Abdomen and pelvis: culdocentesis: 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: culdocentesis

Sample item

A woman with a positive pregnancy test, abdominal pain and hypotension has free fluid on ultrasound. A needle passed through the posterior vaginal fornix enters which peritoneal space?

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

The answer and the reasoning

B. Rectouterine pouch

The posterior vaginal fornix lies directly against the rectouterine pouch (pouch of Douglas), the lowest part of the peritoneal cavity in the upright woman. Blood from a ruptured ectopic pregnancy collects here and can be aspirated by culdocentesis.

Option by option

  • A. Paravesical fossa

    This is a lateral peritoneal fossa beside the bladder, not reached through the posterior fornix.

  • B. Rectouterine pouch (correct)

    Correct. The posterior fornix is in direct contact with the rectouterine pouch.

  • C. Ischiorectal fossa

    This fossa is outside the peritoneum beside the anal canal.

  • D. Vesicouterine pouch

    This pouch lies in front of the uterus between it and the bladder, and is not reached through the posterior fornix.

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.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, Rectouterine pouch. The posterior vaginal fornix lies directly against the rectouterine pouch (pouch of Douglas), the lowest part of the peritoneal cavity in the upright woman.

Why is "Paravesical fossa" not the answer?

This is a lateral peritoneal fossa beside the bladder, not reached through the posterior fornix.

Why is "Ischiorectal fossa" not the answer?

This fossa is outside the peritoneum beside the anal canal.

Why is "Vesicouterine pouch" not the answer?

This pouch lies in front of the uterus between it and the bladder, and is not reached through the posterior fornix.

What concept does this question test?

It tests Abdomen and pelvis: culdocentesis in Anatomy. Blood from a ruptured ectopic pregnancy collects here and can be aspirated by culdocentesis.

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: culdocentesis?

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.