NEET-PG 2015 Practice Questions

Q: What is the posterior relation of the neck of the pancreas?

Origin of portal vein. ***Origin of portal vein*** - The **neck of the pancreas** is intimately associated with the formation of the **hepatic portal vein** [1]. - The **superior mesenteric vein** and **splenic vein** unite behind the pancreatic neck to form the **hepatic portal vein** [1]. *IVC* - The **inferior vena cava (IVC)** lies posterior to the **head of the pancreas**, not the neck. - While it's in proximity, it does not directly relate to the neck in the same way the portal vein does. *Aorta* - The **abdominal aorta** lies posterior to the **body** and **tail of the pancreas**, further superior and to the left. - It is not a direct posterior relation of the pancreatic neck. *Common bile duct* - The **common bile duct** passes through a groove on the posterior surface of the pancreatic **head**, sometimes even embedded within it. - It is not a direct posterior relation of the pancreatic neck, which is a different segment.

Q: Superior vena cava develops from?

Right anterior cardinal vein. Right anterior cardinal vein - The superior vena cava (SVC) forms from the right anterior cardinal vein and the common cardinal vein. - The right anterior cardinal vein directly contributes to the upper portion of the SVC. Left anterior cardinal vein - The left anterior cardinal vein typically regresses or becomes minor tributaries like the left SVC (if persistent) or the coronary sinus. - It does not form the main superior vena cava. Left common cardinal vein - The left common cardinal vein forms the coronary sinus and an oblique vein of the left atrium. - While major vessels drain into it, it does not directly form the superior vena cava. Right subcardinal vein - The right subcardinal vein is primarily involved in the development of the inferior vena cava (IVC), particularly its renal segment. - It does not contribute to the formation of the superior vena cava.

Q: A patient has a herniated intervertebral disc impinging on the right C5 nerve roots. Which of the following movements would most likely be affected?

Flexion of the elbow. ***Flexion of the elbow*** - The **C5 nerve root** is a primary contributor to the innervation of the **biceps brachii** and **brachialis** muscles, which are the prime movers for elbow flexion. - The C5 myotome specifically includes elbow flexion as one of its key motor functions. - Impingement of the C5 nerve root would therefore most directly impact the strength and function of **elbow flexion**, leading to weakness in this movement. *Extension of the fingers* - Finger extension is primarily mediated by the **C7 and C8 nerve roots** via the posterior interosseous nerve (branch of the radial nerve). - C5 does not significantly contribute to finger extension. *Extension of the shoulder* - Shoulder extension involves muscles primarily innervated by the **C6, C7, and C8 nerve roots** (e.g., latissimus dorsi via thoracodorsal nerve, teres major). - While C5 contributes to some shoulder movements (particularly **shoulder abduction** via the deltoid), it is not primarily responsible for shoulder extension. *Flexion of the wrist* - Wrist flexion is primarily served by muscles innervated by the **C6, C7, and C8 nerve roots** (e.g., flexor carpi radialis - C6/C7, flexor carpi ulnaris - C7/C8). - The C5 nerve root has minimal to no role in wrist flexion.

Q: Which of the following is not a posterior relation of the right kidney?

11th rib. ***11th rib*** - The right kidney typically extends from the 12th thoracic vertebra to the 3rd lumbar vertebra, usually covered by the **12th rib**. - The **11th rib** is usually a posterior relation of the **left kidney**, due to the lower position of the right kidney compared to the left kidney. *Diaphragm* - The diaphragm lies **posterior** to both the right and left kidneys, separating them from the pleura and lungs. - This anatomical relationship means that renal procedures or severe kidney infections can sometimes affect the thoracic cavity. *Subcostal nerve* - The **subcostal nerve** (T12) runs inferior to the 12th rib and passes **posterior** to both kidneys. - It provides sensory innervation to the skin and motor innervation to abdominal muscles. *Ilioinguinal nerve* - The **ilioinguinal nerve** (L1) emerges from the lumbar plexus and travels **posterior** to the inferior pole of both kidneys [1]. - It primarily provides sensory innervation to the groin and parts of the external genitalia.

Q: A nerve injured during axillary lymph node dissection leads to loss of sensation in the medial side of the arm. Which nerve is injured?

Intercostobrachial nerve. ***Intercostobrachial nerve*** - The **intercostobrachial nerve** (T2) is the nerve most commonly injured during **axillary lymph node dissection** - It provides **sensory innervation to the medial side of the upper arm**, specifically the skin over the medial and posterior aspects of the arm [1] - This nerve arises from the **lateral cutaneous branch of the second intercostal nerve** and crosses the axilla to reach the arm [1] - Injury during axillary surgery results in **numbness or paresthesia** in the medial upper arm region, which is a well-recognized complication of breast cancer surgery with axillary node dissection [1] - Studies show **30-80% of patients** undergoing axillary dissection experience intercostobrachial nerve injury *Long thoracic nerve* - The **long thoracic nerve** (C5-C7) innervates the **serratus anterior muscle**, which is crucial for scapular protraction and rotation - Damage to this nerve causes **"winged scapula"**, where the scapula protrudes posteriorly - This is a **motor nerve**, not sensory, so injury does not result in sensory deficits in the arm *Medial pectoral nerve* - The **medial pectoral nerve** (C8-T1) primarily innervates the **pectoralis major** and **pectoralis minor** muscles [1] - This is a **motor nerve** playing a role in muscle function rather than sensation [1] - Injury would result in weakness of these muscles, not sensory loss *Accessory nerve* - The **accessory nerve** (cranial nerve XI) innervates the **sternocleidomastoid** and **trapezius muscles** - This nerve is located in the **posterior triangle of the neck**, not in the axilla - Injury would lead to weakness in shrugging the shoulders or turning the head, not sensory loss in the arm during axillary dissection

Q: Which muscle of the arm has additional supinator action?

