Anatomy Perineum –pelvis BRS - Part 1
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- 1.
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
Correct Answer
E. Round ligament of the uterusExplanation
The round ligament of the uterus runs laterally from the uterus through the
deep inguinal ring, inguinal canal, and superficial inguinal ring and becomes lost in the subcutaneous
tissues of the labium majus. Thus, carcinoma of the uterus can spread directly to the
labium majus by traveling in lymphatics that follow the ligament. The pubic arcuate ligament attaches
across the inferior aspect of the pubic symphysis and attaches to the medial borders of the
inferior pubic rami. The suspensory ligament of the ovary runs from the ovary to the pelvic wall
and transmits the ovarian vessels. The cardinal (transverse cervical) ligament runs from the cervix
and the vagina to the pelvic walls. The suspensory ligament of the clitoris runs from the pubic
symphysis and the arcuate pubic ligament to the deep fascia of the body of the clitoris.Rate this question:
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- 2.
A 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
- B.
Left renal vein
- C.
Inferior vena cava
- D.
Left inferior epigastric vein
- E.
Left external pudendal vein
Correct Answer
B. Left renal veinExplanation
A tender swollen left testis may be produced by thrombosis in the left renal
vein, because the left testicular vein drains into the left renal vein. The right testicular vein drains
into the inferior vena cava. The left internal pudendal vein empties into the left internal iliac
vein. The left inferior epigastric drains into the left external iliac vein and the left external pudendal
vein empties into the femoral vein.Rate this question:
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- 3.
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
Correct Answer
C. Superior gluteal nerveExplanation
The superior gluteal nerve leaves the pelvis through the greater sciatic foramen,
above the piriformis. The sciatic nerve, internal pudendal vessels, inferior gluteal vessels and
nerve, and posterior femoral cutaneous nerve leave the pelvis below the piriformis.Rate this question:
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- 4.
A 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
Correct Answer
D. Round ligament of the uterusExplanation
The round ligament of the uterus is found in the inguinal canal along its
course. Other ligaments are not passing through the inguinal canal.Rate this question:
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- 5.
A 29-year-old carpenter sustains severe injuries of the pelvic splanchnic nerve by a deep puncture 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
Correct Answer
A. Ganglia in or near the viscera or pelvic plexusExplanation
The pelvic splanchnic nerves carry preganglionic parasympathetic general
visceral efferent (GVE) fibers that synapse in the ganglia of the inferior hypogastric plexus and in
terminal ganglia in the muscular walls of the pelvic organs. The sympathetic preganglionic fibers
synapse in the sympathetic chain (paravertebral) ganglia or in the collateral (prevertebral) ganglia.
The dorsal root ganglia contains cell bodies of general somatic afferent (GSA) and general visceral
afferent (GVA) fibers and have no synapsis. The two sympathetic trunks unite and terminate
in the ganglion impar (coccygeal ganglion), which is the most inferior, unpaired ganglion located
in front of the coccyx.Rate this question:
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- 6.
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
Correct Answer
D. UreterExplanation
The ureter runs under the uterine artery near the cervix; thus, the ureter is
sometimes mistakenly ligated during pelvic surgery. The other structures mentioned are not
closely related to the uterine artery near the uterine cervix.Rate this question:
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- 7.
A 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
Correct Answer
D. Levator aniExplanation
The pelvic diaphragm is formed by the levator ani and coccygeus, whereas
the urogenital diaphragm consists of the sphincter urethrae and deep transverse perinei muscles.
The piriformis passes through the greater sciatic notch and inserts on the greater trochanter of
the femur. The obturator internus forms the lateral wall of the ischiorectal fossa. The sphincter
ani externus is composed of three layers, including the subcutaneous (corrugator cutis ani), superficial,
and deep portions and maintains a voluntary tonic contracture.Rate this question:
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- 8.
A 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
Correct Answer
C. Preganglionic sympathetic fibersExplanation
The sacral splanchnic nerves consist primarily of preganglionic sympathetic
neurons and also contain general visceral afferent (GVA) fibers. None of the other fibers listed are
contained in these nerves.Rate this question:
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- 9.
