NEET-PG 2012 — Anatomy
98 Previous Year Questions with Answers & Explanations
A patient is found to have a melanoma originating in the skin of the left forearm. After removal of the tumor from the forearm, all axillary lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed. Which axillary nodes would not be removed?
Deltoid ligament is attached to all, except which structure?
Coronary sinus develops from?
What anatomical structures are involved in the closure of the fossa ovalis?
Which of the following is a traction epiphysis ?
Renal papilla opens into -
Cricoid cartilage lies at which vertebral level?
In walking, gravity tends to tilt pelvis and trunk to the unsupported side, the major factor in preventing this unwanted movement is?
Which of the following statements provides the MOST COMPLETE description of sclerotome function during vertebral development?
Which is derived from Wolffian duct?
NEET-PG 2012 - Anatomy NEET-PG Practice Questions and MCQs
Question 1: A patient is found to have a melanoma originating in the skin of the left forearm. After removal of the tumor from the forearm, all axillary lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed. Which axillary nodes would not be removed?
- A. Central lymph nodes
- B. Lateral lymph nodes
- C. Pectoral lymph nodes
- D. Apical lymph nodes (Correct Answer)
Explanation: ***Apical lymph nodes*** - The **apical lymph nodes** are located **medial** to the **medial border of the pectoralis minor muscle**, at the apex of the axilla (Level III) [2]. - Since the removal was restricted to nodes **lateral** to the medial edge of the pectoralis minor, the apical nodes would **not be removed**. - These nodes receive lymph from all other axillary node groups and drain into the subclavian lymphatic trunk. *Central lymph nodes* - **Central lymph nodes** are located **posterior to (deep to)** the pectoralis minor muscle, within the axillary fat (Level II) [1]. - They lie between the medial and lateral borders of the pectoralis minor and are generally considered to be **lateral** to the medial edge of the pectoralis minor, so they would be removed in this dissection. *Lateral lymph nodes* - **Lateral (humeral) lymph nodes** are found along the **lateral border** of the axilla, following the axillary vein (Level I) [1]. - These nodes drain the majority of the upper limb and are clearly **lateral** to the pectoralis minor muscle, so hese would be included in the dissection. *Pectoral lymph nodes* - **Pectoral (anterior) lymph nodes** lie along the **lower border** of the pectoralis minor muscle and the lateral thoracic vessels (Level I). - They receive lymph from the anterior and lateral thoracic walls and much of the breast. - These nodes are located **lateral** to the medial edge of the pectoralis minor and would be removed as part of the surgical procedure.
Question 2: Deltoid ligament is attached to all, except which structure?
- A. Sustentaculum tali
- B. Medial cuneiform (Correct Answer)
- C. Navicular bone
- D. Medial malleolus
Explanation: ***Medial cuneiform*** - The **deltoid ligament** is located on the **medial side of the ankle** and primarily connects the **tibia** to several tarsal bones. It does not attach to the medial cuneiform. - The **medial cuneiform** is a midfoot bone primarily involved in the **tarsometatarsal joint** and is not a direct attachment site for the deltoid ligament. *Medial malleolus* - The **medial malleolus**, the distal end of the **tibia**, serves as the **proximal attachment point** for all four parts of the deltoid ligament. - This strong connection is crucial for **stabilizing the ankle joint** medially. *Navicular bone* - The **tibionavicular part** of the deltoid ligament attaches to the **tuberosity of the navicular bone**. - This attachment helps **limit excessive abduction** and **eversion** of the foot. *Sustentaculum tali* - The **tibiocalcaneal part** of the deltoid ligament attaches to the **sustentaculum tali** on the calcaneus. - This attachment provides significant stability to the **subtalar joint**.
Question 3: Coronary sinus develops from?
- A. Truncus arteriosus
- B. Conus
- C. Sinus venosus (Correct Answer)
- D. AV canal
Explanation: Sinus venosus - The sinus venosus is a primordial cardiac chamber that receives venous blood from the body and placenta in the early embryonic heart. - The left horn of the sinus venosus loses its connection with the systemic venous circulation and becomes the coronary sinus, which drains most of the cardiac veins into the right atrium [1, 4]. Truncus arteriosus - The truncus arteriosus is the embryonic precursor to the ascending aorta and pulmonary trunk. - It does not contribute to the development of the coronary sinus. Conus - The conus (or conus cordis) is the outflow portion of the primitive ventricle and differentiates into the outflow tracts of the right (infundibulum) and left (aortic vestibule) ventricles. - It is not involved in the formation of the coronary sinus. AV canal - The atrioventricular (AV) canal connects the primitive atrium and ventricle and is crucial for the formation of the AV valves and septation of the heart chambers. - It does not directly develop into the coronary sinus.
