Abdomen and pelvis: bladder trauma: 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 · Abdomen and pelvis: bladder trauma

Sample item

A man with a full bladder after drinking alcohol is kicked in the lower abdomen. Free fluid collects in the paracolic gutters and urinary ascites develops. Which part of the bladder most likely ruptured?

ATrigone, fixed to the baseBDome, which is covered by peritoneumCAnterior surface, lying behind the pubic bonesDNeck, held by the puboprostatic ligaments

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

The answer and the reasoning

B. Dome, which is covered by peritoneum

The superior surface and dome are covered by peritoneum and lie highest when the bladder is distended, so blunt trauma ruptures this region into the peritoneal cavity. Pelvic fracture ruptures the extraperitoneal parts, with extravasation into the retropubic space.

Option by option

A. Trigone, fixed to the base
The trigone is fixed to the base and rarely ruptures with abdominal trauma.
B. Dome, which is covered by peritoneum (correct)
Correct. The dome is the only peritoneum-covered area, so rupture allows urine to enter the peritoneal cavity.
C. Anterior surface, lying behind the pubic bones
The anterior surface is extraperitoneal and would leak into the retropubic space.
D. Neck, held by the puboprostatic ligaments
The neck is fixed and extraperitoneal, and its injury causes retropubic extravasation.

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, Dome, which is covered by peritoneum. The superior surface and dome are covered by peritoneum and lie highest when the bladder is distended, so blunt trauma ruptures this region into the peritoneal cavity.

Why is "Trigone, fixed to the base" not the answer?

The trigone is fixed to the base and rarely ruptures with abdominal trauma.

Why is "Anterior surface, lying behind the pubic bones" not the answer?

The anterior surface is extraperitoneal and would leak into the retropubic space.

Why is "Neck, held by the puboprostatic ligaments" not the answer?

The neck is fixed and extraperitoneal, and its injury causes retropubic extravasation.

What concept does this question test?

It tests Abdomen and pelvis: bladder trauma in Anatomy. Pelvic fracture ruptures the extraperitoneal parts, with extravasation into the retropubic space.

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 Abdomen and pelvis: bladder trauma?

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.