus
and contains fibres of first, second and third sacral segments
114.
A. False – The genitofemoral nerve is formed in the substance of
psoas major muscle by the union of branches from L1 and L2,
and emerges from the anterior surface of the psoas major
and runs down on the muscle deep to psoas fascia
B. False
C. True – Just above the inguinal ligament it perforates the psoas fascia
and divides into genital (L2) and femoral (L1) branches. The
genital branch passes through the deep ring and enters the
inguinal canal.
D. True – The genital branch supplies motor fibres to the cremaster
muscle and sensory fibres to the spermatic fascia, tunica
vaginalis of the testis and scrotal skin
E. True
115.
A. False – It contains only the first lumbar segment
B. True - The iliohypogastric nerve, ilioinguinal nerve, lateral cutaneous
nerve of the thigh and the femoral nerve emerge from the
lateral border of the psoas muscle, in that order from above
downwards
C. True – The nerve pierces the lower border of internal oblique and
enters the inguinal canal and emerges through the superficial
inguinal ring
D. True – The structures supplied by the ilioinguinal nerve include
external oblique, internal oblique, transversus abdominis
muscles of the anterior abdominal wall, skin of the upper
medial aspect of the thigh, root of the penis, anterior one-
third of the scrotal skin, mons pubis and labium majora
E. False – It is both sensory and motor
116.
A. False – It is given off just below the origin of the renal artery and
well above the inferior mesenteric artery
B. True – They pass steeply downwards over psoas and genitofemoral
nerve
C. True – The artery on the left side crosses in front of the ureter and
genitofemoral nerve
D. True – The artery on the right side crosses in front of the inferior
vena cava, ureter and genitofemoral nerve
E. True – It supplies the middle portion of the ureter
117.
A. True – It passes down on the psoas major muscle under cover of
the peritoneum.
B. True – Both ureters have three anatomic sites that show narrowings.
They are located at the pelviureteric junction, where it crosses
the pelvic brim and as it enters the bladder wall
C. False – It lies posterior to the gonadal vessels
D. True – The ureter enters the pelvis by crossing the bifurcation of the
common iliac artery anteriorly over the sacroiliac joint
E. False – The ureter is developed from the proximal part of the ureteric
bud which arises as an outgrowth of the mesonephric duct.
The paramesonephric duct gives rise to the duct system in the
female genital tract (Fallopian tube, uterus, cervix and upper
vagina)
118.
A. True - Both ureters lie on the posterior abdominal wall covered
by the peritoneum
B. True – Lower down it is crossed anteriorly by the right colic and
ileocolic vessels and by the root of the mesentery.
C. True – The upper end is supplied by the ureteric branch of the renal
artery. The middle region of the ureter is supplied by the
abdominal aorta, gonadal, common iliac and internal iliac
arteries. The lower end is supplied by branches from inferior
and superior vesical and uterine arteries.
D. True – On a radiograph the ureter lies medial to the tips of the
transverse processes of lumbar vertebrae
E. True – The upper part of the right ureter lies behind the third
part of the duodenum
119.
A. False - The suprarenal glands lie at the upper pole of each kidney
and are asymmetrical. The right gland is pyramidal and
the left is crescentic in shape.
B. True – They lie within their own compartment of renal fascia
C. False - The glands have a rich arterial supply and each receives
blood from three sources which are the renal artery, inferior
phrenic artery, and a branch directly from the aorta. In
contrast there is usually a single vein draining it.
D. True – The inferior vena cava overlaps the anteromedial surface
of the right suprarenal gland
E. False – The medulla develops from neural crest cells. The cortex
is developed from the intermediate mesoderm
120.
A. False – The anterior surface of the right suprarenal gland is
overlapped medially by the inferior vena cava and the rest of
the anterior surface is in contact with the bare area of the
liver. The anterior surface of the upper part of the left
suprarenal gland is covered by the peritoneum of the lesser
sac and the lower part is in contact with the body of the
pancreas and splenic vessels
B. True – The left gland lies on the left crus of the diaphragm and
overlaps the front of the kidney
C. True – The suprarenal gland receives arterial supply from three
sources. Inferior suprarenal artery from the renal artery,
middle suprarenal artery from the abdominal aorta and the
superior suprarenal artery from the inferior phrenic artery
D. False – The zona glomerulosa is in the adrenal cortex. The adrenal
cortex is developed from the intermediate mesoderm and
the adrenal medulla is developed from the neural crest cells
E. True – Preganglionic sympathetic fibres arising from the spinal cord
pass via the sympathetic chain without relay as the greater,
lesser and least splanchnic nerves. The greater splanchnic
nerve ends in the cells of the adrenal medulla
121.
A. True - A small triangular part of the costodiaphragmatic recess of
the pleura lies behind the diaphragm and is an important
posterior relation of the kidney, which is at risk in the lumbar
approach to the kidney.
B. True - The upper pole of the right kidney overlies the twelfth rib,
that of the left kidney the eleventh rib
C. True – The subcostal vein, artery and nerve, on emerging beneath
The lateral arcuate ligament, lie behind the kidney, as do the
iliohypogastric and ilioinguinal nerves as they emerge from the
lateral border of psoas.
D. True - The hilum of the left kidney is related to the pancreas and
on the right to the second part of the duodenum.
E. False - The hilum of the left kidney lies just above and that of the
right just below the transpyloric plane
122.
A. True – The anterior relations of the right kidney are right suprarenal
gland,liver, hepatic flexure of colon, small intestine and second
part of the duodenum.
The anterior relations of the left kidney are left suprarenal
gland, stomach, spleen, pancreas, colon and small intestine
B. True
C. False
D. True
E. False – Subcostal vessels are a posterior relation of both kidneys.
123.
A. False - The kidney develops from two embryonic parts namely the
ureteric bud and metanephric blastema. The metanephric
blastema gives rise to the Bowmans capsule, proximal
convoluted tubule, loop of Henle and distal convoluted tubule.
The ureteric bud gives rise to the collecting ducts, minor
calyces, major calyces, pelvis of the kidney and ureter
B. False
C. True
D. True
E. True
124.
A. True – Androgens are secreted by the zona reticulosa cells of the
adrenal cortex
B. True – The adrenal cortex develops from the intermediate mesoderm
close to the area of the kidney. The adrenal medulla develops
from the neural crest cells.
C. False – The adrenal cortex in supplied from the ………….. It is
the adrenal medulla that is supplied by the myelinated
preganglionic sympathetic fibers which synapse with the
medullary cells.
D. True – The adrenal cortex secretes steroid hormones. The cells that
secrete steroids have an abundance of smooth endoplasmic
reticulum. The rough endoplasmic reticulum is found in
abundance in protein secreting cells
E. True - All endocrine glands have a rich reticulin fibre network.
Pelvis and Perineum

