UPSC-CMS 2014 — Anatomy

Q: Consider the following statements: Venacaval opening of the diaphragm, situated at the level of T8 transmits 1. inferior vena cava 2. vagus nerve 3. branches of the right phrenic nerve 4. thoracic duct Which of the statements given above are correct?

1 and 3. The **venacaval opening (caval hiatus)** is located at the level of **T8 vertebra** in the central tendon of the diaphragm. [1] **Statement 1: Inferior vena cava** ✓ - **CORRECT** - The inferior vena cava is the primary structure passing through the venacaval opening at T8. This opening is specifically designed to allow the IVC to pass from the abdomen into the thorax. **Statement 3: Branches of the right phrenic nerve** ✓ - **CORRECT** - The right phrenic nerve pierces the central tendon of the diaphragm near the venacaval opening. Some terminal branches of the right phrenic nerve pass through or adjacent to the caval opening to supply the inferior surface of the diaphragm [1]. *Statement 2: Vagus nerve* ✗ - *Incorrect* - The vagus nerves (anterior and posterior vagal trunks) pass through the **esophageal hiatus** at the level of **T10 vertebra**, not through the venacaval opening. [1] *Statement 4: Thoracic duct* ✗ - *Incorrect* - The thoracic duct passes through the **aortic hiatus** at the level of **T12 vertebra**, posterior to the diaphragm between the two crura. It does not pass through the venacaval opening. **Three major openings in the diaphragm:** - **T8** - Venacaval opening (IVC + right phrenic nerve branches) - **T10** - Esophageal hiatus (esophagus + vagus nerves) - **T12** - Aortic hiatus (aorta + thoracic duct + azygos vein) ***Therefore, statements 1 and 3 are correct.*** [Practice more Anatomy PYQs on OnCourse]

Q: Sprain of the ankle joint results from an injury to:

Anterior talofibular ligament. ***Anterior talofibular ligament*** - The **anterior talofibular ligament (ATFL)** is the **most commonly injured ligament** in ankle sprains, especially those resulting from **inversion injuries**. - It lies on the lateral aspect of the ankle and connects the **fibula to the talus**, stabilizing the **ankle joint** against anterior displacement and internal rotation of the talus. *Posterior talofibular ligament* - The **posterior talofibular ligament (PTFL)** is part of the lateral collateral ligament complex but is **rarely injured in isolation** or as the primary site in an ankle sprain. - It is typically involved only in **severe ankle sprains** with significant joint instability. *Deltoid ligament* - The **deltoid ligament** is located on the **medial side of the ankle** and is very strong, making it less prone to injury compared to the lateral ligaments. - Injury to the deltoid ligament usually occurs with **eversion injuries** of the ankle, which are less common than inversion injuries. *Spring Ligament* - The **spring ligament (plantar calcaneonavicular ligament)** supports the **medial longitudinal arch of the foot** and is not directly involved in stabilizing the ankle joint against sprains. - Injury to the spring ligament can lead to a **flatfoot deformity** but is not the primary cause of an ankle sprain. [Practice more Anatomy PYQs on OnCourse]

Q: Consider the following structures in the femoral triangle: 1. Femoral canal 2. Femoral Nerve 3. Femoral artery 4. Femoral vein What is the correct sequence of the above from medial to lateral ?

1, 4, 3, 2. The correct order from medial to lateral within the femoral triangle is **Femoral canal (lymphatics)**, **Femoral vein**, **Femoral artery**, and **Femoral nerve**. A common mnemonic for this order is **NAVEL** read from lateral to medial: **N**erve, **A**rtery, **V**ein, **E**mpty space/**L**ymphatics (femoral canal). Therefore, from medial to lateral, the sequence is: Canal (1), Vein (4), Artery (3), Nerve (2). *1, 2, 3, 4* - This sequence incorrectly places the Femoral nerve (2) second from medial and the Femoral vein (4) most lateral, which contradicts the anatomical arrangement. The **Femoral nerve** is the most lateral structure, and the **Femoral canal** is the most medial component. *4, 3, 1, 2* - This order incorrectly positions the Femoral canal (1) second from lateral instead of being the most medial structure. The **Femoral canal** must be the most medial, followed by vein, artery, and nerve. *3, 4, 2, 1* - This sequence incorrectly places the **Femoral artery** as the most medial and the **Femoral canal** as the most lateral, which is completely reversed. The correct medial-to-lateral order is Canal (1), Vein (4), Artery (3), Nerve (2). [Practice more Anatomy PYQs on OnCourse]

