between uterine vessels and ureter is of major importance during surgical
procedures in the female pelvis. At the top of the broad ligament would be
the ovarian artery and vein (answers a and e),which continue on to supply
blood to the fundus. The uterine tube (answer b)also runs along the top
of the broad ligament. The round ligament of the uterus (answer c)runs
anterior to the broad ligament.
431.The answer is h.(Moore and Dalley, pp 404, 409, 433.)In most
males, during a digital rectal exam, you can palpate the main peripheral
portion of the prostate gland (answer a),then just a little more cranially,
both the seminal vesicles (answer c)and ampulla of the vas (ductus) def-
erens (answer e).The main goal of the digital rectal exam is to palpate the
backside of the prostate gland which is the main peripheral portion of the
gland; the site of development of most growth of prostate cancer. An addi-
tional screening tool is the prostate specific antigen (PSA) level within
blood. Generally the PSA level should be below 2.5 ng/mL. Elevated levels
of PSA, however, can also indicate inflammation of the prostate in addition
to cancerous growth. You can notpalpate the ejaculatory ducts (answer b)
as they are embedded within the substance of the prostate gland. You can
notpalpate the epididymis (answer d)during a digital rectal exam as it is
within the scrotum next to the testicles. All other answers (f, g, and i)are
wrong or incomplete.
432.The answer is a.(Moore and Dalley, pp 362–363.)The transverse
midplane diameter is measured between the ischial spines. It can be
approximated by the somewhat greater transverse diameter measured
between the ischial tuberosities (answer b).The distance from the lower
margin of the pubic symphysis to the sacroiliac joint (answer c)defines
the sagittal diameter, which is usually the greatest dimension and, there-
fore, unimportant. The measurement from the sacral promontory to the
inferior margin of the pubic symphysis (answer d)is the diagonal con-
jugate, an estimate of the pelvic inlet.
433.The answer is e.(Moore and Dalley, pp 422–424, 493.)Caudal anal-
gesia can be induced by an injection of anesthetic through the sacral hiatus
into the sacral epidural space of the vertebral canal well caudal to the ter-
mination of the dural sac (answer b).The sacral hiatus represents the
552 Anatomy, Histology, and Cell Biology