NEET-PG 2020 - Anatomy Practice Questions

Q: In the following X-ray of the wrist, what is the exact age of the child?

6 years. ***6 years*** - The appearance of **ossification centers** in the carpals and epiphysis of long bones of the hand and wrist indicates a bone age of approximately 6 years. Key markers for this age include the presence of **capitate, hamate, triquetrum, lunate, scaphoid, and trapezium** ossification centers, as well as the initial appearance of the **distal radial epiphysis** and **epiphyses of phalanges and metacarpals**. - Specifically, the **trapezium** and **scaphoid** ossification centers are typically visible by 5-6 years, and the **distal radial epiphysis** has started to ossify but the **distal ulna epiphysis** is not yet visible, which is characteristic of the 6-year-old child. *2 years* - At 2 years of age, fewer **carpal bones** would be ossified, typically only the capitate and hamate, and possibly the triquetrum. - The **epiphyses** of the distal radius and ulna and many of the phalanges and metacarpals would be less developed or not yet visible. *8 years* - By 8 years, the **distal ulna epiphysis** would typically be visible, and the **trapezoid** would also be ossified, which is not clearly evident yet in this image. - The carpal bones present are consistent with a younger age than 8 years. *9 years* - At 9 years, all **carpal ossification centers** (capitate, hamate, triquetrum, lunate, scaphoid, trapezium, trapezoid, and pisiform) would generally be present, with the pisiform appearing around 9-12 years. - The image lacks the full complement of carpal bones consistently seen at 9 years, especially the **pisiform** and a distinctly visible **trapezoid**.

Q: Identify the cell type marked in the cerebellum.

Purkinje cells. ***Purkinje cells*** - These are **large, flask-shaped neurons** with extensive dendritic trees, forming a single layer in the cerebellar cortex. - The image clearly shows these characteristic large, pear-shaped cell bodies with a surrounding paler area (Purkinje layer), distinguishing them from the smaller, more numerous cells in the granular layer below. *Basket cells* - These are **inhibitory interneurons** located within the **molecular layer** of the cerebellum, superficial to the Purkinje cells. - They are typically smaller than Purkinje cells and send axons that form a "basket" around the somata of Purkinje cells, which is not what is highlighted here. *Granule cells* - These are the **smallest and most numerous neurons** in the brain, found in the **granular layer** of the cerebellum, deep to the Purkinje cells. - They appear as small, densely packed, dark nuclei in the image, distinct from the larger, paler cells indicated by the arrow. *Golgi cells* - These are inhibitory interneurons located in the **granular layer** of the cerebellum, below the Purkinje cell layer. - While larger than granule cells, they are generally smaller and less distinct than Purkinje cells, and their morphology does not match the prominent cells pointed out by the arrow.

Q: Type of joint at site marked by the arrow?

Synovial Joint. ***Synovial Joint*** - The arrow points to a joint demonstrating a **joint capsule**, containing **synovial fluid** within a joint cavity, and lined by **hyaline cartilage**, all hallmarks of a synovial joint. - **Synovial joints** are uniquely designed for movement, allowing for a wide range of motion between bones due to their specific structural components. *Syndesmosis* - A syndesmosis is a type of **fibrous joint** where bones are joined by a sheet or bundle of long irregular connective tissue fibers, such as the **interosseous membrane** between the tibia and fibula. - This joint type allows for very little movement, contrasting with the free movement indicated by the visible joint space. *Symphysis* - A symphysis is a type of **cartilaginous joint** where two bones are joined by a pad of **fibrocartilage**, for example, the **pubic symphysis** or intervertebral discs. - This type of joint allows for limited movement and lacks a joint cavity and synovial fluid. *Synarthrosis* - A **synarthrosis** is a **fibrous, immovable joint** typically found in structures like the sutures of the skull, providing strong, rigid connections. - These joints allow for no movement and lack a joint cavity.