Biceps. ***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.

Q: Uvula vesicae seen in bladder is formed from the following structure?

Median lobe of the prostate. ***Median lobe of the prostate*** - The **uvula vesicae** is a slight median elevation on the internal surface of the **bladder base**, immediately behind the **internal urethral orifice**. - This elevation is formed by the underlying **median (middle) lobe of the prostate** projecting upward beneath the bladder mucosa. - In **benign prostatic hyperplasia (BPH)**, enlargement of the median lobe accentuates this prominence and can cause significant urinary obstruction. *Lateral lobe of the prostate* - Enlargement of the **lateral lobes** causes lateral compression of the prostatic urethra, not a median elevation at the bladder neck. - While they are the most common site of **BPH**, they do not form the uvula vesicae. *Anterior lobe of the prostate* - The **anterior lobe** (or anterior fibromuscular stroma) is located in front of the urethra and is non-glandular. - It does not contribute to the formation of the uvula vesicae or cause significant urinary symptoms. *Posterior lobe of the prostate* - The **posterior lobe** is located behind the urethra and is the most common site for **prostate cancer**. - It does not project into the bladder base and therefore does not form the uvula vesicae.

Q: Which is the first bone to start ossifying?

Clavicle. ***Clavicle*** - The **clavicle** is the **first bone to begin ossification** in the human body, starting around the **5th-6th week of gestation**. - It ossifies via **intramembranous ossification**, making it unique among long bones [1]. - This early ossification is a key landmark in fetal skeletal development and is consistently taught across medical curricula. *Mandible* - The **mandible** begins ossification around the **6th week of gestation**, shortly after the clavicle [1]. - While it is one of the earliest bones to ossify, it is **not the first**. - It also undergoes intramembranous ossification [1]. *Femur* - The **femur**, a long bone, begins ossification around the **7th-8th week of gestation** [1]. - It ossifies via **endochondral ossification**, which typically occurs later than intramembranous ossification [1]. *Tibia* - The **tibia** also begins ossification around the **7th-8th week of gestation**. - Like the femur, it follows the endochondral ossification pathway.

Q: The uterine artery is a branch of which of the following?

Internal iliac artery. ***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.

Q: Which of the following is not formed by the external oblique muscle?

Conjoint tendon. ***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 1

What is the posterior relation of the neck of the pancreas?

Accepted Answer

Origin of portal vein

Answer

IVC

Answer

Aorta

Answer

Common bile duct

Question 2

Superior vena cava develops from?

Accepted Answer

Right anterior cardinal vein

Answer

Left anterior cardinal vein

Answer

Left common cardinal vein

Answer

Right subcardinal vein

Question 3

A patient has a herniated intervertebral disc impinging on the right C5 nerve roots. Which of the following movements would most likely be affected?

Accepted Answer

Flexion of the elbow

Answer

Extension of the fingers

Answer

Extension of the shoulder

Answer

Flexion of the wrist

Question 4

Which of the following is not a posterior relation of the right kidney?

Accepted Answer

11th rib

Answer

Subcostal nerve

Answer

Diaphragm

Answer

Ilioinguinal nerve

Question 5

A nerve injured during axillary lymph node dissection leads to loss of sensation in the medial side of the arm. Which nerve is injured?

Accepted Answer

Intercostobrachial nerve

Answer

Long thoracic nerve

Answer

Medial pectoral nerve

Answer

Accessory nerve

Question 6

Which muscle of the arm has additional supinator action?

Accepted Answer

Biceps

Answer

Brachialis

Answer

Coracobrachialis

Answer

Triceps

Question 7

Uvula vesicae seen in bladder is formed from the following structure?

Accepted Answer

Median lobe of the prostate

Answer

Lateral lobe of the prostate

Answer

Anterior lobe of the prostate

Answer

Posterior lobe of the prostate

Question 8

Which is the first bone to start ossifying?

Accepted Answer

Clavicle

Answer

Femur

Answer

Tibia

Answer

Mandible

Question 9

The uterine artery is a branch of which of the following?

Accepted Answer

Internal iliac artery

Answer

Left common iliac artery

Answer

Internal pudendal artery

Answer

Ovarian artery

Question 10

Which of the following is not formed by the external oblique muscle?

Accepted Answer

Conjoint tendon

Answer

Inguinal ligament

Answer

Lacunar ligament

Answer

Pectineal ligament

NEET-PG 2015

Anatomy