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

A) Renal Cortex
B) Renal Medulla
C) Minor Calyces
D) Major Calyces
E) Renal Pelvis

Correct answer A☑️

Explanation:
The substructures of the nephrons are mainly located within the cortex. The JGA sits next t
o the glomerulus in the cortex.

They play an important role in blood pressure homeostasis as the juxtaglomerular cells produce r
enin. The descending and ascending limbs of the loop of Henle and collecting ducts have sec
tions within both the cortex and medlla
In the male urethra which is the narrowest part
A) Prostatic urethra
B) Membranous urethra
C) Penile urethra
D) Spongy urethra
E) Cavernous urethra
Correct Answer:

Membranous urethra ☑️

Explanation: There are 3 parts to the male urethra:

 1. Prostatic
 2. Membranous
3. Spongy (AKA Penile or Cavernous part)
It is most likely questions will arise regarding the membranous part as it is the shortest, contains t
he external urethral sphincter. Both shortest and narrowest.
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 pals
y. 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 nerve roots.

In Erb's palsy C5 and C6 are the roots primarily affected.

Shoulder Dystocia is the most common cause of Erb's palsy
Brachial plexus injury:2.3-16% case of shoulder dystocia
You are called to see a women after a prolonged labour with failed instrumental delivery convert
ed to c‐section. She is unable to dorsiflex her right foot and complains of pins and needles to the
foot 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. Superficial p
eroneal nerve palsy may cause a similar pattern of sensory loss but innervation of the anterior co
mpartment leg muscles is by the deep peroneal nerve so foot drop wouldn't occur.

This type of nerve palsy is encountered in many surgical fields as the nerve is very superficial as
it winds around the fibular head and prone to compression palsy (especially in thin people) when
using leg bars e.g. in lithotomy position.

An L5 nerve root compression can produce similar symptoms but is less likely given the scenario
.
Where are the proximal and distal centriole located in a spermatozoa?
A) Head
B) Neck
C) Middle Piece
D) Tail
E) End Piece
Head acrosome and neuclus
Neck centriole
Tail microtubule 9:2 link
Middle piece rich in mitochondria
Correct Answer:
Neck
Explanation: The centrioles are located in the neck and lie in the posterior depression of the neck
. They are necessary to initiate zygotic division

What is the lymphatic drainage of the ovaries?

A Common iliac nodes
B External iliac and superficial iliac nodes via the round ligament
C External iliac nodes
D Internal iliac nodes
E Lateral aortic and preaortic nodes

E✅
The answer is lateral aortic and preaortic nodes.

It is useful to remember the following: the

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?
A Common peroneal nerve
B Femoral nerve
C Great saphenous nerve
D Obturator nerve
E Pudendal nerve

A✅
The answer is common peroneal 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 28yearold woman presents to the gynaecology clinic with a history of
dysmenorrhoea,dysparunia and menorrhagia. A vaginal examination reveals a thickened nodule
in the posterior fornix. Which anatomical structure is most likely to be affected?
A Constipated bowel
B Ovaries
C Pectineal ligaments
D Ureter
E Uterosacral ligaments
E✅
The answer is the uterosacral ligament.

The above trio of symptoms is characteristic ofendometriosis

. It is possible to palpate the affected uterosacral ligament by vaginal examination.

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
D Inferior epigastric artery injury
E Vascular injury

E✅
The answer is vascular injury.

The aorta, inferior vena cava and common iliac arteries are put atrisk with the insertion of the
Veress needle. The open entry technique is considered to be saferin this matter.

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
At risk with a Veress entry.
Which structure is lined by nonkeratinised stratified squamous epithelium?
A Endocervix
B Fallopian tubes
C Skin
D Ureters
E Vagina
Fallopian tubes: columnar ciliated
Uterus: columnar
Endocervix: columnar
Ectocervix: stratified squamous

Vagina : stratified squamous

The answer is the vagina.
The endocervix is lined by columnar epithelium.

Skin is lined bykeratinised squamous epithelium.

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
B Common iliac artery
C Inferior vesical artery
D Renal artery
E Uterine artery
The correct answer is the inferior vesical artery. ✅
Abdominal – renal artery, testicular/ovarian artery, and ureteral branches directly from the
abdominal aorta
Pelvic – superior and inferior vesical arteries
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?
A Bulbourethral glands (Cowper’s)
B Glands of skini
C Greater vestibular gland
D Lesser vestibular gland
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.

Bartholin’sabscess may occur due to infection and blockage of these glands.

The lower third of the vagina has lymphatic drainage to which nodes?
A Common iliac nodes
B External iliac nodes
C Internal iliac nodes
D Paraaortic nodes
E Superficial inguinal nodes

The answer is the superficial inguinal 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
✨Lower into superficial inguinal.

Which three muscles form the superficial group of muscles of the perineum?

