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Thursday, October 09, 2008

The artery to the ductus deferens is a branch of

Question 19
The artery to the ductus deferens is a branch of
a.       Inferior epigastric artery
b.      Superior Epigastric Artery
c.       Superior Vesical Artery
d.      Cremasteric Artery
Answer
c) Superior Vesical Artery
Reference
Gray’s Anatomy 38th Edition Page 1559
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Discussion
Each internal iliac artery, about 4 cm long, begins at the common iliac bifurcation, level with the lumbosacral intervertebral disc and anterior to the sacro-iliac joint; it descends posteriorly to the superior margin of the greater sciatic foramen, dividing here into: an anterior trunk, which continues in the same line towards the ischial spine; and a posterior trunk, passing back to the foramen.
Explanation
Ä     Superior Vesical Artery supplies many branches to the vesical fundus; from one the artery to the ductus deferens occasionally starts and accompanies the ductus to the testis, anastomosing with the testicular artery. Others supply the ureter. The beginning of the superior vesical artery is the proximal, patent section of the fetal umbilical artery.
Ä     Often arising with the middle rectal, Inferior Vesical Artery supplies the vesical fundus, prostate, seminal vesicles and lower ureter. Prostatic branches communicate across the midline. The inferior vesical may sometimes provide the artery to the ductus deferens.
Comments
In the fetus the internal iliac artery is twice the size of the external and is the direct continuation of the common iliac. It ascends on the anterior abdominal wall to the umbilicus, converging on its fellow. Having traversed the opening, the two arteries, now umbilical, enter the umbilical cord, coil round the umbilical vein and ultimately ramify in the placenta. At birth, when placental circulation ceases, only the pelvic segment remains patent as the internal iliac artery and part of the superior vesical, the remainder becoming a fibrous medial umbilical ligament raising the peritoneal medial umbilical fold from the pelvis to the umbilicus. In males, the patent part usually gives off an artery to the ductus deferens.
Tips
The remnant of the fetal left umbilical vein is the ligamentum teres of the liver; the obliterated umbilical arteries form the medial umbilical ligaments, enclosed in peritoneal folds of the same name; and the partially obliterated remains of the urachus persist as the median umbilical ligament.
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Explanation
The actual path is seminiferous tubules à Straight tubules à Rete Testis à Efferent ductile à Tail of epididymis à Deferent duct
Comments
Ä     As Highly coiled parts of the seminiferous tubules reach the lobular apices they are less convoluted, assume an almost straight course and unite into 20–30 larger but short straight ducts (tubuli recti), about 0.5 mm in diameter.
Ä     Straight seminiferous tubules enter the fibrous tissue of the mediastinum testis, ascending backwards as a close network (the rete testis) of anastomosing tubes lined by a flat epithelium.
Ä     At the upper pole of the mediastinum, 12–20 efferent ductules (ductuli efferentes) perforate the tunica albuginea to pass from the testis to the epididymis. They are at first straight, becoming enlarged and very convoluted and forming conical lobules of the epididymis, which make up its head (caput).
Ä     Each epididymal lobule is a convoluted duct, 15–20 cm in length. Opposite the lobular bases the ducts open into a single duct of the epididymis, whose coils form the epididymal body (corpus) and tail (cauda). With the coils unravelled the tube measures more than 6 metres, increasing in thickness as it approaches the epididymal tail, where it becomes the deferent duct.
Ä     The coils are held together by bands of fibrous connective tissue. The epididymal body and tail are thus a single tube.
Tips
Ä     Efferent ductules are lined by two types of epithelial cell: tall columnar ciliated cells, their cilia beating towards the epididymis, and shorter non-ciliated cells containing conspicuous lysosomes and shown to be actively endocytic. External to the epithelium, the ductules are surrounded by a thin circular coat of smooth muscle.

