NEET-PG 2013 Practice Questions

Q: Helicine arteries are branches of which artery?

Internal pudendal artery. ***Internal pudendal artery*** - The **internal pudendal artery** is the primary arterial supply to the external genitalia, and its branches, including the **helicine arteries**, are crucial for erectile function. - In males, these arteries supply the **corpus cavernosa** of the penis, and in females, they supply the **clitoris**, playing a key role in sexual arousal. *Femoral artery* - The **femoral artery** is a large artery in the thigh that supplies blood to the lower limb, but it does not directly branch into the helicine arteries of the genitalia. - Its main branches include the **deep femoral artery** and the **superficial femoral artery**, which are involved in blood supply to the muscles and skin of the thigh. *External pudendal artery* - The **external pudendal artery** branches off the femoral artery and supplies the skin of the external genitalia and the perineum, but not the deeper erectile tissues via helicine arteries. - It primarily provides superficial blood supply, such as to the **scrotum** or **labia majora**, and is distinct from the internal pudendal artery's deeper distribution. *None of the options* - This option is incorrect because the **internal pudendal artery** is indeed the origin of the helicine arteries. - The other options provided are incorrect as they do not directly give rise to the helicine arteries.

Q: Superior wall of middle ear is formed by ?

Tegmen tympani. ***Tegmen tympani*** - The **tegmen tympani** is a thin plate of **petrous temporal bone** that forms the roof or superior wall of the middle ear cavity. - This structure separates the middle ear from the **middle cranial fossa** and its contents, including the **temporal lobe of the brain**. *Jugular bulb* - The **jugular bulb** is the dilated superior portion of the **internal jugular vein** and forms part of the **floor (inferior wall)** of the middle ear cavity, not the superior wall. - Its close proximity to the middle ear makes it vulnerable to injury during otologic surgery. *Tympanic membrane* - The **tympanic membrane** (eardrum) forms the **lateral wall** of the middle ear cavity, separating it from the external auditory canal. - It is crucial for **sound transmission** by vibrating in response to sound waves. *Carotid wall* - The **carotid wall** forms the **anterior wall** of the middle ear cavity and is related to the **internal carotid artery** as it narrows through the carotid canal. - This wall is not the superior boundary of the middle ear.

Q: What is Galen's anastomosis?

Internal laryngeal nerve and recurrent laryngeal nerve. ***Internal laryngeal nerve and recurrent laryngeal nerve*** - **Galen's anastomosis** (also known as **ansa Galeni**) is the connection between the **internal laryngeal nerve** (a sensory branch of the superior laryngeal nerve) and the **recurrent laryngeal nerve** (motor branch of the vagus nerve). - This anastomosis occurs in the **laryngeal mucosa** and allows for communication between these two important nerves. - The **internal laryngeal nerve** provides **sensory innervation** to the larynx above the vocal cords, while the **recurrent laryngeal nerve** provides **motor innervation** to most intrinsic laryngeal muscles (except cricothyroid). - This anastomosis is clinically significant in understanding the complex innervation patterns of the larynx. *Recurrent laryngeal nerve and external laryngeal nerve* - While both nerves are branches of the vagus nerve and innervate laryngeal structures, this connection does not constitute **Galen's anastomosis**. - The recurrent laryngeal nerve innervates intrinsic laryngeal muscles (except cricothyroid), while the external laryngeal nerve innervates the **cricothyroid muscle** and is motor in nature. *None of the options* - This option is incorrect because the correct definition of **Galen's anastomosis** is provided in the first option. *Recurrent laryngeal nerve and sympathetic trunk* - While there may be sympathetic contributions to laryngeal innervation, this does not represent **Galen's anastomosis**. - The sympathetic trunk provides autonomic innervation but the specific named anastomosis refers to the connection between the internal laryngeal and recurrent laryngeal nerves.

Q: All pass through jugular foramen except

Mandibular nerve. ***Mandibular nerve*** - The **mandibular nerve** (CN V3) exits the skull through the **foramen ovale**, not the jugular foramen. - It is a branch of the **trigeminal nerve** and is responsible for motor innervation to muscles of mastication and sensory innervation to the lower face and mouth. *Glossopharyngeal nerve* - The **glossopharyngeal nerve** (CN IX) is one of the three cranial nerves that exit through the **jugular foramen**. - It provides motor, sensory, and parasympathetic innervation including taste from posterior third of tongue and motor to stylopharyngeus muscle. *Vagus nerve* - The **vagus nerve** (CN X) is one of the major cranial nerves that exits the skull through the **jugular foramen**. - It provides extensive motor, sensory, and parasympathetic innervation to the head, neck, thorax, and abdomen. *Internal jugular vein* - The **internal jugular vein** is formed at the jugular foramen by the continuation of the **sigmoid sinus**, and it exits the skull through this foramen. - It is one of the primary venous drainage pathways for the brain.