125. Regarding the pelvis

A. The sacro-iliac joint is a synovial joint
B. The sacrotuberous ligament lies anterior to the sacrospinous ligament
C. The sub public angle is wider in male than in female
D. The piriformis muscle leaves the pelvis through the greater sciatic
foramen
E. The inferior pubic rami are everted in males
126. The pelvic outlet is formed by the
A. ischial tuberosities
B. sacrotuberous ligaments
C. alar of the sacrum
D. ischiopubic rami
E. sacroiliac ligaments
127.The levator ani muscle

A. has superior and inferior surfaces covered with fascia
B. is supplied by a branch from the 1st sacral nerve
C. is inserted into the perineal body
D. has fibres forming a sling around the anorectal junction
E. forms the medial boundary of the ischioanal fossa
128. Pelvic peritoneum in the female covers the

A. Superior surface of the bladder
B. Anterior surface of the lower third of the rectum
C. Lateral surface of the urinary bladder
D. Fundus of the uterus
E. Anterior surface of the vagina
129. The rectum in the male

A. rests in front of the 3rd,4th and 5th sacral vertebrae
B. is covered by the peritoneum in its upper 1/3 in front and sides
C. is derived from the lower part of the urogenital sinus
D. is lined by the stratified squamous non keratinizing epithelium
E. drains its upper part to the pre aortic lymph nodes
130. Regarding the anal canal

A. It has internal sphincter composed of striated muscle
B. Its upper part is developed from the hindgut
C. Its lower part is derived from the urogenital sinus
D. Superficial inguinal nodes drain lymph from its upper third
E. Pecten is lined by a simple columnar epithelium
131. Regarding the anal canal

A. The pectinate line separates the ectodermal and endodermal parts
B. The middle rectal artery supplies it
C. The pecten is lined by stratified squamous keratinized epithelium
D. It drains into the superior rectal veins
E. Pectinate line is a site of portosystemic anastomosis
132. Regarding the rectum

A. It is covered by the peritoneum throughout
B. It is developed from the lower part of the urogenital sinus
C. It is lined by a simple columnar epithelium
D. It is supplied by the inferior rectal artery
E. In the male the prostate can be palpated on its anterior wall by per
rectal examination
133. The female urethra is

A. lined by the stratified squamous keratinizing epithelium
B. ten centimeters long
C. supplied by the internal pudendal artery
D. derived from the mesonephric duct
E. drained into the internal iliac nodes
134. Regarding the urinary bladder

A. Its epithelium is derived from endoderm
B. The extrophy of the bladder is due to persistence of the urachus
C. Has no peritoneal covering
D. Is lined by a stratified squamous non keratinizing peithelium
E. Its apex is connected to the umbilicus by the median umbilical
ligament
135.The testis
A. develops in the paraxial mesoderm
B. drains its lymph to the para aortic nodes
C. has the appendix testis which is a derivative of the mesonephric duct
D. is supplied by sympathetic nerve firbres originating from the T10
segment
E. contains diploid cells in the wall of seminiferous tubule
136. The testis
A. The tunica vaginalis completely encloses the testis
B. Has the epididymis located along its anterior border
C. Is supplied by sympathetic nerves arising from T10 spinal segment
D. Has cells of Leydig that secrete testosterone
E. The veins drain into the inferior vena cava on both sides
137.The ductus deferens

A. is lined by a cuboidal epithelium
B. develops from the mesonephric duct
C. passes through the inguinal canal
D. crosses the ureter in the region of the ischial spine
E. joins with that of the opposite side to form the ejaculatory duct
138. Regarding ductus deferens

