Chapter: Anatomy
Topic: Thorax
Subtopic: Trachea and Carina
Keyword Definitions:
Carina: Ridge of cartilage at the bifurcation of trachea into right and left main bronchi.
Trachea: Windpipe connecting larynx to bronchi, conducting air to lungs.
Thoracic vertebrae: 12 vertebrae in mid-back, important landmarks for mediastinal structures.
Clinical relevance: Carina is highly sensitive; foreign bodies contacting it trigger cough reflex. Important in bronchoscopy.
Superior mediastinum: Upper compartment of mediastinum, contains trachea, great vessels, and thymus.
Middle mediastinum: Contains heart, pericardium, main bronchi, and part of tracheal bifurcation.
Lead Question - 2013
Carina is situated at which level ?
a) T3
b) T4
c) T6
d) T9
Explanation: The carina, the bifurcation point of the trachea into right and left main bronchi, is located at the level of T4 vertebra, at the sternal angle. It is a crucial landmark in bronchoscopy and chest imaging. Correct answer is b) T4.
Guessed Question 2
The trachea bifurcates into right and left main bronchi at which anatomical landmark?
a) Sternal angle
b) Xiphoid process
c) Clavicle
d) Manubrium
Explanation: Trachea bifurcation at the carina occurs at the level of the sternal angle (Angle of Louis), corresponding to T4 vertebra. This landmark aids in thoracic procedures and radiology. Correct answer is a) Sternal angle.
Guessed Question 3
Which bronchus is more vertical and prone to aspiration?
a) Right main bronchus
b) Left main bronchus
c) Both equal
d) Segmental bronchi
Explanation: The right main bronchus is wider, shorter, and more vertical, making it a common site for aspirated foreign bodies. Correct answer is a) Right main bronchus.
Guessed Question 4
Carina is lined by which type of epithelium?
a) Stratified squamous
b) Pseudostratified ciliated columnar
c) Simple cuboidal
d) Transitional
Explanation: The carina, like the trachea, is lined by pseudostratified ciliated columnar epithelium, aiding mucus clearance. It contains abundant sensory receptors for cough reflex. Correct answer is b) Pseudostratified ciliated columnar.
Guessed Question 5
Which mediastinal compartment contains the carina?
a) Anterior
b) Middle
c) Posterior
d) Superior
Explanation: The carina lies in the middle mediastinum at the tracheal bifurcation, posterior to the ascending aorta and anterior to esophagus. Correct answer is b) Middle.
Guessed Question 6
Enlarged carinal lymph nodes affect which structure?
a) Trachea
b) Main bronchi
c) Both trachea and bronchi
d) Esophagus only
Explanation: Carinal lymph nodes surround the tracheal bifurcation; enlargement can compress both trachea and main bronchi, causing cough, dyspnea, or atelectasis. Correct answer is c) Both trachea and bronchi.
Guessed Question 7
During bronchoscopy, touching the carina triggers?
a) Sneezing
b) Cough reflex
c) Gag reflex
d) Bradycardia
Explanation: Carina has high density of sensory receptors; contact during bronchoscopy triggers a strong cough reflex, protecting lower airways. Correct answer is b) Cough reflex.
Guessed Question 8
Carina level in relation to sternal angle is?
a) At same level
b) Above
c) Below
d) At xiphoid
Explanation: The carina is at the level of the sternal angle (Angle of Louis) and T4 vertebra, serving as a surface landmark for tracheal bifurcation in imaging and procedures. Correct answer is a) At same level.
Guessed Question 9
Which artery is closely related to carina in posterior mediastinum?
a) Ascending aorta
b) Right pulmonary artery
c) Descending aorta
d) Superior vena cava
Explanation: The right pulmonary artery passes horizontally behind the ascending aorta and anterior to the tracheal bifurcation near the carina, significant in imaging and surgery. Correct answer is b) Right pulmonary artery.
Guessed Question 10
Carina is at which thoracic vertebral level during expiration?
a) T2
b) T4
c) T6
d) T8
Explanation: In adults, the carina is typically at T4–T5 vertebral level at sternal angle during normal respiration. Slight movement occurs with inspiration and expiration. Correct answer is b) T4.
Guessed Question 11
Clinical importance of carina in imaging is?
a) Landmark for mediastinal shift
b) Landmark for tracheal intubation
c) Guide for central line
d) Landmark for thoracotomy only
Explanation: The carina is a key radiological landmark for tracheal bifurcation, detecting mediastinal shift, and guiding endotracheal tube placement during intubation. Correct answer is b) Landmark for tracheal intubation.
Chapter: Anatomy
Topic: Pelvis
Subtopic: Lymphatic Drainage of Female Reproductive Organs
Keyword Definitions:
Para-aortic lymph nodes: Lymph nodes along the abdominal aorta, draining ovaries, uterine tubes, and upper uterus.
External iliac lymph nodes: Nodes along external iliac vessels, draining upper bladder, cervix, and upper vagina.
Superior inguinal lymph nodes: Located in femoral triangle, draining lower vulva, lower vagina, and superficial structures of lower limb.
Deep inguinal lymph nodes: Beneath fascia lata, draining glans penis/clitoris, deep lower limb structures.
Pelvic lymph nodes: Network including obturator, internal iliac, external iliac, and sacral nodes.
Clinical relevance: Knowledge of lymphatic drainage is vital for staging cervical and vaginal cancers and planning surgery or radiotherapy.
Lead Question - 2013
Which lymph nodes drain upper vagina & cervix?
a) Para aortic
b) External iliac
c) Superior inguinal
d) Deep inguinal
Explanation: The upper vagina and cervix primarily drain into the external iliac lymph nodes, with some drainage to internal iliac and obturator nodes. Para-aortic nodes mainly drain ovaries and uterine tubes. Correct answer is b) External iliac.
