Systemic Anatomy — MCQs
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Which of the following structures of joints is not innervated?
Cremasteric artery is a branch of?
Which of the following is a retroperitoneal structure?
Inferior epigastric vein drains into?
Appendices epiploicae are a feature of?
Valve of Heister is seen in
Inferior rectal artery is a branch of?
Which of the following is not a branch of the lumbar plexus?
Superficial epigastric artery is a branch of?
Which of the following structures is not a boundary of Calot's triangle shown in the given image?
Systemic Anatomy Indian Medical PG Practice Questions and MCQs
Question 231: Which of the following structures of joints is not innervated?
- A. Synovium
- B. Ligaments
- C. Capsule
- D. Articular cartilage (Correct Answer)
Explanation: ***Articular cartilage*** - **Articular cartilage** is primarily composed of **chondrocytes** embedded in an extracellular matrix, lacking **nerves** and **blood vessels** [1]. - Its **aneural** nature explains why damage to articular cartilage often causes no direct pain until underlying structures are affected [1]. *Synovium* - The **synovial membrane** is richly innervated with **nociceptors** and **mechanoreceptors**, contributing to pain perception and proprioception within joints. - Inflammation of the synovium (**synovitis**) is a common cause of joint pain. *Capsule* - The **fibrous capsule** surrounding a joint is densely innervated by **sensory nerve endings**, including **nociceptors** and **mechanoreceptors**. - Stretching or damage to the joint capsule can result in significant pain. *Ligaments* - **Ligaments** are **well-innervated** with sensory nerve endings, particularly **proprioceptors** and **nociceptors**. - This innervation allows ligaments to provide feedback on joint position and contribute to pain sensation upon injury.
Question 232: Cremasteric artery is a branch of?
- A. Internal pudendal artery
- B. External pudendal artery
- C. Inferior epigastric artery (Correct Answer)
- D. Superior epigastric artery
Explanation: ***Inferior epigastric artery*** - The **cremasteric artery** (also known as the external spermatic artery) is a branch of the **inferior epigastric artery**. - It supplies the **cremaster muscle** and other structures within the spermatic cord. *Internal pudendal artery* - The **internal pudendal artery** primarily supplies the perineum and external genitalia. - It does not typically give rise to the cremasteric artery. *External pudendal artery* - The **external pudendal artery** typically supplies the skin of the scrotum/labia majora and the perineum [2]. - It is not the origin of the cremasteric artery. *Superior epigastric artery* - The **superior epigastric artery** is a terminal branch of the internal thoracic artery and supplies the upper part of the anterior abdominal wall [1]. - It is anatomically distant and unrelated to the origin of the cremasteric artery.
Question 233: Which of the following is a retroperitoneal structure?
- A. Ileum
- B. Jejunum
- C. Ureter (Correct Answer)
- D. Appendix
Explanation: ***Ureter*** - The **ureters** are tubes that carry urine from the kidneys to the bladder and are located **posterior to the peritoneum**, making them retroperitoneal structures [1]. - This anatomical position means they are covered anteriorly by the peritoneum but not suspended by a mesentery [2]. *Ileum* - The **ileum** is part of the small intestine and is an **intraperitoneal organ**, meaning it is suspended within the abdominal cavity by the mesentery. - Its peritoneal covering allows for significant mobility within the abdomen. *Jejunum* - Like the ileum, the **jejunum** is also an **intraperitoneal organ**, suspended by the mesentery and allowing for free movement. - It is located within the greater sac of the peritoneal cavity. *Appendix* - The **appendix** is typically an **intraperitoneal structure**, suspended by its own mesentery, the mesoappendix. - While it can be located in a retrocecal position (behind the cecum), it remains primarily an intraperitoneal organ due to its peritoneal covering.
Question 234: Inferior epigastric vein drains into?
