1.

The following statements concerning the uterus are correct except:

a) The fundus is part of the uterus above the openings of uterine tubes

b) The long axis of the uterus is usually bent anteriorly on the

long axis of the vagina (anteversion)

c) The nerve supply of the uterus is from the inferior hypogastric plexuses

d) The anterior surface of the cervix is completely covered with peritoneum

e) The uterine veins drain into the internal iliac veins

2. Concerning the vas deferens, all of the following statements are true except:

a) It emerges from the deep inguinal ring and passes around the lateral

margin of the inferior epigastric artery

b) It crosses the ureter in the region of the ischial spine

c) The terminal part is dilated to form the ampulla

d) It lies on the posterior surface of the prostate but is separated from it by

peritoneum

e) It joins the duct of the seminal vesicle to form the ejaculatory duct

3. Concerning the pelvic part of the ureter, the following statements are true

except:

a) It enters the pelvis in front of the bifurication of the common iliac arteries

b) The ureter enters the bladder by passing directly through its wall, there

being no valvular mechanism at its entrance

c) It has a close relationship to the ischial spine before it turns medially toward

the bladder

d) The blood supply of the distal part of the ureter is from the superior vesical

artery

e) It enters the bladder at the upper lateral angle of the trigone

4. Concerning the seminal vesicle, the following statements are true except:

a) The seminal vesicles are related posteriorly to the rectum and can be

palpated through the rectal wall

 b) The seminal vesicles are two lobulated organs that store spermatozoa

c) The upper ends of the seminal vesicles are covered by peritoneum

d) The function of the seminal vesicles is to produce a secretion that is added

to the seminal fluid

e) The seminal vesicles are related anteriorly to the bladder, and no

peritoneum separates these structures

5. Concerning the ovary, the following statements are true except:

a) The lymph drainage is into the para-aortic (lumbar) lymph nodes at the

level of the first lumbar vertebra

b) The round ligament of the ovary extends from the ovary to the upper end of

the lateral wall of the body of the uterus

c) The ovarian fossa is bounded above by the external iliac vessels and behind

by the internal iliac vessels

d) The left ovarian artery is a branch of the left internal iliac artery

e) The obturator nerve lies lateral to the ovary

. Concerning the nerve supply to the urinary bladder, the following statements

are true except:

a) The sympathetic postganglionic fibers originate in the first and second

lumbar ganglia

b) The parasympathetic postganglionic fibers originate in the inferior

hypogastric plexuses

c) The afferent sensory fibers arising in the bladder wall reach the spinal cord

via the pelvic splanchnic nerves and also travel with the sympathetic nerves

d) The parasympathetic preganglionic fibers arise from the second, third and

fourth sacral segments of the spinal cord

e) The parasympathetic postganglionic fibers are responsible for closing the

vesical sphincter during ejaculation

7. Concerning the vagina, the following statements are true except:

a) The area of the vaginal lumen around the cervix is divided into four fornices
 b) The upper part of the vagina is supported by the levator ani muscles and

transverse cervical ligaments

c) The perineal body lies posterior to and supports the lower part of the vagina

d) The upper part of the vagina is not covered with peritoneum

e) The vaginal wall receives a branch of the uterine artery

8. Concerning the visceral layer of pelvic fascia in the female, the following

statements are true except:

a) In the region of the cervix of the uterus, it is called the parametrium

b) It is condensed to form the pubocervical, transverse cervical, and

sacrocervical ligaments of the uterus

Uc)U It covers the obturator internus muscle

d) It does not become continuous above with the fascia transversalis

e) On the lateral wall of the pelvis, it fuses with the parietal layer of the pelvic

fascia

9. The following statements concerning the lymphatic drainage of pelvic

structures are correct except:

