Block 7 Repro Perineum & Pelvis MCQ's

25 Questions | Total Attempts: 3086

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Block 7 Repro Perineum & Pelvis MCQ

There is much that we have covered concerning the Perineum and pelvis and it will most likely be the main topic in the midterm exam. Just how much did you understand when it came to the chapter? Take the Block 7 on Repro Perineum and pelvic MCQ`s and adequately prepare for the exam.


Questions and Answers
  • 1. 
    The rectum and anal canal have a system of anastomoses that will facilitate blood flow in the case of a blockage. Which of the following vessels drains into the portal system of veins?
    • A. 

      Median sacral vein

    • B. 

      Middle rectal vein

    • C. 

      Inferior rectal vein

    • D. 

      Superior rectal vein

    • E. 

      Iliolumbar vein

  • 2. 
    The fascia in the pelvis and perineum consists of three layers that are continuous with abdominal fascial layers. Which of the following types of fascia can all be found in the deep layer of fascia?
    • A. 

      External spermatic fascia & buck's fascia

    • B. 

      Fascia lata & colle's fascia

    • C. 

      Scarpa's fascia & dartos fascia

    • D. 

      Camper's fascia & buck's fascia

    • E. 

      External spermatic fascia & dartos fascia

  • 3. 
    An obstetrician injects local anesthetic to block sensation from the perineum during the third stage of labor. After verifying a bony landmark transvaginally (through the vagina), she blocks the pudendal nerve. Which of the following bony landmarks should she use to locate the pudendal nerve?
    • A. 

      Ischial spine

    • B. 

      External as of cervix

    • C. 

      Sacral promontory

    • D. 

      Pubic symphysis

    • E. 

      Tip of the coccyx

  • 4. 
    Which one of the following nerves can be used to check for reflex and integrity of the spinal cord at L2?
    • A. 

      Genitofemoral

    • B. 

      Ilioinguinal

    • C. 

      Lateral femoral cutaneous

    • D. 

      Obturator

    • E. 

      Iliohypogastric

  • 5. 
    A 29-year-old man injures his perineum jumping over seats in the grandstand following a baseball game. Urine leaking from the ruptured spongy urethra is most likely to collect in which of the following spaces?
    • A. 

      Inguinal canal

    • B. 

      Between Camper's and CoIle's fascia

    • C. 

      Femoral triangle

    • D. 

      Ischioanal fossa

    • E. 

      Rectovesical pouch

  • 6. 
    A 59-year-old woman presents in the emergency department with severe abdominal pain in the lower quadrants, positive rebound tenderness, fever, and elevated WBC. She also reported that she recently had a painful colonoscopy with some post-procedural bleeding. Exploratory laparoscopy found peritonitis with a perforated rectum. Where would the abscess from the peritonitis MOST LIKELY accumulate?
    • A. 

      Infraperitoneal space

    • B. 

      Rectouterine pouch

    • C. 

      Rectovesical pouch

    • D. 

      Vesiculo-uterine space

    • E. 

      Retrorectal pouch

  • 7. 
    During a radical hysterectomy procedure, the surgeon must expose the broad ligament to ligate the uterine arteries that travel within the transverse cervical ligament. Which of the following structures can MOST LIKELY be injured during this procedure?
    • A. 

      Uterosacral ligament

    • B. 

      Suspensory ligament of the ovary

    • C. 

      Ureters

    • D. 

      Sigmoid colon

    • E. 

      Bladder

  • 8. 
    A 55-year-old woman presents in your clinic with procidontia, or appearance of her cervix at the vulva. Based on your knowledge of the structures that provide significant support for the uterus and cervix, which one of these must be weakened or compromised in this case?
    • A. 

      Round ligament of the uterus (ligamentum teres uteri)

    • B. 

      Mesosalpinx

    • C. 

      Mesometrium

    • D. 

      Proper ovarian ligament

    • E. 

