Anatomy mid 1

Question 1

A 53-year-old woman with known kidney disease presents to a hospital because her pain has
become increasingly more severe. A physician performing kidney surgery must remember that:
(A) The left kidney lies a bit lower than the right one
(B) The perirenal fat lies external to the renal fascia
(C) The renal fascia does not surround the suprarenal gland
(D) The left renal vein runs anterior to both the aorta and the left renal artery
(E) The right renal artery is shorter than the left renal artery

Answer 1

(D) The left renal vein runs anterior to both the aorta and the left renal artery

Question 2

A neonatal baby was born with diabetes mel- litus due to an inadequate production of insulin.
Cells in the endocrine portion of the pancreas
that secrete insulin, glucagon, and somatostatin are derived from which of the following?
(A) Ectoderm
(B) Mesoderm
(C) Endoderm
(D) Proctodeum
(E) Neural crest cells

Answer 2

(C) Endoderm

Question 3

A 17-year-old boy suffers a traumatic groin injury during a soccer match. The urologist notices 
tenderness and swelling of the boy’s left testicle that may be produced by thrombosis in which of 
the following veins?
(A) Left internal pudendal vein
(B) Left renal vein
(C) Inferior vena cava
(D) Left inferior epigastric vein
(E) Left external pudendal vein

Answer 3

(B) Left renal vein

Question 4

A 22-year-old woman receives a deep cut in the inguinal canal 1 in. lateral to the pubic tubercle.
Which of the following ligaments is lacerated within the inguinal canal?
(A) Suspensory ligament of the ovary
(B) Ovarian ligament
(C) Mesosalpinx
(D) Round ligament of the uterus
(E) Rectouterine ligament

Answer 4

(D) Round ligament of the uterus

Question 5

A 59-year-old woman comes to a local hospital for uterine cancer surgery. As the uterine
artery passes from the internal iliac artery to the uterus, it crosses superior to which of the following structures that is sometimes mistakenly ligated during such surgery?
(A) Ovarian artery
(B) Ovarian ligament
(C) Uterine tube
(D) Ureter
(E) Round ligament of the uterus

Answer 5

(D) Ureter

Question 6

A 58-year-old man is diagnosed as having a slowly growing tumor in the deep perineal space.
Which of the following structures would most likely be injured?
(A) Bulbourethral glands
(B) Crus of penis
(C) Bulb of vestibule
(D) Spongy urethra
(E) Great vestibular gland

Answer 6

(A) Bulbourethral glands

Question 7

A 59-year-old man is diagnosed with prostate cancer following a digital rectal examination.
For the resection of prostate cancer, it is important to know that the prostatic ducts open into or
on which of the following structures:
(A) Membranous part of the urethra (B) Seminal colliculus
(C) Spongy urethra
(D) Prostatic sinus
(E) Prostatic utricle

Answer 7

(D) Prostatic sinus

Question 8

A 29-year-old woman with a ruptured ec- topic pregnancy is admitted to a hospital for 
culdocentesis. A long needle on the syringe is most efficiently inserted through which of the 
following structures?
(A) anterior fornix of the vagina
(B) Posterior fornix of the vagina
(C) Anterior wall of the rectum
(D) Posterior wall of the uterine body
(E) Posterior wall of the bladder

Answer 8

(B) Posterior fornix of the vagina

Question 9

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) Bulb of the penis
(B) Bulbourethral gland
(C) Membranous part of the male urethra
(D) Deep transverse perineal muscle
(E) Sphincter urethrae

Answer 9

(A) Bulb of the penis

Question 10

A sexually active adolescent presents with an infection within the ischiorectal fossa. Which of
the following structures is most likely injured?
(A) Vestibular bulb
(B) Seminal vesicle
(C) Greater vestibular gland
(D) Inferior rectal nerve
(E) Internal pudendal artery

Answer 10

(D) Inferior rectal nerve

Question 11

A first-year resident in the urology department reviews pelvic anatomy before seeing
patients. Which of the following statements is correct?
(A) The dorsal artery of the penis supplies the glans penis.
(B) The seminal vesicles store spermatozoa. (C) The duct of the bulbourethral gland opens
into the membranous urethra.
(D) The duct of the greater vestibular gland
opens into the vagina.
(E) The anterior lobe of the prostate gland is prone to carcinomatous transformation.

