1. A 52-year-old man is incapable of the penile erection after rectal surgery with prostatectomy.

The
patient most likely has a lesion of which of the following nerves?
a. Perineal nerve
b. Sacral splanchnic nerve
c. Hypogastric plexus
d. Dorsal nerve of the penis
e. Pelvic splanchnic nerve

2. A sexually active adolescent presents with an infection within the ischioanal fossa. Which of the
following structures is mostly likely injured?
a. Internal pudendal artery
b. Greater vestibular gland
c. Seminal vesicles
d. Vestibular bulbh
e. Inferior rectal nerve.

3. A 21-year-old victim of an automobile accident has received destructive damage to structures that form
the boundary of the perineum. Which of the following structures is spared?
a. Ischial tuberosities
b. Sacrotuberous ligament
c. Tip of coccyx
d. Sacrospinous ligament
e. Pubic arcuate ligament

4. A 6-month-old male infant is admitted to the children's hospital because he has no testis in his scrotum.
During physical examination, the pediatrician palpated the testis in the inguinal canal. What is the
diagnosis of this condition?
a. Chordee
b. Cryptorchid testis
c. Epispadias
d. Hypospadias
e. Male pseudohermaphroditism

5. An obstetrician is about to perform a pudendal block so a woman can experience less pain when she
deliver her child. He recalls what he learned in a medical school about this nerve. Which of the following
statements is correct?
a. It passes superficial to the sacrotuberous ligament
b. It arises from lumbar plexus
c. It innervates testis and epididymis in male
d. It provides motor fibers to the cocygeus
e. It can be blocked by injecting an anesthetic near the inferior margin of the ischial spine.

6. A 15-year-old boy presents to the emergency department with rapture of the penile urethra.
Extravasated urine from this injury can spread can spread into which of the following structures?
a. Pelvic cavity
b. Testis
c. Scrotum
d. Thigh
e. Ischioanal fossa.
7. It's important to note that the veins of the rectal plexuses normally appear varicose (dilated and tortuous
even in newborns, and that internal hemorrhoids occurs most commonly in the absence of;
a. Caval hypertension
b. Internal pudendal dilation
c. Inferior rectal dilation
d. Portal hypertension
e. Superior rectal dilation

8. If the venous drainage of the anal canal above the pectinate line is impared in patient with portal
hypertension, there may be an increase in blood flow downward to the systemic venous system via
anastomosis with the inferior rectal vein, which is tributary of the;
a. Inferior mesenteric
b. External iliac
c. Internal pudendal
d. Inferior gluteal
e. Internal iliac

9. A trauma surgeon in the emergency department at a local center examines a 14-year old boy with
extensive pelvic injuries after hit and run accident. The surgeon inspects the ischioanal fossa because it:
a. Is bounded anteriory by the sacrotuberous ligament
b. Has pudendal canal along its medial wall
c. Accumulates urine leaking fromrapture of the bulb of the penis
d. Contains a perineal a perineal branch of the fifth lumbar nerve
e. Contains the inferior rectal vessels.

10. The anal canal superior to the pectinate line differs from the part inferior to pectinate line in its arterial
supply, innervation, and venous and lymphatic drainage. These differences results from the embryological
origins of superior part and inferior part of the anal canal. Which of the following is correct arterial
supply, innervation, and venous and lymphatic drainage of superior two third of anal canal?
a. The superior rectal arteries, inferior hypogastric nerves,inferior rectal veins and superficial inguinal
lymph nodes.
b. The superior rectal arteries, inferior hypogastric plexuses, superior rectal veins and internal iliac lymph
nodes.
c. Inferior rectal arteries,inferior rectal nerves, internal rectal plexus and superficialperficial inguinal
lymph nodes
d. Superior rectal arteries, sympathetic and parasympathetic visceral afferent fibers, middle rectal veins
and internal iliac lymph nodes.
e. NONE OF THE ABOVE.

11. Ischiopubic rami is the one of the boundaries of the perineum; it forms which of the following
boundary of the perineum?
a. Anteriory
b. Laterally
c. Postreolaterally
d. Anterolaterally
e. Posteriorly

12. The pudendal canal (Alcock canal) is an essentially horizontal passageway within the obturator fascia
that covers the medial surface of the obturator internus and lines the lateral wall of the ischio-anal fossa.
The following are the structures passing through Alcock canal EXCEPT?
a. The nerve to obturator internus
b. Internal pudendal artery
c. Perineal nerve
d. Internal pudendal vein
e. Pudendal nerve.

