NEET-PG 2015 Practice Questions

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.

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: 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: 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: Inversion and eversion of foot occurs at which joint

Subtalar. ***Subtalar*** - The **subtalar joint** (talocalcaneal joint) is primarily responsible for **inversion** and **eversion** movements of the foot. - **Inversion** involves tilting the sole of the foot medially (turning inward), while **eversion** involves tilting the sole laterally (turning outward). - This joint allows the foot to **adapt to uneven surfaces** and plays a crucial role in the biomechanics of walking and running. - The subtalar joint is essential for shock absorption and balance during gait. *Ankle* - The **ankle joint** (talocrural joint) is a hinge joint primarily responsible for **dorsiflexion** and **plantarflexion** of the foot. - It allows moving the foot up and down but has minimal contribution to inversion and eversion. *Tarso-metatarsal* - The **tarso-metatarsal joints** (Lisfranc joints) connect the tarsal bones to the metatarsal bones. - These joints contribute primarily to the **stability and arch integrity** of the foot, with minimal movement capacity. - They allow slight gliding movements but not significant inversion or eversion. *None of the options* - This option is incorrect because the **subtalar joint** is indeed the primary joint responsible for inversion and eversion of the foot. - Understanding foot joint biomechanics is essential for diagnosing gait abnormalities, ankle sprains, and foot pathologies.

Q: Root value of the thoracodorsal nerve

C6, C7, C8. ***C6, C7, C8*** - The **thoracodorsal nerve**, also known as the middle subscapular nerve, originates from the **posterior cord of the brachial plexus**. - Its specific root values are **C6, C7, and C8**, which supply motor innervation to the **latissimus dorsi muscle** [1]. - This nerve is one of the three subscapular nerves arising from the posterior cord [1]. *C5, C6, C7* - While these roots contribute to the **posterior cord**, the thoracodorsal nerve specifically arises from **C6, C7, C8**. - **C5** primarily contributes to the **upper and middle trunk** and is more associated with nerves like the **suprascapular** and **axillary nerves**. *C6, T1* - These root values contribute to various nerves of the **brachial plexus**, but not specifically the thoracodorsal nerve. - **T1** contributes mainly to the **medial cord** and its branches like the **ulnar nerve**, not the posterior cord from which the thoracodorsal nerve arises. *T1, T2* - These are typical root values for **intercostal nerves** and contribute to the **sympathetic trunk**, not the **brachial plexus** or its branches like the thoracodorsal nerve. - The brachial plexus predominantly arises from **C5 to T1 spinal nerve roots**, and **T2** is not part of the brachial plexus.

Q: Which of the following statements about fallopian tubes is incorrect?

Lined by cuboidal epithelium. ***Lined by cuboidal epithelium*** - The Fallopian tubes are lined by a **ciliated columnar epithelium**, not cuboidal epithelium, which aids in ovum transport. - This ciliated epithelium is critical for moving the ovum towards the uterus and for sperm transport. *Tubal ostium is the point where the tubal canal meets the peritoneal cavity* - The **tubal ostium** specifically refers to the opening of the **infundibulum** of the Fallopian tube into the **peritoneal cavity**, where it receives the ovum after ovulation. - This opening is surrounded by **fimbriae**, which are finger-like projections that help capture the ovum. *Müllerian ducts develop in females into the Fallopian tubes* - In females, the **Müllerian ducts (paramesonephric ducts)** differentiate to form the **Fallopian tubes**, uterus, cervix, and the upper two-thirds of the vagina. - This development is crucial for the formation of the female reproductive tract in the absence of Anti-Müllerian Hormone (AMH). *Isthmus is the narrower part of the tube that links to the uterus* - The **isthmus** is indeed the **narrower, muscular segment** of the Fallopian tube that connects directly to the **uterus**. - This region is characterized by its thick muscular wall and smaller lumen.

Q: The incudomalleolar joint is a?

Saddle joint. ***Saddle joint*** - The **incudomalleolar joint** is classified as a **saddle joint** (also called a **sellar joint**), which is a type of synovial joint. - It has reciprocally concave-convex articular surfaces that fit together like a rider on a saddle. - This joint allows **slight gliding movements** between the head of the malleus and the body of the incus during sound transmission. - Standard anatomy texts including **Gray's Anatomy** classify this as a saddle joint based on its structural characteristics. *Pivot joint* - A **pivot joint** allows rotation around a single axis, such as the **atlantoaxial joint** (atlas rotating around the dens of axis) or the **proximal radioulnar joint**. - While the ossicular chain as a whole undergoes rotatory movement during sound transmission, the **incudomalleolar joint itself** is not classified as a pivot joint anatomically. *Ellipsoid joint* - An **ellipsoid joint** (condyloid joint) allows movement in two planes (flexion/extension and abduction/adduction) but restricts rotation. - Examples include the **radiocarpal joint** and **metacarpophalangeal joints** of the fingers. - The incudomalleolar joint has a different articular surface configuration. *Hinge joint* - A **hinge joint** permits movement primarily in one plane (flexion and extension), like a door hinge. - Examples include the **elbow joint**, **knee joint**, and **interphalangeal joints**. - This does not match the structural or functional characteristics of the incudomalleolar joint.