A. It begins as a continuation from the upper pole of epididymis
B. It is palpable in spermatic cord
C. It is supplied by a branch of the testicular artery
D. It leaves the spermatic cord at the deep inguinal ring
E. The ampulla of the vas lies behind the base of the bladder
139.Pelvic part of the urogenital sinus in the male gives rise to the
A. penile urethra
B. ejaculatory duct
C. seminal vesicle
D. prostatic urethra
E. membranous urethra
140.Regarding the prostate gland

A. Its base lies against the neck of the bladder
B. It has a skeletal muscle covering
C. Its posterior lobe is devoid of glandular tissue
D. The normal gland can be palpated by per rectal examination
E. Carcinoma of the prostate can directly spread to the pelvic bones
141.Regarding the seminal vesicles

A. They lie on the posterior surface of the bladder
B. The medial surface is related to the vas deferens
C. Develop from the paramesonephric ducts
D. Store spermstozoa
E. Are palpable by per rectal examination
142. The penis
A. consists of two masses of erectile tissue
B. is developed from the genital swellings
C. drains into superficial inguinal lymph nodes
D. is supplied by a branch of the pudendal artery
E. has the bulbospongiosis muscle attached to the side of the pubic arch
Female reproductive organs
143. Regarding the vagina

A. The upper part develops from the urogenital sinus
B. The lower half lies within the perineum
C. It receives an arterial supply from the uterine artery
D. Its posterior wall is completely covered by the peritoneum
E. Its posterior wall is longer than the anterior wall
144. The ovary

A. Is developed from the paraxial mesoderm
B. when diseased will cause pain on the inner side of the thigh on the
same side
C. is supplied by the uterine artery
D. has its own mesentery
E. is attached to the uterus by the ligament of the ovary
145. Regarding the uterus

A. Lymph from the upper part of the body drains in to the para aortic
nodes
B. It is normally anterverted and retroflexed
C. Its body is enclosed by the peritoneum
D. The anterior surface of the cervix is attached to the bladder above the
trigone
E. It is developed from the paramesonephric ducts
146. The broad ligament

A. has the ovary on its anterior margin
B. has the fallopian tube at its upper border
C. has an attachment to the labium majus
D. contains remnants of the mesonephric tubules
E. extend from the uterus to the lateral wall of the pelvis
147. Major supports of the uterus include

A. levator ani muscle
B. round ligament
C. pubo-cervical ligament
D. utero-sacral ligament
E. perineal body
148. Dizygotic twins

A. always have a common chorionic cavity
B. are always of the oppsosite sex
C. have separate amniotic cavities
D. have two placentae
E. aAre commoner than monozygotic twins
149. The uterine tube

A. is the site of fertilization of the ovum
B. is narrowest at the ampulla
C. develops from the paramesonephric ducts
D. is lined by a simplecolumnar ciliated epithelium
E. has an arterial supply from the ovarian artery
150. Which of the following are homologous

A. Penis and clitoris
B. Scrotum and labia minora
C. Testis and ovary
D. Vas deferens and fallopian tube
E. Penile urethra and vaginal fornices
151. Following are branches of internal iliac artery

A. Iliolumbar artery
B. Uterine artery
C. Median sacral artery
D. Inferior epigastric artery
E. Superior gluteal artery
152. The pudendal nerve

A. Consists of second, third and fourth sacral spinal segments
B. Leaves the pelvis through the obturator foramen
C. Lies in the medial wall of the ischiorectal fossa
D. Gives off the dorsal nerve of the penis
E. Supplies the deep transverse perinei muscle
153. The uterine artery

A. is a branch of the posterior division of the internal iliac artery
B. lies within the broad ligament
C. passes above the ureter
D. anastomoses with obturator artery
E. supplies the ovaries
154. The sacral plexus

A. Lies on the obturator internus muscle
B. Receives a contribution from the lumbosacral trunk
C. Supplies the quadratus femoris muscle
D. Gives branches to supply the perianal skin and skin of buttock
E. Supplies the gluteal muscles
155. The internal iliac artery

A. begins in front of the sacroiliac joint
B. ends near the upper margin of the lesser sciatic foramen
C. is crossed anteriorly by the ureter at the pelvic brim
D. gives off the the median sacral artery from its posterior division
E. supplies the vas deferens
Perineum
156. Contents of the deep perineal pouch in the male include

A. membranous urethra
B. perineal membrane
C. internal pudendal vessels
D. dorsal nerve of the penis
E. bulb of the penis
157. Structures that drain directly to the superficial inguinal lymph

nodes include
A. scrotum
B. testis
C. glans penis
D. labia minora
E. clitoris
158.Muscles attached to the perineal body include

A. levator ani
B. superficial transverse perinei
C. external anal sphincter
D. deep transverse perinei
E. ischiocavernosus
159.Muscles found within the superficial perineal pouch include

A. bulbospongiosus muscle
B. ischiocavernosus mucle
C. sphincter urethrae
D. deep transverse perineal muscle
E. superficial transverse perineal muscle
Pelvis and Perineum : Answers and Explanations

