Download Perineum and pelvis

Perineum and pelvis
1. Carcinoma of the uters can spread directly to the labia majora in
lymphatics that follow which of the following structures?
(A)
(B)
(C)
(D)
(E)
Pubic arcuate ligament
Suspensory ligament of the ovary
Cardinal ligament
Suspensory ligament of the clitoris
Round ligament of the uterus
2. Tenderness and swelling of the left testicle may be produced by
thrombosis in which of the following veins ?
(A)
(B)
(C)
(D)
(E)
Left
Left
Left
Left
Left
internal pudendal vein
renal vein
internal iliac vein
internal epigastric vein
external pudendal vein
3. If a stab wound injures structures that leave the pelvis above the
piriformis muscle , which of the following structures is most likely
to be damaged ?
(A)
(B)
(C)
(D)
(E)
Sciatic nerve
Internal pudendal artery
Superior gluteal nerve
Inferior gluteal artery
Posterior femoral cutaneous nerve
4. Which of the following ligaments normally is found in theinguinal
canal ?
(A)
(B)
(C)
(D)
(E)
Suspensory ligament of the ovary
Ovarian ligament
Mesosalpinx
Round ligament of the uterus
Rectouterine ligament
5. Parasympathetic preganglionic fibers in the pelvic splanchnic nerves
synapse in which of the following ganglia ?
(A) Ganglia in or near the viscerae or pelvic plexus
(B)
(C)
(D)
(E)
Sympathetic chain ganglia
Collateral ganglia
Dorsal root ganglia
Ganglia impar
6. As the uterine artery passes from the internal iliac artery to the
uterus ,it crosses which of the following structures that is sometimes
mistakenly ligated during pelvic surgery ?
(A)
(B)
(C)
(D)
(E)
Ovarian artery
Ovarian ligament
Uterine tube
Ureter
Round ligament of the uterus
7. Tearing of the pelvic diaphragm during childbirth leads to paralysis
of which of the following muscles ?
(A)
(B)
(C)
(D)
(E)
Piriformis
Sphincter urethrae
Obturator internus
Levator ani
Sphincter ani externus
8.A lesion on the sacral splanchnic nerves would
of the following nerve fibers?
(A)
(B)
(C)
(D)
(E)
primarily damage which
Postganglionic parasympathetic fibers
Postganglionic sympathetic fibers
Preganglionic sympathetic fibers
Preganglionic parasympathetic fibers
Postganglionic sympathetic and parasympathetic fibers
9.Which of the following statements is correct ?
(A)
(B)
(C)
(D)
(E)
The ovary lies within the broad ligament
The glans clitoris is formed from the corpora cavernosa
Erection of the penis is a sympathetic response
Ejaculation follows parasympathetic stimulation
The ureter crosses superior to the uterine artery near the uterine
cervix
10. Which of the following structures constitues the superior boundary
of the superficial perineal space ?
(A)
(B)
(C)
(D)
(E)
Pelvic diaphragm
Colles’fascia
Superficial layer of the superficial fascia
Deep layer of the superficial fascia
Perineal membrane
11.A slowly growing tumor in the deep perineal space would most likely
injure which of the following structures ?
(A)
(B)
(C)
(D)
(E)
Bulbourethral glands
Crus of penis
Bulb of vestibule
Spongy urethra
Great vestibular gland
12. Which of the following lobes of the prostate gland is commonly involved
in benign hypertrophy ,which obstructs the prostatic urethra ?
(A)
(B)
(C)
(D)
(E)
Anterior lobe
Middle lobe
Right lateral lobe
Left lateral lobe
Posterior lobe
13.The prostatic ducts open into or on which of the following structures ?
(A)
(B)
(C)
(D)
(E)
Membranous part of the urethra
Seminal colliculus
Cavernous urethra
Prostatic sinus
Prostatic utricle
14.The duct of the seminal vesicle
(A)
(B)
(C)
(D)
(E)
joins the duct of a bulbourethral gland to form the ejaculatory duct
opens into the membranous urethra
transmits spermatozoa into the membranous urethra
widens to form the ampulla of the ductus deferens
unites with the ductus deferens to form an ejaculatory duct
15. Which of the following events occurs during ejaculation ?
(A)
(B)
(C)
(D)
(E)
Opening of the urethral sphincter at the neck of the bladder
Pumping out of secretions of the prostate gland and seminal vesicles
Relaxation of smooth muscles in the ductus deferens
Accumulation of semen in the prostatic urethra
Excretion of urine from the bladder
16.Destruction of the urogenital diaphragm most likely causes paralysis
of which of the following muscles ?
