1. Cancer of the uterine cervix reaches an advanced stage and disseminates anteriorly. Which of the following structures is most likely to be involved in the spread of the tumor?
A. Broad ligament
B. Greater vestibular glands
C. Perineal body
D. Urinary bladder
E. Uterine artery
2. A 14-year-old woman in an automobile crash has pelvic trauma. Ultrasound examination reveals that she has a bicornuate uterus with a complete septum and double cervix. Which of the following developmental events best accounts for this condition?
A. Absence of a mesonephric duct on one side
B. Division of the urogenital sinus
C. Duplication of the gubernaculum
D. Incomplete folding of the urogenital folds
E. Malfusion of the distal paramesonephric
ducts
3. A 41-year-old woman presents in the clinic with a uterine prolapse (cervix at introitus) in which the cervix is visible at the vaginal opening. She has delivered seven healthy children. Which of the following structures is the most important support structure of the uterus?
A. Broad ligament
B. Deep transverse perineal muscles
C. Pubocervical ligaments
D. Rectovaginal fascial condensations
E. Transverse cervical ligaments
4. A 44-year-old woman is diagnosed with meta- static ovarian cancer. Which of the following lymph nodes will be the first to harbor dis- seminated ovarian cancer cells?
A. Aortic (lumbar) nodes B. Deep inguinal nodes C. External iliac nodes D. Internal iliac nodes
E. Superficial inguinal nodes
5. A 69-year-old man with a history of athero- sclerotic disease and heavy smoking tells his physician that he is “impotent.” Significant narrowing of which of the following arteries is most likely the cause of this patient’s erectile dysfunction?
A. External iliac
B. Inferior epigastric
C. Internal pudendal
D. Lateral sacral
E. Vas deferens
6. A73-year-oldwomanisadmittedtothehospital with significant abdominal ascites. When she sits upright on the side of her bed, the intra- peritoneal fluid accumulates in her pelvis. Which of the following sites represents the lowest extent of the female abdominopelvic cavity where this fluid will collect?
A. Left paracolic gutter
B. Pararectal fossa
C. Presacral space
D. Rectouterine pouch
E. Vesicouterine pouch
7. A male driver has sustained severe trauma to the pelvic region in a motor vehicle crash, resulting in a tearing of the prostatomembra- nous urethral junction (a tear just superior to the external urethral sphincter). Blood and urine from this injury would collect in which of the following spaces?
A. Anterior lower abdominal wall deep to Scarpa’s (membranous layer of superficial) fascia
B. Beneath the deep (Buck’s) fascia of the penis
C. Beneath the superficial perineal (Colles’) fascia
D. Deep to the dartos fascia of the scrotum and penis
E. Subperitoneal (retroperitoneal) space
8. After an automobile crash the teenage male driver presents to the emergency department with pelvic fractures and paralysis of his urinary bladder. Which of the following nerves was (were) most likely injured and caused this patient’s condition?
A. Ilioinguinal
B. Lumbar splanchnics
C. Pelvic splanchnics
D. Pudendal
E. Superior hypogastric
9. Biopsy of the inguinal lymph nodes reveals metastatic cancer. Which of the following pelvic structures is drained by these nodes?
A. Distal rectum
B. Ovaries
C. Proximal anal canal
D. Urinary bladder
E. Uterine body
10. During surgery deep within the pelvis, the surgeon clamps the transverse cervical (cardi- nal) ligaments and the uterine arteries to provide hemostasis for a female patient. Which of the following structures lies close to these structures and must be preserved?
A. Internal iliac artery
B. Obturator nerve
C. Pudendal nerve
D. Superior gluteal nerve
E. Ureter
11. Sexual arousal and orgasm employ a coordinated regulatory efort mediated by somatic and autonomic nerves, as well as by endocrine and central nervous system input. During male ejaculation, which of the following nerves contract the internal urethral sphincter and prevent the semen from entering the urinary bladder?
A. Least splanchnic
B. Lumbosacral trunk
C. Pelvic splanchnics
D. Pudendal
E. Sacral splanchnics
12. he dissemination of cancer cells from the left testis would enter the testicular veins and then first enter which of the following veins?
A. Inferior mesenteric
B. Inferior vena cava
C. Left inferior epigastric
D. Left internal iliac
E. Left internal pudendal
F. Left renal
13. A forensic pathologist is asked to characterize the bony pelvis of an unidentified and largely decomposed human body. he pathologist identifies the bone as coming from a female. Which of the following pelvic features is unique to the female pelvis?
A. he greater sciatic notch is narrow.
B. he ischial tuberosities are inverted.
C. he obturator foramen is round.
D. he pelvic inlet is heart shaped.
E. he pubic arch is wider.
____ 15. Trauma injuring the pelvic splanchnic nerves would compromise this muscle’s ability to contract.
____ 16. he integrity of this muscle is critical for support of the pelvic viscera.
____17. Contractionofthismuscleexpelsthe last few drops of urine from the male urethra.
____ 18. An abscess in the ischioanal fossa is limited in its spread superiorly by this muscle.
____ 19. Anterior rami of S2-S4 exit the anterior sacral foramina and then pass directly over (superficial to) this muscle.
____ 20. Trauma to the L1-L2 sympathetic outflow would result in the inability to contract this muscle.
21. Duringpelvicsurgery,thesurgeonnoticesthat the inferior gluteal artery and internal pudendal artery are leaving the pelvis just inferior to the piriformis muscle as they are headed for the gluteal region. Next they will pass through which of the following openings?
A. Greater sciatic foramen
B. Deep inguinal ring
C. Femoral canal
D. Pudendal canal
E. Superficial inguinal ring
22. Surgeons operating in the perineal region must be cognizant of this structure, because it is the anchor point for many of the perineal structures. What is this structure?
A. Perineal body
B. Sacrotuberous ligament
C. Superficial transverse perineal muscle
D. Uterosacral ligament
E. Vestibule
23. During a pelvic examination, the gynecologist feels a pulse adjacent to the vaginal fornix. Which of the following arteries is the physician feeling?
A. External iliac artery
B. Internal pudendal artery
C. Ovarian artery
D. Uterine artery
E. Vaginal artery
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