Firstranker's choice
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- Which of the following statement(s) is/are FALSE aboutgenitor-urinary anatomy?
- Superficial dorsal penile artery is a branch of bulbourethral artery
- Penile skin is supplied by superficial external pudendal artery
- Penis receives three venous drainage systems
- There are 5 urethral sphincters in children
- Nerve supply of penis includes pelvic splanchnic nerves
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Correct Answer - A:D
Ans. is 'a' i.e., Superficial dorsal Penile artery is a branch of bulbo-urethral artery & 'd' i.e., There are 5 urethral sphincters in children
Vasculature & Innervation of penis
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A. Arterial supply: mainly by branches of the internal pudendal artery (branch of anterior division of the internal iliac artery).
- Dorsal Arteries of penis supplying the fibrous tissue around corpora and skin of penis.
- Deep arteries of penis (cavernous artery or artery to crura of penis): they pierce the crura and run within the corpora cavernosa, thus supplying the erectile tissue.
- Artery of bulb of penis (Bulbo-urethral artery): supply posterior part of corpus spongiosum + Cowper's glands
- Superficial Deep branches of external pudendal artery (branch of femoral artery): supply penile skin
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B. Venus drainage: The penis is drained by three venous systems: superficial, intermediate, and deep.
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- SUPERFICIAL veins: drains into the left saphenous vein. Veins from more superficial tissue may drain into the external superficial pudendal veins.
- INTERMEDIATE system contains the deep dorsal and circumflex veins, lying within and beneath Buck's fascia.
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DEEP drainage system consists :
- Crural veins
- Cavernosal veins
- The internal pudendal veins
C. Lymphatic drainage:
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- Glans drain into the deep inguinal nodes.
- From rest of the penis lymph drains into the superficial inguinal nodes.
D. Nerve supply
a) Somatic supply:
- Skin of the penis is supplied by pudendal nerve via dorsal nerve of penis and posterior scortal nerve.
- A small area on the dorsum of proximal penis (root) :ilionguinal nerve.
- The muscles, bulbocavernosus and ischeocavernosus: perineal branch of pudendal nerve.
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b) Parasympathetic :It is responsible for erection and is derived from pelvic splanchnic nerves (S2S3S4).
c) Sympathetic :It is responsible for ejaculation(initial part) and is derived from L1 segment via superior and inferior hypogastric plexus.
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- 4th Aortic arch is responsible for the formation of?
- Arch of aorta
- Pulmonary artery
- Pulmonary vein
- Subclavian artery
- Subclavian vein
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Correct Answer - A:D
Ans. is 'a' i.e., Arch of aorta & 'd' i.e., Subclavian artery
Aortic arch IV : The right and left side develop differently :
- Left aortic arch IV forms part of arch of aorta which lies between left common carotid and left subclavian arteries.
- Right aortic arch IV forms most proximal part of right subclavian artery (distal part is formed by right dorsal aorta and right 7th cervical intersegmental artery). The left subclavian artery is formed by left 7th cervical intersegmental artery.
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About other options
- Pulmonary artery -5th aortic arch
- Pulmonary vein - pulmonary veins develop independently (during the formation of septum primum.
- Subclavian vein - Subclavian veins are formed by 7th cervical intersegmental vein
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- All are true regarding renal anatomy EXCEPT?
- Left kidney is related to both 11th & 12th ribs
- Long axis is lateral and upwards
- Supplied by anterior segmental artery
- Supplied by rectal plexus
- Both kidneys move in opposite direction during respiration
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Correct Answer - B:D:E
Ans. is 'b' i.e., Long axis is lateral and upwards, 'd' i.e., Supplied by rectal plexus & 'e' i.e., Both kidneys move in opposite direction during respiration
LOCATION
Left kidney:
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Diaphragm
Costodiaphragmatic recess of the pleura
11th & 12th ribs; last intercostal space
Psoas major
Quadratus lumborum
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transversus abdominis.
Subcostal (T12),
iliohypogastric &
ilioinguinal nerves.
Right kidney:
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Diaphragm
Costodiaphragmatic recess, of the pleura
12th rib, last intercostal space
Psoas major
Quadratus lumborum,
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transversus abdominis.
