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1. The main blood supply of the vulva is: Gynecology MCQ

a) Inferior hemorrhoidal artery.

b) Pudendal artery.

c) Ilioinguinal artery.

d) Femoral artery.

e) InferiorHypogastricartery.

Correct Answer: b) Pudendal artery. Blood supply to the external genitalia is mainly from the
pudendal artery. The lateral aspects of the external genitalia receive their blood supply from
the external pudendal artery, a branch of the femoral artery. The mons pubis is supplied by
the inferior epigastric artery, a branch of the external iliac artery.

2. The principle supports of the uterus are : Gynecology MCQ

a) Iliosacral ligaments

b) Pyriformis muscle

c) Transverse cervical ligaments

d) Infundibular ligaments

e) Uterosacral ligaments
Correct Answer: c and e. The principle supports of the uterus are the transverse cervical
ligaments (cardinal ligaments) and uterosacral ligaments. The infundibulopelvic ligament is
a fold of peritoneum that extends out from the ovary to the wall of the pelvis.

3. The external iliac artery is crossed by: (Select FALSE)

a) The corresponding vein

b) The ovarian vessels

c) The genital branch of the genital femoral nerve

d) The round ligament

e) The ureter

Correct Answer: a) The corresponding vein is FALSE. Both external iliac veins are
accompanied along their course by external iliac arteries. Posteriorly, the artery comes in
relation with its vein in the upper portion of its course. In the lower part of its course the
vein lies medial to it.

4. The uterine artery: (Select FALSE) : Gynecology MCQ

a) Is a branch of the anterior division of the internal iliac artery

b) Runs in front of the ureter

c) Gives a branch to the vagina

d) May anastomose with the obturator artery

e) Divides into arcuate arteries

Correct Answer: d) May anastomose with the obturator artery is FALSE. it anastomoses with
the tubal branches of ovarian artery.

5. The ovarian arteries : Gynecology MCQ

a) Arise just above the renal artery

b) Are crossed by the ureters

c) On the right cross the inferior vena cava

d) On the left cross the left colic artery

e) Reach the ovary through the ovarian ligament

Correct Answer: c) On the right cross the inferior vena cava. Corrected FALSE statements: a)
Arise just below the renal artery

b) Ureters crosses ovarian vessels

d) On the left does not cross the left colic artery

e) After emerging from the aorta, the artery travels down the infundibulopelvic ligament
(suspensory ligament of the ovary), enters the mesovarium, and may anastamose with the
uterine artery in the broad ligament.

6. The most common benign neoplasm of the cervix & endocervix

a) Polyp.

b) Hematoma.

c) Nabothain cyst.
d) Cervical hood.

e) Gartner's duct cyst.

Correct Answer: a) Polyp. These are the most common benign neoplasms of the cervix
(found in 4% of the gynaecological population). These may be endocervical or cervical.

7. Which group of nerves all constitute branches of the pudendal nerve?

a) Internal pudendal nerve, perineal nerve, dorsal clitoral nerve

b) Mid rectal nerve, dostal clitoral nerve, perineal nerve

c) Perineal nerve and posterior clitoral nerve

d) Perineal nerve, dorsal clitoral nerve, inferior rectal nerve

e) Perineal nerve, inferior clitoral nerve, mid rectal nerve

Correct Answer: d) Perineal nerve, dorsal clitoral nerve and inferior rectal nerve. These are
the three important branches of the pudendal nerve.

8. Pelvic Diaphragm : Gynecology MCQ

The pelvic diaphragm is composed of all of the following muscles EXCEPT

a) Iliococcygeus

b) Puborectalis

c) Transversus perinei
d) Pubococcygeus

Correct Answer: c) Transversus perinei.

The muscles of the pelic diaphragm primarily provide pelvic support. These muscles form a
basin or covering of the pelvic outlet and are often grouped together as the levator ani. The
most medial portion of the pelvic diaphragm is formed by the puborectalis. Forming the
bulk of the pelvic diaphragm, the Pubococcygeus and Iliococcygeus muscles cover the
posterior and lateral portion of the pelvic outlet. Transversus perinea muscle is the part of
urogenital diaphragm.

