Systemic Anatomy — MCQs
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Suprarenal gland gets its blood supply from all of the following arteries except:
What is the average number of lobes in a human breast?
Superior pancreaticoduodenal artery is a branch of?
Azygos vein drains into:
Which of the following does not directly drain into right atrium?
What muscle is attached to the superior nuchal line?
What is the uppermost structure in left lung hilum?
What is the nerve supply of the cremasteric muscle?
Uvula vesicae seen in bladder is formed from the following structure?
Which of the following is the MAJOR tributary of the coronary sinus?
Systemic Anatomy Indian Medical PG Practice Questions and MCQs
Question 261: Suprarenal gland gets its blood supply from all of the following arteries except:
- A. Aorta
- B. Inferior phrenic artery
- C. Renal artery
- D. Superior mesenteric artery (Correct Answer)
Explanation: ***Superior mesenteric artery*** - The superior mesenteric artery is the chief artery of the **midgut**, supplying structures such as the small intestine, cecum, ascending colon, and part of the transverse colon [2]. - It does **not directly supply** the suprarenal (adrenal) glands. - This is the **correct answer** as it is the artery that does NOT supply the suprarenal gland. *Aorta* - The **abdominal aorta** gives rise to the **middle suprarenal arteries**, which directly supply the suprarenal glands. - These arteries branch off the abdominal aorta at approximately the L1 vertebral level [1]. *Renal artery* - The **renal artery** gives off the **inferior suprarenal arteries**. - These branches contribute to the blood supply of the suprarenal glands from below. *Inferior phrenic artery* - The **inferior phrenic artery** gives rise to the **superior suprarenal arteries**, which are a major blood supply to the suprarenal glands [1]. - These arteries originate from the inferior phrenic artery, which typically arises directly from the aorta just below the aortic hiatus of the diaphragm.
Question 262: What is the average number of lobes in a human breast?
- A. 5
- B. 10
- C. 15 (Correct Answer)
- D. 20
Explanation: ***15*** - Historically, the human breast was described as containing **15 to 20 lobes**, each being a functionally distinct unit for milk production arranged radially around the nipple [1]. - This was the accepted anatomical teaching at the time of this examination. - **Note:** Modern imaging studies (MRI, ultrasound) have since shown that breasts typically contain **7-10 ductal systems/lobes** rather than 15-20, representing an important update to classical anatomy teaching. *5* - This number is too low and does not represent either the classical (15-20) or modern (7-10) understanding of breast lobe anatomy. - Insufficient to account for the complexity of the mammary ductal system. *10* - This represents the **upper range of modern anatomical understanding** (7-10 lobes based on current imaging studies). - While anatomically accurate by today's standards, the classical teaching referenced in this examination specified 15-20 lobes as average. *20* - Represents the **upper limit** of the classical range (15-20 lobes) [1]. - While within the historical normal range, **15 is considered the more typical average** in classical anatomy texts. - Modern research indicates this number significantly overestimates the actual lobe count.
Question 263: Superior pancreaticoduodenal artery is a branch of?
- A. Hepatic artery
- B. Splenic artery
- C. Gastroduodenal artery (Correct Answer)
- D. Inferior mesenteric artery
Explanation: ***Gastroduodenal artery*** - The **gastroduodenal artery** is a direct branch of the **common hepatic artery** [1], and it gives rise to the **superior pancreaticoduodenal artery**. - This artery is crucial for supplying blood to the **head of the pancreas** and the **duodenum**, forming an anastomosis with the inferior pancreaticoduodenal artery. *Hepatic artery* - The **hepatic artery** (specifically the common hepatic artery) gives rise to the gastroduodenal artery [1], but it does not *directly* give rise to the superior pancreaticoduodenal artery. - The common hepatic artery primarily supplies the **liver**, gallbladder, pylorus, and duodenum [1]. *Splenic artery* - The **splenic artery** is a branch of the celiac trunk that supplies the **spleen**, part of the pancreas, and greater curvature of the stomach via short gastric arteries and the left gastro-omental artery [1]. - It does not directly give rise to the superior pancreaticoduodenal artery. *Inferior mesenteric artery* - The **inferior mesenteric artery** is a major artery that supplies the distal third of the **transverse colon**, descending colon, sigmoid colon, and rectum. - It arises directly from the **abdominal aorta** significantly lower than the celiac trunk branches and is not involved in supplying the pancreas or duodenum directly via the superior pancreaticoduodenal artery.
