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P1EXAM > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Pudendal nerve route
- in relation to pudendal artery

A
  • Upward in *lateral wall of the ischiorectal fossa
  • contained in a sheath of the obturator fascia termed the *pudendal canal.
  • Medial to pudenal Artery
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2
Q

Adominal aorta divides into two common iliac vessels at which spinal level?

A

L4

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3
Q

Which ascending artery can be damaged during open appendicectomy?

A

Deep circumflex artery

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4
Q

When you hold the bony pelvis in anatomical position which two landmarks are at the same level horizontally?

A

Symphysis pubis (aka pubic tubercle) and ischial spine
(think ‘at spines’ etc)

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5
Q

To which fascia is levator ani attached

A

Obturator internus fascia

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6
Q

Facial nerve of the baby gets injured during vaginal delivery because _____?

A

The mastoid process is under developed

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7
Q

Path of the ureters at the sacroiliac joint

A

Pass anterior to bifurcation of common iliac artery at the sacroiliac joint

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8
Q

Structure enters inguinal canal and is identified easily at laparoscopy

A

Round ligament

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9
Q

What bony landmark identifies the level that the aorta bifurcates at?

A

Uppermost edge of iliac crest

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9
Q

Structure in lateral wall of the ischiorectal fossa

A

Obturator internus fascia

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10
Q

Muscles of the pelvic diaphragm

A

Levator ani and coccygeus

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11
Q

Nerve supply to posterior 2/3 of labia majora

A

Perineal nerve (branch of pudendal nerve)

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12
Q

Blood supply to rectus abdominis below umbilicus

A

Inferior epigastric artery

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13
Q

What structure is attached to the anterior superior iliac spine?

A

Inguinal ligament

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14
Q

Multiparous woman with prolapsed uterus has injury to what structures?

A

The cardinal and uterosacral ligaments

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15
Q

What kind of joint is the sacroiliac joint?

A

Synovial

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16
Q

The rectus muscle is supplied by which nerve below this umbilicus

A

Inferior epigastric nerve

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17
Q

Nerve supply to the vagina.
Lower
Autonomic - two plexi

A

Lower vagina: The deep perineal nerve (of the pudendal nerve)

Autonomic:
Pelvic splanchnic plexus
Lumbar splanchnic plexus

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18
Q

Lymphatic drainage of the cervix and vagina

A

Internal iliac, external iliac, obturator, and sacral LN

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19
Q

What is the narrowest portion of the Fallopian tube?

A

Isthmus

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20
Q

Main supporting ligament of the uterus?

A

Cardinal ligament
/ ‘transverse cervical ligament’

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21
Q

IVC drains on the left

A

Right ovarian vein and right renal vein drain to the right IVC

left ovarian vein drains to the left renal vein, which then drains to the left IVC

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22
Q

What surfaces is levator ani attached to?

A

Posterior aspect of pubic bone
Fascia of side wall of pelvis
Ischial spine

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23
Q

What is the nerve root of the ilioinguinal and iliohypogastric nerve

A

L1

(note iliohypogastric gets some fibres from T12)

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24
Q

What is the blood supply of Bartholin’s gland?

A

Deep external pudendal artery

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25
Q

Which muscles are cut during a mediolateral episiotomy?

A

Bulbospongiosus and superficial transverse perineal muscles

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26
Q

What is the nerve supply (name) to the skin of the rectum

A

Inferior rectal nerve

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27
Q

At what vertebral level is the umbilicus

A

L3/L4

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28
Q

What structure demarcates the external iliac artery and the femoral artery?

A

The inguinal ligament

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29
Q

The round ligament of the uterus develops from which embryonic structure? / Homologue of the round ligament in males?

A

Gubernaculum

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30
Q

The ureter crosses in front of the internal iliac artery at what level (structure)?

A

The sacroiliac joint

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31
Q

At what level (structure) is the ureter crossed by the uterine artery?

A

The level of the internal os

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32
Q

‘Relationship of femoral artery’
Femoral artery branches x6

A

Superficial circumflex iliac
Profunda femoris (go laterally)

Superficial epigastric (go medially:)
Superficial external pudendal
Deep external pudendal
Descending genicular

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33
Q

‘Anatomy of the breast’

A

?

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34
Q

What level does the aorta bifurcate at?

