NEET-PG 2015 - Anatomy Practice Questions

Q: Arch of aorta begins at which vertebral level?

T4. ***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].

Q: Intercostal nerve is a branch of?

Ventral rami of thoracic spinal nerves. ***Ventral rami of thoracic spinal nerves*** - Intercostal nerves are direct continuations of the **ventral rami of the thoracic spinal nerves** (T1-T11) [1]. - These nerves run within the **intercostal spaces**, providing sensory and motor innervation to the thoracic wall [2]. *Brachial plexus* - The brachial plexus is formed by the **ventral rami of spinal nerves C5-T1**. - It primarily innervates the **upper limb**, not the intercostal spaces. *Dorsal rami of thoracic spinal nerves* - The dorsal rami of thoracic spinal nerves supply the **deep back muscles** and the skin over the back. - They do not contribute to the innervation of the intercostal spaces or the anterior/lateral thoracic wall. *Ventral rami of cervical spinal nerves* - The ventral rami of cervical spinal nerves form the **cervical plexus (C1-C4)** and contribute to the **brachial plexus (C5-T1)**. - They innervate structures in the neck, diaphragm, and upper limb, but not the intercostal region.

Q: Distance of cricopharynx from incisor teeth

Approximately 15 cm. ***Approximately 15 cm*** - The **cricopharynx** (upper esophageal sphincter at C6 level), which is the narrowest part of the pharynx, is typically located about **15 cm** from the incisor teeth in adults. - This anatomical landmark is crucial in procedures such as **endoscopy**, **intubation**, and **nasogastric tube insertion** to avoid injury. *22 cm* - This distance corresponds to the level of the **aortic arch** (second physiological narrowing of the esophagus). - This is where the aorta crosses anterior to the esophagus, creating the broncho-aortic constriction. *27 cm* - A distance of 27 cm from the incisor teeth corresponds to the level where the **left main bronchus** crosses the esophagus (third physiological narrowing). - This is well beyond the location of the **cricopharynx** and represents the mid-esophageal region. *40 cm* - This measurement represents the approximate total length of the **esophagus**, reaching the **gastroesophageal junction** at the level of the **diaphragmatic hiatus** (cardia of the stomach). - The **cricopharynx** is at the very beginning of this path, much closer to the incisors.

Q: All veins open in sinus venarum except -

Anterior cardiac vein. ***Anterior cardiac vein*** - The **anterior cardiac veins** are unique in that they drain **directly into the right atrium** through small openings (foramina) in the anterior atrial wall, **bypassing the sinus venarum entirely**. - Unlike other cardiac veins, they do **not** drain into the **coronary sinus** or the **sinus venarum**. - They typically number 2-3 veins and drain the anterior surface of the right ventricle. *SVC* - The **superior vena cava (SVC)** opens directly into the **superior part of the sinus venarum** of the right atrium. - It carries deoxygenated blood from the upper body, head, neck, and upper limbs to the heart. *Coronary sinus* - The **coronary sinus** is the largest venous drainage channel of the heart and opens into the **posteromedial part of the sinus venarum**. - It collects blood from most cardiac veins, including the great cardiac vein, middle cardiac vein, and small cardiac vein. *Small cardiac vein* - The **small cardiac vein** drains into the **coronary sinus**, which then opens into the **sinus venarum**. - It runs along the right atrioventricular (coronary) groove and drains the right atrium and right ventricle.

Q: Which of the following statements about the atrioventricular groove is true?

Also called coronary sulcus. ***Also called coronary sulcus*** - The **atrioventricular groove** is a critical anatomical landmark that separates the atria from the ventricles on the external surface of the heart. - This anatomical division is consistently referred to as the **coronary sulcus**, which encircles the entire heart. *Contains left anterior descending coronary artery* - The **left anterior descending (LAD) coronary artery**, also known as the anterior interventricular artery, lies within the **interventricular groove** (or sulcus), not the atrioventricular groove. - The interventricular groove separates the left and right ventricles, distinct from the atrioventricular separation. *Contains left coronary artery* - The **left coronary artery (LCA)** is a short main trunk that almost immediately divides into the **left anterior descending** (LAD) and **circumflex arteries** [1]. - While the **circumflex artery** (a branch of the LCA) runs in the left part of the atrioventricular groove, the main left coronary artery itself is too short to be considered within the groove [1]. *Contains posterior descending artery* - The **posterior descending artery (PDA)**, also known as the posterior interventricular artery, lies within the **posterior interventricular groove**, separating the ventricles posteriorly. - The PDA is a branch of either the right coronary artery (in most people) or the circumflex artery, but it follows the interventricular septum, not the atrioventricular border.

Q: Which artery supplies the anterior part of the interventricular septum?

