Practice Quiz - Rectum, Anal Canal, & Pelvic Floor
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  1. 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
  2. Lymphatic drainage of the terminal portion of the gastrointestinal tract may flow initially into either the superficial inguinal nodes or the pararectal nodes, depending upon whether the lymph is formed above or below the:
    Anorectal Junction
    Muscular Sling of the Puborectalis Muscle
    Pectinate Line
    White Line
    Cutaneous Zone
  3. Which structure is outlined with contrast on a CT using intraperitoneal contrast material?
    Ovary
    Prostate
    Rectum
    Seminal Vesicles
    Vagina
  4. A 64-year-old woman was diagnosed as having carcinoma of the distal gastrointestinal tract. At surgery, lymph nodes from the sacral, internal iliac and inguinal lymph node groups were removed and sent to pathology for study. Only the superificial inguinal nodes contained cancerous cells. In which part of the GI tract was the tumor localized?
    cutaneous portion of anal canal
    distal rectum
    mucosal zone of anal canal
    pectinate line of anal canal
    proximal rectum
  5. Structures within the lower gastrointestinal tract specialized for physical support of fecal material are the:
    Transverse rectal folds
    Circular folds
    Anal valves
    Anal columns
  6. A malignant tumor in the cutaneous zone of the anal canal would most likely metastasize (spread) to which group of lymph nodes?
    Inferior mesenteric
    Pararectal
    Sacral
    Superficial inguinal
  7. Which of these features of the anal canal serves to indicate the point where the mucosal covering of the gastrointestinal tract ends and a skin-like covering begins?
    Mucosal zone
    White line
    Transitional zone
    Pectinate line
  8. The expanded region of the lower rectum, where fecal matter is retained, is known as the:
    Anal columns
    Anal sinuses
    Ampulla
    Transverse folds
  9. An elderly patient notices red blood in his stool. As part of his examination, you insert a proctoscope (sigmoidoscope) through his anal canal. As you pass the scope superiorly through the rectum, the most prominent features to be seen are:
    longitudinal muscle bands
    tenia coli
    transverse rectal folds
    rectovesical pouches
    haustra
  10. Which structure is NOT found within the true pelvis?
    Femoral nerve
    Hypogastric nerve
    Internal pudendal artery
    Obturator artery
    Pelvic splanchnic nerves
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. 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
  17. 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
  18. A patient presents complaining of blood-stained stools and the inability to completely empty his rectum. He also has pain along the back of his thigh and weakness of the posterior thigh muscles. Digital examination reveals a tumor in the posterolateral wall of the rectum. Pressure on what nerve plexus could cause the pain in his lower limb?
    Inferior hypogastric
    Inferior mesenteric
    Lumbar
    Sacral
    Superior hypogastric
  19. 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:
    Piriformis
    Obturator internus
    Levator ani
    Sphincter urethrae
    Bulbospongiosis
  20. 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
  21. The arcus tendineus levator ani is a thickening of fascia of the:
    Coccygeus
    Obturator externus
    Obturator internus
    Piriformis
  22. The sacral outflow of the parasympathetic (craniosacral) system enters the pelvic plexus via:
    Hypogastric nerves
    Pelvic splanchnic nerves
    Pudendal nerves
    Sacral splanchnic nerves
  23. The boundaries of the perineum include all the following except:
    Ischiopubic rami
    Ischial tuberosity
    Tip of the coccyx
    Sacrotuberal ligament
    Sacrospinal ligament
  24. An intrahepatic blockage of the portal venous outflow may cause intestinal blood to drain via portal-systemic anastomoses into the:
    Superior gluteal vein
    Middle rectal vein
    Splenic vein
    Renal vein
    Inferior phrenic vein
  25. What part of the ischioanal (ischiorectal) fossa extends deep to the sacrotuberal ligament?
    Anterior recess
    Genital hiatus
    Posterior recess
    Pudendal canal
  26. The perineum is bounded by all of the following skeletal elements except:
    coccyx
    ischiopubic ramus
    spine of ischium
    symphysis pubis
  27. If the venous drainage of the anal canal above the pectinate line is impaired in a patient with portal hypertension, there may be an increase in blood flow downward to the systemic venous system via anastomoses with the inferior rectal vein, which is a tributary of the:
    External iliac
    Inferior gluteal
    Inferior mesenteric
    Internal iliac
    Internal pudendal