Which of the following is the correct order for Pathway a sperm

Question 18
Which of the following is the correct order for Pathway a sperm
a.       Straight tubules à Rete testis à Efferent tubules
b.      Rete Tubules à Efferent Tubules à Straight Tubule
c.       Efferent Tubule à Rete Testis à Straight Tubules
d.      Straight Tubule à Efferent Tubules à Rete Tubules
Answer
a) Straight tubules à Rete testis à Efferent tubules
Reference:
Gray’s Anatomy 38th Edition Page 1849. Diagram 14.2
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Explanation
The actual path is seminiferous tubules à Straight tubules à Rete Testis à Efferent ductile à Tail of epididymis à Deferent duct
Comments
Ä     As Highly coiled parts of the seminiferous tubules reach the lobular apices they are less convoluted, assume an almost straight course and unite into 20–30 larger but short straight ducts (tubuli recti), about 0.5 mm in diameter.
Ä     Straight seminiferous tubules enter the fibrous tissue of the mediastinum testis, ascending backwards as a close network (the rete testis) of anastomosing tubes lined by a flat epithelium.
Ä     At the upper pole of the mediastinum, 12–20 efferent ductules (ductuli efferentes) perforate the tunica albuginea to pass from the testis to the epididymis. They are at first straight, becoming enlarged and very convoluted and forming conical lobules of the epididymis, which make up its head (caput).
Ä     Each epididymal lobule is a convoluted duct, 15–20 cm in length. Opposite the lobular bases the ducts open into a single duct of the epididymis, whose coils form the epididymal body (corpus) and tail (cauda). With the coils unravelled the tube measures more than 6 metres, increasing in thickness as it approaches the epididymal tail, where it becomes the deferent duct.
Ä     The coils are held together by bands of fibrous connective tissue. The epididymal body and tail are thus a single tube.
Tips
Ä     Efferent ductules are lined by two types of epithelial cell: tall columnar ciliated cells, their cilia beating towards the epididymis, and shorter non-ciliated cells containing conspicuous lysosomes and shown to be actively endocytic. External to the epithelium, the ductules are surrounded by a thin circular coat of smooth muscle.

A surgeon excises a portion of liver to the left of the attachment of the faliciform ligament. The segments that have been resected at

Question 17
A surgeon excises a portion of liver to the left of the attachment of the faliciform ligament. The segments that have been resected at
a.       1a and 4
b.      1 and 4b
c.       2 and 3
d.      1 and 3
Answer
C) 2 and 3
Reference
Gray Page 38th Edition 1797, Sabiston Surgery
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Discussion
Although much of the surface is smoothly continuous, the liver is customarily apportioned by anatomists into a larger right and a much smaller left lobe according to some surface markings and  peritoneal attachments, namely the line of attachment of the falciform ligament anteriorly, and the fissure for the ligamentum teres and ligamentum venosum on the liver's inferior surface. To the right of this groove are two prominences, the quadrate lobe in front, and the caudate lobe behind, separated from each other by the porta hepatis. The gallbladder lies (usually) in a shallow fossa to the right of the quadrate lobe.
Explanation
The above statement (from Gray) clearly says that Caudate Lobe and Quadrate lobe are to the right of the attachment of the falciform ligament. So in this case, based on the diagram given below we can safely assume that these two lobes were not resected. (Do note that Segment 1 is Caudate Lobe)
Comments : Segmental anatomy as defined by Couinaud (the “French” system).
  • According to Couinaud's description, the three main hepatic veins divide the liver into four sectors.
  • He terms the planes through which the veins course the portal scissurae.
  • The right, main, and left portal scissurae define the four sectors, each of which receives a portal pedicle.
  • The main portal scissura divides the liver into right and left sectors. The right portal scissura divides the right and left livers into sectors.
  • It also divides the right liver into anterior and posterior sectors, each of which sectors contains two segments:
  • the anterior sector has segment V inferiorly and segment VIII superiorly, and
  • the posterior sector has segment VI inferiorly and segment VII superiorly.
  • The left portal scissura divides the left liver into superior and inferior sectors.
  • The umbilical fissure divides the anterior sector into two segments:
  • segment IV medially and segment III laterally.
  • The posterior sector has only one segment, segment II, which forms the posterior part of the left lobe.
  • The caudate lobe comprises segment I.
  • The portal veins and hepatic arteriole branches correspond to the segmental anatomy. Likewise, the bile ducts provide segmental drainage.
Tips
I) Caudate/Spigel lobe
II) Left posterolateral segment
III) Left anterolateral segment
IVa) Left superomedial segment
IVb) Left inferomedial segment
V) Right anteroinferior segment
VI) Right posteroinferior segment
VII) Right posterosuperior segment
VIII) Right anterosuperior segment
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(2) 
All-Union Research Center of Mental Health, Academy of Medical Sciences of the USSR, Zagorodnoje shosse 2, korp 2, 113152 Moscow, USSR
Accepted: 9 December 1985  
Summary  Scanning electron microscopy (SEM) was used to examine choroid plexuses in the brain of two human adults aged 44 and 46, respectively, and 12 older subjects from 67 to 98 years of age. It was possible to obtain a three-dimensional view of the ring-like structures (Biondi bodies) located in the cytoplasm of choroid plexus epithelial cells in the older-age group. The filaments forming the rings were clearly visible. No such structures were found between epithelial cells. The intracellular location of the Biondi bodies and their state of preservation compared to other cytoplasmic elements suggest that they may have a destructive effect on epithelial cells of choroid plexuses. The same material was examined by transmission electron microscopy (TEM); the results obtained were in full agreement with the evidence obtained with SEM.
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Biondi ring tangles found in.

