Mock Exam 01
Final Mock 1
MRCOG Part 1 practice — 107 questions with answers and explanations. Cleaned for readability.
Q1. The posterior fontanelle usually closes by what age? - A) 3 months - B) 6 months - C) 9 months - D) 12 months - E) 18 months
Explanation: The sequence of fontanelle closure is as follows: 1) posterior fontanelle generally closes 2-3 months after birth 2) sphenoidal fontanelle is the next to close around 6 months after birth 3) mastoid fontanelle closes next from 6-18 months after birth and 4) the anterior fontanelle is generally the last to close between 1-3 years of age - A) uterus? * Ovarian artery * Uterine artery * Vaginal artery * Superior vesical artery - E) Inferior epigastric artery
Explanation: The artery of the round ligament of the uterus, also known as Sampson's artery, is a branch of the inferior epigastric artery. It runs under, and supplies, the round ligament of the uterus. It constitutes an anastomosis of the uterine artery and ovarian artery.
Q2. At what lumbar vertebrae does the abdominal aorta bifurcate into - A) the two common iliac arteries? - B) L1 - C) L2 - D) L3 - E) L4 L5
Explanation: L4
Q3. The level at which the ovarian artery arises from the abdominal - A) aorta is? - B) T10 - C) T12 - D) L1 - E) L2 L3
Explanation: Ovarian arteries generally arise from the anterolateral (or lateral) aspect of the abdominal aorta caudal to the origin of the renal arteries at the level of L2 vertebrae. - A) superior to the pectinate line? * Celiac trunk artery * Superior mesenteric artery * Inferior mesenteric artery * Internal iliac artery - E) External iliac artery
Explanation: The anal canal above the pectinate line is supplied by the terminal branches of the superior rectal (hemorrhoidal) artery, which is the terminal branch of the inferior mesenteric artery. Above the pectinate line – derived from the embryonic hindgut. Below the pectinate line – derived from the ectoderm of the proctodeum.
Q4. An obstetrician performs a mediolateral episiotomy to expand the - A) birth canal during a child birth. - B) Which of the following muscles is typically incised during this procedure? - C) Bulbospongiosus and Levator ani muscles - D) Ischiocavernosus and Levator ani muscles - E) Bulbospongiosus and Ischiocavernosus muscles * Bulbospongiosus and Deep transverse perineal muscles Bulbospongiosus and Superficial transverse perineal muscles
Explanation: The anatomic structures involved in a mediolateral episiotomy include the vaginal epithelium, transverse perineal muscle, bulbocavernosus muscle, and perineal skin
Q5. Forms the lateral wall of the ischiorectal fossa? - A) Skin - B) Anal canal - C) Obturator internus fascia - D) Vagina - E) Rectum
Explanation: Anteriorly: Posterior free border of urogenital diaphragm. Posteriorly: Lower border of gluteus maximus and sacrotuberous ligament. Medially: Levator ani above and sphincter ani externus below. Laterally: Obturator internus with obturator fascia above and ischial tubrosity below.
Q6. A 30-year-old P1+0 woman presents with painful swelling in right - A) posterolateral part of vagina and fever for 3 days. Diagnosis of Bartholin’s - B) abscess is made. Incision and drainage is planned. - C) What is the anatomical location of Bartholin’s gland? - D) Superficial perineal pouch - E) Deep perineal pouch * Urogenital diaphragm * Ischiorectal fossa Pudendal canal
Explanation: The Bartholin's glands develop from buds in the epithelium of the posterior area of the vestibule. The glands are located bilaterally at the base of the labia minor and drain through 2- to 2.5-cm–long ducts that empty into the vestibule at about the 4 o'clock and 8 o'clock positions.
Q7. Sympathetic supply to the urinary bladder is derived from which - A) lumbar segments? - B) L1 and L2 - C) L2 and L3 - D) L3 and L4 - E) L4 and L5 S2, S3 and S4
Explanation: When the sympathetic nervous system is active, it causes the bladder to increase its capacity without increasing detrusor resting pressure (accommodation) and stimulates the internal urinary sphincter to remain tightly closed. Sympathetic – hypogastric nerve (T12 – L2). It causes relaxation of the detrusor muscle, promoting urine retention. Parasympathetic – pelvic nerve (S2-S4). Increased signals from this nerve causes contraction of the detrusor muscle, stimulating micturition. Somatic – pudendal nerve (S2-4). It innervates the external urethral sphincter, providing voluntary control over micturition. - A) minimum of muscular support? * Sacrospinous ligament * Sacrotuberous ligament * Iliolumbar ligament * Iliofemoral ligament - E) Pubofemoral ligament
Explanation: The iliofemoral ligament is the strongest ligament in the body and attaches the anterior inferior iliac spine (AIIS) to the intertrochanteric crest of the femur. In a standing posture, when the pelvis is tilted posteriorly, the ligament is twisted and tense, which prevents the trunk from falling backwards and the posture is maintained without the need for muscular activity. In this position the ligament also keeps the femoral head pressed into the acetabulum.
