Block 7 Anat Pelvis BRS Pretest W Xpl Prt 2

19 Questions | By Chachelly | Updated: Mar 20, 2022 | Attempts: 80

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Block 7 Anat Pelvis BRS Pretest W Xpl Prt 2 - Quiz

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1.

The most important measurement of the pelvic outlet, indicating the SMALLEST dimension, is the transverse midplane diameter. It is measured between which of the following?
- A.
  
  Ischial spines
- B.
  
  Ischial tuberosities
- C.
  
  Lower margin of the pubic symphysis to the sacroiliac joint
- D.
  
  Sacral promontory to the inferior margin of the pubic symphysis
2.

At delivery, caudal analgesia is induced by administration of anesthetic into the epidural space in the sacral region. The needle is introduced via which of the following?
- A.
  
  Anterior sacral foramina
- B.
  
  Dural sac
- C.
  
  Intervertebral foramina
- D.
  
  Posterior sacral foramina
- E.
  
  Sacral hiatus
3.

Which structure is most susceptible to unintentional damage during a hysterectomy?
- A.
  
  Uterine artery
- B.
  
  Ureter
- C.
  
  Urinary bladder
- D.
  
  Urethra
- E.
  
  Kidney
4.

The patient is a 45-year-old man with a history of colonic diverticulosis. He complains of fever with pain and swelling in the rectal area. You are concerned that the colonic diverticulum may have become infected (diverticulitis) and ruptured into the space indicated by the asterisk in this CT scan. Which of the following is correct regarding the space indicated by the red asterix?
- A.
  
  It is called the paracolic gutter
- B.
  
  The space is largely filled with muscle
- C.
  
  The space is located superior to the pelvic diaphragm
- D.
  
  Pus from the abscessed diverticuli in that space can extend anteriorly deep to the perineal membrane, but inferior to the urogenital diaphragm
- E.
  
  Pus from the abscessed diverticuli in that space can extend superiorly, anterior to the sacrum
5.

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.
  
  Internal pudendal artery
- B.
  
  Obturator artery
- C.
  
  Superior gluteal artery
- D.
  
  Umbilical artery
- E.
  
  Uterine artery
6.

A couple comes to your office because they have been unable to conceive a child after 1 year of trying. You examine the man and notice a darkish mass and fullness of the left scrotum/spermatic cord compared to the smaller right scrotum/spermatic cord. You suggest he follow up with an urologist because you suspect which of the following?
- A.
  
  Undiagnosed cryptorchidism of the right testicle
- B.
  
  Acquired varicocele
- C.
  
  Acquired left femoral hernia
- D.
  
  Acquired right direct femoral hernia
- E.
  
  Congenital absence of the pampiniform plexus on the right side
7.

Which of the following is one of the roles of the sympathetic chain in the pelvis?
- A.
  
  Bladder contraction
- B.
  
  Cutaneous function (sudomotor, vasomotor, pilomotor)
- C.
  
  Erection in males
- D.
  
  Erection in both male and female
8.

Both the autonomic and vascular systems need to function properly for successful male sexual function. Which of the following statements concerning erection, emission, and ejaculation in the male is correct?
- A.
  
  Contraction of the internal urethral sphincter is under control of the parasympathetic nervous system
- B.
  
  The parasympathetic nerves stimulate closure of helical arteries
- C.
  
  Sympathetic neurons stimulate the helicine arteries to dilate and increase blood flow to the corpora cavernosum
- D.
  
  Parasympathetic innervation stimulates emission of seminal fluid
- E.
  
  Contraction of the bulbospongiosus muscles impedes the drainage of blood from the corpus spongiosum
9.

A 45-year-old man was riding a snowmobile and hit a snow-covered rocky outcropping. When standing for the first time after the accident, he slipped and fell on the outcropping and now is experiencing pain in the gluteal region. In this CT scan, the dark linear structure indicated by the arrow is which of the following?
- A.
  
  A fracture of the sacral body
- B.
  
  The sacrococcygeal joint
- C.
  
  A spinal nerve
- D.
  
  The superior gluteal artery
- E.
  
  The inferior gluteal artery
10.

In the hysterosalpingogram below, the dye at C is within which of the following?
- A.
  
  Ovary
- B.
  
  Peritoneal cavity
- C.
  
  Isthmus of the oviduct
- D.
  
  Uterus
- E.
  
  Vagina
11.

. Which of the following locations is optimal for fertilization of an ovulated egg by sperm to occur?
- A.
  
  Ampulla of the oviduct
- B.
  
  Uterus
- C.
  
  Infundibulum of the oviduct
- D.
  
  Isthmus of the oviduct
- E.
  
  Cervical canal of the uterus
12.

Which of the following contains the ovarian neurovascular bundle?
- A.
  
  Broad ligament
- B.
  
  Mesosalpinx
- C.
  
  Mesovarium
- D.
  
  Suspensory ligament of the ovary
- E.
  
  Transverse cervical ligament
13.

