NEET-PG 2012

1213 Questions — Page 8 of 122

Anatomy

4 questions

Q71

The thoracic duct crosses from the right to the left at the level of

Q72

Which structures are located anterior to the transverse sinus?

Q73

In patients with penile or urethral injury, Colle's fascia prevents extravasation of urine from spreading into which anatomical space?

Q74

All are lateral branches of the abdominal aorta, EXCEPT which of the following?

NEET-PG 2012 - Anatomy NEET-PG Practice Questions and MCQs

Question 71: The thoracic duct crosses from the right to the left at the level of

A. T12 vertebra
B. T2 vertebra
C. T4-T5 vertebra (Correct Answer)
D. T6 vertebra

Explanation: ***T4-T5 vertebra*** - The **thoracic duct** crosses from the right to the left side of the vertebral column at the level of the **T4-T5 vertebrae**, specifically just above the root of the left lung. - This crossover is an important anatomical landmark as it signifies the duct's ascent towards the neck to drain into the left subclavian vein. *T12 vertebra* - The **thoracic duct** originates from the **cisterna chyli** at the level of the L1 or L2 vertebra and ascends into the thorax at or below the T12 vertebra, it does not cross over at this level. - This level primarily marks its entry into the thoracic cavity, not its main crossover point. *T6 vertebra* - While the **thoracic duct** is present in the thorax at this level, it does not undergo its characteristic crossover from right to left at the T6 vertebra. - The duct continues its ascent along the right side of the vertebral column before moving across. *T2 vertebra* - By the level of the T2 vertebra, the **thoracic duct** has already crossed to the left side of the vertebral column and is ascending towards its termination in the neck. - The crossover event occurs more inferiorly, at the T4-T5 level.

Question 72: Which structures are located anterior to the transverse sinus?

A. Right atrium
B. Left atrium
C. Right pulmonary artery
D. Aorta (Correct Answer)

Explanation: ***Aorta*** - The **transverse sinus of the pericardium** is a passage within the pericardial cavity that separates the great arteries (aorta and pulmonary trunk) anteriorly from the atria and great veins posteriorly. - The **ascending aorta** and **pulmonary trunk** are both located anterior to the transverse sinus. - This anatomical relationship is clinically important during cardiac surgery, as the transverse sinus can be used to pass ligatures around the great vessels. *Right atrium* - The **right atrium** is located posterior to the transverse sinus. - It forms part of the posterior wall of the pericardial cavity and receives the superior and inferior venae cavae. - The transverse sinus separates the atria from the anteriorly positioned great arteries. *Left atrium* - The **left atrium** is also positioned posterior to the transverse sinus. - It forms the base of the heart and receives the pulmonary veins. - Like the right atrium, it lies behind the plane of the transverse sinus. *Right pulmonary artery* - The **right pulmonary artery** is a branch of the pulmonary trunk that passes to the right lung. - While the **pulmonary trunk** itself is anterior to the transverse sinus, the **right pulmonary artery** branch courses laterally and posteriorly, passing behind the ascending aorta and superior vena cava. - Therefore, the right pulmonary artery is NOT considered anterior to the transverse sinus in the same way the main great vessels (aorta and pulmonary trunk) are.

Question 73: In patients with penile or urethral injury, Colle's fascia prevents extravasation of urine from spreading into which anatomical space?

A. Superficial perineal space
B. None of the options
C. Ischiorectal fossa (Correct Answer)
D. Abdomen

Explanation: ***Ischiorectal fossa*** - Colle's fascia (superficial perineal fascia) is the membranous layer that defines the boundaries of the **superficial perineal space**. - When urethral injury occurs, urine extravasates into the superficial perineal space but is **prevented from spreading laterally and posteriorly** into the ischiorectal fossa because Colle's fascia fuses with the **ischiopubic rami** laterally and the **perineal membrane** posteriorly [1]. - The ischiorectal fossa is a space lateral to the **anal canal** that is separated from the superficial perineal space by these fascial attachments. *Superficial perineal space* - This is actually the space **into which** urine extravasates when penile or urethral injury occurs, not the space that is protected from extravasation [1]. - Colle's fascia forms the inferior boundary of this space, so urine collects here rather than being prevented from entering. *Abdomen* - Colle's fascia in the perineum is continuous with **Scarpa's fascia** of the anterior abdominal wall. - Due to this continuity, urine can actually **track superiorly** into the anterior abdominal wall along this fascial plane. - Therefore, Colle's fascia does NOT prevent spread to the abdomen. *None of the options* - This option is incorrect because Colle's fascia specifically prevents lateral and posterior spread into the ischiorectal fossa through its anatomical attachments.