A 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 stimulation
- E.
Fertilization occurs in the infundibulum or ampulla of the uterine tube.
Correct Answer
E. Fertilization occurs in the infundibulum or ampulla of the uterine tube.Explanation
Fertilization takes place in the infundibulum or ampulla of the uterine tube. The
glans clitoris is derived from the corpora cavernosa, whereas the glans penis is the expanded terminal
part of the corpus spongiosum. Erection of the penis is caused by parasympathetic stimulation,
whereas ejaculation is mediated via the sympathetic nerve. The ovaries are not enclosed in the broad
ligament, but their anterior surface is attached to the posterior surface of the broad ligament.Rate this question:
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- 10.
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
Correct Answer
E. Perineal membraneExplanation
The superior (deep) boundary of the superficial perineal space is the perineal
membrane (inferior fascia of the urogenital diaphragm). Colles' fascia is the deep membranous
layer of the superficial perineal fascia. The deep perineal fascia essentially divides the superficial
perineal space into a superficial and deep compartment. The pelvic diaphragm consists
of the levator ani and coccygeus musclesRate this question:
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- 11.
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
Correct Answer
A. Bulbourethral glandsExplanation
The deep perineal space contains the bulbourethral (Cowper's) glands. The
crus of the penis, bulb of the vestibule, spongy urethra, and great vestibular gland are found in
the superficial perineal space.Rate this question:
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- 12.
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
Correct Answer
B. Middle lobeExplanation
The middle lobe of the prostate gland is commonly involved in benign prostatic
hypertrophy, resulting in obstruction of the prostatic urethra, whereas the posterior lobe is
commonly involved in carcinomatous transformation. The anterior lobe contains little glandular
tissue, and the two lateral lobes on either side of the urethra form the major part of the gland.Rate this question:
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- 13.
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
Correct Answer
D. Prostatic sinusExplanation
Ducts from the prostate gland open into the prostatic sinus, which is a
groove on either side of the urethral crest. The prostate gland receives the ejaculatory duct, which
opens into the prostatic urethra on the seminal colliculus (a prominent elevation of the urethral
crest) just lateral to the prostatic utricle, which is a small blind pouch. The bulbourethral gland
lies on the lateral side of the membranous urethra within the deep perineal space, but its duct
opens into the bulbous portion of the spongy (penile) urethra.Rate this question:
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- 14.
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
Correct Answer
B. Posterior fornix of the vaginaExplanation
A needle should be inserted through the posterior fornix, just below the
posterior lip of the cervix while the patient is in supine position, to aspirate abnormal fluid in the
cul-de-sac of Douglas (rectouterine pouch). Rectouterine excavation is not most efficiently aspirated
by puncture of other structuresRate this question:
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- 15.
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
Correct Answer
C. Superficial inguinal nodesExplanation
The superficial inguinal nodes receive lymph from the penis, scrotum, buttocks,
labium majus, and the lower parts of the vagina and anal canal. These nodes have efferent
vessels that drain primarily into the external iliac and common iliac nodes and ultimately to the
lumbar (aortic) nodes. The internal iliac nodes receive lymph from the upper part of the rectum,
vagina, uterus, and other pelvic organs, and they drain into the common iliac and then to the
lumbar (aortic) nodes.Rate this question:
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- 16.
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
Correct Answer
A. SpHincter urethraeExplanation
The urogenital diaphragm consists of the sphincter urethrae and deep
transverse perineal muscles. Weakness of the muscles, ligaments, and fasciae of the pelvic floor
such as the pelvic diaphragm, urogenital diaphragm, and cardinal (transverse cervical) ligaments
occurs as result of multiple child delivery, advancing age, and menopause. The pelvic diaphragm
is composed of the levator ani and coccygeus muscles. The superficial transverses perinei is one
of the superficial perineal muscles and the obturator internus forms the lateral wall of the ischiorectal
fossa.Rate this question:
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- 17.
