Systemic Anatomy — MCQs
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Inferior pancreaticoduodenal artery is a branch of which of the following arteries?
Which vein is found at the apex of the heart?
Which artery supplies the anterior part of the interventricular septum?
The incudomalleolar joint is a?
Which of the following statements about the first part of the duodenum is false?
All are parts of anterior segment of eye except?
Which of the following statements is true regarding the anatomy of the external nose?
Where is Schatzki's Ring present?
Which of the following arteries does NOT contribute to Little's area?
Thickest portion of sclera is?
Systemic Anatomy Indian Medical PG Practice Questions and MCQs
Question 271: Inferior pancreaticoduodenal artery is a branch of which of the following arteries?
- A. Splenic artery
- B. Left gastric artery
- C. Gastroduodenal artery
- D. Superior mesenteric artery (Correct Answer)
Explanation: ***Superior mesenteric artery*** - The **inferior pancreaticoduodenal artery** is a direct branch of the **superior mesenteric artery (SMA)**. - It supplies the **head of the pancreas** and the **duodenum**, anastomosing with branches from the gastroduodenal artery. *Splenic artery* - The splenic artery is a branch of the **celiac trunk** and primarily supplies the **spleen**, stomach, and pancreas (via pancreatic branches). - It does not give rise to the inferior pancreaticoduodenal artery. *Left gastric artery* - The left gastric artery is a branch of the **celiac trunk** and supplies the **lesser curvature of the stomach** and distal esophagus. - It has no direct connection to the inferior pancreaticoduodenal artery. *Gastroduodenal artery* - The gastroduodenal artery is a branch of the **common hepatic artery** (from the celiac trunk) and gives off the **anterior and posterior superior pancreaticoduodenal arteries**. - While it supplies the head of the pancreas and duodenum, it is not the origin of the inferior pancreaticoduodenal artery, which arises from the SMA.
Question 272: Which vein is found at the apex of the heart?
- A. Coronary sinus
- B. Anterior cardiac vein
- C. Middle cardiac vein
- D. Great cardiac vein (Correct Answer)
Explanation: ***Great cardiac vein*** - The **great cardiac vein** originates near the **apex of the heart** and ascends in the anterior interventricular groove. - It drains blood from the anterior aspects of both ventricles and the left atrium. *Coronary sinus* - The **coronary sinus** is a large venous structure located on the posterior surface of the heart, not at the apex. - It receives most of the venous blood from the myocardium and empties into the right atrium. *Anterior cardiac vein* - The **anterior cardiac veins** typically run across the anterior surface of the right ventricle and drain directly into the right atrium, bypassing the coronary sinus. - They are generally smaller and not found at the apex of the heart. *Middle cardiac vein* - The **middle cardiac vein** runs in the posterior interventricular groove, on the diaphragmatic surface of the heart. - It originates near the apex but on the posterior aspect, making it primarily a posterior vessel.
Question 273: Which artery supplies the anterior part of the interventricular septum?
- A. Right coronary artery
- B. Posterior descending coronary artery
- C. Left anterior descending artery (LAD) (Correct Answer)
- D. None of the options
Explanation: ***Left anterior descending artery (LAD)*** - The **LAD** is a branch of the **left main coronary artery** and is also known as the "widowmaker" due to its critical supply to a large portion of the left ventricle and the interventricular septum [1]. - It gives rise to **septal branches** that typically supply the anterior two-thirds of the interventricular septum [1]. *Right coronary artery* - The **right coronary artery (RCA)** primarily supplies the **right ventricle**, the right atrium, the SA node (in 60% of people), and the AV node (in 90% of people). - It typically supplies the **inferior wall** of the left ventricle and the posterior one-third of the interventricular septum [1]. *Posterior descending coronary artery* - The **posterior descending artery (PDA)** arises from the **RCA** (in approximately 85% of individuals, known as right dominance) or less commonly from the circumflex artery (in left dominance) [1]. - It supplies the **posterior one-third** of the interventricular septum and typically the inferior wall of the left ventricle [1]. *None of the options* - This option is incorrect because the **LAD** clearly and predominantly supplies the anterior part of the interventricular septum.
Question 274: The incudomalleolar joint is a?
