BIOS 3010 Exam 1: Practice Questions

10. The following lateral view MRI of the lumbosacral part of the vertebral column shows: A) L4/L5 IV disc hypertrophy. B) L4/L5 IV disc herniation. C) L5/S1 IV disc hypertrophy. D) L5/S1 IV disc herniation. E) spondylosis of the vertebral lamina at L5.

(Note: above is L4/L5, but just look at the picture and know where the vertebra are) D) L5/S1 IV disc herniation.

13. Which of the following is incorrect pertaining to the supraspinatus muscle? A) It is innervated by a nerve that also supplies cutaneous innervation to the lateral surface of the proximal arm. B) It initiates the process of abduction of the arm. C) It is associated with painful abduction when the subacromial bursa is inflamed. D) It is one of four muscles comprising the rotator cuff. E) During arm abduction against resistance, the muscle can be palpated.

A) It is innervated by a nerve that also supplies cutaneous innervation to the lateral surface of the proximal arm.

1. Which of the following is true pertaining to the tension (Langer) lines of the skin? A) Surgical incisions should be made parallel to these lines to minimize scaring. B) Surgical incisions should avoid cutting through these lines because they contain neurovascular bundles. C) Surgical incisions should avoid cutting through these lines because they indicate the position of the underlying skin ligaments (retinacula cutis). D) They become stretch marks (striae gravidarum) in obese individuals. E) They separate fascial compartments.

A) Surgical incisions should be made parallel to these lines to minimize scaring.

41. Which of the following is correct pertaining to the interossei and lumbrical muscles of the hand? A) The palmar interossei, dorsal interossei, and lumbricals together can produce flexion at the metacarpophalangeal joints and extension at the interphalangeal joints. B) The palmar interossei, dorsal interossei, and lumbricals together can produce extension at the metacarpophalangeal joints and flexion at the interphalangeal joints. C) The palmar and dorsal interossei produce abduction of the fingers, whereas the lumbricals can produce adduction. D) The palmar interossei and lumbricals can produce adduction of the fingers, whereas the dorsal interossei can produce abduction. E) The dorsal interossei and lumbricals can produce abduction of the fingers, whereas the palmar interossei can produce adduction.

A) The palmar interossei, dorsal interossei, and lumbricals together can produce flexion at the metacarpophalangeal joints and extension at the interphalangeal joints.

20. Which of the following is incorrect pertaining to the neurovascular supply of the vertebral column? A) The vertebral bodies are supplied exclusively by the anterior and posterior spinal arteries. B) Venous drainage is to both internal (within the vertebral canal) and external venous plexuses. C) Zygapophyseal joints are supplied by medial branches of posterior rami of spinal nerves. D) Pain fibers from the ligamentum flavum are conveyed by (recurrent) meningeal branches of spinal nerves. E) Proprioceptive fibers from the anterior longitudinal ligament are conveyed by (recurrent) meningeal branches of spinal nerves.

A) The vertebral bodies are supplied exclusively by the anterior and posterior spinal arteries.

13. Which of the following is incorrect pertaining to IV discs? A) They are traversed by blood vessels that are branches of the anterior and posterior spinal arteries. B) They differ in thickness in different parts of the vertebral column. C) Cervical and lumbar discs are thicker anteriorly than posteriorly. D) The nucleus pulposus is primarily composed of water. E) The annulus fibrosus is composed of concentric lamellae of fibrocartilage.

A) They are traversed by blood vessels that are branches of the anterior and posterior spinal arteries.

4. A motor unit: A) contains fewer muscle fibers in muscles that perform precise movements compared to those that perform gross movements. B) refers to all the nerves that innervate a muscle. C) refers to all the muscles that perform a single movement at a joint (e.g., synergistic muscles at the elbow). D) refers to all the fibers entering a dorsal root (spinal) ganglion at a particular spinal level. E) refers to all the nerve fibers innervating a particular muscle within a peripheral nerve.

A) contains fewer muscle fibers in muscles that perform precise movements compared to those that perform gross movements.

2. Upon examining a radiograph of a skull, you notice an extra bone within the sagittal suture. Your immediate reaction is to: A) dismiss the finding because there are often small sutural (wormian) bones within skull sutures that have no clinical significance. B) request a head CT because these bones often develop after head injuries and can be associated with seizures. C) assume that your patient had a vitamin D deficiency during childhood. D) assume that your patient had a fontanelle that remained open beyond the normal period. E) assume that your patient has a minor case of hydrocephalus.

A) dismiss the finding because there are often small sutural (wormian) bones within skull sutures that have no clinical significance.

31. Elbow tendonitis (tennis elbow) is associated with: A) inflammation of the periosteum of the lateral epicondyle of the humerus. B) inflammation of the medial collateral ligament. C) inflammation of the annular ligament. D) rupture of the tendon of the extensor digitorum. E) transient subluxation of the humero-radial-ulnar joint.