      Cardinal ligament

  • 9. 
    A 20-year old woman, 7 weeks after giving vaginal birth to a healthy, 4.25 kg girl, complains that she still has brownish vaginal flow and it has a bad odor. She has pain during defecation. What is your suspicion?
    • A. 

      Due to the big size of the baby, the tissues of the vagina heal slower and there is still occasional bleeding a few weeks after childbirth. The color and odor of the fluid is that of partially disintegrated blood.

    • B. 

      She developed hemorroids during pregnancy, and they bleed and cause pain during defecation.

    • C. 

      There is a fistula between vagina and anal canal due to a tear in the perineum during childbirth.

    • D. 

      She has developed fungal infection during childbirth, and that causes the bad odor

    • E. 

      She has developed a vaginal adenocarcinoma secondary to the trauma

  • 10. 
    A 25 year old full term pregnant woman was admitted to the hospital for delivery of the child. She wanted to have a normal vaginal delivery and wanted to witness it too. After all routine clinical investigations, she was found to be a suitable candidate for vaginal delivery. The type of anesthesia / nerve block that would completely anesthetize the external genitalia and will satisfy the needs of this patient would be
    • A. 

      General anesthesia

    • B. 

      Epidural block

    • C. 

      Pudendal nerve block

    • D. 

      Ilioinguinal nerve block

    • E. 

      Pudendal + Ilioinguinal nerve block

  • 11. 
    A 32 year old woman was brought to the clinic, by her husband, with complaints of severe stabbing pain in right lower abdomen and vaginal bleeding. She also had intermittent pain in her right shoulder, particularly while lying down. On questioning it is learnt that she had missed her period last month. She had also fainted once before being brought to the hospital and felt dizzy. Her blood pressure was found to be lower than the normal limits. Based on the clinical scenario mentioned above the MOST LIKELY diagnosis you would arrive at would be
    • A. 

      Appendicitis

    • B. 

      Ovarian tumour

    • C. 

      Normal menstruation

    • D. 

      Rupture of the fallopian tube

    • E. 

      Ovarian pregnancy

  • 12. 
    A 65 year old man reported to the clinic with complaints of low back pain and difficulty in urination. He also complained of increase in number of visits to the washroom, painful urination and blood in urine. A digital rectal examination revealed an enlarged prostate. Further laboratory investigations revealed abnormally high levels of PSA in his blood. The surgeon arrived at a diagnosis of Stage IV prostate cancer and decided to resect the prostate, other closely relates structures and lymph nodes and follow it up with chemotherapy. The first lymph node that will be infiltrated with cancer cells in case of prostate cancer would be
    • A. 

      External iliac nodes

    • B. 

      Internal iliac nodes

    • C. 

      Superficial inguinal nodes

    • D. 

      Deep inguinal nodes

    • E. 

      Para aortic nodes

  • 13. 
    The space within the fascia lining the lateral wall of the ischioanal fossa is called the ___________  canal. The canal contains a neurovascular bundle that passes from the gluteal region to the perineum through the______________ foramen.
    • A. 

      Pudendal -- greater sciatic

    • B. 

      Pudendal --- lesser sciatic

    • C. 

      Pudendal obturator

    • D. 

      Obturator --- lesser sciatic

    • E. 

      Obturator --- greater sciatic

  • 14. 
    Because the perineal body is susceptible to tearing during childbirth, it may be cut intentionally (episiotomy) where it lies between which of the following structures?
    • A. 

      Anus and vestibule of vagina

    • B. 

      External urethral orifice and ischial tuberosity

    • C. 

      Ischial tuberosity and coccyx

    • D. 

      Coccyx and anus

    • E. 

      Vestibule of vagina and external urethral orifice

  • 15. 
    A 58-year-old woman with a right ovarian tumor undergoes an ovariectomy, which removes the ovary and a portion of the suspensory ligament. What important artery follows the path of the suspensory ligament?
    • A. 

      Ovarian artery

    • B. 

      Uterine artery

    • C. 

      Cervical artery

    • D. 

      Vesical artery

    • E. 