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
Correct Answer
B. Deep dorsal vein of the penisExplanation
The deep dorsal vein, dorsal artery, and dorsal nerve of the penis pass
through a gap between the arcuate pubic ligament and the transverse perineal ligament. The perineal
nerve divides into a deep branch, which supplies all of the perineal muscles, and superficial
branches as posterior scrotal nerves that supply the scrotum. The superficial dorsal vein of the penis
empties into the greater saphenous vein. The deep artery of the penis runs in the corpus cavernosum
penis.Rate this question:
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- 18.
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
Correct Answer
C. Bulbospongiosus and superficial transverse perinealExplanation
The perineal body (central tendon of the perineum) is a fibromuscular node
at the center of the perineum. It provides attachment for the bulbospongiosus, the superficial and
deep transverse perineal muscles, and the sphincter ani externus muscles. Other muscles (ischiocavernosus,
sphincter urethrae, and obturator internus) are not attached to the perineal body.Rate this question:
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- 19.
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
Correct Answer
A. Greater vestibular glandExplanation
The greater vestibular gland is located in the superficial perineal space between
the inferior fascia of the urogenital diaphragm and the membranous layer of the superficial
perineal fascia (Colles' fascia). All of the other structures are found in the deep perineal pouch.Rate this question:
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- 20.
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
Correct Answer
C. Pudendal nerveExplanation
The perineal branch of the pudendal nerve supplies the external urethral
sphincter and bulbospongiosus muscles in the male. All other nervous structures do not supply
skeletal muscles but supply smooth muscles in the perineal and pelvic organs. The pelvic and prostatic
plexuses contain both sympathetic and parasympathetic nerve fibers. The pelvic splanchnic
nerve carries preganglionic parasympathetic fibers, whereas the sacral splanchnic nerve transmits
preganglionic sympathetic fibers.Rate this question:
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- 21.
A 21-y/o marine biologist asks about her first bimanual examination and 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
Correct Answer
A. Anteflexed and antevertedExplanation
The normal position of the uterus is anteverted (i.e., angle of 90 degrees at
the junction of the vagina and cervical canal) and anteflexed (i.e., angle of 160 to 170 degrees at
the junction of the cervix and body).Rate this question:
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- 22.
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
Correct Answer
B. Drains into the prostatic venous plexusExplanation
The deep dorsal vein of the penis lies medial to the dorsal artery of the penis
on the dorsum of the penis and superficial to Buck's fascia, drains into the prostatic plexus of
veins, and is compressed against the underlying deep fascia of the penis during erection.Rate this question:
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- 23.
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
Correct Answer
E. Pelvic splanchnic nerveExplanation
The pelvic splanchnic nerve contains preganglionic parasympathetic fibers,
whereas the sacral splanchnic nerve contains preganglionic sympathetic fibers. Parasympathetic
fibers are responsible for erection, whereas sympathetic fibers are involved with ejaculation. The
right and left hypogastric nerves contain primarily sympathetic fibers and visceral sensory fibers.
The dorsal nerve of the penis and the perineal nerve provide sensory nerve fibers.Rate this question:
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- 24.
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
Correct Answer
D. OvaryExplanation
The lymphatic vessels from the ovary ascend with the ovarian vessels in
the suspensory ligament and terminate in the lumbar (aortic) nodes. Lymphatic vessels from the
perineum, external genitalia, and lower part of the anterior abdominal wall drain into the superficial
inguinal nodes.Rate this question:
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- 25.
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
Correct Answer
D. Inferior rectal nerveExplanation
The ischiorectal fossa contains the inferior rectal nerves and vessels arid
adipose tissue. The bulb of the vestibule and the great vestibular gland are located in the superficial
perineal space, whereas the bulbourethral gland is found in the deep perineal space. The internal
pudendal artery runs in the pudendal canal, but its branches pass through the superficial
and deep perineal spaces.Rate this question:
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- 26.
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
Correct Answer
A. The dorsal artery of the penis supplies the glans penisExplanation
The dorsal artery of the penis supplies the glans penis. The seminal vesicles
store no spermatozoa. The duct of the bulbourethral gland opens into the bulbous portion of the
spongy urethra, whereas the greater vestibular gland opens into the vestibule between the labium
minora and the hymen. The anterior lobe of the prostate is devoid of glandular substance, the
middle lobe is prone to benign hypertrophy, and the posterior lobe is prone to carcinomatous
transformation.Rate this question:
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- 27.
