Anatomy
9 questionsWhich muscle of the arm has additional supinator action?
Insertion of levator scapulae is?
Which of the following is not a branch of the splenic artery?
Which of the following structures does NOT pass through the deep inguinal ring?
Which of the following is not formed by the external oblique muscle?
Inferior epigastric artery forms the boundary of?
Which of the following is NOT a boundary of the foramen of Winslow?
What structure is primarily responsible for forming the anorectal angle?
The uterine artery is a branch of which of the following?
NEET-PG 2015 - Anatomy NEET-PG Practice Questions and MCQs
Question 61: Which muscle of the arm has additional supinator action?
- A. Brachialis
- B. Biceps (Correct Answer)
- C. Coracobrachialis
- D. Triceps
Explanation: ***Biceps*** - The **biceps brachii** powerfully supinates the forearm, especially when the elbow is flexed, due to its distal attachment on the **radial tuberosity**. - Its two heads originate from the scapula, contributing to both **flexion** at the elbow and supination. *Brachialis* - The **brachialis muscle** is the primary and most powerful flexor of the elbow joint. - It inserts onto the **ulna** and does not have any rotational or supinator action. *Coracobrachialis* - The **coracobrachialis** muscle primarily functions in adduction and flexion of the arm at the shoulder joint. - It has no attachments that allow for supination of the forearm. *Triceps* - The **triceps brachii** is the sole extensor of the elbow joint, located on the posterior aspect of the arm. - It is an antagonist to the biceps and has no supinator action.
Question 62: Insertion of levator scapulae is?
- A. Lateral border of scapula
- B. Suprolateral part of scapula
- C. Superior part of medial scapula border (Correct Answer)
- D. Inferior angle of scapula
Explanation: ***Superior part of medial scapula border*** - The **levator scapulae muscle** originates from the **transverse processes of C1-C4 vertebrae** and **inserts** onto the superior part of the medial border of the scapula, between the **superior angle and the spine of the scapula**. - Its main actions are to **elevate** and **rotate** the scapula downward. *Lateral border of scapula* - The **lateral border of the scapula** primarily serves as the attachment site for muscles that move the **humerus**, such as the **teres major** and **teres minor**. - The levator scapulae has no direct insertion on the lateral border. *Suprolateral part of scapula* - This general description is vague and does not precisely identify the insertion point of the levator scapulae. - While it's located superiorly, the specific insertion is on the **medial border**, not broadly "suprolateral." *Inferior angle of scapula* - The **inferior angle of the scapula** is the insertion point for muscles like the **latissimus dorsi** (occasionally) and a key landmark for muscles involved in **scapular rotation**, such as the **serratus anterior**. - The levator scapulae is located much more superiorly and inserts onto the medial border at a higher level than the inferior angle.
Question 63: Which of the following is not a branch of the splenic artery?
- A. Hilar branches of the splenic artery
- B. Short Gastric Arteries
- C. Arteria Pancreatica Magna
- D. Right Gastroepiploic Artery (Correct Answer)
Explanation: ***Right Gastroepiploic Artery*** - This artery originates from the **gastroduodenal artery**, which is a branch of the **common hepatic artery**, not the splenic artery. - It supplies the greater curvature of the stomach and the greater omentum. *Hilar branches of the splenic artery* - These are direct branches of the splenic artery that enter the **hilum of the spleen** [1] to supply the organ itself. - They are essential for the blood supply to the spleen [1]. *Short Gastric Artery* - The **short gastric arteries** arise directly from the splenic artery or its terminal branches [1]. - They supply the fundus and a part of the greater curvature of the stomach [1]. *Arteria Pancreatica Magna* - Also known as the **great pancreatic artery**, this is a significant branch that typically arises from the **splenic artery**. - It supplies the body and tail of the pancreas [1].
Question 64: Which of the following structures does NOT pass through the deep inguinal ring?
