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WorksheetsAnatomy session 4
Total questions: 22
Worksheet time: 22mins
During your OB/GYN rotation, it is time for you to perform your first pelvic exam with a pap smear on your own. Your preceptor asks you, “What main structure are you going to see when you open the speculum?” You answer, “The internal os of the cervix.” Is your preceptor disappointed or proud of your answer?
She laughs in your face and kicks you out.
She gives you a high five and you have to reglove.
What two nerves exit the greater foramen of the pelvis and return through the lesser foramen?
Superior gluteal AND sciatic
Posterior femoral cutaneous AND pudendal
Pudendal AND nerve to obturator internus
Nerve to obturator internus AND inferior gluteal
Piriformis AND obturator externus
Several days after a 34-year-old woman was admitted to the hospital after her automobile collided with a lamppost, her urinary bladder gives evidence of paralysis. A CT scan reveals multiple fractures of her pelvis with a significant pelvic hematoma, either of which could have interrupted or injured the nerve supply of the organ. Which of the following nerves was most likely traumatized?
Superior hypogastric
Pelvic splanchnic
Sacral splanchnic
Lumbar splanchnic
Pudendal
Occlusion of deep veins within the leg would prevent the superficial veins from dilating
True
False
Visualize the pelvic outlet. Which one of these answers is NOT a part of the structures that form the pelvic outlet?
Sacrotuberous ligaments
Subpubic angle
Ischiopubic rami and ischial tuberosities
Anterior sacrococcygeal ligament
Tip of the coccyx
While walking through a haunted house with your friends, you notice the person in front of you walking with a limp. Specifically, when they are lifting their right leg, their right hip is dropping. You recognize that this person may have some sort of damage to what nerve?
Superior Cluneal Nerve
Inferior Gluteal Nerve
Superior Gluteal Nerve
Pudendal Nerve
Sciatic Nerve
A 58-year-old postmenopausal woman is diagnosed with carcinoma of the distal gastrointestinal tract. During surgery lymph nodes from the sacral, internal iliac, and inguinal lymph node groups were removed and sent for histopathologic examination. The pathology report revealed positive cancerous cells only at the inguinal lymph nodes. Which of the following parts of the gastrointestinal tract were most likely affected?
Cutaneous portion of anal canal
Distal rectum
Mucosal zone of anal canal
Pectinate line of anal canal
Proximal rectum at the inferior valve (of Houston)
While running away from Freddy Krueger and trying to hide under a desk, you roll your ankle. While stuck hiding, you think about your injury, noticing that you have lateral edema and tenderness. You know that you likely damaged what?
Calcanofibular Ligament
Deltoid Ligament
Anterior Talofibular Ligament
All of the above
A and C
A 68-year-old man complains of pain upon urination. A CT scan and a biopsy provide evidence of an enlarged, cancerous prostate gland. Subsequently, he undergoes a radical prostatectomy. Postoperatively, he suffers from urinary incontinence because of paralysis of the external urethral sphincter. Which of the following nerves was injured during the operation?
Pelvic splanchnic
Sacral splanchnic
Pudendal
Superior gluteal
Inferior gluteal
A 34-year-old woman is hospitalized because of an enlarged, painful abdomen. An ultrasound examination is performed and the presence of ascites (fluid) in the peritoneal cavity is confirmed. A needle is placed through the posterior vaginal fornix to drain the fluid. Which space must the needle enter to drain the fluid?
Rectouterine pouch
Pararectal fossa
Paravesical space
Uterovesical pouch
Superficial perineal pouch
While playing basketball, one of your friends slips, resulting in their leg abducting to an excessive degree. When they get up, they are wincing and holding their superior medial thigh. Which muscle do you think was strained when they slipped?
Iliopsoas
Popliteus
Pectineus
Sartorius
Vastus Intermedius
A 36-year-old male rodeo rider is admitted to the hospital after being thrown violently from a Brahma bull. An MRI scan reveals rupture of the penile urethra and deep (Buck’s) fascia. Where is the most likely place that extravasated urine will flow?
Ischioanal fossa
Rectovesical pouch
Deep perineal pouch
Retropubic space
Superficial perineal cleft
Which of the following is NOT true about the foot?
The second digit is the line of reference (mid-line)
There are 3 plantar interossei muscles
The second digit has 2 dorsal interossei muscles
The dorsal interossei of the 1st digit performs abduction
A 34-year-old pregnant woman is prepared in the hospital for delivery. The gynecologist decides to perform a pudendal nerve block using a transvaginal approach. Which bony structure would be the most reliable as a landmark to block the pudendal nerve?
Ischial spine
Posterior inferior iliac spine
Ischial tuberosity
Posterior superior iliac spine
Coccyx
A man in your office presents with damage to his Sciatic Nerve following an attack during the annual Purge. The numerous muscles with deficits are results of the Sciatic branching into:
Tibial Nerve
Deep Fibular Nerve
Superficial Fibular Nerve
All of the above
None of the above
A 55-year-old man complains of pain at his anus. Examination reveals external hemorrhoids. Which of the following nerves carries pain sensation from the anus?
Sacral splanchnic
Superior hypogastric
Pelvic splanchnic
Pudendal
Ilioinguinal
A 15-year-old is admitted to the emergency department 2 days after crashing his bicycle. MRI examination reveals severe edema of the boy’s scrotum and abdominal wall and extravasated urine. Which of the following structures is most likely ruptured?
Spongy urethra
Preprostatic urethra
Prostatic urethra
Urinary bladder
Ureter
A patient comes to your office on November 1st stating that they woke up with a sore knee after fighting off a possessed doll the night before. Your exam shows bruising and bite marks on the knee, with lateral tenderness and edema. A varus stress test shows widening of the lateral joint space, with a normal valgus test. Which structure within the patient’s knee was likely injured?
Fibular Collateral Ligament
Patellar Ligament
Anterior Collateral Ligament
Tibial Collateral Ligament
None of the above
A 63-year-old male is admitted to the hospital with ascites, rectal bleeding, and an enlarged cirrhotic liver. He is overweight and has a history of alcohol abuse. Upon clinical examination it is found he is suffering from internal hemorrhoids. Which of the following best describes the nerves containing the pain fibers from his hemorrhoids?
The pain fibers are carried by the inferior rectal nerve.
The pain fibers are carried by the perineal nerve.
The pain fibers are carried by the obturator nerve
The patient would not experience pain because this area is innervated by visceral afferent fibers
The patient would not experience well- localized pain because this area is innervated by pelvic splanchnic nerves
The piriformis leaves through the greater sciatic foramen. What is the only muscle to leave from the lesser sciatic foramen?
Obturator internus
Piriformis
Iliococcygeus
Superior gemellus
No clue
Which of the following Quadriceps muscles flexes the hip?
Vastus Lateralis
Rectus Femoris
Vastus Medialis
Vastus Intermedius
Nice try, it’s all of the above
Walter White has a carcinoma of the rectum. The cancer is most likely to metastasize to which structure?
Spleen
Liver
Kidney
Duodenum
Lung