A Bulbospongiosus, superficial transverse perineal muscle, and ischiocavernous

B Deep transverse perineal muscle, external anal sphincter, and bulbospongiosus
C External vaginal sphincter, deep transverse perineal muscle, and external anal sphincter
D Iliococceageus, ischiocavernosus, and bulbospongiosus
E Levator ani, ischiocavernous, and bulbospongiosus

A✅
The answer is bulbospongiosus, superficial transverse perineal muscle and ischiocavernous.

These three muscles make up the superficial group of perineal muscles.

The bulbospongiosus is superficial to the Bartholin’s glands.

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?
A T8– T12 and L1– L3
B T10– 12 and L1– L2
C S2– S4
D L4– L5 and S1– S4
E L3– L5

B✅
The answer is T10– 12 and L1– L2.

The inferior hypogastric plexus is a continuation of bothhypogastric nerves.

It is derived from the lower three thoracic and upper two lumbar segments.

The parasympathetic and sympathetic supply of this plexus effects uterine contractions and
vasoconstriction.

A urinary catheter Is vigorously inflated in the urethra at the time of caesarean section.
Urineleaks from the rupture into which anatomical space?

A Laterally to the femoral triangles

B Into the vagina
C Into the peritoneal cavity
D Into the lesser pelvis
EInto the anterior abdominal wall and mons pubis
E✅
The answer is into the anterior abdominal wall and mons pubis. This is the only route
possible due to the anatomy of the urethra.

The superficial inguinal ring is strengthened posteriorly by what structure?

A Transversus abdominus
B Superficial inguinal tendon
C Recti adbominus
D Puborectalis
E Falx inguinalis
The answer is the falx inguinalis.

The falx inguinalis is also called the conjoint tendon andstrengthens this anatomical area of
weakness of the abdominal wall. Note that although thesuperficial inguinal tendon sounds
plausible, it actually does not exist.

Which of the following is NOT a branch of the anterior division of the internal iliac artery?
A Ilieolumbar artery
B Internal pudendal artery
C Obturator artery
D Uterine artery
E Vaginal artery

The correct answer is the ilieo lumbar artery.✅

Posterior division branch

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
Illioinguinal is part of inguinal canal

The correct answer is ilioinguinal nerve.✅

The internal pudenda artery leaves the pelvis via:

A Greater sciatic foramen
B Lesser sciatic foramen
C Obturator foramen
D Pudendal canal
E Sacral canal

The correct answer is the greater sciatic foramen.☑️

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.
Regarding the urinary bladder:
A A glycosaminoglycan layer coats the luminal surface of the bladder mucosa
B At the trigone, the epithelium is loosely adherent to the underlying muscle
C The bladder wall consists of two layers of detrusor muscle
D The uterovesical fold creates the Pouch of Douglas
E The urinary bladder is covered entirely by peritoneum

The correct answer is a glycosaminoglycan layer coats the luminal surface of the bladder
mucosa.

The bladder mucosa is transitional epithelium and is loosely connected to the muscularbladder
wall by the lamina propria that serves as a connective tissue layer. T

He bladdersubmucosa or lamina propria is rich in microvasculature and overlies the detrusor

muscle.

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.

The peritoneum covers the

Bladder posteriorly and separates it from the anterior culdesac or vesicouterine pouch and
Abdominal cavity contents.

What size is a follicle that is ready to ovulate?

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

What size is a resting follicle?

A 0.02-0.03 mm
B 2 mm
C 10 mm
D 15 mm
E 20 mm

Correct answer A☑️

Resting follicle have size 0.o2-0.03mm

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

Correct answer A☑️

The follicular antrum is the portion of an ovarian follicle filled with follicular fluid. Appearance
of the follicular antrum during follicular maturation is the first sign that a follicle has reached the
next stage of maturation. It has changed from a primary follicle to a secondary follicle

Which of the following structures does not pass through the diaphragm?
A Azygos vein
B Cisterna chyli
C Inferior vena cava
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

A 21-year-old woman undergoes a laparoscopic ovarian cystectomy to remove a dermoid cyst.

Three days after the operation, she presents to the emergency department feeling unwell and her
haemoglobin level is found to be 6 g/dL.
Damage to a blood vessel is suspected from the laparoscopic procedure.
Which vessel crosses the common and external iliac artery in the infundibulopelvic fold?
A Femoral artery
B Inferior mesenteric artery
C Median sacral artery
D Ovarian artery
E Renal artery

D Ovarian artery ✅

Ovarian arteries are a branch of the abdominal aorta.

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.
Ovarian fosse boundaries also important

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
D Smooth muscle cells
E Stratified squamous epithelium
E Stratified squamous epithelium ☑️

The cervix has a conical shape with a varied epithelium. The ectocervix is the lower intravaginal
portion of the cervix and is lined by non-keratinised stratified squamous 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.

30. A 32-year-old woman undergoes an emergency caesarean section for failure to progress at 9
cm cervical dilatation. Which of the following correctly describes the pelvic shape which has an
anteroposterior diameter of the inlet, greater than the transverse diameter?
A Android
B Anthropoid
C Gynaecoid
D Male
E Platypelloid

. B Anthropoid ☑️

The basic shapes of the pelvis are as follows:

• 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°.

