a) Inferior hemorrhoidal artery.
b) Pudendal artery.
c) Ilioinguinal artery.
d) Femoral artery.
Correct Answer: b) Pudendal artery. Blood supply to the external genitalia is mainly from the pudendal artery. The lateral aspects of the external genitalia receive their blood supply from the external pudendal artery, a branch of the femoral artery. The mons pubis is supplied by the inferior epigastric artery, a branch of the external iliac artery.
a) Iliosacral ligaments
b) Pyriformis muscle
c) Transverse cervical ligaments
d) Infundibular ligaments
e) Uterosacral ligaments
Correct Answer: c and e. The principle supports of the uterus are the transverse cervical ligaments (cardinal ligaments) and uterosacral ligaments. The infundibulopelvic ligament is a fold of peritoneum that extends out from the ovary to the wall of the pelvis.
a) The corresponding vein
b) The ovarian vessels
c) The genital branch of the genital femoral nerve
d) The round ligament
e) The ureter
Correct Answer: a) The corresponding vein is FALSE. Both external iliac veins are accompanied along their course by external iliac arteries. Posteriorly, the artery comes in relation with its vein in the upper portion of its course. In the lower part of its course the vein lies medial to it.
a) Is a branch of the anterior division of the internal iliac artery
b) Runs in front of the ureter
c) Gives a branch to the vagina
d) May anastomose with the obturator artery
e) Divides into arcuate arteries
Correct Answer: d) May anastomose with the obturator artery is FALSE. it anastomoses with the tubal branches of ovarian artery.
a) Arise just above the renal artery
b) Are crossed by the ureters
c) On the right cross the inferior vena cava
d) On the left cross the left colic artery
e) Reach the ovary through the ovarian ligament
Correct Answer: c) On the right cross the inferior vena cava. Corrected FALSE statements: a) Arise just below the renal artery
b) Ureters crosses ovarian vessels
d) On the left does not cross the left colic artery
e) After emerging from the aorta, the artery travels down the infundibulopelvic ligament (suspensory ligament of the ovary), enters the mesovarium, and may anastamose with the uterine artery in the broad ligament.
c) Nabothain cyst.
d) Cervical hood.
e) Gartner's duct cyst.
Correct Answer: a) Polyp. These are the most common benign neoplasms of the cervix (found in 4% of the gynaecological population). These may be endocervical or cervical.
a) Internal pudendal nerve, perineal nerve, dorsal clitoral nerve
b) Mid rectal nerve, dostal clitoral nerve, perineal nerve
c) Perineal nerve and posterior clitoral nerve
d) Perineal nerve, dorsal clitoral nerve, inferior rectal nerve
e) Perineal nerve, inferior clitoral nerve, mid rectal nerve
Correct Answer: d) Perineal nerve, dorsal clitoral nerve and inferior rectal nerve. These are the three important branches of the pudendal nerve.
The pelvic diaphragm is composed of all of the following muscles EXCEPT
c) Transversus perinei
Correct Answer: c) Transversus perinei.
The muscles of the pelic diaphragm primarily provide pelvic support. These muscles form a basin or covering of the pelvic outlet and are often grouped together as the levator ani. The most medial portion of the pelvic diaphragm is formed by the puborectalis. Forming the bulk of the pelvic diaphragm, the Pubococcygeus and Iliococcygeus muscles cover the posterior and lateral portion of the pelvic outlet. Transversus perinea muscle is the part of urogenital diaphragm.
a) Urethra lies anterior to the upper third of the vagina
b) Urethra lies anterior to the lower third of the vagina
c) Bladder when empty lies below and anterior to the uterine body
d) Bladder when empty lies parallel and anterior to uterine body
e) Rectum lies posterior to the body of the uterus
Correct Answer: b,c,e. The urethra is only 3.5 cm long and is anterior to the lower third of the vagina. The bladder when empty lies below the uterovesical fold which arises from the junction between the uterine body and the cervix.
20-year-old woman presents with Bartholin’s abscess. Which one of the following glands is involved?
a) Bulbourethral glands (Cowper’s)
b) Glands of skini
c) Greater vestibular gland
d) Lesser vestibular gland
e) Seminal vescicle
Correct Answer: c) Greater vestibular (Bartholin’s) gland. These are small paired glands located in the superficial perineal pouch. They are partially covered by posterior portions of the bulb of the vestibule and the bulbospongiousus muscles. The duct opens into the vestibule between the hymen and the labium minus. These glands provide lubrication at the introitus. Bartholin’s abscess may occur due to infection and blockage of these glands.
a) Inferior vesical
b) Internal iliac
Correct Answer: c) Ovarian. The ovarian artery is a branch of the aorta. It arises anterolaterally just below the renal artery, running retroperitoneally to leave the abdomen by crossing the common or external iliac artery in the infundibulopelvic fold. It crosses corresponding ureters and supplies twigs to it but does not supply to abdominal organs. The internal iliac artery arises from the common iliac and its inferior branch further supplies to the pelvis.
a) Common iliac nodes
b) External iliac and superficial iliac nodes via the round ligament
c) External iliac nodes
d) Internal iliac nodes
e) Lateral aortic and preaortic nodes
Correct Answer: e) Lateral aortic and pre-aortic nodes. It is useful to remember the following: the bladder drains to the external iliac nodes; the urethra drains to the internal iliac nodes; the fallopian tubes and fundus uteri drain to the external iliac and superficial iliac nodes via the round ligament; and the cervix drains to the external and internal iliac, rectal and sacral nodes and occasionally obturator nodes.
a) The fallopian tube
b) The ureter
c) The uterine artery
d) The ovarian artery
e) The superior vesical artery
Correct Answer:a and c.The broad ligament is made of two layers of peritoneum that covers the fallopian tube, round ligament, and down the sides of the uterus to the cervix.