A

L4

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35
Q

What level does the common iliac divide at

A

S1

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36
Q

What is the lymph node of the uterus

A

Internal iliac lymph node

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37
Q

What nerve passes below the inguinal ligament, medial to the anterior superior iliac crest

A

Lateral cutaneous nerve of the thigh

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38
Q

Blood from the umbilical vein passes through which structure to enter the IVC

A

Ductus venosus

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39
Q

Pain in the medial side of the thigh due to ovarian irritation can be felt through which nerve

A

Obturator nerve

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40
Q

What is the pathway of the piriformis muscle?

A

Ventral/pelvic surface of sacrum
Greater sciatic notch
Greater trochanter of femur

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41
Q

What is the nerve supply (roots) of the pelvic part of Levator ani muscles

A

S3, S4

pudendal nerve
perineal nerve
inferior rectal nerve
All arise from S3/S4 spinal nerves mainly

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42
Q

Most common site for endometriosis

A

Ovary

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43
Q

Most common site for tubal ectopic

A

Ampulla

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44
Q

Which artery supplies the distal portion of the round ligament of the uterus?

A

The inferior epigastric artery

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45
Q

What do the medial umbilical folds in the anterior abdominal wall contain in adults?

A

Obliterated umbilical arteries

MeidaL is LateraL

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46
Q

Total abdominal hysterectomy, postoperative loss of flexion of hip and numbness over anterior and medial thigh. Compression of which nerve is responsible?

A

Femoral nerve

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47
Q

Which nerve or plexus provides sensory innervation to the cervix?

A

Pelvic splanchnic nerve (parasympathetic)

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48
Q

What structure separate the superficial perineal pouch from the deep perineal pouch?

A

Perineal membrane

‘The inferior fascial layer of the urogenital diaphragm’
(B SpR)

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49
Q

Which nerve arises from ventral rami of lumbar plexus and emerges from the medial border of psoas major muscle?

A

Obturator nerve

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50
Q

Which artery gives rise to the deep dorsal penile artery?

A

Internal pudendal artery

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51
Q

At what anatomical landmark does the abdominal aorta bifurcate?

A

Highest point of the iliac crest

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52
Q

Embryological origin, beginning and ending of the round ligament?

A

Gubernaculum ovarii
Anterioinferior to uterine cornua
Labia majora

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53
Q

What structure blocks blood supply to the loop of small intestine at the femoral ring causing strangulated femoral hernia?

A

Lacunar ligament

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54
Q

The deep circumflex artery is a branch of which artery?

A

External iliac artery

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55
Q

Which nerve pierces the internal oblique muscle and passes through the inguinal canal

A

ilioinguinal nerve

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56
Q

At what spinal level does the ovarian artery arise from the abdominal aorta?

A

L1

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57
Q

Which artery supplies the anorectal canal superior to the pectinate line?

A

Inferior mesenteric artery

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58
Q

What is the name of the structure that shunts oxygenated blood from the right to the left atrium in the foetus?

A

Foramen ovale

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59
Q

What is the anatomical location of Bartholin’s gland?

A

Superficial perineal pouch

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60
Q

The immediate layer around the oocyte of the tertiary follicle is known as the ____

A

Zona pellucida

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61
Q

For an ELCS, the obstetrician makes a transverse suprapubic incision. Which of the abdominal wall layers will not be encountered?

A

Posterior rectus sheath

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62
Q

A 35-year-old diabetic woman underwent vaginal surgery. Postoperatively, she has Loss of cutanous sensation over the anterior and lateral surface of the thigh. The compression of which nerve is likely to be responsible?

A

Lateral cutaneous nerve

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63
Q

Which artery supplies the structures derived from the midgut of the embryo?

A

Superior mesenteric artery

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64
Q

Medial umbilical folds represent remnants of which of the following structures?

A

Obliterated umbilical arteries

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65
Q

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

A

Pelvic splanchnic nerves

Parasympathetic - peeing
S2-S4 (Pelvic splanchnic nerves)
Detrusor contracts and internal urethral sphincter relaxes

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66
Q

Which of the following muscles leaves the lesser pelvis through the greater sciatic foramen?

A

Piriformis

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67
Q

To reduce postoperative pain after caesarean section, an obstetrician performs ilioinginal-iliohypogastric nerve block (IINB) on his 25-year-old patient. What is the nerve root of ilioinguinal and iliohypogastric nerve?