• Platypelloid pelvis (5%): flat female type, AP diameter is short, transverse

Diameter is long, subpubic angle is wide.

Android also has ap diameter more than transverse if anthropoid not in option than only you can
choose android

An 18-year-old woman attends the gynaecology clinic complaining of urinary incontinence, 3

months after suffering a third degree perineal tear during a normal vaginal delivery.
Which muscle forms the main bulk of the levator ani muscle?

A Bulbocavernosus
B Iliococcygeus
C Ischiococcygeus
D Pubococcygeus
E Urogenital diaphragm

D Pubococcygeus ☑️

The levator ani muscle is formed by the pubococcygeus, iliococcygeus and ischiococcygeus.

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.

Puborectalis form sling around anorectal junction ☑️

A 63-year-old woman complains of numbness over her thigh following a radical hysterectomy
for stage IV endometrial carcinoma.
What is the nerve root of the obturator nerve?

A Anterior division L1–L4

B Anterior division L2–L4
C Anterior division L3–L4
D Posterior division L2–L4
E Posterior division L3–L4

B Anterior division L2–L4 ☑️

The obturator nerve arises from the anterior division of L2–L4.

It emerges from the medial border of the psoas major and descends along the muscle. It runs
above and in front of the obturator vessels. It passes through the obturator foramen and enters the
thigh through the obturator canal.
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.

The obturator nerve

Provides sensory innervation to the skin on the medial surface of the thigh.

The posterior branch innervates the deeper adductor muscles.

Obturator nerve : anterior division l2-L4 Femoral nerve : posterior division L2–L4

Femoral nerve emerge at lateral border of psoas major

Obturator from medial border of psoas major

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
C lateral cutaneous nerve of the thigh
D Sciatic
E Superior gluteal

A Inferior gluteal ☑️
Gluteus maximus:
• Origin: posterior gluteal line of inner upper ilium, posterior surface of lower
Sacrum, lumbodorsal fascia and sacrotuberous ligament
• Insertion: iliotibial band, gluteal tuberosity
• Nerve: inferior gluteal
• Artery: superior and inferior gluteal arteries
• Action: extension and external rotation of hip

Inf gluteal- gluteaus maximus

Sup gulteal- gluteus medius and minimus

A 47-year-old woman undergoes a routine transabdominal hysterectomy to remove a large

fibroid uterus. She is found to have a fibroid in the broad ligament and there is concern that her
ureter may have been damaged due to the difficult operation.
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
B Runs lateral to the internal iliac artery
C Ovarian vessels enter the pelvis posterior to the ureters
D Upper one-third of the ureters lie in the abdomen
E Ureters cross close to the bifurcation of the common iliac vessels

Answer:
. E Ureters cross close to the bifurcation of the common iliac vessels ☑️

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

Ureter run over psoas major muscle

A 73-year-old woman undergoes a laparoscopic assisted vaginal hysterectomy and

oophorectomy. There is a large bleed during the procedure and it is converted to a laparotomy.
Which of the following provides the arterial blood supply of the left ovary?

A Abdominal aorta
B External iliac artery
C Internal iliac artery
D Left ovarian artery
E Obturator artery

D Left ovarian 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.

During a laparoscopic-assisted vaginal hysterectomy the surgeon accidentally

Damages the ovarian artery.
Regarding the left ovarian artery, which of the following is correct?

A Anastomoses with the vaginal artery

B Is a branch of the abdominal aorta
C Follows the course of the left ovarian artery
D Lies inferiorly to the inferior mesenteric artery
E Supplies both left and right ovaries

B Is a branch of the abdominal aorta☑️

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
The posterior abdominal wall.

These arteries cross the external iliac vessels at thelevel of the pelvic brim. Each artery supplies
its respective ovary and fallopian tube,
Anastomosing with the uterine arteries.

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
B External anal sphincter
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
A Internal pudendal Posterior division of internal iliac
B Ovarian artery Common Iliac
C Testicular artery Abdominal aorta
D Uterine artery Abdominal aorta
E uterine artery. Ant division of internal ilac

E Uterine artery, anterior division of the internal iliac ☑️

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.

Which of the following is not part of the bony pelvis?

A Fourth lumbar vertebrae
B Ilium
C Ischium
D Pubis
E Sacrum

. A Fourth lumbar vertebrae ☑️

.
The bony pelvis consists of the innominate bone, which is formed from the ilium, ischium and
the pubis, together with the sacrum and the fifth lumbar vertebrae.

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.

Which of the following nerves is transmitted by the superficial inguinal ring?

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

Genital branch of genetofemoral nerve too

Never select genitofemoral nerve as whole

Only its genital branch

Which of the following describes the anatomy of the inguinal region?

A The deep inguinal ring lies at the lateral two-thirds of the inguinal ligament
B The deep inguinal ring transmits the ilioinguinal nerve
C The superficial inguinal ring lies below the pubic tubercle
D The superficial inguinal ring transmits the genitofemoral nerve
E The superficial inguinal ring transmits the round ligament

E The superficial inguinal ring transmits the round 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.