13. A 21-year-old woman has a gonorrheal infection that has infiltrated the space between the inferior
fascia of the urogenital diaphragm and the superficial perineal fascia which of the following structures
might be inflammed?
a. Sphincter urethrae
b. Deep transverse perineal muscle
c. Bulbourethral gland
d. Greater vestibular gland
e. Colles fascia

14. During vaginal delivery, surgeons performed median episiotomy in which they cut too far ie through
perineal body into the structures immediately posterior. Which perineal structure did they cut?
a. External anal sphincter
b. Bulbospongiosus muscle
c. Ischiocarvenosus muscle
d. Sacrospinous ligament
e. Sphincter urethrae

15. After episiotomy what follows is delivery of baby then what next is episiotherapy which means
episiotomy repair. During episiotherapy usually there are three layers of tissues to be sutured. Which of
the following sequence is in correct arrangement of these layers during the procedure?
a. Skin and subcutaneous membrane, mucous membranous layer and muscle layer
b. Mucous membranous layer, muscle layer and, subcutaneous membrane and skin
c. Muscle layer, mucous membranous layer and, skin and subcutaneous membrane
d. Muscle layer, fascia layer, mucous membranous layer and skin
e. Skin, subcutaneous membrane and mucous membranous layer.

16. A general surgeon is giving a lecture to a team of surgery residents. She describes characteristics of
structures above the pectinate line of the anal canal which includes;
a. Venous drainage into the caval system
b. Visceral sensory innervation
c. External hemorrhoids
d. Lymphatic drainage into the superficial inguinal nodes
e. Stratified squamous epithelium

17. An 80-year-old man has carcinoma of the superior part of the rectum. The cancer is likely to
metastasize via the veins into which of the following structures?
a. Suprarenal gland
b. Duodenum
c. Spleen
d. Kidney
e. Liver.

18. Internship resident was told to perform DRE ie digital rectal examination, he recalled to anatomy he
learnt past five years ago; during procedure he palpate hard dilated structure and he thought of prostate
gland but he forgot which lobe encountered by his fingers. Identify that lobe he forgotten from the options
below.
a. Isthmus lobe
b. Right lobe
c. Posteroinferior lobe
d. Left lobe
e. NONE OF THE ABOVE

19. After his bath but before getting dressed, a 4-year-old boy was playing with his puppy. The boy's
penis was bitten by puppy and deep dorsal vein was injured. The damaged vein;
a. Is dilated during erection.
b. Lies superficial to the Bucks' fascia
c. Is found in the corpus spongiosum
d. Drains in the prostatic venous plexus
e. Lies lateral to the dorsal artery of the penis.

20. A 39-year-old woman has a history of infection in the perineal region. A comprehensive examination
reveals a tear of the superior boundary of the superficial perineal pouch. Which of the following
structures would most likely be injured?
a. Pelvic diaphragm
b. Perineal membrane
c. Colles' fascia
d. Superficial perineal fascia
e. Deep perineal fascia

21. A fifty eight years old woman with the uterine carcinoma undergo surgical resection. This cancer can
spread directly to the labia majora in lymphatics that follow which of the following structures?
a. Suspensory ligament of the clitoris
b. Round ligament of the uterus
c. Suspensory ligament of the ovary
d. Pubic arcuate ligament
e. Cardinal (or transverse cervical) ligament.

22. A 40 year-old male decided with his wife that their family was complete and that he would have a
vasectomy. A segment of his reproductive tract was ligated and surgically removed, accessed via the
spermatic cord between testis and superficial inguinal ring. Which of the following structures was
partially removed?
a. Ejaculatory duct
b. Duct of the seminal vesicle
c. Ductus deferens
d. Seminiferous tubule
e. Penile urethra

23. The bulb of the penis is traversed by the urethra.

24. The wall of the scrotum has almost seven layers to the testicles, which of the following sequential
arrangements of those layers is correct from deep to superficial layer?
a. Superficial fascia, Colles' fascia,external spermatic fascia,cremasteric fascia, tunica vaginalis and
internal spermatic fascia.
b. Internal spermatic fascia, external spermatic fascia, tunica vaginalis, external cremasteric fascia,
Dartos' muscle and the skin.
c. Tunica vaginalis, internal spermatic fascia, cremasteric fascia, external spermatic fascia,Colles' fascia,
Dartos' muscle and the skin.
d. Tunica vaginalis, internal spermatic fascia,external spermatic fascia, cremasteric fascia, Colles' fascia,
Dartos' fascia and the skin.
e. Skin, Dartos' fascia, Campers' fascia, Colles' fascia, external spermatic fascia, cremasteric fascia and
internal spermatic fascia.

25.

In a female the tissue superficial to this boney structure (Q) is called?

26.
Identify the structure labeled Q
a. Bulbo spongiosus
b. Ishocavernosus
c. Corpus cavernosa
d. Corpus spongiosum
e. Urethra

27.

This protrusion of this bone is called?