Pelvis and Perineum Practice Questions

Q: Which of the following statements about the prostatic urethra is false?

Trapezoid in cross-section. ***Trapezoid in cross-section*** - This statement is false because the prostatic urethra is typically **crescent-shaped** or **horseshoe-shaped** in cross-section due to the anterior-posterior compression by the surrounding prostate gland. - A trapezoid shape is not characteristic of the prostatic urethra's anatomy. *Presence of verumontanum* - The **verumontanum**, or seminal colliculus, is a prominent feature on the posterior wall of the prostatic urethra. - It is an important landmark where the ejaculatory ducts and prostatic utricle open. *Contains urethral crest* - The **urethral crest** is a longitudinal ridge located on the posterior wall of the prostatic urethra. - The verumontanum is part of this crest, and numerous prostatic ducts open into grooves on either side of it. *Opening of prostatic ducts* - Numerous **prostatic ducts** open into the prostatic sinuses, which are grooves located on either side of the urethral crest and verumontanum within the prostatic urethra. - These ducts secrete prostatic fluid into the urethra.

Q: Which of the following structures does not pass deep to the sacrococcygeal ligament?

Superior gluteal artery. ***Superior gluteal artery*** - The **superior gluteal artery** exits the pelvis through the **greater sciatic foramen**, above the piriformis muscle. - It does not extend distally to the region of the sacrococcygeal ligament and therefore does not pass deep to it. *S5 nerve* - The **S5 nerve** exits the sacral canal via the **sacral hiatus**, which is bounded by the sacrococcygeal ligament. - It passes **deep** to this ligament as it exits to innervate structures in the perineum. *Coccygeal nerve* - The **coccygeal nerve** exits the sacral canal through the sacral hiatus, **deep** to the sacrococcygeal ligament. - It contributes to the **coccygeal plexus** and innervates the skin in the anococcygeal region. *Filum terminale* - The **filum terminale** is a fibrous extension of the pia mater that anchors the **spinal cord** to the coccyx. - It descends through the sacral canal and exits at the sacrococcygeal hiatus, passing **deep** to the sacrococcygeal ligament.

Q: Urine extravasation occurs in the following case of penile urethral rupture, except:

Ischiorectal fossa. ***Ischiorectal fossa (Correct - Urine does NOT extravasate here)*** - The **ischiorectal fossa** is protected superiorly by the **urogenital diaphragm** which is attached to the pubic rami and ischial tuberosities. - Urine extravasating from a **penile urethral rupture** is confined to the superficial perineal pouch and **cannot** freely spread into the deep perineal pouch or the ischiorectal fossae due to these fascial boundaries. - This is the exception - the urogenital diaphragm acts as a barrier preventing urine from reaching this space. *Scrotum (Incorrect - Urine DOES extravasate here)* - The **superficial perineal fascia (Colles' fascia)** is continuous with the dartos fascia of the scrotum, allowing urine from a penile urethral rupture to readily spread into the **scrotal sac**. - This results in significant swelling and discoloration of the scrotum. *Abdominal wall (Incorrect - Urine DOES extravasate here)* - **Colles' fascia** is continuous superiorly with **Scarpa's fascia** of the anterior abdominal wall. - Urine from a penile urethral rupture can track beneath Scarpa's fascia, leading to extravasation into the superficial layers of the **lower abdominal wall**. *Below superficial fascia of penis (Incorrect - Urine DOES extravasate here)* - The **penile urethra** is located within the superficial perineal pouch, and a rupture in this segment allows urine to extravasate into the space **below the superficial fascia of the penis**. - This is a direct pathway for urine to spread within the confines of the superficial perineal pouch.

Q: Subpubic angle in females is

90 degrees. ***90 degrees*** - The **subpubic angle** in females typically ranges from **80-90 degrees**, making **90 degrees** the most accurate answer among the given options. - This wider angle is a distinguishing feature of the **female pelvis**, reflecting adaptations for childbirth and is significantly wider than the male angle (50-60 degrees). - Standard anatomy references cite the female subpubic angle as approximately **90 degrees** at the upper limit of normal. *120 degrees* - While the female pelvis has a wider angle than males, **120 degrees** exceeds the normal anatomical range. - This value is an overestimation and not representative of the typical female subpubic angle. *180 degrees* - A subpubic angle of **180 degrees** would imply a completely flat, straight line between the pubic rami, which is anatomically impossible. - This value does not represent any normal anatomical configuration in the human pelvis. *70 degrees* - An angle of **70 degrees** is characteristic of the **male subpubic angle**, which is narrower (typically 50-60 degrees, but can be up to 70 degrees). - This narrower angle is not conducive to childbirth and distinguishes the male from the female pelvis.

Q: Which of the following is an anterior branch of the internal iliac artery?

Superior vesical artery. ***Superior vesical artery*** - The **superior vesical artery** is typically a **patent remnant of the umbilical artery** and supplies the superior part of the urinary bladder and distal ureter. - It is consistently described as an anterior branch of the internal iliac artery, along with the **umbilical, obturator, inferior vesical, middle rectal, uterine, vaginal, and internal pudendal arteries**. *Superior gluteal artery* - The **superior gluteal artery** is the largest branch of the internal iliac artery, but it consistently arises from the **posterior division**. - It exits the pelvis through the **greater sciatic foramen** superior to the piriformis muscle to supply the gluteal muscles. *Ilio-lumbar artery* - The **ilio-lumbar artery** is a branch of the **posterior division** of the internal iliac artery. - It ascends to supply the **psoas major** and **quadratus lumborum muscles**, and anastomoses with the lumbar and deep circumflex iliac arteries. *Inferior gluteal artery* - The **inferior gluteal artery** is a main artery of the gluteal region, but it typically arises from the **posterior division** of the internal iliac artery, or occasionally from a common trunk with the superior gluteal artery, which also originates posteriorly. - It exits the pelvis through the **greater sciatic foramen**, inferior to the piriformis muscle, to supply the gluteus maximus and adjacent structures.

Question 1

Which of the following statements about the prostatic urethra is false?

Accepted Answer

Trapezoid in cross-section

Answer

Presence of verumontanum

Answer

Contains urethral crest

Answer

Opening of prostatic ducts

Question 2

Which of the following structures does not pass deep to the sacrococcygeal ligament?

Accepted Answer

Superior gluteal artery

Answer

S5 nerve

Answer

Coccygeal nerve

Answer

Filum terminale

Question 3

Urine extravasation occurs in the following case of penile urethral rupture, except:

Accepted Answer

Ischiorectal fossa

Answer

Abdominal wall

Answer

Below superficial fascia of penis

Answer

Scrotum

Question 4

Subpubic angle in females is

Accepted Answer

90 degrees

Answer

120 degrees

Answer

180 degrees

Answer

70 degrees

Question 5

Which of the following is an anterior branch of the internal iliac artery?

Accepted Answer

Superior vesical artery

Answer

Superior gluteal artery

Answer

Ilio-lumbar artery

Answer

Inferior gluteal artery

Pelvis and Perineum — MCQs

Pelvis and Perineum — MCQs

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