Practice Quiz - Female Reproductive Anatomy
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  1. The boundaries of the perineum include all the following except:
    Ischiopubic rami
    Ischial tuberosity
    Tip of the coccyx
    Sacrotuberal ligament
    Sacrospinal ligament
  2. A condensation of fibrous tissue in the female located at the center of the posterior border of the perineal membrane is the:
    Frenulum
    Posterior labial commissure
    Perineal body
    Anococcygeal ligament
    Pubovesical ligament
  3. The artery which supplies blood to the major erectile body in both the male and female is the:
    Artery of the bulb
    Dorsal artery of the penis/clitoris
    Deep artery of the penis/clitoris
    Posterior labial/scrotal artery
    Superficial external pudendal artery
  4. The vestibular bulbs/bulb of the corpus spongiosum are firmly attached to the:
    Perineal membrane
    Superior pubic rami
    Ischiopubic rami
    Pubic symphysis
    Ischial tuberosities
  5. What part of the ischioanal (ischiorectal) fossa extends deep to the sacrotuberal ligament?
    Anterior recess
    Genital hiatus
    Posterior recess
    Pudendal canal
  6. The perineum is bounded by all of the following skeletal elements except:
    coccyx
    ischiopubic ramus
    spine of ischium
    symphysis pubis
  7. During childbirth a bilateral pudendal nerve block may be performed to provide anesthesia to the majority of the perineum and the lower one fourth of the vagina. To do this an anesthetic agent is injected near the pudendal nerve as it passes from the pelvic cavity to the perineum. The physician inserts a finger into the vagina and presses laterally to palpate what landmark?
    Arcus tendineus levator ani
    Coccyx
    Ischial spine
    Lateral fornix
    Obturator foramen
  8. During a vaginal delivery, a surgeon performed median episiotomy in which he cut too far (i.e., through the perineal body into the structure immediately posterior). Which perineal structure did he cut?
    Bulbospongiosis muscle
    External anal sphincter muscle
    Ischiocavernosis muscle
    Sacrospinous ligament
    Sphincter urethrae
  9. A patient complains of a boil located on her labia majora. Lymphatic spread of the infection would most likely enlarge which nodes?
    Lumbar nodes
    Sacral nodes
    External iliac nodes
    Superficial inguinal nodes
    Internal iliac nodes
  10. In order to perform an episiotomy prior to childbirth, the perineum must be anesthetized. By inserting a finger in the vagina and pressing laterally, what palpable bony landmark can be used as the posterior limit of the pudendal canal?
    Coccyx
    Ischial tuberosity
    Ischiopubic ramus
    Obturator groove
    Ischial spine
  11. The part of the uterine wall which is not shed during menstruation is the:
    Endometrium
    Myometrium
    Mesometrium
    Cervical mucosa
    Rugae
  12. The extension of the vaginal lumen around the intravaginal part of the uterine cervix is the:
    Cervical canal
    Uterine lumen
    Fornix
    Rectouterine Pouch
    Uterovesical Pouch
  13. Which of the following would be most likely to be damaged by a stab wound into the ischiorectal (ischioanal) fossa 2 cm lateral to the anal canal?
    Crus of the Penis
    Perineal Body
    Pudendal Nerve
    Inferior Rectal Artery
    Vesicular Bulb
  14. Under normal conditions, fertilization occurs in which part of the female reproductive tract?
    Infundibulum of the Uterine Tube
    Ampulla of the Uterine Tube
    Isthmus of the Uterine Tube
    Uterine Lumen
    Cervical Canal
  15. Which pair of structures does NOT differentiate from comparable embryonic structures in the male and female?
    Bulb of corpus spongiosum and vestibular bulb
    Shaft of penis and labia majora
    Glans of penis and glans of clitoris
    Crus of corpus cavernosum penis and crus of corpus cavernosum clitoris
  16. Which structure is outlined with contrast on a CT using intraperitoneal contrast material?
    Ovary
    Prostate
    Rectum
    Seminal Vesicles
    Vagina
  17. Which of the following is considered a part of the broad ligament?
    Mesovarium
    Ovarian ligament
    Round ligament of the uterus
    Suspensory Ligament of the ovary
    Uterosacral ligament
  18. A 27-year-old woman is examined by her gynecologist. Upon rectal examination, a firm structure, directly in front of the rectum in the midline, is palpated through the anterior wall of the rectum. This structure is the:
    bladder
    body of uterus
    cervix of uterus
    pubic symphysis
    vagina
  19. The most inferior extent of the peritoneal cavity in the female is the:
    Pararectal fossa
    Paravesical fossa
    Rectouterine pouch
    Rectovesical pouch
    Vesicouterine pouch
  20. During a hysterectomy, the uterine vessels are ligated. However, the patient's uterus continues to bleed. The most likely source of blood still supplying the uterus is from which artery?