Guessed Question 2
Lower vagina primarily drains into?
a) External iliac nodes
b) Internal iliac nodes
c) Superior inguinal nodes
d) Para-aortic nodes
Explanation: The lower vagina and vulva drain primarily into superficial and superior inguinal lymph nodes, providing a pathway for potential metastasis. Correct answer is c) Superior inguinal nodes.
Guessed Question 3
Ovaries drain mainly to which lymph nodes?
a) External iliac
b) Internal iliac
c) Para-aortic
d) Inguinal
Explanation: Ovarian lymphatics follow the ovarian vessels to the para-aortic (lumbar) lymph nodes near the renal vessels. Correct answer is c) Para-aortic.
Guessed Question 4
Cervical cancer commonly metastasizes to which nodes first?
a) Para-aortic
b) External iliac
c) Superior inguinal
d) Sacral
Explanation: Early cervical cancer spreads to the external iliac, internal iliac, and obturator nodes. Para-aortic and sacral involvement occurs later. Correct answer is b) External iliac.
Guessed Question 5
Which lymph nodes lie along obturator vessels?
a) Obturator nodes
b) External iliac nodes
c) Superior inguinal nodes
d) Para-aortic nodes
Explanation: Obturator lymph nodes are situated along the obturator vessels, draining the pelvic floor, bladder, cervix, and upper vagina. Correct answer is a) Obturator nodes.
Guessed Question 6
Deep inguinal lymph nodes receive drainage from?
a) Lower limb
b) Upper vagina
c) Cervix
d) Para-aortic nodes
Explanation: Deep inguinal nodes lie beneath fascia lata and receive lymph from the lower limb, glans penis/clitoris, and deep structures of the lower pelvis. Correct answer is a) Lower limb.
Guessed Question 7
Which nodes are involved in vulvar carcinoma?
a) Para-aortic
b) Superior inguinal
c) External iliac
d) Obturator
Explanation: Vulvar carcinoma primarily drains to superficial and superior inguinal lymph nodes, which are first sites of metastasis. Correct answer is b) Superior inguinal.
Guessed Question 8
Internal iliac lymph nodes drain?
a) Upper bladder, cervix, uterus
b) Lower limb
c) Ovaries
d) Lower vagina only
Explanation: Internal iliac nodes drain the cervix, upper vagina, bladder, and uterus, forming an important part of pelvic lymphatic network. Correct answer is a) Upper bladder, cervix, uterus.
Guessed Question 9
Para-aortic nodes are clinically important in?
a) Staging ovarian cancer
b) Breast cancer
c) Colon cancer
d) Thyroid cancer
Explanation: Para-aortic lymph nodes receive lymph from ovaries, uterine tubes, and upper uterus, serving as a key site in staging ovarian and some uterine cancers. Correct answer is a) Staging ovarian cancer.
Guessed Question 10
Which pelvic node group is commonly biopsied in cervical cancer?
a) External iliac
b) Para-aortic
c) Superior inguinal
d) Deep inguinal
Explanation: External iliac nodes are commonly biopsied or sampled during pelvic lymphadenectomy in cervical cancer due to their early involvement. Correct answer is a) External iliac.
Guessed Question 11
Obturator nodes are located in relation to?
a) Obturator vessels
b) External iliac vessels
c) Internal thoracic artery
d) Para-aortic region
Explanation: Obturator lymph nodes lie along obturator vessels in the obturator fossa and are part of the primary drainage pathway of the cervix and upper vagina. Correct answer is a) Obturator vessels.
Chapter: Anatomy
Topic: Liver Anatomy
Subtopic: Hepatic Segmentation & Surgical Lobes
Keyword Definitions:
Falciparum ligament: Ligament that attaches the liver to the anterior abdominal wall and diaphragm; separates left and right lobes anatomically.
Couinaud classification: Functional liver segmentation based on portal and hepatic vein anatomy, dividing liver into 8 segments.
Left liver segments: Segments II, III, and IV.
Right liver segments: Segments V, VI, VII, VIII.
Caudate lobe: Segment I, posterior and superior to porta hepatis.
Clinical relevance: Segmental resection is used in hepatocellular carcinoma, trauma, and transplantation.
Porta hepatis: Transverse fissure for hepatic artery, portal vein, and bile ducts.
Lead Question - 2013
Surgeon removes a part of liver to left of falciparum ligament, which segment of liver is removed?
a) 1 & 4
b) 2 & 3
c) 1 & 4
d) 1 & 3
Explanation: The falciform ligament divides the anatomical left and right liver lobes. Segments II and III lie to the left of the ligament in the left lateral sector. Segment I is caudate lobe (posterior), segment IV is medial segment of left lobe. Correct answer is b) 2 & 3.
Guessed Question 2
Which segment is caudate lobe?
a) I
b) II
c) III
d) IV
Explanation: Segment I corresponds to the caudate lobe, located posteriorly between ligamentum venosum and inferior vena cava. It has independent vascular inflow. Correct answer is a) I.
Guessed Question 3
Left medial segment corresponds to which Couinaud segment?
a) II
b) III
c) IV
d) V
Explanation: Left medial segment of liver is segment IV. It is adjacent to the falciform ligament and is part of the left lobe functionally. Correct answer is c) IV.
Guessed Question 4
Right posterior sector contains which segments?
a) V & VI
b) VI & VII
c) VII & VIII
d) V & VIII
Explanation: The right posterior sector of liver includes segments VI and VII. These segments lie posterior to right hepatic vein and are resected in right posterior hepatectomy. Correct answer is b) VI & VII.
