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A) Renal Cortex
B) Renal Medulla
C) Minor Calyces
D) Major Calyces
E) Renal Pelvis
Explanation:
The substructures of the nephrons are mainly located within the cortex. The JGA sits n
ext to the glomerulus in the cortex.
They play an important role in blood pressure homeostasis as the juxtaglomerular cells pro
duce renin. The descending and ascending limbs of the loop of Henle and collecting du
cts have sections within both the cortex and medlla
Correct Answer:
Membranous urethra
The prostatic urethra, which is about 2.5cm long, is the widest and the most dilatable part
of the urethra.
A baby with shoulder dystocia suffers a brachial plexus injury. You diagnose Erb‐
Duchenne palsy. Which nerve roots are typically affected?
A) C3 and C4
B) C4 and C5
C) C5 and C6
D) C6 and C7
E) C7 and T1
Correct Answer:
C5 and C6
Explanation: Erb's or Erb‐
Duchenne palsy is a type of brachial plexus injury. The brachial plexus comprises C5 to T1 n
erve roots.
You are called to see a women after a prolonged labour with failed instrumental delivery co
nverted to c‐
section. She is unable to dorsiflex her right foot and complains of pins and needles to the fo
ot and lower leg. What is the likely diagnosis?
A) Right L5 nerve root compression
B) Right S1 nerve root compression
C) Right Saphenous nerve root compression
D) Right common peroneal nerve root compression
E) Right superficial peroneal nerve root compression
Correct Answer:
Right common peroneal nerve root compression
Explanation:
This patient has "foot drop" caused by compression of the common peroneal nerve. Superf
icial peroneal nerve palsy may cause a similar pattern of sensory loss but innervation of the
anterior compartment leg muscles is by the deep peroneal nerve so foot drop wouldn't occ
ur.
This type of nerve palsy is encountered in many surgical fields as the nerve is very superfici
al as it winds around the fibular head and prone to compression palsy (especially in thin pe
ople) when using leg bars e.g. in lithotomy position.
An L5 nerve root compression can produce similar symptoms but is less likely given the sce
nario.
Neck centriole
Correct Answer:
Neck
Explanation: The centrioles are located in the neck and lie in the posterior depression of th
e neck. They are necessary to initiate zygotic division
B External iliac and superficial iliac nodes via the round ligament
Bladder drains to the external iliac nodes; the urethra drains to the internal iliac nodes;
Thefallopian tubes and fundus uteri drain to the external iliac and superficial iliac nodes via
the
Round ligament;
And the cervix drains to the external and internal iliac, rectal and sacral
nodesandoccasionally obturator nodes.
Clitoris:Deep inguinal ☑️
A 65yearold woman underwent vaginal surgery for which she was in the lithotomy
positionfor 2 ½ hours. Postoperatively you have noticed parasthesia of the lateral side of
the leg, footand foot drop. The compression of which nerve is likely to be responsible?
B Femoral nerve
D Obturator nerve
E Pudendal nerve
The injury is thought to be secondary to compression of the nerve between the lateral head
of the fibula and the bar holding the legs.
When the stirrupsare used, special attention must be paid in order to avoid compression.
Injury to the femoralnerve will cause hypoesthesia in the anterior and anteromedial area on
the thigh below theinguinal ligament.
A Constipated bowel
B Ovaries
C Pectineal ligaments
D Ureter
E Uterosacral ligaments
What is the most serious risk associated with the insertion of a Veress needle through
theumbilicus in a thin patient, an outcome that is unlikely with the Hasan entry technique?
A Bowel perforation
B Damage to liver
C Damage to ureters
E Vascular injury
The risk of bowel damage is not completely avoided using the open entry
Technique.
The common iliac artery arises from the aorta on the left side of the fourth lumbarvertebra
and divulges acutely. The inferior vena cava lies behind the right common iliac vessel.In a
thin patient, the major blood vessels are only a few centimetres away and are particularly
A Endocervix
B Fallopian tubes
C Skin
D Ureters
E Vagina
Uterus: columnar
Endocervix: columnar
The fallopian tubes are lined by ciliary, and ureters bytransitional epithelium.
Ischemic injury to the pelvic ureter may be caused by which one of the following arteries?
A Aorta
D Renal artery
E Uterine artery
Abdominal – renal artery, testicular/ovarian artery, and ureteral branches directly from the
abdominal aorta
Uterine artery, common iliac may contribute minor supply but major supply by vesical
A 20yearoldwoman presents with a painful lump in the vagina. The examination confirms
Bartholin’sabscess. Which one of the following glands is involved?
B Glands of skini
E Seminal vescicle
C
The answer is the greater vestibular (Bartholin’s) gland.
These are small paired glands located in the superficial perineal pouch
. They are partially covered by posterior portions of the bulb of the vestibule and the
bulbospongiousus muscles.
The duct opens into the vestibule betweenthe hymen and the labium minus. These glands
provide lubrication at the introitus.
The lower third of the vagina has lymphatic drainage to which nodes?
D Paraaortic nodes
Remember the embryological difference betweenthe lower one third of the vagina and the
upper twothirds.The upper part is derived from thefused mesonephric ducts, and the lower
onethird from canalisation of the ectodermal thickening.
