Missed Questions Flashcards
Which statement concerning the pudendal n is false?
A. it leaves the pelvis through the greater sciatic foramen and enters the perineum through the lesser sciatic foramen
B. it conveys fibrers from and to the 2nd 3rd and 4th sacral spinal n
C. It conveys parasympathetic fibers
D. Its three primary branches are the inferior rectal n, perineal n, and dorsal n of the clitoris/penis
C is incorrect
it does not convey parasympathetic fibers
which of the following structures cannot be palpated on rectal examination in the male? A. prostate B. bladder C. seminal vesicles D. Ampulla of ductus deferens E. Ureters
E. Ureters
Superficial branches of the perineal n supply which of the following structures
A. Ischiocavernosus/bulbospongiosus
B. Skin of the scrotum/labia majora
C. Urogenital diaphragm and bulb of the penis
D. Skin of the penis
B. Skin of the scrotum/labia majora
Which of the following is a feature of the fundus of the uterus?
A. It is the largest part of the uterus
B. It projects into upper end of the vagina
C. It is a short segment located between the body and the cervix
D. It is located above the uterine ostium of the uterine tube
D. It is located above the uterine ostium of the uterine tube
Which of the following structures is the superficial boundary of the superficial perineal space?
A. Inferior fascia of the urogenital diaphragm
B. Superior fascia of the urogenital diaphragm
C. Superficial layer of the superficial fascia
D. Skin
E. Perineal membrane
E
A 4mo male infant is admitted to the pediatric clinic because he was passing urine near the anus rather than from the tip of his penis. PHysical examination reveals that the patient has a perineal hypospadias. Which of the following embryologic structures failed to fuse properly? A. Labioscrotal folds B. Cloacal membrane C. Urogenital folds D. Genital tubercle E. Urogenital membrane
A. Labioscrotal folds.
Perineal hypospadias is due to a failure of fusion of labioscrotal folds so that the external urethral orifice is between the unfused halves of the scrotum. The cloacal emmbrane is formed from endoderm of the cloaca and ectoderm of the proctodeum and forms the future anus. The urogenital folds normally fuse along the ventral side of the penis to form the spongy urethra. Epispadias is acondition in which the urethra opens on the dorsal surface of the penis resulting from the genital tubrercle devleoping more dorsally during development. The urogenital membrane is bounded by the urogential folds and ruptures to form the urogenital orifice
A 2day old infant girl is dx with tracheoesophageal fistula. in addition, physical examination reveals an imperforate anus. MRI examination reveals that the rectum, vagina, and colon are joined into a single channel. Which of the following structures is directly involved in this malformation? A. Labioscrotal folds B. Persistent cloaca C. Urogenital folds D. Genital Tubercle E. Urogenital membrane
B. Persistent Cloaca
Most anorectal anomalies result form abnormal development of the urorectal septum, ultimately resulting in nondivision of the cloaca into urogenital and anorectal parts. The common outlet of the intestinal, urinary, and reproductive tracts is specifically associated with a persistent cloaca. The labioscrotal folds are involved informing the external urethral orifice only. The urogenital folds normally fuse along the ventral side of the penis to form the spongy urethra. Epispadias is an anomaly in the development of the genital tubercle and involves the urethra orifice. The urogenital membrane is bounded by the urogenital folds and ruptures to form the urogenital orifice.
A 2mo male infant has epispadias and the bladder mucosa is exposed to the outside. Which of the following is likely to cause htis condition?
A. Failure of the primitive streak mesoderm to migrate around the cloacal membrane
B. Failure of the urethral folds to fuse
C. Insufficient androgen stimulation
D. Klinefelter syndrome
E. Persistent Allantois
A. failure of the primitive streak mesoderm to migrate around the cloacal membrane
When the urinary bladder mucosa is open to the outside in the fetus or newborn, the condition is referred to as extrophy of the bladder. The extrophy results from failure of the primitive streak mesoderm to migrate around the cloacal membrane, and it occurs often in combo with epispadias. Penile hypospadias is characterized by a failure of fusion of the labioscrotal folds, with the external urethral orifice located between the two unfused halves of the scrotum. Andorgens are responsible for development of the testes.
A 35yo woman is admitted to the ED with severe left abdominal and back pain. Radiographic evaluation reveals that the left ureter is blocked with a kidney stone. Because the ureter is completely obstructed, an emergency surgical procedure must be performed. Which of the following landmarks is most reliable for the ID of the ureter?
A. The left ureter is located anterior to the left common iliac a
B. The left ureter is located medial to left inferior epigastric a
C. the left ureter is located anterior to the left gonadal a
D. The left ureter is located anteiror to the left renal v
E. The left ureter is located anterior to the left inferior epgiastric a
A. The left ureter is located anterior to the left common iliac a
The ureters cross the pelvic brim anterior to the bifurcation of the common iliac a bilaterally. Because the proximity of this artery to the ureter it is in danger of being damaged during surgery.