- A. Spermatic cord
- B. Internal spermatic fascia
- C. Round ligament
- D. Ilioinguinal nerve (Correct Answer)
Explanation: The ilioinguinal nerve typically passes through the superficial inguinal ring but does not travel through the deep inguinal ring [1]. It lies in the inguinal canal, superficial to the spermatic cord in males and the round ligament in females [1]. The spermatic cord in males enters the inguinal canal through the deep inguinal ring [2]. It contains structures like the vas deferens, testicular artery, pampiniform plexus, and nerves. The internal spermatic fascia is a covering of the spermatic cord that originates from the transversalis fascia at the deep inguinal ring [2]. In females, the round ligament of the uterus is the homologous structure to the spermatic cord in males, and it passes through the deep inguinal ring to enter the inguinal canal. It helps maintain the anteversion of the uterus.
Question 65: Which of the following is not formed by the external oblique muscle?
- A. Inguinal ligament
- B. Lacunar ligament
- C. Pectineal ligament
- D. Conjoint tendon (Correct Answer)
Explanation: ***Conjoint tendon*** - The **conjoint tendon** is formed by the conjoined aponeuroses of the **internal oblique** and **transversus abdominis muscles**, not the external oblique [1]. - It provides posterior wall reinforcement to the inguinal canal. - This is the structure that is definitively **NOT formed by the external oblique muscle**. *Lacunar ligament* - The **lacunar ligament** (Gimbernat's ligament) is a triangular fascial band formed by the medial reflection of the **inguinal ligament**. - It is derived from the **external oblique aponeurosis** and forms the medial boundary of the femoral ring. *Pectineal ligament* - The **pectineal ligament** (Cooper's ligament) is a thickening of the periosteum along the pecten pubis (pectineal line) [3]. - While it is continuous with the lacunar ligament, it is not directly formed by the external oblique muscle itself, but rather represents a separate periosteal structure. - For the purposes of this question, the conjoint tendon is the most appropriate answer as it has no contribution from the external oblique. *Inguinal ligament* - The **inguinal ligament** (Poupart's ligament) is formed by the inferomedial border of the **external oblique aponeurosis**, folding back on itself [2]. - It spans between the **anterior superior iliac spine** and the **pubic tubercle**.
Question 66: Inferior epigastric artery forms the boundary of?
- A. Femoral triangle
- B. Hesselbach's triangle (Correct Answer)
- C. Adductor canal
- D. Popliteal triangle
Explanation: ***Hesselbach's triangle*** - The **inferior epigastric artery** forms the superolateral border of Hesselbach's triangle [1]. - This triangle is clinically significant as it is a common site for **direct inguinal hernias** due to its relative weakness [1]. *Femoral triangle* - The femoral triangle is bounded by the **inguinal ligament superiorly**, the **sartorius muscle laterally**, and the **adductor longus muscle medially**. - It contains the **femoral nerve**, artery, and vein. *Adductor canal* - The adductor canal is an intermuscular tunnel located in the **thigh**, containing the **femoral artery and vein** and the **saphenous nerve**. - Its boundaries are the **vastus medialis**, adductor longus/magnus, and sartorius muscles. *Popliteal triangle* - This term is not a standard anatomical triangle. The correct term is the **popliteal fossa**, which is a diamond-shaped space behind the knee joint. - The popliteal fossa contains structures such as the **popliteal artery and vein**, tibial nerve, and common fibular nerve.
Question 67: Which of the following is NOT a boundary of the foramen of Winslow?
- A. Inferior vena cava
- B. Free border of lesser omentum
- C. 4th part of Duodenum (Correct Answer)
- D. Caudate lobe of liver
Explanation: 4th part of Duodenum[1] - The foramen of Winslow (epiploic foramen) is an opening that connects the greater sac to the lesser sac of the peritoneum. The 4th part of the duodenum is not a boundary of this foramen. - The 4th part of the duodenum is located at the duodenojejunal junction on the left side of the abdomen, far from the foramen of Winslow. - Note: The 1st part of the duodenum (D1) forms the inferior boundary of the foramen of Winslow, along with the hepatic artery. Inferior vena cava[1] - The inferior vena cava (IVC) forms the posterior boundary of the foramen of Winslow. - It lies behind the peritoneum that forms the posterior wall of the lesser sac at this point. Free border of lesser omentum[1] - The free border of the lesser omentum (hepatoduodenal ligament) forms the anterior boundary of the foramen of Winslow. - This ligament contains the portal triad (hepatic artery proper, portal vein, and common bile duct). Caudate lobe of liver[1] - The caudate lobe of the liver forms the superior boundary of the foramen of Winslow.[1] - It lies above the opening, contributing to its roof.