Answer 11

(A) The dorsal artery of the penis supplies the glans penis.

Question 12

A 16-year-old boy presents to the emergency department with a rupture of the penile urethra.
Extravasated urine from this injury can spread into which of the following structures?
(A) Scrotum
(B) Ischiorectal fossa
(C) Pelvic cavity
(D) Testis
(E) Thigh

Answer 12

(A) Scrotum

Question 13

A 23-year-old woman visits her obstetrician for an annual checkup. 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

Answer 13

(E) Uterine cervix

Question 14

A radiologist interprets a lymphangiogram for a 29-year-old patient with metastatic carcinoma. Upper lumbar nodes most likely receive lymph from which of the following structures?
(A) Lower part of the anal canal 
(B) Labium majus
(C) Clitoris
(D) Testis
(E) Scrotum

Answer 14

(D) Testis

Question 15

A 49-year-old woman has a large mass on the pelvic brim. Which of the following structures
is most likely compressed by this mass when crossing the pelvic brim?
(A) Deep dorsal vein of the penis (B) Uterine tube
(C) Ovarian ligament
(D) Uterine artery
(E) Lumbosacral trunk

Answer 15

(E) Lumbosacral trunk

Question 16

A 26-year-old man comes to a hospital with fever, nausea, pain, and itching in the perineal
region. On examination by a urologist, he is diagnosed as having infected bulbourethral (Cowper)
glands. Which of the following structures is/are affected by this infection?
(A) Superficial perineal space
(B) Sphincter urethrae
(C) Production of sperm
(D) Testis
(E) Seminal vesicles

Answer 16

(B) Sphincter urethrae

Question 17

An obstetrician is about to perform a pu- dendal block so a woman can experience less pain
when she delivers her child. He recalls what he learned in medical school about this nerve. Which
of the following statements is correct?
(A) It passes superficial to the sacrotuberous ligament
(B) It innervates the testis and epididymis in a male
(C) It provides motor fibers to the coccygeus
(D) It can be blocked by injecting an anesthetic near the inferior margin of the ischial spine
(E) It arises from the lumbar plexus

Answer 17

(D) It can be blocked by injecting an anesthetic near the inferior margin of the ischial spine

Question 18

A trauma surgeon in the emergency department at a local center examines a 14-year-old boy
with extensive pelvic injuries after a hit and run accident. The surgeon inspects the ischio- rectal
fossa because it
(A) Accumulates urine leaking from rupture of the bulb of the penis
(B) Contains the inferior rectal vessels
(C) Has a pudendal canal along its medial wall
(D) Is bounded anteriorly by the sacrotuberous
ligament
(E) Contains a perineal branch of the fifth lumbar nerve

Answer 18

(B) Contains the inferior rectal vessels

Question 19

A 5-month-old boy is admitted to the children’s hospital because of urine being expelled 
from the dorsal aspect of the penis. Which of the following embryologic structures failed to fuse in 
this patient?
(A) Labioscrotal swellings or folds 
(B) Urogenital sinus
(C) Spongy urethra
(D) Phallus
(E) Urethral folds

Answer 19

(C) Spongy urethra

Question 20

A 78-year-old man has carcinoma of the rectum. The cancer is likely to metastasize via the
veins into which of the following structures?
(A) Spleen
(B) Kidney
(C) Liver
(D) Duodenum
(E) Suprarenal gland

Answer 20

(C) Liver

Question 21

During a partial hysterectomy leaving the ovaries intact, the surgeon detaches the ovary from 
the uterus by transecting the ovarian ligament. This ligament developed from which embryonic 
structure?
(A) Ducts of the prostate gland
(B) Prostatic utricle
(C) Ducts of the bulbourethral glands
(D) Ejaculatory ducts
(E) Duct of the seminal vesicles

Answer 21

(C) Ducts of the bulbourethral glands