a) Lymph from the cervix of the uterus drains into the internal and external

iliac lymph nodes

b) Lymph from the prostate drains into the external iliac lymph

nodes

c) Lymph from the posterior fornix of the vagina drains into the internal and

external iliac lymph nodes

d) Lymph from the trigone of the bladder drains into the internal and external

iliac lymph nodes

e) Lymph from the fundus of the uterus drains into the para-aortic lymph

nodes at the level of the first lumbar vertebrae

10. The following statements concerning the main venous drainage of pelvic

structures are true except:

 a) The venous blood from the left ovary drains into the inferior vena

cava

b) The venous blood from the prostate drains into the interal iliac veins

c) The venous blood from the urinary bladder drains into the internal iliac

veins

d) The venous blood from the mucous membrane of the rectum drains into the

superior rectal vein

e) The venous drainage of the seminal vesicles drains into the internal iliac

veins

11. The following statements concerning the female urethra are true except:

a) It lies immediately anterior to the vagina

b) Its external orifice lies about 2 in. (5 cm) from the clitoris

c) It is about 1.5in (3.75 cm) long

d) It pierces the urogenital diaphragm

e) It is straight, and only minor resistance is felt as a catheter is passed through

the urethtral sphincter

12. The following structures can be palpated by a vaginal examination except:

a) Sigmoid colon

b) Ureters

c) Perineal body

d) Ischial spines

e) Iliopectineal line

13. The following statements concerning the ischiorectal fossa are true except:

a) The pudendal nerve lies in its lateral wall

b) The floor is formed by the superficial fascia and skin

c) The lateral wall is formed by the obturator internus muscle and its fascia

d) The medial wall is formed in part by the levator ani muscle

e) The roof is formed by the urogenital diaphragm

14. The following statements concerning the penis are true except:

a) Its root is formed in the midline by the bulb of the penis which continues

anteriorly as the corpus spongiosum

b) Its roots laterally are formed by the crura, which continue anteriorly as the

corpora cavernosa

c) The penile urethra lies within the corpus spongiosum

d) The glans penis is a distal expansion of the fused corpora cavernosa

e) The penis is suspended from the lower part of the anterior abdominal wall

by two condensations of deep fascia

15. The following statements concerning the perineal structures are correct

except:

a) The anorectal ring is formed by the subcutaneous, superficial and deep

fibers of the external sphincter

b) The urogenital diaphragm is attached laterally to the inferior ramus of the

pubis and the ischial ramus

c) The bulbourethral glands are situated in the deep perineal pouch

d) The anococcygeal body is rarely damaged in child birth

e) The lymph drainage of the skin around the anus is into the medial group of

superficial inguinal nodes

16. The urogenital diaphragm is formed by the following structures except:

a) Deep transverse perineal muscle

b) Perineal membrane

c) Sphincter urethrae

d) Colles' fascia (membranous layer of superficial fascia)

e) Parietal pelvic fascia covering the upper surface of the sphincter urethrae

muscle
17. In the male, the following structures can be palpated on rectal examination

except:

a) Bulb of the penis

b) Urogenital diaphragm

c) Anorectal ring

d) The anterior surface of the rectum

e) Ureter

18. The following statements concerning the anal canal are true except:

a) It is about 1.5 in (3.8 cm) long

b) It pierces the urogenital diaphragm

c) It is related laterally to the external anal sphincter

d) It is the site of an important portal-systemic anastomosis

e) The mucous membrane of the lower half receives its arterial supply from

the inferior rectal artery

19. The following statements concerning the subcutaneous part of the external

anal sphincter are correct except:

a) It encircles the anal canal

b) It is not attached to the anococcygeal

c) It is composed f striated muscle fibers

d) It is not responsible for causing the anal canal and the rectum to join at an

acute angle

e) It is innervated by the middle rectal nerve

20. The following statements concerning the defecation are true except:

a) The act is often preceded by the entrance of the feces into the rectum, which

gives rise to the desire to defecate

b) The muscles of the anterior abdominal wall contract

c) The external anal sphincters and the puborectalis relax

d) The internal sphincter contracts and causes the evacuation of the feces
 e) The mucous membrane of the lower part of the anal canal is extruded