Guessed Question 5
Which ligament separates left lateral and medial sectors?
a) Ligamentum teres
b) Falciform ligament
c) Ligamentum venosum
d) Round ligament
Explanation: The falciform ligament separates left lateral (segments II & III) and medial (segment IV) sectors of the liver, serving as a surface landmark for surgery. Correct answer is b) Falciform ligament.
Guessed Question 6
Segment VIII is part of?
a) Right anterior sector
b) Right posterior sector
c) Left lateral sector
d) Left medial sector
Explanation: Segment VIII is part of the right anterior superior sector of the liver, lying superior to segment V. Correct answer is a) Right anterior sector.
Guessed Question 7
Which segment is independent with venous drainage to IVC?
a) Segment I
b) Segment II
c) Segment IV
d) Segment V
Explanation: Segment I (caudate lobe) has independent inflow from portal and hepatic arteries and drains directly to inferior vena cava, allowing selective resection. Correct answer is a) Segment I.
Guessed Question 8
Left lateral segmentectomy removes which segments?
a) II & III
b) IV & V
c) I & IV
d) V & VIII
Explanation: Left lateral segmentectomy involves resection of segments II and III to treat tumors or trauma confined to left lateral sector. Correct answer is a) II & III.
Guessed Question 9
Medial segment of left lobe (IV) lies adjacent to?
a) Gallbladder
b) Falciform ligament
c) Ligamentum venosum
d) IVC
Explanation: Segment IV (medial segment of left lobe) lies adjacent to falciform ligament anteriorly and ligamentum venosum posteriorly. Correct answer is b) Falciform ligament.
Guessed Question 10
Right lobe anterior superior segment is?
a) V
b) VI
c) VII
d) VIII
Explanation: Segment VIII is the right anterior superior segment of liver, located superiorly in the anterior sector. Correct answer is d) VIII.
Guessed Question 11
Which segment lies posterior to porta hepatis?
a) I
b) II
c) III
d) IV
Explanation: Segment I (caudate lobe) lies posterior to porta hepatis and anterior to IVC, with independent vascular inflow. Correct answer is a) I.
Chapter: Anatomy
Topic: Liver Anatomy
Subtopic: Hepatic Segments & Caudate Lobe
Keyword Definitions:
Caudate lobe: Segment I of the liver, located posteriorly between ligamentum venosum and inferior vena cava.
Couinaud classification: Functional liver segmentation dividing liver into 8 segments based on portal and hepatic vein anatomy.
Falciform ligament: Divides anatomical left and right liver lobes.
Porta hepatis: Transverse fissure containing portal vein, hepatic artery, and bile ducts.
Left lateral segment: Segments II and III of liver, lateral to falciform ligament.
Left medial segment: Segment IV, medial to falciform ligament.
Clinical relevance: Segment I has independent inflow and outflow, important in selective liver resections and transplantation.
Lead Question - 2013
Caudate lobe of liver is ?
a) I
b) III
c) IV
d) VI
Explanation: The caudate lobe corresponds to segment I in Couinaud’s classification. It lies posterior to porta hepatis, anterior to inferior vena cava, and has independent inflow from both right and left portal veins. Its surgical importance lies in selective resections for tumors or transplantation. Correct answer is a) I.
Guessed Question 2
Which segment lies immediately lateral to ligamentum venosum?
a) I
b) II
c) IV
d) V
Explanation: Segment II lies lateral to ligamentum venosum as part of the left lateral sector. Correct answer is b) II.
Guessed Question 3
Segment IV of liver is also called?
a) Left medial segment
b) Right anterior segment
c) Caudate lobe
d) Left lateral segment
Explanation: Segment IV is the left medial segment, situated adjacent to falciform ligament. It is surgically important in left hepatectomy. Correct answer is a) Left medial segment.
Guessed Question 4
Which segment drains directly into IVC?
a) I
b) II
c) IV
d) V
Explanation: Segment I (caudate lobe) drains directly into inferior vena cava via short hepatic veins, independent of main hepatic veins. Correct answer is a) I.
Guessed Question 5
Which ligament lies anterior to caudate lobe?
a) Ligamentum venosum
b) Falciform ligament
c) Round ligament
d) Coronary ligament
Explanation: Ligamentum venosum lies anterior to the caudate lobe, separating it from left medial segment. Correct answer is a) Ligamentum venosum.
Guessed Question 6
Caudate lobe is surgically classified under?
a) Left lobe
b) Right lobe
c) Both lobes
d) None
Explanation: Functionally, caudate lobe (segment I) receives blood from both right and left portal veins, allowing resection as independent unit. Correct answer is c) Both lobes.
Guessed Question 7
Which segment lies posterior to porta hepatis?
a) I
b) II
c) IV
d) V
Explanation: Segment I (caudate lobe) lies directly posterior to porta hepatis and anterior to IVC. Important in imaging and surgery. Correct answer is a) I.
Guessed Question 8
Which segment is part of left lateral sector?
a) II & III
b) I & IV
c) V & VIII
d) VI & VII
Explanation: Left lateral sector comprises segments II and III, lateral to falciform ligament, commonly resected in left lateral segmentectomy. Correct answer is a) II & III.
Guessed Question 9
Which segment lies between left and right lobes?
a) I
b) II
c) III
d) IV
Explanation: Caudate lobe (I) lies posteriorly between left and right anatomical lobes, posterior to porta hepatis, making it central in liver anatomy. Correct answer is a) I.
Guessed Question 10
Which lobe is removed in isolated caudate lobectomy?
a) I
b) II
c) IV
d) V
Explanation: Isolated caudate lobectomy removes segment I, usually for tumor or trauma, due to its independent vascular supply. Correct answer is a) I.
Guessed Question 11
Segment I is bordered by which vein posteriorly?
a) Inferior vena cava
b) Hepatic vein
c) Portal vein
d) Left renal vein
Explanation: Caudate lobe (segment I) lies anterior to inferior vena cava, which forms its posterior boundary. Important landmark in surgery and imaging. Correct answer is a) Inferior vena cava.