A

L1

68
Q

Where is the epidural space located?

A

Between the wall of vertebral cavity and dura mater

69
Q

During a difficult delivery an obstetrician uses forceps to extract the infant. Upon examining the baby you notice forceps impressions posteroinferior to the ear. Which of the following is very likely to be damaged?

A

Facial nerve

70
Q

A 36-year-old woman who had supraspinous ligament fixation 2 days ago complains of pain over right mons pubis, right labia, and the perineum. Which nerve is most likely to be injured?

A

Pudendal nerve

71
Q

Following radical hysterectomy and pelvic lymphadenectomy for Stage I carcinoma of the cervix, 63-year-old woman reports

Numbness along the medial thigh and weakness of hip adduction. Which nerve has been injured?

A

Obturator nerve

[This answer is from the good 2018 paper]

72
Q

At the ventouse cup application area, the baby’s head is left with a “chignon”. In which layer of the skull chignon is found?

A

Subcutaneous

73
Q

When the body is in the upright position, the expected angle between the brim of the pelvis to the horizontal plane is

A

60 degrees

74
Q

Which of the following nerves enters the thigh by passing beneath the inguinal ligament, just medial to the anterior superior iliac spine?

A

Lateral cutaneous nerve of the thigh

75
Q

Lymphatics of the sigmoid colon drain into

A

Inferior mesenteric and pre-aortic lymph nodes

76
Q

Which of the following structures passes through the lesser sciatic foramen

A

Tendon of the obturator internus

PINT: Pudendal nerve, Internal pudendal vessels, Nerve to obturator interns, Tendon of obturator internus (all contents)

77
Q

Which anatomical structure is effected by Sheehans syndrome? (PPH, failure to breastfeed)

A

Anterior pituitary

78
Q

What nerve passes over the anterior surface of the psoas major muscle?

A

Genitofemoral nerve

79
Q

The ovarian artery is a branch of which artery?

A

Abdominal aorta

80
Q

Which artery supplies the foregut derivatives of the digestive system?

A

Coeliac trunk

81
Q

Ductus venosus is completely obliterated after birth to form what adult structure?

A

Ligamentum venosum

82
Q

Which of the following is a remnant of the mesonephric duct in the female?
Found in the lateral wall of the vagina

A

Gartner duct

The paramesonephric ducts for the female reproductive organs

83
Q

Which of the following arteries may occasionally arise as a branch of the external iliac artery or inferior epigastric artery instead of as a branch of the internal iliac artery?

A

Obturator artery

84
Q

Which of the following structure consists of two bands of connective tissue and also support the bladder?

A

Pubocervical ligament

85
Q

Transversus abdominis plane block for analgesia: Where is the local anaesthetic deposited?

A

Between the transversus abdominis muscle and the internal oblique muscle

86
Q

Which nerve or nerve plexus provides sensory innervation to the cervix?

A

Pelvic splanchnic nerve

87
Q
  1. Caput medusae are due to engorgement of which of the following vessels?
A

superficial epigastric veins

88
Q

What type of joint is formed at the symphysis pubis?

A

Secondary cartilaginous

89
Q

Attempted pudendal nerve block, but blood seen on drawing back prior to injecting anaesthetic. What vessel has been entered?

A

Internal pudendal

90
Q

There is injury to a vessel during right lateral port insertion. This vessel is a branch of which artery?

A

External Iliac artery
(Injured vessel: deep circumflex artery)

91
Q

What is the relation of nerve with femoral artery and vein from lateral to medial?

A

NAV

92
Q

Dorsal artery of clitoris and deep artery of clitoris are a branch of?

A

Internal pudendal artery

93
Q

What is the dermatome level at suprapubic incision

A

L1

94
Q

What is the level of dermatome for epidural at umblical region ?

A

T10

95
Q

What is the nerve supply of external anal sphincter ?

A

Inferior anal nerve
(Busy SpR)

96
Q

Which structure in female is homologous to male prostate?

A

Skene’s gland

97
Q

Area between the labia majora is defined as____?

A

The pudendal cleft

98
Q

Pyramidalis is supplied by which nerve?

A

Subcostal nerve

99
Q

Pain due to ovarion irritation can be felt through which spinal segment?

