Biology Quiz: The Anatomy Of The Perineum

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  • 1/20 Questions

    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 are sometimes mistakenly ligated during such surgery?

    • Ovarian artery
    • Ovarian ligament
    • Uterine tube
    • Ureter
    • Round ligament of the uterus
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About This Quiz

How much do you understand the anatomy of the Perineum? The perineum is the space between the anus and scrotum in the male and between the anus and the vulva in the female. It plays a vital role in the body functions as such micturition, defecation, sexual intercourse, and childbirth. If you are looking to learn some more about this region, be sure to take this interesting quiz. All the best!

Biology Quiz: The Anatomy Of The Perineum - Quiz

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  • 2. 

    A young couple is having difficulty conceiving a child. Their physician at a reproduction and fertility clinic explains to them that:

    • The ovary lies within the broad ligament

    • The glans clitoris is formed from the corpus spongiosum

    • Erection of the penis is a sympathetic response

    • Ejaculation follows parasympathetic stimulation

    • Fertilization occurs in the infundibulum or ampulla of the uterine tube.

    Correct Answer
    A. Fertilization occurs in the infundibulum or ampulla of the uterine tube.
    Explanation
    Fertilization takes place in the infundibulum or ampulla of the uterine tube. The
    glans clitoris is derived from the corpora cavernosa, whereas the glans penis is the expanded terminal
    part of the corpus spongiosum. Erection of the penis is caused by parasympathetic stimulation,
    whereas ejaculation is mediated via the sympathetic nerve. The ovaries are not enclosed in the broad
    ligament, but their anterior surface is attached to the posterior surface of the broad ligament.

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  • 3. 

    A 29-year-old woman is admitted to a hospital because the birth of her child is several days overdue. Tearing of the pelvic diaphragm during childbirth leads to paralysis of which of the following muscles?

    • Piriformis

    • Sphincter urethrae

    • Obturator internus

    • Levator ani

    • Sphincter ani externus

    Correct Answer
    A. Levator ani
    Explanation
    The pelvic diaphragm is formed by the levator ani and coccygeus, whereas
    the urogenital diaphragm consists of the sphincter urethrae and deep transverse perinei muscles.
    The piriformis passes through the greater sciatic notch and inserts on the greater trochanter of
    the femur. The obturator internus forms the lateral wall of the ischiorectal fossa. The sphincter
    ani externus is composed of three layers, including the subcutaneous (corrugator cutis ani), superficial,
    and deep portions and maintains a voluntary tonic contracture.

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  • 4. 

    An elderly man with benign enlargement of his prostate experiences difficulty in urination, urinary frequency, and urgency. Which of the following lobes of the prostate gland is commonly involved in benign hypertrophy that obstructs the prostatic urethra?

    • Anterior lobe

    • Middle lobe

    • Right lateral lobe

    • Left lateral lobe

    • Posterior lobe

    Correct Answer
    A. Middle lobe
    Explanation
    The middle lobe of the prostate gland is commonly involved in benign prostatic hypertrophy, resulting in obstruction of the prostatic urethra, whereas the posterior lobe is commonly involved in the carcinomatous transformation. The anterior lobe contains little glandular tissue, and the two lateral lobes on either side of the urethra form the major part of the gland.

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  • 5. 

    A 68-year-old woman with uterine carcinoma undergoes surgical resection. This cancer can spread directly to the labia majora in lymphatics that follow which of the following structures?

    • Pubic arcuate ligament

    • Suspensory ligament of the ovary

    • Cardinal (transverse cervical) ligament

    • Suspensory ligament of the clitoris

    • Round ligament of the uterus

    Correct Answer
    A. Round ligament of the uterus
    Explanation
    The round ligament of the uterus runs laterally from the uterus through the deep inguinal ring, inguinal canal, and superficial inguinal ring and becomes lost in the subcutaneous tissues of the labium majus. Thus, carcinoma of the uterus can spread directly to the labium majus by traveling in lymphatics that follow the ligament. The pubic arcuate ligament attaches across the inferior aspect of the pubic symphysis and attaches to the medial borders of the inferior pubic rami. The suspensory ligament of the ovary runs from the ovary to the pelvic wall and transmits the ovarian vessels. The cardinal (transverse cervical) ligament runs from the cervix and the vagina to the pelvic walls. The suspensory ligament of the clitoris runs from the pubic symphysis and the arcuate pubic ligament to the deep fascia of the body of the clitoris.