125.
A. True – The articular surfaces of this joint are jagged and very little
movement is present at this joint. With ageing fibrous
adhesions occur and gradual obliteration of the joint cavity
takes place; earlier in males and after the menopause in
females
B. False – The sacrotuberous ligament is found posterior to the
sacrospinous ligament. The sacrotuberous ligament is a flat
fibrous band of great strength having a wide attachment. It is
attached to the posterior border of the ilium and posterior
superior and posterior inferior iliac spines, to the transverse
tubercles of the sacrum and to the upper part of the coccyx
and is inserted to the medial surface of the ischial tuberosity
C. False – The subpubic angle is larger in females forming an obtuse
angle wich is considered as a sex difference
D. True - The piriformis muscle arises from the front of the middle
three pieces of the sacrum within the pelvis and leaves the
pelvis through the greater sciatic foramen to be attached to
the greater trochanter of the femur
E. True – The crus of the penis is attached to this everted inferior pubic
ramus
126.
A. True – The pelvic outlet is bounded anteriorly by the pubic
symphysis, arcuate or inferior pubic ligament, posteriorly by
the coccyx and on each side by the ischiopubic rami, ischial
tuberosities and sacrotuberous ligaments.
B. True
C. False – The alar of the sacrum forms a part of the pelvic inlet.
D. True
E. False – Sacroiliac ligaments are ligamentous bands that surround the
capsule of the sacroiliac joint.
127.
A. True – The pelvic surface of the levator ani and coccygeus is covered
by the superior fascia of the pelvic diaphragm. The inferior
surface is covered by the inferior fascia of the pelvic
diaphragm which blends with the obturator fascia laterally
B. False – It is mainly supplied from the sacral plexus by branches of S3
and S4 spinal segments. Puborectalis may be supplied from
below by the perineal branch of S4 and inferior rectal branch
of the pudendal nerve, in common with the external anal
sphincter
C. True - The muscles attached to the perineal body include the
external anal sphincter, pubovaginalis (levator prostate), a
part of levator ani, bulbospongiosus and the superficial and
deep transverse perinei muscles
D. True – Fibres arising more anteriorly from the inner aspect of the
body of the pubis form a sling around the anorectal junction
and this part of the muscle is called the puborectalis.
Contraction of this muscle sling helps in defaecation
E. True – The ischioanal fossa is wedge shaped. The external sphincter
of the anal canal and the leavator ani muscles form the
medial wall of each fossa and the lateral wall is formed by the
ischial tuberosity with the obturator internus muscle
128.
A. True – The pelvic peritoneum covers the superior surface of the
bladder and is reflected from a little in front of the posterior
margin of this surface on to the undersurface of the uterus
B. False – The upper one-third of the rectum is covered by the
peritoneum in front and on the sides; the middle one-third is
covered only in front and the lower one-third which is dilated
to form the ampulla is devoid of peritoneum. It is reflected
forwards on to the upper part of the vagina to form the
rectouterine pouch (of Douglas)
C. False
D. True - The fundus, the anterior or vesical surface and the posterior
or the intestinal surface of the uterus are covered by the
peritoneum
E. False – The only part of the vagina to have a peritoneal covering is
the posterior fornix. This peritoneal covering is the part that
forms the front of the rectouterine pouch (of Douglas)
129.
A. True – The rectum lies in front of the sacrum from the mid of 3rd
sacral segment and descends up to the tip of the coccyx
B. True – The rectum in the male is covered by the peritoneum in its
upper 1/3 in front and on the sides and in its middle 1/3
only in front
C. False – The rectum is developed from the distal part of the hindgut.
The urogenital sinus gives rise to the urinary bladder and
urethra
D. False – The rectum is lined by the simple columnar epithelium with
goblet cells. Only the lower 1/3 of the anal canal is lined by
the stratified squamous non keratinizing epitelium
E. True – Lymphatics of the upper rectum drains along the inferior
mesenteric artery to pre aortic nodes. The lymphatics from
the lower rectum reach the internal iliac nodes along the
middle and inferior rectal vessels
130.
A. False – The anal canal consists of internal and external sphincters.
The internal anal sphincter is continuous with the inner
circular and outer longitudinal muscle layers of the anal
canal. Hence it is developed from the splanchnic mesoderm
and consists of smooth muscle. The external anal sphincter
consists of three parts, namely, deep, superficial and
subcutaneous parts derived from the somatic mesoderm
(striated muscle)
B. True – The upper part of the anal canal above the pectinate line is
developed from the hindgut and the lower part below the
pectinate line is developed from the proctodeum (ectodermal
origin)
C. False – refer B above
D. False – The upper part of the anal canal above the pectinate line
drains into the internal iliac nodes. The lower part of the anal
canal below the pectinate line drains into the superficial
inguinal nodes
E. True – The pecten is the area below the pectinate line and is lined by
a stratified squamous non keratinized epithelium. The area
above the pectinate line (anal column area) is lined by a
simple columnar epithelium
131.
A. True – The anal canal above the pectinate line is lined by a simple
columnar epithelium and below the pectinate line is lined by
a stratified squamous non keratinized epithelium
B. False – The superior rectal branches and the inferior rectal artery
supply the mucosa above and below the pectinate line
respectively. The middle rectal artery supplies the rectum
C. False– The pecten area is lined by the stratified squamous non
keratinized epithelium (ectodermal)
D. True – The area above the pectinate line drains into the superior
rectal vein (a tributary of portal vein) and the area below the
pecten drains into the inferior rectal vein (systemic veins)
E. True – In portal hypertension this anastomosis dilates to form the
internal haemorrhoids (internal piles) as it is a portosystemic
anastomosis
132.
A. False - Only the front and sides of the upper third and the front of the
middle third of the rectum are covered by the peritoneum.
The lower third is devoid of a peritoneal covering
B. False – The rectum is developed from the distal part of the hindgut
and the mucosa is endodermal in origin. The urogenital sinus
gives rise to the urinary bladder and urethra
C. True – It is lined by the gut epithelium which is the simple columnar
epithelium