Chapter: Anatomy
Topic: Male Reproductive System
Subtopic: Testicular Anatomy & Position
Keyword Definitions:
Testis: Male gonad responsible for spermatogenesis and androgen secretion.
Spermatic cord: Contains vas deferens, testicular artery, pampiniform plexus, lymphatics, and nerves.
Cremaster muscle: Elevates testis for temperature regulation.
Pampiniform plexus: Venous network surrounding testicular artery, helps thermoregulation.
Scrotum: Skin pouch housing testes, maintaining lower temperature than body for spermatogenesis.
Clinical relevance: Higher position of right testis is normal; important in cryptorchidism evaluation and orchidopexy planning.
Cryptorchidism: Undescended testis, more common on right side; may cause infertility and malignancy risk.
Lead Question - 2013
Location of testis is higher on ?
a) Right side
b) Left side
c) May be on right or left side
d) Same level on both sides
Explanation: Anatomically, the right testis usually hangs slightly higher than the left within the scrotum due to variations in spermatic cord length. This is normal and clinically important to distinguish from pathological causes like hydrocele or cryptorchidism. Correct answer is a) Right side.
Guessed Question 2
Which testis is more commonly undescended in cryptorchidism?
a) Right
b) Left
c) Both equally
d) None
Explanation: Cryptorchidism is more frequently observed on the right side, possibly due to delayed descent or shorter gubernacular attachment. Early detection is essential to prevent infertility and malignancy. Correct answer is a) Right.
Guessed Question 3
The testis descends during which gestational period?
a) 7–8 weeks
b) 12–14 weeks
c) 28–32 weeks
d) After birth
Explanation: Testicular descent occurs in two phases: transabdominal (7–12 weeks) and inguinoscrotal (28–32 weeks). This ensures the testes reach scrotum for optimal spermatogenesis. Correct answer is c) 28–32 weeks.
Guessed Question 4
Which structure guides testicular descent?
a) Gubernaculum
b) Cremaster muscle
c) Vas deferens
d) Epididymis
Explanation: The gubernaculum anchors the testis and guides its passage from the abdomen to scrotum during fetal development. Failure of this leads to cryptorchidism. Correct answer is a) Gubernaculum.
Guessed Question 5
Normal testis temperature is maintained at?
a) Same as body
b) 2–4°C lower than body
c) 2–4°C higher
d) Variable
Explanation: Scrotum maintains testicular temperature 2–4°C below body temperature, essential for spermatogenesis. Cremaster and pampiniform plexus regulate this. Correct answer is b) 2–4°C lower than body.
Guessed Question 6
Which side is more prone to varicocele?
a) Left
b) Right
c) Both equally
d) None
Explanation: Varicocele occurs more commonly on the left due to longer left testicular vein draining into left renal vein at a right angle, increasing venous pressure. Correct answer is a) Left.
Guessed Question 7
Right testis is higher due to?
a) Shorter spermatic cord
b) Longer spermatic cord
c) Smaller size
d) Heavier weight
Explanation: Right testis is slightly higher because the right spermatic cord is usually shorter than the left, resulting in a higher scrotal position. Correct answer is a) Shorter spermatic cord.
Guessed Question 8
Which muscle elevates the testis?
a) Cremaster
b) Dartos
c) External oblique
d) Rectus abdominis
Explanation: Cremaster muscle contracts reflexively to elevate the testis toward the body for thermoregulation and protection. Important in cremasteric reflex testing. Correct answer is a) Cremaster.
Guessed Question 9
Scrotal septum separates:
a) Right & left testis
b) Testis & epididymis
c) Testis & spermatic cord
d) Epididymis & vas deferens
Explanation: Scrotal septum divides scrotum into right and left compartments, each containing a testis and epididymis, preventing torsion spread. Correct answer is a) Right & left testis.
Guessed Question 10
Pampiniform plexus function is?
a) Thermoregulation
b) Hormone secretion
c) Sperm transport
d) Scrotal support
Explanation: Pampiniform plexus of veins surrounds testicular artery to cool arterial blood, maintaining ideal temperature for spermatogenesis. Correct answer is a) Thermoregulation.
Guessed Question 11
Testicular position abnormality is called?
a) Cryptorchidism
b) Varicocele
c) Hydrocele
d) Orchitis
Explanation: Cryptorchidism refers to undescended testis, more often on the right. It increases infertility and malignancy risk, requiring early intervention. Correct answer is a) Cryptorchidism.
Chapter: Anatomy
Topic: Male Pelvis
Subtopic: Prostate Support & Pelvic Floor Muscles
Keyword Definitions:
Prostate: Male accessory sex gland located below the bladder, surrounding prostatic urethra, secretes seminal fluid.
Pubococcygeus: Part of levator ani muscle, supports pelvic viscera including prostate and bladder neck.
Levator ani: Group of muscles (pubococcygeus, iliococcygeus, puborectalis) forming pelvic diaphragm, supports pelvic organs.
Ischiococcygeus (coccygeus): Posterolateral pelvic floor muscle, stabilizes coccyx, assists levator ani.
Iliococcygeus: Part of levator ani, supports pelvic viscera posteriorly.
Clinical relevance: Pelvic floor muscles prevent prolapse of prostate and bladder; important in prostatectomy and urinary continence.
Perineal body: Fibromuscular structure connecting levator ani, perineal muscles, and external anal sphincter, supports prostate anteriorly.
Lead Question - 2013
Support of prostate is ?
a) Pubococcygeus
b) Ischiococcygeus
c) Ilioccygeus
d) None of the above
Explanation: The pubococcygeus muscle, part of the levator ani, forms the anterior pelvic floor and directly supports the prostate. It maintains prostate position, contributes to continence, and prevents prolapse. Correct answer is a) Pubococcygeus.