Q8. In which part of the female urogenital system describes the - A) Vestibule? - B) Space between labium minus - C) Space between labium majus - D) Space between labia minora and majora - E) Area around hymen Area between hymen and labia minora
Explanation: Structures opening in the vulval vestibule are the urethra, vagina, bartholin's glands, and skene's ducts.
Q9. To perform an elective lower segment caesarean section, the - A) obstetrician makes a transverse suprapubic incision. - B) Which of the following abdominal wall layers will not be encountered - C) transected during this incision? - D) Anterior rectus sheath - E) Posterior rectus sheath * Rectus abdominis muscle * Skin and subcutaneous tissue Transversalis fascia and parietal peritoneum
Explanation: Posterior rectus sheath
Q10. A 35-year-old diabetic woman underwent vaginal surgery. - A) Postoperatively, she has loss of cutanous sensation over the anterior and - B) lateral surface of the thigh. - C) The compression of which nerve is likely to be responsible? - D) Superior gluteal nerve - E) Sciatic nerve * Femoral nerve * Lateral cutaneous nerve Obturator nerve
Explanation: Meralgia paresthetica is a medical condition resulting from compression (pressure on or squeezing) of the lateral femoral cutaneous nerve (LFCN). This large nerve supplies sensation to the front and side of thigh. Meralgia paresthetica results in sensations of aching, burning, numbness, or stabbing in the thigh area. - A) from which of the following nerves? * Greater splanchnic * Lesser splanchnic * Least splanchnic * Superior hypogastric plexus - E) Pelvic splanchnic
Explanation: The detrusor muscle is under autonomic control. The parasympathetic nervous system stimulates the muscarinic stretch receptors in the bladder through the pelvic nerve fibers. When urine fills the bladder, the M3 receptors located within the bladder become stretched and stimulated, which leads to the contraction of the detrusor muscle for urination. At the same time, the parasympathetic fibres inhibit the internal urethral sphincter, which causes relaxation allowing for bladder emptying. - A) the greater sciatic foramen? * Pubococcygeus * Puborectalis * Iliococcygeus * Piriformis - E) Coccygeus
Explanation: The piriformis muscle passes through the foramen and occupies most of its volume.
Q11. To reduce postoperative pain after caesarean section, an - A) obstetrician performs lliohypogastric and llioinguinal nerve block on his - B) 25-year-old patient. - C) What is the nerve root of lliohypogastric and llioinguinal nerve? - D) T12 - E) T12 and L1 * L1 * L2 L1 and L2
Explanation: The T12–L1 nerve root gives rise to the ilioinguinal and iliohypogastric nerves
Q12. During a difficult delivery an obstetrician uses forceps to extract - A) the infant. Upon examining the baby you notice forceps impressions - B) postero inferior to the ear. - C) Which of the following is very likely to be damaged? - D) Trigeminal nerve - E) Facial nerve * Abducens nerve * Brachial plexus Radial nerve
Explanation: Facial nerve
Q13. A 36-year-old woman who had supraspinous ligament fixation 2 - A) days ago complains of pain over right mons pubis, right labia, and the - B) perineum. - C) Which nerve is most likely to be injured? - D) Iliohypogastric nerve - E) Ilioinguinal nerve * Genitofemoral nerve * Pudendal nerve Posterior femoral cutaneous nerve
Explanation: Sacrospinous colpopexy requires the placement of a suture through the sacrospinous ligament, under which lies the pudendal nerve. Entrapment of this nerve may result in perineal or buttock pain.
Q14. Following Radical hysterectomy and Pelvic lymphadenectomy for - A) Stage I carcinoma of the cervix, 63-year-old woman reports numbness - B) along the medial thigh as well as weakness of hip adduction. - C) Which nerve most likely to have been injured during the operation? - D) Obturator nerve - E) Femoral nerve * Superior gluteal nerve * Inferior gluteal nerve Sciatic nerve
Explanation: Femoral nerve - A) the inguinal ligament, just medial to the anterior superior iliac spine? * Femoral nerve * Iliohypogastric nerve * Ilioinguinal nerve * Genitofemoral nerve - E) Lateral cutaneous nerve of thigh
Explanation: Entrapment is caused by compression of the nerve near the ASIS and inguinal ligament and is commonly known as Meralgia paraesthetica or Bernhardt-Roth syndrome.
Q15. A 30-year-old para 1 woman with previous normal delivery went - A) into spontaneous labour at term and was fully dilated for 3 hours. After - B) pushing for 90 minutes, ventouse delivery was performed for maternal - C) exhaustion. At the ventouse cup application area, the baby's head is left - D) with a "chignon". - E) In which layer of the skull chignon is found? * Subcutaneous * Subaponeurotic * Subperiosteal * Subdural Extradural
Explanation: Subcutaneous - A) femoral artery? * Crest of the ilium * Inguinal ligament * Pubic tubercle * Symphysis pubis - E) Obturator foramen
Explanation: The external bony landmark to the level of the bifurcation of the common iliac artery is the anterosuperior iliac spine The external iliac artery passes beneath the inguinal ligament in the lower part of the abdomen and becomes the femoral artery.