The canal’s boundaries are:

• Anterior wall: external oblique aponeurosis, with lateral reinforcement from the internal
oblique
• Posterior wall: transversalis fascia, with the conjoint tendon (internal oblique and
Transversus abdominis) providing medially
• Superiorly: internal oblique
• Inferiorly: inguinal ligament

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

Correct Answer: Foramen ovale.☑️

Explanation:
Foetal circulation is characterised by presence of three shunts:
Ductus venosus,
Foramen ovale and
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
Right atrium to the left atrium via the foramen ovale.

Where does the inferior rectal vein drain? (2018)

A.Superior mesenteric vein

B Superior rectal vein
C.External pudendal vein
D.Middle rectal vein
E.Internal pudendal vein
Correct Answer: Internal pudendal vein.
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)

Superior mesenteric artery

Inferior mesenteric artery
Bifurcation of aorta
Coeliac trunk
Median sacral artery

Correct Answer: Inferior mesenteric artery.

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
Correct Answer: 60°.

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°.

What is the origin of obturator artery? (2018)

A.Internal Iliac artery

B.External Iliac artery
C.Common Iliac artery
D.Deep circumflex iliac artery
E Femoral artery
Correct Answer: Internal Iliac artery.
Explanation: Obturator artery is a branch of anterior trunk of internal iliac artery.

The artery of the round ligament of the uterus, also known as Sampson’s artery, is a branch of
the inferior epigastric artery

Muscles of internal anal sphincter are derived from: ( 2018)

Longitudinal muscle
Circular muscle
Lavatory ani
External anal sphincter
Detrusor muscle
Correct Answer: Circular 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.
Internally, it is separated from the mucous membrane by internal venous plexus. It is externally
separated from the external sphincter muscle by a conjoint sheath derived from levator ani and
the longitudinal muscles of the rectum.

Nerve and blood supply

Nerve supply: Hypogastric nerve and the pelvic splanchnic nerves.
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).

Muscles found in the scrotum: ( 2018)

Ductus muscle
Tunica albuginea
Dartos muscle
Tunica vaginalis
Sacrum

Correct Answer: Dartos muscle.

Explanation:
The dartos muscle is a sympathetically innervated dermal layer within the scrotum.
Scrotum layers
Some Damn Englishman Called It The Testis

Skin
Dartos
External spermatic fascia
Cremaster fascia
Internal spermatic fascia
Tunica vaginalis
Testis

Inferior epigastric artery is a branch of: (2018)

Internal iliac artery

Superior mesenteric artery
Inferior mesenteric artery
External iliac artery
Superior epigastric artery

Correct Answer: External iliac artery .

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.

Branches of external iliac artery:

 Deep circumflex iliac artery
 Inferior epigastric artery Terminal branch:

When the external iliac artery passes posterior to the inguinal ligament, it is known as the
femoral artery
What is the level of dermatome for epidural at umbilical region? ( 2018)

L1
T12
T10
L3
L1 and L2
Correct Answer: T10. ☑️

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.

Dermatomal innervation of some important regions are:

✨ T4 dermatome innervates the skin region around the nipple
✨ T7 the xiphoid process,
✨T10 the umbilicus
Area of inguinal ligament: T12
✨L1 the groin and S2 the perineum

✨Upper limb (lateral aspect) is from C4-C6,

✨ medial aspect is from C8-T1
✨Skin of the lower limb is innervated from T12-S3.
✨Lateral foot: S1

Ovarian pain may refered to medial thigh too

Uterine pain dermatome involved in first and second stages?

First stage: T11-T12

Second stage:S2,3,4

Suprapubic incision:T12 dermatome

Pfannensteil incision:L1 dermatome

Highest pain to abolish uterine pain: T10

Lowest level to abolish pain L2
Which muscles form the pelvic diaphragm? ( 2018)

Levator ani and coccygeus

Levator ani and piriformis
Obturator internus and coccygeus
Obturator internus and levator ani
Obturator internus and piriformis
Correct Answer: Levator ani and coccygeus .

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.

The levator ani Is made up of three parts: Pubococcygeus, puborectalis, and iliococcygeus. The
coccygeus, situated behind the levator ani and frequently tendinous as much as
Muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.

Bulk of levator anni by pubococcygeous ☑️

Following radical hysterectomy and pelvic lymphadenectomy for Stage I carcinoma of the
cervix, a 63-year-old woman reports weakness of hip adduction. Which nerve most likely to
have been injured during the operation? (2018)

Obturator nerve
Femoral nerve
Inferior gluteal nerve
Superior gluteal 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 ovarian fossa Is a depression in the lateral wall of the pelvis.

The anterior branch of the obturator nerve innervates the adductor longus, adductor brevis and
gracilis muscles,
As well as giving innervation to the hip joint. As a result,

✨there are chances of getting injury to obturator nerve following radical hysterectomy and
pelvic lymphadenectomy which may again lead to weakness of hip adduction.