A

T10

100
Q

During Laparoscopy structure is seen which is a remnant of Mesonephric duct

A

Epoophoron

Paramesonephric ducts form the female reproductive organs

101
Q

During sacrospinous ligament fixation which artery and which nerve can be damaged?

A

inferior gluteal artery (busy SpR)
Pudendal nerve

102
Q

Superior vesiclular artery is a direct branch from which artery?

A

Anterior division of Internal iliac artery

103
Q

In renal transplant, kidney is anastomosed to

A

external iliac artery

104
Q

Brachial plexus diagram - what structure does D represent

A

Median nerve

105
Q

What anatomical space does the external urethral sphincter occupy?

A

Deep perineal pouch

106
Q

What nerve is most commonly injured during gynaecological laparotomy ?

A

Femoral nerve

(Busy SpR)

107
Q

What artery is the umbilical artery a branch of?

A

The anterior division of the internal iliac artery

108
Q

How is the diagonal conjugate diameter measured?

A

From lower border of symphsis pubis to sacral promontory.

109
Q

Person in lithotomy for 2 hours, develops foot drop, what nerve causes this?

A

Common perineal nerve

110
Q

What artery is the inferior vesicular artery a branch of?

A

Anterior division of internal iliac artery

111
Q

What structure does ligamentum arteriosus come from?

A

Ductus arteriosus

112
Q

What is the direct arterial blood supply of decidua ?

A

spiral arteries

113
Q

In a multiparous woman with prolapse, which muscle is most likely to be injured

A

Pubococcygeus

Pelvic floor =
Pubococcygeus
Ileococcygeus
(Ischio)coccygeus

Levator ani = pubocyccygeus (around vagina etc at front)+ ilicoccygeus (+puborectalis)

114
Q

Identify the bone of the foetal skull

A

Parietal bone

Anterior to posterior:
Bones: Frontal, parietal, occipital
Sutures: coronal, saggital, lamboid

115
Q

Between which bones is the coronal suture located?

A

Between frontal and parietal

116
Q

Are there two umbilical veins or two umbilical arteries?

A

one umbilical vein; two umbilical arteries

117
Q

Image of ectropion, what do arrows point to here?

A

Columnar epithelium

118
Q

What artery is the appendicular artery a branch of?

A

Ileocolic artery

Superior mesenteric artery branches:
Ileocolic
Right colic
Middle colic

119
Q

Deep perineal and dorsal clitoral nerve are branches of ___?

A

Internal pudendal nerve

120
Q

Remnants of the embryological umbilical arteries become which two structures
- ligament (obliterated)
- artery (patent)

A

Medial umbilical ligament
Umbilical artery, which gives rise to the superior vesical artery

121
Q

Sympathetic supply of bladder comes from which nerve?

A

Hypogastric nerve

Sympathetic
T10 - L2 ~ hypogastric nerve
Detrusor relaxation; storage

122
Q

Where is the vestibule?

A

Between the two labia minora

123
Q

Where is a femoral hernia

A

Femoral: inferior and lateral to pubic tubercle

Contrast: Inguinal: Superior and medial to the pubic tubercle

124
Q

What are the nerve roots of the perineal nerve

A

S2, S3, S4

125
Q

In Horseshoe Kidney what is the structure preventing the kidney to ascend from pelvis to abdomen?

A

Inferior mesenteric artery

126
Q

What muscle is found in the scrotum?

A

Dartos muscle

127
Q

What is the angle of the vagina to the horizontal plane while standing?

A

60 degrees

128
Q

What is the origin of the obturator artery?

A

The internal iliac artery

vagina / uterine / middle rectal
inferior vesical / superior vesical / umbilical
obturator / inferior gluteal / internal pudendal

Posterior branches
ileolumbar / lateral sacral / superior gluteal

129
Q

Muscles of internal sphincter derived from _____?

A

Circular muscle

NOT external anal sphincter etc.

130
Q

Where does the inferior rectal vein drain?

A

Internal pudendal vein

131
Q

What type of epithelium is found in Fallopian tubes?

A

Simple columnar

Remember columnar can be ciliated

132
Q

How many cm is the anteroposterior diameter of the pelvic inlet?

A

11cm

133
Q

What is velamentous insertion?

A

Umbilical insertion into the membranes

134
Q

What is battledore insertion?