Q16. Lymphatics of the sigmoid colon drain into - A) Superior mesenteric and Pre aortic lymph nodes - B) Inferior mesenteric and Pre aortic lymph nodes - C) Internal iliac lymph nodes - D) External iliac lymph nodes - E) Obturator lymph nodes
Explanation: Splenic flexure- Pericolic, middle colic, left colic, inferior mesenteric Descending colon- Pericolic, left colic, inferior mesenteric, sigmoid Sigmoid colon- Pericolic, inferior mesenteric, superior rectal, superior hemorrhoidal, sigmoidal, sigmoid mesenteric * Coeliac trunk * Superior mesenteric artery * Inferior mesenteric artery * Internal iliac artery - E) External iliac artery
Explanation: Inferior mesenteric artery - A) sciatic foramen? * Iliococcygeus * Piriformis * Sciatic nerve * Posterior femoral cutaneous nerve - E) Tendon of obturator internus
Explanation: The lesser sciatic foramen has as its boundaries the ischial body anteriorly, the ischial spine and the sacrospinous ligament superiorly and the sacrotuberous ligament posteriorly. The tendon and nerve of obturator internus as well as the pudendal nerve and vessels pass through the foramen. - A) digestive system? * Coeliac trunk * Superior mesenteric artery * Inferior mesenteric artery * Right umbilical artery - E) Intercostal artery
Explanation: Coeliac trunk * Labia minora * Labia majora * Deep inguinal ring * Superficial inguinal ring - E) Lateral vaginal wall
Explanation: Labia majora * Primary cartilaginous * Secondary cartilaginous * Gomphosis * Condyloid - E) Synovial
Explanation: Synovial
Q17. The deep circumflex iliac artery is a branch of which artery? - A) Internal iliac artery - B) External iliac artery - C) Internal pudendal artery - D) Common iliac artery - E) Femoral artery
Explanation: (Page 2) 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. External iliac artery * Internal iliac LN * External iliac LN * Aortic LN * External iliac + internal iliac + obturator + sacral LNs - E) External iliac + internal iliac + common iliac + aortic LNs
Explanation: Q18. A 30-years-old primigravida presents in a spontinous labour at 41 - A) weeks of gestation. On vaginal examination the cervix is 8 cm dilated and - B) the position of the vertex is left occipto-posterior. - C) What is the presenting diameter? - D) Bitemporal - E) Occipito Frontal * Submento Bregmatic * Suboccipito Bregmatic Vertico Mental
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
Explanation: 3,1,4,2 branch of the external iliac artery or inferior epigastric artery instead of as - A) a branch of the internal iliac artery? * Internal pudendal artery * Obturator artery * Superior gluteal artery * Umbilical artery - E) Uterine artery
Explanation: Corona mortis, Latin for "crown of death", is a common variant vascular anastomosis between the external iliac artery or deep inferior epigastric artery and the obturator artery.
Q19. Blood supply to the medial part of the anterior abdominal wall - A) below the umbilicus? - B) Superficial epigastric artery - C) Superior epigastric artery - D) Superior mesenteric artery - E) Inferior epigastric artery Inferior mesenteric artery
Explanation: Very important to be familiar with due to associated laparoscopic port injuries. - A) connective tissue and also support the bladder? * Urachus * Pubocervical ligament * Uterosacral ligament * Coccygeus muscle - E) Levator ani muscle
Explanation: The urachus or median umbilical ligament is an epithelial tubular structure located in the middle line that spreads from the anterosuperior part of the bladder to the navel. The function of the median umbilical ligament, in the postnatal life, is to support the urinary bladder.
Q20. A 48-year-old woman visits her GP complaining of pain on the - A) inner surface of her right thigh. A detailed history reveals that she has - B) recently experienced some dull, diffuse pain in the lower right abdominal - C) wall. She is sent for a CT scan which reveals an inflamed right ovary. - D) Which nerve is referring pain from the parietal peritoneum near the ovary - E) to the inner thigh? * Ilioinguinal * Saphenous * Anterior femoral cutaneous * Obturator Femoral
the psoas major muscle? * Ilioinguinal * Femoral * Obturator * Genitofemoral Lateral femoral cutaneous
Explanation: The lumbar plexus is embedded within the muscle and its branches emerge from it : Anterior aspect: genitofemoral nerve Lateral border: iliohypogastric, ilioinguinal, lateral femoral cutaneous and femoral nerves Medial border: obturator nerve and lumbosacral trunk
(Very important for exam)
Q21. A 25-year-old woman has a routine smear test for the first time. - A) She complains of discomfort during the procedure. - B) Which nerve or nerve plexus provided sensory innervations to the cervix? - C) Pudendal nerve - D) Pelvic splanchnic nerve - E) Sacral splanchnic nerve * Superior hypogastric plexus Inferior hypogastric plexus
Explanation: The cervix is largely innervated by the inferior nerve fibres of the uterovaginal plexus. The afferent fibres mostly ascend through the inferior hypogastric plexus to enter the spinal cord via T10-T12 and L1 nerve fibres.
