Block 7 Anatomy Perineum Pelvis BRS W Exp Prt 3

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Block 7 Anatomy Perineum Pelvis BRS W Exp Prt 3 - Quiz


Questions and Answers
  • 1. 

    A 49-year-old woman has a large mass on the pelvic brim. Which of the following structures was 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

    Correct Answer
    E. Lumbosacral trunk
    Explanation
    All of the listed structures do not cross the pelvic brim except the lumbosacral
    trunk, which arises from L4 and L5, enters the true pelvis by crossing the pelvic brim,
    and contributes to the format ion of the sacral plexus. The deep dorsal vein of the penis enters the
    pelvic cavity by passing under the symphysis pubis between the arcuate and transverse perineal
    ligaments.

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  • 2. 

    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.

      Clitoris

    • C.

      Labium majus

    • D.

      Testis

    • E.

      Scrotum

    Correct Answer
    D. Testis
    Explanation
    Lymphatic vessels from the testis and epididymis ascend along the testicular
    vessels in the spermatic cord through the inguinal canal and continue upward in the abdomen
    to drain into the upper lumbar nodes. The lymph from the other structures drains into
    the superficial inguinal lymph nodes.

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  • 3. 

    After repair of a ruptured diverticulum, a 31-year-old patient begins to spike with fever and complains of abdominal pain. An infection in the deep perineal space would most likely damage which of the following structures?

    • A.

      Ischiocavernosus muscles

    • B.

      Superficial transverse perineal muscles

    • C.

      Levator ani

    • D.

      Sphincter urethrae

    • E.

      Bulbospongiosus

    Correct Answer
    D. Sphincter urethrae
    Explanation
    The sphincter urethrae is found in the deep perineal space, whereas the
    other structures are located in the superficial perineal space.

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  • 4. 

    During pelvic surgery, a surgeon notices severe bleeding from the artery that remains within the true pelvis. Which of the following arteries is most likely to be injured?

    • A.

      Iliolumbar artery

    • B.

      Obturator artery

    • C.

      Uterine artery

    • D.

      Internal pudendal artery

    • E.

      Inferior gluteal artery

    Correct Answer
    C. Uterine artery
    Explanation
    Of all the arteries listed, the uterine artery remains within the pelvic cavity.

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  • 5. 

    A neurosurgeon performs surgical resection of a rare meningeal tumor in the sacral region. He tries to avoid an injury of the nerve that arises from the lumbosacral plexus and remains within the abdominal or pelvic cavity. To which of the following nerves should he pay particular attention?

    • A.

      Ilioinguinal nerve

    • B.

      Genitofemoral nerve

    • C.

      Lumbosacral trunk

    • D.

      Femoral nerve

    • E.

      Lateral femoral cutaneous nerve

    Correct Answer
    C. Lumbosacral trunk
    Explanation
    The lumbosacral trunk is formed by part of the ventral ramus of the fourth
    lumbar nerve and the ventral ramus of the fifth lumbar nerve. This trunk contributes to the formation
    of the sacral plexus by joining the ventral ramus of the first sacral nerve in the pelvic cavity
    and does not leave the pelvic cavity. All other nerves leave the abdominal and pelvic cavities.
    The ilioinguinal nerve accompanies the spermatic cord or the round ligament of the uterus, continues
    through the inguinal canal, and emerges through the superficial inguinal ring. The genitofemoral
    nerve divides into a genital branch, which enters the inguinal canal through the deep
    inguinal ring and exits through the superficial inguinal ring and supplies the cremaster muscle
    and the scrotum or labium majus, and a femoral branch, which passes deep to the inguinal ligament
    and enters the femoral triangle. The femoral nerve enters the femoral triangle deep to the
    inguinal ligament and lateral to the femoral vessels and divides into numerous branches. The lateral
    femoral cutaneous nerve runs in front of the iliacus and behind the inguinal ligament and
    innervates the skin of the anterior and lateral thigh.

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  • 6. 

    A woman is delivering a breech baby. The obstetrician decides it is best to perform a mediolateral episiotomy. Which of the following structures, should the obstetrician avoid incising?

    • A.

      Vaginal wall

    • B.

      Superficial transverse perineal muscle

    • C.

      Bulbospongiosus

    • D.

      Levator ani

    • E.

      Perineal membrane

    Correct Answer
    D. Levator ani
    Explanation
    An obstetrician should avoid incising the levator ani and the external anal
    sphincter. The levator ani is the major part of the pelvic diaphragm, which forms the pelvic floor
    and supports all of the pelvic organs. None of the other choices applies here.

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  • 7. 

    A 22-year-old victim of an automobile accident has received destructive damage to structures that form the boundary of the perineum. Which of the following structures is spared?

    • A.

      Pubic arcuate ligament

    • B.

      Tip of the coccyx

    • C.

      Ischial tuberosities

    • D.

      Sacrospinous ligament

    • E.

      Sacrotuberous ligament

    Correct Answer
    D. Sacrospinous ligament
    Explanation
    The sacrospinous ligament forms a boundary of the lesser sciatic foramen.
    The pubic arcuate ligament, tip of the coccyx, ischial tuberosities, and sacrotuberous ligament all
    form part of the boundary of the perineum

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  • 8. 

    A 32-year-old man undergoes vasectomy as a permanent birth control. A physician performing the vasectomy by making an incision on each side of the scrotum should remember  which of the following statements is most applicable to the scrotum?

    • A.

      It is innervated by the ilioinguinal and genitofemoral nerves

    • B.

      It receives blood primarily from the testicular artery

    • C.

      Its venous blood drains primarily into the renal vein on the left

    • D.

      Its lymphatic drainage is primarily into upper lumbar nodes

    • E.

