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50 Cards in this Set

  • Front
  • Back
A 68-year-old woman with uterine carcinoma
undergoes surgical resection. This cancer
can spread directly to the labia majora in lymphatics
that follow which of the following
structures?
(A) Pubic arcuate ligament
(B) Suspensory ligament of the ovary
(C) Cardinal (transverse cervical) ligament
(D) Suspensory ligament of the clitoris
(E) Round ligament of the uterus
E
17-year-old boy suffers a traumatic groin
injury during a soccer match. The urologist notices
tenderness and swelling of the boy's left
testicle that may be produced by thrombosis in
which of the following veins?
(A) Left internal pudendal vein
(8) Left renal vein
(C) Inferior vena cava
(D) Left inferior epigastric vein
(E) Left external pudendal vein
B
On a busy Saturday night in Chicago, a 16-
year-old boy presents to the emergency room
with a stab wound from a knife that enters the
pelvis above the piriformis muscle. Which of
the following structures is most likely to be
damaged?
(A) Sciatic nerve
(B) Internal pudendal artery
(C) Superior gluteal nerve
(D) Inferior gluteal artery
(E) Posterior femoral cutaneous nerve
c
22-year-old woman receives a deep cut
in the inguinal canal 1 inch lateral to the pubic
tubercle. Which of the following ligaments is
lacerated within the inguinal canal?
(A) Suspensory ligament of the ovary
(B) Ovarian ligament
(C) Mesosalpinx
(D) Round ligament of the uterus
(E) Rectouterine ligament
D
29-year-old carpenter sustains severe injuries
of the pelvic splanchnic nerve by a deeppuncture wound, which has become contaminated.
The injured parasympathetic preganglionic
fibers in the splanchnic nerve are most
likely to synapse in which of the following
ganglia?
(A) Ganglia in or near the viscera or pelvic
plexus
(B) Sympathetic chain ganglia
(C) Collateral ganglia
(D) Dorsal root ganglia
(E) Ganglion impar
A
59-year-old woman comes to a local hospital
for uterine cancer surgery. As the uterine
artery passes from the internal iliac artery to
the uterus, it crosses superior to which of the
following structures that is sometimes mistakenly
ligated during such surgery?
(A) Ovarian artery
(B) Ovarian ligament
(C) Uterine tube
(D) Ureter
(E) Round ligament of the uterus
D
29-year-old woman is admitted to a hospital
because the birth of her child is several
days overdue. Tearing of the pelvic diaphragm
during childbirth leads to paralysis of which of
the following muscles?
(A) Piriformis
(B) Sphincter urethrae
(C) Obturator internus
(D) Levator ani
(E) Sphincter ani externus
D
37-year-old small business manager receives
a gunshot wound in the pelvic cavity, resulting
in a lesion of the sacral splanchnic
nerves. Which of the following nerve fibers
would primarily be damaged?
(A) Postganglionic parasympathetic fibers
(B) Postganglionic sympathetic fibers
(C) Preganglionic sympathetic fibers
(D) Preganglionic parasympathetic fibers
(E) Postganglionic sympathetic and parasympathetic
fibers
C
young couple is having difficulty conceiving
a child. Their physician at a reproduction
and fertility clinic explains to them that:
(A) The ovary lies within the broad ligament
(B) The glans clitoris is formed from the corpus
spongiosum
(C) Erection of the penis is a sympathetic response
(D) Ejaculation follows parasympathetic stimu
lation
(E) Fertilization occurs in the infundibulum
or ampulla of the uterine tube.
E
A 46-year-old woman has a history of infection
in her perineal region. A comprehensive
examination reveals a tear of the superior
boundary of the superficial perineal space.
Which of the following structures would most
likely be injured?
(A) Pelvic diaphragm
(B) Colles' fascia
(C) Superficial perineal fascia
(D) Deep perineal fascia
(E) Perineal membrane
E
A 58-year-old man is diagnosed as having
a slowly growing tumor in the deep perineal
space. Which of the following structures would
most likely be injured?
(A) Bulbourethral glands
(B) Crus of penis
(C) Bulb of vestibule
(D) Spongy urethra
(E) Great vestibular gland
A
An elderly man with benign enlargement
of his prostate experiences difficulty in urination,
urinary frequency, and urgency. Which of
the following lobes of the prostate gland is
commonly involved in benign hypertrophy
that obstructs the prostatic urethra?
(A) Anterior lobe
(B) Middle lobe
(C) Right lateral lobe
(D) Left lateral lobe
(E) Posterior lobe
B
A 59-year-old man is diagnosed with
prostate cancer following a digital rectal examination.
For the resection of prostate cancer, it is
important to know that the prostatic ducts open
into or on which of the following structures?
(A) Membranous part of the urethra
(B) Seminal colliculus
(C) Spongy urethra
(D) Prostatic sinus
(E) Prostatic utricle
D
A 29-year-old woman with a ruptured ectopic
pregnancy is admitted to a hospital for
culdocentesis. A long needle on the syringe is
most efficiently inserted through which of the
following structures?
