NEET-PG 2012 — Anatomy

Q: A patient is found to have a melanoma originating in the skin of the left forearm. After removal of the tumor from the forearm, all axillary lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed. Which axillary nodes would not be removed?

Apical lymph nodes. ***Apical lymph nodes*** - The **apical lymph nodes** are located **medial** to the **medial border of the pectoralis minor muscle**, at the apex of the axilla (Level III) [2]. - Since the removal was restricted to nodes **lateral** to the medial edge of the pectoralis minor, the apical nodes would **not be removed**. - These nodes receive lymph from all other axillary node groups and drain into the subclavian lymphatic trunk. *Central lymph nodes* - **Central lymph nodes** are located **posterior to (deep to)** the pectoralis minor muscle, within the axillary fat (Level II) [1]. - They lie between the medial and lateral borders of the pectoralis minor and are generally considered to be **lateral** to the medial edge of the pectoralis minor, so they would be removed in this dissection. *Lateral lymph nodes* - **Lateral (humeral) lymph nodes** are found along the **lateral border** of the axilla, following the axillary vein (Level I) [1]. - These nodes drain the majority of the upper limb and are clearly **lateral** to the pectoralis minor muscle, so hese would be included in the dissection. *Pectoral lymph nodes* - **Pectoral (anterior) lymph nodes** lie along the **lower border** of the pectoralis minor muscle and the lateral thoracic vessels (Level I). - They receive lymph from the anterior and lateral thoracic walls and much of the breast. - These nodes are located **lateral** to the medial edge of the pectoralis minor and would be removed as part of the surgical procedure. [Practice more Anatomy PYQs on OnCourse]

Q: Deltoid ligament is attached to all, except which structure?

Medial cuneiform. ***Medial cuneiform*** - The **deltoid ligament** is located on the **medial side of the ankle** and primarily connects the **tibia** to several tarsal bones. It does not attach to the medial cuneiform. - The **medial cuneiform** is a midfoot bone primarily involved in the **tarsometatarsal joint** and is not a direct attachment site for the deltoid ligament. *Medial malleolus* - The **medial malleolus**, the distal end of the **tibia**, serves as the **proximal attachment point** for all four parts of the deltoid ligament. - This strong connection is crucial for **stabilizing the ankle joint** medially. *Navicular bone* - The **tibionavicular part** of the deltoid ligament attaches to the **tuberosity of the navicular bone**. - This attachment helps **limit excessive abduction** and **eversion** of the foot. *Sustentaculum tali* - The **tibiocalcaneal part** of the deltoid ligament attaches to the **sustentaculum tali** on the calcaneus. - This attachment provides significant stability to the **subtalar joint**. [Practice more Anatomy PYQs on OnCourse]

Q: Which is derived from Wolffian duct?

Appendix of epididymis. The **appendix of the epididymis** is a vestigial structure directly derived from the mesonephric (Wolffian) duct in males. It is an embryological remnant of this duct, located at the head of the epididymis. *Appendix of the testis* - The **appendix of the testis** (hydatid of Morgagni) is a remnant of the paramesonephric (Müllerian) duct, not the Wolffian duct. - It is usually found on the upper pole of the testis, typically near the epididymis. *Uterine structure* - **Uterine structures** (uterus, fallopian tubes, and upper vagina) are derived from the paramesonephric (Müllerian) ducts in females [1]. - The Wolffian ducts largely regress in females due to the absence of testosterone. *Hydatid of Morgagni* - The term **hydatid of Morgagni** can refer to the appendix of the testis (Müllerian duct remnant) or, less commonly, to the appendix of the epididymis (Wolffian duct remnant). - However, in common clinical and anatomical usage, it almost exclusively refers to the **appendix of the testis**, which is a Müllerian duct derivative. [Practice more Anatomy PYQs on OnCourse]

Q: All are derived from ectoderm except for which of the following?

Adrenal cortex. ***Adrenal cortex*** - The adrenal cortex is derived from the **intermediate mesoderm**, specifically from the cells lining the posterior abdominal wall. The cells migrate to develop into the adrenal cortex. - It produces various steroid hormones, including **aldosterone**, **cortisol**, and **androgens**, which regulate diverse bodily functions. *Lens of the eye* - The lens of the eye is derived from the **surface ectoderm**. It forms from an invagination of the surface ectoderm called the lens placode. - Its primary function is to **focus light** onto the retina. *Hair follicles* - Hair follicles develop from the **surface ectoderm** [1]; they are invaginations of the epidermis that extend into the dermis. - They produce hair, which provides **insulation** and **protection** [1]. *Nails* - Nails are also derivatives of the **surface ectoderm**, forming thickened plates on the dorsal surface of the distal phalanges. - They provide **protection** to the fingertips and aid in grasping objects. [Practice more Anatomy PYQs on OnCourse]

Q: Which muscle stabilizes the clavicle during movement of the shoulder?

