new Flashcards
- During a practice match, a heavyweight prizefighter endured an illegal hit to the left flank. Following
the match, a focused assessment with sonography for trauma (FAST) exam revealed that blood from a
renal laceration had tracked inferiorly and accumulated in the groove between the psoas major and
iliacus muscles. What nerve would you expect to be irritated by blood in this location?
A. Sciatic
B. Femoral
C. Obturator
D. Superior gluteal
E. Lateral femoral cutaneous
B. Femoral
Which one of the following statements best describes the muscles of the pelvis?
A. The obturator internus muscle leaves the pelvis through the greater sciatic foramen.
B. The levator ani muscle is composed of the pubococcygeus, puborectalis, and iliococcygeus.
C. The pelvic diaphragm is a sling of muscle that separates the true pelvis from the false pelvis.
D. The piriformis muscle forms the lateral wall of the pelvis.
E. The coccygeus muscle attaches to the sacrotuberous ligament.
B. The levator ani muscle is composed of the pubococcygeus, puborectalis, and iliococcygeus.
3. Typically, the posterior division of the internal iliac artery supplies A. structures of the perineum B. muscles of the medial thigh C. meninges of the sacral spinal roots D. uterus and uterine tubes E. prostate
C. meninges of the sacral spinal roots
4. The components of the pelvic splanchnic nerves are most similar to the components of the A. lumbar splanchnic nerves B. sacral splanchnic nerves C. pudendal nerve D. vagus nerve E. hypogastric nerves
D. vagus nerve
Carcinoma of the prostate can metastasize to bone and the brain through its connections with the
vertebral venous plexus. Which other structures communicate with this venous plexus?
A. Breast
B. Spinal cord
C. Intercostal muscles
D. Esophagus
E. All of the above
E. All of the above
6. Although branches of the uterine artery anastomose extensively throughout the pelvis, the main stem of the vessel travels within the A. proper ovarian ligament B. cardinal ligament C. uterosacral ligament D. ovarian suspensory ligament E. round ligament
B. cardinal ligament
- Which of the following statements accurately describes the relations of the ureter?
A. It is crossed anteriorly by the gonadal vessels on the posterior abdominal wall.
B. It crosses the brim of the pelvis at the bifurcation of the common iliac artery.
C. In females it passes under the uterine artery ~2 cm lateral to the cervix.
D. It enters the bladder at the posterolateral aspect of the trigone.
E. All of the above
E. all the above
. During a routine physical exam on a male patient, you test the integrity of the external anal sphincter.
What spinal cord segments are involved in this?
A. T12–L1
B. L2–L4
C. L4–L5
D. S1–S2
E. S2–S4
E. S2–S4
9. The superficial perineal fascia is continuous with the A. perineal membrane B. dartos fascia C. deep penile fascia D. tunica albuginea of the penis E. endopelvic fascia
B. dartos fascia
- The boundary of the pelvic inlet
A. provides the attachment site for the pelvic diaphragm
B. includes the iliac crests
C. includes the ramus of the ischium
D. is crossed by the ovarian and testicular arteries
E. separates the cavity of the true pelvis from the abdominal cavity
E. separates the cavity of the true pelvis from the abdominal cavity
- Several years after delivering her twin boys, Laura experienced mild uterine prolapse and urinary
incontinence. Her gynecologist was able to confirm that the angle of her anococcygeal ligament had
changed, suggesting a laxity in her pelvic floor muscles. Which muscles insert on the anococcygeal
ligament?
A. Coccygeus
B. Iliococcygeus
C. Piriformis
D. Deep transverse perineal
E. Obturator internus
B. Iliococcygeus
- Tumors that metastasize via the bloodstream often form metastases in the first capillary bed that the
cells reach after they enter the bloodstream. Based on their venous drainage, tumors in which of the
following locations are likely to reach the lung before they reach the liver?
A. Ascending colon
B. Sigmoid colon
C. Pancreas
D. Superior (proximal) rectum
E. Inferior (distal) rectum
E. Inferior (distal) rectum
13. Which one of the following structures passes through the genital hiatus? A. Ductus deferens B. Cavernous nerves C. Round ligament D. Obturator nerve E. External iliac artery
B. Cavernous nerves
- A 44-year-old woman undergoes a total hysterectomy for painful fibroids. The ovaries will not be
removed during the procedure. Which of the following ligaments must be preserved?
A. Suspensory ligament
B. Ovarian ligament
C. Uterosacral ligament
D. Transverse cervical ligament
E. Round ligament
A. Suspensory ligament
- Which of the following statements best describes the uterine cervix?