(A)
(B)
(C)
(D)
(E)
Sphincter urethrae
Coccygeus
Superficial transversus perinei
Levator ani
Obturator internus
17.A benign tumor located tumor located near a gap between the arcuate
pubic ligament and the transverse perineal ligament might compress which
of the following structures?
(A)
(B)
(C)
(D)
(E)
Dorsal nerve of the penis
Deep dorsal vein of the penis
Superficial dorsal vein
Dorsal artery of the penis
Deep artery of the penis
18.If an obtetrician performs a median episiotomy that damages the
perineal body ,the function of which of the following muscles might be
impaired ?
(A)
(B)
(C)
(D)
(E)
Ischiocavernosus and sphincter urethrae
Deep transverse perineal obturator internus
Bulbospongiosus and superficial transverse perineal
External anal sphincter and sphincter urethrae
Bulbospongiosus and ischiocavernosus
19.A 22-year-old man has a gonorrheal infection that has infiltrated the
space between the inferior fascia of the urogenital diaphragm and the
superficial perineal fascia.Which of the following structures might be
inflamed ?
(A)
(B)
(C)
(D)
Prostate gland
Bulbourethral gland
Membranous part of the male urethra
S uperficial transverse perineal muscle
(E) Sphincter urethrae
20. Which of the following ducts opens into the prostatic sinus ?
(A)
(B)
(C)
(D)
(E)
Duct of the seminal vesicle
Duct of the prostate gland
Ejaculatory duct
Duct of the bulbourethral gland
Ductus deferens
21.The normal position of the uterus is
(A)
(B)
(C)
(D)
(E)
anteflexed and anteverted
retroflexed and anteverted
anteflexed and retroverted
retroverted and retroflexed
anteverted and retroverted
22.The deep dorsal vein of the penis
(A)
(B)
(C)
(D)
(E)
lies deep to buck’s fascia
drains into the prostatic venous plexus
lies lateral to the dorsal artery of the penis
is found in the corpus spongiosum
is dilated during erection
23. A 62-year-old man is incapable of penile erection after rectal surgery
with prostatectomy.The patient most likely has a lesion of which of the
following nerves ?
(A)
(B)
(C)
(D)
(E)
Dorsal nerve of the penis
Perineal nerve
Hypogastric nerve
Sacral splanchnic nerve
Pelvic splanchnic nerve
24. Which of the following structures is drained by the lumbar (aortic)
lymph nodes ?
(A)
(B)
(C)
(D)
(E)
Perinum
Lower part of the vagina
External genitalia
Ovary
Lower part of the anterior abdominal wall
25.Infection within the ischiorectal fossa most likely injures w hich of
the following structures ?
(A)
(B)
(C)
(D)
(E)
Vestibular bulb
Seminal vesicle
Greater vestibular gland
Inferior rectal nerve
Internal pudendal artery
26. Which of the following statements concerning structures in the
perineum and pelvis is correct ?
(A)
(B)
(C)
(D)
(E)
The dorsal artery of the penis supplies the glans penis
The mesometrium is a fold of peritoneum that suspends the uterine tube
The duct of the bulbourethral gland opens into the membranous urethra
The duct of the greater vestibular gland opens into the vagina
The anterior lobe of the prostate gland is prone to carcinomatous
transformation
27. Which of the following structures plays the most important role in
the support of the uterus?
(A)
(B)
(C)
(D)
(E)
Levator ani
Sphincter urethrae
Uterosacral ligament
Ovarian ligament
Arcuate pubic ligament
28. A 16-year-old boy presents to the emergency department with rupture
of the penile urethra. Extravasated urine from this injury can spread into
which of the following structures ?