A) inflammation of the periosteum of the lateral epicondyle of the humerus.

21. The following lateral radiograph of the thoracic part of the vertebral column is from a patient with severe osteoporosis. Which of the following conditions does it demonstrate? A) kyphosis B) scoliosis C) lordosis D) IV disc herniation E) vertebral body hypertrophy

A) kyphosis

8. Fusion of the diaphysis with the epiphysis: A) occurs at different ages for different long bones. B) is evident radiologically throughout life. C) is a permanent weak spot in bones. D) is technically a symphysis. E) only occurs in bones of the skull.

A) occurs at different ages for different long bones.

4. In the following image of a lateral radiograph of the cervical part of the vertebral column, the arrow points to a fracture of the: A) pars interarticularis of the axis (hangman's fracture). B) posterior arch of the atlas. C) lamina of the atlas. D) spinous process of C3. E) occipital condyles.

A) pars interarticularis of the axis (hangman's fracture).

19. Which of the following associations pertaining to the brachial plexus is incorrect? A) pre-fixed brachial plexus—compression of inferior trunk by 1st rib B) wounds in the posterior triangle of the neck—brachial plexus injuries C) acute brachial plexus neuritis—severe onset of shoulder pain D) hyperabduction syndrome—paresthesia E) inferior brachial plexus injuries—clawhand

A) pre-fixed brachial plexus—compression of inferior trunk by 1st rib

9. The trapezius can perform all of the following functions except: A) protract the scapula. B) retract the scapula. C) elevate the scapula. D) depress the scapula. E) rotate the scapula.

A) protract the scapula.

17. In the following radiograph of the wrist, the arrow points to the: A) scaphoid. B) lunate. C) pisiform. D) articular disc. E) capitate.

A) scaphoid.

16. Which of the following is incorrect pertaining to the lymphatic system? A) It provides a means by which extracellular fluid can be drained back into the venous circulation. B) All lymph from the body enters the venous circulation via the thoracic duct. C) It provides a pathway for spread of carcinoma. D) Blockage often results in edema of the affected region. E) In lymphangitis, red streaks can appear in the skin.

B) All lymph from the body enters the venous circulation via the thoracic duct.

20. Which of the following reasons best explains why it is easier to do a "chin-up" (hands supinated) than a "pull-up" (hands pronated)? A) Because the brachialis is a less-effective elbow flexor in the pronated position. B) Because the biceps is a less-effective flexor in the pronated position. C) Because the brachioradialis is a less-effective flexor in the pronated position. D) Because the long digital flexors can better assist with elbow flexion in the supinated position. E) Because the humero-radial-ulnar joint is better aligned in the supinated position.

B) Because the biceps is a less-effective flexor in the pronated position.

44. Which of the following is incorrect pertaining to carpal tunnel syndrome? A) It may involve weakness in the thenar muscles. B) It may involve anesthesia of the central palm. C) It may involve paresthesia in the lateral 3½ digits. D) It may be caused by inflammation of the synovial sheaths of the flexor tendons. E) Surgical transection of the flexor retinaculum typically relieves its associated symptoms.

B) It may involve anesthesia of the central palm.

23. Which of the following is incorrect pertaining to radiology? A) CT scans should be viewed as if you were standing at the feet end of a bed of a supine patient. B) Ultrasonography of the pelvic viscera is facilitated by an empty bladder. C) MRI is based on magnetic signals transmitted by protons within body structures. D) Nuclear magnetic imaging requires the intravenous administration of radioactive material. E) PET scans can reveal the activation of specific regions of the brain.

B) Ultrasonography of the pelvic viscera is facilitated by an empty bladder.

7. Lumbar spinal stenosis refers to: A) a narrowing of the lumbar intervertebral foramina. B) a narrowing of the vertebral (spinal) canal in one or more of the lumbar vertebrae. C) a congenitally restricted dural sheath in the lumbar region. D) osteoporotic changes in the lumbar bodies that reduce lumbar movements. E) progressive abnormal shortening of the lumbar spinous processes resulting in extreme lordosis.

B) a narrowing of the vertebral (spinal) canal in one or more of the lumbar vertebrae.

22. You examine a baseball pitcher who complains of weakened elbow flexion and has a rounded soft protuberance on the anterior surface of the distal part of his arm. Your most likely diagnosis is: A) a damaged musculocutaneous nerve in association with a "pulling" of the coracobrachialis. B) a ruptured long head of biceps tendon. C) a ruptured short head of biceps tendon. D) a ruptured brachialis tendon. E) an elbow dislocation.

B) a ruptured long head of biceps tendon.

