Pelvic Cavity and Perineum Test Questions
College of Medicine
Gross Anatomy
These Questions have come from the old tests available in the Center For Academic
Excellence. Please note that all of the questions have not been checked, and some of
the answers may be wrong.
1. The uvula vesicae is present due to the
A.
B.
C.
D.
E.
sphincter vesicae
ureteric orifice
interureteric crest
rectal ampulla
median lobe prostate
2. The lymph vessels from the testis and epididymis
A. ascend within the spermatic cord
B. pass to the superficial inguinal nodes
C. pass to the L1 lumbar lymph nodes
D. all the above
E. only A and C
3. The vas deferens ends by joining the
A.
B.
C.
D.
E.
ureter
urethra
ejaculatory duct
seminal vesicles
prostatic duct
4. The usual location for injection to block most of the pudendal nerve is
A.
B.
C.
D.
E.
midway between ischial tuberosity and sciatic nerve
close to ischial spine
close to perineal body
into superficial perineal pouch
into retropubic space
5. The vestibule of the female perineum
A.
B.
C.
D.
is bordered by the labia majora
contains the openings of the ducts of the bulbourethral glands
contains the opening of the urethra
contains the opening of the anal gland
6. Which structure is neither a boundary nor a content of the deep perineal pouch?
A.
B.
C.
D.
E.
external urethral sphinctor
deep transverse perineus muscle
perineal membrane
bulbourethral glands
greater vestibular glands
7. When a needle is inserted into the posterior wall of the vagina at the posterior fornix,
the point of the needle will be
A.
B.
C.
D.
superior to the pelvic diaphragm
anterior to the broad ligament
both
neither
8. In a supine male patient, excess fluid will tend to accumulate in the
A.
B.
C.
D.
E.
F.
right anterior subphrenic recess
pouch of Douglas
pouch of Morrison
rectopubic space
rectovesical pouch
both C and E above
9. The broad ligament encloses the
A.
B.
C.
D.
ovarian ligament
round ligament of the uterus
both
neither
10. The uterine artery reaches the uterus first within the
A.
B.
C.
D.
broad ligament
cardinal ligament (transverse cervical)
pubocervical ligament
sacrocervical ligament
11. In a patient with a suspected carcinoma of the labium majus, which group of lymph
nodes would you examine for metastases?
A.
B.
C.
D.
E.
superficial inguinal
external iliac
internal iliac
para aortic
inferior mesenteric
12. The uterus normally exhibits a 90 degree angle of anteversion between
A.
B.
C.
D.
oviduct and body of uterus
fundus and body of uterus
body and cervix of uterus
vagina and cervix
E. bladder and body of uterus
13. Lymphatics draining the labia majora follow the
A.
B.
C.
D.
E.
ovarian ligament
fundiform ligament of the ovary
round ligament of the uterus
sacrouterine ligaments
pubocervical ligaments
14. The anterior boundary of the ovarian fossa is formed by the
A.
B.
C.
D.
E.
obturator artery
external iliac artery
internal iliac artery
ureter
broad ligament
15. Muscles responsible for anal continence include
A.
B.
C.
D.
E.
Coccygeus
Puborectalis
Obturator internus
External anal sphincter
Both B and D
16. True statements concerning the vagina include
A.
B.
C.
D.
E.
F.
Part of its lumen surrounding the cervix is called the fornices.
Its anterior wall is related to the bladder above and to the urethra below.
Its upper half lies superior to the pelvic floor.
Lymphatic drainage from its lower third is to superficial inguinal nodes.
The posterior wall is related to the pouch of Douglas and the rectal ampulla.
All of the above.
17. Lymph draining from the uterus runs into the
A.
B.
C.
D.
E.
internal and external iliac nodes
lumbar nodes
superficial inguinal nodes
all of the above
A and C
18. Pain from a subphrenic abscess that irritates the central portion of the parietal
peritoneum lining the diaphragm is usually referred to the
A.
B.
C.
D.
E.
umbilical region
left hypochondriac region
epigastric region
medial side of arm
shoulder region
19. An aneurysm of the abdominal aorta at the aortic hiatus of the diaphragm is most
likely to result in compression of which of the following?
A. vagus nerve and azygos vein
B. esophagus and vagus nerve
C. azygos vein and thoracic duct
D. thoracic duct and vagus nerve
E. IVC and phrenic nerve
20. If the urethra in males is torn distal to the UG diaphragm, urine might accumulate in
the
A.
B.
C.
D.
E.
retropubic space
medial aspect of the thigh
ischiorectal perineal pouch
superficial perineal pouch
paravesical fossa
21. The inferior hypogastric plexus contains parasympathetic fibers from the
A.