The upper two thirds of the vagina drain to the internal and external nodes
Which three muscles form the superficial group of muscles of the perineum?
A Bulbospongiosus, superficial transverse perineal muscle, and ischiocavernous
C External vaginal sphincter, deep transverse perineal muscle, and external anal sphincter
Deep perineal muscles: Sphincter urethrae and deep transverse perineal Muscle make
deep layer of perineal muscle
The Inferior hypogastric plexus is an important plexus supplying the hind gut. What are
itsnerve root origins?
C S2– S4
E L3– L5
It is derived from the lower three thoracic and upper two lumbar segments.
A urinary catheter Is vigorously inflated in the urethra at the time of caesarean section.
Urineleaks from the rupture into which anatomical space?
The answer is into the anterior abdominal wall and mons pubis. This is the only route
possible due to the anatomy of the urethra.
A Transversus abdominus
C Recti adbominus
D Puborectalis
E Falx inguinalis
Which of the following is NOT a branch of the anterior division of the internal iliac artery?
A Ilieolumbar artery
C Obturator artery
D Uterine artery
E Vaginal artery
A direct inguinal hernia that develops from the weakness of the conjoint tendon can
causedamage to the:
A Genitofemoral nerve
B Iliohypogastric nerve
C Ilioinguinal nerve
D Pudendal nerve
E Subcostal nerve
C Obturator foramen
D Pudendal canal
E Sacral canal
The internal pudendal artery is an artery thatbranches off the internal iliac artery, providing
blood to the external genitalia.
The Internal pudendal artery is the terminal branch of the anterior trunk of the internal iliac
artery. It issmaller in the female than in the male.
It exits the pelvic cavity through the greater sciaticforamen, inferior to the piriformis
muscle, to enter the gluteal region. It then curves around thesacrospinous ligament to
enter the perineum through the lesser sciatic foramen.
It travelsthrough the pudendal canal with the internal pudendal veins and the pudendal
nerve.
At the trigone, the epithelium is more densely adherent to the underlying muscle.
A layer of fattyconnective tissue covers most of the anterior and lateral bladder in the
retropubic space andcan be viewed cystoscopically in the case of a bladder perforation.
Bladder posteriorly and separates it from the anterior culdesac or vesicouterine pouch and
A 2 mm
B 4 mm
C 10 mm
D 15 mm
E 20 mm
Correct answer E ☑️
Before ovulation occurs, the average diameter of a dominant follicle is 22 to 24 mm. The
dominant follicle has the quickest growth and largest size. However, the growth of a follicle
does not always mean that it contains a mature egg
A 0.02-0.03 mm
B 2 mm
C 10 mm
D 15 mm
E 20 mm
Prenatal 0.2mm
Antral follicles are small follicles (about 2mm in diameter) that we can see – and measure
and count – with ultrasound.
Vaginal ultrasound is the best way to accurately assess and count these small structures.
With regard to ovulation, what is the fluid filled space in a follicle called?
A Antrum
B Basal lamina
C Blastocyst
D Lacuna
E Uniblastocyst
Which of the following structures does not pass through the diaphragm?
A Azygos vein
B Cisterna chyli
D Oesophagus
E Thoracic duct
.B Cisterna chyli
The cisterna chyli is a dilated sac at the base of the thoracic duct, which forms part of the
lymphatic drainage of the pelvis and abdomen.
The lymph passes to the thoracic duct which, after passing through the aortic hiatus,
opens into the junction of the left subclavian vein and internal jugular vein
Which vessel crosses the common and external iliac artery in the infundibulopelvic fold?
A Femoral artery
E Renal artery
D Ovarian artery
They run retroperitoneally, leaving the abdomen by crossing the common or external iliac
arteries in the infundibulopelvic fold.
They are medial to the ureter in the upper abdomen and cross obliquely anterior to the
ureter in the middle to lower lumbar region, lying lateral to the ureter in the lower abdomen
and pelvis.
The Infundibulopelvic ligament is a fold of the peritoneum, also known as the suspensory
ligament of the ovary. It passes laterally from the ovary to the wall of the pelvis.s.
29. A 27-year-old woman has a cervical smear result which shows ‘borderline’ changes.
Which cells line the ectocervix?
A Ciliated cells
B Columnar epithelium
C Cuboidal epithelium
The endocervix Is the cavity of the cervix, linking the external and the internal os. It is lined
bymucin-secreting simple columnar epithelium.
The border between these two types of epithelium is the squamocolumnar junction, or
transformation zone. The transformation zone is the area where metaplasia frequently
takes place and it is from here that the cervical smear test is taken .There are certain times
when metaplasia is physiological, such as during puberty when the endocervix everts and
postmenopause when the transformation moves upwards.
A Android
B Anthropoid
C Gynaecoid
D Male
E Platypelloid
. B Anthropoid ☑️
• Gynaecoid pelvis: (50%): normal female type, inlet is slightly transverse oval; sacrum is
wide with average concavity and inclination; subpubic angle is 90–100°.
• Anthropoid pelvis (25%): ape-like; anteroposterior (AP) diameters are long; transverse
diameter short; sacrum long and narrow, subpubic angle is narrow.