Subclavius. ***Subclavius*** - The **subclavius muscle** originates from the first rib and inserts into the inferior surface of the clavicle, acting to **depress the clavicle** and prevent its displacement, thus enhancing shoulder stability during movement. - It plays a crucial role in protecting the underlying **neurovascular structures** (brachial plexus and subclavian vessels) from external trauma to the shoulder. *Pectoralis major* - This large, fan-shaped muscle primarily functions in **adduction, medial rotation, and flexion of the humerus** at the shoulder joint [1]. - It does not directly stabilize the clavicle but rather acts on the arm. *Latissimus dorsi* - The **latissimus dorsi** is a broad muscle of the back responsible for **extension, adduction, and internal rotation of the humerus** [1]. - Its actions are mainly on the humerus and it does not directly stabilize the clavicle. *Serratus anterior* - The **serratus anterior** muscle primarily **protracts and rotates the scapula**, keeping it pressed against the thoracic wall. - While it's essential for **scapular stability** and overhead arm movements, it does not directly stabilize the clavicle. [Practice more Anatomy PYQs on OnCourse]

98 Previous Year Questions with Answers & Explanations

Questions

A patient is found to have a melanoma originating in the skin of the left forearm. After removal of the tumor from the forearm, all axillary lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed. Which axillary nodes would not be removed?

Deltoid ligament is attached to all, except which structure?

Which is derived from Wolffian duct?

All are derived from ectoderm except for which of the following?

Which muscle stabilizes the clavicle during movement of the shoulder?

Nutrient artery runs ?

Inferior parathyroid develops from which pharyngeal pouch?

Which of the following is derived from endoderm?

Skeletal derivative of 2nd pharyngeal arch -

Q10

Which of the following structures is not derived from the ectoderm?

NEET-PG 2012 - Anatomy NEET-PG Practice Questions and MCQs

Question 1: A patient is found to have a melanoma originating in the skin of the left forearm. After removal of the tumor from the forearm, all axillary lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed. Which axillary nodes would not be removed?

A. Central lymph nodes
B. Lateral lymph nodes
C. Pectoral lymph nodes
D. Apical lymph nodes (Correct Answer)

Explanation: ***Apical lymph nodes*** - The **apical lymph nodes** are located **medial** to the **medial border of the pectoralis minor muscle**, at the apex of the axilla (Level III) [2]. - Since the removal was restricted to nodes **lateral** to the medial edge of the pectoralis minor, the apical nodes would **not be removed**. - These nodes receive lymph from all other axillary node groups and drain into the subclavian lymphatic trunk. *Central lymph nodes* - **Central lymph nodes** are located **posterior to (deep to)** the pectoralis minor muscle, within the axillary fat (Level II) [1]. - They lie between the medial and lateral borders of the pectoralis minor and are generally considered to be **lateral** to the medial edge of the pectoralis minor, so they would be removed in this dissection. *Lateral lymph nodes* - **Lateral (humeral) lymph nodes** are found along the **lateral border** of the axilla, following the axillary vein (Level I) [1]. - These nodes drain the majority of the upper limb and are clearly **lateral** to the pectoralis minor muscle, so hese would be included in the dissection. *Pectoral lymph nodes* - **Pectoral (anterior) lymph nodes** lie along the **lower border** of the pectoralis minor muscle and the lateral thoracic vessels (Level I). - They receive lymph from the anterior and lateral thoracic walls and much of the breast. - These nodes are located **lateral** to the medial edge of the pectoralis minor and would be removed as part of the surgical procedure.

Question 2: Deltoid ligament is attached to all, except which structure?

A. Sustentaculum tali
B. Medial cuneiform (Correct Answer)
C. Navicular bone
D. Medial malleolus

Explanation: ***Medial cuneiform*** - The **deltoid ligament** is located on the **medial side of the ankle** and primarily connects the **tibia** to several tarsal bones. It does not attach to the medial cuneiform. - The **medial cuneiform** is a midfoot bone primarily involved in the **tarsometatarsal joint** and is not a direct attachment site for the deltoid ligament. *Medial malleolus* - The **medial malleolus**, the distal end of the **tibia**, serves as the **proximal attachment point** for all four parts of the deltoid ligament. - This strong connection is crucial for **stabilizing the ankle joint** medially. *Navicular bone* - The **tibionavicular part** of the deltoid ligament attaches to the **tuberosity of the navicular bone**. - This attachment helps **limit excessive abduction** and **eversion** of the foot. *Sustentaculum tali* - The **tibiocalcaneal part** of the deltoid ligament attaches to the **sustentaculum tali** on the calcaneus. - This attachment provides significant stability to the **subtalar joint**.