Subcostal (T12),
iliohypogastric &
ilioinguinal nerves.
Arterial Supply:
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- Each kidney is supplied by renal arteries, left and right, which branch from left & right phrenic artery which branch directly from
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the abdominal aorta.
- Posterior, apical, upper anterior, middle anterior and lower are 5 segments of vascular supply in each kidney
- Kidneys receive approximately 20% of the cardiac output.
- Renal artery ? Segmentalarteries ? Interlobar arteries (penetrate the renal capsule and extend through the renal columns between the renal pyramids)
- Interlobar arteries supply ? Arcuate arteries (run through the boundary of the cortex and the medulla) ? Interlobular arteries ? Afferent arterioles (supply the glomeruli).
- Branches of renal artery are end arteries.
- Right renal artery is longer and passes behind IVC.
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NERVE SUPPLY:
- Kidney is supplied by renal plexus, an offshoot of coelic plexus.
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- True statement regarding anatomy of nasolacrimal apparatus is/are?
- Nasolacrimal duct opens in inferior meatus
- There is upper & lower canaliculus
- Most people have common canaliculus
- Canaliculus is lined by Ciliary stratified columnar epithelium
- Nasolacrimal duct is fractured in most head and neck injuries
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Correct Answer - A:B:C:E
Ans. is 'a' i.e., Nasolacrimal duct opens in inferior meatus, 'b' i.e., There is upper & lower canaliculus, 'c' i.e., Most people have common canaliculus & `e' i.e., Nasolacrimal duct is fractured in most head and neck injuries
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Nasolacrimal (drainage) apparatus consists of:
- Lacrimal canaliculi
- Lacrimal sac
- Nasolacrimal duct
Lacrimal canaliculi
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- There are two lacrimal canaliculi - superior and inferior on each side.
- They unite to form a common canaliculusand drain via the sinus of Maier into the lacrimal sac posterior to the medial palpebral ligament and anterior to the orbicularis oculi muscle.
- It is lined by stratified squamous epithelium supported by elastic tissue.
Lacrimal sac:
- The lacrimal sac lies in the lacrimal fossa on the inferomedial aspect of the bony orbit between the posterior and anterior lacrimal crests.
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- The sac receives the lacrimal canaliculi before it drains via the valve of Krause into the nasolacrimal duct.
Nasolacrimal duct
- The nasolacrimal duct is the inferior continuation of the lacrimal sac
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2 parts:
- intraosseous part (12 mm): lies within the nasolacrimal canal of the maxilla
- membranous part (3-5 mm): runs in the nasal mucosa; terminates below the inferior nasal meatus as a slit-like opening where it is covered by a mucosal fold called the valve of Hasner
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- Posterior interosseous nerve supplies?
- Extensor carpi radialis longus
- Extensor carpi radialis brevis
- Extensor carpi ulnaris
- Brachioradialis
- Extensor pollicis longus
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Correct Answer - B:C:E
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Ans. is 'b' i.e., Extensor carpi radialis brevis, 'c' i.e., Extensor carpi ulnaris & `e' i.e., Extensor pollicis longus
- The posterior interosseous nerve is a pure motor nerve and innervates supinator & extensor carpi radialis.
It supplies:?
- Extensor carpi ulnaris
- Extensor digitorum
- Extensor digitiminimi
- Abductor pollicis longus
- Extensor pollicis longus and brevis
- Extensor indicis
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- Cavernous sinus receives blood from?
- Superior ophthalmic vein
- Superior petrosal sinus
- Inferior petrosal sinus
- Spheno-parietal sinus
- Basilar plexus ofveins
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Correct Answer - A:D
Ans. is 'a' i.e., Superior ophthalmic vein & 'd' i.e., Spheno-parietal sinus
Tributaries (incoming channels) of cavernous sinus
- Superior ophthalmic vein
- A branch of inferior ophthalmic vein or sometimes vein itself.
- Central vein of retina (it may also drain into superior ophthalmic vein).
- Superficial middle cerebral vein.
- Inferior cerebral vein.