Question 74: All are lateral branches of the abdominal aorta, EXCEPT which of the following?

A. Right testicular artery
B. Left renal artery
C. Middle suprarenal artery
D. Celiac trunk (Correct Answer)

Explanation: ***Celiac trunk*** - The **celiac trunk** is an anterior branch of the abdominal aorta, supplying the foregut derivatives. - It arises from the ventral aspect of the aorta, distinguishing it from lateral branches. *Right testicular artery* - The **testicular arteries** (gonadal arteries) are paired lateral branches of the abdominal aorta. - They arise inferior to the renal arteries and descend to supply the testes in males. *Left renal artery* - The **renal arteries** [1] [3] are large paired lateral branches of the abdominal aorta. - They supply the kidneys [2] and typically arise just inferior to the superior mesenteric artery. *Middle suprarenal artery* - The **middle suprarenal arteries** are paired lateral branches, typically arising directly from the abdominal aorta. - They supply the suprarenal (adrenal) glands [2].

Internal Medicine

1 questions

Q71

Renal vein thrombosis is associated with all of the following conditions except:

Physiology

5 questions

Q71

Nonshivering thermogenesis in adults is due to:

Q72

What is the primary physiological effect of increased 2,3-DPG on hemoglobin?

Q73

Which sensory modalities are most directly affected by lesions of the primary somatosensory cortex?

Q74

Which of the following statements about volume receptors is NOT true?

Q75

Tetanic contraction is due to accumulation of?

NEET-PG 2012 - Physiology NEET-PG Practice Questions and MCQs

Question 71: Nonshivering thermogenesis in adults is due to:

A. Muscle metabolism
B. Thyroid hormone
C. Noradrenaline
D. Brown fat between the shoulders (Correct Answer)

Explanation: ***Brown fat between the shoulders*** - In adults, the primary **effector tissue** for **non-shivering thermogenesis** is **brown adipose tissue (BAT)**, with major depots located between the shoulders, around the neck, and along the spine. - **BAT** contains specialized mitochondria with **uncoupling protein 1 (UCP1)** that uncouples oxidative phosphorylation, generating heat instead of ATP. - This is the tissue where non-shivering thermogenesis actually occurs, making it the direct answer to what non-shivering thermogenesis is "due to." *Noradrenaline* - **Noradrenaline** is the key neurotransmitter that **activates brown fat** via **β3-adrenergic receptors** to initiate non-shivering thermogenesis. - While noradrenaline is the **trigger/stimulus**, the actual heat production occurs in brown adipose tissue. - Noradrenaline itself does not produce heat directly; it acts as the signal that activates the thermogenic machinery in BAT. *Thyroid hormone* - **Thyroid hormone** increases **basal metabolic rate** and can potentiate the thermogenic response by upregulating UCP1 expression in brown fat. - Its role is **permissive and long-term** rather than being the immediate effector of acute non-shivering thermogenesis. - It modulates overall cellular metabolism but is not the primary mechanism for rapid heat generation in cold exposure. *Muscle metabolism* - **Muscle contraction** during shivering generates heat through increased ATP hydrolysis, which is **shivering thermogenesis**. - **Non-shivering thermogenesis** specifically refers to heat production **without muscle contraction**, making muscle metabolism the mechanism for shivering, not non-shivering, thermogenesis.

Question 72: What is the primary physiological effect of increased 2,3-DPG on hemoglobin?

A. Increased affinity of hemoglobin to oxygen
B. Decreased affinity of hemoglobin to oxygen (Correct Answer)
C. Left shift of oxygen-hemoglobin dissociation curve
D. Right shift of oxygen-hemoglobin dissociation curve

Explanation: ***Decreased affinity of hemoglobin to oxygen*** - **2,3-Diphosphoglycerate (2,3-DPG)** binds to the beta subunits of deoxyhemoglobin, stabilizing the **deoxygenated state** and thus **reducing hemoglobin's affinity for oxygen**. - This is the **primary molecular mechanism** by which 2,3-DPG exerts its effect, facilitating **oxygen unloading** in peripheral tissues. - This decreased affinity manifests graphically as a **right shift** in the oxygen-hemoglobin dissociation curve. *Increased affinity of hemoglobin to oxygen* - This is incorrect because 2,3-DPG specifically works to **decrease hemoglobin's affinity** for oxygen, promoting oxygen release. - Increased affinity would mean oxygen is held more tightly, which is counterproductive for **oxygen delivery** to tissues. *Left shift of oxygen-hemoglobin dissociation curve* - A **left shift** indicates **increased affinity** of hemoglobin for oxygen, meaning oxygen is held more tightly. - Since 2,3-DPG decreases affinity, it causes a **right shift**, not a left shift. *Right shift of oxygen-hemoglobin dissociation curve* - While this is the **graphical representation** of 2,3-DPG's effect, it is a **consequence** of the primary molecular mechanism (decreased affinity). - A right shift signifies that for any given partial pressure of oxygen, hemoglobin is **less saturated** with oxygen, reflecting the decreased affinity caused by 2,3-DPG binding.