through the anus ahead of the fecal mass

21. The process of ejaculation depends on the following processes except:

a) The sphincter of the bladder contracts

b) The sympathetic preganglionic nerve fibers arising from the first and

second lumbar segments of the spinal cord must be intact

c) The smooth muscle of the epididymis, ductus (vas) deferens, seminal

vesicles and prostate contracts

d) The bulbourethral glands and the urethral glands are active

e) The bulbospngiosus muscles relax

22. The following structures receive innervation from the branches of the

pudendal nerve except:

a) Labia minora

b) Urethral sphincter

c) The posterior fornix of the vagina

d) Ischiocavernosus muscles

e) Skin of the penis or clitoris

23. The following structures are closely related to the rectouterine pouch (pouch

of Douglas) except:

a) Anteriorly is situated in the posterior surface of the upper part of the vagina

b) Posteriorly is situated the upper part of the rectum

c) The trigone of the bladder is directly related to its anterior wall

d) Anteriorly is situated in the posterior surface of the body of the uterus

e) Laterally is situated in the sacrocervical ligaments passing forward to the

cervix

24. Support for the uterus either directly or indirectly, is provided by the

following structures except:

 a) The perineal body

b) The mesosalpinx

c) The transverse cervical (cardinal) ligaments

d) The levator ani muscles

e) The pubocervical ligaments

25. The following statements regarding the ovary are correct except:

a) It is attached to the posterior layer of the broad ligament

b) It ovulates an ovum into the peritoneal cavity

c) It is attached to the lateral pelvic wall by the round ligament of the ovary

d) It normally is not related to the posterior fornix of the vagina

e) The right ovarian vein drains into the inferior vena cava

26. The following statements regarding the urinary bladder are true except:

a) It lies in the visceral layer of the pelvic fascia beneath the peritoneum

b) When the bladder is empty, the internal surface is wrinkled except at the

trigone, which is smooth

c) Parasympathetic nerve fibers innervate the detrusor muscle

d) The trigone is the area between the openings of the urethra and the two

ureters

e) In children, the bladder is located entirely within the pelvis

27. The broad ligament contains all of the following except:

a) The round ligament of the ovary

b) The uterine artery

c) The round ligament of the uterus

d) The uterine tubes

e) Ureters

22. The following structures receive innervation from the branches of the

pudendal nerve except:

 a) Labia minora

b) Urethral sphincter

c) The posterior fornix of the vagina

d) Ischiocavernosus muscles

e) Skin of the penis or clitoris

23. The following structures are closely related to the rectouterine pouch (pouch

of Douglas) except:

a) Anteriorly is situated in the posterior surface of the upper part of the vagina

b) Posteriorly is situated the upper part of the rectum

c) The trigone of the bladder is directly related to its anterior wall

d) Anteriorly is situated in the posterior surface of the body of the uterus

e) Laterally is situated in the sacrocervical ligaments passing forward to the

cervix

24. Support for the uterus either directly or indirectly, is provided by the

following structures except:

a) The perineal body

b) The mesosalpinx

c) The transverse cervical (cardinal) ligaments

d) The levator ani muscles

e) The pubocervical ligaments

25. The following statements regarding the ovary are correct except:

a) It is attached to the posterior layer of the broad ligament

b) It ovulates an ovum into the peritoneal cavity

c) It is attached to the lateral pelvic wall by the round ligament of the ovary

d) It normally is not related to the posterior fornix of the vagina

e) The right ovarian vein drains into the inferior vena cava

26. The following statements regarding the urinary bladder are true except:
 a) It lies in the visceral layer of the pelvic fascia beneath the peritoneum

