Year 2 Anatomy quiz questions

25 y/o male is stabbed in the right arm near the axilla. His ulnar nerve is completely cut. Of the movements below, which would be most greatly affected? A) adduction of the thumb B) abduction of the thumb C) extension of the thumb D) extension of the index finger E) opposition of the thumb

A

32 y/o woman presents with laceration wound in her mid forearm on the anterior side. What is the most appropriate exam to evaluate nerve function? A) ask pt to abduct & adduct fingers to check ulnar nerve B) ask pt to flex her interphalanx joints of the fingers to check radial nerve C) ask pt to oppose her tip of thumb to the tip of other fingers to check ulnar nerve D) ask for extension of the wrist to check for radial nerve

A

39 y/o complains of pain in right arm. Tingling and numbness in little finger and ring finger of right hand. Area of pain in limb is localised to medial side of the arm and forearm and ulnar side of the hand. General muscle strength in the right extremity is less than in the left, and there is particular weakness of opposition and adduction of the right thumb. Wasting of the right hypothenar and thenar eminence is evident, and patient cannot hold a piece of paper between index and middle finger. Most likely site of injury A) lower trunk of brachial plexus B) upper trunk of brachial plexus C) posterior cord of brachial plexus

A

A lesion of the posterior limb of the internal capsule on the right may result in: A) transcortical apraxia B) a drooping of the corner of the mouth on the right C) retrograde amnesia

A

Where would you find the cell bodies of preganglionic sympathetic neurons? A) Interomediolateral cell column of the thoracic spinal cord B) Prevertebral ganglia C) Medulla oblongata D) Lateral horn of the sacral spinal cord E) Paravertebral ganglai

A

Which of the following, from lateral to medial, describes the order of the contents in the cubital fossa? A) tendon of biceps brachii, brachial artery, median nerve B) tendon of biceps brachii, brachial artery, radial nerve C) tendon of brachialis, brachial artery, median nerve

A

Which of the following is correct regarding the boundaries of the anatomical snuffbox? A) Ulnar border: tendon of extensor pollicis longus; radial border: tendons of abductor pollicis longus and extensor pollicis brevis B) Ulnar border: tendon of extensor pollicis longus; radial border: tendons of adductor pollicis longus and extensor pollicis brevis C) Radial border: tendon of extensor pollicis longus; ulnar border: tendons of abductor pollicis longus and extensor pollicis brevis

A (big one is extensor pollicis longus on ulnar side)

A 55 y/o man died following an accident. During autopsy, specimen of his brain revealed a possible right acoustic neuroma. His wife mentioned her husband was suffering from hearing loss, tinnitus, vertigo and unsteady gait. In addition to the VIII nerve, which other structures might be also affected in such a case? A) facial nerve B) anterior inferior cerebellar artery C) trochlear nerve D) posterior inferior cerebellar artery E) substantia nigra

A (facial & vestibulocochlear run together)

At the level of L5 on a standard AP radiograph, where do the ureters course inferiorly along?

A line joining the tips of the transverse process of the lower lumbar vertebrae

Your patient has suffered a stroke involving the posterior cerebral artery. You might expect the patient to exhibit: A) a homonymous hemianopsia with macular sparing B) bladder incontinence C) alexia (inability to recognise written words) with agraphia (inability to write) D) aculculia E) transcortical apraxia

A) a homonymous hemianopsia with macular sparing PCA supplies occipital lobe C is done by parietal and temporal lob D (calculations) is done by parietal lobe which is supplied by MCA

A patient has suffered a stroke caused by occlusion of the right anterior cerebral artery. This patient is most likely to present with: A) loss of pain and temperature sensations in the left leg B) weakness of the right leg C) drooping of the corner of the mouth on the left D) a non-fluent aphasia E) a loss of discriminative touch from the right side of the face

A) a loss of pain and temperature sensations in the left leg

Your patient has an apparent language problem in which his speech lacks rhythm and is reduced to the use of nouns and verbs in the wrong tense. He seems to hear and understand things that are said to him and can repeat single words but not a full sentence. The patient has right lower face weakness, and his right upper limb is weak. There are no sensory deficits. The language problem is most likely due to a : A) broca aphasia B) wernicke aphasia C) Gerstmann aphasia D) fluent aphasia E) sensory aphasia

A) broca aphasia Broca is motor speech area located in frontal lobe, Wernicke's is sensory speech area located in parietal and temporal lobe