• Android pelvis (20%): male type, inlet is triangular or heart-shaped with anterior narrow
apex, subpubic angle is narrow <90°.
Android also has ap diameter more than transverse if anthropoid not in option than only
you can choose android
A Bulbocavernosus
B Iliococcygeus
C Ischiococcygeus
D Pubococcygeus
E Urogenital diaphragm
D Pubococcygeus ☑️
Although considered in three parts, the muscle forms a continuous sheet, which provides
significant support to the pelvic organs.
Pubococcygeus forms the bulk of the levator ani muscle, arising from the back of the pubis
and the white line that runs in front of the obturator canal. Its fibres form a U-shaped loop
which runs around the urethra, vagina and with the medial fibres blending with the upper
urethra. Intermediate fibres loop around the vagina, closing the lower end on contraction.
Lateral fibres run around the anus, inserting into the lateral and posterior walls of the anal
canal between the internal and external sphincters.
Iliococcygeus arises from the white line behind the obturator canal and inserts into the
lateral margins of the coccyx.
Ischiococcygeus arises from ischial spine and inserts into the coccyx.
After passing through the obturator canal, it divides into the anterior and a posterior
branch.
The anterior branch provides an articular branch to the hip and anterior adductor muscles.
Provides sensory innervation to the skin on the medial surface of the thigh.
Obturator nerve : anterior division l2-L4 Femoral nerve : posterior division L2–L4
35. A 32-year-old woman complains of pain in the right buttock. She is 36 weeks pregnant
and has a history of chronic back pain. Which nerve supplies the gluteus maximus muscle?
A Inferior gluteal
B Internal obturator
D Sciatic
E Superior gluteal
A Inferior gluteal ☑️
Gluteus maximus:
• Origin: posterior gluteal line of inner upper ilium, posterior surface of lower
With regards to the path of the ureter, which of the following is correct?
A In the broad ligament, both ureters pass over their respective uterine artery
Answer:
The ureters leave the kidney and travel inferiorly and medially along the psoas
Muscle.
They run along the posterior pelvic brim and cross anteriorly to the bifurcation of the
common iliac vessels
. They continue posteroinferiorly and turn medially at the ischial spines. They then run in
the base of the broad ligament where they are crossed by the uterine artery (water under
the bridge).
The ureter passes the lateral vaginal fornix and enters the bladder
Which of the following provides the arterial blood supply of the left ovary?
A Abdominal aorta
E Obturator artery
Both ovaries receive their arterial supply from the ovarian arteries, which are direct
branches of the abdominal aorta.
Venous drainage: of the
Right ovary is supplied by the right ovarian vein, a branch of the inferior vena cava (IVC).
The left ovary’s venous supply is from the left renal vein, which then drains into the IVC.
The differing blood supply of the ovaries, in comparison to the other pelvic viscera, reflects
the embryonic origin and subsequent descent of the ovaries from near the kidneys, down
into the pelvis.
The ovarian arteries both arise from the abdominal aorta. The paired arteries, which sit
below the renal arteries and above the inferior mesenteric artery, descend along
Arterial and venous supply to the ovaries follow a similar course, however, the right ovary
receives its venous supply from the right ovarian vein, which reaches the inferior vena cava
and the left ovary is supplied by the left renal vein.
A 32-year-old woman has an episiotomy repaired following a forceps delivery. Which of the
following does not insert into the perineal body?
A Bulbocavernosus
C Ischiocavernosus
D Levator ani
E Transverse perineal
C Ischiocavernosus ☑️
The perineal body (or central tendon of the perineum) is a midline structure formed of
fibromuscular tissue found between the vagina and the anus in females.
The external anal sphincter, transverse perineal muscles, bulbocavernosus muscle and the
levator ani muscles all insert into the perineal body.
The Ischiocavernosus muscle is a muscle of the superficial pouch of the perineum. Lying
between the perineal membrane and the subcutaneous tissue, it arises from the inferior
ischial ramus and compresses the crus clitoris, hence promoting clitoral erection.
A woman undergoes an emergency caesarean section at full dilatation following a failed
trial of instrumental delivery. There is a lateral extension to the uterine excision which is
bleeding.
Identify which of the following gives the correct pairing of artery and its origin.
Artery. Origin
The uterine artery is a branch of the anterior division of internal iliac artery (the main artery
to supply the pelvic viscera).
Ovarian arterial supply comes from the ovary arteries which are direct branches of the
abdominal arteries. Equivalent to the female ovarian arteries is the testicular artery, which
is a branch of the abdominal aorta and supplies the testes.
The Internal pudendal artery, which supplies the perineum, is a branch of the anterior
division of the internal iliac artery.
B Ilium
C Ischium
D Pubis
E Sacrum
The sacrum is actually formed from the five sacral vertebrae. The sacrum articulates with
the fifth lumbar vertebrae. Figure 1.7 shows the structure of the bony pelvis.
A Femoral nerve
B Genitofemoral nerve
C Ilioinguinal nerve
D Peroneal nerve
E Sciatic nerve
C Ilioinguinal nerve ☑️
Only the ilioinguinal nerve passes through the superficial inguinal ring; it is not carried
through the deep inguinal ring, having travelled down the lateral abdominal wall between
the internal and external oblique muscles
A The deep inguinal ring lies at the lateral two-thirds of the inguinal ligament
The deep inguinal ring is situated at the midpoint of the inguinal ligament. It can
Be located by finding the midpoint between the anterior superior iliac spine and the pubic
tubercle.
