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Anatomy session 4

Total questions: 22

Worksheet time: 22mins

Name
Class
Date
1.

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?

a)

She laughs in your face and kicks you out.

b)

She gives you a high five and you have to reglove.

2.

What two nerves exit the greater foramen of the pelvis and return through the lesser foramen?

a)

Superior gluteal AND sciatic

b)

Posterior femoral cutaneous AND pudendal

c)

Pudendal AND nerve to obturator internus

d)

Nerve to obturator internus AND inferior gluteal

e)

Piriformis AND obturator externus

3.

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?

a)

Superior hypogastric

b)

Pelvic splanchnic

c)

Sacral splanchnic

d)

Lumbar splanchnic

e)

Pudendal

4.

Occlusion of deep veins within the leg would prevent the superficial veins from dilating

a)

True

b)

False

5.

Visualize the pelvic outlet. Which one of these answers is NOT a part of the structures that form the pelvic outlet?

a)

Sacrotuberous ligaments

b)

Subpubic angle

c)

Ischiopubic rami and ischial tuberosities

d)

Anterior sacrococcygeal ligament

e)

Tip of the coccyx

6.

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?

a)

Superior Cluneal Nerve

b)

Inferior Gluteal Nerve

c)

Superior Gluteal Nerve

d)

Pudendal Nerve

e)

Sciatic Nerve

7.

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?

a)

Cutaneous portion of anal canal

b)

Distal rectum

c)

Mucosal zone of anal canal

d)

Pectinate line of anal canal

e)

Proximal rectum at the inferior valve (of Houston)

8.

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?

a)

Calcanofibular Ligament

b)

Deltoid Ligament

c)

Anterior Talofibular Ligament

d)

All of the above

e)

A and C

9.

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?

a)

Pelvic splanchnic

b)

Sacral splanchnic

c)

Pudendal

d)

Superior gluteal

e)

Inferior gluteal

10.

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?

a)

Rectouterine pouch

b)

Pararectal fossa

c)

Paravesical space

d)

Uterovesical pouch

e)

Superficial perineal pouch

11.

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?

a)

Iliopsoas

b)

Popliteus

c)

Pectineus

d)

Sartorius

e)

Vastus Intermedius

12.

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?

a)

Ischioanal fossa

b)

Rectovesical pouch

c)

Deep perineal pouch

d)

Retropubic space

e)

Superficial perineal cleft

13.

Which of the following is NOT true about the foot?

a)

The second digit is the line of reference (mid-line)

b)

There are 3 plantar interossei muscles

c)

The second digit has 2 dorsal interossei muscles

d)

The dorsal interossei of the 1st digit performs abduction

14.

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?

a)

Ischial spine

b)

Posterior inferior iliac spine

c)

Ischial tuberosity

d)

Posterior superior iliac spine

e)

Coccyx

15.

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:

a)

Tibial Nerve

b)

Deep Fibular Nerve

c)

Superficial Fibular Nerve

d)

All of the above

e)

None of the above

16.

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?

a)

Sacral splanchnic

b)

Superior hypogastric

c)

Pelvic splanchnic

d)

Pudendal

e)

Ilioinguinal

17.

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?

a)

Spongy urethra

b)

Preprostatic urethra

c)

Prostatic urethra

d)

Urinary bladder

e)

Ureter

18.

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?

a)

Fibular Collateral Ligament

b)

Patellar Ligament

c)

Anterior Collateral Ligament

d)

Tibial Collateral Ligament

e)

None of the above

19.

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?

a)

The pain fibers are carried by the inferior rectal nerve.

b)

The pain fibers are carried by the perineal nerve.

c)

The pain fibers are carried by the obturator nerve

d)

The patient would not experience pain because this area is innervated by visceral afferent fibers

e)

The patient would not experience well- localized pain because this area is innervated by pelvic splanchnic nerves

20.

The piriformis leaves through the greater sciatic foramen. What is the only muscle to leave from the lesser sciatic foramen?

a)

Obturator internus

b)

Piriformis

c)

Iliococcygeus

d)

Superior gemellus

e)

No clue

21.

Which of the following Quadriceps muscles flexes the hip?

a)

Vastus Lateralis

b)

Rectus Femoris

c)

Vastus Medialis

d)

Vastus Intermedius

e)

Nice try, it’s all of the above

22.

Walter White has a carcinoma of the rectum. The cancer is most likely to metastasize to which structure?

a)

Spleen

b)

Liver

c)

Kidney

d)

Duodenum

e)

Lung