B.
C.
D.
E.
lumbar splanchnics
pelvic splanchnics
sacral splanchnics
vagus nerves
greater splanchnics
22. A 42 y/o man with portal hypertension due to cirrhosis of the liver presents to the
emergency department. The most practical method of shunting blood around the liver
involves which of the following?
A.
B.
C.
D.
E.
SMV to IMV
Portal vein to SVC
Portal vein to IVC
Splenic vein to left renal vein
Superior rectal vein to left colic vein
23. Parasympathetic preganglionic fibers in the pelvic splanchnics synapse in
A. ganglia in or near the viscerae or pelvic plexus
B. sympathetic chain ganglia
C. collateral ganglia
D. dorsal root ganglia
E. ganglion impar
24. As the uterine artery passes from the internal iliac artery it crosses the
A.
B.
C.
D.
E.
ovarian artery
ovarian ligament
uterine tube
ureter
round ligament of the uterus
25. A lesion on the sacral splanchnics would primarily damage
A. postganglionic parasympathetics
B. postganglionic sympathetics
C. preganglionic sympathetics
D. preganglionic parasympathetics
E. postganglionic parasympathetics and sympathetics
26. Which of the following is the superior boundary of the superficial perineal pouch?
A. pelvic diaphragm
B. Colle’s fascia
C. superficial layer of superficial fascia
D. deep layer of superficial fascia
E. perineal membrane
27. A slowly growing tumor in the deep perineal pouch would most likely injure
A. Cowper’s glands
B. Crus of penis
C. Bulb of vestibule
D. Spongy urethra
E. Greater vestibular glands
28. Which of the following lobes of the prostate is commonly involved in benign
hypertrophy?
A.
B.
C.
D.
E.
anterior
middle
right lateral
left lateral
posterior
29. A benign tumor located near a gap between the arcuate pubic ligament and the
transverse perineal ligament might compress the
A. dorsal nerve of the penis
B. deep dorsal vein of the penis
C. superficial dorsal vein
D. dorsal artery of the penis
30. If an obstetrician performs a median episiotomy that damages the perineal body,
which muscles will be impaired?
A.
B.
C.
D.
E.
ischiocavernosus and sphincter urethrae
deep transverse perineus and obturator internus
bulbospongiosus and superficial transverse perineus
external anal sphincter and sphincter urethrae
bulbospongiosus and ischiocavernosus
31. A 16 y/o boy w/ rupture of the penile urethra. Extravasated urine can spread into the
A.
B.
C.
D.
E.
scrotum
ishiorectal fossa
deep perineal pouch
testis
thigh
32. Which is true of the ischiorectal fossa?
A. it accumulates urine leaking from a bulb of the penis
B. it contains inferior rectal vessels
C. it has a pudendal canal along its medial wall
D. it is bounded anteriorly by the sacrotuberous ligament
E. it contains a perineal branch of the lumbar nerve
33.What nerve in the posterior abdominal wall lies between the iliacus and the psoas
major?
A.
B.
C.
D.
E.
genitofemoral
subcostal
femoral
obturator
lumbosacral trunk
34. All of the following structures are found in the deep perineal space except the
A.
B.
C.
D.
E.
external urethral sphincter m.
deep transverse perineal m.
prostatic urethra
dorsal n of the penis
dorsal a of the penis
35. The most caudal (inferior) of the spinal nerves to provide cutaneous innervation to the
anterior abdominal wall is:
A.
B.
C.
D.
E.
T6
T8
T10
L1
L4
36. The internal pudendal a. is usually a branch of the:
A. common iliac
B. external iliac
C. internal iliac
D. superior gluteal
E. inferior gluteal
37. Potential sites for obstruction of the ureters are:
A.
B.
C.
D.
E.
junction with the renal pelvis and at the wall of the bladder
at a renal pyramid and also a major calyx
at the urethral crest and also the prostatic sinus
at the sphincter urethrae and the navicular fossa
at the prostatic utricle and the uterine cervix
38. Which of these structures does not pass through either the pelvic diaphragm or
urogenital diaphragm?
A.
B.
C.
D.
E.
anal canal
male urethra
female urethra
spermatic cord
vagina
39. The inferior rectal nerves:
A. are branches of the pudendal nerve
B. do not traverse the ischiorectal fossa
C. supply the major portion of the levator ani muscle
D. supply skin of only the lateral portions of the ischiorectal fossa
40. Lying within the urogenital diaphragm is the:
A. deep transverse perineal muscle
B. bulbo-urethral glands
C. seminal colliculus
D. All of the above
E. both (only A and B)
41. The uterine artery reaches the uterus by passing:
A.