A. In a normally anteflexed uterus, the cervix is tilted posteriorly.
B. Vaginal fornices surround its supravaginal part.
C. It is the attachment site for the round ligament.
D. It makes up the inferior third of the uterus.
E. It communicates with the uterine cavity through the external os.
D. It makes up the inferior third of the uterus.
- A 53-year-old man had an aortic aneurysm that extended through his aortic bifurcation into his
common iliac arteries. During the open repair, the surgeon opened the vessels longitudinally and fixed
a synthetic graft to the walls of the vessels above and below the aneurysm. Following surgery, the
man experienced retrograde ejaculation because of damage to nerves that innervated his internal
urethral sphincter. Which nerves were damaged?
A. Sympathetic nerves of the superior hypogastric plexus
B. Parasympathetic nerves of the superior hypogastric plexus
C. Somatic nerves of the sacral plexus
D. Pelvic splanchnic nerves
E. Sympathetic trunk
A. Sympathetic nerves of the superior hypogastric plexus
- You are treating a 34-year-old woman for hemorrhoids. Although she does not complain of pain, the
hemorrhoids protrude into her anal canal and are becoming ulcerated. There is no evidence of portal
hypertension, but blood from the ulcers is bright red. Based on her brief history, what can you surmise
about her condition?
A. The prolapsed tissue contains the dilated veins of the external rectal plexus.
B. The hemorrhoids originate from below the dentate line.
C. The dilated veins in the hemorrhoids drain to the inferior rectal veins.
D. The dilated veins communicate with the rectal arteries to form an arteriovenous hemorrhoidal
plexus.
E. All of the above
D. The dilated veins communicate with the rectal arteries to form an arteriovenous hemorrhoidal
plexus.
- During a robotic prostatectomy on a 41-year-old man, the cavernous nerves were inadvertently
damaged. What symptoms would you expect in this patient?
A. Loss of tone in his external anal sphincter
B. Urinary incontinence
C. Inability to ejaculate
D. Inability to form an erection
E. Loss of sensation at the tip of the penis
D. Inability to form an erection
19. Structures that pass through the greater sciatic foramen include the A. obturator internus B. coccygeus C. iliopsoas D. piriformis E. obturator nerve
D. piriformis
- The tendinous arch of the pelvic fascia
A. is a condensation of endopelvic fascia
B. includes the lateral rectal ligament
C. supports the pelvic viscera
D. provides an attachment site for the pelvic diaphragm
E. All of the above
C. supports the pelvic viscera
- Structures that drain (directly or indirectly) into the deep inguinal lymph nodes include the
A. glans of the penis
B. perianal skin
C. supralateral part of the uterus via the round ligament
D. scrotum
E. all of the above
E. all of the above
- During the national championships an Olympic gymnast fell backward off the balance beam, fracturing
the tip of her coccyx and subluxing (dislocating) her sacroiliac joint. The team physician was
concerned about damage to her sacral plexus and its branches that exit the pelvis. Nerves of the sacral
plexus pass through the
A. posterior sacral foramina
B. obturator canal
C. lesser sciatic foramen
D. superficial inguinal ring
E. deep inguinal ring
C. lesser sciatic foramen
- A young, pregnant woman in her third trimester was alarmed when she experienced a sharp pain in the
anterior part of her labia majora when she stood up. Her obstetrician assured her that this was a
common problem in late pregnancy and was most likely caused by
A. stretching of the round ligament
B. tightening of the inguinal ligament
C. pressure on the obturator nerve
D. irritation of the perineal branch of the pudendal nerve
E. stretching of the iliohypogastric nerve
A. stretching of the round ligament
- A vascular surgeon is repairing an aneurysm of the aortic bifurcation that extends along the right
common iliac artery to its division into internal iliac and external iliac branches. What structure does
the surgeon encounter that is at risk as it crosses over the pelvic brim at this distal end of the
aneurysm?
A. Ureter
B. Testicular artery
C. Lumbosacral trunk
D. Sciatic nerve
E. Ductus deferens
A. Ureter
Similar to other sections of the large intestine, the rectum is characterized by A. teniae coli B. haustra C. a mesentery D. epiploic appendices E. None of the above
E. None of the above
Which of the following are found within the superficial perineal space?
A. Bulbourethral glands
B. External urethral sphincter
C. Bulbospongiosus muscle
D. Anterior extension of ischioanal fat pad
E. Inferior rectal nerve
C. Bulbospongiosus muscle