D. False – It is supplied by the superior rectal artery (a branch of the
Inferior mesenteric artery), middle rectal artery (a branch of
the internal iliac artery) and median sacral artery (a branch of
the abdominal aorta). The inferior rectal artery supplies the
anal canal
E. True – By per rectal examination in the male, the prostate, seminal
vesicle, base of the urinary bladder and the rectovesical
pouch (if fluid is filled) could be palpated on the anterior
rectal wall. In the female all internal reproductive organs
could be felt. In both sexes some bony parts namely the lower
sacrum and coccyx, the ischial spine and the ischial tuberosity
could be palpated on the posterior rectal wall
133.
A. False - The uppermost part of the female urethra is lined by the
transitional epithelium followed by the stratified squamous
non keratinizing epithelium at the external urethral meatus.
B. False - The urethra in the female is 4 cm long. During later stages of
pregnancy it can get stretched and could increase its length
up to 10 cm.
C. True - Upper part of the female urethra is supplied by the inferior
vescical and vaginal arteries with the lower end being
supplied by internal pudendal artery
D. False - It is developed from the lower part of the urogenital sinus. The
remnants of the mesonephric duct in the female is seen as
epoophoron and paroophoron.
E. True - Lymph from the female urethra mainly drains into internal
iliac nodes but some may reach the external iliac nodes.
134.
A. True – The urogenital sinus becomes the bladder and therefore
the epithelium of the bladder is endodermal and the
surrounding mesoderm which is developed from the
splanchnic mesoderm forms the muscle and connective
tissue. The incorporation of the lower ends of mesonephric
the ducts into the posterior part of the bladder forms the
trigone which is intermediate mesoderm in origin
B. False – The fusion of the anterior abdominal wall below the umbilicus
is facilitated by the migrating primitive streak mesoderm. If
this migration fails, the anterior abdominal wall will not fuse
leading to exposure of the bladder wall. This is called the
extrophy of the bladder. Persistence of the urachus leads to
urine discharge from the umbilical region
C. False – The superior surface and the upper part of the posterior
surface are covered by the peritoneum in both sexes
D. False – It is lined by the transitional epithelium
E. True – The apex of the bladder points anteriorly and lies behind
symphysis pubis. It is connected to the umbilicus by the
median umbilical ligament – which is the fibrosed (obliterated)
urachus
135.
A. False – Both gonads (testis and ovary) develop in the gonadal ridge in
the pelvic region of the intermediate mesoderm. The paraxial
mesoderm forms the dermatomes, myotomes and
sclerotomes of each spinal segment
B. True – The testis drains into para aortic nodes lying alongside the
aorta at second lumbar vertebral level and do not drain into
inguinal nodes although the overlying scrotal skin does
C. False – The derivatives of the mesonephric duct include efferent
ducts, epidydimis and vas deferens in the male and
epoophoron and paroophoron in the ffemale. Appendix testis
and utriculus prostaticus are the remnants of the
paramesonephric duct attached to the testis in the male
D. True – The sympathetic preganglionic fibres originate from the tenth
thoracic segment of the spinal cord and pass in the greater or
lesser splanchnic nerves to the celiac ganglia and synapse
there. The postganglionic sympathetic fibres reach the testis
via the testicular artery
E. True – The primary spermatogonia in the walls of the seminiferous
tubules are diploid cells.
Secondary spermatogonia, spermatids and sperms are haploid
cells.
136.
A. False – It covers the whole testis except the posterior border
B. False – The epididymis is attached to its posterolateral surface
C. True
D. True – Cells of Leydig or interstitial cells are found as clusters
scattered among the cells of connective tissue in between the
seminiferous tubules. They constitute the endocrine portion of
the testis and secrete testosterone
E. False – The veins emerging from the testis form the pampiniform
plexus. In the inguinal canal the plexus separates out into
about four veins which join to form two that leave the deep
inguinal ring. The left vein drains into the left renal vein where
the right drains directly into the inferior vena cava.
137.
A. False – It is lined by a pseudostratified columnar epithelium with
stereocilia
B. True - The mesonephric duct gives rise to the efferent ducts,
epididymis and vas deferens in the male
C. True - It passes through the inguinal canal and enters the abdomen
by emerging through the deep inguinal ring
D. True – It passes downward and backwards on the lateral wall of the
pelvis and crosses the ureter in the region of the ischial spine
E. False - It joins with the duct of the seminal vesicle to form the
ejaculatory duct. The ejaculatory ducts pierce the posterior
wall of the prostate and open into the prostatic urethra
138.
A. False – It begins as a continuation from the tail of the epididymis
B. True
C. False – The artery to the ductus deferens arises from the superior vesical (or
sometimes from the inferior vesical) artery. The epididymis is
supplied by a branch of the testicular artery
D. True
E. True – The part of the ductus lying behind the base of the bladder is dilated
and tortuous, and is known as the ampulla
139.
A. False - The urogenital sinus has a definitive part, pelvic part and a
phallic part. The definitive part gives rise to the urinary
bladder, the pelvic part gives rise to the ejaculatory duct,
seminal vesicle, prostate, prostatic urethra and membranous
urethra in the male. The phallic part gives rise to the penile
urethra.
B. True
C. True
D. True
E. True
140.
A. True - Prostate gland is conical in shape with its base lying against
the neck of the bladder and the apex lying inferiorly against
the urogenital diaphragm
B. False – The smooth muscle of the bladder wall pass without
interruption to the prostate as the prostate is continuous
with the neck of the bladder
C. False – The prostate has five lobes namely the anterior lobe, median
or middle lobe, posterior lobe and left and right lateral lobes.
The anterior lobe lies in front of the urethra and is devoid of
glandular tissue. All other lobed consist of glandular tissue
D. True – The following can be felt by the index finger inserted into the
anal canal and rectum in the male
Opposite the terminal phalanx- contents of rectovesical
pouch, posterior surface of the bladder, seminal vesicles and
vas deferens
Opposite the middle phalanx – the prostate
Opposite the proximal phalanx – perineal body, urogenital
diaphragm and bulb of the penis
E. True – The prostatic venous plexus is directly connected to the