B.
C.
D.
E.
within the broad ligament to the side of the ligament
above and anterior to the ureter
first to its cervical portion
all of the above
both B and C but not A
42. The venous drainage of the rectum and anus include:
A.
B.
C.
D.
E.
superior rectal veins which normally drain to the inferior mesenteric vein
middle rectal veins which normally drain to the internal iliac vein
inferior rectal veins which normally drain to the internal pudendal vein
only A and B above
A, B and C above
43. This/these structures lie(s) immediately behind a portion of the vagina
A.
B.
C.
D.
E.
rectouterine pouch of Douglas
ampulla of the rectum
perineal body
all the above
B and C but not A
44. The muscle that covers the crus of the penis or clitoris is the:
A. bulbospongiosus
B. deep transverse perineus
C. ischiocavernosus
D. sphincter urethra
E. superficial transverse perineus
45. The following statements are true of serous cavities:
A. The thoracic cavity contains three completely separate serous cavities.
B. The peritoneal cavity contains two sacs which are connected via a small opening the
epiploic foramen.
C. The male contains two more serous sacs than the female.
D. Only A and B above
E. A , B and C above
46. The deep dorsal vein of the penis
A. lies deep to Bucks fascia
B. drains into the prostatic venous plexus
C. both
D. neither
47. The internal anal sphincter
A. is formed by a thickening of the circular layer of smooth muscle
B.
C.
D.
E.
consists of three parts, designated subcutaneous, superficial and deep
is synonymous with the puborectalis
contracts during defecation to force the fecal mass through the anal canal
is innervated by the inferior rectal nerve
48. Which statements concerning the lower (inferior) half of the anal canal are TRUE?
A.
B.
C.
D.
Its lymphatic drainage is to the superficial inguinal lymph nodes.
Its mucous membrane is thrown into vertical folds called anal columns.
Both
Neither
49. Internal hemorrhoids are:
A. varicosities of the tributaries of the superior rectal vein and are covered by mucous
membrane
B. painless and are only sensitive to stretch
C. both
D. neither
50. Which statement about the rectum is TRUE?
A. the upper part of the rectum lies anterior to the piriformis and the lumbar plexus
B. the lower part of the rectum is dilated, lies superior to the pelvic diaphragm and is
designated the rectal ampulla
C. The lower third of the rectum has peritoneum on its anterior surface but not its lateral
and posterior surfaces
D. The rectum begins at the pelvic brim as a continuation of the sigmoid colon
E. The superior rectal artery is usually a branch of the internal iliac artery.
51. When the uterus is bent forward at the internal os, it is referred to as:
A. anteflexion
B. anteversion
C. retroversion
D. retroflexion
52. A 30 y/o female complained to her physician that she had unsuccessfully tried to
become pregnant. The physician ordered a hysterosalpingogram (a radiographic
procedure in which contrast material is injected through the external os of the uterus) to
test for patency of the female reproductive tract. Once the contrast material entered the
infundibulum of the Fallopian tubes, it would pass directly into the:
A.
B.
C.
D.
isthmus of the oviducts
internal os
cervical canal
intramural part of the oviduct
E. peritoneal cavity
53.Which statement concerning the piriformis muscle is FALSE?
A.
B.
C.
D.
E.
It originates from the pelvic (anterior) surface of the sacrum.
It passes through the greater sciatic foramen
It is a lateral rotator of the femur
It is sometimes pierced by the common fibular nerve
It lies between the inferior gluteal artery and internal pudendal artery
54. A young boy falls on a sharp stick and ruptures the bulb of his penis, resulting in the
escape of urine into the superficial perineal pouch; the urine could be expected to
extend to which of the following regions?
A.
B.
C.
D.
into the lower anterior abdominal wall, deep to Scarpa’s fascia
into the ischiorectal fossa deep to Colle’s fascia
both
neither
55. The sacral plexus is formed on the internal surface of the ______ m.
A.
B.
C.
D.
E.
obturator internus
obturator externus
piriformis
psoas
levator ani
56. In comparisons of the male and female bony pelvis, each of the following statements
is true except:
A.
B.
C.
D.
E.
the pelvic outlet is larger than in the female
the infrapubic (subpubic) angle is smaller in the female
the ilia flare out more in the female than in the male
the ischial rami are heavier and stronger in the male than in the female
the pelvic inlet tends to be more heart-shaped in the male and oval in the female
57. The pelvic brim (inlet) is formed partly by the:
A. arcuate line of the ischium
B. ischiopubic rami
C. sacrotuberous ligament
D. iliac crest
E. pectinial line
58. The superomedial boundary of the ischiorectal fossa is the:
A. fascia of obturator internus
B.