- A. Femoral vein
- B. External iliac vein (Correct Answer)
- C. Internal iliac vein
- D. Internal pudendal vein
Explanation: ***External iliac vein*** - The **inferior epigastric vein** runs superiorly from the **inguinal ligament** and is a direct tributary of the external iliac vein, which then continues as the common iliac vein. [2] - This anatomical connection is crucial in understanding the venous drainage of the **anterior abdominal wall** inferior to the umbilicus. [2] *Femoral vein* - The **femoral vein** is a continuation of the popliteal vein and drains the lower limb, eventually becoming the external iliac vein above the inguinal ligament. [1] - The inferior epigastric vein does **not directly drain** into the femoral vein. *Internal iliac vein* - The **internal iliac vein** primarily drains structures within the **pelvis** and the **gluteal region**. - It does not receive direct drainage from the inferior epigastric vein, which is associated with the anterior abdominal wall. [2] *Internal pudendal vein* - The **internal pudendal vein** drains structures of the **perineum** and parts of the external genitalia. - It is a tributary of the internal iliac vein and plays no direct role in draining the inferior epigastric region.
Question 235: Appendices epiploicae are a feature of?
- A. Duodenum
- B. Stomach
- C. Colon (Correct Answer)
- D. Jejunum
Explanation: ***Colon*** - **Appendices epiploicae** are small, fat-filled pouches of peritoneum attached to the outer surface of the **colon**, distinguishing it from other parts of the gastrointestinal tract. - They are most numerous and prominent on the **transverse** and **sigmoid colon** [1]. *Duodenum* - The **duodenum** is the first part of the small intestine and lacks appendices epiploicae. - Its distinguishing features include **Brunner's glands** in the submucosa. *Stomach* - The **stomach** is characterized by rugae (folds of the mucosa) and multiple muscle layers, but it does not have appendices epiploicae. - Its primary function is mechanical and chemical digestion of food. *Jejunum* - The **jejunum**, part of the small intestine, is characterized by prominent **plica circulares (circular folds)** and long villi, but it does not possess appendices epiploicae. - It is mainly involved in nutrient absorption [2].
Question 236: Valve of Heister is seen in
- A. Cystic duct (Correct Answer)
- B. Common bile duct
- C. Common hepatic duct
- D. Pancreatic duct
Explanation: ***Cystic duct*** - The **spiral valve of Heister** (or Valves of Heister) are a series of crescentic folds of mucous membrane found within the cystic duct [1]. - These valves are thought to help prevent the collapse or over-distension of the cystic duct, ensuring a continuous flow of bile to and from the gallbladder. *Common bile duct* - The common bile duct is formed by the union of the **cystic duct** and the **common hepatic duct**. - It does not contain the Valve of Heister; its primary function is to transport bile to the duodenum. *Common hepatic duct* - The common hepatic duct is formed by the union of the **right and left hepatic ducts** from the liver. - It also does not contain the Valve of Heister; its role is to drain bile from the liver. *Pancreatic duct* - The pancreatic duct (or **Duct of Wirsung**) carries digestive enzymes from the pancreas to the duodenum. - It is anatomically distinct from the biliary system and does not contain the Valve of Heister.
Question 237: Inferior rectal artery is a branch of?
- A. Inferior mesenteric artery
- B. Superior mesenteric artery
- C. Coeliac trunk
- D. Internal pudendal artery (Correct Answer)
Explanation: ***Internal pudendal artery*** - The **inferior rectal artery** is a direct branch of the internal pudendal artery which supplies the anal canal [1]. - The **internal pudendal artery** is a branch of the internal iliac artery, supplying structures in the perineum [1]. *Inferior mesenteric artery* - The inferior mesenteric artery supplies the **distal transverse colon**, descending colon, sigmoid colon, and superior part of the rectum (via the superior rectal artery) [1]. - It does not directly supply the lower anal canal, which is the domain of the inferior rectal artery. *Superior mesenteric artery* - The superior mesenteric artery supplies the **small intestine** and the **proximal large intestine** up to the transverse colon [1]. - It supplies the midgut derivatives and is not involved in supplying the rectum or anal canal directly. *Coeliac trunk* - The coeliac trunk is the main arterial supply to the **foregut** organs, including the stomach, liver, spleen, and pancreas [1]. - It does not supply any part of the rectum or anal canal.