Question 73: Which sensory modalities are most directly affected by lesions of the primary somatosensory cortex?

A. Pain, temperature, and touch
B. Vibration and proprioception
C. Localization and two-point discrimination (Correct Answer)
D. All of the options

Explanation: ***Localization and two-point discrimination*** - Lesions in the **primary somatosensory cortex** (S1) lead to profoundly impaired **discriminative touch**, which includes the ability to precisely localize tactile stimuli and distinguish between two closely spaced points. - These are the **most characteristic deficits** of S1 lesions, representing the cortex's unique role in processing **spatial discrimination and fine sensory analysis**. - S1 is essential for the **integrative functions** that allow precise spatial mapping of sensory inputs. *Pain, temperature, and touch* - Basic touch perception is affected, but **pain and temperature** are primarily mediated by the **spinothalamic tracts** with substantial processing in the thalamus, insular cortex, and anterior cingulate cortex rather than S1. - Crude touch sensation remains relatively preserved with S1 lesions; it is the **discriminative quality** that is lost. - These modalities are NOT the most directly affected by isolated S1 lesions. *Vibration and proprioception* - **Vibration** and **proprioception** are indeed significantly impacted by S1 lesions as S1 receives thalamic projections from the **dorsal column-medial lemniscus (DCML) pathway**. - However, these modalities have substantial **subcortical representation** in the thalamus and can be partially preserved even with cortical damage. - In contrast, **localization and two-point discrimination** are purely cortical functions with no subcortical processing, making them the MOST directly and exclusively dependent on S1 integrity. *All of the options* - This is incorrect because pain and temperature perception is NOT most directly affected by S1 lesions—these are primarily processed by other pathways and cortical areas (spinothalamic system, insular cortex).

Question 74: Which of the following statements about volume receptors is NOT true?

A. They are located in carotid sinus (Correct Answer)
B. They are low pressure receptors
C. They mediate vasopressin release
D. They provide afferents for thirst control

Explanation: ***They are located in carotid sinus*** - Volume receptors, primarily **atrial stretch receptors** and receptors in the **pulmonary vessels**, are located in the low-pressure areas of the circulation, not the carotid sinus. - The carotid sinus primarily contains **baroreceptors** which detect changes in arterial pressure, not blood volume. *They are low pressure receptors* - This statement is true; volume receptors are indeed **low-pressure receptors** found in the atria and great veins. - They primarily monitor **extracellular fluid volume** and central venous pressure. *They provide afferents for thirst control* - This statement is true; when blood volume decreases, the firing rate of these receptors decreases, signaling the **central nervous system** to stimulate thirst. - This is an important mechanism for regulating **fluid intake** and maintaining hydration. *They mediate vasopressin release* - This statement is true; a decrease in blood volume reduces the afferent signaling from volume receptors, which consequently stimulates the release of **vasopressin (ADH)**. - Vasopressin then increases **water reabsorption** in the kidneys to conserve fluid.

Question 75: Tetanic contraction is due to accumulation of?

A. Na+
B. K+
C. Ca2+ (Correct Answer)
D. Cl-

Explanation: ***Ca2+*** - **Tetanic contraction** results from a rapid succession of muscle stimulations, leading to the sustained elevation of **intracellular calcium (Ca2+)** levels. - This persistent high Ca2+ concentration in the sarcoplasm allows for continuous binding to **troponin**, maintaining the activation of cross-bridge cycling. *Na+* - **Sodium (Na+)** influx is primarily responsible for the **depolarization** of the muscle cell membrane, leading to an **action potential**. - While essential for initiating the contraction, Na+ accumulation itself does not directly cause the sustained high Ca2+ levels characteristic of tetany. *K+* - **Potassium (K+)** efflux is crucial for the **repolarization** of the muscle cell membrane after an action potential. - Accumulation of K+ in the extracellular space can contribute to muscle fatigue and reduce excitability, but it does not directly lead to tetanic contraction. *Cl-* - **Chloride (Cl-)** ions play a significant role in stabilizing the resting membrane potential and contributing to muscle **repolarization**, particularly in skeletal muscle. - While important for muscle function, changes in Cl- concentration do not directly cause the sustained Ca2+ release required for tetanic contraction.