- A. Saddle joint (Correct Answer)
- B. Pivot joint
- C. Ellipsoid joint
- D. Hinge joint
Explanation: ***Saddle joint*** - The **incudomalleolar joint** is classified as a **saddle joint** (also called a **sellar joint**), which is a type of synovial joint. - It has reciprocally concave-convex articular surfaces that fit together like a rider on a saddle. - This joint allows **slight gliding movements** between the head of the malleus and the body of the incus during sound transmission. - Standard anatomy texts including **Gray's Anatomy** classify this as a saddle joint based on its structural characteristics. *Pivot joint* - A **pivot joint** allows rotation around a single axis, such as the **atlantoaxial joint** (atlas rotating around the dens of axis) or the **proximal radioulnar joint**. - While the ossicular chain as a whole undergoes rotatory movement during sound transmission, the **incudomalleolar joint itself** is not classified as a pivot joint anatomically. *Ellipsoid joint* - An **ellipsoid joint** (condyloid joint) allows movement in two planes (flexion/extension and abduction/adduction) but restricts rotation. - Examples include the **radiocarpal joint** and **metacarpophalangeal joints** of the fingers. - The incudomalleolar joint has a different articular surface configuration. *Hinge joint* - A **hinge joint** permits movement primarily in one plane (flexion and extension), like a door hinge. - Examples include the **elbow joint**, **knee joint**, and **interphalangeal joints**. - This does not match the structural or functional characteristics of the incudomalleolar joint.
Question 275: Which of the following statements about the first part of the duodenum is false?
- A. 5 cm long
- B. Is superior part
- C. Develops from foregut
- D. Supplied by the superior mesenteric artery (Correct Answer)
Explanation: ***Supplied by the superior mesenteric artery*** - The first part of the duodenum, derived from the **foregut**, receives its blood supply from the **gastroduodenal artery**, a branch of the celiac artery [1], [2]. - The **superior mesenteric artery** primarily supplies the **midgut** derivatives, which include the distal half of the duodenum and onward [2]. *5 cm long* - The first part of the duodenum is indeed the **shortest** and widest section, typically measuring about **5 cm (2 inches)** in length. - This length allows it to course from the pylorus to the inferior border of the L1 vertebra. *Is superior part* - This statement is correct as the first part courses **superiorly** and then posteriorly, crossing the right crus of the diaphragm. - It lies at the level of the **L1 vertebra**. *Develops from foregut* - The first part of the duodenum, along with the other upper gastrointestinal structures (stomach, liver, pancreas), indeed develops from the **embryonic foregut** [1]. - The transition from foregut to midgut occurs at the level of the **major duodenal papilla**.
Question 276: All are parts of anterior segment of eye except?
- A. Lens
- B. Cornea
- C. Aqueous humor
- D. Vitreous (Correct Answer)
Explanation: ***Vitreous*** - The **vitreous humor**, or simply vitreous, is a transparent, gel-like substance that fills the space posterior to the lens and anterior to the retina, making it part of the **posterior segment** of the eye [3]. - Its main function is to maintain the shape of the eye and keep the retina in place. *Lens* - The **lens** is a transparent, biconvex structure located behind the iris and in front of the vitreous, making it a key component of the **anterior segment** [2]. - It works to focus light onto the retina, changing shape to alter the focal length of the eye. *Cornea* - The **cornea** is the transparent, outermost layer of the eye that covers the iris, pupil, and anterior chamber, clearly positioning it within the **anterior segment** [2]. - It plays a crucial role in focusing light into the eye. *Aqueous humor* - The **aqueous humor** is a clear, watery fluid located in the space between the cornea and the lens (the anterior and posterior chambers), which is definitively part of the **anterior segment** [1]. - It nourishes the cornea and lens and maintains intraocular pressure.
Question 277: Which of the following statements is true regarding the anatomy of the external nose?
- A. The lower one-third is primarily cartilaginous. (Correct Answer)
- B. The upper two-thirds is entirely bony.
- C. The lateral aspect has only a single cartilage.
- D. The external nose is supported by two nasal bones.