12. The arrow in the following radiograph points to the: (process above the colored region) A) clavicle. B) acromion process. C) coracoid process. D) superior angle of scapula. E) superior part of glenoid fossa.

B) acromion process.

16. Typically, cervical disc herniation: A) results from forcible hyperextension. B) affects the spinal nerve exiting at the level of the affected disc (C5 nerve affected with C4/C5 disc herniation). C) is associated with vertebral body fracture. D) is associated with osteoarthritis of the facet joints. E) is associated with rupture of the ligamentum flavum.

B) affects the spinal nerve exiting at the level of the affected disc (C5 nerve affected with C4/C5 disc herniation).

23. The denticulate ligaments: A) anchor the dural sac to the walls of the vertebral canal. B) anchor the spinal cord to the dural sac. C) are composed of arachnoid matter. D) are composed of dura matter. E) attach to the filum terminale.

B) anchor the spinal cord to the dural sac.

45. A laceration of the thenar eminence that results in complete section of the recurrent branch of the median nerve would result in: A) claw hand. B) ape hand. C) loss of all ability to abduct the thumb. D) loss of all ability to adduct the thumb. E) loss of all ability to flex the metacarpophalangeal joint of the thumb.

B) ape hand.

9. During vertebral ossification, the costal elements in the cervical region: A) become part of the spinous processes. B) become part of the transverse processes. C) become part of the vertebral arch. D) never develop. E) degenerate.

B) become part of the transverse processes.

25. What muscle attaches at the radial tuberosity? A) brachialis B) biceps brachii C) pronator teres D) brachioradialis E) anconeus

B) biceps brachii

3. In the emergency room you see a 65-year-old woman who fell on her outstretched right hand while walking on ice. Upon examination of the right limb, you feel and see a dorsal protrusion just proximal to the wrist. You suspect a: A) fractured lunate. B) fractured distal radius (Colles fracture). C) mid-radial fracture. D) dislocated first carpometacarpal joint. E) dislocated midcarpal joint.

B) fractured distal radius (Colles fracture).

9. Osteoarthritis: A) develops from osteoporosis. B) is associated with a loss of articular cartilage. C) primarily affects non-weight bearing joints. D) is associated with a reduction in vascular supply to a joint. E) results in joints that are hypermobile.

B) is associated with a loss of articular cartilage.

13. Arteriosclerosis: A) is associated with increased elasticity of arterial walls. B) is associated with ischemia. C) occurs in venules. D) is most significant clinically in collateral arteries. E) only occurs in vessels supplying the heart.

B) is associated with ischemia.

14. The cervicoaxillary canal: A) forms the base of the axilla. B) is bounded by the first rib, clavicle, and superior edge of the scapula. C) conducts the subclavian artery. D) leads to the quadrangular space. E) is occluded in a shoulder dislocation.

B) is bounded by the first rib, clavicle, and superior edge of the scapula.

8. Following a left radical mastectomy, a woman is unable to abduct her arm more than 90 degrees. Which of the following structures do you suspect was injured during the surgical procedure? A) dorsal scapular nerve B) long thoracic nerve C) suprascapular nerve D) serratus posterior superior muscle E) rotator cuff component of the shoulder joint capsule

B) long thoracic nerve

2. Following an avulsion fracture of the greater tubercle of the humerus, the humerus would primarily be: A) laterally rotated. B) medially rotated. C) abducted. D) flexed. E) extended.

B) medially rotated.

1. In the following lateral radiograph of the thoracic part of the vertebral column, the arrow points to the: A) head of a rib. B) pedicle of vertebra. C) superior articular facet. D) lamina of vertebrae. E) spinal nerve.

B) pedicle of vertebra.

27. The rotatores: A) have a relatively large mechanical advantage for producing trunk rotation. B) possibly function primarily as "kinesiological monitors" or organs of proprioception. C) are part of the erector spinae group of muscles. D) are attached to the transverse processes of a pair of consecutive vertebrae. E) when acting bilaterally, can produce trunk flexion.

B) possibly function primarily as "kinesiological monitors" or organs of proprioception.

40. Opposition of the thumb: A) primarily involves rotation at the 1st metacarpophalangeal joint. B) primarily involves contraction of a muscle that lies deep to the abductor pollicis brevis. C) primarily involves contraction of a muscle that is innervated by the ulnar nerve. D) is a movement that requires lateral rotation of the thumb. E) is a movement that requires flexion of the thumb's interphalangeal joint.

B) primarily involves contraction of a muscle that lies deep to the abductor pollicis brevis.

5. A coronal knife cut through the head could potentially: A) separate the lobule of the outer ear (auricle) from the rest of the auricle. B) separate the tip of the nose from the rest of the nose. C) separate the entire outer ear (auricle) from the head. D) separate the brain from the spinal cord. E) separate one nostril from the other.

