Systemic Anatomy — MCQs
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All of the following muscles have dual nerve supply except which one?
Pubic symphysis is which type of joint?
In sexual assault of a child, the hymen is usually not ruptured due to:
All of the following arteries are branches of the coeliac trunk, EXCEPT which one?
Which is the primary segment of the liver drained by the right hepatic vein?
Which bone has the maximum anatomical contribution to the floor of the orbit?
Which of the following is not the part of ethmoid bone?
Which of the following is a tributary of the coronary sinus?
Which of the following is a traction epiphysis ?
Which of the following is NOT an anterior relation of the right kidney?
Systemic Anatomy Indian Medical PG Practice Questions and MCQs
Question 291: All of the following muscles have dual nerve supply except which one?
- A. Pectoralis major
- B. Flexor digitorum profundus
- C. Biceps brachii (Correct Answer)
- D. Subscapularis
Explanation: ***Biceps brachii*** - The **biceps brachii** muscle is solely innervated by the **musculocutaneous nerve (C5, C6, C7)**. - This muscle is a prime mover for forearm supination and elbow flexion and does not receive nerve supply from any other nerve. *Subscapularis* - The **subscapularis** muscle has a dual nerve supply from both the **upper and lower subscapular nerves (C5, C6)**. - This dual innervation ensures motor control of the subscapularis, which is an important medial rotator of the humerus. *Pectoralis major* - The **pectoralis major** muscle receives a dual nerve supply from both the **medial and lateral pectoral nerves** [1]. - The **lateral pectoral nerve** primarily supplies the clavicular head, while the **medial pectoral nerve** supplies both the sternocostal head and a portion of the clavicular head [1]. *Flexor digitorum profundus* - The **flexor digitorum profundus** muscle has a dual nerve supply from the **median nerve** (innervating the lateral half for digits 2 and 3) and the **ulnar nerve** (innervating the medial half for digits 4 and 5). - This dual innervation allows for independent or coordinated flexion of the distal phalanges of the fingers.
Question 292: Pubic symphysis is which type of joint?
- A. Gomphosis
- B. Fibrous joint
- C. Primary cartilaginous
- D. Secondary cartilaginous (Correct Answer)
Explanation: ***Secondary cartilaginous*** - The **pubic symphysis** is a classic example of a **secondary cartilaginous joint**, also known as a **symphysis**. - These joints are characterized by a plate of **fibrocartilage** sandwiched between two layers of hyaline cartilage, uniting two bones and allowing for limited movement. *Gomphosis* - A **gomphosis** is a type of **fibrous joint** where a peg-like process fits into a socket, primarily found in the attachment of teeth to their sockets in the jaw. - It is distinct from the cartilaginous structure of the pubic symphysis. *Fibrous joint* - While fibrous joints are characterized by fibrous connective tissue connecting bones, this category is too broad, and doesn't specify the unique cartilaginous nature of the pubic symphysis. - Examples include sutures in the skull, syndesmoses, and gomphoses, none of which fit the structure of the pubic symphysis. *Primary cartilaginous* - A **primary cartilaginous joint**, or **synchondrosis**, involves bones united by **hyaline cartilage**, like the epiphyseal plates of growing bones. - These joints are typically temporary and eventually ossify, or they allow for very restricted movement, unlike the fibrocartilage and slight movement of the pubic symphysis.
Question 293: In sexual assault of a child, the hymen is usually not ruptured due to:
- A. Elastic and distensible (Correct Answer)
- B. Anatomically immature
- C. Thick and fibrous
- D. Deep seated
Explanation: ***Elastic and distensible*** - The **prepubertal hymen is elastic, thin, and highly distensible**, allowing it to stretch considerably without tearing during trauma - This **elasticity is due to lack of estrogenization** before puberty, making the hymenal tissue more flexible and resistant to rupture - In forensic examinations of child sexual abuse, an **intact hymen does not exclude penetrating trauma** due to this distensibility - The elastic nature allows the hymen to accommodate penetration and return to near-normal appearance *Thick and fibrous* - This describes the **post-pubertal hymen** after estrogenization, not the prepubertal hymen - After puberty, increased estrogen makes the hymen thicker, more vascularized, and less elastic - In children, the hymen is actually thin and pliable, the opposite of thick and fibrous *Anatomically immature* - While technically the prepubertal anatomy differs from adults, this term is vague - "Anatomical immaturity" does not specifically explain the resistance to rupture - The key feature is elasticity, not simply immaturity *Deep seated* - The hymen's position relative to the vaginal introitus does not significantly differ in children - Depth is not the protective factor - tissue elasticity is the primary reason
Question 294: All of the following arteries are branches of the coeliac trunk, EXCEPT which one?