Q: The upward extension of thyroid swelling is prevented by which of the following structures

Pretracheal fascia. ***Pretracheal fascia*** - The **pretracheal fascia** is a deep cervical fascia layer that **envelops the thyroid gland** and is continuous with the fibrous capsule of the gland. - Due to its attachments, particularly to the **cricoid cartilage** and **recurrent laryngeal nerve sheath**, it anchors the thyroid gland and **restricts its upward movement** during swallowing. *Sternothyroid* - The **sternothyroid muscle** depresses the larynx and thyroid gland, but it does **not inherently prevent upward extension** of a thyroid swelling. - Its action is on the **movement of the larynx** and thyroid, rather than an anatomical barrier to swelling. *Thyrohyoid membrane* - The **thyrohyoid membrane** connects the thyroid cartilage to the hyoid bone and allows for movement between them, but it has no direct role in **preventing upward extension of a thyroid swelling**. - It is mainly involved in **laryngeal elevation** during swallowing. *Ligament of Berry* - The **ligament of Berry** (or lateral suspensory ligament) connects the thyroid gland to the **cricoid cartilage** and **trachea** [1]. - While it offers some stability to the thyroid gland, its primary role is to **anchor the gland posteriorly** rather than prevent the upward extension of a swelling [1].

Q: Episiotomy incision was extended posteriorly beyond perineal body injuring the structure immediately posterior to it. Which structure has been injured?

External anal sphincter. ***External anal sphincter*** - An overextended **episiotomy incision** that goes beyond the perineal body posteriorly will likely injure the **external anal sphincter**, which is immediately posterior to the perineal body [4]. - Injury to this sphincter can lead to **fecal incontinence** [1]. *Ischiocavernosus* - The **ischiocavernosus muscle** is located more laterally in the perineum and plays a role in clitoral erection, not directly posterior to the perineal body. - An episiotomy extending posteriorly would not typically involve this muscle. *Urethral sphincter* - The **urethral sphincter** is located anterior to the perineal body and surrounds the urethra [3]. - Injury to this sphincter is associated with anterior perineal trauma, not posterior extension of an episiotomy [3]. *Bulbospongiosus* - The **bulbospongiosus muscle** is a superficial perineal muscle that surrounds the vaginal orifice and contributes to the perineal body [4]. - While it can be involved in an episiotomy, the structure immediately posterior to the perineal body itself is the external anal sphincter [2].

Q: What is the nerve supply of the shown muscle?

Dorsal scapular. ***Dorsal scapular*** - The image points to the **levator scapulae muscle**, which elevates and rotates the scapula. - The **dorsal scapular nerve** (C5 root, with contributions from C3-C4) innervates the levator scapulae, as well as the rhomboid major and minor muscles. - This nerve arises from the C5 root of the brachial plexus and pierces through the middle scalene muscle. - Clinically, injury to the dorsal scapular nerve can cause **medial scapular winging** and difficulty elevating the shoulder. *Suprascapular* - The suprascapular nerve (C5-C6) primarily innervates the **supraspinatus and infraspinatus muscles**, which are involved in rotator cuff function. - It does not supply the levator scapulae muscle. - This nerve passes through the suprascapular notch beneath the superior transverse scapular ligament. *Dorsal rami of C1* - The **dorsal ramus of C1** (suboccipital nerve) primarily innervates the muscles of the suboccipital triangle: rectus capitis posterior major and minor, obliquus capitis superior and inferior. - These nerves are involved in fine head and neck movements but do not innervate the levator scapulae. - The levator scapulae receives segmental innervation from C3-C4 cervical nerves directly, in addition to the dorsal scapular nerve. *Subscapular* - The subscapular nerves (upper and lower, from C5-C6) innervate the **subscapularis muscle**, which is part of the rotator cuff. - They also innervate the **teres major muscle**, but not the levator scapulae. - These are branches from the posterior cord of the brachial plexus.

Q: Episotomy extended posteriorly beyond perineal body injuring structure posterior to it, which structure is injured?

