Pelvis and perineum: urethral injury: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Pelvis and perineum: urethral injury

Sample item

After a straddle injury a man has a perineal haematoma and cannot void. Urine later infiltrates the scrotum, the penis and the lower anterior abdominal wall, but not the thighs or the anal region. Which structure is most likely torn?

AAnterior wall of the bladderBBulbar (spongy) urethra below the perineal membraneCProstatic urethraDMembranous urethra above the perineal membrane

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Bulbar (spongy) urethra below the perineal membrane

A bulbar urethral tear after a straddle injury lets urine escape into the superficial perineal pouch. It is limited by the attachments of Colles' fascia (to the ischiopubic rami and the fascia lata of the thigh) and spreads to the scrotum, penis and up the abdominal wall under Scarpa's fascia, but not into the thighs or anal region.

Option by option

A. Anterior wall of the bladder
Bladder injury leaks into the pelvis or peritoneum, not into the superficial perineal pouch.
B. Bulbar (spongy) urethra below the perineal membrane (correct)
Correct. Urine from a bulbar tear fills the superficial perineal pouch and tracks along Colles' and Scarpa's fascia.
C. Prostatic urethra
The prostatic urethra is deep inside the prostate and is not exposed in straddle injuries.
D. Membranous urethra above the perineal membrane
A membranous urethral tear occurs with pelvic fractures and extravasates into the deep pouch and pelvis, not the superficial pouch.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, Bulbar (spongy) urethra below the perineal membrane. A bulbar urethral tear after a straddle injury lets urine escape into the superficial perineal pouch.

Why is "Anterior wall of the bladder" not the answer?

Bladder injury leaks into the pelvis or peritoneum, not into the superficial perineal pouch.

Why is "Prostatic urethra" not the answer?

The prostatic urethra is deep inside the prostate and is not exposed in straddle injuries.

Why is "Membranous urethra above the perineal membrane" not the answer?

A membranous urethral tear occurs with pelvic fractures and extravasates into the deep pouch and pelvis, not the superficial pouch.

What concept does this question test?

It tests Pelvis and perineum: urethral injury in Anatomy. It is limited by the attachments of Colles' fascia (to the ischiopubic rami and the fascia lata of the thigh) and spreads to the scrotum, penis and up the abdominal wall under Scarpa's fascia, but not into the thighs or anal region.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pelvis and perineum: urethral injury?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.