Block 7 Anat Pelv & Perineum Prt 3
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The pelvis is charged with allowing movement of the body. It contains the reproductive organs, bladder as well as the rectum. Keep increasing your understanding on block 7 on anatomy of pelvis and perineum by taking the third quiz in the series. All the best as you prepare for the assessment test!
- 1.
A pregnant patient seeks your counsel pertaining to anesthesia during delivery. She is particularly interested in a caudal epidural block. You explain that this procedure:
- A.
Eliminates all pain associated with labor and delivery
- B.
Just minimizes the pain sensations that arise from the lower part of the birth canal (cervix and vagina) and the perineum.
- C.
Just minimizes the pain sensations that arise from the body and fundus of the uterus
- D.
Just minimizes the pain associated with fibers traveling in the pudendal nerve.
- E.
Is typically not used for delivery, but rather for an episiotomy.
Correct Answer
B. Just minimizes the pain sensations that arise from the lower part of the birth canal (cervix and vagina) and the perineum.Explanation
The correct answer is "just minimizes the pain sensations that arise from the lower part of the birth canal (cervix and vagina) and the perineum." This is because a caudal epidural block is a type of anesthesia that specifically targets the lower part of the birth canal, providing pain relief in that area during labor and delivery. It does not eliminate all pain associated with labor and delivery, nor does it minimize pain sensations in other areas of the body or the pudendal nerve. It is also not typically used for an episiotomy.Rate this question:
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- 2.
Which of the following is incorrect pertaining to the uterine tubes?Which of the following is incorrect pertaining to the uterine tubes?
- A.
They lie in the mesosalpinx part of the broad ligament.
- B.
They allow the development of peritonitis from genitourinary tract infections.
- C.
They may be ligated to prevent pregnancy
- D.
They may become the site of an ectopic pregnancy.
- E.
Their distal part, the ampulla, surrounds the ovary.
Correct Answer
E. Their distal part, the ampulla, surrounds the ovary.Explanation
The uterine tubes do not surround the ovary, rather the distal part of the uterine tube, known as the ampulla, is located near but does not surround the ovary. The ampulla is the site where fertilization typically occurs.Rate this question:
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- 3.
In the following hysterosalpingogram, the arrows indicate the:
- A.
Uterine arteries.
- B.
Uterine tubes.
- C.
Mesovarium.
- D.
Round ligaments.
- E.
Ureters
Correct Answer
B. Uterine tubes.Explanation
The hysterosalpingogram is a radiographic procedure used to evaluate the uterus and fallopian tubes. The arrows in the image indicate the direction of contrast dye flowing through the reproductive system. Since the fallopian tubes are the structures that connect the uterus to the ovaries and are responsible for transporting the egg from the ovary to the uterus, it is logical to conclude that the arrows indicate the uterine tubes.Rate this question:
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- 4.
The anorectal flexure of the anal canal:
- A.
Occurs at the level of S3.
- B.
Is maintained by the transverse rectal folds
- C.
Is where the alimentary tract penetrates the pelvic diaphragm.
- D.
Is within the rectovesical pouch.
- E.
Is where the omental appendices cease.
Correct Answer
C. Is where the alimentary tract penetrates the pelvic diapHragm.Explanation
The correct answer is "is where the alimentary tract penetrates the pelvic diaphragm." The anorectal flexure is the point where the rectum transitions into the anal canal and passes through the pelvic diaphragm. This flexure allows for the storage of feces in the rectum before defecation. The other options provided are incorrect as they do not accurately describe the location or function of the anorectal flexure.Rate this question:
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- 5.
Which of the following is incorrect pertaining to the perineal body?
- A.
Stretching or tearing during parturition is associated with prolapse of pelvic viscera.
- B.
It is an attachment site for the external anal sphincter.
- C.
It is an attachment site for both the superficial and deep transverse perineal muscles
- D.
It lies anterior to the vestibule in females.
- E.
It blends anteriorly with the perineal membrane.
Correct Answer
D. It lies anterior to the vestibule in females.Explanation
The perineal body is a fibromuscular structure located between the anus and the posterior part of the vagina in females. It serves as an attachment site for various muscles, including the external anal sphincter and the superficial and deep transverse perineal muscles. It also blends anteriorly with the perineal membrane. However, it does not lie anterior to the vestibule in females. The vestibule is a space located between the labia minora, and the perineal body is situated posterior to it.Rate this question:
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- 6.
In the emergency room you examine a young boy whose was injured while trying to climb a fence. He says he hit his "bottom" hard while straddling the horizontal bar at the top of the fence. Your examination reveals that his penis and scrotum are edematous as is the lower part of his anterior abdominal wall. Only the most superior aspects of his thighs are also edematous. You suspect the boy:
- A.
Ruptured his corpus cavernosa and the swelling is due to blood.
- B.
Bruised his penis and scrotum and the swelling is due to lymph.
- C.
Ruptured his spongy urethra and the swelling is due to urine
- D.
Ruptured his internal pudendal vein and the swelling is due to blood.
