anat - repro

Question 1

In a patient with stage 4 ovarian cancer, where is the MOST LIKELY first lymphatic spread of metastasis?

a. Paraaortic
b. Common iliac
c. Superficial inguinal
d. Deep inguinal

Answer 1

a. Paraaortic (lumbar)

Question 2

Consider melanoma located on the labia majora. The cancer will MOST LIKELY metastasize first to which lymph nodes?

a. Deep inguinal
b. Superficial inguinal
c. Common iliac
d. Paraaortic

Answer 2

b. Superficial inguinal

Question 3

During labour and delivery, you put in a pudendal nerve block. Which part of the labia majora would not be denervated?

a. Posterior 2/3 by S3
b. Anterior 2/3 by L1
c. Anterior 1/3 by L1
d. Posterior 1/3 by S3

Answer 3

c. Anterior 1/3 by L1 (ilioinguinal n.)

Branches of pudendal nerve:
1. perineal nerve
- motor: muscles of superficial and deep pouches
branches:
- posterior scrotal (labial) nerve –> sensory to posterior scrotum (M) labia minora and all EXCEPT anterior labia majora (F)
- deep perineal nerve
motor: muscles of superficial perineal pouch
sensory: vestibule and inferior part of vagina (F)

2. inferior rectal nerve
   - motor: external anal sphincter
   - sensory: peri-anal skin
3. dorsal nerve of penis (clitoris)

Question 4

what are the branches of pudendal nerve?

Answer 4

1. perineal nerve
   - posterior scrotal (labial) nerve
   - deep perineal nerve (motor innervation to external urethral sphincter, deep transverse perineal muscle)
2. inferior rectal nerve
   - motor: external anal sphincter
   - sensory: peri-anal skin
3. dorsal nerve of penis (clitoris)

Question 5

which muscle most clearly demarcates the boundary between urogenital and anal triangles?

Answer 5

superficial transverse perineal muscle

Question 6

rupture of _____ portion of urethra results in collection of urine within pelvis (deep perineal pouch)

Answer 6

membranous

Question 7

rupture of _____ portion of _____ urethra results in collection of urine within superficial space

Answer 7

bulbous portion; spongy

Question 8

what prevents urine from spreading laterally into the thigh when there is rupture of bulbous portion of spongy urethra?

Answer 8

Colles fascia as it is firmly attached to deep fascia and ischiopubic ramus

Question 9

what prevents urine from spreading posteriorly into anal canal when there is rupture of bulbous portion of spongy urethra?

Answer 9

Colles fascia and perineal membrane are fused

Question 10

rupture of ____ urethra results in collection of urine within penis

Answer 10

distal spongy

Question 11

what is the lymphatic drainage of testes?

Answer 11

para-aortic (lumbar) lymph nodes

Question 12

what is the lymphatic drainage of scrotum?

Answer 12

superficial inguinal lymph nodes

Question 13

what nerves provide sensory innervation to anterior scrotum?

Answer 13

ilioinguinal and genitofemoral nerve

Question 14

what is the lymphatic drainage of skin and prepuce of penis?

Answer 14

superficial inguinal nodes

Question 15

what is the lymphatic drainage of glans of penis?

Answer 15

deep inguinal nodes

Question 16

what the origin of enlargement of BPH in the prostate?

Answer 16

transition zone

Question 17

what is the origin of prostate cancer in prostate?

Answer 17

peripheral zone

Question 18

what are the 3 parts of the broad ligament of uterus?

Answer 18

mesometrium (enclose uterus)
mesosalpinx (enclose fallopian tubes)
mesovarium (enclose ovaries)

Question 19

which fold of peritoneum holds ovarian vessels?

a. ovarian ligament
b. mesosalpinx
c. round ligament
d. falciform ligament
e. suspensory ligament of ovary

Answer 19

e. suspensory ligament of ovary (continuous with mesovarium)

Question 20

which ligament anchors ovary to uterus?

a. suspensory ligament of ovary
b. ovarian ligament
c. round ligament
d. cardinal ligament

Answer 20

b. ovarian ligament (remnant of gubernaculum)

Question 21

what are the ligaments located within broad ligament?

Answer 21

1. suspensory ligament (pelvic wall to ovaries)
2. round ligament (uterus to labia majora)
3. ovarian ligament (ovaries to uterus)

Question 22

which ligament connects uterus to labia majora?

a. suspensory ligament of ovary
b. ligament of ovary
c. round ligament
d. cardinal ligament

Answer 22

c. round ligament (remnant of gubernaculum; goes through inguinal canal to labia)

Question 23

which ligament connects the cervix to pelvic wall?

a. suspensory ligament of ovary
b. ligament of ovary
c. round ligament
d. cardinal ligament

Answer 23

d. cardinal ligament

Question 24

which ligament connects ovaries to pelvic wall?

a. suspensory ligament of ovary
b. ligament of ovary
c. round ligament
d. cardinal ligament

Answer 24

a. suspensory ligament of ovary

Question 25

which vessel crosses anteriorly to the ureter? a. ovarian artery b. internal pudendal artery c. uterine artery d. inferior rectal artery e. lateral sacral artery

Answer 25

c. uterine artery

Question 26

which part of male urethra is surrounded by internal urethral sphincter?

Answer 26

pre-prostatic urethra

Question 27

which part of male urethra is surrounded by external urethral sphincter?

Answer 27

membranous urethra

Question 28

in pelvic floor injury due to childbirth, which two levator ani muscles are more often torn?

Answer 28

puborectalis and pubococcygeus

Question 29

which is the narrowest part of the fallopian tube? a. infundibulum b. ampulla c. isthmus d. intramural

Answer 29

c. isthmus

Question 30

which artery needs to be ligated before a total hysterectomy?

Answer 30

uterine artery

Question 31

what are the pelvic floor muscles?

Answer 31

1. levator ani - puborectalis - pubococcygeus - iliococcygeus 2. coccygeus

Question 32

proportionally, the female pelvis has a ____ than the male pelvis a. larger pelvic inlet b. smaller subpubic angle c. narrower pubic arch d. smaller pelvic outlet e. narrower pelvic inlet

Answer 32

a. larger pelvic inlet

Question 33

to which lymph nodes will lymph from prostate most likely drain first? a. para-aortic b. inguinal c. lumbar d. internal iliac e. external iliac

Answer 33

d. internal iliac

Question 34

which 2 nerves provide sensory innervation to anterior 1/3 of labia majora?

Answer 34

ilioinguinal and genitofemoral nerves

Question 35

While reviewing a radiograph of the pelvis, a surgeon noticed a fracture line involving the boundary of the pelvic inlet. Which of the following structures is possibly damaged? A. Anterior inferior iliac spine B. Iliac crest C. Inferior pubic ramus D. Promontory of the sacrum

Answer 35

D. Promontory of the sacrum

Question 36

Which of the arteries supplying the clitoris pass through and supply the corpora cavernosa? a. Deep arteries b. Arteries of the bulb c. Dorsal arteries d. Internal pudendal arteries

Answer 36

a. Deep arteries