Q: Cephalhematomas are most commonly found over:

Parietal bone. ***Parietal bone*** - The **parietal bones** are the most common site for cephalhematomas due to their prominence and susceptibility to trauma during vaginal delivery [1]. - The **force of uterine contractions** and contact with the birth canal can cause blood vessels beneath the periosteum of the parietal bone to rupture [1]. *Occipital bone* - While possible, cephalhematomas are less commonly observed over the **occipital bone** compared to the parietal region. - The **occipital protrusion** is less frequently subjected to the specific shearing forces that cause subperiosteal bleeding. *Temporal bone* - Cephalhematomas over the **temporal bone** are rare, primarily because this area is less frequently directly impacted during birth. - The relatively thinner bone and surrounding muscles also provide some protection against the typical trauma leading to this condition. *Frontal bone* - Cephalhematomas are generally uncommon over the **frontal bone**. - This area is less exposed to direct pressure and friction from the maternal pelvis during delivery. [Practice more Anatomy PYQs on OnCourse]

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Consider the following statements: Venacaval opening of the diaphragm, situated at the level of T8 transmits 1. inferior vena cava 2. vagus nerve 3. branches of the right phrenic nerve 4. thoracic duct Which of the statements given above are correct?

Sprain of the ankle joint results from an injury to:

Consider the following structures in the femoral triangle: 1. Femoral canal 2. Femoral Nerve 3. Femoral artery 4. Femoral vein What is the correct sequence of the above from medial to lateral ?

Cephalhematomas are most commonly found over:

UPSC-CMS 2014 - Anatomy UPSC-CMS Practice Questions and MCQs

Question 1: Consider the following statements: Venacaval opening of the diaphragm, situated at the level of T8 transmits 1. inferior vena cava 2. vagus nerve 3. branches of the right phrenic nerve 4. thoracic duct Which of the statements given above are correct?

A. 1 and 3 (Correct Answer)
B. 1 and 4
C. 2 and 3
D. 1 and 2

Explanation: The **venacaval opening (caval hiatus)** is located at the level of **T8 vertebra** in the central tendon of the diaphragm. [1] **Statement 1: Inferior vena cava** ✓ - **CORRECT** - The inferior vena cava is the primary structure passing through the venacaval opening at T8. This opening is specifically designed to allow the IVC to pass from the abdomen into the thorax. **Statement 3: Branches of the right phrenic nerve** ✓ - **CORRECT** - The right phrenic nerve pierces the central tendon of the diaphragm near the venacaval opening. Some terminal branches of the right phrenic nerve pass through or adjacent to the caval opening to supply the inferior surface of the diaphragm [1]. *Statement 2: Vagus nerve* ✗ - *Incorrect* - The vagus nerves (anterior and posterior vagal trunks) pass through the **esophageal hiatus** at the level of **T10 vertebra**, not through the venacaval opening. [1] *Statement 4: Thoracic duct* ✗ - *Incorrect* - The thoracic duct passes through the **aortic hiatus** at the level of **T12 vertebra**, posterior to the diaphragm between the two crura. It does not pass through the venacaval opening. **Three major openings in the diaphragm:** - **T8** - Venacaval opening (IVC + right phrenic nerve branches) - **T10** - Esophageal hiatus (esophagus + vagus nerves) - **T12** - Aortic hiatus (aorta + thoracic duct + azygos vein) ***Therefore, statements 1 and 3 are correct.***