vertebral veins. During abdominal straining or coughing the
prostatic venous blood could flow in a reverse direction and
enter vertebral veins. The frequent occurrence of metstases of
carcinoma of prostate in the lower part of the vertebral
column and pelvic bones could be explained due to the above.
141.
A. True - They lie on the base of the bladder above the prostate on the
posterior aspect. The left and right vas deferens lie side by
side on the posterior surface and separates the seminal
vesicles from each other
B. True – The terminal part of the vas deferens lies on the medial
surface of each seminal vesicle
C. False – It develops from the mesonephric duct. The paramesonephic
ducts in the male regress and its remnants are the utriculus
prostaticus and appendix testis
D. False – They do not store spermatozoa but produce about 60% of the
seminal fluid which contains substances which are essential
for the nourishment of spermatozoa
E. True - By per rectal examination in the male, the prostate, seminal
vesicle, base of the urinary bladder and the rectovesical
pouch (if fluid is filled) could be palpated on the anterior
rectal wall. In the female all internal reproductive organs
could be felt. In both sexes some bony parts namely the lower
sacrum and coccyx, the ischial spine and the ischial tuberosity
could be palpated on the posterior rectal wall
142.
A. False – The root of the penis consists of three masses of erectile
tissue namely the bulb of the penis, and right and left crura
of the penis. The bulb continues forward in to the body of the
penis as the corpus spongiosum. The two crura converge
forwards and lie side by side in the dorsal part of the body of
the penis forming corpora cavernosa
B. False – The penis is developed from the genital tubercle present in
the indifferent stage of external genitalia. In the female it
gives rise to the clitoris. The genital swellings give rise to the
scrotum in the male and the labia majora in the female
C. True - The skin of the penis drains into the superficisl inguinal nodes
and the deep structures of the penis drains into internal iliac
nodes
D. True – The deep arteries of the penis supply the corpora cavernosa,
the artery of the bulb supplies the corpora cavernosa, the
artery of the bulb supplies the corpus spongiosum and the
dorsal artery of the penis also supplies it. All three arteries are
branches of the internal pudendal artery
E. False - The bulbospongiosus muscle covers the bulb of the penis. The
ischiocavernosus muscle covers the crus of the penis which is
attached to the side of the pubic arch
Female Reproductive Organs
143.
A. False –The upper part develops from the paramesonephric ducts and
the lower part is developed from the urogenital sinus
B. True – The upper half of the vagina lies above the pelvic floor and
lower half lies within the perineum
C. True – The vaginal branch of the internal iliac artery is supplemented
by the uterine, inferior vesical and middle rectal vessels. The
branches of these vessels make good anastomotic
connections on the vaginal wall
D. False – The posterior fornix is covered by the peritoneum of the front
of the rectouterine pouch (of Douglas). It is the only part of
the vagina to have a peritoneal covering
E. True – Also the posterior fornix is deeper than the other fornices
144.
A. False - The ovary develops from the gonadal ridge formed by the
intermediate mesoderm. The germ cells develop in the wall of
the yolk sac and migrate to the developing gonads at sixth
week intrauterine life. Paraxial mesoderm gives rise to
segmental muscles of the vertebral column, ribs, vertebrae
and annulus fibrosus of intervertebral discs.
B. True - The ovary is closely related to the obturator nerve from which
it is separated from the parietal peritoneum. Therefore a
diseased ovary can cause referred pain along the cutaneous
distribution of the obturator nerve which is the inner side of
the thigh.
C. False - The ovary is supplied by the ovarian artery, a branch of the
abdominal aorta. The uterine artery supplies the uterus and
the fallopian tubes.
D. True - The anterior border of the ovary is attached to the broad
ligament (posterior leaf) by a fold of peritoneum called
mesovarium.
E. True - The lower pole of the ovary is attached to the uterus by the
ligament of ovary.
145.
A. True - Lymph from the upper part of body, fundUs and fallopian tube
drains into para aortic nodes. (some may drain into external
iliac nodes). Lower part of the uterine body drains into
external iliac nodes, and the cervix drains into both external
and internal iliac nodes and to sacral nodes.
B. False - The normal position of the uterus is anteverted and
anteflexed. Other abnormal positions are
C. True - The body of the uterus is enclosed by the peritoneum which
becomes the broad ligament laterally. The posterior surface
of the cervix is also covered by the peritoneum but the
anterior surface of the cervix has no peritoneal covering.
D. True - Due to this relationship and being deep to the vescicouterine
pouch, the anterior surface of the cervix has no peritoneal
covering.
E. True - The uterus develops from the lower third of the fused
paranesonephric ducts while the fallopian tube develops from
the upper 2/3 of the paramesonephric ducts.
146.
A. False - The anterior layer of the round ligament is bulged forwards by
the round ligament of the uterus just below the uterine tube.
The ovary is related to the posterior layer of the ligament from
which it is suspended (mesovarium).
B. True - The upper border of the broad ligament is free forming the
mesosalpinx containing the fallopian tube
C. False - The broad ligament extends from the side wall of uterus to the
pelvic wall. It is the round ligament of the uterus that extends
from the junction of the uterus and the fallopian tube and
passing through the inguinal canal gets attached distally to
the fibro fatty tissue of the labium majus.
D. True - Between the two layers of the broad ligament lie the fallopian
tubes, lymphatics, round ligament, ligament of the ovary and
remnants of the mesonephric tubules namely paroophoron
and epoophoron.
E. True
147.
A. True – The uterus is supported by the tone of the levator ani muscles
and condensations of pelvic fascia, which form three
important ligaments, namely, transverse cervical (cardinal)
ligaments, pubocervical ligaments and uterosacral ligaments.
B. False - The round ligament of the uterus is the counterpart of the
gubernaculums testis in the male
C. True
D. True
E. True
148.
A. False - Dizygotic twins are produced by the fertilization of two ova by two
separate sperms giving rise to two separate zygotes. They will not
resemble each other can have the same or opposite sex, have a
different genetic constitution, always have two placentae, two amniotic
