Systemic Anatomy Practice Questions

Q: The dermatome level of the structure indicated in the image is: (Recent NEET Pattern 2019)

T10. ***T10*** - The dermatome for **T10** corresponds to the level of the **umbilicus**. - This is a crucial anatomical landmark for dermatomal assessment, neurological examination, and clinical correlation. - The T10 dermatome is consistently tested in NEET-PG examinations. *T12* - The dermatome for **T12** is located just inferior to the umbilicus, typically corresponding to the **suprapubic region** or inguinal area. - It does not correspond to the umbilicus itself. *L1* - The dermatome for **L1** is generally located in the **inguinal region** and upper anterior thigh. - This is significantly lower than the umbilicus. *L3-L4* - **L3-L4** refers to a **vertebral level**, not a dermatomal level. - While the umbilicus is anatomically located at approximately the L3-L4 vertebral level, the question asks for the **dermatome**, which is T10. - Dermatomes and vertebral levels should not be confused.

Q: Which nerve passes through the structure shown? (Recent NEET Pattern 2019)

Inferior alveolar nerve. ***Inferior alveolar nerve*** - The image points to the **mandibular foramen**, an opening on the medial surface of the mandibular ramus. - The **inferior alveolar nerve** enters the mandible through this foramen to supply sensation to the mandibular teeth. *Lingual nerve* - The **lingual nerve** typically runs anterior to the inferior alveolar nerve in the infratemporal fossa but does not pass through the mandibular foramen. - It supplies general sensation and taste to the anterior two-thirds of the tongue. *Buccal nerve* - The **buccal nerve** passes between the two heads of the lateral pterygoid muscle and supplies sensation to the buccal mucosa and gingiva, not traveling within the mandible. - It arises from the anterior division of the mandibular nerve. *Hypoglossal nerve* - The **hypoglossal nerve (CN XII)** is a motor nerve for the tongue muscles and is located entirely outside the mandible. - It exits the skull through the hypoglossal canal and runs in the neck and floor of the mouth.

Q: All investigations are useful in work up of this condition except:

Invertogram at 24 hours. ***Urine for meconium particles*** - **Urine for meconium particles** is actually a valuable and standard investigation in **anorectal malformations** to detect **rectourinary fistulas**. - The presence of meconium in urine indicates a **communication between the rectum and urinary tract**, which is crucial information for surgical planning and management. *Invertogram at 24 hours* - An **invertogram** is a plain X-ray taken with the infant inverted for 3-5 minutes, allowing gas in the rectum to rise to the highest point. - This helps determine the **level of rectal pouch termination** relative to the **pubococcygeal line**, which is essential for distinguishing between high and low anorectal malformations. *Ultrasound* - **Perineal ultrasound** can assess the **perineal body thickness**, presence of a **rectal pouch**, and help visualize **fistulous connections**. - It is particularly useful in **real-time assessment** of the anatomy and can identify associated **genitourinary anomalies** commonly seen with anorectal malformations. *Lateral pelvic radiography* - A **lateral pelvic radiograph** provides information about the **sacral anatomy** and helps assess the **level of anorectal malformation**. - It is crucial for identifying associated **sacral anomalies** (sacral dysgenesis, hemisacrum) which occur in up to 60% of patients with anorectal malformations and affect surgical outcomes.

Q: What is the name of the marked blood vessel, which is a branch of external carotid artery?

Lingual artery. ***Correct: Lingual artery*** - The image shows a vessel branching off the anterior aspect of the **external carotid artery** and extending towards the tongue region, which is characteristic of the **lingual artery**. - This artery typically arises at the level of the **greater horn of the hyoid bone** and supplies the **tongue** and floor of the mouth. - The anterior projection and course towards the tongue region are key identifying features. *Incorrect: Superior thyroid artery* - The superior thyroid artery typically branches off the **external carotid artery** more inferiorly, often near its origin, and descends to supply the **thyroid gland**. - This vessel, in contrast, is marked higher up and projects anteriorly towards the tongue, not inferiorly towards the thyroid. *Incorrect: Ascending pharyngeal artery* - The **ascending pharyngeal artery** usually arises from the medial or posterior aspect of the external carotid artery as a small, slender branch. - It ascends vertically to supply the **pharynx**, prevertebral muscles, and middle ear, not showing the anterior horizontal course seen in the marked vessel. *Incorrect: Maxillary artery* - The maxillary artery is a terminal branch of the **external carotid artery** that originates behind the neck of the mandible, deep to the parotid gland at a higher level. - It has a complex course with many branches supplying deep structures of the face, but its origin is much more posterior and superior than the marked vessel.