9. In a sagittal cross section of the pelvis

a) Urethra lies anterior to the upper third of the vagina

b) Urethra lies anterior to the lower third of the vagina

c) Bladder when empty lies below and anterior to the uterine body

d) Bladder when empty lies parallel and anterior to uterine body

e) Rectum lies posterior to the body of the uterus

Correct Answer: b,c,e. The urethra is only 3.5 cm long and is anterior to the lower third of the
vagina. The bladder when empty lies below the uterovesical fold which arises from the
junction between the uterine body and the cervix.

10. Bartholin’s abscess : Gynecology MCQ

20-year-old woman presents with Bartholin’s abscess. Which one of the following glands is
involved?
a) Bulbourethral glands (Cowper’s)

b) Glands of skini

c) Greater vestibular gland

d) Lesser vestibular gland

e) Seminal vescicle

Correct Answer: c) Greater vestibular (Bartholin’s) gland. These are small paired glands
located in the super cial perineal pouch. They are partially covered by posterior portions of
the bulb of the vestibule and the bulbospongiousus muscles. The duct opens into the
vestibule between the hymen and the labium minus. These glands provide lubrication at the
introitus. Bartholin’s abscess may occur due to infection and blockage of these glands.

11. Which artery is a direct branch of the aorta?

a) Inferior vesical

b) Internal iliac

c) Ovarian

d) Uterian

e) Vaginal

Correct Answer: c) Ovarian. The ovarian artery is a branch of the aorta. It arises
anterolaterally just below the renal artery, running retroperitoneally to leave the abdomen by
crossing the common or external iliac artery in the infundibulopelvic fold. It crosses
corresponding ureters and supplies twigs to it but does not supply to abdominal organs.
The internal iliac artery arises from the common iliac and its inferior branch further supplies
to the pelvis.

12. What is the lymphatic drainage of the ovaries?

a) Common iliac nodes

b) External iliac and super cial iliac nodes via the round ligament

c) External iliac nodes

d) Internal iliac nodes

e) Lateral aortic and preaortic nodes

Correct Answer: e) Lateral aortic and pre-aortic nodes. It is useful to remember the
following: the bladder drains to the external iliac nodes; the urethra drains to the internal
iliac nodes; the fallopian tubes and fundus uteri drain to the external iliac and super cial
iliac nodes via the round ligament; and the cervix drains to the external and internal iliac,
rectal and sacral nodes and occasionally obturator nodes.

13. Which of the following structures lie within the broad ligament?

a) The fallopian tube

b) The ureter

c) The uterine artery

d) The ovarian artery

e) The superior vesical artery

Correct Answer:a and c.The broad ligament is made of two layers of peritoneum that covers
the fallopian tube, round ligament, and down the sides of the uterus to the cervix.

The ureter, superior vesical artery and the ovarian artery are all retroperitoneal.

The uterine artery runs between the leaves of the broad ligament along the lateral wall of
the uterus. It also contains ovarian ligament and round ligament.

14. Pudendal nerve does not supply : Gynecology MCQ

a) Labia Minora

b) Ischiocavernosus

c) Posterior Fornix of Vagina

d) Urethral Sphincter

Correct Answer: c) Posterior Fornix of Vagina. The pudendal nerve is a mixed motor and
sensory nerve, and does not carry parasympathetic bres. The nerve has 3 branches: the
clitoral, perineal, and inferior hemorrhoidal. It supplies:

1) Clitoris.

2) Bulbospongiosus, Ischiocavernosus muscles and Transeversus perinei muscles. Also to

the skin of the inner portions of labia majora, labia minora and vestibule. The external
urethral sphincter is controlled by the deep perineal branch of the pudendal nerve.

3) External anal sphincter and perineal skin.

upper vagina - parasympathetic bres from pelvic splanchnic nerves (S2-S4)

lower 2-3cm vagina - pudendal nerve

15. Transverse vaginal sulcus corresponds to

a) Junction of urethra and bladder

b) Junction of cervix and vagina

c) Lower limit of rectum

d) Upper limit of bladder

Correct Answer: a) Junction of urethra and bladder. On inspection of vagina, 3 grooves can
be distinguished in the anterior vaginal wall : 1) Submeatal sulcus, 2) Transverse vaginal
sulcus corresponds to the upper border of posturethral ligament and 3) Bladder sulcus.
Bladder sulcus indicates the upper limit of the relation of the bladder to the anterior vaginal
wall.