Q22. After an elective caesarean section the anesthetic team decided - A) to perform an ultrasound-guided transversus abdominis plane block for - B) analgesia. If the needle is correctly positioned where will be deposit the - C) local anaesthetic? - D) Beneath the peritoneum - E) Into the transversus abdominis muscle * Between the transversus abdominis muscle and the internal oblique * muscle * Between the transversus abdominis muscle and the external oblique * muscle Between the internal oblique and the external oblique muscle
Explanation: The transversus abdominis plane (TAP) block is an abdominal wall block that provides somatic coverage potentially from T6 to L1 but most typically from T10-L1. For a transversus abdominis plane (TAP) block, an anaesthetic injection is administered in the area between the internal oblique and transversus abdominis muscles in the stomach wall. * Levator ani and coccygeus * Levator ani and piriformis * Obturator internus and coccygeus * Obturator internus and levator ani - E) Obturator internus and piriformis
Explanation: Levator ani and coccygeus
Q23. The ovarian artery is a branch of? - A) Abdominal aorta - B) Common iliac artery - C) External iliac artery - D) Internal iliac artery - E) Uterine artery
Explanation: Abdominal aorta
Q24. During childbirth a bilateral pudendal nerve block may be - A) performed to provide anesthesia to the Majority of the perineum and the - B) lower one fourth of the vagina. To do this an anesthetic agent is injected - C) near the pudendal nerve. During the procedure blood comes in on - D) withdrawal the plunger of the anesthetic syringe. - E) Which of the following vessels has been entered? * Obturator * Femoral * Vaginal * External pudendal Internal pudendal
Explanation: Pudendal nerve block is a form of analgesia occasionally given before vaginal childbirth, episiotomy and other minor vaginal procedures. To administer a pudendal nerve block, the patient is placed in the lithotomy position, and the ischial spine is palpated transvaginally. Local anaesthetic is then injected into the tissues around the ischial spine. The procedure is then completed on the opposite side. As the pudendal nerve is accompanied by the internal pudendal artery, it is essential to aspirate before injecting local anaesthetic – this ensures that local anaesthetic is not administered into the systemic circulation.
Q25. A 55 year-old woman has recurrent urinary retention after a - A) radical hysterectomy done for stage I carcinoma of the cervix. - B) Which of the following nerves should be preserved in radical - C) hysterectomy? - D) Obturator - E) Pudendal * Genitofemoral * Superior hypogastric plexus Inferior hypogastric plexus
Explanation: Nerve sparing radical hysterectomy (NSRH) is a technique in which the neural part of the cardinal ligament which encloses the inferior hypogastric plexus, as well as the bladder branch (distal part of the plexus), remains intact. By this way, the bladder's innervation is safe and its functional recovery is more rapid.
Q26. During Laparoscopy an injury to vessel during right lateral port - A) insertion this vessel is a branch of which artery? - B) External iliac artery - C) Internal iliac artery - D) Uterine artery - E) Aorta Inferior epigastric artery
Explanation: External iliac artery
Q27. Surgeon wants to take blood from femoral artery. - A) What is the relation of nerve with femoral artery and vein from lateral to - B) medial? - C) VAN - D) AVN - E) NAV * All of above None of above
Explanation: Acronym for the contents of the femoral triangle (lateral to medial) – NAVEL: Nerve, Artery, Vein, Empty space (allows the veins and lymph vessels to distend to accommodate different levels of flow), Lymph nodes.
Q28. Dorsal artery of clitoris and deep artery of clitoris are a branch of? - A) External iliac artery - B) Internal pudendal artery - C) Abdominal aorta - D) Coeliac trunk - E) None of above
Explanation: Internal pudendal artery T10 L1 T12 L2 L3
- T12
- L1
- T10
- L3
- E) L4
Explanation: T10 * Pelvic splanchnic nerve * Pudendal Nerve * Inferior hypogastric plexus * External iliac artery - E) None of above
Explanation: The external anal sphincter receives somatic innervation from the inferior anal nerve, a branch of the pudendal nerve (S2-S4). As a result, this muscle is under voluntary control.
Q29. Pudendal cleft is defined as - A) Area between labia minora - B) Area between labia majora - C) Area between labia majora & hymen - D) Area between labia minora & hymen - E) All of above
Explanation: The lower part of the mons pubis is divided by a fissure – the pudendal cleft – which separates the mons pubis into the labia majora. After puberty, the clitoral hood and the labia minora can protrude into the pudendal cleft in a variable degree.