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  • 6. 

    A 22-year-old woman receives a deep cut in the inguinal canal 1 inch lateral to the pubic tubercle. Which of the following ligaments is lacerated within the inguinal canal?

    • Suspensory ligament of the ovary

    • Ovarian ligament

    • Mesosalpinx

    • Round ligament of the uterus

    • Rectouterine ligament

    Correct Answer
    A. Round ligament of the uterus
    Explanation
    The round ligament of the uterus is found in the inguinal canal along its course. Other ligaments are not passing through the inguinal canal.

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  • 7. 

    A 29-year-old woman with a ruptured ectopic pregnancy is admitted to a hospital for culdocentesis. A long needle on the syringe is most efficiently inserted through which of the following structures?

    • Anterior fornix of the vagina

    • Posterior fornix of the vagina

    • Anterior wall of the rectum

    • Posterior wall of the uterine body

    • Posterior wall of the bladder

    Correct Answer
    A. Posterior fornix of the vagina
    Explanation
    A needle should be inserted through the posterior fornix, just below the posterior lip of the cervix while the patient is in the supine position, to aspirate abnormal fluid in the cul-de-sac of Douglas (rectouterine pouch). Rectouterine excavation is not most efficiently aspirated by puncture of other structures

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  • 8. 

    A 29-year-old carpenter sustains severe injuries of the pelvic splanchnic nerve by a deep puncture wound, which has become contaminated. The injured parasympathetic preganglionic fibers in the splanchnic nerve are most likely to synapse in which of the following ganglia?

    • Ganglia in or near the viscera or pelvic plexus

    • Sympathetic chain ganglia

    • Collateral ganglia

    • Dorsal root ganglia

    • Ganglion impar

    Correct Answer
    A. Ganglia in or near the viscera or pelvic plexus
    Explanation
    The pelvic splanchnic nerves carry preganglionic parasympathetic general visceral efferent (GVE) fibers that synapse in the ganglia of the inferior hypogastric plexus and in terminal ganglia in the muscular walls of the pelvic organs. The sympathetic preganglionic fibers synapse in the sympathetic chain (paravertebral) ganglia or in the collateral (prevertebral) ganglia. The dorsal root ganglia contain cell bodies of general somatic afferent (GSA) and general visceral afferent (GVA) fibers and have no synapsis. The two sympathetic trunks unite and terminate in the ganglion impar (coccygeal ganglion), which is the most inferior, unpaired ganglion located in front of the coccyx.

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  • 9. 

    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?

    • Left internal pudendal vein

    • Left renal vein

    • Inferior vena cava

    • Left inferior epigastric vein

    • Left external pudendal vein

    Correct Answer
    A. Left renal vein
    Explanation
    A tender swollen left testis may be produced by thrombosis in the left renal vein because the left testicular vein drains into the left renal vein. The right testicular vein drains into the inferior vena cava. The left internal pudendal vein empties into the left internal iliac vein. The left inferior epigastric drains into the left external iliac vein and the left external pudendal vein empties into the femoral vein.

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  • 10. 

    On a busy Saturday night in Chicago, a 16- year-old boy presents to the emergency room with a stab wound from a knife that enters the pelvis above the piriformis muscle. Which of the following structures is most likely to be damaged?

    • Sciatic nerve

    • Internal pudendal artery

    • Superior gluteal nerve

    • Inferior gluteal artery

    • Posterior femoral cutaneous nerve

    Correct Answer
    A. Superior gluteal nerve
    Explanation
    The superior gluteal nerve leaves the pelvis through the greater sciatic foramen, above the piriformis. The sciatic nerve, internal pudendal vessels, inferior gluteal vessels and nerve, and posterior femoral cutaneous nerve leave the pelvis below the piriformis.