B) separate the tip of the nose from the rest of the nose.

2. In the following AP radiograph of the inferior thoracic and lumbosacral parts of the vertebral column, the arrow points to the: A) spinous process of L3. B) spinous process of L4. C) spinous process of L5. D) median sacral crest. E) lamina of L5.

B) spinous process of L4.

46. You examine a patient who is an avid bicycle rider. He complains of sensory loss on the medial side of his hands and you find some weakness in his intrinsic hand muscles, but not in any other muscle group. You suspect that: A) the patient used a hand posture that put excessive pressure on the superficial branch of his radial nerve. B) the patient used a hand posture that put excessive pressure on his ulnar nerve. C) repetitive wrist flexion and extension that occurred with braking caused swelling of the patient's long flexor tendons at the wrist. D) the patient's flexed trunk but extended neck posture during riding stressed his neck vertebrae so that osteophytes developed reducing the size of his C8/T1 intervertebral foramen. E) the patient probably has a cervical rib and that extended periods in the riding position resulted in inflammation around the nerves surrounding this structure.

B) the patient used a hand posture that put excessive pressure on his ulnar nerve.

33. The carpal bone just below the thumb is: A) scaphoid. B) trapezium. C) triquetrum. D) pisiform. E) epiphysis of the first metacarpal.

B) trapezium.

27. You are assisting in the emergency room when the attending physician examines a patient after an elbow injury. The physician holds the proximal interphalangeal joint of the little finger and asks the patient to flex the distal phalanx. This procedure tests the functionality of what nerve? A) radial B) ulnar C) median D) posterior interosseous E) anterior interosseous

B) ulnar

10. In which of the following activities would the latissimus dorsi be least important? A) using the crawl stroke while swimming B) using the backstroke while swimming C) using the breaststroke while swimming D) performing a chin-up E) paddling a canoe

B) using the backstroke while swimming

22. Which of the following is incorrect pertaining to plain radiographs? A) In a PA projection the x-rays traverse the patient from posterior to anterior. B) To minimize distortion the region of the body being examined should be as close as possible to the x-ray film or detector. C) Compact bone appears white on a radiograph because bone is relatively radiolucent. D) Enhancement of the visibility of certain structures on radiographs is facilitated by having the patient ingest a barium-containing compound. E) Standard chest radiographs should be viewed as if you were facing the patient.

C) Compact bone appears white on a radiograph because bone is relatively radiolucent.

7. Which of the following is incorrect pertaining to a fracture of a bone? A) The fracture should be "reduced" to heal properly. B) A collar of bone (callus) forms to hold the bones together while healing. C) Greenstick fractures are most common in the elderly. D) Osteoporotic bones break more easily than normal bones. E) Tearing of the periosteum accounts for the acute pain associated with fracture.

C) Greenstick fractures are most common in the elderly.

15. Which of the following is incorrect pertaining to the axillary vein? A) If lacerated in the axilla, there is a risk of producing an air embolus. B) It is the vessel that is actually punctured in a typical "subclavian" vein puncture for catheter insertion. C) It lies deep to the axillary artery as the vessels cross the 1st rib. D) It is formed by the union of the brachial and basilic veins. E) It may receive blood from the inguinal region of the body.

C) It lies deep to the axillary artery as the vessels cross the 1st rib.

34. What is the clinical significance of a superficial ulnar artery? A) It often compresses the median nerve in the arm, producing paresthesia and muscle weakness. B) It is often pinched during elbow flexion, producing mild ischemia in the forearm muscles. C) Its superficial course in the cubital fossa results in it being mistakenly used for venipuncture. D) Its caliber is typically smaller than the normal ulnar artery and, under compromising situations, may be unable to provide sufficient blood to the hand. E) It accompanies the median nerve in the forearm and passes deep to the flexor retinaculum, resulting in hand ischemia in any patient suffering from carpal tunnel syndrome.

C) Its superficial course in the cubital fossa results in it being mistakenly used for venipuncture.

3. Which of the following is incorrect pertaining to joints? A) They receive blood from vessels surrounding the joint. B) Most articular nerves are branches of the nerves to the muscles that cross the joint. C) Loss of nerve supply results in avascular necrosis of the joint. D) Some joints do not permit any movement. E) Joint nerves transmit proprioceptive information.

C) Loss of nerve supply results in avascular necrosis of the joint.

6. Which of the following is incorrect pertaining to the thoracic part of the vertebral column? A) includes the most frequently fractured vertebra B) presence of costal facets C) Most vertebrae have horizontal spinous processes. D) articular facets that are most effective at limiting flexion E) Inferior vertebrae have mammillary processes.