Question 16
Biondi ring tangles found in.
a.       Choroidal plexus cells
b.      Golgi type II cells
c.       Basket cells
d.      ??
Answer
a) Choroid Plexus
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Reference, Discussion, Explanation:
Biondi bodies in the choroid plexus epithelium of the human brain
Journal
Publisher
Springer Berlin / Heidelberg
ISSN
0302-766X (Print) 1432-0878 (Online)
Issue
Category
Short Communications
DOI
10.1007/BF00218405
Pages
239-240. (1986;244(1):239-40)
Subject Collection
SpringerLink Date
Monday, November 29, 2004
A. I. Kiktenko1   Contact Information
(1) 
All-Union Research Center of Mental Health, Academy of Medical Sciences of the USSR, Moscow, USSR
(2) 
All-Union Research Center of Mental Health, Academy of Medical Sciences of the USSR, Zagorodnoje shosse 2, korp 2, 113152 Moscow, USSR
Accepted: 9 December 1985  
Summary  Scanning electron microscopy (SEM) was used to examine choroid plexuses in the brain of two human adults aged 44 and 46, respectively, and 12 older subjects from 67 to 98 years of age. It was possible to obtain a three-dimensional view of the ring-like structures (Biondi bodies) located in the cytoplasm of choroid plexus epithelial cells in the older-age group. The filaments forming the rings were clearly visible. No such structures were found between epithelial cells. The intracellular location of the Biondi bodies and their state of preservation compared to other cytoplasmic elements suggest that they may have a destructive effect on epithelial cells of choroid plexuses. The same material was examined by transmission electron microscopy (TEM); the results obtained were in full agreement with the evidence obtained with SEM.
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Which is the Nucleus of Masseteric Reflex - Nucleus of Mesencephalic Tract of Spinal Nerve

Question 15
Which is the Nucleus of Masseteric Reflex
a.       Chief Sensory Nucleus
b.      Nucleus of Spinal Tract of Trigeminal Nerve
c.       Nucleus of Mesencephalic Tract of Spinal Nerve
d.      Dorsal Vagal Nucleus
Answer
c. Nucleus of Mesencephalic Tract of Spinal Nerve
Reference
Gray’s Anatomy 38th Edition Page 1237
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Ä     The trigeminal, the largest cranial nerve, is the sensory supply to the face, the greater part of the scalp, the teeth, the oral and nasal cavities, the dura mater and the cerebral blood vessels. It gives the motor supply to the masticatory muscles, and the anterior belly of digastric and mylohyoid, and contains proprioceptive nerve fibres from the masticatory and probably the extraocular and facial muscles
Expanation
a.       Chief Sensory Nucleus is concerned with Tactile sensation.
b.      Nucleus of Spinal Tract of Trigeminal Nerve is concerned with Pain and Temperature Sensation.
c.       Nucleus of Mesencephalic Tract of Spinal Nerve is concerned with proprioception
d.      Dorsal Vagal Nucleus is a General Visceral Efferent Nucleus which innervates glands of the head, the sphincter pupillae and ciliary muscles, and the thoracic and abdominal viscera.
Comments
Ä     Masseter is supplied by a branch of the anterior trunk of the mandibular nerve.
Tips
Other ascending fibres enter the mesencephalic nucleus, a column of unipolar cells, whose peripheral branches may convey proprioceptive impulses from the masticatory muscles; it is also stated that similar impulses reach it from the teeth and from the facial and ocular muscles. Its neurons are unique in being the only primary sensory neurons with somata in the CNS. It is the relay for the only supraspinal monosynaptic reflex, namely the 'jaw-jerk'. If, however, the primary proprioceptive neurons of extraocular muscles are in fact situated in their motor nerves or in the trigeminal ganglion, some mesencephalic trigeminal neurons may be 'secondary' in status. Small multipolar cells, possibly interneurons, occur near the unipolar neurons.

