Short Quiz on EXTERNAL GENITALIA

Instruction

1. This Test has 12 Questions 
2. There is 1 Mark for each correct Answer

MCQ – 1

Which of the following about lymphatics of the vulva is true ?

Do not cross the labiocrural fold

Traverse labia from medial to lateral

Drain directly into deep femoral glands

Do not freely communicate with each other

Explanation :

Ans. B. Traverse labia from medial to lateral
Special features of Vulval lymphatics are as follows :

  • The lymphatics of each side freely communicate with each other.
  • The lymphatics hardly cross beyond labiocrural fold.
  • Vulval lymphatics also anastomose with lymphatics of lower 1/3 of the vagina and drain into external iliac nodes.
  • Superficial lymph nodes are the primary lymph nodes that act as sentinel glands of vulva. Deep inguinal nodes are secondarily involved. It is unusual to find pelvic glands without metastasis in inguinal nodes. Glands of Cloquet or Rosenmuller which is the uppermost deep femoral gland is absent in 50% of cases.
  • “From the upper 2/3 of the left and right labia majora superficial lymphatics pass towards the symphysis and turn laterally to joint the medial superficial inguinal nodes.”                                                                       
  • Hence they traverse labia from medial to lateral.

MCQ – 2

The commonest reason for adherent labia minora in a newborn is :

Female pseudohermaphroditism

Testicular feminisation

Vaginal atresia

Denudation of the surface epithelium

Explanation :

Ans.D. Denudation of the surface epithelium

Labial adhesion (adhesive vulvitis) is the condition when the labia minora have adhered together.

  • Causes: Commonly, it is due to mild infection of the vulva which is favored by lack of local defense due to the absence of estrogen. There is denudation of the surface epithelium of the labia minora → adhesions.

  • The adhesions of the labia minora start from behind forward leaving a small opening at the foremost tip through which urine escapes out.

  • Rarely, it may be a manifestation of a minor form of masculinization following maternal intake of androgen during pregnancy.


MCQ – 3

The inner surface of the labia minora medial to the Hart line is lined by which of the following type of epithelium?

Cuboidal epithelium

Columnar epithelium

Squamous epithelium

Stratified squamous epithelium

Explanation :

The inner surface of the labia minora medial to the Hart line is lined by squamous epithelium that is non keratinized and the lateral portion of the inner surface is covered by stratified squamous epithelium.

Labia minora is a thin fold of tissue, which lies medial to each labia majora.
In males the structure homologous to this is ventral shaft of penis.
Superiorly labia minora divides into two lamella.
The lower pair fuses to form frenulum of the clitoris and upper pair merges to form the prepuce. Inferiorly, labia minora fuses to form the fourchette. 
 

MCQ – 4

Bartholin’s duct opens and drains its secretion to:

Labia majora and minora

A groove between labia minora and hymen

The lower vagina

The upper vagina

Explanation :

Greater vestibular or Bartholin glands are the homologs of the male bulbourethral or Cowper glands.
They are in contact with and often overlapped by the posterior ends of the vestibular bulbs.
Each gland is connected to the vestibule by an approximately 2-cm long duct.
The ducts open in the groove between the labia minora and the hymen–the vestibule–at approximately 5 and 7 o’clock positions.
The glands contain columnar cells that secrete clear or whitish mucus with lubricant properties.

 
Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 38. Anatomy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.

MCQ – 5

The embryonic development of the vestibule of the vagina is from which of the following developmental structures?

Genital ridge

Wolffian duct

Urogenital sinus

Mullerian duct

Explanation :

Clitoris develops from three swellings of the somato-pleurae known as genital tubercle, urogenital folds and labioscrotal folds, while urethra, vestibule and lower vagina are derived from the urogenital sinus.


MCQ – 6

Lymphatic drainage of clitoris is to:

Glands of cloquet

Superficial inguinal lymph nodes

Deep inguinal lymph nodes

a and c

Explanation :

A. i.e. Glands of cloquet; C. i.e. Deep inguinal lymph nodes 

–   Glans penis & clitoris drain in deep inguinal lymph nodes of Cloquet or Rosenmuller

Superficial inguinal lymph nodes drain anterior abdominal wall below umbilicus, perineum, anal canal (gluteal region) but not clitoris & toes and fingers.


MCQ – 7

Scrotum is analogus to-

Labia minor

Labia majora

Uterus

Vagina

Explanation :

B i.e. Labia majora


MCQ – 8

Clitoris develops from which of the following:

Genital tubercle

Genital ridge

Wolffian duct

Mullerian duct

Explanation :

Phallic tubercle or genital tubercle

  • Present in the development of the urinary and reproductive organs.
  • It forms in the ventral, caudal region of mammalian embryos of both sexes and eventually develops into a phallus.
  • In the human fetus the genital tubercle develops around week 4 of gestation and by week 9 becomes recognizably either a clitoris or penis.
  • This should not be confused with the sinus tubercle which is a proliferation of endoderm induced by paramesonephic ducts.
  • Even after the phallus is developed, the term genital tubercle remains, but only as the terminal end of it, which develops into either the glans penis or the glans clitoridis.

MCQ – 9

Triangular space between clitoris and hymen ‑

Fourchette

Fossa navicularis

Vestibule

Labia minora

Explanation :

Ans. is ‘c’ i.e., Vestibule

Female genitals :‑

  • The labia mojora are the two elongated folds of skin projecting downwards and backwards from the mons veneris.
  • The labia minora are two thin folds of skin just within labia majora.
  • The lower portions of labia called fourchette.
  • The depression between fourchette and the vaginal orifice is called fossa navicularis.
  • The Vestibule is the triangular surface which extends from clitoris (above) to hymen (below) and labia minora (laterally).
  • Urethral opening is 2.5 cm behind the clitoris, and immediately in front of vaginal opening.
  • Vulva includes mons veneris, clitoris, labia majora, labia minora, vestibule, hymen and urethral opening.

MCQ – 10

Lymphatic drainage of Vulva is into ‑

Obturator nodes

Internal iliac nodes

Superficial inguinal nodes

Paraaortic nodes

Explanation :

Ans. is ‘c’ i.e., Superficial inguinal nodes
Lymphatics of Vulva drain primarily into superficial inguinal lymph nodes and subsequently to deep inguinal and external iliac ndes. Lymphatics of Clitoris primarily drain into deep inguinal nodes.


MCQ – 11

The structure  marked with arrow opens and drains its secretion to?

Labia majora and minora

A groove between labia minora and hymen

The lower vagina

The upper vagina

Explanation :

Ans;B).

This structure is Bartholin gland.

  • The ducts open in the groove between the labia minora and the hymen–the vestibule–at approximately 5 and 7 o’clock positions.
  • The glands contain columnar cells that secrete clear or whitish mucus with lubricant properties.

MCQ – 12

 Identify the Anatomical structure [Arrow] shown in Photograph 

Labia majora

 Labia minora 

 Mons pubis 

None of the above

Explanation :

The labia majora are two marked folds of skin that extend from the mons pubis downward and backward to merge with the skin of the perineum. They form the lateral boundaries of the vulval or pudendal cleft, which receives the openings of the vagina and the urethra.


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