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  • 11. 

    A 37-year-old man is suffering from carcinoma of the skin of the glans penis. Cancer cells are likely to metastasize directly to which of the following lymph nodes?

    • External iliac nodes

    • Internal iliac nodes

    • Superficial inguinal nodes

    • Aortic (lumbar) nodes

    • Common iliac nodes

    Correct Answer
    A. Superficial inguinal nodes
    Explanation
    NOTICE THE QUESTION SAYS -SKIN-, the glans would drain to the deep inguinal nodes The superficial inguinal nodes receive lymph from the penis, scrotum, buttocks, labium majus, and the lower parts of the vagina and anal canal. These nodes have efferent vessels that drain primarily into the external iliac and common iliac nodes and ultimately to the lumbar (aortic) nodes. The internal iliac nodes receive lymph from the upper part of the rectum, vagina, uterus, and other pelvic organs, and they drain into the common iliac and then to the lumbar (aortic) nodes.

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  • 12. 

    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?

    • Bulbourethral glands

    • Crus of penis

    • Bulb of vestibule

    • Spongy urethra

    • Great vestibular gland

    Correct Answer
    A. Bulbourethral glands
    Explanation
    The deep perineal space contains the bulbourethral (Cowper's) glands. The crus of the penis, bulb of the vestibule, spongy urethra, and great vestibular gland are found in the superficial perineal space.

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  • 13. 

    A 39-year-old man is unable to expel the last drops of urine from the urethra at the end of micturition because of paralysis of the external urethral sphincter and bulbospongiosus muscles. This condition may occur as a result of injury to which of the following nervous structures?

    • Pelvic plexus

    • Prostatic plexus

    • Pudendal nerve

    • Pelvic splanchnic nerve

    • Sacral splanchnic nerve

    Correct Answer
    A. Pudendal nerve
    Explanation
    The perineal branch of the pudendal nerve supplies the external urethral sphincter and bulbospongiosus muscles in the male. All other nervous structures do not supply skeletal muscles but supply smooth muscles in the perineal and pelvic organs. The pelvic and prostatic plexuses contain both sympathetic and parasympathetic nerve fibers. The pelvic splanchnic nerve carries preganglionic parasympathetic fibers, whereas the sacral splanchnic nerve transmits preganglionic sympathetic fibers.

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  • 14. 

    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?

    • Membranous part of the urethra

    • Seminal colliculus

    • Spongy urethra

    • Prostatic sinus

    • Prostatic utricle

    Correct Answer
    A. Prostatic sinus
    Explanation
    Ducts from the prostate gland open into the prostatic sinus, which is a groove on either side of the urethral crest. The prostate gland receives the ejaculatory duct, which opens into the prostatic urethra on the seminal colliculus (a prominent elevation of the urethral crest) just lateral to the prostatic utricle, which is a small blind pouch. The bulbourethral gland lies on the lateral side of the membranous urethra within the deep perineal space, but its duct opens into the bulbous portion of the spongy (penile) urethra.

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  • 15. 

    A 46-year-old woman has a history of infection in her perineal region. A comprehensive examination reveals a tear of the superior boundary of the superficial perineal space. Which of the following structures would most likely be injured?

    • Pelvic diaphragm

    • Colles' fascia

    • Superficial perineal fascia

    • Deep perineal fascia

    • Perineal membrane

    Correct Answer
    A. Perineal membrane
    Explanation
    The superior (deep) boundary of the superficial perineal space is the perineal membrane (inferior fascia of the urogenital diaphragm). Colles' fascia is the deep membranous layer of the superficial perineal fascia. The deep perineal fascia essentially divides the superficial perineal space into a superficial and deep compartment. The pelvic diaphragm consists of the levator ani and coccygeus muscles

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  • 16. 