Q30. In renal transplant kidney renal artery is anastomosed to? - A) Vesical artery - B) Aorta - C) External iliac artery - D) Internal iliac artery - E) Uterine artery
Explanation: The renal vein is anastomosed end to side to the external iliac vein. The arterial anastomosis can be performed either end to side to the external iliac artery or end to end to the divided internal iliac artery.
Q31. Pyramidalis is supplied by which nerve? - A) Obturator - B) Genitofemoral nerve - C) Ilioinguinal - D) Subcostal - E) Iliohypogastric
Explanation: Subcostal
Q32. Pain due to ovarion irritation can be felt through which nerve - A) segment? - B) T10 - C) T12 - D) L1 - E) L2 L3
Explanation: T10
Q33. During Sacrospinous ligament fixation which artery can be - A) damaged? - B) Internal pudendal artery - C) Internal iliac artery - D) External iliac artery - E) Femoral artery Inferior vesical artery
Explanation: Those are recalled options but in fact the most susceptible artery to be damaged is Inferior gluteal artery The coccygeal branch of the inferior gluteal artery passes immediately behind the midportion of the sacrospinous ligament and pierces the sacrotuberous ligament in multiple sites The pudendal vessels and nerve pass immediately medial and inferior to the ischial spine (within 0.5 cm of the spine) and behind the sacrospinous ligament.
Q34. Superior vesicle artery is direct branch from - A) Anterior division of Internal iliac - B) Posterior division of Internal iliac - C) External iliac artery - D) Umbilical artery - E) None of above
Explanation: Anterior division of Internal iliac surgeon find resistance at internal os. - A) What is the ratio of uterine corpus to this point? * 1:1 * 1:2 * 1:3 * 2:1 - E) 3:1
Explanation: After the menopause, a significant reduction in uterine size and in the corpus-cervix ratio happens to be 1.5 to 1 or 1 to 1
Q35. Regarding Breech presentation, What is the Bi-trochanteric - A) diameter? - B) 9 cm - C) 10 cm - D) 11 cm - E) 8 cm 13 cm
Explanation: (Page 3) 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. 80. 81. 82. 83. 84. 85. 86. 87. 88. 10 cm
Q36. Blood supply for ascending part of colon? - A) Superior mesenteric artery - B) Inferior mesenteric artery - C) Right anterior mesenteric artery - D) Coeliac trunk - E) Right colic artery
Explanation: The ascending colon receives arterial supply from two branches of the superior mesenteric artery; the ileocolic and right colic arteries, take care that choices also includes superior mesenteric , so choose direct branch. * Loss of Motor supply * Excessive Sympathetic stimulation * Excessive Parasympathetic stimulation * Loss of Parasympathetic supply - E) Loss of Sympathetic supply
Explanation: Loss of Sympathetic supply - A) gynecological laparotomy? * Obturator nerve * Ilioinguinal nerve * Iliohypogastric nerve * Femoral nerve - E) Lateral cutaneous nerve
Explanation: Of all reports of gynaecological associated neuropathy, the femoral nerve is most frequently implicated, with an incidence of at least 11%
Q37. The Umbilical artery is branch of? - A) Anterior division of Internal iliac artery - B) Posterior division of Internal iliac artery - C) Abdominal aorta - D) Internal pudendal artery - E) External iliac artery
Explanation: Anterior division of Internal iliac artery
Q38. How Diagonal conjugate diameter is measured ? - A) From upper border of symphysis pubis to sacral promontory - B) From lower border of symphysis pubis to sacral promontory - C) From the back of symphsis pubis to tip of coccyx - D) From sacroiliac joint to opposite iliopectineal line - E) It is the distance between ischial tuberosities
Explanation: From lower border of symphysis pubis to sacral promontory
Q39. Regarding inferior vesical artery, where does it come from? - A) Anterior division of Internal iliac artery - B) Posterior division of Internal iliac artery - C) Abdominal aorta - D) Internal pudendal artery - E) External iliac artery
Explanation: Anterior division of Internal iliac artery
Q40. A woman after delivery found to be in lithotomy position for 2 - A) hours, now she develop drop foot. - B) What nerve most likely to be the cause? - C) Tibial nerve - D) Femoral nerve - E) Sciatic nerve * Common peroneal nerve Lateral cutaneous nerve
Explanation: Common peroneal nerve
Q41. A 36-year-old woman underwent a total abdominal hysterectomy - A) for uterine fibroids. Postoperatively she complains of loss of flexion of her - B) left hip and numbness over her left anterior and medial thigh. - C) The compression of which nerve is likely to be responsible? - D) Common peroneal nerve - E) Femoral nerve * Ilioinguinal nerve * Obturator nerve Pudendal nerve
Explanation: Femoral nerve - A) perineal pouch from the deep perineal pouch? * Superior levator ani * Inferior levator ani * Superior fascia of urogenital diaphragm * Perineal membrane - E) Colles fascia
Explanation: The perineal membrane is a thin triangular horizontal layer of dense tough fascia in the perineum which divides the urogenital triangle into superficial (inferior) and deep (superior) perineal pouches. - A) emerges from the medial border of psoas major muscle? * Femoral nerve * Genitofemoral nerve * Lateral femoral cutaneous nerve * Common peroneal nerve - E) Obturator nerve
Explanation: Obturator nerve
Q42. A 19-year-old extremely anxious patient requests labor epidural - A) analgesia. During epidural placement, cerebrospinal fluid obtained in the - B) needle catheter. - C) Which along spinal cord dose the needle traverse obtaining CSF leakage - D) from the needle catheter? - E) Vertebral canal * Space between wall of vertebral canal and dura mater * Space between arachnoid and dura mater * Space between arachnoid and pia mater Spinal canal
Explanation: Space between arachnoid and pia mater - A) artery? * Internal pudendal * Testicular * Inferior vesicle * Obturator - E) Umbilical
Explanation: The arteries of penis are direct branches of internal pudendal arteries. The arteries of penis give rise to the dorsal artery of penis, which, in turn give rise to the artery of the bulb of penis and the deep artery of penis.