A 1yo male infant is admitted to the pediatric clinic because he is passing urine on the underside of the penis. Which embryological structure failed to fuse? A. Spongy urethra B. labioscrotal . folds C. Urethral folds D. urogenital folds E. Genital tubercle
C. Urethral folds
Hypospadias is a developmental defect in the urethra resulting in urine being expelled from the ventral side of the penis. This ectopic malformation may present when the urethral folds fail to completely fuse. Failure of fusion of the spongy urethra would result in epispadias. . A failure of the labioscrotal folds to fuse will cause the external urethral orifice to be situated bretween the two scrotal halves. This is referred to as penile hyospadias. failure of the urogenital folds to fuse would lead to agenesis of the external urethral folds.
A 4mo infant is admitted to the pediatric clinc because urine can be observed passing through an opennig on the dorsum of the penis. Which of the following embryologic structures most likely failed to fuse? A. Spongy urethra B. Labioscrotal folds C. Cloacal membrane D. Urogenital folds E. Genital tubercle
A. Spongy urethra
Epispadias is a developmental defect in the spongy urethra resulting in urine being expelled from the dorsal aspect of the penis. A failure of the labioscrotal fodls to fuse will cause the external urethral orifice to be situated between the two scrotal havles. This is referred to as penile hypospadias. Failure of the urogenital folds to fuse would lead to agenesis of the external urethral folds. The genital tubercle would not directly cause epispadias., as the tubercle still develops, but more dorsally.
A 54 yo man is admitted to the hospital with severe back pain. Radiographic examination suggests carcinoma of the left kidney blocking the drainage of the testicular vein. Which of the following conditions will be most likely associated with these signs? A. Varicocele B. Rectocele C. Cystocele D. Hydrocele E. Hypospadias
A. Varicocele
Varicose veins occur with loss of elasticity within the walls of the vessels. As the veins weaken, they consequently dilate under pressure. A varicocele often occurs with the varicosity of the veins of the pampiniform venous plexus, resulting in the swelling of the veins. This condition can arise from a tumor in the left kidney, which occludes the testicular vein due to an anatomic constrction and increased pressure in veins draining the testis. A hydrocele is an accumulation of fluid within the cavity of the tunica vaginalis. Hypospadias occurs from failure of fusion of the urethral and labioscrotal folds, resulting in an external urethral opening on the vetnral surface of the penis or the perineum.
A 68 . yo man is admitted to the hospital with painful urination and nocturia (urination during the night). MRI examination reveals enlargement and irregularity of the uvula of the urethra. This enlargement resulted in difficulty with ureinary voiding and inadequate empyting of the bladder. Which of the following lobes of the prostate will most likely be hypertrophied? A. Anterior B. Median C. Lateral D. Posterior E. Lateral and posterior
B. Median
When the internal urethral orifice is obstructed, it is most likely due to enlargement of the median lobe of the prostate gland .The prostate gland is located at the base of the urinary bladder and is often describe as possessing five ill-defined lobes, although this is not accepted by most urologists. The middle lobe consists of glandular tissue dorsal to the uvula of the urethral meatus of the urinary bladder, adjacent to the beginning of the urethra. This glandular tissue is most frequently involved in benign hypertrophy.
Radiographic studies of a 42yo woman reveal that she has a vulvar malignancy involving the clitoris. Removal of all affected LLN would be indicated to avoid spread of this cancer. Which are the first LN to filter the lymphatic drainage of the involved area? A. Superficial and deep inguinal LN B. INternal iliac LN C. Para-aortic LN D. Presacral LN E. Axillary LN
A. Superficial and deep inguinal LN
The deep inguinal LN drain the glans clitoris and receive lymph also from the superficial nodes. the internal iliac nodes drain the inferior pelvic structures, deep perineal structures, and sacral nodes. The para-aortic LN, or lumbar nodes, receive lymph from the common iliac nodes. The drainage of the presacral LN can pass to the common or internal ilaic.
While performing a voiding cystourethrogram on a 45 yo man, the urology resident was too forceful when he inserted the catheter and accieently damaged the wall of hte membranous portion of the urethra in the deep perineal compartment (urogenital diaphragm). Which of the following structures would most likely be traumatized at this location?
A. Bulbospongiosus M
B. Sphincter urethra (compressor urethra)
C. Corpus cavernosus penis (crus)
D. Ischiocavernosus m
E. Opening to the bulbourethral gland
B. Sphincter urethra (compressor urethra)
If the membranous portion of the urethra isinjured, urine and blood can leak upward into the retropubic space limited inferiorly by the urogenital diaphragm and the muscle within (compressor urethra), which would be injured. The bulbospongiosus m and otehr perineal muscles, the corpus cavernosum, and the openings of the bulbourethral ducts are inferior and anterio to the region of injury.