- A. Splenic artery
- B. Left gastric artery
- C. Common hepatic artery
- D. Right gastric artery (Correct Answer)
Explanation: ***Right gastric artery*** - The **right gastric artery** typically originates from the **proper hepatic artery**, which is a branch of the common hepatic artery. - Therefore, it is not a direct branch of the coeliac trunk itself. *Left gastric artery* - The **left gastric artery** is one of the three main direct branches of the **coeliac trunk**. - It supplies the lesser curvature of the stomach and the abdominal esophagus. *Splenic artery* - The **splenic artery** is another major direct branch of the **coeliac trunk**. - It supplies the spleen, pancreas, and parts of the stomach via various branches. *Common hepatic artery* - The **common hepatic artery** is the third main direct branch of the **coeliac trunk**. - It gives rise to the proper hepatic artery and the gastroduodenal artery, supplying the liver, gallbladder, pylorus, and duodenum.
Question 295: Which is the primary segment of the liver drained by the right hepatic vein?
- A. I
- B. II
- C. IV
- D. VII (Correct Answer)
Explanation: ***VII*** - The **right hepatic vein** drains the **posterior segment** of the right lobe, which includes segments **VI and VII**. Segment VII is particularly well-drained by this vein. [3] - Understanding hepatic venous drainage is crucial for **surgical planning** and interpreting imaging studies of the liver. [4] *I* - Segment I, the **caudate lobe**, is unique in its venous drainage, often by small veins directly into the **inferior vena cava (IVC)** or occasionally into the left and middle hepatic veins. [1] - It has a separate blood supply and drainage which differentiates it from other segments. [4] *II* - Segment II is part of the **left lateral segment** and is primarily drained by the **left hepatic vein**. - The left hepatic vein typically drains segments II and III. [2] *IV* - Segment IV, or the **quadrate lobe**, is primarily drained by the **middle hepatic vein**. - The middle hepatic vein also drains segment VIII and the anterior aspect of segment V.
Question 296: Which bone has the maximum anatomical contribution to the floor of the orbit?
- A. Maxillary (Correct Answer)
- B. Zygomatic
- C. Sphenoid
- D. Palatine
Explanation: ***Maxillary*** - The **maxilla** contributes the most significantly to the **orbital floor**, forming approximately **75%** of its surface area. - The orbital plate of the maxilla is a thin, triangular bone that also forms the roof of the **maxillary sinus**. *Zygomatic* - The **zygomatic bone** forms the **lateral wall** and the **lateral portion** of the **orbital floor**. - Its contribution to the overall floor is less extensive than that of the maxilla (approximately 20-25%). *Sphenoid* - The **sphenoid bone** does **NOT** contribute to the **orbital floor** at all. - It forms parts of the **posterior wall** and **lateral wall** (via greater and lesser wings) of the orbit, but has no anatomical contribution to the floor. *Palatine* - The **palatine bone** (via its orbital process) contributes a very small, **posterior-most part** of the **orbital floor**. - Its contribution is minimal (less than 5%) compared to the maxilla and zygomatic bone.
Question 297: Which of the following is not the part of ethmoid bone?
- A. Agger nasi
- B. Crista galli
- C. Uncinate process
- D. Inferior turbinate (Correct Answer)
Explanation: ***Inferior turbinate*** - The **inferior turbinate** (or inferior nasal concha) is a separate paired facial bone, distinct from the ethmoid bone. - It articulates with the maxilla, lacrimal, palatine, and ethmoid bones but is not a component of the ethmoid. *Agger nasi* - The **agger nasi** is an anatomical variant, an anterior expansion of the ethmoid air cells, and is thus functionally part of the ethmoid complex. - While not a distinct bone, it is an **ethmoid cell** that can be found in the anterior aspect of the middle meatus. *Crista galli* - The **crista galli** is a prominent, upward projection from the cribriform plate of the ethmoid bone, serving as an attachment point for the falx cerebri. - It is an integral and easily recognizable part of the **ethmoid bone**. *Uncinate process* - The **uncinate process** is a sickle-shaped bony projection that arises from the inferior aspect of the ethmoid bone. - It forms the anterior boundary of the **hiatus semilunaris** and is crucial for the drainage of the frontal and maxillary sinuses.