      Its dartos tunic is continuous with the perineal membrane

    Correct Answer
    A. It is innervated by the ilioinguinal and genitofemoral nerves
    Explanation
    The scrotum is innervated by branches of the ilioinguinal, genitofemoral,
    pudendal, and posterior femoral cutaneous nerves. The scrotum receives blood from the posterior
    scrotal branches of the internal pudendal arteries and the anterior scrotal branches of the external
    pudendal arteries, but it does not receive blood from the testicular artery. Similarly, the scrotum
    is drained by the posterior scrotal veins into the internal pudendal vein. The lymph vessels
    from the scrotum drain into the superficial inguinal nodes, whereas the lymph vessels from the
    testis drain into the upper lumbar nodes. The dartos tunic is continuous with the membranous
    layer of the superficial perineal fascia (Colles' fascia).

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  • 9. 

    A 37-year-old woman complains of a bearing-down sensation in her womb and an increased frequency of and burning sensation on urination. On examination by her gynecologist, she is diagnosed with the uterine prolapse. Which of the following structures provides the primary support for the cervix of the uterus?

    • A.

      External anal sphincter

    • B.

      Broad ligament of the uterus

    • C.

      Cardinal (transverse cervical) ligament

    • D.

      Round ligament of the uterus

    • E.

      Suspensory ligament of the ovary

    Correct Answer
    C. Cardinal (transverse cervical) ligament
    Explanation
    The cardinal (transverse cervical) ligament provides the major ligamentous
    support for the uterus. The sphincter ani externus does not support the uterus. The broad and
    round ligaments of the uterus provide minor supports for the uterus. The suspensory ligament of
    the ovary does not support the uterus.

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  • 10. 

    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

    Correct Answer
    C. Liver
    Explanation
    Cancer cells from the rectal cancer are likely to metastasize to the liver via
    the superior rectal, inferior mesenteric, splenic, and portal veins. Cancer cells are not directly
    spread to the other organs listed. The spleen and duodenum drain their venous blood to the portal
    venous system and the kidney and suprarenal gland empty into the caval (inferior vena cava)
    system.

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  • 11. 

    Which structure extends between the vestibule and the cervix of the uterus and serves as the excretory channel for the products of menstruation?

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    • E.

      E

    Correct Answer
    D. D
    Explanation
    The vagina is the genital canal in the female, extending from the vestibule
    to the uterine cervix. The vagina transmits the products of menstruation and receives the penis
    in copulation.

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  • 12. 

    Which structure in the female that is much shorter than that in the male?

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    • E.

      E

    Correct Answer
    A. A
    Explanation
    In females, the urethra extends from the bladder, runs above the anterior
    vaginal wall, and pierces the urogenital diaphragm to reach the urethral orifice in the vestibule
    behind the clitoris. It is about 4 cm long. In males, the urethra is about 20 cm long.

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  • 13. 

     Into which structure does hemorrhage occur after injury to the inferior rectal vessels?

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    • E.

      E

    Correct Answer
    E. E
    Explanation
    The ischiorectal fossa lies in the anal triangle and is bound laterally by the
    obturator internus with its fascia and superomedially by the levator ani and external anal sphincter.
    It contains the inferior rectal vessels. Thus, hemorrhage occurs in the ischiorectal fossa when
    it is ruptured.

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  • 14. 

    Which structure has Houston's valve or fold, with its venous blood drained by the portal venous system?

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    • E.

      E

    Correct Answer
    C. C
    Explanation
    The mucous membrane and the circular smooth muscle layer of the rectum
    form three transverse folds; the middle one is called Houston's valve. The venous blood returns
    to the portal venous system via the superior rectal vein.

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  • 15. 

    Which structure is innervated by the nerve  passing through both the greater and lesser sciatic foramina?

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    • E.

      E

    Correct Answer
    B. B
    Explanation
    The answer is B. The obturator internus muscle and its fascia form the lateral wall of the ischiorectal
    fossa. This muscle is innervated by the nerve to the obturator internus, which passes
    through the greater and lesser sciatic foramen.

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  • 16. 

    Which structure, when fractured, results in paralysis of the obturator internus muscles?

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    • E.

      E

    Correct Answer
    E. E
    Explanation
    The greater trochanter provides an insertion site for the obturator internus
    muscle.

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  • 17. 

    Which structure secretes fluid containing fructose, which allows for forensic determination of rape?

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    • E.

      E

    Correct Answer
    B. B
    Explanation
    The seminal vesicle is a lobulated glandular structure and produces the alkaline
    constituent of the seminal fluid, which contains fructose and choline. Fructose, which is
    nutritive to spermatozoa, also allows forensic determination of rape, whereas choline crystals are
    the preferred basis for the determination of the presence of semen.

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  • 18. 

    In which structure would ligation of the external iliac artery reduce blood pressure?

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    • E.

      E

    Correct Answer
    A. A
    Explanation
    The external iliac artery becomes the femoral artery immediately after passing
    the inguinal ligament. Therefore, ligation of the external iliac artery reduces blood pressure
    in the femoral artery.

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  • 19. 

    A knife wound to the obturator foramen might injure which structure?

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    • E.

      E

    Correct Answer
    D. D
    Explanation
    The obturator foramen transmits the obturator nerve and vessels. Therefore,
    the knife wound in this foramen injures the obturator nerve and vessels.

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  • 20. 

    A stab wound immediately superior to the pubic symphysis on the anterior pelvic wall would most likely injure which visceral organ first?

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    • E.

      E

    Correct Answer
    C. C
    Explanation
    The bladder is situated in the anterior part of the pelvic cavity. Thus, a stab
    wound superior to the pubic symphysis would injure the bladder

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • May 27, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • Mar 19, 2012
    Quiz Created by
    Chachelly
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