The superficial inguinal ring lies just above, and lateral to the pubic tubercle.
The deep and superficial rings mark the entrance (deep ring) and exit (superficial ring) to
the inguinal canal.
• Anterior wall: external oblique aponeurosis, with lateral reinforcement from the internal
oblique
• Posterior wall: transversalis fascia, with the conjoint tendon (internal oblique and
Running through the canal is the round ligament in females and the spermatic cord in
males.
The ilioinguinal nerve passes through the superficial inguinal ring only, having travelled
down the lateral abdominal wall between the internal and external oblique muscle.
Which of the following structures have the primary mechanism of shunting blood
away from the pulmonary circulation: ( 2018)
A.Foramen ovale
B.Ductus arteriosus
C.Ductus venosus
D.Hypogastric arteries
E.Umbilical vein
Explanation:
Ductus venosus,
Ductus arteriosus.
These shunts permit the blood to bypass the liver and lungs, and shunt the most
Oxygenated blood from the right to the left side of the heart.
The less oxygenated blood (lateral stream) is sent to the right ventricle, whereas the more
oxygenated blood is shunted to the left atrium via foramen ovale and ultimately supplies
the foetal heart and brain
. A large proportion of the oxygenated blood is shunted directly into the left atrium through
an opening between the left and right atria called the foramen ovale.
Thus the oxygenated blood returning from the placenta goes from the
Explanation:
The lower part of the external hemorrhoidal plexus is drained by the inferior rectal veins
(or inferior hemorrhoidal veins). They drain into the internal pudendal vein.
In horseshoe kidney what is the structure preventing the kidney to ascend from pelvis
to abdomen? (2018)
Bifurcation of aorta
Coeliac trunk
Explanation:
The lower poles of the kidneys fuse together to form a horseshoe-shape during the time of
fetal development (when kidneys are in pelvis). The central portion of the kidney may be
found just inferior (L4/L5) to the inferior mesenteric artery (L3) because the normal
embryologic ascent of the kidneys is arrested due central fusion of the kidneys
Angle of the vagina with the horizontal while standing is: ( 2018)
45°
60°
70°
80°
90
Explanation:
The vagina tilts posteriorly between the urethra and rectum, with the urethra bound to its
anterior wall.
If standing, the vaginal tube will point in an upward-backward direction to form a 45° angle
with the uterus and an about 60° angle to the horizontal.
However, the exact angles are variable depending on individual anatomy and with contents
of the bladder and colon.
The angle of the vagina with the horizontal while standing is 60°.
E Femoral artery
The artery of the round ligament of the uterus, also known as Sampson’s artery, is a branch
of the inferior epigastric artery
Longitudinal muscle
Circular muscle
Lavatory ani
Detrusor muscle
Explanation:
Internal anal sphincter
Internal anal sphincter is formed by thickening of the circular smooth muscle coat of the
lower part of rectum.
It surrounds the upper three-fourths of the anal canal and extends from the upper end of
the anal canal up to the white line.
Blood supply: Superior rectal artery (branch of inferior mesenteric artery); middle rectal
artery (branch of internal iliac artery); and inferior rectal artery (branch of internal
pudendal artery).
Ductus muscle
Tunica albuginea
Dartos muscle
Tunica vaginalis
Sacrum
Explanation:
The dartos muscle is a sympathetically innervated dermal layer within the scrotum.
Scrotum layers
Skin
Dartos
Cremaster fascia
Tunica vaginalis
Testis
Explanation:
Inferior epigastric vessel arises from the external iliac artery just superior to the inguinal
ligaments.
It runs superiorly in the transversalis fascia to enter the rectus sheath below the arcuate
line. It enters the lower part of the rectus abdominis and anastomoses with the superior
epigastric artery.
When the external iliac artery passes posterior to the inguinal ligament, it is known as the
femoral artery
L1
T12
T10
L3
L1 and L2
Explanation:
A dermatome is the area of skin supplied by a single spinal nerve. They have a segmental
distribution
Represented as narrow bands of skin running almost horizontally along the trunk in a
regular fashion.
Lateral foot: S1
Second stage:S2,3,4
Explanation:
The pelvic diaphragm is a muscular partition formed by levator ani and coccygei, that may
be included
In the parietal fascia on their upper and lower aspects. It separates the pelvic cavity above
from the perineal region below.
Muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.
Obturator nerve
Femoral nerve
Sciatic nerve
Correct Answer: Obturator nerve.
Explanation:
The obturator nerve and vessels are present in the floor of the ovarian fossa where it also
crosses the pelvic part of ureter.
The anterior branch of the obturator nerve innervates the adductor longus, adductor brevis
and gracilis muscles,
there are chances of getting injury to obturator nerve following radical hysterectomy
and pelvic lymphadenectomy which may again lead to weakness of hip adduction.