    Inferior vesical
    Internal pudendal
    Middle rectal
    Ovarian
    Superior vesical
  21. A female patient is found to have an ectopic (tubal) pregnancy (embryo develops in the uterine tube). In order to gain access to the peritoneal cavity endoscopically to remove the embryo, the instrument can be passed into the vagina and through the:
    anterior fornix
    cervix
    posterior fornix
    retropubic space
    vesicouterine pouch
  22. During a hysterectomy and an oophorectomy, the uterine and ovarian vessels must be ligated. These vessels can be found in which ligaments?
    Broad and ovarian
    Broad and suspensory
    Round and ovarian
    Round and suspensory
    Suspensory and ovarian
  23. A female patient comes to your office with lower abdominal pain. She missed her last menses and her pregnancy test is positive. Ultrasound imaging reveals a cyst-like structure in the right uterine tube which you feel may be a tubal pregnancy. In order to confirm your diagnosis and to remove the tubal embryo, you can gain access to the patient's lower pelvic cavity by passing a culdoscope through the vagina and the:
    vesicouterine pouch
    posterior fornix
    cervix
    isthmus
    ampulla
  24. During a hysterectomy, care must be taken in ligation of the uterine vessels because they cross the _________ superiorly.
    ureter
    round ligament of the uterus
    ovarian artery
    lumbosacral trunk
    inferior hypogastric plexus
  25. The part of the broad ligament giving attachment and support to the uterine tube is the:
    mesometrium
    mesovarium
    mesosalpinx
    round ligament
  26. Which structure is NOT found within the true pelvis?
    Femoral nerve
    Hypogastric nerve
    Internal pudendal artery
    Obturator artery
    Pelvic splanchnic nerves
  27. A structure which takes the form of a hood anterosuperior to the clitoris:
    Frenulum of the clitoris
    Labia majora
    Labia minora
    Prepuce
  28. A structure which is homologous to the male scrotum:
    Labia minora
    Labia majora
    Glans
    Shaft of corpus cavernosum
  29. Which skeletal feature would you consider to be most characteristic of the female pelvis?
    Subpubic angle of 90 degrees or greater
    Marked anterior curvature of the sacrum
    Tendency to vertical orientation of the iliac bones
    Prominent medial projection of the ischial spines
  30. You are observing a doctor perform an abdominal hysterectomy. She notes that it is vital to protect the ureter which is found in the base of the:
    mesometrium
    mesovarium
    mesosalpinx
    round ligament of the uterus
    suspensory ligament of the ovary
  31. A female patient is found to have an ectopic (tubal) pregnancy. In order to gain access to the peritoneal cavity endoscopically to remove the tubal embryo, the instrument can be passed through the posterior fornix of the vagina piercing into the:
    external os
    internal os
    rectouterine pouch
    rectovesical pouch
    vesicouterine pouch
  32. The male pelvis tends to differ from the female pelvis in that the male pelvis often has a:
    larger pelvic inlet
    smaller subpubic angle
    straighter sacral curvature
    larger pelvic outlet
    rounder pelvic inlet
  33. The rectouterine pouch is the lowest extent of the female peritoneal cavity. At its lowest, it provides a coat of peritoneum to a portion of the:
    urinary bladder
    urethra
    uterine cervix
    vagina
  34. In a CT scan of the pelvis, the uterus is located:
    posterior to the bladder and rectum
    posterior to the bladder and anterior to the rectum
    anterior to the bladder and rectum
    anterior to the bladder and posterior to the rectum
  35. Which statement is true regarding pelvic veins?
    The external iliac vein lies medial to the external iliac artery
    The external iliac veins join to form the inferior vena cava
    The inferior vena cava cannot be imaged
    Pelvic veins are usually imaged using an arteriogram
  36. What bony landmark on the lateral pelvic wall may be used as a reference for localizing female pelvic anatomy or pain phenomena?
    Coccyx
    Ischial spine
    Ischial tuberosity
    Obturator canal
    Pectineal line
  37. Which statement about the pelvic floor is NOT correct?
    Along with the pelvic brim, it defines the true pelvic cavity
    It is a funnel-shaped skeletal muscle
    It is referred to as the pelvic diaphragm
    It is tensed during defecation
    It projects into the anal triangle
  38. Following pregnancy and delivery, a 32-year-old woman continued to have problems with urinary incontinence which developed during pregnancy. Her obstetrician counseled her to strengthen the muscle bordering the vagina and urethra, increasing its tone and exerting pressure on the urethra. This physical therapy was soon adequate to restore urinary continence. What muscle was strengthened?