Question 264: Azygos vein drains into:
- A. Right subcostal vein
- B. Right ascending lumbar vein
- C. Superior vena cava (Correct Answer)
- D. Brachiocephalic
Explanation: ***Superior vena cava*** - The **azygos vein** is a major venous channel that drains the walls of the thorax and abdomen, emptying directly into the **superior vena cava (SVC)**. [1] - This connection is crucial for venous return from the posterior thoracic wall, pericardium, and bronchi, especially bypassing the inferior vena cava if it's obstructed. [1] *Right subcostal vein* - The right subcostal vein is a tributary that helps form the **azygos vein**; it does not receive drainage from the azygos vein. - It contributes to the initial formation of the azygos system, not its termination. *Brachiocephalic* - The **brachiocephalic veins** are formed by the union of the internal jugular and subclavian veins, and they merge to form the **superior vena cava**. - The azygos vein drains into the superior vena cava, not directly into the brachiocephalic veins. *Right ascending lumbar vein* - The **right ascending lumbar vein** is a major tributary that contributes to the formation of the **azygos vein** in the lumbar region. - It drains into the azygos system, illustrating its origin rather than its termination.
Question 265: Which of the following does not directly drain into right atrium?
- A. Inferior vena cava
- B. Great cardiac vein (Correct Answer)
- C. Anterior cardiac vein
- D. Venae cordis minimi
Explanation: ***Great cardiac vein*** - The **great cardiac vein** drains into the **coronary sinus**, which then empties into the right atrium [1]. - It does not drain directly into the right atrium, distinguishing it from the other options. *Inferior vena cava* - The **inferior vena cava** is one of the major vessels that drains directly into the **right atrium**. - It carries deoxygenated blood from the lower body to the right atrium. *Anterior cardiac vein* - The **anterior cardiac veins** drain directly into the **right atrium**. - They tend to drain the anterior surface of the right ventricle. *Venae cordis minimi* - Also known as **Thebesian veins**, these are small veins that drain directly into the cardiac chambers, including the **right atrium**. - They represent a direct communication between the myocardial capillaries and the cardiac chambers.
Question 266: What muscle is attached to the superior nuchal line?
- A. Trapezius muscle (Correct Answer)
- B. Scalenus anterior
- C. Coracobrachialis muscle
- D. Biceps Brachii muscle
Explanation: ***Trapezius muscle*** - The **trapezius muscle** is a large, triangular muscle of the back that extends from the **occipital bone** (including the superior nuchal line) to the lower thoracic vertebrae. - Its **superior fibers** originate from the **medial one-third of the superior nuchal line** and the external occipital protuberance. *Scalenus anterior* - The **scalenus anterior** muscle originates from the **transverse processes of cervical vertebrae**, specifically C3-C6. - It inserts onto the **first rib** and is involved in neck flexion and elevation of the first rib during forced inspiration. *Coracobrachialis muscle* - The **coracobrachialis muscle** originates from the **coracoid process of the scapula**. - It inserts into the **medial surface of the humerus** and is involved in shoulder flexion and adduction. *Biceps Brachii muscle* - The **biceps brachii muscle** has two heads: the short head originates from the **coracoid process**, and the long head originates from the **supraglenoid tubercle of the scapula**. - It inserts onto the **radial tuberosity** and is primarily responsible for elbow flexion and forearm supination.
Question 267: What is the uppermost structure in left lung hilum?
- A. Pulmonary artery (Correct Answer)
- B. Pulmonary vein
- C. Bronchial artery
- D. Left mainstem bronchus
Explanation: ***Pulmonary artery*** - In the **left lung hilum**, the **pulmonary artery** typically lies superior to the bronchus. - This anatomical position helps differentiate it from the relations in the right lung hilum, where the pulmonary artery is anterior to the bronchus. *Pulmonary vein* - The **pulmonary veins** are usually located anterior and inferior to the bronchus in both lung hila. - They tend to be the most anterior and inferior structures carrying oxygenated blood from the lungs. *Bronchial artery* - **Bronchial arteries** are smaller vessels that typically run on the posterior surface of the bronchi. - They are not considered the uppermost main structure in the hilum. *Left mainstem bronchus* - The **left mainstem bronchus** is usually found inferior to the pulmonary artery and posterior to the pulmonary veins in the left hilum. - It is a prominent structure but not the most superior.