- Sphenoparietal sinus
- Frontal trunk of middle meningeal vein (it may also drain into pterygoid plexus or into sphenoparietal sinus).
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- Inner Waldayer's ring includes?
- Jugulo-diagastricnodes
- Jugulo-omohoid nodes
- Palatine tonsil
- Tubal tonsil
- Pharyngeal tonsil
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Correct Answer - C:D:E
Ans. is 'c' i.e., Palatine tonsil, 'd' i.e., Tubal tonsil & `e' i.e., Pharyngeal tonsil
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Waldeyer's Lymphatic Rings
- Pharyngeal Tonsil
- Tubal Tonsil
- Palatine Tonsil
- Lingual Tonsil
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Inner Ring
Outer Ring
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- Structure(s) passing through aortic opening into the chest include?
- Thoracic duct
- Azygousvein
- Hemiazygous vein
- Esophagus
- Inferior vena cava
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Correct Answer - A:B
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Ans. is a i.e., Thoracic duct & 'b' i.e., Azygous vein
- The aortic hiatus is a hole in the diaphragm. It is the lowest and most posterior of the large apertures.
- It is located approximately at the level of the twelfth thoracic vertebra (T12).
- Through it passes the aorta, the azygos vein, the thoracic duct, and hemi-azygos vein passes through the left crus.
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- Constituents of Rotator cuffincludes all EXCEPT?
- Teres major
- Teres minor
- Supraspinatus
- Infraspinatus
- Subscapularis
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Correct Answer - A
Ans.is 'a' i.e., Teres major
Each one of these muscles is part of the rotator cuff and plays an important role:
- Supraspinatus. This holds your humerus in place and keeps your upper arm stable. And helps lift your arm.
- Infraspinatus. This is the main muscle that lets you rotate and extend your shoulder
- Teres Minor. This is the smallest rotator cuff muscle. Its main job is to assist with rotation of the arm away from the body.
- Subscapularis. This holds your upper arm bone to your shoulder blade and helps you rotate your arm, hold it straight out and lower it.
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- Not TRUE statement regarding parotid gland is/are?
- Deep lobe contains deep lymphatics
- Divided into superficial and deep lobes by facial nerve
- Parotid duct opens opposite to the second upper molar
- Ectodermal in origin
- Auriculotemporal nerve is the main sensory nerve
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Correct Answer - A
Ans. is 'a' i.e., Deep lobe contains deep lymphatics
Development:
- Parotid gland is the first salivary gland to appear, in early 6' week.
- It is ectodermal in origin and develops from the buccal epithelium just lateral to the angle of mouth
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Structures emerging from parotid
The following structures emerge from the parotid gland:
Anterior border:
- Parotid duct
3 Terminal branches of facial nerve:
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- The zygomatic and buccal branches: toward the temporal region, eyelids and cheek, respectively.
- Mandibular branch : Run along the body of the mandibletowards the mouth
Apex:
- 5th terminal branch of facial nerve: Cervical branch continues into the neck (to platysma).
- Anterior & posterior divisions of retromandibular vein
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Posterior border:
- Posterior auricular nerve
- Posterior auricular artery
- Posterior auricular vein
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Along base:
- superficial temporal artery
- temporal branch of facial nerve
- Auriculotemporal nerve
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STRUCTURES WITHIN GLAND:
Arteries:
- External carotid artery enters through posteromedial surface
- Maxillary artery
- Superficial temporal vessel
- Posterior auricular artery
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Veins:
- The retromandibular veins
- Facial Nerve
- Parotid Duct (Stenson's duct)
- The duct turns opens into the vestibule of the mouth (gingivo- buccal vestibule) opposite the crown of the upper 2nd molar tooth
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Nerve supply:
- PARASYMPATHETIC: auriculo temporal nerve
- SYMPTHETIC SUPPLY- plexus around the external carotid artery.
- SENSORY NERVES: auriculotemporal nerve, except for parotid fascia & overlying skin which are innervated by Great auricular nerve (C2, C3).
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- External anal sphincter is innervated by?