b) When the bladder is empty, the internal surface is wrinkled except at the

trigone, which is smooth

c) Parasympathetic nerve fibers innervate the detrusor muscle

d) The trigone is the area between the openings of the urethra and the two

ureters

e) In children, the bladder is located entirely within the pelvis

27. The broad ligament contains all of the following except:

a) The round ligament of the ovary

b) The uterine artery

c) The round ligament of the uterus

d) The uterine tubes

e) Ureters

28. Malignant tumors of the trigone of the bladder spread (metastasize) to the

following lymph nodes:

a) Lumbar

b) Sacral

c) External iliac only

d) External and internal iliac

e) Superficial inguinal

29. In males, traumatic injury to the perineum may rupture the bulb of the penis

or penile urethra. The resulting leakage of blood or urine may be found in all of

the following areas except:

a) The anterior abdominal wall

b) The ischiorectal fossa

c) The scrotum

d) The penis

e) The superficial perineal puch

30. The deep perineal space (pouch) contains the:

a) Internal pudendal artery

b) Pudendal artery

c) Sphincter urethtrae

d) Both A and B

e) Both A and C

31. The following is true about the pudendal canal except:

a) Can be palpated throughout its entire length during rectal examination

b) Is a fascial tunnel

c) Contains the terminal branches of the pudendal nerve

d) Lies in the lateral wall of the ischiorectal fossa

32. All of the following statements about the ductus deferens are true except:

a) It opens via the ejaculatory duct into the prostatic urethtra

b) It begins at the head of the epididymis

c) It is one of the contents of the spermatic cord

d) It enters the abdominal cavity at the deep inguinal ring

e) It is retroperitoneal

33. Which one of the following is true regarding the muscles of the pelvis:

a) The obturator internus muscle leaves the pelvis through the greater sciatic

foramen

b) The levator ani muscle is composed of the pubococcygeus, puborectalis and

iliococcygeus

c) The pelvic diaphragm is a sling of muscle that separates the true pelvis from

the false pelvis

d) The piriformis is one of the components forming the lateral pelvic walls

34. Which one of the following is true:

a) The urinary bladder in the male sits at a lower level than that of the female

because of the presence of the prostate

 b) The scrotum is actually an external genital organ, but is in direct continuity

with male pelvic organs via the vas deferens

c) The efferent ductules unite at the superior aspect of the testis to form the

ductus deferens

d) The gonadal artery in the male and female is a branch from the anterior

division of the internal iliac artery

35. The urethra is located in the:

a) Ischiorectal fossa

b) Deep perineal pouch

c) Superficial perineal pouch

d) Both B and C

e) All of the above

36. The bulb of the penis is located in the:

a) Deep perineal pouch

b) Superficial perineal pouch

c) Ischiorectal fossa

d) None of the above

37. Primary support for the uterus is derived from the:

a) Lateral (transverse) cervical ligaments

b) Pubocervical ligaments

c) Sacrocervical ligaments

d) Round ligament of the uterus

e) Broad ligament

38. Which is not considered a usual branch of the anterior division of the

internal iliac artery:

a) Internal pudendal artery

b) Iliolumbar artery
 c) Obturator artery

d) Umbilical artery

e) Middle rectal artery

39. Which of the following statements about the rectum is false?

a) The sciatic nerve is derived from the segments L4 and 5; S1, 2 and 3

b) In the pudendal nerve is derived from the segments L3, 4 and 5

c) The pelvic splanchnic nerve is derived from the segments S2, 3 and 4

d) The obturator nerve is derived from the segments L2, 3 and 4

e) The lumbosacral trunk is derived from the segments L4 and 5

40. Which of the following ligaments is attached to the uterus and composed of

peritoneum:

a) Transverse cervical (cardinal) ligaments

b) Broad ligament

c) Round ligament

d) Suspensory ligament of ovary

e) Medial umbilical fold

41. Which statement is false about the pudendal nerve?

a) It carries fibers from the spinal cord segments S2-S4

b) It innervates the levator ani muscle

c) It innervates the internal sphincters of bladder and rectum

d) It runs in the ischiorectal fossa

e) It exits the pelvis through the greater sciatic foramen

42. The male urethtra:

a) In rupture urethra urine may be found in the scrotum

b) Its entire epithelial lining is stratified squamous type

c) Is 5 inches long

d) The membranous part receives the ejactulatory ducts

e) Has 3 constrictions
43. The transverse (lateral) cervical ligament is pierced by the:

a) Superior hypogastric plexus

b) Uterine artery

c) Ureter

d) Both B and C

e) All of the above

44. The deep perineal space is deep to the perineal membrane. It contains:

a) Membranous urethra

b) Vagina

c) Deep transverse perinea muscles

d) All of the above

e) Both A and C

45. Regarding the spermatic cord, select the false statement:

a) The vas deferens starts in the tail of epididymis

b) The internal spermatic fascia arises from the internal oblique muscle

c) The testicular artery arises from the aorta

d) The cremasteric artery arises from the inferior epigastric artery

e) Lymphatics from the ductus deferens drain to internal iliac nodes

46. Which of the following is not a branch of the internal iliac artery?

a) Inferior vesical

b) Umbilical

c) Superior gluteal

d) Iliolumbar

e) Inferior epigastric

47. Which of the following is true?

a) The urinary bladder in male sits at a lower level than that of the female

because of the presence of the prostate

 b) The scrotum is actually an external genital organ, but is in direct continuity

with male pelvic organs via the ductus deferens

c) The efferent ductules inite at the superior aspect of the testis to form the

ductus deferens

d) The gonadol artery in the male and female is a branch from the anterior

division of the internal iliac artery

e) The lymphatics of the ovary drain to the internal iliac nodes

48. The following statements concerning the ischio-anal fossa are true except:

a) The pudendal nerve lies in its lateral wall

b) The floor is formed by the superficial fascia and skin

c) The lateral wall is formed by the obturator internus muscle and its fascia

d) The medial wall in part is formed by the levator ani muscle

e) The roof is formed by the urogenital diaphragm

49. Which is statement is not true concerning the anal canal?

a) It is about 1.5 inches (3.75cm) long

b) It is lined by ciliated columnar epithelium

c) It is related laterally to the external anal sphincter

d) It is the site of an important portal-systemic anastomosis

e) The mucous membrane f the lower half receives its arterial supply from the

inferior rectal artery

50. All of the following structures exit the pelvis via the greater sciatic foramen

except:

a) Piriformis muscle

b) Superior gluteal vessels

c) Internal pudendal vessels

d) Obturator internus muscle

e) Inferior gluteal vessels

51. The pelvic diaphragm:

a) Forms the inferior boundary of the pelvic cavity

 b) Can be divided into levator ani and coccygeus muscles

c) Exhibits midline openings for the rectum and urethra in the male

d) Is attached to the pubis, lateral pelvic wall (arcus tendineus) and ischial

spine

e) All of the above

52. The ovaries are anchored to the lateral pelvic wall by the:

a) Ovarian ligament

b) Broad ligament

c) Suspensory ligament

d) Mesovarium

e) Round ligament

53. Which of the following statements is true?

a) The internal pudendal artery is embedded in a fascial canal within the

urogenital triangle

b) The pudendal nerve is a branch of the lumbar plexus

c) The posterior scrotal (labial) nerves are not branches of the inferior rectal

nerve

d) The pudendal nerve enters the perineum (from the gluteal region) by

passing through the greater sciatic foramen

e) The pudendal nerve supplies the external anal sphincter

54. Which of the following has an intra- and extrapelvic component:

a) Broad ligament

b) Ovarian ligament

c) Round ligament of the uterus

d) Transverse cervical (cardinal) ligament

e) More than one of the above

55. Which structures do not pass through the deep perineal pouch of the

urogenital triangle:
 a) Urethra

b) Root of the clitoris

c) Deep transverse perineal muscle

d) Internal pudendal artery

e) Vagina

56. The urinary bladder:

a) Is lined by stratified squamous epithelium

b) Has lymphatics which drain to nodes alongside the internal iliac artery

c) Has a trigone whose endothelium is endoderm-derived

d) Has a medial umbilical ligament arising from its apex

e) Lies anterior to the anal canal in the male

57. Concerning the pudendal nerve, select the incorrect statement:

a) Is the main motor and sensory supply of the pelvic floor and perineum

b) Has a root value of S1-3

c) Passes between piriformis and coccygeus to reach the ischioanal fossa

d) Has the inferior rectal nerve as one of its branches which supplies the

levator ani

e) Has the perineal nerve as one of its terminal branches

58. Which is not true about the rectum?

a) Receives its blood supply from the superior, middle and inferior rectal

arteries, the superior being the main artery supplying the mucous membrane

b) Receives some of its blood supply from the middle rectal artery- a branch of

the internal iliac artery which may sometimes be absent

c) Receives some of its blood supply from the internal pudendal artery via the

inferior rectal artery

d) Has a venous drainage which includes the middle rectal vein, which drains

to the portal circulation

e) Has a lymph drainage which reaches both the inferior mesenteric and
 internal iliac lymph nodes

59. The Prostate Gland:

a) Has peritoneum on its posterior surface

b) Releases its secretions into the ejaculatory duct

c) Is supported by both the urogenital and pelvic diaphragms

d) If healthy, cannot be palpated by rectal digital examination

e) All of the abov

• 60. The rectum and anal canal have a system of anastomoses that will
facilitate blood flow in the case of a blockage. Which of the following vessels
drains into the portal system of veins?
o A. Median sacral vein
o B. Middle rectal vein
o C. Inferior rectal vein
o D. Superior rectal vein
o E. Iliolumbar vein
• 61. The fascia in the pelvis and perineum consists of three layers that are
continuous with abdominal fascial layers. Which of the following types of
fascia can all be found in the deep layer of fascia?
o A. External spermatic fascia & buck's fascia
o B. Fascia lata & colle's fascia
o C. Scarpa's fascia & dartos fascia
o D. Camper's fascia & buck's fascia
o E. External spermatic fascia & dartos fascia

• 62. An obstetrician injects local anesthetic to block sensation from the

perineum during the third stage of labor. After verifying a bony landmark
transvaginally (through the vagina), she blocks the pudendal nerve. Which of
the following bony landmarks should she use to locate the pudendal nerve?
o A. Ischial spine
o B. External as of cervix
o C. Sacral promontory
o D. Pubic symphysis
o E. Tip of the coccyx
• 63. Which one of the following nerves can be used to check for reflex and
integrity of the spinal cord at L2?
o A. Genitofemoral
o B. Ilioinguinal
o C. Lateral femoral cutaneous
o D. Obturator
o E. Iliohypogastric
• 64. A 29-year-old man injures his perineum jumping over seats in the
grandstand following a baseball game. Urine leaking from the ruptured
spongy urethra is most likely to collect in which of the following spaces?
o A. Inguinal canal
o B. Between Camper's and CoIle's fascia
o C. Femoral triangle
o D. Ischioanal fossa
o E. Rectovesical pouch

• 65. A 59-year-old woman presents in the emergency department with severe

abdominal pain in the lower quadrants, positive rebound tenderness, fever,
and elevated WBC. She also reported that she recently had a painful
colonoscopy with some post-procedural bleeding. Exploratory laparoscopy
found peritonitis with a perforated rectum. Where would the abscess from the
peritonitis MOST LIKELY accumulate?
o A. Infraperitoneal space
o B. Rectouterine pouch
o C. Rectovesical pouch
o D. Vesiculo-uterine space
o E. Retrorectal pouch