L1 vertebra
L2 vertebra
L3 vertebra
L4 vertebra
L5 vertebra
Answer:
Celiac trunk:T12-L1(T12)
SMA:L1
GONADAL:L2
RENAL:L1-L2(L2)
IMA:L3
Explanation:
The ovary is supplied by the ovarian artery, a direct branch of the abdominal aorta. The
ovarian artery
Bifurcation of aorta:L4-L5(L4)
Iliac crest:L4-L5
Kindly note the range of vertebrae and also note the one written in bracket if both level
come in comparison
Transversalis fascia
The deep inguinal ring is situated in the transversalis fascia, midway between the anterior
superior iliac spine and the symphysis pubis, and lies about 1.25 cm above the inguinal
ligament and is lateral to the epigastric vessels.
The Inferior epigastric artery runs medial to the deep inguinal ring. Clinically, this has
value in differentiating indirect (lateral to artery) from direct (medial to arte
Explanation:
The deep inguinal ring is situated in the transversalis fascia, midway between the anterior
superior iliac spine and the symphysis pubis, and lies about 1.25 cm above the inguinal
ligament and is lateral to the epigastric vessels.
The inferior epigastric artery runs medial to the deep inguinal ring. Clinically, this has value
in differentiating indirect (lateral to artery) from direct (medial to artery) inguinal hernias.
Pia matter
Pia matter. ☑️
The choroid plexus resides within the meninges, the membrane lining that cover and
protect the
Central nervous system. The meninges are composed of three layers known as the dura
mater,
Found in the innermost layer of the meninges, the pia mater and produces CSF in the
ventricles of the
Brain. It is formed by the invagination of the vascular pia mater into the ventricular cavity.
Explanation:
The two main vessels supplying the abdominal wall from above are medially located
superior
Epigastric artery and laterally musculophrenic artery both of which arises from the internal
thoracic
Artery. Blood supply from below is provided by the inferior epigastric artery located
medially and the
Deep circumflex iliac artery laterally and both of these arteries arising from external iliac
artery.
Which type of epithelium lines the distal urethra near the external urethral orifice?
(2017)
Transitional
Squamous
Cuboidal
Stratified columnar
Simple columnar
The female urethra is a narrow membranous canal about 4 cm long, and extending from the
internal
To the external urethral orifice. This is much shorter in comparison to the male urethra,
which is about
20 cm long. Throughout its length, the urethra is closely related to the anterior wall of the
vagina. Its
Pudendal nerve
Hypogastric nerves
None of these
Explanation:
The sympathetic innervation of the bladder originates in the lower thoracic and upper
lumbar spinal cord segments (T10-L2), the preganglionic axons running to sympathetic
neurons in the inferior mesenteric ganglion and the ganglia of the pelvic plexus.
The postganglionic fibers from these ganglia travel in the hypogastric and pelvic nerves to
the bladder where sympathetic activity causes the internal urethral sphincter to close.
Of the bladder, and in males, the smooth muscle fibers of the prostate gland.
Internal iliac
Inferior vesical
Superior vesical
External iliac
Internal pudendal
The umbilical artery gives rise to both a nonfunctional remnant of the fetal
circulation and an active vessel giving supply to the bladder.
In the adult,
External pudendal
Internal pudendal
Ilioinguinal
Iliohypogastric
None of these
Explanation:
The internal pudendal nerve arises from the anterior rami of the second to fourth sacral
roots. The pudendal nerve divides into three branches:
Motor fibers to detrusor muscle of the urinary bladder are derived from which of
the following nerves?
Greater splanchnic
T11-L2
Superior plexus
Sacral plexus
Explanation:
The stimulation of parasympathetic nervous system causes the contraction of the detrusor
muscle.
The sympathetic nerves supply to the detrusor muscle is by hypogastric nerve (T10-L2),
whereas,
Correct Answer: Pelvic surface of sacrum, greater sciatic notch, greater trochanter.
Explanation:
The origin of piriformis muscle occurs from the anterior part of the sacrum, the part of the
ischial spine
In the gluteal region, and also from the superior margin of the greater sciatic notch (as well
as the
Sacrotuberous ligament and the sacroiliac joint capsule). It exits the pelvis through the
greater sciatic
Foramen to insert on the greater trochanter of the femur. Also, its tendon often joins with
the tendons
Of the superior gemellus, inferior gemellus, and obturator internus muscles prior to
insertion.
Condyloid
Synovial
Primary cartilaginous
Secondary cartilaginous
Fibrous
Explanation:
The sacroiliac joint is the synovial joint between the sacrum and the ilium bones of the
pelvis.
Vestibule is:
B and C both
B>C
Explanation:
The vestibule is the part of the vulva lying between the two labia minora laterally and
extends medially
To the hymenal sulci. The Bartholin’s glands are located in the vestibule on either side
There is difficulty in extracting blood in the upper arm, the intern decided to extract
from the femoral vein. What is the relation of the femoral vein to the artery and nerve from
lateral to
Medial?
VAN
NAV
AVN
NVA
ANV
Explanation:
Medial to lateral, these structures can be described with a mnemonic ‘VAN’ (Vein, Artery,
and Nerve).
At the upper end of the femoral triangle, femoral vein lies medial to the femoral artery.
However, at
The apex of the femoral triangle the vein lies behind the artery. The great saphenous vein
joins the
Femoral vein.
