NEET-PG 2015 Practice Questions

Q: What is the posterior relation of the neck of the pancreas?

Origin of portal vein. ***Origin of portal vein*** - The **neck of the pancreas** is intimately associated with the formation of the **hepatic portal vein** [1]. - The **superior mesenteric vein** and **splenic vein** unite behind the pancreatic neck to form the **hepatic portal vein** [1]. *IVC* - The **inferior vena cava (IVC)** lies posterior to the **head of the pancreas**, not the neck. - While it's in proximity, it does not directly relate to the neck in the same way the portal vein does. *Aorta* - The **abdominal aorta** lies posterior to the **body** and **tail of the pancreas**, further superior and to the left. - It is not a direct posterior relation of the pancreatic neck. *Common bile duct* - The **common bile duct** passes through a groove on the posterior surface of the pancreatic **head**, sometimes even embedded within it. - It is not a direct posterior relation of the pancreatic neck, which is a different segment.

Q: Superficial inguinal ring is a defect in the:

External oblique aponeurosis. ***External oblique aponeurosis*** - The **superficial inguinal ring** is a triangular opening in the **aponeurosis of the external oblique muscle** [1]. - It allows passage of the **spermatic cord** in males and the **round ligament of the uterus** in females. *Transverse abdominis aponeurosis* - The **transverse abdominis aponeurosis** contributes to the posterior wall of the **inguinal canal**, but not the superficial inguinal ring itself [2]. - The deepest abdominal muscle, its aponeurosis forms the **conjoint tendon** with the internal oblique aponeurosis. *Internal oblique muscle* - The **internal oblique muscle** forms the arching roof and part of the anterior wall of the **inguinal canal** [2]. - Its aponeurosis contributes to the **conjoint tendon** and the falx inguinalis. *Internal oblique aponeurosis* - The **internal oblique aponeurosis** is part of the anterior wall and forms the conjoint tendon with the transverse abdominis aponeurosis [2]. - This aponeurosis does not form the superficial inguinal ring; instead, it is found deeper to the external oblique aponeurosis.

Q: Which of the following is not a posterior relation of the right kidney?

11th rib. ***11th rib*** - The right kidney typically extends from the 12th thoracic vertebra to the 3rd lumbar vertebra, usually covered by the **12th rib**. - The **11th rib** is usually a posterior relation of the **left kidney**, due to the lower position of the right kidney compared to the left kidney. *Diaphragm* - The diaphragm lies **posterior** to both the right and left kidneys, separating them from the pleura and lungs. - This anatomical relationship means that renal procedures or severe kidney infections can sometimes affect the thoracic cavity. *Subcostal nerve* - The **subcostal nerve** (T12) runs inferior to the 12th rib and passes **posterior** to both kidneys. - It provides sensory innervation to the skin and motor innervation to abdominal muscles. *Ilioinguinal nerve* - The **ilioinguinal nerve** (L1) emerges from the lumbar plexus and travels **posterior** to the inferior pole of both kidneys [1]. - It primarily provides sensory innervation to the groin and parts of the external genitalia.

Q: A nerve injured during axillary lymph node dissection leads to loss of sensation in the medial side of the arm. Which nerve is injured?

Intercostobrachial nerve. ***Intercostobrachial nerve*** - The **intercostobrachial nerve** (T2) is the nerve most commonly injured during **axillary lymph node dissection** - It provides **sensory innervation to the medial side of the upper arm**, specifically the skin over the medial and posterior aspects of the arm [1] - This nerve arises from the **lateral cutaneous branch of the second intercostal nerve** and crosses the axilla to reach the arm [1] - Injury during axillary surgery results in **numbness or paresthesia** in the medial upper arm region, which is a well-recognized complication of breast cancer surgery with axillary node dissection [1] - Studies show **30-80% of patients** undergoing axillary dissection experience intercostobrachial nerve injury *Long thoracic nerve* - The **long thoracic nerve** (C5-C7) innervates the **serratus anterior muscle**, which is crucial for scapular protraction and rotation - Damage to this nerve causes **"winged scapula"**, where the scapula protrudes posteriorly - This is a **motor nerve**, not sensory, so injury does not result in sensory deficits in the arm *Medial pectoral nerve* - The **medial pectoral nerve** (C8-T1) primarily innervates the **pectoralis major** and **pectoralis minor** muscles [1] - This is a **motor nerve** playing a role in muscle function rather than sensation [1] - Injury would result in weakness of these muscles, not sensory loss *Accessory nerve* - The **accessory nerve** (cranial nerve XI) innervates the **sternocleidomastoid** and **trapezius muscles** - This nerve is located in the **posterior triangle of the neck**, not in the axilla - Injury would lead to weakness in shrugging the shoulders or turning the head, not sensory loss in the arm during axillary dissection