Guessed Question 2
Which muscle elevates pelvic floor and supports bladder?
a) Pubococcygeus
b) Coccygeus
c) Iliococcygeus
d) External anal sphincter
Explanation: Pubococcygeus elevates the pelvic floor and supports bladder and prostate. Strengthening it improves urinary continence. Correct answer is a) Pubococcygeus.
Guessed Question 3
Posterior pelvic floor muscle stabilizing coccyx is?
a) Pubococcygeus
b) Coccygeus
c) Iliococcygeus
d) Rectococcygeus
Explanation: Coccygeus (ischiococcygeus) lies posterolaterally, stabilizing the coccyx and assisting levator ani in pelvic support. Correct answer is b) Coccygeus.
Guessed Question 4
Which part of levator ani is more posterior?
a) Pubococcygeus
b) Iliococcygeus
c) Puborectalis
d) Coccygeus
Explanation: Iliococcygeus forms posterior part of levator ani, supporting rectum and pelvic viscera posteriorly. Correct answer is b) Iliococcygeus.
Guessed Question 5
Pelvic diaphragm is formed by?
a) Levator ani + Coccygeus
b) Rectus abdominis
c) Obturator internus
d) Gluteus maximus
Explanation: Pelvic diaphragm consists of levator ani (pubococcygeus, iliococcygeus, puborectalis) and coccygeus muscles, providing support to pelvic organs. Correct answer is a) Levator ani + Coccygeus.
Guessed Question 6
Perineal body connects all except?
a) Levator ani
b) Bulbospongiosus
c) Puborectalis
d) Coccygeus
Explanation: Perineal body connects levator ani, external anal sphincter, and perineal muscles, but not coccygeus directly. Supports prostate and pelvic floor. Correct answer is d) Coccygeus.
Guessed Question 7
Which muscle contributes to urinary continence?
a) Pubococcygeus
b) Coccygeus
c) Iliococcygeus
d) Gluteus maximus
Explanation: Pubococcygeus supports urethra and prostate, maintains urethral closure, aiding urinary continence. Correct answer is a) Pubococcygeus.
Guessed Question 8
Posterior boundary of pelvic floor is formed by?
a) Coccygeus
b) Pubococcygeus
c) Iliococcygeus
d) Bulbospongiosus
Explanation: Coccygeus (ischiococcygeus) forms posterior boundary of pelvic floor, supporting sacrum and coccyx. Correct answer is a) Coccygeus.
Guessed Question 9
Which muscle is most anterior in levator ani?
a) Pubococcygeus
b) Iliococcygeus
c) Coccygeus
d) Puborectalis
Explanation: Pubococcygeus lies anteriorly, forming main support for prostate, bladder, and urethra. Correct answer is a) Pubococcygeus.
Guessed Question 10
Which muscle attaches to pubic bone and coccyx?
a) Pubococcygeus
b) Iliococcygeus
c) Coccygeus
d) External anal sphincter
Explanation: Pubococcygeus originates from pubic bone and inserts into coccyx and anococcygeal raphe, supporting prostate and pelvic viscera. Correct answer is a) Pubococcygeus.
Guessed Question 11
Which muscle forms central part of pelvic floor?
a) Pubococcygeus
b) Iliococcygeus
c) Coccygeus
d) Obturator internus
Explanation: Pubococcygeus forms central part of pelvic floor, supporting prostate, bladder, and urethra, crucial in male pelvic anatomy. Correct answer is a) Pubococcygeus.
Chapter: Anatomy
Topic: Pelvic Vessels
Subtopic: Obturator Artery Variations
Keyword Definitions:
Obturator artery: Branch of internal iliac artery supplying medial thigh, hip joint, and obturator foramen structures.
Aberrant obturator artery: Variant artery usually arising from external iliac or inferior epigastric artery instead of internal iliac.
Inferior epigastric artery: Branch of external iliac artery supplying anterior abdominal wall, sometimes gives rise to aberrant obturator artery.
Profunda femoris artery: Deep femoral artery, major branch of femoral artery supplying thigh muscles.
Clinical relevance: Aberrant obturator artery crosses superior pubic ramus, risk of severe hemorrhage during hernia or pelvic surgery.
External iliac artery: Continuation of common iliac artery, becomes femoral artery after inguinal ligament.
Herniorrhaphy risk: Aberrant obturator artery injury can occur in laparoscopic or open inguinal hernia repair.
Lead Question - 2013
In case of aberrant obturator artery, it arises most commonly from ?
a) Common iliac artery
b) Femoral artery
c) Profunda femoris artery
d) Inferior epigastric artery
Explanation: The aberrant obturator artery most commonly arises from the inferior epigastric artery, a branch of the external iliac artery. Knowledge of this variant is important to prevent hemorrhage during inguinal hernia repair, pelvic, or orthopedic surgeries. Correct answer is d) Inferior epigastric artery.
Guessed Question 2
Normal obturator artery arises from?
a) Internal iliac artery
b) External iliac artery
c) Femoral artery
d) Profunda femoris
Explanation: Normally, obturator artery arises from the internal iliac artery, supplying medial thigh and hip structures. Variations like aberrant obturator artery increase surgical risk. Correct answer is a) Internal iliac artery.
Guessed Question 3
Obturator artery supplies all except?
a) Hip joint
b) Adductor muscles
c) Quadriceps
d) Obturator foramen region
Explanation: Obturator artery supplies hip joint, adductor muscles, and obturator region, but quadriceps are supplied mainly by femoral artery branches. Correct answer is c) Quadriceps.