Other tributaries of the femoral vein correspond to the branches of femoral artery.
Nerve passing below inguinal ligament medial to anterior superior iliac spine:
Femoral nerve
Ilioinguinal nerve
Genitofemoral nerve
Explanation:
The lateral femoral cutaneous nerve of thigh is formed by the posterior divisions of L2 and
L3 spinal nerves (whereas the anterior divisions of these nerve roots contribute to the
obturator nerve).
The nerve emerges from the lateral border of the psoas major muscle inferior to the
iliolumbar ligament
And then courses laterally around the iliac fossa on the anterior surface of the iliacus
muscle deep to
The iliac fascia
Obturator nerve
Genitofemoral nerve
Subcostal nerve
Ilioinguinal
Iliohypogastric
Explanation:
Pyramidalis is a small triangular muscle located anterior to the lower part of rectus
abdominis muscle within the rectus sheath. It is attached by tendinous fibers to
anterosuperior margin of pubis and by the ligamentous fibers in front of the pubic
symphysis.
Ileocolic artery
Inferior mesenteric
Left colic
Middle colic
Right colic
The ileocolic artery is the lowest branch arising from the concavity of the superior
mesenteric artery. It passes downward and to the right behind the peritoneum toward the
right iliac fossa, where it divides into a superior and an inferior branch; the
Inferior gives rise to the appendicular artery, which anastomoses with the end of the
superior mesenteric artery.
Explanation:
Sagittal or longitudinal suture: This suture lies longitudinally across the vault of the skull
in midline between the anterior fontanelle and the posterior fontanelle. It lies between the
two
Parietal bones.
Coronal suture: This suture is present between the parietal and frontal bones, and
extends transversely on either side from the anterior fontanelle.
Lambdoid suture: This suture separates the occipital bone from the two parietal bones
and extends transversely both on the right and left side from the posterior fontanelle.
Frontal/metopic suture: This suture is present between the two halves of the frontal bone
in the skull of infants and children and usually disappears by the age of 6 years.
Umbilical artery
Obturator artery
Explanation:
The internal iliac vessel arises at the bifurcation of the common iliac vessel opposite the
lumbosacral
Articulation and passes downwards to the upper margin of the greater sciatic foramen
where it divides
Into two large trunks: anterior and posterior, both of which give rise to various branches.
Which of the following structures form the lateral border of ischiorectal fossa? (2017)
Levator ani
Anal canal
Coccygeus muscle
Explanation:
Ischiorectal fossa: Lateral to the anal canal on either side, there is a triangular depression
called the
Ischiorectal fossa, which has a base directed to the surface of the perineum and its apex is
at the line of meeting of the obturator and anal fascia.
Roof: The levator ani muscle forms the inner wall and roof of the ischiorectal fossae
Laterally: The tuberosity of the ischium, the obturator fascia and the obturator internus
Muscle.
Anteriorly
: The fascia of Colles covering the transversus perinei superficialis, and the inferior fascia
of
Ischiorectal fossa
Explanation:
In females, the deep perineal pouch contains part of the urethra, the external urethral
sphincter, the
Labia minora
Labia majora
Round ligament is a fibrous band attached to the uterus immediately below the entrance of
the uterine tube.
It extends laterally and anteriorly, hooks around the inferior epigastric artery, travels in
the inguinal canal and eventually ends in the labium majus (labia majora). The round
ligament is usually accompanied in the foetus by a process of peritoneum, the processus
vaginalis.
10 cm
9 cm
11 cm
12 cm
15 cm
Explanation:
Bitrochanteric diameter can be defined as the distance between the highest points of the
two greater
Kindly note if
Engaging diameter of subocipito frontal mentioned than choose presentation as
occipitoposterior
And if
And if
And some times they say presenting diameter is direct occipitoposterior tell engaging
diameter
Than choose occcipito frontal not suboccipitofrontal
What is the measurement of the antero-posterior diameter of the pelvic inlet at the time
of engagement of foetal head?
11 cm
12 cm
13 cm
14 cm
20 cm
• Obstetric conjugate (10.5 cm): The obstetric conjugate is measured from the midpoint
of sacral promontory to the most bulging point on the back of symphysis pubis. This is the
shortest AP diameter of the pelvic inlet and measures about 10.5 cm.
Diagonal conjugate (12 cm): It is measured from the tip of sacral promontory to the
lower border of pubic symphysis.
•
Out of three AP diameters of the pelvic inlet, only diagonal conjugate can be assessed
clinically during the late pregnancy or at the time of the labour.
Which of the following arteries supplying the uterine endometrium, act as the
end arteries?
Uterine artery
Radial artery
Spiral artery
Straight arteries
Arcuate arteries
From the arcuate vessels, branches known as the radial arteries arise at right angles.
They reach the basal layers of endometrium where they are termed as the basal arteries.
Spiral arterioles of the endometrium are derived. These are the end vessels.
Explanation:
The fibers of the deep layer of the external anal sphincter fuse with the puborectalis part of
the levator
Ani muscle.
Perineal nerve
Obturator nerve
Explanation:
The cervix is composed of two parts: supravaginal part (between the uterine isthmus and
the vagina) and the vaginal part (which protrudes into the vagina).