Q: Base of the heart is formed by?

Left atrium. ***Left atrium*** - The **left atrium** forms the major part of the **base of the heart**, receiving the four pulmonary veins. [1] - It lies in the posterior-superior aspect of the heart and is separated from the thoracic vertebrae by the **pericardium** and the **esophagus**. *Right atrium* - The **right atrium** forms the right border of the heart and receives deoxygenated blood from the **superior and inferior vena cava**. - It primarily forms part of the **anterior surface** of the heart, not the base. *Right ventricle* - The **right ventricle** forms a large part of the **anterior surface** and inferior border of the heart. - It is responsible for pumping blood to the **pulmonary circulation** but does not form the base. *Left ventricle* - The **left ventricle** forms the **apex** of the heart and much of its **left border** and **diaphragmatic surface**. - Its primary role is to pump oxygenated blood into the **systemic circulation**.

Q: Sensory nerve supply of gall bladder is through -

Vagus nerve (Cranial Nerve X). ***Vagus nerve (Cranial Nerve X)*** - The **vagus nerve** provides the primary **sensory (visceral afferent) innervation** to the gallbladder, carrying information about distension, contraction, and physiological state. - These **parasympathetic sensory fibers** travel through the vagus nerve to medullary centers, monitoring gallbladder function and participating in reflex arcs. - The vagus nerve is the main pathway for **general sensory innervation** of the gallbladder as per standard anatomical texts. *Celiac plexus (sympathetic fibers)* - The **celiac plexus** contains **sympathetic afferent fibers** that primarily transmit **pain sensation** from the gallbladder, especially during inflammation or biliary colic [1]. - These pain fibers travel via sympathetic pathways to spinal segments **T8-T9**, mediating referred pain to the epigastric region and right upper quadrant [1]. - While important for pain transmission, the celiac plexus is not classified as the primary sensory nerve supply in anatomical nomenclature. *Trigeminal nerve (Cranial Nerve V)* - The **trigeminal nerve** provides **sensory innervation to the face** and motor innervation to muscles of mastication. - It has no role in innervation of abdominal viscera, including the gallbladder. *Facial nerve (Cranial Nerve VII)* - The **facial nerve** controls **facial expression muscles**, provides taste sensation to the anterior two-thirds of the tongue, and supplies parasympathetic fibers to lacrimal and salivary glands. - It does not innervate any abdominal organs.

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: Radiological sign in case of Perthes disease?

Flattening of femoral head. ***Flattening of femoral head*** - **Flattening** and **fragmentation** of the femoral head are characteristic radiological findings in **early-stage** Perthes disease. - This flattening is a direct consequence of the **avascular necrosis** and subsequent **remodeling** of the femoral epiphysis. *Fragmentation of femoral head epiphysis* - While **fragmentation** is a key feature of Perthes disease, it's typically observed **after** the initial flattening and sclerosis in the avascular stage. - It represents the process of **resorption** and **revascularization** as the bone attempts to heal. *Lateral femoral head displacement* - **Lateral displacement** of the femoral head is a more common finding in conditions like **slipped capital femoral epiphysis (SCFE)**, where the epiphysis slips from the metaphysis. - In Perthes disease, the primary issue is the **necrosis and collapse** of the femoral head itself, rather than displacement from the neck. *Limited hip abduction* - **Limited hip abduction** is a clinical sign, not a radiological sign, and it is a common symptom in Perthes disease due to pain, inflammation, and deformity of the femoral head. - Radiological signs are visual abnormalities observed on imaging studies like X-rays.