Question 268: What is the nerve supply of the cremasteric muscle?
- A. Pudendal nerve
- B. Femoral branch of genitofemoral
- C. Genital branch of genitofemoral nerve (Correct Answer)
- D. Ilioinguinal nerve
Explanation: ***Genital branch of genitofemoral nerve*** - The **genital branch of the genitofemoral nerve** (L1-L2) directly innervates the cremaster muscle, controlling its contraction. - This nerve provides the **efferent (motor) limb** of the **cremasteric reflex**, causing elevation of the testis when the inner thigh is stroked. - The afferent (sensory) limb of this reflex is carried by the ilioinguinal nerve or femoral branch of the genitofemoral nerve. *Pudendal nerve* - The **pudendal nerve** (S2-S4) primarily innervates the perineum and external genitalia, responsible for sensation and motor function of the pelvic floor and sphincters. - It does not supply the cremaster muscle. *Femoral branch of genitofemoral* - The **femoral branch of the genitofemoral nerve** supplies sensation to the skin of the upper anterior thigh. - It provides sensory input (afferent limb) for the cremasteric reflex but does not have motor innervation to the cremaster muscle. *Ilioinguinal nerve* - The **ilioinguinal nerve** (L1) provides sensory innervation to the skin of the upper medial thigh, root of the penis/mons pubis, and parts of the scrotum/labia majora. - While it traverses the inguinal canal and may contribute to the afferent limb of the cremasteric reflex, it does not innervate the cremaster muscle itself.
Question 269: Uvula vesicae seen in bladder is formed from the following structure?
- A. Lateral lobe of the prostate
- B. Anterior lobe of the prostate
- C. Posterior lobe of the prostate
- D. Median lobe of the prostate (Correct Answer)
Explanation: ***Median lobe of the prostate*** - The **uvula vesicae** is a slight median elevation on the internal surface of the **bladder base**, immediately behind the **internal urethral orifice**. - This elevation is formed by the underlying **median (middle) lobe of the prostate** projecting upward beneath the bladder mucosa. - In **benign prostatic hyperplasia (BPH)**, enlargement of the median lobe accentuates this prominence and can cause significant urinary obstruction. *Lateral lobe of the prostate* - Enlargement of the **lateral lobes** causes lateral compression of the prostatic urethra, not a median elevation at the bladder neck. - While they are the most common site of **BPH**, they do not form the uvula vesicae. *Anterior lobe of the prostate* - The **anterior lobe** (or anterior fibromuscular stroma) is located in front of the urethra and is non-glandular. - It does not contribute to the formation of the uvula vesicae or cause significant urinary symptoms. *Posterior lobe of the prostate* - The **posterior lobe** is located behind the urethra and is the most common site for **prostate cancer**. - It does not project into the bladder base and therefore does not form the uvula vesicae.
Question 270: Which of the following is the MAJOR tributary of the coronary sinus?
- A. Anterior cardiac vein
- B. Thebesian vein
- C. Oblique vein of Marshall
- D. Great cardiac vein (Correct Answer)
Explanation: ***Great cardiac vein*** - The **great cardiac vein** is the largest and most significant tributary, draining areas supplied by the **left main coronary artery** and its branches. - It runs in the **anterior interventricular groove**, accompanying the anterior interventricular artery, and then curves around the left side of the heart to empty into the coronary sinus. *Anterior cardiac vein* - The **anterior cardiac veins** typically drain directly into the **right atrium**, bypassing the coronary sinus [1]. - They primarily drain the anterior surface of the **right ventricle**. *Thebesian vein* - The **Thebesian veins** (venae cordis minimae) are small veins that open directly into the **chambers of the heart**, not the coronary sinus. - They are responsible for a small amount of **physiological shunt** of deoxygenated blood into the left heart chambers. *Oblique vein of Marshall* - The **oblique vein of Marshall** (oblique vein of the left atrium) is a small vein originating from the posterior wall of the left atrium. - It is a **remnant of the left superior vena cava** and empties into the left extremity of the coronary sinus, but it is not considered the major tributary in terms of blood flow volume.
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