Explanation: ***The lower one-third is primarily cartilaginous.*** - The **lower one-third** of the external nose, including the nasal tip and alae, is predominantly supported by **alar cartilages** (lower lateral cartilages) and other minor cartilages, giving it flexibility. - This cartilaginous structure allows for movement and shaping of the nostrils. - This statement is **anatomically accurate and complete**. *The upper two-thirds is entirely bony.* - This is **incorrect**. - The **upper one-third** is bony (nasal bones and frontal process of maxilla). - The **middle one-third** is primarily **cartilaginous** (upper lateral cartilages). - Therefore, the upper two-thirds consists of **both bone and cartilage**, not entirely bone. *The lateral aspect has only a single cartilage.* - This is **incorrect**. - The lateral aspect contains **multiple cartilages**: upper lateral cartilages, lower lateral (alar) cartilages, and accessory cartilages. - The presence of multiple cartilages provides structural support and flexibility. *The external nose is supported by two nasal bones.* - This is **incomplete and misleading**. - While two **nasal bones** do form the superior bony bridge (upper one-third), the external nose is also supported by: - Frontal process of the maxilla - Upper and lower lateral cartilages - Septal cartilage - Stating only the nasal bones ignores the majority of nasal support structures.
Question 278: Where is Schatzki's Ring present?
- A. Upper end of trachea
- B. Lower end of esophagus (Correct Answer)
- C. Upper end of esophagus
- D. Lower end of trachea
Explanation: ***Lower end of esophagus*** - **Schatzki's Ring** is a localized narrowing that can occur at the **gastroesophageal junction**, specifically at the squamocolumnar junction. - This ring is a common cause of intermittent **dysphagia** for solid foods. [2] *Upper end of trachea* - The upper end of the trachea is the **larynx** or a region just below it, which is anatomically distinct from the esophagus. - Constrictions in this area are generally unrelated to Schatzki's Ring and typically involve conditions like **subglottic stenosis**. *Upper end of esophagus* - The upper end of the esophagus contains the **upper esophageal sphincter** (UES), which is a muscular structure. [3] - While strictures can occur here, they are not referred to as Schatzki's Ring. *Lower end of trachea* - The lower end of the trachea **bifurcates into the bronchi** and is part of the respiratory system. [1] - Anatomically, it is separate from the esophagus, and issues here would be related to respiratory conditions, not Schatzki's Ring.
Question 279: Which of the following arteries does NOT contribute to Little's area?
- A. Sphenopalatine artery
- B. Posterior Ethmoidal artery (Correct Answer)
- C. Greater palatine artery
- D. Anterior Ethmoidal artery
Explanation: Posterior Ethmoidal artery - The posterior ethmoidal artery primarily supplies the posterior ethmoidal cells and part of the sphenoid sinus, but it does not contribute to the vascular plexus in Little's area. - Little's area, also known as Kiesselbach's plexus, is formed by anastomoses of several arteries on the anterior nasal septum. Sphenopalatine artery - The sphenopalatine artery, a terminal branch of the maxillary artery, is a major contributor to Little's area through its septal branch. - It supplies a significant portion of the nasal septum and is frequently involved in posterior epistaxis. Greater palatine artery - The greater palatine artery, a branch of the descending palatine artery (from the maxillary artery), enters the nasal cavity through the incisive canal and contributes to Little's area on the nasal septum. - It primarily supplies the hard palate and then anastomoses with other vessels in the anterior nasal septum. Anterior Ethmoidal artery - The anterior ethmoidal artery, a branch of the ophthalmic artery, is a key contributor to Little's area. - It supplies the anterior and middle ethmoidal cells and also contributes to the blood supply of the dura mater.
Question 280: Thickest portion of sclera is?
- A. Anterior to rectus muscle insertion
- B. Limbus
- C. Posterior to rectus muscle insertion
- D. Near the optic nerve (Correct Answer)
Explanation: ***Near the optic nerve*** - The sclera is thickest at its posterior aspect, particularly around the **optic nerve head**, where it blends with the dura mater [1]. - This region provides a robust anchoring point for the optic nerve and structural support for the posterior globe. *Anterior to rectus muscle insertion* - The sclera in this region, while relatively thick compared to the equator, is not the absolute thickest part. - This area is important for attaching the **extraocular muscles**, but the maximum thickness is not found here. *Posterior to rectus muscle insertion* - The sclera thins out slightly as it moves posteriorly from the muscle insertions towards the equator of the globe. - This section is generally of moderate thickness, not the thickest. *Limbus* - The limbus, the junction between the cornea and sclera, is a transition zone where the sclera has an intermediate thickness. - It is an important anatomical landmark but not the thickest point of the sclera.
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