At which level ovarian artery arises from abdominal aorta? ( 2018)

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

Correct Answer: L2 vertebra.

Explanation:
The ovary is supplied by the ovarian artery, a direct branch of the abdominal aorta. The ovarian
artery
Arises from the aorta at the level of second lumbar vertebra.

Bifurcation of aorta:L4-L5(L4)

Bifurcation of common illac:L5-S1(L5)

Iliac crest:L4-L5

Kindly note the range of vertebrae and also note the one written in bracket if both level come in
comparison
Prefer bracket one

Indirect inguinal hernia is related to: ( 2017)

Lateral to inferior epigastric arteries

Medial to inferior epigastric arteries
Weakening of conjoint tendon
Aponeurosis of the external oblique
Transversalis fascia
Correct Answer: Lateral to inferior epigastric arteries.

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 arte

Correct Answer: Lateral to inferior epigastric arteries.

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.

How to differentiate femoral with inguinal?

Femoral is 4 cm lateral and below pubic tubercle

Femoral hernia more common in females

Inguinal: above and Medial to pubic tubercle
Femoral :below and lateral to pubic tubercle

✨Indirect inguinal hernias arise

✨lateral and superior to the course of the inferior epigastric vessel

✨Direct inguinal hernias protrude

✨medial to the inferior epigastric vessels

Choroid plexus can be found in which of the layer of meninges? (2017)

Arachnoid and dura matter
Pia matter
Dura matter and pia matter
Arachnoid and pia matter
Dura matter and endocranium
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,
Arachnoid mater and pia mater.

The choroid plexus is located in the ventricular system and can be

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.

Located in the inner most layer of meninges pia matter

Which artery provides blood supply to the medial part of the anterior abdominal wall below the
umbilicus?

Superior epigastric artery

Superior mesenteric artery
Intercostal arteries
Inferior mesenteric artery
Inferior epigastric artery

Correct Answer: Inferior epigastric artery.

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

Dr Maria MRCOG 1 Mentor Medhome:

Correct Answer: Squamous.

Explanation:
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
Lining is composed of stratified squamous epithelium, which becomes transitional near the
bladde

All orifice squamous epithelium

Sympathetic supply of bladder largely comes from?

Pudendal nerve
Pelvic splanchnic nerve
Hypogastric nerves
None of these
All of the above
Correct Answer: Hypogastric nerves .

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.
Postganglionic sympathetic fibers also innervate the blood vessels
Of the bladder, and in males, the smooth muscle fibers of the prostate gland.

During laparoscopy, the remnant of the umbilical artery could be identified sometimes that it is
patent. In the adult, the patent segment supplies which vessel?

Internal iliac
Inferior vesical
Superior vesical
External iliac
Internal pudendal
Correct answer C☑️

✨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,

the obliterated area of the vessel is identifiable as the medial umbilical ligament and

the patent segment is the superior vesical artery.

Median umbilical Urachus

Deep perineal and dorsal clitoral nerves are a branch of:

External pudendal
Internal pudendal
Ilioinguinal
Iliohypogastric
None of these

Correct Answer: Internal pudendal.

Explanation:
The internal pudendal nerve arises from the anterior rami of the second to fourth sacral roots.
The pudendal nerve divides into three branches:
1. The dorsal nerve of the clitoris
2. The inferior haemorrhoidal or rectal nerve
3. The deep perineal nerves

Motor fibers to detrusor muscle of the urinary bladder are derived from which of the following
nerves?

Pelvic splanchnic nerves

Greater splanchnic
T11-L2
Superior plexus
Sacral plexus

Correct Answer: Pelvic splanchnic nerves .

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,
Parasympathetic supply is by pelvic splanchnic nerve (S2-S4).

Motor here means: motor acton of detrusor muscle that is contraction

The pathway of piriformis muscle:

Lumbar surface of sacrum, greater sciatic notch, greater trochanter
Pelvic surface of sacrum, greater sciatic notch, trochanter
Lumbar surface of sacrum, lesser sciatic notch, greater trochanter
Pelvic surface of sacrum, lesser sciatic notch, greater trochanter
Pelvic surface of sacrum, greater sciatic notch, greater trochanter
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.

The sacroiliac joint is what type of joint?

Condyloid
Synovial
Primary cartilaginous
Secondary cartilaginous
Fibrous

Correct Answer: Synovial.

Explanation:
The sacroiliac joint is the synovial joint between the sacrum and the ilium bones of the pelvis.
Strongest ligament of sacroiliac joint?
Interosseous ligament is strongest ligament of joint
Sacroiliac resist horizontal rotation of pelvis
Vestibule is:

Area between two labia majora

Area between two labia minora
Area between hymen and labia minora
Area between hymen and labia majora
Area between labia majora and labia minora

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

Correct Answer: NAV.

