Systemic Anatomy — MCQs
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Arch of aorta begins at which vertebral level?
The internal anal sphincter is a part of which of the following?
Common hepatic artery is a branch of:
What is the primary lymphatic drainage pathway of the ovary?
What is the uppermost structure in left lung hilum?
Shortest part of male urethra is :
Which of the following statements about the first part of the duodenum is false?
What muscle is attached to the superior nuchal line?
Suprarenal gland gets its blood supply from all of the following arteries except:
The incudomalleolar joint is a?
Systemic Anatomy Indian Medical PG Practice Questions and MCQs
Question 251: Arch of aorta begins at which vertebral level?
- A. T2
- B. T5
- C. T3
- D. T4 (Correct Answer)
Explanation: ***T4*** - The **arch of the aorta** typically begins at the level of the **upper border of the fourth thoracic vertebra (T4)**. - This anatomical landmark is crucial for understanding the **topography of the mediastinum** and the branching of the great vessels. *T2* - The **T2 vertebral level** is too high; the arch of the aorta does not begin this superiorly. - This level is often associated with structures like the **trachea** and **esophagus** in the superior mediastinum, but not the aortic arch's origin. *T3* - The **T3 vertebral level** is also too high for the typical origin of the aortic arch. - The **manubrium of the sternum** generally extends down to this level, but the aorta's arch begins slightly lower. *T5* - The **T5 vertebral level** is too low; at this point, the arch of the aorta has usually already passed posteriorly and begun its descent as the **descending aorta** [1]. - The **bifurcation of the trachea** typically occurs at the T4/T5 intervertebral disc level. *T2* - The left recurrent laryngeal nerve (RLN) separates from the vagus as it passes anterior to the arch of the aorta [1].
Question 252: The internal anal sphincter is a part of which of the following?
- A. Puborectalis muscle
- B. Deep perineal muscles
- C. Internal longitudinal fibers
- D. Internal circular fibers (Correct Answer)
Explanation: ***Internal circular fibers*** - The **internal anal sphincter** is an involuntary muscle formed by the thickening of the **circular smooth muscle layer** of the rectum. - This sphincter maintains **tonic contraction** and is responsible for about 80% of resting anal pressure [1]. *Puborectalis muscle* - The **puborectalis muscle** is a voluntary muscle, forming a sling around the anorectal junction to maintain the **anorectal angle** [1]. - It is part of the **levator ani muscles**, which are skeletal muscles, not smooth muscle [1]. *Deep perineal muscles* - The **deep perineal muscles** are a group of skeletal muscles located in the urogenital diaphragm. - They are involved in functions such as **urinary continence** and **erection**, but do not form the internal anal sphincter. *Internal longitudinal fibers* - The **longitudinal muscle layer** of the rectum continues downwards as the conjoined longitudinal muscle, which blends with the external anal sphincter. - These fibers contribute to the **anorectal ring** and support the anal canal but do not form the internal anal sphincter itself.
Question 253: Common hepatic artery is a branch of:
- A. Splenic artery
- B. Superior mesenteric artery
- C. Inferior mesenteric artery
- D. Coeliac trunk (Correct Answer)
Explanation: ***Coeliac trunk*** - The **common hepatic artery** is one of the three main branches arising from the **coeliac trunk**, which is the first major anterior branch of the abdominal aorta [1]. - It typically supplies the **liver**, gallbladder, pylorus of the stomach, and part of the duodenum through its various branches [1]. *Splenic artery* - The **splenic artery** is another major branch of the coeliac trunk, primarily supplying the **spleen**, and also gives off branches to the stomach and pancreas [1]. - It does not directly give rise to the common hepatic artery. *Superior mesenteric artery* - The **superior mesenteric artery (SMA)** originates just inferior to the coeliac trunk from the abdominal aorta and supplies structures of the **midgut**, including the small intestine, and parts of the large intestine. - It is not a direct source of the common hepatic artery. *Inferior mesenteric artery* - The **inferior mesenteric artery (IMA)** arises from the abdominal aorta further inferior to the SMA and supplies the **hindgut**, including the distal transverse colon to the superior part of the rectum. - It is anatomically distinct and separate from the arterial supply to the foregut-derived organs supplied by the common hepatic artery.