Q: Spermatogenesis begins at -

Puberty. ***Puberty*** - **Spermatogenesis**, the process of sperm production, is initiated and sustained by the surge of **gonadotropin-releasing hormone (GnRH)**, which begins at puberty. - This hormonal signal leads to the secretion of **luteinizing hormone (LH)** and **follicle-stimulating hormone (FSH)**, crucial for testicular function and sperm development. *Birth* - At birth, the male testes contain **spermatogonia**, but these cells remain dormant and do not begin active sperm production. - Hormonal levels at birth are not conducive to initiating spermatogenesis. *5 years* - While some hormonal changes occur in early childhood, they are not sufficient to trigger the full process of spermatogenesis. - The reproductive system is still in a quiescent state before puberty. *18 years* - By 18 years, spermatogenesis is typically well-established and has been ongoing for several years, having started at puberty. - This age marks a period of full reproductive maturity, not the initiation of sperm production.

Q: The delusion that involves the belief that a familiar person has been replaced by someone else is known as?

Capgras syndrome. ***Capgras syndrome*** - This **delusional misidentification syndrome** is characterized by the belief that a familiar person (e.g., a spouse, child, or parent) has been replaced by an identical imposter. - It often occurs in individuals with **schizophrenia**, **dementia**, or following **brain injury**. *Cotard syndrome* - This syndrome involves a nihilistic delusion where the individual believes they are **dead**, do not exist, or have lost their organs or blood. - It is often associated with severe **depression**, psychosis, or neurological disorders. *Othello syndrome* - Also known as **delusional jealousy**, this involves the unfounded belief that one's partner is being unfaithful. - It is a **primary delusional disorder** but can also be seen in conditions like alcohol dependence or neurodegenerative diseases. *Fregoli syndrome* - This is another **delusional misidentification syndrome** where the person believes that different people are actually the same person in disguise. - It is the opposite of Capgras syndrome and may occur in **schizophrenia** or **organic brain disorders**.

Question 1

What is the posterior relation of the neck of the pancreas?

Accepted Answer

Origin of portal vein

Answer

IVC

Answer

Aorta

Answer

Common bile duct

Question 2

Superficial inguinal ring is a defect in the:

Accepted Answer

External oblique aponeurosis

Answer

Internal oblique muscle

Answer

Transverse abdominis aponeurosis

Answer

Internal oblique aponeurosis

Question 3

Which of the following is not a posterior relation of the right kidney?

Accepted Answer

11th rib

Answer

Subcostal nerve

Answer

Diaphragm

Answer

Ilioinguinal nerve

Question 4

A nerve injured during axillary lymph node dissection leads to loss of sensation in the medial side of the arm. Which nerve is injured?

Accepted Answer

Intercostobrachial nerve

Answer

Long thoracic nerve

Answer

Medial pectoral nerve

Answer

Accessory nerve

Question 5

Base of the heart is formed by?

Accepted Answer

Left atrium

Answer

Right atrium

Answer

Right ventricle

Answer

Left ventricle

Question 6

Sensory nerve supply of gall bladder is through -

Accepted Answer

Vagus nerve (Cranial Nerve X)

Answer

Celiac plexus (sympathetic fibers)

Answer

Trigeminal nerve (Cranial Nerve V)

Answer

Facial nerve (Cranial Nerve VII)

Question 7

Arch of aorta begins at which vertebral level?

Accepted Answer

T4

Answer

T2

Answer

T5

Answer

T3

Question 8

Radiological sign in case of Perthes disease?

Accepted Answer

Flattening of femoral head

Answer

Fragmentation of femoral head epiphysis

Answer

Lateral femoral head displacement

Answer

Limited hip abduction

Question 9

Spermatogenesis begins at -

Accepted Answer

Puberty

Answer

Birth

Answer

5 years

Answer

18 years

Question 10

The delusion that involves the belief that a familiar person has been replaced by someone else is known as?

Accepted Answer

Capgras syndrome

Answer

Cotard syndrome

Answer

Othello syndrome

Answer

Fregoli syndrome

NEET-PG 2015

Anatomy

Orthopaedics

Physiology

Psychiatry