Question 2: Sprain of the ankle joint results from an injury to:

A. Posterior talofibular ligament
B. Deltoid ligament
C. Spring Ligament
D. Anterior talofibular ligament (Correct Answer)

Explanation: ***Anterior talofibular ligament*** - The **anterior talofibular ligament (ATFL)** is the **most commonly injured ligament** in ankle sprains, especially those resulting from **inversion injuries**. - It lies on the lateral aspect of the ankle and connects the **fibula to the talus**, stabilizing the **ankle joint** against anterior displacement and internal rotation of the talus. *Posterior talofibular ligament* - The **posterior talofibular ligament (PTFL)** is part of the lateral collateral ligament complex but is **rarely injured in isolation** or as the primary site in an ankle sprain. - It is typically involved only in **severe ankle sprains** with significant joint instability. *Deltoid ligament* - The **deltoid ligament** is located on the **medial side of the ankle** and is very strong, making it less prone to injury compared to the lateral ligaments. - Injury to the deltoid ligament usually occurs with **eversion injuries** of the ankle, which are less common than inversion injuries. *Spring Ligament* - The **spring ligament (plantar calcaneonavicular ligament)** supports the **medial longitudinal arch of the foot** and is not directly involved in stabilizing the ankle joint against sprains. - Injury to the spring ligament can lead to a **flatfoot deformity** but is not the primary cause of an ankle sprain.

Question 3: Consider the following structures in the femoral triangle: 1. Femoral canal 2. Femoral Nerve 3. Femoral artery 4. Femoral vein What is the correct sequence of the above from medial to lateral ?

A. 1, 2, 3, 4
B. 4, 3, 1, 2
C. 1, 4, 3, 2 (Correct Answer)
D. 3, 4, 2, 1

Explanation: The correct order from medial to lateral within the femoral triangle is **Femoral canal (lymphatics)**, **Femoral vein**, **Femoral artery**, and **Femoral nerve**. A common mnemonic for this order is **NAVEL** read from lateral to medial: **N**erve, **A**rtery, **V**ein, **E**mpty space/**L**ymphatics (femoral canal). Therefore, from medial to lateral, the sequence is: Canal (1), Vein (4), Artery (3), Nerve (2). *1, 2, 3, 4* - This sequence incorrectly places the Femoral nerve (2) second from medial and the Femoral vein (4) most lateral, which contradicts the anatomical arrangement. The **Femoral nerve** is the most lateral structure, and the **Femoral canal** is the most medial component. *4, 3, 1, 2* - This order incorrectly positions the Femoral canal (1) second from lateral instead of being the most medial structure. The **Femoral canal** must be the most medial, followed by vein, artery, and nerve. *3, 4, 2, 1* - This sequence incorrectly places the **Femoral artery** as the most medial and the **Femoral canal** as the most lateral, which is completely reversed. The correct medial-to-lateral order is Canal (1), Vein (4), Artery (3), Nerve (2).

Question 4: Cephalhematomas are most commonly found over:

A. Occipital bone
B. Parietal bone (Correct Answer)
C. Temporal bone
D. Frontal bone

Explanation: ***Parietal bone*** - The **parietal bones** are the most common site for cephalhematomas due to their prominence and susceptibility to trauma during vaginal delivery [1]. - The **force of uterine contractions** and contact with the birth canal can cause blood vessels beneath the periosteum of the parietal bone to rupture [1]. *Occipital bone* - While possible, cephalhematomas are less commonly observed over the **occipital bone** compared to the parietal region. - The **occipital protrusion** is less frequently subjected to the specific shearing forces that cause subperiosteal bleeding. *Temporal bone* - Cephalhematomas over the **temporal bone** are rare, primarily because this area is less frequently directly impacted during birth. - The relatively thinner bone and surrounding muscles also provide some protection against the typical trauma leading to this condition. *Frontal bone* - Cephalhematomas are generally uncommon over the **frontal bone**. - This area is less exposed to direct pressure and friction from the maternal pelvis during delivery.