The uterovaginal nerve plexus lying in the base of the broad ligament on the either side of
the supravaginal part of the cervix gives rise to the
From lumbar splanchnic nerves, whereas the parasympathetic fibres are derived from the
pelvic splanchnic nerves.
Inferior mesenteric
Explanation:
The superior mesenteric artery is a large anterior branch arising just below coeliac trunk
which supplies the parts of the gut, which are derived from the midgut.
But the superior mesenteric artery supplies the ascending colon and most of the
transverse colon. The inferior mesenteric artery supplies the distal
3:1
1:1
1:2
2:1
Explanation:
The adult uterus comprises of two main parts: body (uterine corpus) and cervix.
During the reproductive years, the corpus is twice as long as the cervix. After menopause,
the reverse is true and the cervix is twice as long as the uterine corpus. So, the ratio
between the two is 1 :1 after menopause.
Gonadal artery
Lumbar artery
Explanation:
The thoracic aorta pierces the diaphragm at T12 to become the abdominal aorta. It gives
IMA at l3 Level which further give superior rectal artery
Ischiorectal fossa
Pudendal canal
Urogenital diaphragm
Explanation:
Superior border of the perineal pouch: Perineal membrane which is the inferior
fascia of the urogenital diaphragm
Inferior border: The fascia of the Colles, which is the deep membranous layer of
the superficial perineal fascia.
Urethral artery.
Nerves: Posterior scrotal nerves in males and posterior labial nerves in females.
Other: Crura of penis in males, crura of clitoris in females, bulb of penis in males,
bulb of vestibule in females, Bartholin’s glands in females.
Explanation:
The pudendal cleft is delimited on both sides by the labia majora, two folds of skin
whose subcutaneous tissue is of the same type and joins that of the mons veneris. The
connective tissue is
Skene gland
Gartner duct
Bartholin’s gland
Labia majora
Women have glandular tissue below the bladder and surrounding the urethra that appears
to be homologous to the male prostate. This tissue (also called “female prostate”
or Skene’s glands
Pudendal nerve
Explanation:
The external sphincter is a voluntary sphincter, which surrounds the entire length of the
anal canal.
This is made up of striated muscle, which comprises of subcutaneous part, superficial part
and deep part.
Nerve supply to the external anal sphincter is by the inferior rectal branch of the pudendal
nerve
T12
L4
S1
S2
S3
Correct answer B
Correct Answer: Internal pudendal artery.
Explanation:
Internal pudendal artery is a branch of internal iliac artery.
Dr Maria MRCOG 1 Mentor Medhome:
A 35-year-old woman undergoes a total abdominal hysterectomy for uterine fibroids. After
the operation she complains of loss of flexion of her left hip and numbness over her
left anterior and medial thigh. The compression of which nerve is likely to be re
Femoral nerve
Ilioinguinal nerve
Obturator nerve
Pudendal nerve
Explanation:
The femoral nerve descends from the lumbar plexus in the abdomen through the psoas
major muscle which then travels through the pelvis to the midpoint of the inguinal
ligament and it traverses behind the inguinal ligament into the thigh.
Muscle. This may be associated with difficulty in extending the knees and flexing the hip
joints.
The knee may give way on walking and the patient has difficulty climbing stairs. There is
numbness over
The anterior aspect of the thigh and medial region of the leg.
Illioinguinal : groin
Dr Maria MRCOG 1 Mentor Medhome:
Which of the following structure passes through the greater sciatic foramen?
Pubococcygeus
Iliococcygeus
Puborectalis
Piriformis
Coccygeus
Explanation:
The greater sciatic foramen contains:
• Seven nerves: Sciatic nerve, superior gluteal nerve, inferior gluteal nerve, pudendal
nerve, posterior femoral cutaneous nerve of the thigh , nerve to quadratus femoris, and
nerve to
obturator internus
• Three vessel sets: Superior gluteal artery & vein, inferior gluteal artery & vein and
internal pudendal artery & vein
Which of the following abdominal wall layers will not be encountered transected during an
elective lower segment caesarean section making a transverse suprapubic incision by
the obstetrician?
Explanation:
While giving a lower transverse suprapubic incision during the caesarean section the
following layers
Should be cut:
Skin
Subcutaneous tissue
Four days after the operation, she presents to the emergency department feeling unwell
and
Her hemoglobin level is found to be 5 g/dL. After doing laparoscopy, damage to a blood
vessel is suspected. Which vessel crosses the common and external iliac artery in
the infundibulopelvic fold?
Femoral artery
Iliac artery
Ovarian artery
Renal artery
Explanation:
The ovary is supplied by the ovarian artery which arises from the aorta just below the renal
artery and
Runs downwards on the anterior surface of the psoas muscle to the pelvic brim, where it
crosses in front of the ureter and then passes into the infundibulopelvic fold of the broad
ligament.
During childbirth a bilateral pudendal nerve block may be performed to provide anesthesia
to the majority of the perineum and the lower one fourth of the vagina.
To do this an anesthetic agent is injected near the pudendal nerve. During the procedure
blood comes in
On withdrawal the plunger of the anesthetic syringe. Which of the following vessels has
been
Entered?