C) Most vertebrae have horizontal spinous processes.

20. Which of the following is incorrect pertaining to the sympathetic motor system? A) It consists of preganglionic and postganglionic neurons. B) Postganglionic neurons typically liberate norepinephrine. C) Preganglionic fibers pass through both the "white" and "gray" rami. D) It contains fibers that reach viscera using splanchnic nerves. E) It facilitates sweating.

C) Preganglionic fibers pass through both the "white" and "gray" rami.

14. Which of the following is correct pertaining to the longitudinal ligaments of the vertebral column? A) Both tend to limit hyperflexion. B) Both tend to limit hyperextension. C) The anterior limits hyperextension whereas the posterior limits hyperflexion. D) The anterior limits hyperflexion whereas the posterior limits hyperextension. E) Both limit lateral flexion.

C) The anterior limits hyperextension whereas the posterior limits hyperflexion.

16. Which of the following is incorrect pertaining to lymphatic drainage of the upper limb? A) The apical axillary lymph nodes receive lymph from all the other axillary groups. B) The axillary nodes may be enlarged in breast cancer. C) The left humeral (lateral) axillary nodes receive lymph from both upper limbs. D) Metastatic spread to the axillary nodes may require excision of part of the axillary vein. E) Removal of the axillary nodes may result in lymphedema of the upper limb.

C) The left humeral (lateral) axillary nodes receive lymph from both upper limbs.

14. The leg depicted below is characterized by: A) insufficient arterial supply. B) loss of muscle tone. C) varicose veins. D) muscle atrophy. E) hypertrophy of epidermal cells.

C) Varicose veins

12. Spina bifida cystica refers to a congenital anomaly characterized by: A) an asymptomatic bifurcation of the cauda equina. B) a division of the L5 vertebral body that is often associated with sciatica. C) a developmental defect of one more lumbar vertebral arches that may be associated with limb paralysis and deficiencies in bowel/bladder control. D) an abnormal division of spinal nerves so that lower limb movement control is disturbed. E) the spinous processes of all of the presacral vertebral column being bifid.

C) a developmental defect of one more lumbar vertebral arches that may be associated with limb paralysis and deficiencies in bowel/bladder control.

24. The image below represents: A) a plain radiograph. B) a CT scan. C) a nuclear medicine scan. D) an MRI scan. E) a myelogram.

C) a nuclear medicine scan.

30. The ridge indicated by the arrow in the following photograph overlies the tendon of which of the following muscles? A) extensor pollicis longus B) extensor pollicis brevis C) abductor pollicis longus D) abductor pollicis brevis E) first dorsal interossei

C) abductor pollicis longus

6. In the following axial MRI through the distal third of the arm, the brachial artery is labeled number 1 (see thin leader line on image). What is the structure indicated by the arrow? A) ulnar artery B) radial nerve C) cephalic vein D) short head of biceps tendon E) basilic vein

C) cephalic vein

7. You observe a physician perform a muscle test by having the patient abduct her arm 90 degrees and move the arm forward against resistance. What muscle (or part of a muscle) is the physician testing? A) middle deltoid B) subscapularis C) clavicular head of pectoralis major D) sternocostal head of pectoralis major E) serratus anterior

C) clavicular head of pectoralis major

42. In the following angiogram of the wrist and hand, the arrow points to the: A) ulnar artery. B) radial artery. C) deep branch of the ulnar artery. D) superficial branch of the radial artery. E) princeps pollicis artery.

C) deep branch of the ulnar artery.

5. In the following AP radiograph of the mouth and upper cervical part of the vertebral column, the arrow A points to the: A) uvula. B) spinous process of C3. C) dens (odontoid) process of C2 (axis). D) anterior tubercle of C1 (atlas). E) canine tooth.

C) dens (odontoid) process of C2 (axis).

6. Circumduction is a combination of which of the following movements? A) flexion and extension B) flexion and rotation C) flexion, extension, adduction, abduction D) abduction, adduction, medial rotation, lateral rotation E) flexion, extension, medial rotation, lateral rotation

C) flexion, extension, adduction, abduction

21. The ridge indicated by the arrow in the following photograph overlies the tendon of which of the following muscles? A) palmaris longus B) palmaris brevis C) flexor carpi radialis D) flexor digitorum superficialis E) abductor pollicis longus

C) flexor carpi radialis

36. Which of the following would not be associated with a complete section of the ulnar nerve at the wrist? A) inability to abduct the little finger B) inability to grasp a piece of paper between the extended 4th and 5th digits C) inability to flex the metacarpophalangeal joint while extending interphalangeal joints of the 2nd digit D) clawhand E) loss of all sensation on the palmar aspect of the little finger

C) inability to flex the metacarpophalangeal joint while extending interphalangeal joints of the 2nd digit

38. In the following coronal MRI of the hand, the arrow points to the: A) lumbrical. B) palmaris brevis. C) interossei. D) tendon of flexor digitorum profundus. E) tendon of extensor digitorum.