Q: Testicular artery is a branch of -

Abdominal aorta. ***Abdominal aorta*** - The **testicular arteries**, also known as **gonadal arteries**, originate directly from the anterior aspect of the **abdominal aorta**. - They typically arise just inferior to the **renal arteries** at the level of the second lumbar vertebra (L2) and descend to supply the testes. *Common iliac artery* - The common iliac artery is a terminal branch of the **abdominal aorta**, but it gives rise to the internal and external iliac arteries, not directly the testicular artery. [2] - It bifurcates at the level of the sacroiliac joint. [3] *External iliac artery* - The external iliac artery primarily supplies the **lower limb** and gives off the inferior epigastric and deep circumflex iliac arteries. [1] - It does not directly provide branches to the testes. *Internal iliac artery* - The internal iliac artery primarily supplies the **pelvic organs**, gluteal region, and perineum. - While it has numerous branches, none of them are the main gonadal arteries; it contributes to the blood supply of the reproductive organs through other smaller branches. [3]

Q: Left anterior descending artery is a direct branch of

Left coronary artery. ***Left coronary artery*** - The left coronary artery (LCA) is a major coronary artery that arises from the **aorta** and quickly branches into two main arteries: the **left anterior descending (LAD) artery** [1] and the circumflex artery. - The LAD artery, also known as the **"widowmaker"**, supplies oxygenated blood to the **anterior wall of the left ventricle** and the interventricular septum, making it crucial for heart function. *Right coronary artery* - The **right coronary artery (RCA)** typically supplies the **right atrium**, most of the **right ventricle**, and the inferior wall of the left ventricle, which are distinct areas from the LAD's supply. - The RCA originates from the **right sinus of Valsalva** and travels in the atrioventricular groove, while the LAD originates from the left main coronary artery [1]. *Circumflex artery* - The circumflex artery is another main branch of the **left coronary artery**, typically supplying the **lateral and posterior walls of the left ventricle** and the left atrium. - While it branches from the same parent vessel as the LAD, it is a direct branch itself, not the origin of the LAD [1]. *Ascending aorta* - The ascending aorta is the initial part of the aorta that originates from the **left ventricle** and gives rise to the **coronary arteries** (both left and right coronary arteries). - It is the source from which the **left coronary artery** (and thus the LAD indirectly) originates, but it is not a direct branch itself.

Q: Highest point of iliac crest is seen at?

L4. ***L4*** - The **highest point of the iliac crest** typically corresponds to the level of the **L4 vertebral body**. - This anatomical landmark is crucial for procedures like **lumbar punctures** and determining the location for **epidural anesthesia**. *L3* - The L3 vertebral level is generally located slightly **above the highest point of the iliac crest**. - While close, it is not the most consistent anatomical correlation for the highest point. *S2* - The **S2 vertebral level** is significantly **below the iliac crests**, marking the approximate midpoint of the sacroiliac joint. - This level is used as a landmark for the **dermatome of the posterior thigh**. *S1* - The **S1 vertebral level** is also located **below the iliac crests**, forming the most superior segment of the sacrum. - It is used as a landmark for the **dermatome of the lateral foot and posterior leg**, and corresponds to the ankle jerk reflex.

Q: Which of the following is TRUE about bronchopulmonary segments?

Pulmonary veins are intersegmental. Detailed knowledge of lung anatomy is essential for thoracic surgery. ***Pulmonary veins are intersegmental*** - The **pulmonary veins** run in the connective tissue septa **between** the bronchopulmonary segments, making them **intersegmental** [1]. - This anatomical arrangement allows surgeons to ligate the veins without affecting adjacent segments during a segmentectomy. *Spherical in shape* - Bronchopulmonary segments are typically **pyramid-shaped** or cone-shaped, with their apices directed towards the hilum [1]. - Their irregular, wedge-like structure allows them to fit together within the lung. *Artery is intersegmental* - The **bronchial arteries** and **pulmonary arteries** are **intrasegmental**, meaning they run **within** the bronchopulmonary segment alongside the bronchi. - Each segment has its own arterial supply, allowing for independent blood flow. *Non resectable* - Bronchopulmonary segments are considered **functionally and surgically independent units**, making them **resectable** [1]. - This allows for the removal of diseased segments while preserving healthy lung tissue, such as in cases of **lung cancer** or localized infection.