Question 254: What is the primary lymphatic drainage pathway of the ovary?
- A. Deep inguinal
- B. Superficial inguinal
- C. Obturator
- D. Paraaortic (Correct Answer)
Explanation: ***Paraaortic*** - The **ovaries** develop embryologically in the abdominal cavity near the kidneys, and their lymphatic drainage follows the **ovarian vessels** (which arise from the aorta). - Lymph drains primarily to the **paraaortic (lumbar) lymph nodes** located along the **aorta** in the retroperitoneum at the level of L1-L2. - This is clinically important in ovarian cancer staging and treatment planning. *Deep inguinal* - The **deep inguinal lymph nodes** primarily drain the deep structures of the lower limb, perineum, and external genitalia. - They do not receive lymphatic drainage directly from the ovaries. *Superficial inguinal* - The **superficial inguinal lymph nodes** drain the skin of the lower abdomen, buttocks, perineum, external genitalia, and the superficial lower limb. - The ovaries are internal intra-abdominal organs and do not drain into these nodes. *Obturator* - The **obturator lymph nodes** are pelvic lymph nodes that primarily drain pelvic structures such as the bladder, uterine body, cervix, and upper vagina. - While adjacent to pelvic organs, they are not the primary drainage site for the ovaries, which drain superiorly along the ovarian vessels to the paraaortic nodes.
Question 255: What is the uppermost structure in left lung hilum?
- A. Pulmonary artery (Correct Answer)
- B. Pulmonary vein
- C. Bronchial artery
- D. Left mainstem bronchus
Explanation: ***Pulmonary artery*** - In the **left lung hilum**, the **pulmonary artery** typically lies superior to the bronchus. - This anatomical position helps differentiate it from the relations in the right lung hilum, where the pulmonary artery is anterior to the bronchus. *Pulmonary vein* - The **pulmonary veins** are usually located anterior and inferior to the bronchus in both lung hila. - They tend to be the most anterior and inferior structures carrying oxygenated blood from the lungs. *Bronchial artery* - **Bronchial arteries** are smaller vessels that typically run on the posterior surface of the bronchi. - They are not considered the uppermost main structure in the hilum. *Left mainstem bronchus* - The **left mainstem bronchus** is usually found inferior to the pulmonary artery and posterior to the pulmonary veins in the left hilum. - It is a prominent structure but not the most superior.
Question 256: Shortest part of male urethra is :
- A. Prostatic
- B. Membranous (Correct Answer)
- C. Bulbar
- D. Penile
Explanation: ***Membranous*** - The **membranous urethra** is the shortest and narrowest part of the male urethra, passing through the **deep perineal pouch**. - Its short length makes it particularly vulnerable to injury during trauma to the pelvis [1]. *Prostatic* - The **prostatic urethra** is approximately 3-4 cm long and runs through the prostate gland. - It is one of the longer segments of the male urethra and drains the ejaculatory ducts. *Bulbar* - The **bulbar urethra** is a segment of the spongy (penile) urethra, located within the bulb of the penis [1]. - It is generally longer than the membranous part and wider distally. *Penile* - The **penile urethra**, also known as the spongy urethra, is the longest part of the male urethra, extending through the corpus spongiosum of the penis. - It measures around 15 cm and expands at its distal end to form the navicular fossa.
Question 257: Which of the following statements about the first part of the duodenum is false?
- A. 5 cm long
- B. Is superior part
- C. Develops from foregut
- D. Supplied by the superior mesenteric artery (Correct Answer)
Explanation: ***Supplied by the superior mesenteric artery*** - The first part of the duodenum, derived from the **foregut**, receives its blood supply from the **gastroduodenal artery**, a branch of the celiac artery [1], [2]. - The **superior mesenteric artery** primarily supplies the **midgut** derivatives, which include the distal half of the duodenum and onward [2]. *5 cm long* - The first part of the duodenum is indeed the **shortest** and widest section, typically measuring about **5 cm (2 inches)** in length. - This length allows it to course from the pylorus to the inferior border of the L1 vertebra. *Is superior part* - This statement is correct as the first part courses **superiorly** and then posteriorly, crossing the right crus of the diaphragm. - It lies at the level of the **L1 vertebra**. *Develops from foregut* - The first part of the duodenum, along with the other upper gastrointestinal structures (stomach, liver, pancreas), indeed develops from the **embryonic foregut** [1]. - The transition from foregut to midgut occurs at the level of the **major duodenal papilla**.