The ureter, superior vesical artery and the ovarian artery are all retroperitoneal.
The uterine artery runs between the leaves of the broad ligament along the lateral wall of the uterus. It also contains ovarian ligament and round ligament.
a) Labia Minora
c) Posterior Fornix of Vagina
d) Urethral Sphincter
Correct Answer: c) Posterior Fornix of Vagina. The pudendal nerve is a mixed motor and sensory nerve, and does not carry parasympathetic fibres. The nerve has 3 branches: the clitoral, perineal, and inferior hemorrhoidal. It supplies:
2) Bulbospongiosus, Ischiocavernosus muscles and Transeversus perinei muscles. Also to the skin of the inner portions of labia majora, labia minora and vestibule. The external urethral sphincter is controlled by the deep perineal branch of the pudendal nerve.
3) External anal sphincter and perineal skin.
upper vagina - parasympathetic fibres from pelvic splanchnic nerves (S2-S4)
lower 2-3cm vagina - pudendal nerve
a) Junction of urethra and bladder
b) Junction of cervix and vagina
c) Lower limit of rectum
d) Upper limit of bladder
Correct Answer: a) Junction of urethra and bladder. On inspection of vagina, 3 grooves can be distinguished in the anterior vaginal wall : 1) Submeatal sulcus, 2) Transverse vaginal sulcus corresponds to the upper border of posturethral ligament and 3) Bladder sulcus. Bladder sulcus indicates the upper limit of the relation of the bladder to the anterior vaginal wall.
a) Pudendal nerve/ vessels
b) Sciatic nerve
c) Hypogastric venous plexus
d) Inferior gluteal vessels
Correct Answer: a) Pudendal nerve/ vessels. The sciatic nerve lies superior and lateral to the sacrospinous ligament. Superior to the ligament lies the inferior gluteal vessels and the hypogastric venous plexus.The pudendal nerve passes between the piriformis muscle and ischiococcygeus muscles and leaves the pelvis through the lower part of the greater sciatic foramen. It then enters the gluteal region, crossing over the sacrospinous ligament near to where it attaches to the ischial spine. Re-entering the pelvis through the lesser sciatic foramen, it accompanies the internal pudendal vessels upwards and forwards along the lateral wall of the ischiorectal fossa, being contained in a sheath of the obturator fascia termed the pudendal canal (Alcock's canal), along with the internal pudendal blood vessels.
d) Labia majora
e) Broad ligament
Correct Answer: b) Vagina
A Gartner's duct cyst is a benign vaginal cystic lesion that arises from the vestigial remnant of a mesonephric duct or Gartner's duct. They are typically small asymptomatic cysts that occur along the lateral walls of the vagina, following the course of the duct. They can, however, enlarge to substantial proportions and be mistaken for urethral diverticulum or other structures.
Which of the following structures is at risk for injury during a McCall's culdoplasty?
a) Sciatic nerve
c) Internal iliac vein
d) Pudendal nerve
e) Urinary bladder
Correct Answer: b) Rectum. Most common complication of McCall's culdoplasty is laceration of bowel or rectum as perirectal fascia is incorporated into the sutures.
a) Common iliac nodes
b) External iliac nodes
c) Internal iliac nodes
d) Superficial inguinal nodes
e) Para-aortic nodes
Correct Answer: d) superficial inguinal nodes. Remember the embryological difference between the lower one-third of the vagina and the upper two-thirds. The upper part is derived from the fused mesonephric ducts, and the lower one-third from canalisation of the ectodermal thickening. The upper two-thirds of the vagina drain to the internal and external nodes.
Following sentences: True or False.
1) Intact nerve supply is essential to initiate normal labour.
2) Normal labor occurs in patients with a transected spinal cord.
Correct Answer: 1) False, 2) True. Uterine contractions are involuntary and for the most part, indepependent of extrauterine control. Myometrial contractions in paraplegic women are normal, though painless, as in women with bilateral lumbar sympathectomy.
a) Broad ligament
b) Inguinal ligament
c) Ischiorectal fossa
d) Round ligament
e) Urogenital diaphragm
Correct Answer: d) Round ligament. The round ligament arises from the body of the uterus antero inferior to the cornue. It passes through the layers of broad ligaments across the psoas and external iliac vessels. It then passes through the deep inguinal ring and the inguinal canal to the labium majus. In the fetus, the round ligament is surrounded by a peritoneum, processus vaginalis, which is obliterated at birth but may remain patent as the canal of Nuck.
A urinary catheter is vigorously inflated in the urethra at the time of cesarean section. Urine leaks from the rupture into which anatomical space?
a) Into the anterior abdominal wall and mons pubis
b) Into the lesser pelvis
c) Into the peritoneal cavity
d) Into the vagina
e) Laterally to the femoral triangles
Correct Answer: a) Into the anterior abdominal wall and mons pubis. This is the only route possible due to the anatomy of the urethra.
"Authored By Dr.Niraj Mahajan"
MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.Read more [+]