Q43. The bifurcation of the abdominal aorta occurs at the level of which - A) of the following structures? - B) Lowest point of costal margin - C) Highest point of iliac crest - D) Pubic tubercle - E) Anterior superior iliac spine Posterior superior iliac spine
Explanation: Highest point of iliac crest
Q44. An 18-year-old woman who had inflammation of the right ovary - A) complains painful spasms in the muscles and some numbness on the skin - B) of the medial part of her right thigh. - C) The following nerves is mostly involved? - D) Femoral nerve - E) Genitofemoral nerve * Sciatic nerve * Obturator nerve Nerve to obturator internus
Explanation: Obturator nerve - A) when a transverse suprapubic skin incision is made? * Superficial epigastric * Superficial circumflex iliac * Deep circumflex iliac * Superior epigastric - E) Inferior epigastric
Explanation: Along its course, the superficial epigastric artery provides with small branches that supply the superficial inguinal lymph nodes, subcutaneous tissue and skin of the inguinal region and anterior abdominal wall below the umbilicus.
Q45. Identify which of the following gives the correct pathway of - A) piriformis muscle. - B) Origin - Exits pelvis - via Insertion - C) Ventral surface of sacrum, Greater sciatic notch, Greater trochanter of - D) femur - E) Ventral surface of sacrum, Lesser sciatic notch, Greater trochanter of femur * Ventral surface of sacrum, Greater sciatic notch, Lesser trochanter of * femur * Dorsal surface of sacrum, Greater sciatic notch, Greater trochanter of * femur * Dorsal surface of sacrum, Lesser sciatic notch, Lesser trochanter of femur
Explanation: Ventral surface of sacrum, Greater sciatic notch, Greater trochanter of femur - A) intestine at the femoral ring causing strangulated femoral hernia? * Inguinal ligament * Lacunar ligament * Pectineal ligament * Pubic tubercle - E) Pubis symphysis
Explanation: The lacunar ligament is the only boundary of the femoral canal that can be cut during surgery to release a femoral hernia. Care must be taken when doing so as up to 25% of people have an aberrant obturator artery (corona mortis) which can cause significant bleeding.
Q46. The level of the umbilicus varies in obese women. - A) What reference point can be used instead? - B) Transpyloric plane - C) Subcostal plane - D) Supracostal plane - E) Level of anterior superior iliac spine Transtubercular line
Explanation: Transtubercular line - A) and passes through the inguinal canal? * Iliohypogastric * Ilioinguinal * Genital branch of the genitofemoral * Obturator - E) Lateral femoral cutaneous
Explanation: The ilioinguinal nerve pierces the internal oblique muscle at the superficial inguinal ring entering the inguinal canal and traveling along the spermatic cord (in males) or the round ligament (in females) The genital branch of genitofemoral passes through the deep inguinal ring and enters the inguinal canal. In men, the genital branch supplies the cremaster and scrotal skin. In women, the genital branch accompanies the round ligament of uterus, terminating in and innervating the skin of the mons pubis and labia majora.
Q47. Coronal suture is located in? - A) between temporal and occipital - B) between two parietal bones - C) between parietal and temporal - D) between posterior part of parietal and occipital - E) between frontal and parietal
Explanation: between frontal and parietal
Q48. Appendicular artery is a branch of - A) Inferior mesenteric artery - B) Ileocolic artery - C) Left colic artery - D) Middle colic artery - E) Right colic artery
Explanation: Ileocolic artery
Q49. Sigmoid Colon - A) Mesentery | Blood Supply | Lymphatic - B) No Superior Mesenteric a. pre aortic LN - C) No Inferior Mesenteric a. pre aortic LN - D) Yes Inferior Mesenteric a. pre aortic LN - E) Yes Superior Mesenteric a. pre aortic LN Yes Inferior Mesenteric a. inguinal LN
Explanation: Yes Inferior Mesenteric a. pre aortic LN
Q50. Choroid Plexus can be found impinging on? - A) arachnoid and dura matter - B) dura matter and pia matter - C) arachnoid and pia matter - D) dura matter and endocranium - E) pia matter and cerebral cortex
Explanation: The choroid plexus resides in the innermost layer of the meninges (pia mater) which is in close contact with the cerebral cortex and spinal cord. It is a highly organised tissue that lines all the ventricles of the brain except the frontal/occipital horn of the lateral ventricles and the cerebral aqueduct.