Question 4: What anatomical structures are involved in the closure of the fossa ovalis?
- A. Septum primum + Endocardial cushion
- B. Septum primum + Septum secundum (Correct Answer)
- C. Endocardial cushions + Septum secundum
- D. None of the options
Explanation: The septum primum acts as a valve, closing against the septum secundum postnatally due to changes in atrial pressure. This fusion effectively closes the foramen ovale, leading to the formation of the fossa ovalis. The endocardial cushions are important for the formation of the atrial and ventricular septa, as well as the AV valves, but not directly for the closure of the fossa ovalis. The septum primum is directly involved, but its apposition with the endocardial cushions doesn't close the foramen ovale. While both structures contribute to heart development, their direct interaction is not responsible for the closure of the fossa ovalis. The septum secundum forms the muscular rim of the fossa ovalis, and the endocardial cushions are critical for atrial septation, but not the final closure here. This option is incorrect because the specific combination of septum primum and septum secundum is indeed responsible for the closure of the fossa ovalis.
Question 5: Which of the following is a traction epiphysis ?
- A. Tibial condyles
- B. Head of femur
- C. Trochanter of femur
- D. Coracoid process of scapula (Correct Answer)
Explanation: ***Coracoid process of scapula*** - A **traction epiphysis** (also called atavistic epiphysis) serves as an attachment site for muscles and tendons, transferring muscle force to the bone without bearing significant weight or forming articular surfaces. - The **coracoid process** is a classic example, anchoring the **pectoralis minor, coracobrachialis, and short head of biceps brachii**, as well as important ligaments (coracoclavicular and coracoacromial). - It develops from a separate ossification center purely for muscle and ligament attachment, not for articulation or weight-bearing. *Tibial condyles* - The **tibial condyles** are **pressure epiphyses** (articular epiphyses) that form the superior articular surface of the tibia. - They articulate with the femoral condyles to form the knee joint and bear significant weight during standing and movement. - Their primary function is joint formation and contribution to longitudinal bone growth. *Trochanter of femur* - The **greater and lesser trochanters** are large bony prominences that serve as muscle attachment sites, but they are better classified as **apophyses** rather than true traction epiphyses. - An **apophysis** is a secondary ossification center that does not contribute to longitudinal bone growth and serves primarily for muscle attachment. - While functionally similar to traction epiphyses, the term "traction epiphysis" is more specifically applied to structures like the coracoid process, tibial tuberosity, and calcaneal tuberosity. *Head of femur* - The **head of femur** is a classic **pressure epiphysis** that articulates with the acetabulum to form the hip joint. - It bears significant body weight and contributes to the longitudinal growth of the femur. - Its primary functions are joint formation and weight transmission, not muscle attachment.
Question 6: Renal papilla opens into -
- A. Cortex
- B. Pyramid
- C. Minor calyx (Correct Answer)
- D. Major calyx
Explanation: ***Minor calyx*** - The **renal papilla** is the apex of the renal pyramid, which drains urine directly into a **minor calyx**. - Minor calyces then merge to form major calyces, eventually leading to the renal pelvis. *Cortex* - The **renal cortex** is the outer layer of the kidney, containing glomeruli and convoluted tubules, and does not directly receive urine from the papilla. - Urine is primarily formed and filtered in the cortex and then flows into the medulla. *Pyramid* - A **renal pyramid** is a conical structure within the renal medulla, and the renal papilla is its tip, but it doesn't open *into* the pyramid itself. - Instead, the pyramid *contains* the structures that contribute to the papilla. *Major calyx* - A **major calyx** is formed by the convergence of several minor calyces. - The renal papilla drains into the minor calyx, which then, in turn, drains into the major calyx.
Question 7: Cricoid cartilage lies at which vertebral level?
- A. C3
- B. C6 (Correct Answer)
- C. T1
- D. T4
Explanation: **C6** - The **cricoid cartilage** is an important anatomical landmark, as it signifies the transition from the **laryngopharynx** to the **esophagus** and the start of the **trachea**. - Its location at **C6 vertebral level** is significant for procedures like tracheostomy and in identifying the narrowest part of the adult airway. *C3* - The C3 vertebral level is typically associated with the **hyoid bone**, which is superior to the cricoid cartilage. - The **epiglottis** and the superior aspect of the larynx are more commonly found at C3-C4. *T1* - The T1 vertebral level is in the **thoracic spine**, well below the neck, and is associated with the **apex of the lung** and the **first rib**. - The airway structures at this level are primarily the **trachea** as it enters the thorax. *T4* - The T4 vertebral level is significant as it marks the approximate location of the **carina**, where the trachea bifurcates into the main bronchi. - This level is much lower than the larynx and cricoid cartilage.