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
Correct Answer
A. Levator aniExplanation
The pelvic diaphragm, particularly the levator ani, provides the most important
support for the uterus, although the urogenital diaphragm and the uterosacral and ovarian
ligaments support the uterus. The arcuate pubic ligament arches across the inferior aspect of
the pubic symphysis.Rate this question:
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- 28.
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
Correct Answer
A. ScrotumExplanation
Extravasated urine from the penile urethra below the perineal membrane
spreads into the superficial perineal space, scrotum, penis, and anterior abdominal wall. However,
it does not spread into the testis, ischiorectal fossa, pelvic cavity, and thigh because Scarpa's fascia
ends by firm attachment to the fascia lata of the thigh.Rate this question:
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- 29.
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
Correct Answer
E. Uterine cervixExplanation
In addition to the uterine cervix, the uterus, uterine tubes, ovaries, and
ureters can be palpated. The apex of the urinary bladder is the anterior end of the bladder; thus,
it cannot be palpated. The fundus of the uterus is anterosuperior part of the uterus. The terminal
part of the round ligament of the uterus emerges from the superficial inguinal ring and becomes
lost in the subcutaneous tissue of the labium majus.Rate this question:
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- 30.
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
Correct Answer
D. Uterine tubeExplanation
The uterine tubes lie in the broad ligament. The anterior surface of the
ovary is attached to the posterior surface of the broad ligament of the uterus. The ureter
descends retroperitoneally on the lateral pelvic wall but is crossed by the uterine artery in the
base (in the inferomedial part) of the broad ligament. The terminal part of the round ligament
of the uterus becomes lost in the subcutaneous tissue of the labium majus. The suspensory ligament
of the ovary is a band of peritoneum that extends superiorly from the ovary to the
pelvic wallRate this question:
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- 31.
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
Correct Answer
A. Prostate glandExplanation
The prostate gland may be palpated on rectal examination. The ejaculatory
duct runs within the prostate gland and cannot be felt. In the male, the pelvic part of the ureter
lies lateral to the ductus deferens and enters the posterosuperior angle of the bladder, where it is
situated anterior to the upper end of the seminal vesicle, and thus cannot be palpated during rectal
examination. However, in the female the ureter can be palpated during vaginal examination
because it runs near the uterine cervix and the lateral fornix of the vagina to enter the posterosuperior
angle of the bladder. The testis are examined during a routine annual check-up but obviously
not during a rectal examination.Rate this question:
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- 32.
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
Correct Answer
B. Pelvic splanchnic nerveExplanation
Parasympathetic preganglionic fibers in the pelvic splanchnic nerve are responsible
for erection of the penis. Sympathetic preganglionic fibers in the sacral splanchnic
nerve are responsible for ejaculation. The pudendal nerve supplies the external anal sphincter and
perineal muscles and supplies general somatic afferent (GSA) fibers to the perineal region. The
dorsal nerve of the penis is a terminal branch of the pudendal nerve and supplies sensation of the
penis. The posterior scrotal nerves are superficial branches of the perineal nerve and supply sensory
fibers to the scrotum.Rate this question:
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- 33.
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
Correct Answer
A. Promontory of the sacrumExplanation
The pelvic inlet (pelvic brim) is bounded by the promontory and the anterior
border of the ala of the sacrum, the arcuate line of the ilium, the pectineal line, the pubic
crest, and the superior margin of the pubic symphysis.Rate this question:
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- 34.
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
Correct Answer
B. Iliohypogastric nerveExplanation
The iliohypogastric nerve innervates the skin above the pubis. The skin of
the urogenital triangle is innervated by the pudendal nerve, perineal branches of the posterior
femoral cutaneous nerve, anterior scrotal or labial branches of the ilioinguinal nerve, and the genital
branch of the genitofemoral nerve.Rate this question:
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