• 66. During a radical hysterectomy procedure, the surgeon must expose the
broad ligament to ligate the uterine arteries that travel within the transverse
cervical ligament. Which of the following structures can MOST LIKELY be
injured during this procedure?
o A. Uterosacral ligament
o B. Suspensory ligament of the ovary
o C. Ureters
o D. Sigmoid colon
o E. Bladder

• 67. A 55-year-old woman presents in your clinic with procidontia, or

appearance of her cervix at the vulva. Based on your knowledge of the
structures that provide significant support for the uterus and cervix, which one
of these must be weakened or compromised in this case?
o A. Round ligament of the uterus (ligamentum teres uteri)
o B. Mesosalpinx
o C. Mesometrium
o D. Proper ovarian ligament
o E. Cardinal ligament
• 68. A 20-year old woman, 7 weeks after giving vaginal birth to a healthy, 4.25
kg girl, complains that she still has brownish vaginal flow and it has a bad
odor. She has pain during defecation. What is your suspicion?
o A. Due to the big size of the baby, the tissues of the vagina heal slower and there
is still occasional bleeding a few weeks after childbirth. The color and odor of the
fluid is that of partially disintegrated blood.
o B. She developed hemorroids during pregnancy, and they bleed and cause pain
during defecation.
o C. There is a fistula between vagina and anal canal due to a tear in the perineum
during childbirth.
o D. She has developed fungal infection during childbirth, and that causes the bad
odor
o E. She has developed a vaginal adenocarcinoma secondary to the trauma

• 69. A 25 year old full term pregnant woman was admitted to the hospital for
delivery of the child. She wanted to have a normal vaginal delivery and wanted
to witness it too. After all routine clinical investigations, she was found to be a
suitable candidate for vaginal delivery. The type of anesthesia / nerve block
that would completely anesthetize the external genitalia and will satisfy the
needs of this patient would be
o A. General anesthesia
o B. Epidural block
o C. Pudendal nerve block
o D. Ilioinguinal nerve block
o E. Pudendal + Ilioinguinal nerve block

• 70. A 32 year old woman was brought to the clinic, by her husband, with
complaints of severe stabbing pain in right lower abdomen and vaginal
bleeding. She also had intermittent pain in her right shoulder, particularly
while lying down. On questioning it is learnt that she had missed her period
last month. She had also fainted once before being brought to the hospital
and felt dizzy. Her blood pressure was found to be lower than the normal
limits. Based on the clinical scenario mentioned above the MOST LIKELY
diagnosis you would arrive at would be
o A. Appendicitis
o B. Ovarian tumour
o C. Normal menstruation
o D. Rupture of the fallopian tube
o E. Ovarian pregnancy

• 71. A 65 year old man reported to the clinic with complaints of low back pain
and difficulty in urination. He also complained of increase in number of visits
to the washroom, painful urination and blood in urine. A digital rectal
examination revealed an enlarged prostate. Further laboratory investigations
revealed abnormally high levels of PSA in his blood. The surgeon arrived at a
 diagnosis of Stage IV prostate cancer and decided to resect the prostate,
other closely relates structures and lymph nodes and follow it up with
chemotherapy. The first lymph node that will be infiltrated with cancer cells in
case of prostate cancer would be
o A. External iliac nodes
o B. Internal iliac nodes
o C. Superficial inguinal nodes
o D. Deep inguinal nodes
o E. Para aortic nodes
• 72. The space within the fascia lining the lateral wall of the ischioanal fossa is
called the ___________ canal. The canal contains a neurovascular bundle that
passes from the gluteal region to the perineum through the______________
foramen.
o A. Pudendal -- greater sciatic
o B. Pudendal --- lesser sciatic
o C. Pudendal obturator
o D. Obturator --- lesser sciatic
o E. Obturator --- greater sciatic

• 73. Because the perineal body is susceptible to tearing during childbirth, it

may be cut intentionally (episiotomy) where it lies between which of the
following structures?
o A. Anus and vestibule of vagina
o B. External urethral orifice and ischial tuberosity
o C. Ischial tuberosity and coccyx
o D. Coccyx and anus
o E. Vestibule of vagina and external urethral orifice