C) interossei.

26. The brachioradialis: A) has a tendon that passes deep to the flexor retinaculum. B) attaches to the medial epicondyle of the humerus. C) is innervated by the radial nerve. D) acts at both the elbow and wrist joints. E) extends the elbow.

C) is innervated by the radial nerve.

24. One of your patients is about to undergo emergency surgery to repair an upper abdominal aortic aneurysm. You explain to your patient that there is a distinct risk that when he awakes from surgery, the lower half of his body will be paralyzed. The most likely reason for this is that: A) the anesthesiologist will incorrectly inject the anesthetic fluid into the spinal cord instead of into the lumbar cistern. B) the surgeon will accidentally cut into the spinal cord. C) ligation of the aorta will interrupt blood flow to the great anterior medullary artery (of Adamkiewicz). D) access to the aorta requires partial transaction of the lumbosacral trunk. E) during surgery venous thrombosis may result in a stroke.

C) ligation of the aorta will interrupt blood flow to the great anterior medullary artery (of Adamkiewicz).

12. A concentric muscle contraction: A) occurs when a muscle exerts a force and lengthens. B) is an isometric contraction. C) occurs when a muscle exerts a force and shortens. D) only occurs in limb muscles. E) occurs only in smooth muscle.

C) occurs when a muscle exerts a force and shortens.

11. The following lateral view MRI of the lumbosacral part of the vertebral column shows: A) a fracture of the vertebral body at L5. B) a fracture of the sacrum. C) spondylolisthesis. D) sacral movement associated with parturition. E) separation of the sacroiliac ligament.

C) spondylolisthesis.

19. Excessive lumbar lordosis is associated with all of the following except: A) pregnancy. B) obesity. C) unequal limb length. D) "hollow back." E) anterior rotation of the pelvis.

C) unequal limb length.

1. Which of the following is incorrect pertaining to the clavicle? A) It is attached via ligaments to the coracoid process. B) The superior surface is grooved for the subclavian artery. C) After a fracture, the medial segment is raised by the sternocleidomastoid muscle. D) Fractures are almost always accompanied by acromioclavicular dislocation. E) Patients with fractured clavicles typically need to support the ipsilateral upper limb with the contralateral one.

D) Fractures are almost always accompanied by acromioclavicular dislocation.

8. Which of the following is incorrect pertaining to the sacrum? A) It articulates with the L5 vertebra at the lumbosacral angle. B) It articulates with the coccyx at its apex. C) Its sacral hiatus leads to the sacral canal. D) Its cornua articulate with the inferior articular facets of the L5 vertebra. E) It articulates with the ilium at the auricular surface.

D) Its cornua articulate with the inferior articular facets of the L5 vertebra.

29. Which of the following statements is incorrect pertaining to the extensors carpi radialis longus and brevis muscles? A) When only the two muscles act together, wrist extension and abduction is produced. B) When the two muscles act with the extensor carpi ulnaris, only wrist extension is produced. C) When the two muscles act with the flexor carpi ulnaris, only wrist abduction is produced. D) One of the muscles is innervated by the ulnar and the other by the deep branch of the radial nerve. E) Both attach to the humerus.

D) One of the muscles is innervated by the ulnar and the other by the deep branch of the radial nerve.

47. Which of the following relationships at the wrist is incorrect? A) The median nerve lies deep to the tendon of the palmaris longus. B) The ulnar artery and nerve lie lateral to the tendon of the flexor carpi ulnaris. C) The radial artery can be compressed against the radius. D) The radial artery lies medial to the tendon of the flexor carpi radialis. E) The scaphoid can be palpated in the floor of the anatomical snuffbox.

D) The radial artery lies medial to the tendon of the flexor carpi radialis.

32. Which of the following is incorrect pertaining to the anatomic "snuffbox"? A) It is bounded anteriorly by the tendons of abductor pollicis longus and extensor pollicis brevis. B) It is bounded posteriorly by the tendon of extensor pollicis longus. C) The radial artery traverses its floor. D) The superficial branch of the radial nerve emerges from it. E) The radial styloid process can be palpated within it.

D) The superficial branch of the radial nerve emerges from it.

18. A dermatome is: A) all of the muscles innervated by a peripheral nerve. B) all of the skin innervated by a peripheral nerve. C) all of the muscles innervated by a single spinal nerve. D) all of the skin innervated by a single spinal nerve. E) all of the skin overlying a group of synergistic muscles.

D) all of the skin innervated by a single spinal nerve.