Guessed Question 4
Which artery is at risk in laparoscopic inguinal hernia repair?
a) Aberrant obturator artery
b) Internal pudendal
c) Inferior mesenteric
d) Superior gluteal
Explanation: Aberrant obturator artery runs close to superior pubic ramus and may be injured during laparoscopic or open inguinal hernia repair. Surgeons must identify its course to prevent hemorrhage. Correct answer is a) Aberrant obturator artery.
Guessed Question 5
Inferior epigastric artery arises from?
a) External iliac artery
b) Internal iliac artery
c) Femoral artery
d) Profunda femoris
Explanation: Inferior epigastric artery originates from external iliac artery, ascends along abdominal wall, and may give rise to aberrant obturator artery. Correct answer is a) External iliac artery.
Guessed Question 6
Which variant artery crosses superior pubic ramus?
a) Aberrant obturator artery
b) Internal iliac artery
c) Inferior gluteal artery
d) Femoral artery
Explanation: Aberrant obturator artery passes over superior pubic ramus, making it vulnerable during pelvic surgery. Knowledge of its presence is critical for surgical safety. Correct answer is a) Aberrant obturator artery.
Guessed Question 7
Profunda femoris artery supplies?
a) Thigh muscles
b) Abdomen
c) Pelvis
d) Perineum
Explanation: Profunda femoris artery is the deep femoral artery supplying thigh muscles via perforating branches. It rarely gives rise to aberrant obturator artery. Correct answer is a) Thigh muscles.
Guessed Question 8
Common iliac artery divides into?
a) Internal and external iliac arteries
b) Femoral and profunda femoris
c) Superior and inferior epigastric
d) Obturator and femoral
Explanation: Common iliac artery bifurcates into internal and external iliac arteries. External iliac continues as femoral artery, while internal iliac supplies pelvis, including obturator artery. Correct answer is a) Internal and external iliac arteries.
Guessed Question 9
During hernia repair, which artery is most likely injured?
a) Aberrant obturator artery
b) Femoral artery
c) Internal pudendal artery
d) Inferior mesenteric artery
Explanation: Aberrant obturator artery runs close to pubic bone and is prone to injury during hernia repair, potentially causing severe bleeding. Correct answer is a) Aberrant obturator artery.
Guessed Question 10
Which artery forms anastomosis with obturator artery?
a) Inferior epigastric artery
b) Femoral artery
c) Profunda femoris artery
d) Internal pudendal artery
Explanation: Inferior epigastric artery can form anastomosis with obturator artery; this is clinically important in cases of aberrant origin and collateral circulation during surgery. Correct answer is a) Inferior epigastric artery.
Guessed Question 11
Artery variant most relevant in pelvic surgery?
a) Aberrant obturator artery
b) Superior gluteal artery
c) Internal pudendal artery
d) Median sacral artery
Explanation: Aberrant obturator artery is clinically significant in pelvic and hernia surgeries due to its variant origin and course, which may lead to unexpected hemorrhage if unrecognized. Correct answer is a) Aberrant obturator artery.
Chapter: Anatomy
Topic: Male Reproductive System
Subtopic: Spermatic Cord & Fasciae
Keyword Definitions:
Internal spermatic fascia: Thin fascia surrounding spermatic cord and testis, derived from transversalis fascia, lies deep to cremasteric fascia.
Cremasteric fascia: Fascial layer derived from internal oblique muscle, contains cremasteric muscle fibers, elevates testis.
External spermatic fascia: Derived from external oblique aponeurosis, superficial to cremasteric fascia.
Fascia transversalis: Fascial layer lining the inner surface of anterior abdominal wall, forms internal spermatic fascia when covering spermatic cord.
Colle's fascia: Superficial perineal fascia, continuous with Scarpa's fascia, not involved in spermatic cord layers.
Clinical relevance: Knowledge of fascia layers is crucial during hernia repair, hydrocele surgery, and orchidopexy to prevent injury.
Spermatic cord: Contains vas deferens, testicular artery, pampiniform plexus, lymphatics, nerves, and fasciae layers.
Lead Question - 2013
Internal spermatic fascia is derived from ?
a) External oblique muscle
b) Internal oblique muscle
c) Fascia transversalis
d) Colle's fascia
Explanation: Internal spermatic fascia is derived from the fascia transversalis as the testis descends through the deep inguinal ring. It lies deep to the cremasteric fascia and provides a protective covering around the spermatic cord. Correct answer is c) Fascia transversalis.
Guessed Question 2
Cremasteric fascia is derived from?
a) External oblique
b) Internal oblique
c) Transversalis fascia
d) Colle's fascia
Explanation: Cremasteric fascia arises from internal oblique muscle and carries cremasteric muscle fibers around spermatic cord and testis. It allows reflex elevation of testis. Correct answer is b) Internal oblique.
Guessed Question 3
External spermatic fascia is derived from?
a) External oblique aponeurosis
b) Internal oblique
c) Transversalis fascia
d) Dartos fascia
Explanation: External spermatic fascia is derived from the aponeurosis of external oblique muscle, lying superficial to cremasteric fascia, forming outer covering of spermatic cord. Correct answer is a) External oblique aponeurosis.
Guessed Question 4
Dartos fascia is continuous with?
a) Colle's fascia
b) Internal oblique
c) Transversalis fascia
d) External oblique
Explanation: Dartos fascia (superficial fascia of scrotum) is continuous with Colle's fascia in perineum and Scarpa's fascia of abdomen. It contains smooth muscle fibers. Correct answer is a) Colle's fascia.
Guessed Question 5
Layer immediately deep to external spermatic fascia?
a) Cremasteric fascia
b) Internal spermatic fascia
c) Tunica vaginalis
d) Dartos fascia
Explanation: Cremasteric fascia, containing cremasteric muscle, lies deep to external spermatic fascia and superficial to internal spermatic fascia, providing reflexive testicular elevation. Correct answer is a) Cremasteric fascia.
