MRCOG Part 1 Subject Guide

MRCOG Part 1: Anatomy

~85 questionsMedium priority

Anatomy in MRCOG Part 1 focuses almost entirely on clinically relevant anatomy for obstetrics and gynaecology — pelvic anatomy, the reproductive tract, the perineum, and surgical anatomy of importance in O&G procedures. Approximately 85 questions.

Topics Covered

Pelvic Anatomy

  • Bony pelvis — types (gynaecoid, android, anthropoid, platypelloid) and obstetric dimensions
  • Pelvic floor muscles — levator ani components, pudendal nerve
  • Pelvic fascia, ligaments — uterosacral, cardinal (Mackenrodt's), round ligament
  • Peritoneum and pouches — pouch of Douglas (rectouterine), vesicouterine pouch

Reproductive Tract

  • Uterus — layers (endometrium, myometrium, perimetrium), blood supply (uterine artery), relations
  • Cervix — internal and external os, transformation zone
  • Fallopian tubes — parts (interstitial, isthmus, ampulla, infundibulum), blood supply
  • Ovary — position, ligaments (ovarian ligament, suspensory ligament), blood supply (ovarian artery)
  • Vagina — relations, fornices, blood supply, lymphatic drainage

Surgical Anatomy

  • Ureter — course through pelvis, relation to uterine artery ("water under the bridge")
  • Ureter in relation to uterosacral ligaments and cardinal ligaments — risk of injury
  • Bladder — position, trigone, relation to uterus and cervix
  • Rectum — relation to posterior vagina and rectovaginal septum
  • Inguinal canal — structures, hernia types, round ligament passage

Perineum & Vulva

  • Vulva — labia majora, minora, clitoris, vestibule, Bartholin's glands
  • Perineal body — muscles attached, obstetric importance
  • Anal sphincter — external (voluntary, pudendal nerve) vs internal (involuntary, autonomic)
  • Lymphatic drainage — vulva and lower vagina to inguinal nodes; upper vagina and cervix to iliac nodes

Exam Tips for Anatomy

1

The ureter course is one of the most tested anatomy topics — know exactly where it is at risk in hysterectomy ("water under the bridge").

2

Lymphatic drainage is regularly tested: know the difference between vulval/lower vaginal drainage (inguinal) and upper vaginal/cervical drainage (iliac).

3

Bony pelvis types and their obstetric implications are tested — gynaecoid is the most favourable for vaginal delivery.

4

The relations of the pelvic organs to each other are tested as scenario-based questions about surgical risks.

5

Know the pudendal nerve path (Alcock's canal) and what structures it innervates — relevant to perineal anaesthesia.

Recommended Book

Gray's Anatomy for Students or Last's Anatomy — focus on pelvis and perineum chapters only.

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