Question 258: What muscle is attached to the superior nuchal line?
- A. Trapezius muscle (Correct Answer)
- B. Scalenus anterior
- C. Coracobrachialis muscle
- D. Biceps Brachii muscle
Explanation: ***Trapezius muscle*** - The **trapezius muscle** is a large, triangular muscle of the back that extends from the **occipital bone** (including the superior nuchal line) to the lower thoracic vertebrae. - Its **superior fibers** originate from the **medial one-third of the superior nuchal line** and the external occipital protuberance. *Scalenus anterior* - The **scalenus anterior** muscle originates from the **transverse processes of cervical vertebrae**, specifically C3-C6. - It inserts onto the **first rib** and is involved in neck flexion and elevation of the first rib during forced inspiration. *Coracobrachialis muscle* - The **coracobrachialis muscle** originates from the **coracoid process of the scapula**. - It inserts into the **medial surface of the humerus** and is involved in shoulder flexion and adduction. *Biceps Brachii muscle* - The **biceps brachii muscle** has two heads: the short head originates from the **coracoid process**, and the long head originates from the **supraglenoid tubercle of the scapula**. - It inserts onto the **radial tuberosity** and is primarily responsible for elbow flexion and forearm supination.
Question 259: Suprarenal gland gets its blood supply from all of the following arteries except:
- A. Aorta
- B. Inferior phrenic artery
- C. Renal artery
- D. Superior mesenteric artery (Correct Answer)
Explanation: ***Superior mesenteric artery*** - The superior mesenteric artery is the chief artery of the **midgut**, supplying structures such as the small intestine, cecum, ascending colon, and part of the transverse colon [2]. - It does **not directly supply** the suprarenal (adrenal) glands. - This is the **correct answer** as it is the artery that does NOT supply the suprarenal gland. *Aorta* - The **abdominal aorta** gives rise to the **middle suprarenal arteries**, which directly supply the suprarenal glands. - These arteries branch off the abdominal aorta at approximately the L1 vertebral level [1]. *Renal artery* - The **renal artery** gives off the **inferior suprarenal arteries**. - These branches contribute to the blood supply of the suprarenal glands from below. *Inferior phrenic artery* - The **inferior phrenic artery** gives rise to the **superior suprarenal arteries**, which are a major blood supply to the suprarenal glands [1]. - These arteries originate from the inferior phrenic artery, which typically arises directly from the aorta just below the aortic hiatus of the diaphragm.
Question 260: The incudomalleolar joint is a?
- A. Saddle joint (Correct Answer)
- B. Pivot joint
- C. Ellipsoid joint
- D. Hinge joint
Explanation: ***Saddle joint*** - The **incudomalleolar joint** is classified as a **saddle joint** (also called a **sellar joint**), which is a type of synovial joint. - It has reciprocally concave-convex articular surfaces that fit together like a rider on a saddle. - This joint allows **slight gliding movements** between the head of the malleus and the body of the incus during sound transmission. - Standard anatomy texts including **Gray's Anatomy** classify this as a saddle joint based on its structural characteristics. *Pivot joint* - A **pivot joint** allows rotation around a single axis, such as the **atlantoaxial joint** (atlas rotating around the dens of axis) or the **proximal radioulnar joint**. - While the ossicular chain as a whole undergoes rotatory movement during sound transmission, the **incudomalleolar joint itself** is not classified as a pivot joint anatomically. *Ellipsoid joint* - An **ellipsoid joint** (condyloid joint) allows movement in two planes (flexion/extension and abduction/adduction) but restricts rotation. - Examples include the **radiocarpal joint** and **metacarpophalangeal joints** of the fingers. - The incudomalleolar joint has a different articular surface configuration. *Hinge joint* - A **hinge joint** permits movement primarily in one plane (flexion and extension), like a door hinge. - Examples include the **elbow joint**, **knee joint**, and **interphalangeal joints**. - This does not match the structural or functional characteristics of the incudomalleolar joint.
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