Q: Which of the following statements regarding axillary lymph nodes is incorrect?

Lateral group lies along lateral thoracic vessels. ***Lateral group lies along lateral thoracic vessels*** - The **lateral group** of axillary lymph nodes is located along the **axillary vein**, receiving lymph primarily from the upper limb [1]. - The **lateral thoracic vessels** are associated with the central and posterior groups of axillary lymph nodes, not the lateral group. *Posterior group lies along subscapular vessels* - The **posterior (subscapular) group** of axillary lymph nodes is indeed located along the **subscapular vessels**. - This group receives lymph from the posterior wall of the trunk and the posterior shoulder region. *Apical group is terminal lymph nodes* - The **apical group** (also known as the subclavian group) is considered the **terminal lymph nodes** of the axilla. - Lymph from all other axillary nodes eventually drains into the apical group before continuing to the supraclavicular nodes and then into the subclavian lymphatic trunk [2]. *Apical group lies along axillary vessels* - The **apical group** of axillary lymph nodes is situated in the apex of the axilla, superior to the pectoralis minor muscle, and lies in close proximity to the **axillary vessels** [1]. - This location allows it to receive lymph from other axillary groups and drain into the supraclavicular lymph nodes.

Q: Which muscle is the deepest in the anterior neck region?

Longus colli. ***Longus colli*** - The **longus colli** muscle is the **deepest muscle** located in the anterior neck region, running along the front of the cervical vertebral column from C1 to T3. - It lies in the **prevertebral layer**, deep to all other anterior neck structures including the carotid sheath, visceral compartment, and superficial muscles. - Its position directly anterior to the vertebral bodies makes it the deepest anterior neck muscle. *Platysma* - The platysma is the **most superficial muscle** of the neck, located just beneath the skin in the superficial fascia. - It is not a deep muscle and lies superficial to all other neck muscles. *Sternocleidomastoid* - The sternocleidomastoid is enclosed within the **investing layer of deep cervical fascia**, making it relatively superficial. - While prominent in the anterior and lateral neck, it is not the deepest anterior neck muscle. *Trapezius* - The trapezius is a large, **superficial muscle of the back and posterior neck**. - It is not located in the anterior neck and is a superficial, not deep, muscle.

Q: Which of the following structures pass through the superior orbital fissure?

All of the options. ***All of the options*** - The **superior orbital fissure** is a key opening in the skull that allows passage of several important cranial nerves and vessels into the orbit. - The **oculomotor nerve**, **trochlear nerve**, and **superior ophthalmic vein** are all established structures that pass through this fissure. *Oculomotor nerve* - The **oculomotor nerve (CN III)** passes through the superior orbital fissure to innervate most of the extrinsic eye muscles. - It controls movements such as **adduction**, **elevation**, and **depression** of the eyeball, and also innervates the **levator palpebrae superioris** muscle for eyelid elevation [1]. *Trochlear nerve* - The **trochlear nerve (CN IV)**, which innervates the **superior oblique muscle**, also passes through the superior orbital fissure. - The superior oblique muscle is responsible for **intorsion** and **depression** of the eye, particularly when the eye is adducted [1]. *Superior ophthalmic vein* - The **superior ophthalmic vein** drains blood from structures within the orbit and passes through the superior orbital fissure to drain into the **cavernous sinus**. - This vein provides a connection between the facial veins and the cavernous sinus, which can be clinically relevant in cases of infection spread.

Q: Which of the following drugs is known to have low first pass metabolism?

Theophylline. ***Theophylline*** - **Theophylline** exhibits **low first-pass metabolism**, meaning a significant portion of the orally administered drug reaches systemic circulation unchanged. - This characteristic contributes to its relatively **high bioavailability** when given orally. *Lidocaine* - **Lidocaine** undergoes extensive **first-pass metabolism** in the liver, leading to very low oral bioavailability. - Due to this, it is typically administered **parenterally** (e.g., intravenously or topically) to achieve therapeutic concentrations. *Propranolol* - **Propranolol** is known for its significant **first-pass metabolism**, which results in a much lower bioavailability after oral administration compared to intravenous. - This extensive metabolism necessitates higher oral doses to achieve the same therapeutic effect as parenteral administration. *Morphine* - **Morphine** also undergoes substantial **first-pass metabolism** in the liver, where it is primarily glucuronidated. - This leads to a lower oral bioavailability compared to other routes of administration and contributes to a higher oral dose requirement.

Q: Which beta-1 antagonist is used in congestive cardiac failure?