Question 3: Which is derived from Wolffian duct?

A. Appendix of epididymis (Correct Answer)
B. Appendix of the testis
C. Uterine structure
D. Hydatid of Morgagni

Explanation: The **appendix of the epididymis** is a vestigial structure directly derived from the mesonephric (Wolffian) duct in males. It is an embryological remnant of this duct, located at the head of the epididymis. *Appendix of the testis* - The **appendix of the testis** (hydatid of Morgagni) is a remnant of the paramesonephric (Müllerian) duct, not the Wolffian duct. - It is usually found on the upper pole of the testis, typically near the epididymis. *Uterine structure* - **Uterine structures** (uterus, fallopian tubes, and upper vagina) are derived from the paramesonephric (Müllerian) ducts in females [1]. - The Wolffian ducts largely regress in females due to the absence of testosterone. *Hydatid of Morgagni* - The term **hydatid of Morgagni** can refer to the appendix of the testis (Müllerian duct remnant) or, less commonly, to the appendix of the epididymis (Wolffian duct remnant). - However, in common clinical and anatomical usage, it almost exclusively refers to the **appendix of the testis**, which is a Müllerian duct derivative.

Question 4: All are derived from ectoderm except for which of the following?

A. Hair follicles
B. Nails
C. Lens of the eye
D. Adrenal cortex (Correct Answer)

Explanation: ***Adrenal cortex*** - The adrenal cortex is derived from the **intermediate mesoderm**, specifically from the cells lining the posterior abdominal wall. The cells migrate to develop into the adrenal cortex. - It produces various steroid hormones, including **aldosterone**, **cortisol**, and **androgens**, which regulate diverse bodily functions. *Lens of the eye* - The lens of the eye is derived from the **surface ectoderm**. It forms from an invagination of the surface ectoderm called the lens placode. - Its primary function is to **focus light** onto the retina. *Hair follicles* - Hair follicles develop from the **surface ectoderm** [1]; they are invaginations of the epidermis that extend into the dermis. - They produce hair, which provides **insulation** and **protection** [1]. *Nails* - Nails are also derivatives of the **surface ectoderm**, forming thickened plates on the dorsal surface of the distal phalanges. - They provide **protection** to the fingertips and aid in grasping objects.

Question 5: Which muscle stabilizes the clavicle during movement of the shoulder?

A. Pectoralis major
B. Latissimus dorsi
C. Subclavius (Correct Answer)
D. Serratus anterior

Explanation: ***Subclavius*** - The **subclavius muscle** originates from the first rib and inserts into the inferior surface of the clavicle, acting to **depress the clavicle** and prevent its displacement, thus enhancing shoulder stability during movement. - It plays a crucial role in protecting the underlying **neurovascular structures** (brachial plexus and subclavian vessels) from external trauma to the shoulder. *Pectoralis major* - This large, fan-shaped muscle primarily functions in **adduction, medial rotation, and flexion of the humerus** at the shoulder joint [1]. - It does not directly stabilize the clavicle but rather acts on the arm. *Latissimus dorsi* - The **latissimus dorsi** is a broad muscle of the back responsible for **extension, adduction, and internal rotation of the humerus** [1]. - Its actions are mainly on the humerus and it does not directly stabilize the clavicle. *Serratus anterior* - The **serratus anterior** muscle primarily **protracts and rotates the scapula**, keeping it pressed against the thoracic wall. - While it's essential for **scapular stability** and overhead arm movements, it does not directly stabilize the clavicle.

Question 6: Nutrient artery runs ?

A. Away from epiphysis (Correct Answer)
B. Towards metaphysis
C. None of the options
D. Away from metaphysis

Explanation: ***Away from epiphysis*** - The **nutrient artery** runs away from the **dominant (faster-growing) epiphysis** towards the non-dominant end of the bone. - This follows the classic anatomical rule: **"To the elbow, from the knee"** - nutrient arteries point towards the elbow in upper limb bones and away from the knee in lower limb bones. - The **nutrient foramen** is directed obliquely away from the more actively growing end, established during bone development. - Examples: In the humerus, it runs towards the elbow (away from proximal epiphysis); in the femur, it runs away from the knee (away from distal epiphysis). *Towards metaphysis* - While the artery does course towards the metaphyseal region of the slower-growing end, this option is less anatomically precise. - The standard teaching emphasizes the relationship with the **dominant epiphysis** rather than the metaphysis. *Away from metaphysis* - This is **incorrect** - the nutrient artery actually runs **towards** the metaphysis of the non-dominant end. - It runs **away from** the dominant epiphysis, not away from the metaphysis. *None of the options* - This is incorrect as **"Away from epiphysis"** correctly describes the direction of the nutrient artery relative to the dominant growing end.