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
Anterior iliac nerve
Ilioinguinal nerve
Genitofemoral nerve
Lateral cutaneous nerve of thigh

Correct Answer: Lateral cutaneous nerve of thigh.

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

Pyramidalis is supplied by which nerve? (

Obturator nerve
Genitofemoral nerve
Subcostal nerve
Ilioinguinal
Iliohypogastric

Correct Answer: Subcostal nerve.

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.

It Is innervated by a small branch of the subcostal nerve and is supplied by branches of the
inferior epigastric artery.

Appendiceal artery is a branch of:

Ileocolic artery
Inferior mesenteric
Left colic
Middle colic
Right colic
Correct Answer: Ileocolic artery.
Explanation:
Appendiceal artery is a branch of Ileocolic artery.

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.

Coronal suture is located in:

Between frontal and parietal
Between posterior part of parietal and occipital
Between parietal and temporal
Between two parietal bones
Between temporal and occipital

Correct Answer: Between frontal and parietal .

Explanation:

The foetal skull has the following main sutures:

 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.

Squamous suture between temporal and parietal bone

Inferior vesicle artery is a branch of which of the following vessel?

Umbilical artery
Anterior trunk of internal iliac artery
Posterior trunk of internal iliac artery
External iliac vessel
Obturator artery

Correct Answer: Anterior trunk of internal iliac 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
Obturator internus fascia
Obturator externus fascia

Correct Answer: Obturator internus fascia.

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.

Boundaries of ischiorectal fossae:

 Roof: The levator ani muscle forms the inner wall and roof of the ischiorectal fossae
 Medially: The sphincter ani externus and the anal fascia
 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
The urogenital diaphragm
 Posteriorly: The gluteus maximus and the sacrotuberous ligament.

Dr Maria MRCOG 1 Mentor Medhome:

In which of the following anatomical spaces is the external urethral sphincter present?
Superficial perineal pouch
Deep perineal pouch
Ischiorectal fossa
Superficial inguinal space
Deep inguinal space

Correct Answer: Deep perineal pouch.

Explanation:

In females, the deep perineal pouch contains part of the urethra, the external urethral sphincter,
the
Deep transverse perineal muscles and the areolar tissue.
In males, it also contains the bulbourethral glands.

In female internal urethral sphincter is not present

Dr Maria MRCOG 1 Mentor Medhome:

Which one of the following is the termination of round ligament?
Labia minora
Labia majora
Deep inguinal ring
Superficial inguinal ring
Lateral vaginal wall

Correct Answer: Labia majora.

Explanation:
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.

What is bitrochanteric diameter in case of breech presentation? ( 2017)

10 cm
9 cm
11 cm
12 cm
15 cm

Correct Answer: 10 cm.

Explanation:
Bitrochanteric diameter can be defined as the distance between the highest points of the two
greater
Trochanters of the femurs in a foetus. It represents the diameter of engagement, which presents at
the
Pelvic inlet in cases of breech presentation. It measures 10 cm.

Kindly note if
Engaging diameter of subocipito frontal mentioned than choose presentation as occipitoposterior

And if

Engaging diameter of occipitofrontal mentioned than choose direct occipitoposterior

Dr Maria MRCOG 1 Mentor Medhome:
Kindly note if
Engaging diameter of subocipito frontal mentioned than choose presentation as occipitoposterior

And if

Engaging diameter of occipitofrontal mentioned than choose direct occipitoposterior

If they say you engaging diameter was

Subocipito frontal and tell presenting part diameter
Than you have to choose occipitoposterior not direct occipitoposterior

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

Correct Answer: 11 cm.

Explanation:
There are three anterior posterior diameters of the pelvic inlet. These are as follows:

 Anterior-posterior diameter of the pelvic inlet, also known as the true conjugate:
measures 11cm. This diameter is measured from the midpoint of sacral promontory to the upper
border of pubic symphysis.

 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.

Only diagonal conjugate DC can be measured clinically:

True conjugate= DC-1cm
Obstetric conjugate=DC-2cm

Dr Maria MRCOG 1 Mentor Medhome:

Which of the following arteries supplying the uterine endometrium, act as the end arteries?

Uterine artery
Radial artery
Spiral artery
Straight arteries
Arcuate arteries

Correct Answer: Spiral artery.🤗

Explanation:
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.

From the basal arteries,

Spiral arterioles of the endometrium are derived. These are the end vessels.
Dr Maria MRCOG 1 Mentor Medhome:
Fibres of levator ani fuse with which of the following?

Superficial layer of external anal sphincter

Deep layer of external anal sphincter
Subcutaneous layer of external anal sphincter
Both superficial and deep layers of the external anal sphincter
None of the above

Correct Answer: Deep layer of external anal sphincter.

Explanation:
The fibers of the deep layer of the external anal sphincter fuse with the puborectalis part of the
levator
Ani muscle.

The external anal sphincter is comprised of three indistinct parts, or zones:

The upper or deep part,
The middle or superficial part and the lower or subcutaneous part.