Following the birth of her third child a 38-year-old woman was undergoing a hysterectomy because of pelvic pain associated with endometriosis. Since she had an android pelvis, cesarean sections had been performed with each delivery of her children. An open (surgical) hysterectomy approach was performed in order to also remove any peritoneal endometrium, in which the ovaries were to be spared. The OB specifically identified and spared a right and left ureter during the clamping and removal of the uterine arteries. After surgery, she developed left sided low back pain. An intravenous pyelogram was ordered and showed normal function of the right kidney and normal function of the upper portion of the left kidney, but there was little kidney function in the inferior pole of the lower portion of the left kidney and two ureters exiting from that kidney. What likely happened during the hysterectomy?
- A.
  
  Spontaneous kidney failure as a result of the pyelogram
- B.
  
  Damage to one of the left duplicated ureters
- C.
  
  Kidney failure as a result of the anesthetic given during surgery
- D.
  
  Kidney stone development
14.

Pap smears are the collection of cells from the uterine cervix to look for cytological evidence of transformation to cancerous forms, most typically due to a viral infection. While most women do not report any discomfort associated with the collection of cervical cells, a few women do. To which of the following somatic areas does the uterine cervix refer pain to?
- A.
  
  Epigastric region
- B.
  
  Medial thigh and buttock
- C.
  
  Inguinal and pubic regions, anterior labia majora, medial thigh
- D.
  
  Lateral leg and perineum
- E.
  
  Subcostal and umbilical regions
15.

Episiotomies are performed to control tearing during a vaginal delivery. When performing a mediolateral episiotomy, an OBGYN will likely cut through several structures of the perineum. What perineal structures must be sutured back together following a typical mediolateral episiotomy?
- A.
  
  Vaginal wall, pubococcygeus, and piriformis muscles
- B.
  
  Vaginal wall, pubococcygeus, and iliococcygeus muscles
- C.
  
  Vaginal wall, bulbospongiosus, and superficial transverse perineal muscles
- D.
  
  Vaginal wall, prepuce, and rectus abdominis muscle
- E.
  
  Vaginal wall, sacrospinous and sacrotuberous ligaments
16.

A man comes to your office because he thinks he has bilateral hernias and bilateral pain in the inguinal area. Upon physical examination he does not have a direct nor indirect inguinal hernia, but does have bilateral palpable superficial inguinal lymph nodes, which are tender. You formulate a differential diagnosis of locations from which lymph drains into the superficial inguinal lymph nodes. Which anatomical region or structure does not drain into the superficial inguinal lymph nodes and thus should be EXCLUDED from your differential diagnosis list?
- A.
  
  Penis
- B.
  
  Scrotum
- C.
  
  Testicles
- D.
  
  Anus
- E.
  
  Epididymides
17.

A 35-year-old married woman comes to the emergency room due to sudden onset of nausea, vomiting, positional hypotension, and tachycardia. She also complains of sudden abdominal fullness and generalized pelvic pain. Her period is “late,” with the last menses 55 days ago. A pregnancy test is positive. Pelvic sonogram suggests extravasated fluid in the peritoneal cavity and pooling in the rectouterine pouch (of Douglas) and a mass in the left fallopian tube. A culdocentesis yields fresh blood. You correctly suggest that she be admitted for which of the following?
- A.
  
  D and C (dilation and curettage)
- B.
  
  Endoscopic exploration to rule out ectopic pregnancy
- C.
  
  Ovariectomy for ovarian cancer
- D.
  
  Hysterectomy for fibroids
- E.
  
  Cystocele repair
18.

A 50-year-old multiparous woman comes to your office to rule out cancer. She reports a growing mass or fullness on the anterior wall of her vagina. Upon physical examination you detect a soft, bulging, and a very compressible mass on the anterior surface of the vagina. When you push on the bulging mass she feels the need to urinate. You order a CT because you suspect which of the following?
- A.
  
  Rectocele
- B.
  
  Cystocele
- C.
  
  Cervical cancer
- D.
  
  Didelphic uterus
- E.
  
  Indirect inguinal hernia
19.

A 30-year-old woman makes her first prenatal visit to your office. She is excited and anxious as this is her first pregnancy. She brings up the topic of pain relief during vaginal delivery. She states that she would like to try “natural birth” but would like to have the option of some pain relief. However, she would prefer not to have a caudal epidural block. You suggest a pudendal nerve block. One of the advantages of a pudendal nerve block is that the woman can still feel uterine contractions and thus can actively participate in the birthing process, yet also has some pain relief. What would you tell your patient regarding how to perform a pudendal nerve block and an advantage to performing the injection transvaginally versus injecting through perineal skin?
- A.
  
  The pudendal nerve serves the skin around the anterior/lateral entrance of the vagina; the nerve wraps around the ischial spine, which is used as landmark; transvaginal administration is less painful since the upper portion of the vagina has fewer pain receptors
- B.
  
  The pudendal nerve serves the skin around the posterior/lateral entrance of the vagina; the nerve wraps around the ischial spine, which is used as a landmark; transvaginal administration is less painful since the upper portion of the vagina has fewer pain receptors
- C.
  
  The pudendal nerve serves the skin around the anterior/lateral entrance of the vagina; the nerve wraps around the ischial tuberosity, which is used as landmark; transvaginal administration is less painful since the upper portion of the vagina has fewer pain receptors
- D.
  
  The pudendal nerve serves the skin around the posterior/lateral entrance of the vagina; the nerve wraps around the ischial tuberosity, which is used as a landmark; transvaginal administration is less painful since the upper portion of the vagina has fewer pain receptors