Pelvis: levator ani and continence: 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.

Try it

Anatomy · Pelvis: levator ani and continence

Sample item

A 35-year-old woman has faecal incontinence after an obstetric injury, with loss of the anorectal angle. Which muscle forms a sling pulling the anorectal junction forwards to maintain this angle?

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

The answer and the reasoning

C. Puborectalis

Puborectalis is the most medial part of levator ani and loops behind the anorectal junction, pulling it forwards to form the anorectal angle, which acts as a flap valve at rest. Relaxation of the sling during defecation straightens the angle. Weakness or denervation causes incontinence.

Option by option

  • A. Pubococcygeus

    Pubococcygeus supports pelvic organs but does not make the sling around the rectum.

  • B. External anal sphincter

    The external anal sphincter closes the anal canal but does not create the angle.

  • C. Puborectalis (correct)

    Correct. The puborectalis sling holds the anorectal angle.

  • D. Iliococcygeus

    Iliococcygeus is the lateral thin part of the pelvic floor, with no role in the angle.

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.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, Puborectalis. Puborectalis is the most medial part of levator ani and loops behind the anorectal junction, pulling it forwards to form the anorectal angle, which acts as a flap valve at rest.

Why is "Pubococcygeus" not the answer?

Pubococcygeus supports pelvic organs but does not make the sling around the rectum.

Why is "External anal sphincter" not the answer?

The external anal sphincter closes the anal canal but does not create the angle.

Why is "Iliococcygeus" not the answer?

Iliococcygeus is the lateral thin part of the pelvic floor, with no role in the angle.

What concept does this question test?

It tests Pelvis: levator ani and continence in Anatomy. Relaxation of the sling during defecation straightens the angle. Weakness or denervation causes incontinence.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: levator ani and continence?

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.