All of the following are Somatic Efferent except

Question 14
All of the following are Somatic Efferent except
a.       Facial nerve
b.      III Nerve
c.       IV Nerve
d.      VI Nerve
Answer
a) Facial nerve
Reference:
Gray’s Anatomy 38th Edition Pages 238, 241
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  • General somatic efferent neurons exit ventrally in a similar manner to those of the spinal cord, comprising the oculomotor, trochlear, abducens and hypoglossal nerves. Thus nerves III, IV, VI and XII parallel the organization of the somatic motor neurons in the spinal cord.
Explanation
Self Explanatory
Comments
  • The second motor component, special branchial efferent, comprises the accessory nerve and the motor parts of the trigeminal, facial, glossopharyngeal and vagus nerves, whose nerve exit points lie more dorsally than the somatic motor system.
  • The cranial nerves also contain a third class of efferent neurons, the general visceral efferent neurons (parasympathetic preganglionic) travelling in nerves III, VII, IX and X, which leave the hindbrain via the same exit points as the special branchial efferent fibres.
  • The most rostral sensory ganglion, the trigeminal (V) comprises both neural crest and placode-derived neurons that mediate general somatic afferent functions. In the case of more caudal cranial nerves (VII, IX and X) the same applies, but the two cell populations form separate ganglia in the case of each nerve. Analogous with the trigeminal, the proximal series of ganglia is neural crest derived (forming the proximal ganglion of VII, the superior ganglion of IX and the jugular ganglion of X) while the distal series derives from placodal cells (forming the geniculate ganglion of VII, the petrosal ganglion of IX and the nodose ganglion of X). These ganglia contain neurons that mediate special, general visceral and somatic afferent functions. The VIIth nerve has a vestibular ganglion containing both crest and placodal cells and an acoustic ganglion from placodal neurons only; it conveys special somatic afferents.
  • Both neurons and supporting cells of the cranial autonomic ganglia in the head and the trunk originate from neural crest cells
Tips
Types of Functional Components in a Nerve
Fibres and Sensation Carried
Nucleus
Sensory or Afferent
Visceral
General
General Visceral Afferent
·        Pain arising from Viscera
·        Dorsal Nucleus of Vagus
Special
Special Visceral Afferent
·        Taste
·        Nucleus Tractus Solitarius
·        Nucleus of Dorsal Visceral Gray
Somatic
General
General Somatic Afferent
·        Exteroceptive impulses – cutaneous sensations of pan, touch and temperature -
·        Proprioceptive impulses arising in muscles, tendon and joints conveying information regarding movement and position of joint
·        Chief Sensory Nucleus (Tactile)
·        Nucleus of Spinal Tract of Trigeminal Nerve (Pain Temp)
·        Nucleus of Mesencephalic Tract of Spinal Nerve (Proprioception)
·         
Special
Special Somatic Afferent
·        Vision
·        Hearing
·        Equilibrium
·        Nucleus of the Vestibulocochlear nerver
Motor of Efferent
Visceral
General
General Visceral Efferent
·        General visceral efferent neurons
·        Parasympathetic preganglionic (III, VII, IX and X)
·        innervate glands of the head,
·        the sphincter pupillae and ciliary muscles,
·        and the thoracic and abdominal viscera.
·        Smooth muscle
·        Cardiac Muscle
·        Glands
·        Dorsal Vagal Nucleus
·        Superior Salivatory Nucleus
·        Inf Salivatory Nucleus
·        Lacrimatory Nucleus
·        Edinger Westpal Nucleus
Special
Special Visceral Efferent
·        (accessory nerve and the motor parts of the V, VII, IX, X nerves)
·        Also called as Branchial Efferent.
·        Striated muscles developing within the pharyngeal (branchial) arches
·        Mucles of Mastication, face, larynx
·        Nucleus Ambigus
Somatic
General
General Somatic Efferent
·        Supply striated muscle now known to be derived from the cranial (occipital) somites and prechordal mesenchyme.
·        Muscles of Body wall and Limbs
·        Eye and Tongue
·         
·        Oculomotor Nucleus (III)
·        Trochlear Nucleus (IV)
·        Abducent Nucleus (VI)
·        Hypoglossal Nucleus (XII)