Q: Most prominent and largest air cell of ethmoidal sinus?

Bulla ethmoidalis. ***Bulla ethmoidalis*** - The **bulla ethmoidalis** is universally present and is consistently described as the **largest and most prominent** of the anterior ethmoid air cells. - It forms an anatomical landmark that is consistently superior and posterior to the **hiatus semilunaris**. *Onodi cell* - The **Onodi cell** is a posterior ethmoid air cell that pneumatizes laterally and superiorly into the sphenoid bone, in close proximity to the optic nerve. - While clinically significant due to its relationship with the optic nerve, it is not the largest or most prominent ethmoidal air cell. *Haller cell* - A **Haller cell** is an infraorbital ethmoid cell located along the floor of the orbit, extending into the maxillary sinus. - These cells can contribute to **ostial obstruction** of the maxillary sinus but are typically small compared to the bulla ethmoidalis. *Agger nasi cell* - The **agger nasi cell** is the most anterior ethmoid air cell, located in the lacrimal bone anterior to the frontal recess. - It is often one of the first ethmoid cells to pneumatize but is generally small and not considered the most prominent.

Q: Articular surfaces ≥3 are present in which type of joint?

Compound joint. ***Compound joint*** - A **compound joint** is defined by having **three or more articular surfaces**, meaning multiple bones articulate within a single joint capsule. - Examples include the **elbow joint** (humerus, ulna, radius) and the **knee joint** (femur, tibia, patella). *Complex joint* - A **complex joint** is characterized by the presence of an **intra-articular disc or meniscus**, which divides the joint cavity. - This feature helps to absorb shock and improve congruity, but it doesn't necessarily dictate the number of articular surfaces. *Synarthrosis joint* - A **synarthrosis joint** is an **immovable joint** where bones are very close together, such as the sutures of the skull. - These joints prioritize stability over movement and typically do not involve distinct articular surfaces in the same way as synovial joints. *Simple joint* - A **simple joint** involves the articulation of **only two bones** or two articular surfaces within a single joint capsule. - Examples include the **phalangeal joints** (interphalangeal joints) and the **hip joint** (femur and pelvis).

Question 1

The dermatome level of the structure indicated in the image is: (Recent NEET Pattern 2019)

Accepted Answer

T10

Answer

T12

Answer

L1

Answer

L3-L4

Question 2

Which nerve passes through the structure shown? (Recent NEET Pattern 2019)

Accepted Answer

Inferior alveolar nerve

Answer

Lingual nerve

Answer

Buccal nerve

Answer

Hypoglossal nerve

Question 3

All investigations are useful in work up of this condition except:

Accepted Answer

Invertogram at 24 hours

Answer

Urine for meconium particles

Answer

Ultrasound

Answer

Lateral pelvic radiography

Question 4

What is the name of the marked blood vessel, which is a branch of external carotid artery?

Accepted Answer

Lingual artery

Answer

Superior thyroid artery

Answer

Ascending pharyngeal artery

Answer

Maxillary artery

Question 5

Testicular artery is a branch of -

Accepted Answer

Abdominal aorta

Answer

Common iliac artery

Answer

External iliac artery

Answer

Internal iliac artery

Question 6

Left anterior descending artery is a direct branch of

Accepted Answer

Left coronary artery

Answer

Right coronary artery

Answer

Circumflex artery

Answer

Ascending aorta

Question 7

Highest point of iliac crest is seen at?

Accepted Answer

L4

Answer

L3

Answer

S2

Answer

S1

Question 8

Which of the following is TRUE about bronchopulmonary segments?

Accepted Answer

Pulmonary veins are intersegmental

Answer

Spherical in shape

Answer

Artery is intersegmental

Answer

Non resectable

Question 9

Most prominent and largest air cell of ethmoidal sinus?

Accepted Answer

Bulla ethmoidalis

Answer

Onodi cell

Answer

Haller cell

Answer

Agger nasi cell

Question 10

Articular surfaces ≥3 are present in which type of joint?

Accepted Answer

Compound joint

Answer

Complex joint

Answer

Synarthrosis joint

Answer

Simple joint

Systemic Anatomy — MCQs

Systemic Anatomy — MCQs

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