• 74. A 58-year-old woman with a right ovarian tumor undergoes an

ovariectomy, which removes the ovary and a portion of the suspensory
ligament. What important artery follows the path of the suspensory ligament?
o A. Ovarian artery
o B. Uterine artery
o C. Cervical artery
o D. Vesical artery
o E. Umbilical artery
• 75. On your ob/gyn rotation you have seen several women who have
endonnetriosis. Because of your knowledge of anatomy, you know that any
excess fluid that may result because of the endometriosis may accumulate in
which of the following areas when you have the patient in a supine position?
o A. Hepatorenal pouch
o B. Rectovesical pouch
o C. Rectouterine pouch
o D. Vesicouterine pouch
 o E. Pubovesical pouch

• 76. Which of the following is the correct path of the pudendal nerve as it
courses from the pelvic cavity to the ischioanal fossa?
o A. Enters the lesser sciatic foramen, courses around the ischial spine and
through the obturator foramen
o B. Enters the gluteal foramen, courses around the ischial spine and enters the
pudendal canal
o C. Enters the greater sciatic foramen, courses around the ischial spine, enters
the lesser sciatic foramen and then courses in the pudendal canal
o D. Enters the lesser sciatic foramen, courses through the greater sciatic foramen
and wraps around the ischial spine before entering the pudendal canal

• 77. Which of the following positions of the uterus & vagina is the "usual"
position in a female?
o A. Anteverted
o B. Anteverted & anteflexed
o C. Retroverted & retroflexed
o D. Retroverted
• 78. Erection is primarily controlled by_____________________ nervous
innervations while ejaculation and remission are primarily controlled
by_____________ nervous innervation.
o A. Sympathetic - Parasympathetic
o B. Parasympathetic - Sympathetic
o C. Somatic - Parasympathetic
o D. Somatic - Sympathetic

• 79. The anterior recess of the ischioanal fossa is continuous with what
perinea' space (pouch)?
o A. Superficial perinea' space
o B. Skin and fascial space
o C. Space above the pelvic diaphragm
o D. Deep perineal space

• 80. Which of the following is a branch of the pudendal nerve?

o A. Vaginal nerve
o B. Ilioinguinal nerve
o C. Genitofemoral nerve
o D. Perineal nerve
o E. Nerve to ductus deferens
• 81. Which of the following muscles is most important in creating the pelvic
diaphragm?
o A. Piriformis
o B. Obturator internus
o C. External anal sphincter
o D. Levator ani
o E. Tendinous arch

• 82. Your cousin was rollerblading and took a pretty bad fall in the park. He is
now in the ER and has swelling in his scrotum, anterior abdominal wall and
around his penis. He is freaking out to you, of course. Which of the following
was most likely injured?
o A. Prostatic urethra
o B. Penile (spongy) urethra
o C. Intermediate (membranous) urethra
o D. Pre-prostatic urethra

• 83. A 23-year old male is hit by a car while crossing a busy street. Among his
many injuries is a torn sacrospinous ligament. Name (i) the muscle that will
most likely also be affected and (ii) the nerve that may also be compromised.
o A. Obturator internus muscle - pudendal nerve
o B. Levator ani muscle - pudendal nerve
o C. Coccygeus muscle - pudendal nerve
o D. Levator ani muscle - perineal nerve
o E. Coccygeus muscle - perineal nerve

• 84. In your obstetrics rotation, the resident physician asks you to measure the
diagonal conjugate of a 23-year old female patient who is hoping to get
pregnant. You know that this measurement is between which of the following
structures?
o A. Sacral promontory and coccyx
o B. Sacral promontory and superior edge of pubic symphysis
o C. Sacral promontory and inferior edge of pubic symphysis
o D. Coccyx and ischial spine
o E. Coccyx and inferior edge of pubic symphysis