cavities and two chorionic cavities. Of all twins 70% are dizygotic and
30% are monozygotic
B. False
C. True
D. True
E. True
149.
A. True – the uterine tube receives the ovum from the ovary and
provides a site where the fertilization of the ovum can takes
place
B. False - The narrowest part of the tube is the region called the
isthmus. The ampulla is widest part of the tube
C. True
D. True – It is lined by the simple columnar ciliated epithelium
E. True – It is supplied by the uterine artery of the internal iliac artery
and the ovarian artery of the abdominal aorta
150.
A. True
B. False - The homologous structure of the scrotum is the labia majora.
The homologous structure of the labia minora is the penile
urethra.
C. True
D. False - Vas deferens develops from the mesonephric duct. The
remnants of the vas deferens in the female is the paroophoron
and epoophoron which are its homologous structures. The
Fallopian tube develops from the upper 2/3 of
paramesonephric ducts is the utriculus prostaticus and
appendix testis which is its homologous structure.
E. False - Homologous structure of the penile urethra is the labia minora
and the vestibule.
151.
A. True – The internal iliac artery divides into anterior and posterior
divisions. Branches arising from the posterior division are
iliolumbar, lateral sacral and superior gluteal. The anterior
division gives off nine branches, three associated with the
bladder (superior vesical, obliterated umbilical and inferior
vesical), three other visceral branches (middle rectal, uterine
and vaginal), and three parietal branches (obturator, internal
pudendal and inferior gluteal)
B. True
C. False – The median sacral artery arises from the back of the
abdominal aorta above its bifurcation and ends in front of the
coccyx.
D. False – The inferior epigastric artery arises from the external iliac
artery near its lower end just above the inguinal ligament
E. True
152.
A. True – The pudendal nerve is a branch of the sacral plexus consisting
of second, third and fourth sacral segments.
B. False – The pudendal nerve enters the pudendal canal on the lateral
wall of the ischiorectal fossa
C. False
D. True – The dorsal nerve of the penis (clitoris) is one of the terminal
branches (the other terminal branch is the perineal nerve)
which runs forward deep to perineal membrane and piercing
it supplies the skin of the penis (clitoris).
E. True – The motor part of the perineal nerve (branch of pudendal
nerve) supplies the ischiocavernosus, bulbospongiosus,
superficial and deep transversus perinei and sphincter
urethrae muscles
153.
A. False – It arises from the anterior division of the internal iliac artery
B. True - It runs medially in the base of the broad ligament passing
above the ureter to reach the junction of the cervix and the
body of the uterus
C. True
D. False – Near the entrance of the uterine tube it turns laterally to
supply the tube and anastomoses with the tubal branches of
the ovarian artery
E. False – The ovary is supplied by the ovarian artery, a branch of the
abdominal aorta given off just below the renal artery
The uterine artery supplies the body, fundus and cervix of the
uterus, and gives off branches to supply the uterine tubes and
the vagina
154.
A. False – It rests upon piriformis muscle and is covered anteriorly by
the parietal pelvic fasicia
B. True – It is formed by the lumbosacral trunk and the anterior rami of
the upper four sacral nerves
C. True – It is supplied by the nerve to quadratus femoris (anterior
divisions of L4,L5,S1). This nerve also supplies the inferior
gamellus and the hip joint
D. True – The perineal branch of S4 which passes between the
coccygeus and levator ani enters the ischioanal fossa and
supplies the perianal skin. The perforating cutaneous nerve
arising from S2 and S3 supplies the skin of the buttock
E. True – The superior gluteal (L4, L5, S1) and inferior gluteal (L5, S1, S2)
nerves supply the gluteal muscles
155.
A. True – The common iliac artery bifurcates at the pelvic brim
oppostite the sacroiliac joint to form the external and internal
iliac arteries
B. False – It passes downwards from its origin and divides into an
anterior and a posterior division at the upper margin of the
greater sciatic foramen
C. True
D. False – The branches of the posterior division of the internal iliac
artery iliolumbar, lateral sacral and superior gluteal arteries.
The median sacral artery arises from the posterior aspect of
the aorta a little above the point where it bifurcates into the
two common iliac arteries
E. True – The inferior vesical artery given off from its anterior division
supplies the trigone and lower part of the bladder, the ureter,
vas deferens, seminal vesicle and prostate.
Perineum
156.
A. True - The contents of the deep perineal pouch are the membranous
urethra, bulbo urethral glands, sphincter urethrae and deep
transverse perinei muscle, dorsal nerve of penis, internal
pudendal artery, artery to the bulb and dorsal artery of penis.
The perineal membrane forms the inferior boundary of the
deep perineal pouch and therefore not a content. Bulb of the
penis is present in the superficial perineal pouch.
B. False
C. True
D. True
E. False
157.
A. True –There are two groups of superficial inguinal lymph nodes
namely the proximal and distal groups. The proximal group
receives lymph from the buttock, back of the body below the
waist, umbilicus and anterior abdominal wall below umbilicus,
external genitalia in both sexes excluding the testis, lower
vagina, lower part of anal canal and perineum and from uterus
via lymphatics accompanying the round ligament. The distal
group receives all superficial lymphatics from the lower limb
except the posterolateral part of the calf. The
superficial inguinal lymph nodes drain mainly into the external
iliac nodes. Testis drains into para aortic nodes. The
glans penis drains into deep inguinal nodes.
B. False
C. False
D. True
E. True
158.
A. True – The perineal body (central tendon of the perineum) is
fibomuscular mass located between the anal canal and the
vagina (or the bulb of the penis). Muscles attaching to it are
the superficial and deep transverse perinei, bulbospongiosis,
levator ani and external sphincter.
B. True
C. True
D. True
E. False – Ischiocavernosus arises from the posterior part of the
perineal membrane and ischiopubic rami and inserts into the
corpus cavernosum
159.
A. True – The muscles found within the superficial perineal pouch are
the superficial transverse perineal, ischiocavernosus and
bulbospongiosus muscles. It also contains branches of the
internal pudendal vessels, branches of the perineal nerve and
greater vestibular glands in the female (Bartholin glands)
B. True
C. False –Sphincter urethrae and deep transverse perineal muscles are
in the depth perineal space
D. False
E. True

