Abdomen and pelvis: lymphatic spread from the uterine fundus: 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: lymphatic spread from the uterine fundus

Sample item

A woman with endometrial carcinoma of the fundus has an enlarged node in the superficial inguinal group although the pelvic nodes are normal. Which lymphatic route explains it?

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

The answer and the reasoning

D. Lymphatics along the round ligament through the inguinal canal

Most uterine lymph drains to the iliac and para-aortic nodes, but a small fraction from the region of the fundus follows the round ligament through the inguinal canal to the superficial inguinal nodes. This explains inguinal metastasis from a fundal tumour.

Option by option

  • A. Lymphatics along the uterosacral ligament to sacral nodes

    The uterosacral route carries a small cervical drainage to sacral nodes.

  • B. Lymphatics along the uterine artery to internal iliac nodes

    This route carries lymph from the body and cervix to the internal iliac nodes, not to the groin.

  • C. Lymphatics along the ovarian vessels to para-aortic nodes

    The ovarian route drains the fundus to the para-aortic nodes, not to the groin.

  • D. Lymphatics along the round ligament through the inguinal canal (correct)

    Correct. A fundal pathway through the round ligament drains to the superficial inguinal nodes.

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 D, Lymphatics along the round ligament through the inguinal canal. Most uterine lymph drains to the iliac and para-aortic nodes, but a small fraction from the region of the fundus follows the round ligament through the inguinal canal to the superficial inguinal nodes.

Why is "Lymphatics along the uterosacral ligament to sacral nodes" not the answer?

The uterosacral route carries a small cervical drainage to sacral nodes.

Why is "Lymphatics along the uterine artery to internal iliac nodes" not the answer?

This route carries lymph from the body and cervix to the internal iliac nodes, not to the groin.

Why is "Lymphatics along the ovarian vessels to para-aortic nodes" not the answer?

The ovarian route drains the fundus to the para-aortic nodes, not to the groin.

What concept does this question test?

It tests Abdomen and pelvis: lymphatic spread from the uterine fundus in Anatomy. This explains inguinal metastasis from a fundal tumour.

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 Abdomen and pelvis: lymphatic spread from the uterine fundus?

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.