Guessed Question 6
Deep inguinal ring is an opening in?
a) Transversalis fascia
b) External oblique
c) Internal oblique
d) Rectus sheath
Explanation: Deep inguinal ring is an opening in the transversalis fascia, allowing passage of spermatic cord (male) or round ligament (female). Internal spermatic fascia derives from this fascia. Correct answer is a) Transversalis fascia.
Guessed Question 7
Which fascia surrounds testis directly?
a) Internal spermatic fascia
b) Cremasteric fascia
c) External spermatic fascia
d) Dartos fascia
Explanation: Internal spermatic fascia lies immediately around spermatic cord and testis, derived from transversalis fascia, providing protective layer. Correct answer is a) Internal spermatic fascia.
Guessed Question 8
Which fascia layer contains cremasteric muscle?
a) Cremasteric fascia
b) External spermatic fascia
c) Internal spermatic fascia
d) Dartos fascia
Explanation: Cremasteric fascia contains cremasteric muscle fibers originating from internal oblique, responsible for testicular elevation. Correct answer is a) Cremasteric fascia.
Guessed Question 9
Spermatic cord layers in order from superficial to deep?
a) External spermatic, cremasteric, internal spermatic
b) Internal spermatic, cremasteric, external spermatic
c) Cremasteric, external spermatic, internal spermatic
d) External spermatic, internal spermatic, cremasteric
Explanation: Layers from superficial to deep: external spermatic fascia (external oblique), cremasteric fascia (internal oblique), internal spermatic fascia (transversalis fascia). This knowledge is crucial in hernia and orchidopexy procedures. Correct answer is a) External spermatic, cremasteric, internal spermatic.
Guessed Question 10
Tunica vaginalis is derived from?
a) Processus vaginalis
b) Internal oblique
c) External oblique
d) Transversalis fascia
Explanation: Tunica vaginalis forms from the processus vaginalis, a peritoneal outpouching descending with testis. It surrounds testis and epididymis, separate from fascia layers. Correct answer is a) Processus vaginalis.
Guessed Question 11
Which fascia is clinically relevant in hydrocele surgery?
a) Internal spermatic fascia
b) Cremasteric fascia
c) External spermatic fascia
d) Dartos fascia
Explanation: Internal spermatic fascia is incised during hydrocelectomy to access tunica vaginalis. Understanding fascia layers prevents injury to cord structures. Correct answer is a) Internal spermatic fascia.
Chapter: Anatomy
Topic: Hepatobiliary System
Subtopic: Portal Vein
Keyword Definitions:
Portal vein: Vein formed by confluence of superior mesenteric and splenic veins, carrying nutrient-rich blood from GI tract to liver.
Hepatic portal circulation: Circulatory system delivering venous blood from intestines, pancreas, spleen, and stomach to liver for metabolism and detoxification.
Splenic vein: Drains spleen, pancreas, and parts of stomach, contributes to portal vein.
Superior mesenteric vein: Drains small intestine, cecum, ascending and transverse colon, joins splenic vein to form portal vein.
Clinical relevance: Portal vein thrombosis or hypertension affects liver function, can cause varices and ascites.
Liver: Receives ~75% of blood via portal vein, ~25% via hepatic artery.
Spleen: Drains into splenic vein, not supplied directly by portal vein.
Lead Question - 2013
Portal vein supplies ?
a) Spleen
b) Liver
c) Pancreas
d) Colon
Explanation: The portal vein carries nutrient-rich venous blood from gastrointestinal organs and spleen to the liver for detoxification and metabolism. It does not supply the spleen, colon, or pancreas directly. Correct answer is b) Liver.
Guessed Question 2
Portal vein is formed by?
a) Superior mesenteric + splenic veins
b) Inferior mesenteric + splenic veins
c) Superior mesenteric + inferior mesenteric veins
d) Hepatic veins
Explanation: Portal vein is formed by the union of the superior mesenteric and splenic veins behind the neck of pancreas. This vein carries blood to the liver. Correct answer is a) Superior mesenteric + splenic veins.
Guessed Question 3
Portal vein carries blood from all except?
a) Spleen
b) Pancreas
c) Kidneys
d) Stomach
Explanation: Portal vein collects blood from GI organs, spleen, and pancreas, but not kidneys. Renal veins drain directly into inferior vena cava. Correct answer is c) Kidneys.
Guessed Question 4
Which vein drains into portal vein?
a) Splenic vein
b) Renal vein
c) Femoral vein
d) Brachial vein
Explanation: Splenic vein drains spleen and joins superior mesenteric vein to form portal vein. Other veins drain into systemic circulation. Correct answer is a) Splenic vein.
Guessed Question 5
Portal vein enters liver at?
a) Porta hepatis
b) Hepatic hilum
c) Both a and b
d) Falciform ligament
Explanation: Portal vein enters the liver at the porta hepatis (hepatic hilum), along with hepatic artery and bile duct. Correct answer is c) Both a and b.
Guessed Question 6
Clinical significance of portal vein thrombosis?
a) Portal hypertension
b) Varices
c) Ascites
d) All of the above
Explanation: Thrombosis of the portal vein obstructs venous flow to the liver, causing portal hypertension, esophageal varices, splenomegaly, and ascites. Correct answer is d) All of the above.
Guessed Question 7
Which artery supplies liver along with portal vein?
a) Hepatic artery
b) Celiac artery
c) Splenic artery
d) Superior mesenteric artery
Explanation: Liver receives blood from portal vein (~75%) and hepatic artery (~25%). Hepatic artery arises from celiac trunk. Correct answer is a) Hepatic artery.