- E.
Ruptured his deep perineal pouch and the swelling is due to an inflammatory reaction resulting from the release of fluid from the bulbourethral glands.
Correct Answer
C. Ruptured his spongy urethra and the swelling is due to urineExplanation
The correct answer is that the boy has ruptured his spongy urethra and the swelling is due to urine. This can be inferred from the symptoms described, such as the edema in the penis and scrotum, as well as the lower part of the anterior abdominal wall. The fact that only the most superior aspects of his thighs are also edematous suggests that the swelling is localized to the area around the urethra. The rupture of the spongy urethra would lead to urine escaping into the surrounding tissues, causing the edema.Rate this question:
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- 7.
In the following image of a coronal section through the rectum and anal canal, the arrow indicates:
- A.
The pudendal canal.
- B.
The superficial perineal space.
- C.
The deep perineal space
- D.
The ischioanal fossa.
- E.
An ischioanal fistula.
Correct Answer
D. The ischioanal fossa.Explanation
The arrow in the image is indicating the ischioanal fossa. The ischioanal fossa is a space located on either side of the anal canal, between the pelvic diaphragm and the skin of the anal region. It is filled with fat and contains important structures such as the pudendal nerve and vessels. The other options mentioned in the question, such as the pudendal canal, superficial perineal space, deep perineal space, and ischioanal fistula, are not correctly identified by the arrow in the image.Rate this question:
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- 8.
The superficial and deep perineal pouches are separated superiorly by the:
- A.
Deep transverse perineal muscles
- B.
Superficial transverse perineal muscles
- C.
Perineal membrane
- D.
Deep perineal fascia (investing or Gallaudet fascia).
- E.
Membranous layer of the subcutaneous tissue of the perineum.
Correct Answer
C. Perineal membraneExplanation
The superficial and deep perineal pouches are separated superiorly by the perineal membrane. This membrane is a strong, fibrous sheet that extends between the ischiopubic rami and acts as a barrier between the two pouches. It provides structural support to the perineum and helps maintain the integrity of the pelvic floor.Rate this question:
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- 9.
According to current concepts, the external urethral sphincter:
- A.
Is similar in males and females.
- B.
Only exists in females.
- C.
Only exists in males.
- D.
Is innervated by pelvic splanchnic nerves.
- E.
Has an inferior part in males that acts as a true sphincter of the intermediate (membranous) urethra.
Correct Answer
E. Has an inferior part in males that acts as a true spHincter of the intermediate (membranous) urethra.Explanation
The external urethral sphincter has an inferior part in males that acts as a true sphincter of the intermediate (membranous) urethra. This means that it is only present in males and not in females. It is innervated by pelvic splanchnic nerves.Rate this question:
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- 10.
Which of the following is incorrect pertaining to the ischioanal fossa?
- A.
The anococcygeal ligament prevents the spread of infection from one fossa to the other.
- B.
Each fossa is bounded medially by the external anal sphincter.
- C.
Each fossa is traversed by the inferior anal vessels and nerves.
- D.
Tenderness between the anus and ischial tuberosity is a diagnostic sign associated with an ischioanal abscess.
- E.
Loss of the fat within each fossa (occurs with extreme starvation) is associated with rectal prolapse.
Correct Answer
A. The anococcygeal ligament prevents the spread of infection from one fossa to the other.Explanation
The anococcygeal ligament does not prevent the spread of infection from one ischioanal fossa to the other. Instead, each fossa is separated by a midline septum called the anococcygeal raphe, which prevents the spread of infection.Rate this question:
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- 11.
The pectinate line of the anal canal:
- A.
Denotes the separation of the external and internal sphincter ani muscles.
- B.
Denotes the separation between the rectal and anal mucosa.
- C.
Separates the part of the anal canal that is sensitive to laceration from the part that is not.
- D.
Separates the part of the anal canal that is innervated by sympathetic fibers from that innervated by parasympathetic fibers.
- E.
Indicates the anorectal junction.
Correct Answer
C. Separates the part of the anal canal that is sensitive to laceration from the part that is not.Explanation
The pectinate line of the anal canal separates the part of the anal canal that is sensitive to laceration from the part that is not. This means that above the pectinate line, the anal canal is lined with columnar epithelium and is not sensitive to pain or laceration. Below the pectinate line, the anal canal is lined with stratified squamous epithelium and is sensitive to pain and laceration. This distinction is important for understanding the different types of hemorrhoids that can occur in the anal canal.Rate this question:
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- 12.
Hemorrhoids are:
- A.
Enlarged anal lymph nodes
- B.
Infected anal sinuses
- C.
Varicosities in rectal/anal veins.
- D.
Infected and enlarged anal mucus glands.
- E.
Arteriovenous malformations in the anal mucosa.