    An obstetrician performs a median episiotomy  on a woman before parturition to prevent uncontrolled tearing. If the perineal body is damaged, the function of which of the following muscles might be impaired?

    • Ischiocavernosus and sphincter urethrae

    • Deep transverse perineal and obturator internus

    • Bulbospongiosus and superficial transverse perineal

    • External anal sphincter and sphincter urethrae

    • Bulbospongiosus and ischiocavernosus

    Correct Answer
    A. Bulbospongiosus and superficial transverse perineal
    Explanation
    The perineal body (central tendon of the perineum) is a fibromuscular node at the center of the perineum. It provides attachment for the bulbospongiosus, the superficial and deep transverse perineal muscles, and the sphincter ani externus muscles. Other muscles (ischiocavernosus, sphincter urethrae, and obturator internus) are not attached to the perineal body.

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  • 17. 

    A 37-year-old small business manager receives a gunshot wound in the pelvic cavity, resulting in a lesion of the sacral splanchnic nerves. Which of the following nerve fibers would primarily be damaged?

    • Postganglionic parasympathetic fibers

    • Postganglionic sympathetic fibers

    • Preganglionic sympathetic fibers

    • Preganglionic parasympathetic fibers

    • Postganglionic sympathetic and parasympathetic fibers

    Correct Answer
    A. Preganglionic sympathetic fibers
    Explanation
    The sacral splanchnic nerves consist primarily of preganglionic sympathetic neurons and also contain general visceral afferent (GVA) fibers. None of the other fibers listed are contained in these nerves.

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  • 18. 

    A 43-year-old man has a benign tumor located near a gap between the arcuate pubic ligament and the transverse perineal ligament. Which of the following structures is most likely compressed by this tumor?

    • Perineal nerve

    • Deep dorsal vein of the penis

    • Superficial dorsal vein

    • Posterior scrotal nerve

    • Deep artery of the penis

    Correct Answer
    A. Deep dorsal vein of the penis
    Explanation
    http://upload.wikimedia.org/wikipedia/commons/5/51/Gray321.pngThe deep dorsal vein, dorsal artery, and dorsal nerve of the penis pass through a gap between the arcuate pubic ligament and the transverse perineal ligament. The perineal nerve divides into a deep branch, which supplies all of the perineal muscles, and superficial branches as posterior scrotal nerves that supply the scrotum. The superficial dorsal vein of the penis empties into the greater saphenous vein. The deep artery of the penis runs in the corpus cavernosum penis.

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  • 19. 

    A 42-year-old woman who has had six children develops weakness of the urogenital diaphragm. Paralysis of which of the following muscles would cause such a symptom?

    • Sphincter urethrae

    • Coccygeus

    • Superficial transversus perinei

    • Levator ani

    • Obturator internus

    Correct Answer
    A. Sphincter urethrae
    Explanation
    The urogenital diaphragm consists of the sphincter urethrae and deep
    transverse perineal muscles. Weakness of the muscles, ligaments, and fasciae of the pelvic floor
    such as the pelvic diaphragm, urogenital diaphragm, and cardinal (transverse cervical) ligaments
    occurs as result of multiple child delivery, advancing age, and menopause. The pelvic diaphragm
    is composed of the levator ani and coccygeus muscles. The superficial transverses perinei is one
    of the superficial perineal muscles and the obturator internus forms the lateral wall of the ischiorectal
    fossa.

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  • 20. 

    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?

    • Greater vestibular gland

    • Bulbourethral gland

    • Membranous part of the male urethra

    • Deep transverse perineal muscle

    • Sphincter urethrae

    Correct Answer
    A. Greater vestibular gland
    Explanation
    The greater vestibular gland is located in the superficial perineal space between the inferior fascia of the urogenital diaphragm and the membranous layer of the superficial perineal fascia (Colles' fascia). All of the other structures are found in the deep perineal pouch.

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  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Mar 19, 2012
    Quiz Created by
    Chachelly
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