(A)
(B)
(C)
(D)
(E)
Scrotum
Ischiorectal fossa
Deep perineal space
Testis
Thigh
29.During vaginal examination , which of the following structures may be
palpated ?
(A) Apex of the urinary bladder
(B) Fundus of the uterus
(C) Terminal part of the round ligament of the uterus
(D) Body of the clitoris
(E) Uterine cervix
30. Which of the following structures lies in the broad ligament for all
or part of its course?
(A)
(B)
(C)
(D)
(E)
Ovary
Proximal part of the pelvic ureter
Terminal part of the round ligament of the uterus
Uterine tube
Suspensory ligament of the ovary
31.During rectal examination in the male, which of the following
structures is most readily palpated ?
(A)
(B)
(C)
(D)
(E)
Prostate gland
Epididymis
Ejaculatory duct
Ureter
Testis
32. Which of the following statements concerning the levator ani is
correct ?
(A)
(B)
(C)
(D)
(E)
It is innervated by the pelvic splanchnic nerve
The iliococcygeus is the most anteromedial part of the levator ani
The pubococcygeus may be torn during parturition
It forms the lateral wall of the ischiorectal fossa
It forms the major part of the urogenital diaphragm
33.Part of the boundary of the pelvic inlet is formed by which of the
following structures ?
(A)
(B)
(C)
(D)
(E)
Promontory of the sacrum
Anterior-inferior iliae spine
Inguinal ligament
Iliac crest
Pubic tubercle
34.A 32-year-old patient with multiple fractures of the pelvis has no
cutaneous sensation in the urogenital triangle. The function of which of
the following nerves is most likely to be spared ?
(A)
(B)
(C)
(D)
(E)
Ilioinguinal nerve
Iliohypogastric nerve
Posterior cutaneous nerve of the thigh
Pudendal nerve
Genitofemoral nerve
35.The victim of an automobile accident has received destructive damage
to structures that form the boundary of the perineum. Which of the
following structures is spared ?
(A)
(B)
(C)
(D)
(E)
Pubic arcuate ligament
Tip of the coccyx
Ischial tuberosities
Sacrospinous ligament
Sacrotuberous ligament
36. Which of the following statements is most applicable to the scrotum?
(A)
(B)
(C)
(D)
(E)
It is innervated by the ilioinguinal nerve
It receives blood primarily from the testicular artery
Its venous blood drains primarily into the renal vein on the left
Its lymphatic drainage is primarily into upper lumbar nodes
Its dartos tunic is continuous with perineal membrane
37.A 37-year-old woman with uterine prolapse has an intact anal canal .
Which of the following structures is most likely to function normally?
(A)
(B)
(C)
(D)
(E)
External and sphincter
Broad ligament of the uterus
Cardinal (transverse) cervical ligament
Pelvic diaphragm
Sphincter urethrae
38.When performing a mediolateral episiotomy during breech delivery,an
obstetrician should avoid incising which of the following structures ?
(A)
(B)
(C)
(D)
(E)
Vaginal wall
Superficial transverse perineal muscle
Bulbospongiosus
Levator ani
Perineal membrane
39.During pelvic surgery,a surgeon notices severe bleeding from the
artery that remains within the true pelvis. Which of the following artery
is most likely to be injured ?
(A)
(B)
(C)
(D)
(E)
Iliolumbar artery
Obturator artery
Uterine artery
Internal pudendal artery
Inferior gluteal artery
40. Which of the following nerves from the lumbosacral plexus remains
within the abdominal or pelvic cavity ?
(A)
(B)
(C)
(D)
(E)
Ilioinguinal nerve
Genitofemoral nerve
Lumbosacral trunk
Femoral nerve
Lateral femoral cutaneous nerve
41.Infection in the deep perineal space would most likely damage Which
of the following structures ?
(A)
(B)
(C)
(D)
(E)
Ischiocavernosus muscles
Superficial transverse perineal muscles
Levator ani
Sphincter urethrae
Bulbospongiosus
42.Upper lumbar nodes most likely receive lymph from which of the
following structures ?
(A)
(B)
(C)
(D)
(E)
Lower part of the anal canal
Labium majus
Clitoris
Testis
Scrotum
43. Which of the following structures
brim ?
