Embryology: velamentous cord insertion: 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 · Embryology: velamentous cord insertion

Sample item

At rupture of membranes a woman has painless vaginal bleeding and fetal bradycardia, and the blood is of fetal origin. Vessels were seen crossing the membranes over the internal os. Which cord abnormality predisposes to this?

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

The answer and the reasoning

B. Velamentous insertion of the cord

In velamentous insertion the cord attaches to the membranes and its vessels run unprotected by Wharton jelly before reaching the placenta. If these vessels cross the cervical os (vasa previa) they can tear when membranes rupture, causing fetal exsanguination.

Option by option

  • A. Battledore insertion at the placental margin

    Battledore insertion is at the margin of the placenta and the vessels are protected.

  • B. Velamentous insertion of the cord (correct)

    Correct. Unprotected membranous vessels may lie over the os and rupture with the membranes.

  • C. Single umbilical artery

    A single umbilical artery is associated with anomalies but not with membranous vessels.

  • D. True knot of the cord

    A true knot can cause cord compression, not bleeding from membrane vessels.

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, Velamentous insertion of the cord. In velamentous insertion the cord attaches to the membranes and its vessels run unprotected by Wharton jelly before reaching the placenta.

Why is "Battledore insertion at the placental margin" not the answer?

Battledore insertion is at the margin of the placenta and the vessels are protected.

Why is "Single umbilical artery" not the answer?

A single umbilical artery is associated with anomalies but not with membranous vessels.

Why is "True knot of the cord" not the answer?

A true knot can cause cord compression, not bleeding from membrane vessels.

What concept does this question test?

It tests Embryology: velamentous cord insertion in Anatomy. If these vessels cross the cervical os (vasa previa) they can tear when membranes rupture, causing fetal exsanguination.

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 Embryology: velamentous cord insertion?

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.