Question 298: Which of the following is a tributary of the coronary sinus?
- A. Anterior cardiac vein
- B. Smallest cardiac vein
- C. Thebesian vein
- D. Great cardiac vein (Correct Answer)
Explanation: ***Great cardiac vein*** - The **great cardiac vein** is a major tributary that drains into the **coronary sinus**, carrying deoxygenated blood from the anterior and left ventricular walls [1]. - It travels alongside the **anterior interventricular artery** (LAD) and then wraps around the left side of the heart to join the coronary sinus [1]. *Anterior cardiac vein* - The **anterior cardiac veins** typically collect blood directly into the **right atrium**, bypassing the coronary sinus [1]. - They primarily drain the anterior wall of the right ventricle. *Thebesian vein* - **Thebesian veins** (or venae cordis minimae) are small veins that drain blood from the **myocardium directly into the heart chambers**, predominantly the atria [1]. - They represent a direct communication between the myocardial capillaries and the heart chambers, not tributaries of the coronary sinus. *Smallest cardiac vein* - The term "smallest cardiac vein" is often used synonymously with **Thebesian veins** [1]. - These veins empty directly into the **heart chambers**, serving as an ancillary drainage system, rather than converging into the coronary sinus.
Question 299: Which of the following is a traction epiphysis ?
- A. Tibial condyles
- B. Head of femur
- C. Trochanter of femur
- D. Coracoid process of scapula (Correct Answer)
Explanation: ***Coracoid process of scapula*** - A **traction epiphysis** (also called atavistic epiphysis) serves as an attachment site for muscles and tendons, transferring muscle force to the bone without bearing significant weight or forming articular surfaces. - The **coracoid process** is a classic example, anchoring the **pectoralis minor, coracobrachialis, and short head of biceps brachii**, as well as important ligaments (coracoclavicular and coracoacromial). - It develops from a separate ossification center purely for muscle and ligament attachment, not for articulation or weight-bearing. *Tibial condyles* - The **tibial condyles** are **pressure epiphyses** (articular epiphyses) that form the superior articular surface of the tibia. - They articulate with the femoral condyles to form the knee joint and bear significant weight during standing and movement. - Their primary function is joint formation and contribution to longitudinal bone growth. *Trochanter of femur* - The **greater and lesser trochanters** are large bony prominences that serve as muscle attachment sites, but they are better classified as **apophyses** rather than true traction epiphyses. - An **apophysis** is a secondary ossification center that does not contribute to longitudinal bone growth and serves primarily for muscle attachment. - While functionally similar to traction epiphyses, the term "traction epiphysis" is more specifically applied to structures like the coracoid process, tibial tuberosity, and calcaneal tuberosity. *Head of femur* - The **head of femur** is a classic **pressure epiphysis** that articulates with the acetabulum to form the hip joint. - It bears significant body weight and contributes to the longitudinal growth of the femur. - Its primary functions are joint formation and weight transmission, not muscle attachment.
Question 300: Which of the following is NOT an anterior relation of the right kidney?
- A. Hepatic flexure
- B. Liver
- C. 4th part of duodenum (Correct Answer)
- D. 2nd part of duodenum
Explanation: ***4th part of duodenum*** - The **4th part of the duodenum** is located to the **left of the vertebral column** and is related to the **left kidney**, not the right kidney. - This segment passes superiorly along the left side of the aorta to become continuous with the jejunum at the duodenojejunal flexure. *Liver* - The **right kidney's superior part** is in direct contact with the **right lobe of the liver**, often separated only by the peritoneum [1]. - This is a significant anterior relation, explaining why liver enlargement can sometimes displace the right kidney. *Hepatic flexure* - The **hepatic flexure** (right colic flexure) of the colon lies immediately inferior to the liver and anterior to the **lower part of the right kidney**. - This anatomical relationship means that the right kidney can be affected by diseases of the colon in this region. *2nd part of duodenum* - The **descending (2nd) part of the duodenum** lies anterior to the **hilum and medial part of the right kidney** [1]. - Its retroperitoneal position places it in close proximity to the renal structures, making it a key anterior relation.
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