    Coccygeus
    Ischiocavernosus
    Obturator Internus
    Piriformis
    Puborectalis
  39. Preganglionic parasympathetic nerve fibers within the pelvic (inferior hypogastric) plexus arise from S2, 3, 4 and enter the plexus via:
    gray rami communicantes
    hypogastric nerves
    pelvic splanchnic nerves
    sacral splanchnic nerves
    white rami communicantes
  40. While performing a hysterectomy, the resident must ligate the uterine artery. To avoid iatrogenic injury to the ureters, she must be aware that the ureter passes ___________ the artery at the level of the ______________.
    Over; cervix
    Over; fundus of uterus
    Over; pelvic brim
    Under; cervix
    Under; pelvic brim
  41. After giving birth, a patient complains of urinary stress incontinence characterized by dribbling of urine with an increase in intra-abdominal pressure. Her physician suspects injury to the pelvic floor during delivery which may have altered the position of the neck of bladder and the urethra. Which muscle was most likely damaged during the vaginal delivery?
    Bulbospongiosus
    Coccygeus
    Levator ani
    Obturator internus
    Piriformis
  42. A caudal epidural block is a form of regional anesthetic used in childbirth. Within the sacral canal, the anesthetic agent bathes the sacral spinal nerve roots which would anesthetize all of the following nerves except:
    Pelvic splanchnics
    Pudendal
    S2 dorsal root
    Sacral splanchnics
    S2 ventral primary ramus
  43. In a patient with rectal cancer located in the wall of the ampulla, you find that the cancer has spread to the muscle immediately lateral to the ampulla. This muscle is the:
    Piriformus
    Obturator internus
    Levator ani
    Sphincter urethrae
    Bulbospongeosis
  44. The pelvic splanchnic nerves primarily carry ____________ to the _____________ plexus.
    Preganglionic parasympathetics--superior hypogastric
    Preganglionic parasympathetics--inferior hypogastric
    Postganglionic parasympathetics--superior hypogastric
    Postganglionic sympathetics--superior hypogastric
    Postganglionic sympathetics--superior hypogastric
  45. The arcus tendineus levator ani is a thickening of fascia of the:
    Coccygeus
    Obturator externus
    Obturator internus
    Piriformis
  46. The sacral outflow of the parasympathetic (craniosacral) system enters the pelvic plexus via:
    Hypogastric nerves
    Pelvic splanchnic nerves
    Pudendal nerves
    Sacral splanchnic nerves
  47. A woman with breast cancer subsequently develops metastases in her vertebral column. The most direct route for spread of the tumor to the vertebral column was via:
    branches of the cephalic vein
    branches of the lateral thoracic vein
    branches of the thoracoacromial veins
    lymphatic vessels draining into the axilla
    branches of the intercostal veins
  48. Mastitis is a condition which involves:
    A type of leukemia
    Inflammation of the breast
    Infection of lymph nodes
    Mast cells
    Tumors of glandular tissue
  49. In the process of doing an axillary lymph node dissection in a 50 year-old patient, the surgery resident cleans the space between the pectoralis major and minor muscles, in an attempt to remove all of the lateral pectoral lymph nodes. Upon recovery it is noted that the patient's lower pectoralis major is paralyzed. The nerve most likely injured is the:
    axillary
    lateral pectoral
    medial pectoral
    suprascapular
    thoracodorsal
  50. In lymphatic drainage of the breast, the major portion (about 75%) enters eventually into which group of nodes?
    Central axillary
    Deltopectoral
    Lateral axilllary
    Parasternal
    Subscapular
  51. The prognosis in breast cancer is poorer as more proximal lymph nodes are found to have cancerous cells in them. Spread of cancer to which of the following axillary nodes would indicate the worst prognosis?
    apical
    central
    lateral
    pectoral
    subscapular
  52. During the planning of therapeutic intervention for a 54-year-old female patient with cancer of the right breast, a 3rd year medical student would need to first consider where most of the cancer cells would metastasize, which would be:
    Abdominal wall
    Anterior mediastinum
    Axillary lymph nodes
    Opposite breast
    Parasternal lymph nodes
  53. Breast cancer cells can spread directly to the cranial cavity and brain via the vertebral venous plexus. Through which route can they reach this plexus?
    Axillary lymph nodes
    Internal thoracic vein
    Intercostal veins
    Parasternal lymph nodes
    Thoracoacromial artery
  54. Upon finding a malignant tumor in the medial portion of the breast of a 40-year-old female, the surgeon began to search for the lymph nodes that would be the first ones reached by metastatic spread of cancer cells from this site. Which group(s) would have to be examined to determine whether metastasis had occurred?
    Central only
    Parasternal only
    Parasternal and apical
    Parasternal and lateral
    Parasternal and pectoral
  55. While observing a mastectomy on a 60-year-old female patient, a medical student was asked by the surgeon to help tie off the arteries that supply the medial side of the breast. The artery that gives origin to these small branches is the:
    Internal thoracic
    Musculophrenic
    Posterior intercostal
    Superior epigastric
    Thoracoacromial