Question 8: In walking, gravity tends to tilt pelvis and trunk to the unsupported side, the major factor in preventing this unwanted movement is?
- A. Adductor muscles
- B. Quadriceps
- C. Gluteus medius and minimus (Correct Answer)
- D. Gluteus maximus
Explanation: ***Gluteus medius and minimus*** - The **gluteus medius** and **gluteus minimus** are essential **abductors** of the hip, primarily responsible for stabilizing the pelvis during the **single-limb support phase of gait**. - When one leg is lifted during walking, these muscles on the **stance leg side** contract to prevent the pelvis from tilting downwards on the unsupported swing leg side. *Adductor muscles* - **Adductor muscles** (adductor longus, brevis, magnus, pectineus, gracilis) primarily function to bring the thigh toward the midline of the body. - While they play a role in gait stability, their main action is not to prevent the lateral pelvic tilt described. *Quadriceps* - The quadriceps femoris group (rectus femoris, vastus lateralis, medialis, intermedius) are powerful **extensors of the knee**. - They are crucial for weight acceptance and propulsion during walking but do not directly prevent lateral pelvic tilt [1]. *Gluteus maximus* - The **gluteus maximus** is the largest and most powerful muscle of the hip, primarily responsible for **hip extension** and **external rotation**. - It is crucial for activities like climbing stairs or running, but its main role in normal walking is not to prevent lateral pelvic tilt; that function is more specific to the gluteus medius and minimus.
Question 9: Which of the following statements provides the MOST COMPLETE description of sclerotome function during vertebral development?
- A. The notochord forms the nucleus pulposus.
- B. The sclerotome contributes to the formation of vertebral bodies.
- C. The sclerotome surrounds the notochord and the neural tube during development. (Correct Answer)
- D. The sclerotome surrounds the notochord.
Explanation: ***The sclerotome surrounds the notochord and the neural tube during development.*** - The **sclerotome** is the part of the somite that differentiates into mesenchymal cells and migrates to surround both the developing **notochord** (which gives rise to the nucleus pulposus) and the **neural tube** (which forms the spinal cord). - This encirclement is crucial for the formation of the **vertebral column**, providing protection and a structural framework. *The notochord forms the nucleus pulposus.* - While true that the **notochord** contributes to the **nucleus pulposus**, this statement describes the fate of the notochord itself, not the function of the sclerotome. - The question asks for the function of the sclerotome, and this option only details one specific derivative. *The sclerotome contributes to the formation of vertebral bodies.* - This statement is partially true, as the **sclerotome** does indeed form the **vertebral bodies**, arches, and intervertebral discs. - However, it is not the *most complete* description of its function during development, as it omits the crucial aspect of surrounding the neural tube. *The sclerotome surrounds the notochord.* - This statement is correct but **incomplete** as it only mentions the notochord. - The **sclerotome** also surrounds the **neural tube**, which is a vital part of its developmental role in forming the vertebral canal.
Question 10: Which is derived from Wolffian duct?
- A. Appendix of epididymis (Correct Answer)
- B. Appendix of the testis
- C. Uterine structure
- D. Hydatid of Morgagni
Explanation: The **appendix of the epididymis** is a vestigial structure directly derived from the mesonephric (Wolffian) duct in males. It is an embryological remnant of this duct, located at the head of the epididymis. *Appendix of the testis* - The **appendix of the testis** (hydatid of Morgagni) is a remnant of the paramesonephric (Müllerian) duct, not the Wolffian duct. - It is usually found on the upper pole of the testis, typically near the epididymis. *Uterine structure* - **Uterine structures** (uterus, fallopian tubes, and upper vagina) are derived from the paramesonephric (Müllerian) ducts in females [1]. - The Wolffian ducts largely regress in females due to the absence of testosterone. *Hydatid of Morgagni* - The term **hydatid of Morgagni** can refer to the appendix of the testis (Müllerian duct remnant) or, less commonly, to the appendix of the epididymis (Wolffian duct remnant). - However, in common clinical and anatomical usage, it almost exclusively refers to the **appendix of the testis**, which is a Müllerian duct derivative.