MCQ Anatomy-thorax-Abdo-Pelvis

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Chapter 3 : Pelvis and Perineum

2. Regarding intercostal nerves

3. Regarding intercostal arteries

4. External intercostal muscle

5. Internal thoracic artery

7. The first rib

8. Branches of the internal thoracic artery are

9. Primary cartilaginous joints are

10. Regarding thoracic vertebrae

11. Regarding the inlet of the thorax

12. The aortic opening in the diaphragm

13. The thoracic sympathetic trunk

14. The diaphragm is developed from the

15. Derivatives of the septum transversum include

16. The oesophageal opening in the diaphragm

18. Regarding the arcuate ligaments of the diaphragm

19. The superior vena cava

20. Regarding the superior mediastinum

21. The thoracic duct

22. Regarding the arch of the aorta

23. The ascending aorta

24. The trachea

26. The trachea

27. The pulmonary trunk

28. The left main bronchus

29. At the sternal angle

30. Regarding the development of the venous system

31. Veins draining into the right brachiocephalic vein include

32. Structures found in both superior and posterior mediastina are

33. The thymus

34. The thymus

35. In the foetal circulation mixing of oxygenated and deoxygenated blood

36. Embryonic structures that contribute to the inter-atrial septum include

37. Ligaments that have foetal vessels of origin include

38. The right atrium

39. The ductus arteriosus

40. The right coronary artery

41. The left atrium

42. Regarding the development of the heart

43. The descending thoracic aorta

44. The azygos vein

45. Branches arising from the descending thoracic aorta are

46. Regarding the thoracic part of the oesophagus

47. The oesophagus

48. The right phrenic nerve

Lungs and Pleurae

49. The right lung

50. The parietal pleura

51. Regarding the bronchopulmonary segments

52. Regarding the pleura

Thorax : Answers and Explanations

Thoracic wall and diaphragm

Lungs and Pleurae

53. The transpyloric plane

54. Regarding the anterior abdominal wall

55. At the transpyloric plane

56. The inguinal canal

57. The superficial inguinal ring

58. Regarding the inguinal canal

59. The inguinal canal

60. The rectus abdominis muscle

62. Regarding the rectus sheath

63. The anterior abdominal wall is supplied by the