External anal sphincter. ***External anal sphincter*** - An episiotomy extending posteriorly beyond the **perineal body** (the central tendon of the perineum) is likely to involve the **external anal sphincter (EAS)**, which lies immediately posterior to the perineal body. - Injury to the EAS can lead to **fecal incontinence** due to its role in voluntary control of defecation. *Urethral sphincter* - The **urethral sphincter** is located anterior to the vaginal introitus and is not typically affected by a posterior extension of an episiotomy. - Damage to the urethral sphincter would lead to **urinary incontinence**, not directly related to posterior perineal injury. *Ischiocavernosus* - The **ischiocavernosus muscle** covers the crus of the clitoris (or penis in males) and is located more laterally and anteriorly in the perineum. - Its primary role is in **clitoral (or penile) erection**, and it is generally not injured by an episiotomy, especially one extending posteriorly. *Bulbospongiosus* - The **bulbospongiosus muscle** surrounds the vaginal opening and bulb of the vestibule, lying superficial to the perineal membrane. - While an episiotomy cuts through this muscle, a posterior extension *beyond* the perineal body would primarily involve structures further back, such as the **external anal sphincter**, not just the bulbospongiosus.

Q: Remnants of Wolffian ducts in a female are found in

Broad ligament. ***Broad ligament*** - In females, remnants of the **Wolffian (mesonephric) ducts** can persist as structures such as the **epoophoron**, **paroophoron**, and **Gartner's duct cysts**, which are typically found within the broad ligament [1]. - The **broad ligament** is a fold of peritoneum that extends from the lateral walls of the uterus to the sidewalls of the pelvis, enclosing these developmental remnants. *Uterovesical pouch* - This is a peritoneal reflection between the **uterus and the bladder** and does not typically contain remnants of the Wolffian ducts. - It is a common site for fluid accumulation but not for developmental anomalies related to the mesonephric system. *Pouch of Douglas* - Also known as the **recto-uterine pouch**, this is the most dependent part of the peritoneal cavity in females, located between the **uterus and the rectum**. - While it can accumulate fluid or pathology, it is not where Wolffian duct remnants are primarily located. *Iliac fossa* - The **iliac fossa** contains structures like the **iliacus muscle**, **lymph nodes**, and parts of the bowel, but it is not the anatomical location for the remnants of the Wolffian ducts in females. - This region is more involved in supporting abdominal contents and housing major blood vessels and nerves rather than reproductive developmental remnants.

Question 1

In the following X-ray of the wrist, what is the exact age of the child?

Accepted Answer

6 years

Answer

2 years

Answer

8 years

Answer

9 years

Question 2

Identify the cell type marked in the cerebellum.

Accepted Answer

Purkinje cells

Answer

Basket cells

Answer

Granule cells

Answer

Golgi cells

Question 3

Type of joint at site marked by the arrow?

Accepted Answer

Synovial Joint

Answer

Syndesmosis

Answer

Symphysis

Answer

Synarthrosis

Question 4

The upward extension of thyroid swelling is prevented by which of the following structures

Accepted Answer

Pretracheal fascia

Answer

Sternothyroid

Answer

Thyrohyoid membrane

Answer

Ligament of berry

Question 5

Episiotomy incision was extended posteriorly beyond perineal body injuring the structure immediately posterior to it. Which structure has been injured?

Accepted Answer

External anal sphincter

Answer

Ischiocavernosus

Answer

Urethral sphincter

Answer

Bulbospongiosus

Question 6

What is the nerve supply of the shown muscle?

Accepted Answer

Dorsal scapular

Answer

Suprascapular

Answer

Dorsal rami of C1

Answer

Subscapular

Question 7

Episotomy extended posteriorly beyond perineal body injuring structure posterior to it, which structure is injured?

Accepted Answer

External anal sphincter

Answer

Urethral sphincter

Answer

Ischiocavernosus

Answer

Bulbospongiosus

Question 8

Remnants of Wolffian ducts in a female are found in

Accepted Answer

Broad ligament

Answer

Uterovesical pouch

Answer

Pouch of Douglas

Answer

Iliac fossa

NEET-PG 2020 — Anatomy