Q: Which of the following is not a recognized stage of prophase I in meiosis?

Arachytene. ***Arachytene*** - **Arachytene** is not a recognized stage of prophase I in meiosis. - The correct stages are leptotene, zygotene, pachytene, diplotene, and diakinesis. *Diakinesis* - **Diakinesis** is the final stage of prophase I, where homologous chromosomes condense further, and the nuclear envelope begins to break down. - Chiasmata terminalize, and the bivalents are ready for metaphase I. *Leptotene* - **Leptotene** is the first stage of prophase I, characterized by the condensation of chromatin into visible chromosomes. - Chromosomes appear as long, thin threads. *Zygotene* - **Zygotene** is the second stage of prophase I, where homologous chromosomes pair up in a process called **synapsis**, forming bivalents. - The synaptonemal complex begins to form between homologous chromosomes.

Q: Labour pain in uterus is carried by

Sympathetic nerves. ***Sympathetic nerves*** - Pain signals from the **uterus** during the first stage of labor (cervical dilation and uterine contractions) are transmitted via **visceral afferent fibers that accompany the sympathetic nerves** through the **hypogastric plexus**. - These fibers synapse in the **thoracolumbar spinal cord** at **T10-L1 segments**, leading to referred pain in these dermatomes. - The pathway is: Uterus → Uterine plexus → Superior hypogastric plexus → Sympathetic chain → T10-L1 dorsal roots. *Splanchnic nerve* - While visceral afferents do travel with splanchnic nerves in the thoracoabdominal region, for **uterine pain** specifically, the standard medical terminology refers to **sympathetic nerves** and the **hypogastric plexus** as the primary pathway. - Splanchnic nerves typically refer to thoracic sympathetic contributions (T5-T12) to upper abdominal viscera. *Pudendal nerve* - The **pudendal nerve (S2-S4)** primarily innervates the perineum, external genitalia, and pelvic floor structures. - It transmits pain during the **second stage of labor**, particularly with stretching of the perineum and vaginal distension, but **not from the uterus itself**. *Parasympathetic nerves* - **Parasympathetic innervation (S2-S4 via pelvic splanchnic nerves)** to the uterus influences motor function but does **not transmit nociceptive (pain) signals** during labor. - These nerves are involved in visceral reflexes and efferent control, not the primary afferent pain pathway.

Question 1

What is the primary lymphatic drainage pathway of the ovary?

Accepted Answer

Paraaortic

Answer

Deep inguinal

Answer

Superficial inguinal

Answer

Obturator

Question 2

What is the uppermost structure in left lung hilum?

Accepted Answer

Pulmonary artery

Answer

Pulmonary vein

Answer

Bronchial artery

Answer

Left mainstem bronchus

Question 3

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 4

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 5

Inversion and eversion of foot occurs at which joint

Accepted Answer

Subtalar

Answer

Ankle

Answer

Tarso-metatarsal

Answer

None of the options

Question 6

Root value of the thoracodorsal nerve

Accepted Answer

C6, C7, C8

Answer

T1, T2

Answer

C5, C6, C7

Answer

C6, T1

Question 7

Which of the following statements about fallopian tubes is incorrect?

Accepted Answer

Lined by cuboidal epithelium

Answer

Tubal ostium is the point where the tubal canal meets the peritoneal cavity

Answer

Müllerian ducts develop in females into the Fallopian tubes

Answer

Isthmus is the narrower part of the tube that links to the uterus

Question 8

The incudomalleolar joint is a?

Accepted Answer

Saddle joint

Answer

Pivot joint

Answer

Ellipsoid joint

Answer

Hinge joint

Question 9

Which of the following is not a recognized stage of prophase I in meiosis?

Accepted Answer

Arachytene

Answer

Diakinesis

Answer

Leptotene

Answer

Zygotene

Question 10

Labour pain in uterus is carried by

Accepted Answer

Sympathetic nerves

Answer

Pudendal nerve

Answer

Parasympathetic nerves

Answer

Splanchnic nerve

NEET-PG 2015

Anatomy

Physiology