Question 68: What structure is primarily responsible for forming the anorectal angle?
- A. Circular smooth muscle layer
- B. Longitudinal smooth muscle layer
- C. Puborectalis muscle (Correct Answer)
- D. Internal anal sphincter muscle
Explanation: ***Puborectalis muscle*** - The **puborectalis muscle** is a U-shaped sling of skeletal muscle that originates from the pubis and loops around the posterior aspect of the anorectal junction, pulling the rectum anteriorly [1]. - This anterior traction creates the characteristic **anorectal angle**, which is crucial for maintaining fecal continence at rest [1], [2]. *Circular smooth muscle layer* - The **circular smooth muscle layer** is part of the involuntary muscular wall of the rectum and anal canal. - While it contributes to internal anal sphincter function, its primary role is not in forming the acute anorectal angle [2]. *Longitudinal smooth muscle layer* - The **longitudinal smooth muscle layer** runs along the entire gastrointestinal tract, including the rectum, and contributes to the overall structure and peristalsis. - It does not directly form the anorectal angle; that function is specific to the puborectalis muscle. *Internal anal sphincter muscle* - The **internal anal sphincter** is an involuntary smooth muscle thickening of the circular muscle layer, primarily responsible for resting anal tone [2]. - It plays a vital role in continence but does not contribute to the creation of the anorectal angle [2].
Question 69: The uterine artery is a branch of which of the following?
- A. Left common iliac artery
- B. Internal iliac artery (Correct Answer)
- C. Internal pudendal artery
- D. Ovarian artery
Explanation: ***Internal iliac artery*** - The **uterine artery** is a direct branch of the **internal iliac artery**, specifically its anterior division, which supplies blood to the uterus [1]. - This artery is crucial for maintaining the vascular supply to the uterus, especially during pregnancy. *Left common iliac artery* - The **common iliac artery** bifurcates into the **internal iliac artery** and the **external iliac artery** [2]; it is not a direct source of the uterine artery. - The common iliac artery is a more proximal vessel in the arterial tree. *Internal pudendal artery* - The **internal pudendal artery** is also a branch of the **internal iliac artery**, but it primarily supplies the perineum and external genitalia, not the uterus. - It is often associated with structures such as the clitoris, labia, and structures of the anal triangle. *Ovarian artery* - The **ovarian artery** originates directly from the **abdominal aorta**, usually just below the renal arteries, and supplies the ovaries [2]. - Although it supplies the reproductive system, it is distinct from the uterine artery's origin and primary territory.
Internal Medicine
1 questionsIn which portion of the esophagus do esophageal varices primarily occur?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 61: In which portion of the esophagus do esophageal varices primarily occur?
- A. All sites
- B. Upper
- C. Lower (Correct Answer)
- D. Middle
Explanation: **Lower** - Esophageal varices are most commonly found in the **distal (lower) third of the esophagus** [1] because this is where the portal venous system (short gastric and left gastric veins) anastomoses with the systemic venous system (white esophageal veins draining into the azygous system) [1]. - Increased portal pressure (e.g., in **portal hypertension** due to liver cirrhosis) causes blood to back up into these collateral vessels, leading to their dilation and formation of varices, particularly prominent in the lower esophagus [1]. *Upper* - While some collateral circulation exists throughout the esophagus, varices are not predominantly found in the upper portion as the primary portosystemic anastomoses responsible for variceal formation are more distal. - Varices in the upper esophagus are less common and typically less clinically significant in terms of bleeding risk. *Middle* - The middle portion of the esophagus has some venous drainage, but it is not the primary site for the significant portosystemic collaterals that lead to the formation of large, high-risk varices. - Varices can extend into the middle esophagus, but their origin and highest concentration are usually in the lower third. *All sites* - While varices can technically be found at various points along the esophagus, stating "all sites" is inaccurate because they have a **marked predilection for the lower third** due to specific anatomical venous connections [1]. - The risk of rupture and bleeding is also highest in the larger varices found in the lower esophagus [1].