Q51. During a hysterectomy, vaginal bleeding may be a significant - A) complication even after removal of the uterus and ligation of the uterine - B) arteries. - C) Such bleeding would most likely originate from which of the following - D) arteries which anastomoses with uterine artery? - E) internal pudendal * superior hemorrhoidal * inferior mesenteric * superior vesical ovarian
Explanation: ovarian
Q52. Indirect Inguinal Hernia - A) medial to inferior epigastric arteries - B) lateral to inferior epigastric arteries - C) weakening of conjoint tendon - D) All of above - E) None of above
- Superficial perineal pouch
- Deep perineal pouch
- Ischiorectal fossa
- Superficial inguinal space Deep inguinal space
Explanation: The layers of the urogenital triangle (deep to superficial): Deep perineal pouch – a potential space between the deep fascia of the pelvic floor (superiorly) and the perineal membrane (inferiorly). It contains part of the urethra, external urethral sphincter, and the vagina in the female. In males, it also contains the bulbourethral glands and the deep transverse perineal muscles. Perineal membrane – a layer of tough fascia, which is perforated by the urethra (and the vagina in the female). The role of the membrane is to provide attachment for the muscles of the external genitalia. Superficial perineal pouch – a potential space between the perineal membrane (superiorly) and the superficial perineal fascia (inferiorly). It contains the erectile tissues that form the penis and clitoris, and three muscles – the ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles. The greater vestibular glands (Bartholin’s glands) are also located in the superficial perineal pouch. The pouch is bounded posteriorly to the perineal body. Perineal fascia (very important) – a continuity of the abdominal fascia that has two components: Deep fascia: covers the superficial perineal muscles and protruding structures (e.g. penis & clitoris). Superficial fascia is composed of a further two layers of fascia: Superficial layer – continuous with Camper’s fascia of the anterior abdominal wall Deep layer (Colles’ fascia) – continuous with Scarpa’s fascia of the anterior abdominal wall Skin – The urethral and vaginal orifices open out onto the skin
Q53. In Horseshoe Kidney what is the structure preventing the kidney - A) to ascend from pelvis to abdomen? - B) superior mesenteric a. - C) inferior mesenteric a. - D) coeliac trunk - E) bifurcation of aorta None of above
Explanation: With a horseshoe kidney, ascent into the abdomen is restricted by the inferior mesenteric artery (IMA) which hooks over the isthmus. Hence horseshoe kidneys are low lying. As a result of this fusion the inferior pole of each kidney point medially which is the reverse of the normal renal axis. * Tunica Vasculosa * Tunica Vaginalis * Tunica Albuginea * Dartos - E) All of above
Explanation: Dartos muscle
Q54. Perineal Nerve Supply nerve root - A) L1,L2 - B) L4,L5 - C) L3,L4, L5 - D) S2,S3,S4 - E) S3,S4
Explanation: S2,S3,S4
Q55. Angle of the vagina with the horizontal plane while standing? - A) 45 - B) 60 - C) 70 - D) 80 - E) 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-degree angle with the uterus and an about 60-degree angle to the horizontal. However, the exact angles are variable depending on individual anatomy and with contents of the bladder and colon.
Q56. Joint which resist horizontal rotation of the pelvis? - A) Sacroiliac - B) Sacrospinous - C) Ileolumbar - D) None of above - E) Sacrotuberous
Explanation: Sacroiliac
(Page 4) 89. 90. 91. 92. 93. 94. 95. 96. 97. 98. 99. 100. 101. 102. 103. 104. 105. 106. 107. Logout * Internal Iliac a. * External Iliac a. * Common Iliac a. * Deep circumflex iliac a. - E) Femoral a.