Question 7: Inferior parathyroid develops from which pharyngeal pouch?

A. 1st
B. 2nd
C. 3rd (Correct Answer)
D. 4th

Explanation: The inferior parathyroid glands develop from the dorsal wing of the third pharyngeal pouch. Due to their origin, they often migrate further caudally than the superior parathyroid glands, sometimes even locating within the thymus which also develops from the third pouch. *1st* - The first pharyngeal pouch contributes to the formation of the eustachian tube, tympanic cavity, and mastoid air cells. - It has no role in the development of the parathyroid glands. *2nd* - The second pharyngeal pouch mainly gives rise to the palatine tonsils and their crypts. - It is not involved in the development of parathyroid tissue. *4th* - The fourth pharyngeal pouch gives rise to the superior parathyroid glands and the parafollicular cells (C cells) of the thyroid, which produce calcitonin. - While it forms parathyroid tissue, it is for the superior glands, not the inferior ones.

Question 8: Which of the following is derived from endoderm?

A. Gall bladder (Correct Answer)
B. Lens
C. Spleen
D. Lymph nodes

Explanation: ***Gall bladder*** - The **gallbladder**, along with other organs of the **gastrointestinal tract** such as the liver, pancreas, and epithelial lining of the digestive and respiratory systems, originates from the **endoderm** [1]. - The endoderm forms the primitive gut tube, from which these accessory digestive organs bud off. *Lens* - The **lens of the eye** is derived from the **surface ectoderm**, which invaginates to form the lens vesicle. - This contrasts with the neural ectoderm, which forms the neural tube and retina. *Spleen* - The **spleen** is derived from the **mesoderm**, specifically from mesenchymal cells in the dorsal mesentery of the stomach. - It is involved in blood filtration and immune responses, making it a lymphoid organ. *Lymph nodes* - **Lymph nodes** are primarily derived from the **mesoderm**, specifically from specialized mesenchymal cells that form their connective tissue capsule and stroma. - The immune cells within the lymph nodes, such as lymphocytes, originate from hematopoietic stem cells that migrate into these developing structures.

Question 9: Skeletal derivative of 2nd pharyngeal arch -

A. Malleus
B. Incus
C. Stapes (Correct Answer)
D. Maxilla

Explanation: ***Stapes*** - The **2nd pharyngeal arch** (also known as the hyoid arch) gives rise to several structures, including Reichert's cartilage, which forms the **stapes** bone, the styloid process, the lesser horn of the hyoid, and the upper part of the hyoid body. - Its muscles include the **stapedius**, stylohyoid, posterior belly of the digastric, and muscles of facial expression. *Malleus* - The **malleus** is derived from the **1st pharyngeal arch** (Meckel's cartilage), along with the incus. - The 1st pharyngeal arch is also responsible for forming the malleus, incus, and mandible. *Incus* - Similar to the malleus, the **incus** also originates from the **1st pharyngeal arch** (Meckel's cartilage). - Both the malleus and incus are crucial components of the middle ear ossicles but are structurally distinct from the stapes. *Maxilla* - The **maxilla** development is primarily from the **maxillary prominence** of the first pharyngeal arch, which is a subdivision of the first arch but does not originate from the 2nd arch. - It forms a significant portion of the midface and upper jaw, contributing to the nasal cavity and orbital floor.

Question 10: Which of the following structures is not derived from the ectoderm?

A. Brain
B. Retina
C. Eustachian tube (Correct Answer)
D. Lens

Explanation: ***Eustachian tube*** - The **Eustachian tube** (auditory tube) is derived from the **endoderm**, specifically from the first pharyngeal pouch. - It connects the nasopharynx to the middle ear and is responsible for equalizing pressure [1]. *Lens* - The **lens** of the eye develops from the surface ectoderm through an invagination called the **lens placode**. - This ectodermal origin is crucial for its transparency and refractive properties. *Brain* - The **brain** is a primary derivative of the ectoderm, specifically the **neural tube**, which forms from the neural plate during neurulation. - This ectodermal origin gives rise to the entire central nervous system. *Retina* - The **retina** of the eye, along with the optic nerve, develops from the **neuroectoderm** (a part of the neural tube). - Its ectodermal origin is essential for its light-sensing function.