Some fibres from the deep part of the external anal sphincter blend with the puborectalis

Dr Maria MRCOG 1 Mentor Medhome:

What is the sensory nerve supply to the cervix?

Pelvic splanchnic nerves

Inferior rectal nerve
Perineal nerve
Superior rectal nerve
Obturator nerve

Correct Answer: Pelvic splanchnic nerves.

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
Parasympathetic and sympathetic nerves supplying the vagina

. The sympathetic fibres are derived

From lumbar splanchnic nerves, whereas the parasympathetic fibres are derived from the pelvic
splanchnic nerves.

Uterus has symptomatic supply

Cervix has parasympathetic

Metastasis to the ascending colon has occurred in a patient with ovarian cancer. What is the
blood supply for ascending part of colon, which needs to be resected in this patient because it is
involved in the oncology surgery?

Superior mesenteric artery

Inferior mesenteric
Right anterior mesenteric
Right colic artery
Middle colic artery

Correct Answer: Superior mesenteric artery.

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.

The blood supply to the colon comes

From the superior and inferior mesenteric arteries.

But the superior mesenteric artery supplies the ascending colon and most of the transverse
colon. The inferior mesenteric artery supplies the distal
One-third portion of transverse colon and the sigmoid colon.

Dr Maria MRCOG 1 Mentor Medhome:

On performing hysteroscopy on a postmenopausal women surgeon find resistance at internal os.
What is the ratio of cervix and uterine corpus till this point?

1:3
3:1
1:1
1:2
2:1

Correct Answer: 1 :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.
Dr Maria MRCOG 1 Mentor Medhome:
Superior rectal artery is directly branched from:

Gonadal artery
Lumbar artery
Superior mesenteric artery
Inferior mesenteric artery
Medial sacral artery

Correct Answer: Inferior mesenteric 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
Kindly tell which branch or internal illac is usually absent?

Middle rectal artery is usually absent ,☑️

Dr Maria MRCOG 1 Mentor Medhome:

What is the anatomical location of Bartholin’s gland?
Deep perineal pouch
Ischiorectal fossa
Pudendal canal
Superficial perineal pouch
Urogenital diaphragm

Correct Answer: Superficial perineal pouch

Explanation:
Superficial perineal pouch
 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.
Contents of superficial perineal pouch
 Muscles: Ischiocavernosus, Bulbospongiosus and Superficial Transverse Perineal
muscles.
 Erectile bodies: Corpus cavernosum of penis and clitoris and corpus spongiosus of penis.
 Vessels: Posterior scrotal arteries in males, labial arteries in females, artery to
bulb/vestibule,
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.

Dr Maria MRCOG 1 Mentor Medhome:

Pudendal cleft can be defined as:
Area between labia majora and thigh
Area between labia majora and hymen
Area between labia majora
Area between labia minora
None of the above

Correct Answer: Area between labia majora.

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
Particularly rich in collagen as well as elastic fibers.

Which structure in female is homologous to male prostate?

Skene gland
Gartner duct
Bartholin’s gland
Labia majora
None of the above

Correct answer A☑️

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

What is the nerve supply of external anal sphincter?

Pelvic splanchnic nerve
Pudendal nerve
Inferior hypogastric plexus
Superior hypogastric plexus
None of the above

Correct Answer: 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
And perineal branch of the fourth sacral nerve.

Which dermatome level innervates the fifth digit of the foot?

T12
L4
S1
S2
S3

Correct answer C☑️

Dorsal artery of clitoris and deep artery of clitoris is a branch of:

External iliac artery

Internal pudendal artery
Superior vesical artery
Inferior vesicular artery
Middle rectal artery
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
Common peroneal nerve
Femoral nerve
Ilioinguinal nerve
Obturator nerve
Pudendal nerve

Correct Answer: Femoral 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.

Injury to the femoral nerve causes weakness of the quadriceps

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.
Upper medial : femoral
Lower medial: obturator
Illioinguinal : groin

Dr Maria MRCOG 1 Mentor Medhome:

Which of the following structure passes through the greater sciatic foramen?

Pubococcygeus
Iliococcygeus
Puborectalis
Piriformis
Coccygeus

Correct Answer: Piriformis .

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

 One muscle: Piriformis

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?

Anterior rectus sheath

Posterior rectus sheath
Rectus abdominis muscle
Skin and subcutaneous tissue
Transversalis fascia and parietal peritoneum
B
Correct Answer: Posterior rectus sheath .
Explanation:
While giving a lower transverse suprapubic incision during the caesarean section the following
layers
Should be cut:
 Skin
 Subcutaneous tissue
 Anterior rectus sheath
A 23-year-old woman undergoes an ovarian cystectomy (laparoscopic) to remove a cyst.
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
Median sacral artery

Correct Answer: Ovarian 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.
Dr Maria MRCOG 1 Mentor Medhome:
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

Correct Answer: 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
Dr Maria MRCOG 1 Mentor Medhome:
Caput medusae are due to engorgement of which of the following vessels?
Hepatic vein
Splenic vein
Umbilical vein
Umbilical artery
Superficial epigastric 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?
1. Deep part of external sphincter
2. Subcutaneous part of external sphincter
3. Internal sphincter
4. Superficial part of external sphincter

1,4,2,3
2,1,4,3
3,1,4,2
3,2,1,4
2,4,1,3

Correct Answer: 3,1,4,2.