      Umbilical artery

  • 16. 
    On your ob/gyn rotation you have seen several women who have endonnetriosis. Because of your knowledge of anatomy, you know that any excess fluid that may result because of the endometriosis may accumulate in which of the following areas when you have the patient in a supine position?
    • A. 

      Hepatorenal pouch

    • B. 

      Rectovesical pouch

    • C. 

      Rectouterine pouch

    • D. 

      Vesicouterine pouch

    • E. 

      Pubovesical pouch

  • 17. 
    Which of the following is the correct path of the pudendal nerve as it courses from the pelvic cavity to the ischioanal fossa?
    • A. 

      Enters the lesser sciatic foramen, courses around the ischial spine and through the obturator foramen

    • B. 

      Enters the gluteal foramen, courses around the ischial spine and enters the pudendal canal

    • C. 

      Enters the greater sciatic foramen, courses around the ischial spine, enters the lesser sciatic foramen and then courses in the pudendal canal

    • D. 

      Enters the lesser sciatic foramen, courses through the greater sciatic foramen and wraps around the ischial spine before entering the pudendal canal

  • 18. 
    Which of the following positions of the uterus & vagina is the "usual" position in a female?
    • A. 

      Anteverted

    • B. 

      Anteverted & anteflexed

    • C. 

      Retroverted & retroflexed

    • D. 

      Retroverted

  • 19. 
    Erection is primarily controlled by_____________________ nervous innervations while ejaculation and remission are primarily controlled by_____________ nervous innervation.
    • A. 

      Sympathetic - Parasympathetic

    • B. 

      Parasympathetic - Sympathetic

    • C. 

      Somatic - Parasympathetic

    • D. 

      Somatic - Sympathetic

  • 20. 
    The anterior recess of the ischioanal fossa is continuous with what perinea' space (pouch)?
    • A. 

      Superficial perinea' space

    • B. 

      Skin and fascial space

    • C. 

      Space above the pelvic diaphragm

    • D. 

      Deep perineal space

  • 21. 
    Which of the following is a branch of the pudendal nerve?
    • A. 

      Vaginal nerve

    • B. 

      Ilioinguinal nerve

    • C. 

      Genitofemoral nerve

    • D. 

      Perineal nerve

    • E. 

      Nerve to ductus deferens

  • 22. 
    Which of the following muscles is most important in creating the pelvic diaphragm?
    • A. 

      Piriformis

    • B. 

      Obturator internus

    • C. 

      External anal sphincter

    • D. 

      Levator ani

    • E. 

      Tendinous arch

  • 23. 
    Your cousin was rollerblading and took a pretty bad fall in the park. He is now in the ER and has swelling in his scrotum, anterior abdominal wall and around his penis. He is freaking out to you, of course. Which of the following was most likely injured?
    • A. 

      Prostatic urethra

    • B. 

      Penile (spongy) urethra

    • C. 

      Intermediate (membranous) urethra

    • D. 

      Pre-prostatic urethra

  • 24. 
    A 23-year old male is hit by a car while crossing a busy street. Among his many injuries is a torn sacrospinous ligament. Name (i) the muscle that will most likely also be affected and (ii) the nerve that may also be compromised.
    • A. 

      Obturator internus muscle - pudendal nerve

    • B. 

      Levator ani muscle - pudendal nerve

    • C. 

      Coccygeus muscle - pudendal nerve

    • D. 

      Levator ani muscle - perineal nerve

    • E. 

      Coccygeus muscle - perineal nerve

  • 25. 
    In your obstetrics rotation, the resident physician asks you to measure the diagonal conjugate of a 23-year old female patient who is hoping to get pregnant. You know that this measurement is between which of the following structures?
    • A. 

      Sacral promontory and coccyx

    • B. 

      Sacral promontory and superior edge of pubic symphysis

    • C. 

      Sacral promontory and inferior edge of pubic symphysis

    • D. 

      Coccyx and ischial spine

    • E. 

      Coccyx and inferior edge of pubic symphysis

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