Left anterior descending artery (LAD). ***Left anterior descending artery (LAD)*** - The **LAD** is a branch of the **left main coronary artery** and is also known as the "widowmaker" due to its critical supply to a large portion of the left ventricle and the interventricular septum [1]. - It gives rise to **septal branches** that typically supply the anterior two-thirds of the interventricular septum [1]. *Right coronary artery* - The **right coronary artery (RCA)** primarily supplies the **right ventricle**, the right atrium, the SA node (in 60% of people), and the AV node (in 90% of people). - It typically supplies the **inferior wall** of the left ventricle and the posterior one-third of the interventricular septum [1]. *Posterior descending coronary artery* - The **posterior descending artery (PDA)** arises from the **RCA** (in approximately 85% of individuals, known as right dominance) or less commonly from the circumflex artery (in left dominance) [1]. - It supplies the **posterior one-third** of the interventricular septum and typically the inferior wall of the left ventricle [1]. *None of the options* - This option is incorrect because the **LAD** clearly and predominantly supplies the anterior part of the interventricular septum.

Q: Which of the following does not directly drain into right atrium?

Great cardiac vein. ***Great cardiac vein*** - The **great cardiac vein** drains into the **coronary sinus**, which then empties into the right atrium [1]. - It does not drain directly into the right atrium, distinguishing it from the other options. *Inferior vena cava* - The **inferior vena cava** is one of the major vessels that drains directly into the **right atrium**. - It carries deoxygenated blood from the lower body to the right atrium. *Anterior cardiac vein* - The **anterior cardiac veins** drain directly into the **right atrium**. - They tend to drain the anterior surface of the right ventricle. *Venae cordis minimi* - Also known as **Thebesian veins**, these are small veins that drain directly into the cardiac chambers, including the **right atrium**. - They represent a direct communication between the myocardial capillaries and the cardiac chambers.

Q: Which are the segments of the upper lobe of the right lung?

Apical, anterior, posterior. ***Apical, anterior, posterior*** - The **right upper lobe** is consistently divided into three bronchopulmonary segments: **apical**, **anterior**, and **posterior** [1]. - These segments are named according to their anatomical position and the branching of the **tertiary bronchi** that supply them [1]. *Anterior, posterior, medial* - While **anterior** and **posterior** segments exist, the "medial" segment is not a standard division of the right upper lobe. - The term "medial" is typically associated with the **middle lobe** of the right lung (medial and lateral segments) [1]. *Lateral, medial, superior* - The segments **lateral** and **medial** are characteristic of the **right middle lobe** [1]. - "Superior" is a general directional term and not a specific segment name within the upper lobe in this context, although the apical segment is superiorly located. *Basal, medial, lateral* - **Basal** segments are found in the **lower lobes** of the lungs (e.g., anterior basal, medial basal, posterior basal, lateral basal). - **Medial** and **lateral** segments are typical of the **right middle lobe**, not the upper lobe [1].

Q: What is the uppermost structure in left lung hilum?

Pulmonary artery. ***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.

Q: What is the primary lymphatic drainage pathway of the ovary?

Paraaortic. ***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 1

Arch of aorta begins at which vertebral level?

Accepted Answer

T4

Answer

T2

Answer

T5

Answer

T3

Question 2

Intercostal nerve is a branch of?

Accepted Answer

Ventral rami of thoracic spinal nerves

Answer

Brachial plexus

Answer

Dorsal rami of thoracic spinal nerves

Answer

Ventral rami of cervical spinal nerves

Question 3

Distance of cricopharynx from incisor teeth

Accepted Answer

Approximately 15 cm

Answer

22 cm

Answer

27 cm

Answer

40 cm

Question 4

All veins open in sinus venarum except -

Accepted Answer

Anterior cardiac vein

Answer

SVC

Answer

Coronary sinus

Answer

Small cardiac vein

Question 5

Which of the following statements about the atrioventricular groove is true?

Accepted Answer

Also called coronary sulcus

Answer

Contains left anterior descending coronary artery

Answer

Contains posterior descending artery

Answer

Contains left coronary artery

Question 6

Which artery supplies the anterior part of the interventricular septum?

Accepted Answer

Left anterior descending artery (LAD)

Answer

Right coronary artery

Answer

Posterior descending coronary artery

Answer

None of the options

Question 7

Which of the following does not directly drain into right atrium?

Accepted Answer

Great cardiac vein

Answer

Inferior vena cava

Answer

Anterior cardiac vein

Answer

Venae cordis minimi

Question 8

Which are the segments of the upper lobe of the right lung?

Accepted Answer

Apical, anterior, posterior

Answer

Lateral, medial, superior

Answer

Basal, medial, lateral

Answer

Anterior, posterior, medial

Question 9

What is the uppermost structure in left lung hilum?

Accepted Answer

Pulmonary artery

Answer

Pulmonary vein

Answer

Bronchial artery

Answer

Left mainstem bronchus

Question 10

What is the primary lymphatic drainage pathway of the ovary?

Accepted Answer

Paraaortic

Answer

Deep inguinal

Answer

Superficial inguinal

Answer

Obturator

NEET-PG 2015 — Anatomy