Question 238: Which of the following is not a branch of the lumbar plexus?
- A. Ilioinguinal nerve
- B. Genitofemoral nerve
- C. Iliohypogastric nerve
- D. Subcostal nerve (Correct Answer)
Explanation: ***Subcostal nerve*** - The **subcostal nerve** is the ventral ramus of the **T12 spinal nerve** and is therefore part of the **thoracic spinal nerves**, not the lumbar plexus. - It runs inferior to the 12th rib, innervates the **external oblique muscle**, and contributes to the innervation of the **rectus abdominis** and **pyramidalis muscles**. *Iliohypogastric nerve* - This nerve is a branch of the **lumbar plexus** (L1) and innervates the **internal oblique** and **transversus abdominis muscles** [1]. - It also provides cutaneous innervation to the **suprapubic region** and a small part of the buttock. *Ilioinguinal nerve* - The ilioinguinal nerve is also a branch of the **lumbar plexus** (L1) and runs parallel to the iliohypogastric nerve [1]. - It provides cutaneous innervation to the **upper medial thigh**, base of the penis/mons pubis, and the anterior part of the scrotum/labium majus. *Genitofemoral nerve* - Originating from the **lumbar plexus** (L1, L2), the genitofemoral nerve divides into a **genital branch** and a **femoral branch**. - The genital branch innervates the **cremaster muscle** in males and the **labia majora** in females, while the femoral branch supplies cutaneous innervation to the **anterior thigh**.
Question 239: Superficial epigastric artery is a branch of?
- A. Internal pudendal artery
- B. External pudendal artery
- C. Internal iliac artery
- D. Femoral artery (Correct Answer)
Explanation: ***Femoral artery*** - The **superficial epigastric artery** is one of the initial branches that arises directly from the **femoral artery** in the femoral triangle, just below the inguinal ligament. - It supplies the **skin** and **superficial fascia** over the lower part of the anterior abdominal wall and the superficial inguinal lymph nodes [1]. *Internal pudendal artery* - The **internal pudendal artery** is a branch of the **internal iliac artery** and primarily supplies structures in the perineum and genitalia. - It does not supply the anterior abdominal wall. *External pudendal artery* - The **external pudendal artery** is also a branch of the **femoral artery**, but it supplies the skin of the external genitalia (scrotum/labia majora) and adjacent thigh. - It does not supply the superficial epigastric region. *Internal iliac artery* - The **internal iliac artery** primarily supplies the pelvic organs, gluteal region, and medial thigh. - While it has many branches, the superficial epigastric artery is not one of them.
Question 240: Which of the following structures is not a boundary of Calot's triangle shown in the given image?
- A. Common hepatic duct
- B. Cystic duct
- C. Inferior surface of the liver
- D. Gallbladder (Correct Answer)
Explanation: ***Gallbladder*** - The image depicts **Calot's triangle**, which is an important anatomical landmark in gallbladder surgery. The gallbladder itself is located within this region, but it is not one of the defined boundaries of the triangle. - While central to the anatomy shown, the **gallbladder** is surrounded by the structures that form the triangle's boundaries rather than bounding it itself. *Common hepatic duct* - The **common hepatic duct** forms the medial boundary of Calot's triangle. - This duct is formed by the union of the right and left hepatic ducts and carries bile from the liver. *Cystic duct* - The **cystic duct** forms the lateral (or inferior) boundary of Calot's triangle. - This duct connects the gallbladder to the common hepatic duct. *Inferior surface of the liver* - The **inferior surface of the liver** forms the superior boundary of Calot's triangle. - Specifically, this refers to the edge of the right lobe of the liver at the base of the gallbladder fossa.
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