(A)
(B)
(C)
(D)
(E)
Deep dorsal vein of the penis
Uterine tube
Ovarian ligament
Uterine artery
Lumbosacral trunk
most likely crosses the pelvic
44. Which of the following statements is most applicable to the
bulbourethral (Cowper’s) gland ?
(A)
(B)
(C)
(D)
(E)
It lies in the superficial perineal space
It is embedded in the sphincter urethrae
It produces sperm
Its duct opens into the membranous portion of the penile urethra
It lies on either side of the bulb of the penis
45. Which of the following statements best explains the sphincter
urethrae ?
(A)
(B)
(C)
(D)
(E)
Smooth muscle
Innervated by the perineal nerve
Lying between the perineal membrane and Colles’fascia
Enclosed in the pelvic fascia
Part of the pelvic diaphragm
46.The pudendal nerve
(A)
(B)
(C)
(D)
passes superficial to the sacrotuberrous ligament
innervates the testis and epididymis
provides motor fibers to the coccygeus
can be blocked by injecting an anesthetic near the inferior margin
of the ischial spine
(E) arises from the lumbar plexus
47. Which of the following statements concerning the ischiorectal fossa
is correct ?
(A)
(B)
(C)
(D)
(E)
It
It
It
It
It
accumulates urine leaking from rupture of the bulb of the penis
contains the inferior rectal vessels
has a pudendal canal along its medial wall
is bounded anteriorly by the sacrotuberous ligament
contains a perineal branch of the fifth lumbar nerve
48.The seminal colliculus of the prostate gland is infected,and its fine
openings are closed . Which of the following structures is most likely
to be disturbed ?
(A)
(B)
(C)
(D)
Ducts of the prostate gland
Prostatic utricle
Ducts of the bulbourethral glands
Ejaculatory ducts
(E) Duct of the seminal vesicles
49. Which of the following best describes characteristics of structures
above the pectinate line of the anal canal ?
(A)
(B)
(C)
(D)
(E)
Stratified squamous epithelium
Venous drainage into the caval system
Lymphatic drainage into the superficial inguinal nodes
Visceral sensory innervation
External hemorrhoids
50. Which of the following best describes characteristics
pelvis compared to the female ?
(A)
(B)
(C)
(D)
(E)
Smaller and lighter
Transversely oval inlet
Smaller outlet
Wider and shallower cavity
Larger subpubic angle
Answer
questions 51-55 using the diagram below
51. Which of the following structures passes through C ?
(A)
(B)
(C)
(D)
(E)
Iliolumbar artery
Umbilical artery
Ilioinguinal nerve
Obturator nerve
Nerve to the obturator internus muscle
52. Which of the following structures passes through D ?
(A)
(B)
(C)
(D)
(E)
Pudendal nerve
Posterior cutaneous nerve of the thigh
Tendon of the obturator externus muscle
Inferior gluteal artery
Piriformis muscle
53. Which of the following structures passes through A
(A) Quadratus femoris muscle
(B) Lumbosacral trunk
(C) Internal pudendal artery
?
of the male
(D) Obturator nerve
(E) Tendon of the obturator internus muscle
54. Which of the following structures passes through B ?
(A)
(B)
(C)
(D)
(E)
Greater saphenous
Saphenous nerve
External pudendal artery
Femoral vein
Genitofemoral nerve
55. Which of the following structures passes through both A and D ?
(A)
(B)
(C)
(D)
(E)
External pudendal arter
Nerve to quadratus femoris
Obturator nerve
Tendon of the obturator internus
Pudendal nerve
Match each of the following descriptions with the appropriate lettered
structure in the magnetic resonance image(MRI) of the perineum and pelvis
in the female.
56.Structure that extends between the vestibule and the cervix of the
uterus and serves as the excretory channel for the products of
menstruation .
57. Structure in the female that is much shorter than that in the male
58. Structure into which hemorrhage occurs following injury to the
inferior rectal vessels.
59. Structure that has houston’s valve or fold ,with its venous blood
drained by the portal venous system.
60. Structure that is innervated by the nerve passing through both the
greater and lesser sciatic foramina.