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
From the perianal skin by external venous plexus.

2. Superficial part: It is elliptical in shape and lies external to the lower part of the internal
sphincter between the levels of the pectinate line and the white line. The fibres of this part
are
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?

Internal iliac lewy neurites (LN)

External iliac LN
Aortic LN
External iliac + internal iliac + common iliac + aortic LNs
External iliac + internal iliac + obturator + sacral LNs

Correct Answer: External iliac + internal iliac + obturator + sacral LNs.

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.

Lateral part: external iliac, para cervical,obturator nodes

Posterior: sacral

Posterolateral: internal illac

And vagina lymphatic drainage?

Upper2/3rd: external+ internal illac

Lower 1/3rd : superficial inguinal

Vula, external genitilia all in sup inguinal

Clitoris in : deep inguinal

Ovary: para aortic

Fundus+ uper body part of uterus +lateral fallopian tube: para aortic

Cornua of uterus: superficial inguinal

Lower body of uterus: external iliac

Medical fallopian tube: internal illac

Following is the narrowest part of Fallopian tube?

Intramural part
Isthmus
Ampulla
Infundibulum
Fimbriae

A✅
Intramural shortest and narrowest
Isthmamus narrower
Ampuls widest

The deep circumflex iliac artery is a branch of which artery?

Internal iliac artery

Internal pudendal artery
External iliac artery
Common iliac artery
Femoral artery

Just Google the diameter of different parts of fallopian tube you will get to know
intramural is narrowest

Correct Answer: External iliac artery.

Explanation:
The external iliac artery arises from the common iliac artery and gives off two branches:
the inferior
Epigastric artery and the deep circumflex iliac artery. The deep circumflex iliac artery
and the
Corresponding vein run along the internal surface of the ala of the ilium to supply the
muscles located
There.

Dr Maria MRCOG 1 Mentor Medhome:

During laparoscopy you visualise medial umbilical folds. What structure does it contain?

Median umbilical ligament

Umbilical vein
Inderior epigastric vein
Umbilical artery
Urachus
Correct answer D☑️

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

Dr Maria MRCOG 1 Mentor Medhome:

Which of the following arteries is a terminal branch (not paired) of the abdominal aorta?

Gonadal
Median sacral
Phrenic
Renal
Suprarenal

B ✅✅✅

Correct Answer: Median sacral.

Explanation:
The thoracic aorta pierces the diaphragm at T12 to become the abdominal aorta.
The abdominal aorta has three terminal branches which are:
Right and left common iliac arteries and the median sacral artery.

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

What is the characteristic feature of Hirschsprung's disease? 2018)

Presence of parasympathetic nerve ganglia

Absence of parasympathetic nerve ganglia
Absence of sympathetic nerve ganglia
Presence of sympathetic nerve ganglia
None of the above

Correct Answer: Absence of parasympathetic nerve ganglia

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.

Which vertebral level does the aorta bifurcate? (2018)

L1
L2
L3
L4
T12

Correct Answer: L4.

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.

Common illac bifurcation at L5

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?

Ventral nerve of clitoris

Medial rectal nerve
Lateral rectal nerve
Superior rectal nerve
Inferior rectal nerve

Correct Answer: Inferior rectal nerve.

Explanation:
It is important to be aware of the anatomy of the pudendal nerve as pudendal nerve block
is a
commonly used procedure. Pudendal nerve block targets the pudendal nerve trunk as it
enters the
lesser sciatic foramen, approximately 1 cm inferior and medial to the attachment of the
sacrospinous
ligament to the ischial spine.

Artery supplying round ligament is a branch of:

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.

Dr Maria MRCOG 1 Mentor Medhome:

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?

Ventral nerve of clitoris

Medial rectal nerve
Lateral rectal nerve
Superior rectal nerve
Inferior rectal nerve

Correct Answer: Inferior rectal nerve.

Explanation:
It is important to be aware of the anatomy of the pudendal nerve as pudendal nerve block
is a
Commonly used procedure. Pudendal nerve block targets the pudendal nerve trunk as it
enters the
Lesser sciatic foramen, approximately 1 cm inferior and medial to the attachment of the
sacrospinous
Ligament to the ischial spine.

Artery supplying round ligament is a branch of:

Inferior epigastric
External iliac
Uterine
Uterine
Internal iliac

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:

Internal iliac artery

Inferior epigastric artery
Superior gluteal artery
Inferior gluteal or internal pudendal arteries
External iliac artery

Correct Answer: Internal iliac artery .

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°

Correct Answer: 45°,60°.

Explanation:
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.

90• is the angle of anti version

That is bending of uterus over longitudinal axis of vagina