Guessed Question 8
Portal venous blood is rich in?
a) Nutrients
b) Oxygen
c) Hormones
d) Lymph
Explanation: Portal vein carries nutrient-rich blood from intestines, stomach, spleen, and pancreas to liver for metabolism. Oxygen content is less than arterial blood. Correct answer is a) Nutrients.
Guessed Question 9
Which structure is not part of hepatic portal system?
a) Superior mesenteric vein
b) Splenic vein
c) Inferior vena cava
d) Portal vein
Explanation: Inferior vena cava is part of systemic venous circulation, not portal system. Portal system includes portal vein and tributaries. Correct answer is c) Inferior vena cava.
Guessed Question 10
Which organ directly receives portal venous blood?
a) Liver
b) Spleen
c) Pancreas
d) Stomach
Explanation: Portal venous blood is delivered to the liver for metabolism, detoxification, and storage of nutrients. Other organs drain blood into portal vein but do not receive it. Correct answer is a) Liver.
Guessed Question 11
Portal vein is posterior to which structure?
a) Pancreas
b) Duodenum
c) Stomach
d) Gallbladder
Explanation: Portal vein is formed posterior to the neck of pancreas by superior mesenteric and splenic veins. Correct answer is a) Pancreas.
Chapter: Anatomy
Topic: Female Reproductive System
Subtopic: Cervix Structure
Keyword Definitions:
Cervix: Lower part of uterus connecting uterine cavity to vagina, composed of connective tissue and smooth muscle.
Connective tissue: Provides structural support, rich in collagen and elastin fibers, predominant in cervix.
Smooth muscle: Involuntary muscle fibers present in cervical stroma, responsible for contractility during labor.
Cervical stroma: Tissue matrix of cervix containing both connective tissue and smooth muscle, contributing to strength and elasticity.
Ratio connective tissue : smooth muscle: Determines cervical rigidity and ability to dilate during childbirth.
Clinical relevance: Understanding tissue ratio is essential in cervical surgeries, obstetrics, and assessment of cervical insufficiency.
Fornices: Recesses around cervix within vaginal canal, composed mainly of connective tissue.
Lead Question - 2013
Ratio of connective tissue : smooth muscle in cervix is ?
a) 2:1
b) 5:1
c) 8:1
d) None
Explanation: The cervical stroma is composed predominantly of connective tissue, which provides tensile strength, while smooth muscle is comparatively lesser. Histological studies show the ratio of connective tissue to smooth muscle in the cervix is approximately 5:1. Correct answer is b) 5:1.
Guessed Question 2
Which component predominates in cervical stroma?
a) Smooth muscle
b) Connective tissue
c) Epithelium
d) Cartilage
Explanation: Connective tissue is the major component of cervical stroma, providing tensile strength and elasticity. Smooth muscle is less abundant. Epithelium lines the canal but is not part of stroma. Correct answer is b) Connective tissue.
Guessed Question 3
Cervical smooth muscle is important for?
a) Contractions during labor
b) Hormone production
c) Structural support
d) Blood supply
Explanation: Smooth muscle in the cervix contributes to contractile function, allowing dilation during labor. It does not produce hormones or provide primary structural support. Correct answer is a) Contractions during labor.
Guessed Question 4
Which type of connective tissue is abundant in cervix?
a) Collagen
b) Elastic cartilage
c) Bone
d) Adipose tissue
Explanation: Collagen fibers are abundant in cervical connective tissue, providing tensile strength and rigidity, while elastin allows flexibility. Correct answer is a) Collagen.
Guessed Question 5
Cervical insufficiency is due to:
a) Weak connective tissue
b) Excess smooth muscle
c) Infection
d) Fibrosis
Explanation: Weak connective tissue in cervical stroma can lead to cervical insufficiency, resulting in premature dilation and pregnancy loss. Smooth muscle deficiency is not a primary cause. Correct answer is a) Weak connective tissue.
Guessed Question 6
During pregnancy, cervical connective tissue:
a) Becomes more rigid
b) Becomes softer and more elastic
c) Converts to smooth muscle
d) Does not change
Explanation: Hormonal changes during pregnancy cause remodeling of cervical connective tissue, increasing elasticity and allowing dilation at labor. Correct answer is b) Becomes softer and more elastic.
Guessed Question 7
Which layer forms the bulk of cervical wall?
a) Stroma
b) Epithelium
c) Mucosa
d) Serosa
Explanation: The cervical stroma forms the bulk of cervical wall, composed mainly of connective tissue with interspersed smooth muscle. Epithelium lines the canal. Correct answer is a) Stroma.
Guessed Question 8
Clinical importance of connective tissue in cervix?
a) Determines cervical strength
b) Enables dilation
c) Supports uterus
d) All of the above
Explanation: Connective tissue in cervix provides structural integrity, allows remodeling and dilation during labor, and supports uterine position. Correct answer is d) All of the above.
Guessed Question 9
Major histological change of cervix during labor:
a) Connective tissue remodeling
b) Smooth muscle hypertrophy
c) Epithelium proliferation
d) Calcification
Explanation: Cervical connective tissue undergoes remodeling under hormonal influence (collagen breakdown, increased water content), enabling dilation. Correct answer is a) Connective tissue remodeling.
Guessed Question 10
Ratio of smooth muscle : connective tissue in cervix?
a) 1:5
b) 1:2
c) 2:1
d) 5:1
Explanation: Since connective tissue predominates with a ratio of 5:1, smooth muscle : connective tissue ratio is 1:5. Correct answer is a) 1:5.
Guessed Question 11
Cervical collagen provides:
a) Tensile strength
b) Contractility
c) Hormonal function
d) Vascular supply
Explanation: Collagen fibers in cervical stroma provide tensile strength and rigidity, essential for structural support of uterus and controlled dilation during labor. Correct answer is a) Tensile strength.