(A) Anterior fornix of the vagina
(B) Posterior fornix of the vagina
(C) Anterior wall of the rectum
(D) Posterior wall of the uterine body
(E) Posterior wall of the bladder
B
A 37-year-old man is suffering from carcinoma
of the skin of the glans penis. Cancer
cells are likely to metastasize directly to which
of the following lymph nodes?
(A) External iliac nodes
(B) Internal iliac nodes
(C) Superficial inguinal nodes
(D) Aortic (lumbar) nodes
(E) Common iliac nodes
C
A 42-year-old woman who has had six
children develops a weakness of the urogenital
diaphragm. Paralysis of which of the following
muscles would cause such a symptom?
(A) Sphincter urethrae
(B) Coccygeus
(C) Superficial transversus perinei
(D) Levator ani
(E) Obturator internus
A
A 43-year-old man has a benign tumor located
near a gap between the arcuate pubic ligament
and the transverse perineal ligament.
Which of the following structures is most likely
compressed by this tumor?
(A) Perineal nerve
(B) Deep dorsal vein of the penis
(C) Superficial dorsal vein
(D) Posterior scrotal nerve
(E) Deep artery of the penis
B
An obstetrician performs a median episiotomy
on a woman before parturition to prevent
uncontrolled tearing. If the perineal body
is damaged, the function of which of the following
muscles might be impaired?
(A) Ischiocavernosus and sphincter urethrae
(B) Deep transverse perineal and obturator
internus
(C) Bulbospongiosus and superficial transverse
perineal
(D) External anal sphincter and sphincter
urethrae
(E) Bulbospongiosus and ischiocavernosus
C
A 22-year-old man has a gonorrheal infection
that has infiltrated the space between the
inferior fascia of the urogenital diaphragm and
the superficial perineal fascia. Which of the following
structures might be inflamed?
(A) Greater vestibular gland
(B) Bulbourethral gland
(C) Membranous part of the male urethra
(D) Deep transverse perineal muscle
(E) Sphincter urethrae
A
A 39-year-old man is unable to expel the
last drops of urine from the urethra at the end
of micturition because of paralysis of the external
urethral sphincter and bulbospongiosus
muscles. This condition may occur as a result
of injury to which of the following nervous
structures?
(A) Pelvic plexus
(B) Prostatic plexus
(C) Pudendal nerve
(D) Pelvic splanchnic nerve
(E) Sacral splanchnic nerve
C
A 21-year-old marine biologist asks about
her first himanual examination arid it is explained
to her that the normal position of the
uterus is:
(A) Anteflexed and anteverted
(B) Retroflexed and anteverted
(C) Anteflexed and retroverted
(D) Retroverted arid retroflexed
(E) Anteverted and retroverted
A
After his bath, but before getting dressed, a
4-year-old boy was playing with his puppy. The
boy's penis was bitten by the puppy and the
deep dorsal vein was injured. The damaged vein:
(A) Lies deep to Buck's fascia
(B) Drains into the prostatic venous plexus
(C) Lies lateral to the dorsal artery of the penis
(D) Is found in the corpus spongiosum
(E) Is dilated during erection
B
A 62-year-old man is incapable of penile
erection after rectal surgery with prostatectomy.
The patient most likely has a lesion of
which of the following nerves?
(A) Dorsal nerve of the penis
(B) Perineal nerve
(C) Hypogastric nerve
(D) Sacral splanchnic nerve
(E) Pelvic splanchnic nerve
E
A 23-year-old massage therapist who specializes
in women's health attends a lecture at
an annual conference on techniques of massage.
She asks which of the following structures
is drained by the lumbar (aortic) lymph nodes?
(A) Perineum
(B) Lower part of the vagina
(C) External genitalia
(D) Ovary
(E) Lower part of the anterior abdominal wall
D
A sexually active adolescent presents with
an infection within the ischiorectal fossa.
Which of the following structures is most likely
injured?
(A) Vestibular bulb
(B) Seminal vesicle
(C) Greater vestibular gland
(D) Inferior rectal nerve
(E) Internal pudendal artery
D
A first-year resident in the urology department
reviews pelvic anatomy before seeing patients.
Which of the following statements is
correct?
(A) The dorsal artery of the penis supplies the
glans penis
(B) The seminal vesicles store spermatozoa
(C) The duct of the hulbourethral gland
opens into the membranous urethra
(D) The duct of the greater vestibular gland
opens into the vagina
(E) The anterior lobe of the prostate gland is
prone to carcinomatous transformation
A
A 43-year-old woman presents with a prolapsed
uterus. Repair of a prolapsed uterus requires
knowledge of the supporting structures
of the uterus. Which of the following structures
plays the most important role in the support
of the uterus?
(A) Levator ani
(B) Sphincter urethrae
(C) Uterosacral ligament
(D) Ovarian ligament
(E) Arcuate pubic ligament
A
A 16-year-old boy presents to the emergency
department with rupture of the penile urethra. Extravasated urine from this injury
can spread into which of the following structures?