24. What is the correct order of structures in the cubital fossa from lateral to medial? A) brachial artery, median nerve, biceps tendon B) brachial artery, biceps tendon, median nerve C) median nerve, brachial artery, biceps tendon D) biceps tendon, brachial artery, median nerve E) biceps tendon, median nerve, brachial artery

D) biceps tendon, brachial artery, median nerve

11. Which of the following associations is incorrect? A) repetitive strenuous exercise—hypertrophy of skeletal muscle B) smooth muscle in uterus during pregnancy—hyperplasia of muscle cells C) testing of muscle activity—electromyography D) cardiac muscle—regenerates after a heart attack E) muscle testing—diagnosis of nerve injury

D) cardiac muscle—regenerates after a heart attack

25. In the following myelogram, the drawn "loop" encircles the: A) filum terminale. B) conus medullaris. C) body of L3. D) cauda equina. E) sympathetic trunk.

D) cauda equina.

11. Following a knife wound to the neck, you notice that the medial border of a patient's left scapula is located further from the midline than that of his right scapula. The nerve most likely injured by the wound is the: A) long thoracic. B) thoracodorsal. C) suprascapular. D) dorsal scapular. E) spinal accessory.

D) dorsal scapular.

18. While driving under the influence of alcohol, one of your patients hit a streetlight head-on at 50 mph. There is some concern that she injured her vertebral column. As a result of this accident, which of the following injuries would be most likely? A) fracture of the facet joints at C3/C4 B) fracture of the facet joints at T12/L1 C) fracture of the facet joints at L5/S1 D) fracture of the body of T12 E) dislocation of C3 on C4

D) fracture of the body of T12

21. The parasympathetic system: A) is a lumbosacral outflow system. B) has a greater distribution than the sympathetic system. C) causes reduced blood flow to the limbs in cold conditions. D) has relatively short postganglionic neurons compared to the sympathetic system. E) is associated with fibers that convey pain from the limbs.

D) has relatively short postganglionic neurons compared to the sympathetic system

26. The semispinalis capitis: A) is part of the erector spinae group of muscles. B) when acting unilaterally, rotates the head so that the face points to the ipsilateral side. C) when acting bilaterally, flexes the neck. D) is innervated by cervical and upper thoracic posterior rami. E) is superficial to the splenius capitis.

D) is innervated by cervical and upper thoracic posterior rami.

5. The cephalic vein: A) becomes the brachial vein. B) becomes the axillary vein. C) originates on the medial side of the dorsal venous network at the wrist. D) pierces the clavipectoral fascia. E) empties into the subclavian vein.

D) pierces the clavipectoral fascia.

23. You examine a patient with a horizontal, posterior, mid-humeral knife wound that reaches the bone. In addition to the muscular lesions, you expect the injury severed the: A) ulnar nerve and superior ulnar collateral artery. B) ulnar nerve and deep artery of the arm. C) radial nerve and humeral nutrient artery. D) radial nerve and deep artery of the arm. E) median nerve and brachial artery.

D) radial nerve and deep artery of the arm.

37. "Wrist-drop" is associated with: A) unopposed action of the lumbricals and interossei. B) rupture of the extensor digitorum. C) avulsion of the olecranon. D) section of the radial nerve at the mid-humeral level. E) section of the superficial branch of the radial nerve.

D) section of the radial nerve at the mid-humeral level.

15. Which of the following is incorrect pertaining to herniation of the nucleus pulposus? A) usually occurs posterolaterally B) may produce lumbago C) may produce sciatica D) tends to occur acutely in an elderly person E) typically occurs at or near the lumbosacral junction

D) tends to occur acutely in an elderly person

43. You examine a patient who has a condition in which each time his index finger is flexed and extended, there is an audible "snap." Which of the following is the likely cause of this "trigger finger?" A) infection in the midpalmar space B) osteoarthritis of the metacarpophalangeal joint C) carpal tunnel syndrome D) thickening of the fibrous digital sheath and swelling of the flexor tendons E) calcification of the origin of the lumbrical muscle

D) thickening of the fibrous digital sheath and swelling of the flexor tendons

4. Which of the following is incorrect pertaining to the scaphoid? A) It articulates with the radius. B) It is the most frequently fractured carpal bone. C) Fracture is accompanied by pain along the lateral side of the wrist. D) A complication associated with fracture is avascular necrosis. E) It attaches to the flexor retinaculum.

E) It attaches to the flexor retinaculum.

28. Which of the following is incorrect pertaining to the pronator quadratus? A) It is innervated by the anterior interosseous branch of the median nerve. B) It is the prime mover for pronation. C) It initiates the movement of pronation. D) It helps maintain the integrity of the interosseous membrane between the radius and ulna when upward thrusts are transmitted through the wrist. E) It can be palpated by deeply pressing an index finger two-thirds of the proximal-distal length of the forearm, at the middle of its ventral surface.

