EBCOG – PART 1 – ANATOMY

1.A healthy 5 ft 6 in. tall, adult female is most likely to have a pelvic inlet that would be classified as which of the following Caldwell-Moloy types?

2.Hernias occur more commonly in men than in women beneath the thickened lower margin of a fascial aponeurosis extending from the pubic tubercle to the anterior superior iliac spine. This thickened fascia is called which of the following?

3. The inguinal canal in an adult female was opened surgically. Which of the following structures would normally be found?

4. The human pelvis is a complex structure that permits upright posture and being capable with childbirth despite the relatively large fetal head. Which option includes all of the bones that make up the pelivs?

5. During normal delivery, an infant must pass through the maternal true pelvis. Which of the following most accurately describes the characteristics of the true pelvis?

6. The part of the pelvis lying above the linea ter-minalis has little effect on a woman’s ability to deliver a baby vaginally. What is the name of this portion of the pelvis?

7. The plane from the sacral promontory to the inner posterior surface of the pubic symphysis is an important dimension of the pelvis for normal delivery. What is the name of this plane?

8. During an operation, a midline incision was made at an anatomic location 2 cm below the umbilicus. Which of the following lists (in order) the layers of the anterior abdominal wall as they would be incised or separated?

9. Under the influence of relaxin and the pressure of pregnancy the junction between the two pubic bones may become unstable near the time of delivery. This will result in a waddling gait in the woman to minimize discomfort. What is this junction called?

10. The shape of the escutcheon may change with masculinization. The presence of a male escutcheon in a female is one of the clinical signs of hirsutism or increased testosterone. What is the usual shape of the escutcheon in the normal female?

11. During the performance of a pelvic examination, the area of the Bartholin’s ducts should be inspected. Where do the Bartholin’s glands’ ducts open?

12. During a physical examination myrtiform caruncles may be noted. What are they?

13. The clitoris is a major sensory sexual organ. Where does it get its major nerve supply from?

14. In the uterus of a normal female infant, what is the size relationship of the cervix, isthmus, and fundus?

15. How do nabothian cysts occur?

16. What is the uterine corpus mainly composed of?

17. The uterus and adnexa have some relatively fixed anatomic characteristics that can be noted on pelvic examination or laparoscopic observation. Which of the following characteristics would you most likely find in a normal patient?

18. A patient presents approximately 10 years post-menopausal with complaints of pressure vaginally and the sensation that something is falling out. When told she has a fallen uterus, she wonders if it is due to the damage from her round ligaments since she had a great deal of round ligament pain during her pregnancies. Which of the following ligaments provide the most support to the uterus in terms of preventing prolapse?

19. Pelvic inflammatory disease (PID) occurs in women because of which of the following characteristics of the fallopian tube?

20. In a female, which of the following best describes the urogenital diaphragm?

21. The levator ani is the major component of the pelvic diaphragm, which is commonly compromised during pregnancy and delivery with resulting prolapse of uterus, bladder/urethra, and /or rectum. This is especially true if obstetric lacerations are not repaired keeping the normal anatomical relationships in mind. Which of the following is the best description of the levator ani?

22. Which of the following is the best description of the pelvic diaphragm?

23. When performing a hysterectomy, the surgeon should be aware that at its closest position to the cervix, the ureter is normally separated from the cervix by which of the following distances?

24. When performing surgery, the position of important structures should be well known to avoid injury.What is the ureter’s relationship to the arteries in its course through the pelvis?

25. Urinary incontinence is a major problem for some women. Which of the following characteristics of the female urethra helps prevent incontinence?

26. The anatomy of the spinal cord and dural space is important when giving regional spinal anesthesia. At what approximate spinal level do the dural space and the spinal cord, respectively, end?

27. During a hysterectomy, vaginal bleeding may be a significant complication even after removal of the uterus. Such bleeding would most likely originate from which of the following arteries?

28. Anterior vulvar cancer is most likely to spread primarily to which of the following lymph nodes?

29. Which artery provides the main blood supply to the vulva?

30. During delivery, which of the following muscles is most likely to be obviously torn?

31. A patient develops a neurologic disease that destroys components of S2, S3, S4 bilaterally. What clinical manifestation would you expect the patient to have as a result?

32. A 56-year-old woman comes to your office for a yearly examination. During physical examination, you notice that her left breast has a 2-cm area of retraction in the upper-outer quadrant that can be seen by simple inspection. What is the most likely diagnosis?

33. A woman who is 32 weeks pregnant comes in complaining of lumps in her breasts. These lumps are multiple in number and on inspection are within the areola. By palpation they seem to be small, superficial, uniform in size, nontender, and soft. What is the most likely diagnosis?

34. A woman has a radical hysterectomy and pelvic lymphadenectomy for Stage I carcinoma of the cervix. After surgery she complains that she cannot adduct her left leg and there is an absence of sensation on the medial aspect of her left thigh. What is the most likely explanation?

35. During delivery of a first twin, a very tight nuchal cord is reduced from the baby’s neck by clamping and dividing it. After this, the second twin (as yet unborn) develops severe fetal distress. Of thefollowing, what is the most likely mechanism for the distress in the second twin?