Metoprolol. ***Metoprolol*** - **Metoprolol succinate** (extended-release formulation) is a selective **beta-1 antagonist** proven to reduce mortality and hospitalizations in **chronic heart failure with reduced ejection fraction (HFrEF)**. - It works by **reducing heart rate, myocardial oxygen demand**, and preventing adverse cardiac remodeling through inhibition of chronic sympathetic activation. - Along with **bisoprolol and carvedilol**, it is one of the **three beta-blockers with proven mortality benefit** in heart failure trials. *Atenolol* - While atenolol is a selective beta-1 antagonist, it **lacks evidence for mortality benefit** in heart failure. - It has **high hydrophilicity** and renal elimination, leading to less favorable pharmacokinetics compared to metoprolol. - More commonly used for **hypertension and angina** rather than heart failure management. *Esmolol* - **Esmolol** is an ultra-short-acting selective beta-1 antagonist used for **acute control of heart rate** in perioperative and critical care settings. - Its **very short half-life (9 minutes)** makes it unsuitable for chronic management of heart failure. - Administered only **intravenously** and requires continuous infusion. *Bisoprolol* - While **bisoprolol is also approved** for heart failure and has proven mortality benefit (CIBIS-II trial), this question likely expects **metoprolol** as the answer given the historical context. - Both bisoprolol and metoprolol are acceptable answers, but **metoprolol** has been more widely studied and is more commonly cited in Indian medical exams. - Bisoprolol has **greater beta-1 selectivity** than metoprolol but similar clinical outcomes in heart failure.

Q: Which of the following statements about clonidine is incorrect?

First line for AMI. ***First line for AMI*** - Clonidine is **not first-line** for **Acute Myocardial Infarction (AMI)** as it can cause **bradycardia** and **hypotension**, potentially worsening cardiac output. - First-line AMI treatments include **thrombolytics**, **antiplatelet agents** (aspirin), **beta-blockers**, and **ACE inhibitors** for optimal cardiac protection. *Alpha 2 receptor agonist* - Clonidine is indeed an **alpha-2 adrenergic receptor agonist** that acts centrally in the **medulla oblongata**. - It reduces **sympathetic outflow** from the CNS, leading to decreased **heart rate**, **blood pressure**, and **peripheral vascular resistance**. *Sudden withdrawal causes rebound hypertension* - Abrupt clonidine discontinuation causes dangerous **rebound hypertension** due to sudden loss of **sympathetic inhibition**. - **Gradual tapering** over 1-2 weeks is essential to prevent this potentially life-threatening complication. *Controls loose motions due to diabetic neuropathy* - Clonidine effectively treats **diabetic diarrhea** by stimulating **alpha-2 receptors** in the enteric nervous system. - It **slows intestinal transit** and **enhances fluid absorption**, making it useful for **autonomic neuropathy-related** gastrointestinal symptoms.

Question 1

Helicine arteries are branches of which artery?

Accepted Answer

Internal pudendal artery

Answer

None of the options

Answer

Femoral artery

Answer

External pudendal artery

Question 2

Superior wall of middle ear is formed by ?

Accepted Answer

Tegmen tympani

Answer

Jugular bulb

Answer

Tympanic membrane

Answer

Carotid wall

Question 3

What is Galen's anastomosis?

Accepted Answer

Internal laryngeal nerve and recurrent laryngeal nerve

Answer

Recurrent laryngeal nerve and external laryngeal nerve

Answer

None of the options

Answer

Recurrent laryngeal nerve and sympathetic trunk

Question 4

All pass through jugular foramen except

Accepted Answer

Mandibular nerve

Answer

Vagus nerve

Answer

Internal jugular vein

Answer

Glossopharyngeal nerve

Question 5

Which of the following statements regarding axillary lymph nodes is incorrect?

Accepted Answer

Lateral group lies along lateral thoracic vessels

Answer

Posterior group lies along subscapular vessels

Answer

Apical group is terminal lymph nodes

Answer

Apical group lies along axillary vessels

Question 6

Which muscle is the deepest in the anterior neck region?

Accepted Answer

Longus colli

Answer

Sternocleidomastoid

Answer

Platysma

Answer

Trapezius

Question 7

Which of the following structures pass through the superior orbital fissure?

Accepted Answer

All of the options

Answer

Oculomotor nerve

Answer

Trochlear nerve

Answer

Superior ophthalmic vein

Question 8

Which of the following drugs is known to have low first pass metabolism?

Accepted Answer

Theophylline

Answer

Lidocaine

Answer

Propranolol

Answer

Morphine

Question 9

Which beta-1 antagonist is used in congestive cardiac failure?

Accepted Answer

Metoprolol

Answer

Atenolol

Answer

Esmolol

Answer

Bisoprolol

Question 10

Which of the following statements about clonidine is incorrect?

Accepted Answer

First line for AMI

Answer

Alpha 2 receptor agonist

Answer

Sudden withdrawal causes rebound hypertension

Answer

Controls loose motions due to diabetic neuropathy

NEET-PG 2013

Anatomy

Pharmacology