Obturator
Femoral
Vaginal
External pudendal
Internal pudendal
Explanation:
The internal pudendal artery terminates in branches which supply the perineal and vulval
structures, including the erectile tissue of the vestibular bulb and clitoris.
A pregnancy increases the blood supply to this area as well as increases the number of
erectile tissue around the vagina; thus any tear or incision in this region may bleed
profusely.
This is the reason during episiotomy bleeding comes out from internal pudendal artery.
Medial to lateral
Vein -nerve- artery
Hepatic vein
Splenic vein
Umbilical vein
Umbilical artery
Correct answer C
Explanation:
Caput medusae, also known as palm tree sign, are one of the cardinal features of portal
hypertension.
Its appearance is due to distended and engorged superficial epigastric veins, which are
seen radiating from the umbilicus across the abdomen.
It is caused by dilation of the paraumbilical veins, which carries oxygenated blood from
mother to fetus in utero normally closes within one week of birth, becoming re-canalised
due to portal hypertension caused by liver failure.
Which of the following describes the correct order of musculature of the anal canal
from deep to superficial?
3. Internal sphincter
1,4,2,3
2,1,4,3
3,1,4,2
3,2,1,4
2,4,1,3
Explanation:
The external sphincter is a voluntary sphincter, which surrounds the entire length of the
anal canal.
This is made up of striated muscle, which comprises of the following three parts:
1. Subcutaneous part: This lies below the level of the white line, i.e. inferior to the level
of the internal sphincter. The subcutaneous part forms a flat band around the anus.
It is separated
Attached posteriorly to the coccyx and anococcygeal raphe, and anteriorly to the perineal
body.
3. Deep part: This lies external to the upper half of the internal sphincter (above the
level of the pectinate line). It is annular in shape and surrounds the anorectal
junction. It has no bony attachment and is inserted into the perineal body.
Dr Maria MRCOG 1 Mentor Medhome:
What is the lymphatic drainage of cervix and upper vagina?
Explanation:
The lymphatics from the cervix pass either laterally in the base of the broad ligament
or posteriorly along the uterosacral ligaments to reach the sidewall of the pelvis.
Most of the vessels drain to the external iliac nodes, internal iliac, obturator and
sacral LNs, but some vessels also pass directly to the common iliac and lower para-
aortic nodes.
Posterior: sacral
A
Intramural shortest and narrowest
Isthmamus narrower
Ampuls widest
Just Google the diameter of different parts of fallopian tube you will get to know
intramural is narrowest
In which quadrant of the breast does the drainage of posterior intercostal nodes
occur?
Superolateral quadrant
Superomedial quadrant
Inferomedial quadrant
Inferolateral quadrant
None of the above
D
Correct Answer: Inferolateral quadrant.
Explanation:
Inferolateral quadrant is the quadrant of breast where lymphatic drainage occurs.
The lymph vessels
Of the breast are situated into two layers (superficial and deep), making subareolar
plexus (superficial and deep) that are interconnected.
Superficial lymph vessels transmit the lymph fluid into the axillary lymph nodes.
The majority of lymph drains into the subareolar plexus and then into the pectoral
group of axillary lymph nodes. 75% of lymph drains to this group of lymph nodes
Gonadal
Median sacral
Phrenic
Renal
Suprarenal
Explanation:
The thoracic aorta pierces the diaphragm at T12 to become the abdominal aorta.
The median sacral artery arises directly from the abdominal aorta at the point
where it bifurcates into the two common iliac arteries.
It descends over the L4 and L5 vertebrae as well as the sacrum and coccyx to
supply the sacrum.
At the level of the sacroiliac joint, it is crossed anteriorly by the ureter
Explanation:
Hirschsprung disease is the absence of parasympathetic ganglion cells (Auerbach
and Meissner
plexuses) in the large intestine. This deficiency creates a nonperistaltic segment of
variable length, a
tonically contracted anorectal sphincter, and delayed passage of meconium.
Functional obstruction
occurs at the level of the affected segment.
L1
L2
L3
L4
T12
Explanation:
The aorta can be divided into four sections as follows
• ascending aorta
• aortic arch
• thoracic (descending) aorta
• abdominal aorta
Studies have shown that in majority of the cases it terminates at the level of L4
vertebral body by
bifurcating into the left and right common iliac arteries.
A 26 year old women has lidocaine injected around the pudendal nerve during
vaginal
delivery. Which of the following is a terminal branch of the pudendal nerve that will
be blocked by this procedure?
Inferior epigastric
External iliac
Uterine
Uterine
Internal iliac
Inferior epigastric
External iliac
Uterine
Uterine
Internal iliac
A
Correct Answer: Inferior epigastric.
Explanation:
The round ligament travels laterally and anteriorly, hooks around the inferior
epigastric artery, and
Travels through the inguinal canal to eventually end in the labium majus.
In abnormal obturator artery (AOA), obturator artery does not originate from:
Explanation:
The obturator artery (OA) normally arises from the anterior trunk of internal iliac
artery. However, the
Origin site of OA is highly variable, and it may arise from external iliac artery, inferior
epigastric branch,
Superior or inferior gluteal artery.
What is the angle of vagina with the uterus and to the horizontal while standing?
0°,30°
30°,45°
45°,60°
60°,45°
90°,0°