Free OBGYN Board Review Sample Questions

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Your First Free OB/GYN Review Question

Which of the following nerves is responsible for sensory innervations to the perineum?

• A) Anococcygeal
• B) Femoral
• C) Lateral femoral cutaneous
• D) Perineal
• E) Pudendal

The Answer and Explanation

Did you get it right? The correct answer is: E

More than 60 nerves innervate the female pelvis, providing both motor and sensory effects. The pudendal nerve is responsible for sensory innervation to the perineum.

As the fetus descends in the late first stage or second stage of labor, distention of the vagina, pelvic floor, and perineum elicit stimuli through the pudendal nerve and the anterior primary divisions of sacral nerves S2 through S4. This pain is predominantly somatic and is better localized than pain that occurs earlier in labor. The pudendal block is therefore useful primarily in the second stage of labor after delivery to facilitate repair of perineal lacerations. The block involves injecting local anesthetic transvaginally into the vicinity of the pudendal nerve below the ischial spines.

• Answer A: The anococcygeal nerve provides sensory innervation to the skin overlying the coccyx.
• Answer B: The femoral nerve provides sensory innervation to the skin overlying the anterior thigh.
• Answer C: The lateral femoral cutaneous nerve provides sensory innervation to the skin overlying the lateral thigh.
• Answer D: The perineal nerve provides sensory innervation to the skin overlying the posterior aspect of the labium majus.

Bottom Line

The pudendal nerve provides both sensory and motor innervation to the perineum.

For more information, see:

• ACOG Practice Bulletin 209: Obstetric Analgesia and Anesthesia. 2020.
• Te Linde’s Operative Gynecology, 12th ed. Chapter 1: Surgical Anatomy of the Female Pelvis.
• Anderson D. Pudendal nerve block for vaginal birth. J Midwifery Womens Health. 2014 Nov-Dec;59(6):651-659.

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