16. Which of the following structures lies posterior to the ischial spine?

a) Pudendal nerve/ vessels

b) Sciatic nerve

c) Hypogastric venous plexus

d) Inferior gluteal vessels

Correct Answer: a) Pudendal nerve/ vessels. The sciatic nerve lies superior and lateral to
the sacrospinous ligament. Superior to the ligament lies the inferior gluteal vessels and the
hypogastric venous plexus.The pudendal nerve passes between the piriformis muscle and
ischiococcygeus muscles and leaves the pelvis through the lower part of the greater sciatic
foramen. It then enters the gluteal region, crossing over the sacrospinous ligament near to
where it attaches to the ischial spine. Re-entering the pelvis through the lesser sciatic
foramen, it accompanies the internal pudendal vessels upwards and forwards along the
lateral wall of the ischiorectal fossa, being contained in a sheath of the obturator fascia
termed the pudendal canal (Alcock's canal), along with the internal pudendal blood vessels.

17. Location of Gartner's cyst : Gynecology MCQ

a) Hymen

b) Vagina

c) Cervix

d) Labia majora

e) Broad ligament

Correct Answer: b) Vagina

A Gartner's duct cyst is a benign vaginal cystic lesion that arises from the vestigial remnant
of a mesonephric duct or Gartner's duct. They are typically small asymptomatic cysts that
occur along the lateral walls of the vagina, following the course of the duct. They can,
however, enlarge to substantial proportions and be mistaken for urethral diverticulum or
other structures.

18. McCall's Culdoplasty : Gynecology MCQ

Which of the following structures is at risk for injury during a McCall's culdoplasty?

a) Sciatic nerve

b) Rectum

c) Internal iliac vein

d) Pudendal nerve

e) Urinary bladder

Correct Answer: b) Rectum. Most common complication of McCall's culdoplasty is

laceration of bowel or rectum as perirectal fascia is incorporated into the sutures.

19. The lower third of the vagina has lymphatic drainage to which nodes?

a) Common iliac nodes

b) External iliac nodes

c) Internal iliac nodes

d) Super cial inguinal nodes

e) Para-aortic nodes

Correct Answer: d) super cial inguinal nodes. Remember the embryological difference
between the lower one-third of the vagina and the upper two-thirds. The upper part is
derived from the fused mesonephric ducts, and the lower one-third from canalisation of the
ectodermal thickening. The upper two-thirds of the vagina drain to the internal and external
nodes.
20. Motor function of the uterus occurs via sympathetic and parasympathetic nerves.

Following sentences: True or False.

1) Intact nerve supply is essential to initiate normal labour.

2) Normal labor occurs in patients with a transected spinal cord.

Correct Answer: 1) False, 2) True. Uterine contractions are involuntary and for the most part,
indepependent of extrauterine control. Myometrial contractions in paraplegic women are
normal, though painless, as in women with bilateral lumbar sympathectomy.

21. The canal of Nuck is associated with what?

a) Broad ligament

b) Inguinal ligament

c) Ischiorectal fossa

d) Round ligament

e) Urogenital diaphragm

Correct Answer: d) Round ligament. The round ligament arises from the body of the uterus
antero inferior to the cornue. It passes through the layers of broad ligaments across the
psoas and external iliac vessels. It then passes through the deep inguinal ring and the
inguinal canal to the labium majus. In the fetus, the round ligament is surrounded by a
peritoneum, processus vaginalis, which is obliterated at birth but may remain patent as the
canal of Nuck.
22. Urinary Catheter : Gynecology MCQ

A urinary catheter is vigorously in ated in the urethra at the time of cesarean section. Urine
leaks from the rupture into which anatomical space?

a) Into the anterior abdominal wall and mons pubis

b) Into the lesser pelvis

c) Into the peritoneal cavity

d) Into the vagina

e) Laterally to the femoral triangles

Correct Answer: a) Into the anterior abdominal wall and mons pubis. This is the only route
possible due to the anatomy of the urethra.

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