C.
D.
E.
pelvic diaphragm
fascia of obturator externus
membranous layer of superficial fascia in the anal triangle
inferior fascia of the urogenital diaphragm
59. The round ligament of the ovary (ovarian ligament):
A. is attached to the posterior border of the ovary
B. conducts blood vessels to the ovary from the lateral pelvic wall
C. attaches the anterior border of the ovary to the back of the broad ligament
D. is attached to the isthmus of the uterus
E. is the remains of the upper part of the gubernaculum
60. Carcinoma of the uterus can spread directly to the labia majora by traveling in
lymphatics that follow the:
A. round ligament of the ovary
B. fundiform ligament of the ovary
C. round ligament of the uterus
D. sacrouterine ligaments
E. pubocervical ligaments
61. In draining an abscess in the ischiorectal fossa, injuries to the pudendal nerve and
internal pudendal vessels should be prevented by avoiding the:
A.
B.
C.
D.
E.
anterior wall
medial wall
posterior wall
lateral wall
base (floor)
62. A patient with advanced carcinoma of the rectum complained of pain in the lower
limb; this pain would most likely be the result of metastatic involvement of the:
A.
B.
C.
D.
E.
saphenous nerve
perineal nerve
sciatic nerve
femoral nerve
obturator nerve
63. The lateral surface of the prostate is most closely related to the:
A.
B.
C.
D.
E.
obturator internus m.
piriformis m.
levator ani m.
sphinctor urethrae
urogenital diaphragm
64. Which statement concerning the levator ani muscle is FALSE?
A.
B.
C.
D.
E.
It, along with the coccygeus muscle, forms the pelvic diaphragm.
It originates partly from the iliopectineal lines, part of the pelvic brim.
Part of it inserts into the perineal body.
One of its parts is the sphincter vaginae
Its puborectalis part forms a sling around the junction of the rectum and anal canal.
65. Which statement concerning the sacral plexus is FALSE?
A. It lies on the posterior pelvic wall, anterior to the piriformis m.
B. It includes contributions from the fourth and fifth lumbar nerves.
C. Its largest branch is the sciatic nerve, which enters the gluteal region inferior to
piriformis muscle.
D. Most of its branches leave the pelvis through the lesser sciatic foramen.
E. Its sacral nerves have connections with the sacral sympathetic trunk via gray, but not
white, rami communicantes.
66. The arcus tendineus is:
A.
B.
C.
D.
a thickened band of obturator internus fascia
located between the spine of the ischium and the pubic bone
both
neither
67. Colle’s fascia of the perineum is a continuation of this layer of the abdomen:
A.
B.
C.
D.
E.
transversalis fascia
Scarpa’s fascia
Camper’s fascia
Transversus abdominis aponeurosis
Internal abdominal oblique aponeurosis
68. Which statement concerning the urogenital diaphragm is FALSE?
A.
B.
C.
D.
E.
it is attached laterally to the right and left ischiopubic rami
it has skeletal muscle fibers in its posterior edge, called the deep transverse perineus
it is pierced by the urethra and vagina in the female
it lies directly inferior to the neck of the urinary bladder in the male
it lies inferior to the anterior part of the pelvic diaphragm
69. The membranous part of the urethra:
A. passes through the bulb of the penis
B. passes through the corpus spongiosum
C. receives (directly) the ejaculatory ducts
D. receives (directly) the ducts of the bulbourethral glands
E. is surrounded by skeletal (striated) muscle
70. Structures located within the superficial perineal pouch of the female include:
A. bulbs of the vestibule
B. greater vestibular glands
C. both
D. neither
71. Structures attached directly to the perineal membrane include:
A.
B.
C.
D.
bulb of vestibule
corpus cavernosum of penis
both
neither
72. In the male the posterior surface of the bladder is separated from the rectum by the:
A. seminal vesicles
B. vasa deferentia
C. rectovesical septum
D. All of the above
E. A and C , but not B
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
E
E
C
B
C
E
A
F
C
B
A
D
C
E
E
F
D
E
C
D
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
B
D
A
D
C
E
A
B
B
C
A
B
C
C
D
C
A
D
A
E
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
D
E
D
C
E
C
A
A
C
B
A
E
E
A
C
B
E
B
E
C
61
62
63
64
65
66
67
68
69
70
71
72
D
C
C
B
D
C
B
D
E
C
A
D