A

Insertion into the periphery of the placenta

135
Q

What is the epithelium of the distal urethra?

A

Stratified squamous epithelium

136
Q

What is the submentobregmatic diameter?
Define + length

A

~ top of head to occiput
9.5cm

137
Q

What creates the dimple landmark in the gluteal region

A

Posterior superior iliac spine

138
Q

Which ligament is used to repair prolapse?

A

Sacrospinous ligament

139
Q

Placenta accreta case. Which vessel should you ligate prophylactically during caesarean hysterectomy?

A

Uterine artery

140
Q

Woman bled 4 litres after vaginal delivery. The anastomoses between uterine artery and which artery should be ligated to stop bleeding?

A

Ovarian artery

141
Q

What is the blood supply and lymphatics of the sigmoid colon? Does it have mesentery?

A

Yes has mesentery
Inferior mesenteric artery
Pre-aortic LN

142
Q

Which abdominal artery may bleed when you do a lower transverse CS

A

pfannestiel: superficial epigastric artery

Transverse suprapubic: inferior epigastric vessels

(Busy SpR)
Each is the answer when the other isn’t one of 5 options available.

143
Q

Ratio of uterus corpus to cervix

A

2:1

144
Q

Where does the uterine vein drain to?
Where does the uterine artery branch from?

A

Internal iliac vein

Anterior division of internal iliac artery

145
Q

Innervation of external urethral sphincter

A

Pudendal nerve S2-S4

146
Q

Which muscle does not insert into the perineal body?

A

Ischiocavernosus

147
Q

Laparoscopy image, arrow marking a structure

A

Ureter

148
Q

What lymph node does the scrotum drain to?

A

Superficial inguinal LN

149
Q

What is the nerve supply of iliacus muscle?

A

Femoral nerve

150
Q

Joint which resist horizontal rotation of the pelvis?
(i.e. prevents anterior/posterior tilt

A

Sacroiliac

151
Q

The external pudendal artery is a branch of

A

The femoral artery

152
Q

The common hepatic artery is a branch of the

A

Celiac trunk

Right: hepatic artery
Left: left gastric and splenic arteries

153
Q

Nerve supply of the bladder
Sympathetic
Parasympathetic

A

Sympathetic - hypogastric (T10-L2)
Parasympathetic - pelvic splanchnic nerve (S2,3,4)

154
Q

~Ligament hanging down between the lobes of liver

A

Falciform ligament

155
Q

What is the nerve supply of the internal anal sphincter?

A

Pelvic splanchnic nerves

IAS - pelvic splanchnic nerves
EAS - inferior rectal branch of pudendal n, and perineal branch of S4

156
Q

Bulb of the vestibule is engorged with blood following stimulation of which nerve during sexual arousal?

A

Labial branch of the perineal nerve

157
Q

Which nerve supplies the area over the femoral triangle?

A

GenitoFEMORAL

Busy SpR says ilioinguinal nerve

158
Q

Direct and indirect hernias are separated by which vessels?

A

Inferior epigastric

159
Q

Renal hilum anterior to posterior

A

Vein, artery, renal pelvis,

160
Q

Which structures divides the paravesical spaces from the pararectal spaces

A

cardinal ligament
?and uterine artery

161
Q

Which vulval structure does not contain paracrine glands

A

Mons pubis

162
Q

Features of
Jejunum vs terminal ileum

A

Jejunum shorter, thick walled
Ileum longer, thin walled

163
Q

The pectinate line (dentate line) distinguishes ?

A

divides the upper two-thirds and lower third of the anal canal.

Embryology: hindgut-proctodeum junction.

164
Q

Which muscle is the sacral plexus situated behind?

A

Piriformis

165
Q

What is the mediaN umbilical ligament/fold a remnant of?

A

The urachus
(which connects allantois and cloaca)

166
Q

Sacrotuberous and sacrospinous ligaments prevent rotation in which direction (ant/post) and plane?

A

Prevent posterior rotation at horizontal plane of sacrum

167
Q

What is the blood supply of the transverse colon

A

Middle colic artery

Branch of the superior mesenteric artery
Ileocolic
Right colic
Middle colic

168
Q

What vessel does interventional radiologist place balloons in to minimise blood loss at placenta accreta caesarean?

A

Internal iliac arteries

P1EXAM (27 decks)

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