Correct Answer
C. Varicosities in rectal/anal veins.Explanation
Hemorrhoids are varicosities in the rectal/anal veins. Varicosities refer to the abnormal enlargement and swelling of the veins, which can occur in various parts of the body including the rectal and anal area. Hemorrhoids are commonly caused by increased pressure on the veins, such as straining during bowel movements or pregnancy. They can cause discomfort, itching, bleeding, and pain. Treatment options include lifestyle changes, over-the-counter creams or ointments, and in severe cases, surgical removal.Rate this question:
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- 13.
In the following coronal MRI of the penis and scrotum from a normal male, the arrow indicates the:
- A.
Corpus spongiosum
- B.
Corpus cavernosum.
- C.
Pampiniform venous plexus.
- D.
Vas deferens.
- E.
Testis
Correct Answer
B. Corpus cavernosum.Explanation
The arrow in the coronal MRI of the penis and scrotum is pointing to the corpus cavernosum. The corpus cavernosum is one of the two cylindrical structures that run along the length of the penis and are responsible for erectile function. It is filled with spongy tissue and surrounded by a fibrous sheath. The corpus cavernosum becomes engorged with blood during sexual arousal, leading to an erection. This structure is important for maintaining sexual function in males.Rate this question:
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- 14.
In male urethral catheterization:
- A.
The diameter of the urethra at the external urethral orifice is narrower than at any other point.
- B.
The urethra is least protected (most likely to rupture) at the bulb.
- C.
The intermediate (membranous) segment is the most distensible part of the urethra.
- D.
The location of the ducts of the bulbourethral glands must be identified in order to avoid injuring the glands.
- E.
The patient is likely to feel the most discomfort (sharpest pain) when the catheter penetrates the prostatic urethra.
Correct Answer
A. The diameter of the urethra at the external urethral orifice is narrower than at any other point.Explanation
The correct answer is that the diameter of the urethra at the external urethral orifice is narrower than at any other point. This is because the external urethral orifice is the opening of the urethra, and it needs to be narrow in order to prevent urine leakage. As the urethra extends further into the body, it gradually widens to allow for the passage of urine.Rate this question:
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- 15.
The blood that results in penile erection is primarily derived from the:
- A.
Posterior scrotal arteries.
- B.
Deep arteries of the penis.
- C.
Deep branches of the external pudendal arteries.
- D.
Deep dorsal vein.
- E.
Superficial dorsal veins.
Correct Answer
B. Deep arteries of the penis.Explanation
The deep arteries of the penis are responsible for supplying blood to the erectile tissues in the penis, which results in penile erection. These arteries are located deep within the penis and are responsible for the increased blood flow that occurs during sexual arousal. The other options, such as the posterior scrotal arteries, deep branches of the external pudendal arteries, deep dorsal vein, and superficial dorsal veins, are not directly involved in the process of penile erection.Rate this question:
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- 16.
Circumcision involves:
- A.
Removal of the glans of the penis.
- B.
Removal of the prepuce of the penis.
- C.
Removal of the corona of the glans of the penis.
- D.
Enlarging the external urethral orifice
- E.
Surgically constructing a new external urethral orifice
Correct Answer
B. Removal of the prepuce of the penis.Explanation
The correct answer is "removal of the prepuce of the penis." Circumcision is a surgical procedure that involves the removal of the prepuce, which is the fold of skin that covers the glans of the penis. This procedure is commonly practiced for cultural, religious, or medical reasons. It is important to note that circumcision does not involve the removal of the glans, the corona of the glans, or the construction of a new external urethral orifice.Rate this question:
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- 17.
Which of the following is not associated with male erection or ejaculation?
- A.
Closure of the vesical (internal urethral) sphincter.
- B.
Contraction of urethral smooth musculature.
- C.
Contraction of bulbospongiosus.
- D.
Parasympathetic impulses reaching the penis from the prostatic nervous plexus.
- E.
Contraction of the smooth muscle of the helical arteries.
Correct Answer
E. Contraction of the smooth muscle of the helical arteries.Explanation
The smooth muscle of the helical arteries is responsible for maintaining blood flow to the penis during an erection. When this smooth muscle contracts, it restricts blood flow and causes the erection to subside. Therefore, contraction of the smooth muscle of the helical arteries is not associated with male erection or ejaculation.Rate this question:
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- 18.
Which of the following is incorrect pertaining to the female perineum?
- A.
The greater vestibular glands are typically palpable.
- B.
The bulbs of the vestibule are composed of erectile tissue.
- C.
Located immediately within the vaginal orifice, the hymen is a thin fold of mucous membrane that ruptures in young women with physical activity or sexual intercourse.
- D.
The vestibule is the space enclosed by the labia minora.
- E.
The mons pubis is composed of skin covering fatty tissue.
Correct Answer
A. The greater vestibular glands are typically palpable.Explanation
The greater vestibular glands are actually typically not palpable. These glands, also known as Bartholin's glands, are located on either side of the vaginal opening and are responsible for producing lubrication during sexual arousal. While they can become palpable if they become enlarged or infected, in their normal state they are not typically felt during a physical examination.Rate this question:
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.JPG "In the following image of a coronal section through the rectum and anal canal, the arrow indicates:")
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