Explanation: Internal Iliac a. * Superior mesentric vein * Superior rectal vein * External pudendal vein * Middle rectal vein - E) Internal pudendal vein
Explanation: Internal pudendal vein
Q57. Aetiology of Hirschsprung's disease - A) Abnormality in circular muscle - B) Abnormality in longitudinal muscle - C) Abnormality in sympathetic ganglia - D) Abnormality in parasympathetic ganglia - E) None of above
Explanation: Abnormality in parasympathetic ganglia
Q58. A primi is informed that engagement has occurred. - A) Which is the anteroposterior diameter of the inlet through which the - B) biparietal diameter has to cross? - C) 10 - D) 11 - E) 12 * 13 14
Explanation: Q59. Uterine vein drains into - A) Left renal vein - B) Internal iliac vein - C) Splenic vein - D) Inferior vena cava - E) Portal vein
Explanation: Internal iliac vein
Q60. Diagram of rectus muscle below umbilicus during suprapubic - A) incision after cutting rectus sheath, which structure to be encountered? - B) Fascia transversalis - C) Internal anal sphincter - D) Continuation of circular rectal muscles - E) All of above None of above
Explanation: Fascia transversalis * Ureter * Uterine artery * External iliac artery * Internal iliac artery - E) Inferior epigastric artery
Explanation: Q61. Difference between jejunum and ileum - A) Jejunum : Thin walled, longer, long arcades - B) Ileum : Thicker, shorter, short arcades - C) Jejunum : Thin walled, longer, short arcades - D) Ileum : Thick walled, shorter, long arcades - E) Jejunum : Thick walled, shorter, long arcades * Ileum : Thin walled, longer, short arcades * All of above None of above
Explanation: Jejunum : Thick walled, shorter, long arcades Ileum : Thin walled, longer, short arcades
Q62. Sacral plexus situated behind which muscle? - A) Piriformis - B) Pyramidalis - C) Obturator internus - D) Diaphragm - E) None of above
Explanation: Piriformis
Q63. During laparoscopy surgeons have limitation of - A) lymphadenectomy on lateral abdominal wall due this structure - B) Obliterated umblical artery - C) Superior mesenteric artery - D) Inferior mesenteric artery - E) Inferior epigastric artery Internal iliac artery
Explanation: Inferior epigastric artery (There was an image attached to it showing IEA) But remember this. THERE ARE BOUNDRIES FOR PELVIC LYMPHADENECTOMY: The genitofemoral nerve laterally, bifurcation of the common iliac artery cranially, the deep circumflex iliac vein caudally, the obturator nerve inferiorly, and the obliterated umbilical artery medially.
Q64. Sacrotuberous and sacrospinous ligaments prevent from - A) Anterior rotation at horizontal line of sacrum - B) Posterior rotation at horizontal line of sacrum - C) Downward displacement of ilium and ischium - D) All of above - E) None of above
Explanation: The sacrospinous and sacrotuberous ligaments assist in pelvic stability. The ligament works with the sacrotuberous ligament to prevent rotation of the ilium past the sacrum thus preventing excessive twisting of the pelvis, low back pain, and SIJ strain.
Q65. Uterine artery supplies what percentage of blood supply to ovary? - A) 10% - B) 20% - C) 30% - D) 40% - E) 50%
Explanation: Q66. Difference between inguinal and femoral hernia - A) INGUINAL : Superior and medial to pubic tubercle - B) FEMORAL : Inferior and lateral to pubic tubercle - C) INGUINAL : Inferior and lateral topubic tubercle - D) FEMORAL : Superior and medial to pubic tubercle - E) INGUINAL : Superior and lateral to pubic tubercle * FEMORAL : Inferior and Medial to pubic tubercle * All of above None of above
Explanation: INGUINAL : Superior and medial to pubic tubercle FEMORAL : Inferior and lateral to pubic tubercle beneath the inguinal ligament, just medial to the anterior superior iliac - A) spine? * Femoral nerve * Iliohypogastric nerve * Ilioinguinal nerve * Genitofemoral nerve - E) Lateral cutaneous nerve of thigh
Explanation: Lateral cutaneous nerve of thigh * T12-L1 * L1-L2 * L1-L3 * L2-4 - E) L4-S1
Explanation: L2-4
Q67. A 20 year old woman presents with a painful lump in the vagina. - A) The examination confirms Bartholin's abscess. - B) Which of the following gland is involved? - C) Bulbourethral glands - D) Glands of Skene - E) Greater vestibular gland * Lesser vestibular gland Seminal vesicle
Explanation: Greater vestibular 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 & the bulbospongiousus muscles. The duct opens into the vestibule between the hymen and the labium minus. These glands provide lubrication at the introitus (Bartholin's abscess may occur due to infection and blockage of these glands)
Q68. How is diagonal conjugate diameter measured? - A) From sacral promontory to superior border of symphysis pubis - B) From sacral promontory to inferior border of symphysis pubis - C) From back of symphysis pubis to tip of coccyx - D) From sacroiliac joint to opposite iliopectineal lines - E) Between ischial tuberosity
Explanation: From sacral promontory to inferior border of symphysis pubis * Internal iliac artery * External iliac artery * Femoral artery * Deep epigastric artery - E) Superficial epigastric artery
Explanation: Internal iliac artery * Foramen of Monro * Foramen of Luschka * Cerebral Aqueduct * Third ventricle - E) Lateral ventricle
Explanation: The most common site of this blockage is at the cerebral aqueduct, called aqueductal stenosis. Though this occurs more commonly in children, it can present in adulthood.