(A) Scrotum
(B) Ischiorectal fossa
(C) Pelvic cavity
(D) Testis
(E) Thigh
A
A 23-year-old woman visits her obstetrician
for an annual checkup. During vaginal examination,
which of the following structures
may be palpated?
(A) Apex of the urinary bladder
(B) Fundus of the uterus
(C) Terminal part of the round ligament of
the uterus
(D) Body of the clitoris
(E) Uterine cervix
E
A 53-year-old bank teller is admitted to a
local hospital for surgical removal of a benign
pelvic tumor confined within the broad
ligament. There is a risk of injuring which of
the following structures that lies in this ligament?
(A) Ovary
(B) Proximal part of the pelvic ureter
(C) Terminal part of the round ligament of
the uterus
(D) Uterine tube
(E) Suspensory ligament of the ovary
D
A 72-year-old man comes to his physician
for an annual check-up. Which of the following
structures is most readily palpated during
rectal examination?
(A) Prostate gland
(B) Epididymis
(C) Ejaculatory duct
(D) Ureter
(E) Testis
A
A 48-year-old college football coach undergoes
a radical prostatectomy for a malignant
tumor in his prostate. Following surgery, he is
incapable of achieving an erection. Which of
the following nerves is most likely damaged
during the surgery?
(A) Sacral splanchnic nerve
(B) Pelvic splanchnic nerve
(C) Pudendal nerve
(D) Dorsal nerve of the penis
(E) Posterior scrotal nerve
B
While performing a pelvic exenteration,
the surgical oncologist notices a fractured or
ruptured boundary of the pelvic inlet. Which
of the following structures is most likely damaged?
(A) Promontory of the sacrum
(B) Anterior-inferior iliac spine
(C) Inguinal ligament
(D) Iliac crest
(E) Arcuate pubic ligament
A
A 32-year-old patient with multiple fractures
of the pelvis has no cutaneous sensation
in the urogenital triangle. The function of
which of the following nerves is most likely to
be spared?
(A) Ilioinguinal nerve
(B) Iliohypogastric nerve
(C) Posterior cutaneous nerve of the thigh
(D) Pudendal nerve
(E) Genitofemoral nerve
B
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
D
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
A
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
C
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
D
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
C
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
C
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
D
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) Labium majus
(C) Clitoris
(D) Testis
(E) Scrotum
D
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
E
A 26-year-old man comes to a hospital
with fever, nausea, pain, and itching in the perineal
region. On examination by an urologist,
he is diagnosed as having infected bulbourethral
(Cowper's) glands. Which of the following
structures is affected by this infection?
(A) Superficial perineal space.
(B) Sphincter urethrae.
(C) Production of sperm.
(D) Testis
(E) Seminal vesicles
B
A 21-year-old man is involved in a highspeed
motor vehicle accident. As a result, he
has extensive damage to his sphincter urethrae.
Which of the following statements best
explains the injured sphincter urethrae?
(A) Smooth muscle
(B) Innervated by the perineal nerve
(C) Lying between the perinea] membrane
and CoIles' fascia
(D) Enclosed in the pelvic fascia
(E) Part of the pelvic diaphragm
B
An obstetrician is about to perform a pudendal
block so a woman can experience less
pain when she delivers her child. He recalls
what he learned in medical school about this
nerve:
(A) It passes superficial to the sacrotuberous
ligament
(B) It innervates the testis and epididymis in
a male
(C) It provides motor fibers to the coccygeus
(D) It can be blocked by injecting an anesthetic
near the inferior margin of the ischial
spine
(E) It arises from the lumbar plexus
D
A trauma surgeon in the emergency room
at a local center examines a 14-year-old boy
with extensive pelvic injuries after a hit and
run accident. The surgeon inspects the ischiorectal
fossa because it:
(A) Accumulates urine leaking from rupture
of the bulb of the penis
(B) Contains the inferior rectal vessels
(C) Has a pudendal canal along its medial wall
(D) Is bounded anteriorly by the sacrotuberous
ligament
(E) Contains a perineal branch of the fifth
lumbar nerve
B
An elderly man with prostatitis is seen at
an internal medicine clinic. The seminal colliculus
of his prostate gland is infected, and its
fine openings are closed. Which of the following
structures is most likely to be disturbed?
(A) Ducts of the prostate gland
(B) Prostatic utricle
(C) Ducts of the bulbourethral glands
(ID) Ejaculatory ducts
(E) Duct of the seminal vesicles
D
A general surgeon is giving a lecture to a
team of surgery residents. She describes characteristics
of structures above the pectinate line
of the anal canal, which include
(A) Stratified squamous epithelium
(B) Venous drainage into the caval system
(C) Lymphatic drainage into the superficial
inguinal nodes
(D) Visceral sensory innervation
(E) External hemorrhoids
D
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
C