- S2,S3,S4
- S2, S3
- S1,S2
- L5,SI
- L2,L3
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Correct Answer - A
Ans. is a i.e., S2, S3, S4
Anal Sphincters :
Two sphincters, internal and external, surround the anal canal:
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A. Internal sphincter (sphincter ani internus):
- Involuntary
- Sympathetic fibers through superior hypogastric plexus
- Parasympathetic fibers from pelvic splanchnic nerves (S2 S3 S4).
B. External sphincter (sphincter ani externus)
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- Voluntary
- Surrounds the entire length of anal canal
- Inferior rectal nerve (S2 S3 S4) and perineal branch
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- A patient had a lesion in the wrist. On examination the thumb was laterally rotated & adducted, with ape thumb deformity. Which is the nerve involved?
- Median
- Ulnar
- Radial
- Post interosseous nerve
- None
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Correct Answer - A
Ans. is 'a' i.e., Median
Ape thumb (Simian thumb) deformity : -
- The Ape Hand Deformity is caused by damage to the distal median nerve(also called a Median Claw lesion), and subsequent loss of opponenspollicis muscle function.
- The thumb is adducted and laterally rotated so that the thumb lies in the same plane as the other fingers. It is due to over action of adductor pollicis (supplied by ulnar nerve).
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- Spring ligament refers to?
- Plantar calcaneonavicular ligament
- Short planter ligament
- Long planter ligament
- Both'b' &'c'
- None
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Correct Answer - A
Ans. is 'a' i.e., Plantar calcaneonavicular ligament
The spring ligament (Plantar calcaneonavicular ligament) is a group of ligaments which connect calcaneum to navicular.
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It consists of :?
- Superomedial ligament.
- Medioplantar oblique ligament (medial or intermedialcalcaneonavicular ligament).
- Inferoplantar longitudinal ligament (Lateral calcaneonavicular ligament).
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- Which of the following is NOT a content of medial wall of middle ear?
- Oval window
- Round window
- Processuscochlearformis
- Aditus & antrum
- Notch of Rivinus
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Correct Answer - D:E
Ans. is 'd' i.e., Aditus & antrum & 'e' i.e., Notch of Rivinus
Medial or inner labyrinthic wall of middle ear (Parieslabyrinthica):
- It is formed by the lateral wall of labyrinth.
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It presents following structures
- Promontory: It is a bony bulge which is due to the basal coil of cochlea. Tympanic plexus present over it.
- Oval window (fenestra vestibuli/ovalis):
- The footplate of stapes
- Round window(fenestra cochleae/rotunda): covered by the secondary tympanic membrane.
- Horizontal tympanic part of fallopian canal for facial nerve
- The tympanic segment of facial nerve canal
- Lateral semicircular canal
- Processuscochleariformis
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- The tendon of tensor tympani takes a turn on this process and then is inserted on the neck of malleus.
- Processuscochleariformis is an important surgical landmark for the
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level of the genu of the facial nerve.
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- Pronator quadrates has same innervations as following muscles?
- Flexor pollicis longus
- Flexor digitorum superficialis
- Palmaris longus
- Flexor digitorumprofundus of middle finger
- Flexor carpi ulnaris
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Correct Answer - A:B:C:D
Ans. is'a' i.e., Flexor pollicis longus, 'b' i.e., Flexor digitorum superficialis, 'c' i.e., Palmaris longus, 'd' i.e., Flexor digitorumprofundus of middle finger
All the flexor muscles of the forearm are supplied by median nerve, except the flexoraulnaris and the medial half of flexor digitorumprofundus to the ulnar two fingers (4th& 5th finger).
MEDIAN NERVE INNERVATONS:
- The median nerve innervates the majority of the muscles in the anterior forearm, and some intrinsic hand muscles.
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Anterior Forearm
Innervates muscles in the superficial and intermediate layers:
- Superficial layer: Pronator teres, flexor carpi radialis and palmaris longus.
- Intermediate layer: Flexor digitorum superficialis.
The median nerve also gives rise to the anterior interosseous nerve, which supplies the deep flexors:
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- Deep layer: Flexor pollicis longus, pronator quadratus, and the lateral half of the flexor digitorumprofundus (the medial half of the
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