E) It can be palpated by deeply pressing an index finger two-thirds of the proximal-distal length of the forearm, at the middle of its ventral surface.

22. Which of the following is incorrect pertaining to the lumbar cistern? A) It contains CSF. B) It contains the cauda equina. C) It contains the internal filum terminale. D) It typically begins in adults at L2. E) It contains epidural fat.

E) It contains epidural fat.

28. Which of the following is incorrect pertaining to the vertebral artery? A) It traverses the transverse foramina of the cervical vertebrae. B) If partially occluded, it can cause dizziness upon turning the head. C) It traverses the suboccipital triangle. D) It traverses a groove on the posterior arch of the atlas. E) It only has branches that supply the brain.

E) It only has branches that supply the brain.

15. The system by which nutrient-rich blood passes from the capillary beds of the alimentary tract to the capillary beds (sinusoids) of the liver is an example of: A) an arteriovenular anastomosis. B) a lymphatic network. C) a double-flow system. D) a double-absorption system. E) a portal venous system.

E) a portal venous system.

39. Dupuytren contracture refers to: A) an abnormal spasticity in the flexor digitorum profundus tendons. B) an abnormal spasticity in the flexor pollicis longus tendons. C) a tightening of the flexor retinaculum that results in carpal tunnel syndrome. D) a tightening of the anterior skin of the hand, resulting in reduced mobility and an increase depth in the skin creases. E) a shortening and thickening of the palmar fascia of the hand, resulting in partial flexion of the digits.

E) a shortening and thickening of the palmar fascia of the hand, resulting in partial flexion of the digits.

3. Which of the following is incorrect pertaining to typical cervical vertebrae? A) nearly horizontal articular facets B) most mobile region of the vertebral column C) presence of transverse foramina D) presence of uncinate processes E) dislocations that are always associated with spinal cord damage

E) dislocations that are always associated with spinal cord damage

17. Which one of the following associations is incorrect? A) tectorial membrane—superior continuation of the posterior longitudinal ligament B) cruciate (cruciform) ligament—composed of the transverse ligament of the atlas and the longitudinal bands C) rupture of the transverse ligament of the atlas—atlantoaxial subluxation D) rupture of the alar ligaments—increased range in head movements E) fracture of the dens—anterior dislocation of C3-C5 vertebrae

E) fracture of the dens—anterior dislocation of C3-C5 vertebrae

17. The central nervous system: A) consists of the sympathetic and parasympathetic systems. B) typically recovers (slowly) from injury via renewed growth and reconnection of the damaged neurons. C) consists of the brain and the 12 cranial nerves. D) consists of the brain, spinal cord, and the 12 cranial nerves. E) is separated from cerebrospinal fluid by the pia mater.

E) is separated from cerebrospinal fluid by the pia mater.

35. Which of the following would not be associated with a complete section of the median nerve at the elbow? A) inability to flex both the proximal and the distal interphalangeal joints of digits 2 and 3 B) atrophy of thenar eminence muscles C) greatly weakened pronation D) loss of sensation on the lateral aspect of the palmar surface of the hand E) loss of ability to adduct the thumb

E) loss of ability to adduct the thumb

10. Which of the following associations is incorrect? A) saddle joint—carpometacarpal joint of the thumb B) condyloid joint—permit circumduction C) ball and socket joint—hip joint D) plane joint—acromioclavicular joint E) pivot joint—biaxial joint

E) pivot joint—biaxial joint

19. Transecting an anterior (ventral) root of a spinal nerve (rhizotomy) might be recommended to: A) relieve muscle weakness. B) reduce severe limb pain. C) increase heart rate. D) reduce lymph flow. E) reduce excessive muscle tone (spasticity).

E) reduce excessive muscle tone (spasticity).

48. Scapulohumeral rhythm refers to: A) the changing articular configuration of the humeral head in the glenoid cavity with movement. B) the protective contractions of the rotator cuff muscles with humeral abduction. C) the protractive and retractive movements of the scapula that occur with humeral flexion and extension. D) the association between the movements at the glenohumeral and acromioclavicular joints. E) the relationship between movements at the glenohumeral and scapulothoracic "joints" during humeral abduction.

E) the relationship between movements at the glenohumeral and scapulothoracic "joints" during humeral abduction.

18. In the emergency room you examine a patient who was thrown from a motorcycle in such a way that, upon landing, his neck and shoulder were widely separated. Which of the following would not be consistent with your suspicion that he is suffering from Erb-Duchenne palsy? A) medially rotated arm at rest B) weak shoulder abduction C) weak elbow flexion D) sensory loss on lateral aspect of arm E) weak digital flexion

E) weak digital flexion