Andy, 12 y/o boy, falls from bicycle and hits head. Initial exam in ED is normal, but later in the day he becomes noticeably lethargic. He is brought back to ED where he is too drowsy to answer the examiner's questions. His right pupil is 7mm and his left pupil is 4mm. Patellar tendons reflexes are brisker on left and Babinski sign elicited on the left. CT reveals a pool of blood has displaced the right temporal lobe to the left. The haematoma is evacuated and a blood vessel is cauterised. Through which opening did the lacerated blood vessel enter the cranial cavity? A) foramen spinosum B) stylomastoid foramen C) foramen lacerum D) Carotid canal E) jugular foramen

A) foramen spinosum (it's middle meningeal artery)

Branches of the external iliac artery include which of the following? a) inferior epigastric artery b) obliterated umbilical artery c) obturator artery d) superior gluteal artery e) uterine artery

A) inferior epigastric artery. All the others are internal iliac artery

Ovarian torsion: A) may occur secondary to an ovarian mass B) is usually painless C) demonstrates increased vascular flow on ultrasound D) is best assessed with CT

A) may occur secondary to an ovarian mass. Is incredibly painful, demonstrates decreased vascular flow on u/s and is best assessed using u/s

The coordination of the detrusor muscle and external sphincter occurs in the? a) pons b) midbrain c) medulla

A) pons

Which of the following statements about the colon is true? A) the ascending colon has no mesentery B) the hepatic flexure is supplied by inferior mesenteric artery C) the descending colon is intraperitoneal D) the sigmoid colon is retroperitoneal E) the transverse colon has no mesentery

A- ascending colon has no mesentery -The hepatic flexure is actually supplied by superior mesenteric artery -Descending colon is retroperitoneal -Sigmoid colon is intraperitoneal -Transverse colon does indeed have mesentery For retroperitoneal structures: SAD PUCKER S-Suprarenal glands A-Aorta & IVC D-Duodenum (2nd & 3rd parts) P-pancreas U-Ureters C-Colon (ascending & descending) K-Kidneys E-Esophagus R-Rectum

Which part of the rib is most likely to be broken in a patient with chest injury? a. Angle b. Anterior end c. Head d. Neck e. Tubercle

A. angle

To achieve less scar tissue, skin incisions should be made: a. Parallel to the tension lines b. Perpendicular to the tension lines c. Perpendicular to skin creases

A. parallel to tension lines

The segment of the transverse colon developed from the midgut is: a. Proximal 2/3rds of transverse colon b. Distal 2/rds of the transverse colon c. Distal 1/3rd of the transverse colon

A. proximal 2/3rds of transverse colon

The transverse colon is derived from both the midgut and hindgut; therefore, it receives blood supply from branches of the: a. Superior mesenteric & inferior mesenteric arteries b. Coeliac trunk and superior mesenteric artery c. Coeliac trunk and inferior mesenteric artery

A. superior mesenteric & inferior mesenteric arteries (foregut is coeliac trunk)

There are 4 main borders of the heart. Which of the following is most correct? a. Right border consists entirely of the right atrium b. Right border consists of entirely of the right ventricle c. The left border is mainly the left atrium

A. the right border consists entirely of the right atrium

With regards to the rule of nine, which of the following is true? a. Upper limb 9% b. Lower limb 9% c. Back of thorax & abdomen 9%

A. upper limb 9%

Where would a patient experience pain/tenderness with frontal sinusitis?

Above the eyes, forehead

What is the complication of a mastoid abscess if not treated properly?

Abscess can spread upward, eroding temporal bone leading to meningitis or brain abscess

Injury to the upper trunk of the left brachial plexus may result in: A) a pronated left forearm B) difficulty in adducting the left shoulder C) loss of muscle function of the intrinsic muscles of the left hand D) loss of sensation on the inner side of the arm and forearm E) loss of power in abducting the left shoulder

Affected nerves would be nerve to subclavius, suprascapular nerve, axillary and musculocutaneous nerve A) a pronated left forearm & E) loss of power in abducting left shoulder Upper trunk will result in patient looking like they want a tip (adducted arm, internally rotated, pronated forearm)

What are the afferent and efferent branches of the corneal reflex?

Afferent: trigeminal nerve (opthalmic branch) Efferent: facial nerve

A young male suffers a traumatic injury that lacerates the penile urethra. Urine leaks into the perineum. Where else might the extravasated urine be found?

Anterior abdominal wall

Which area of the nasal septum does epistaxis most commonly arise from?

Anterior area- Kiesselbach's plexus

A 35-year-old man is brought to the emergency room with lower extremity pain after he fell from his motorcycle. He also complains that his right foot cannot step on the road. Physical examination reveals swelling in the middle of the right leg, hematoma, no open wound, tenderness, palpable bone fragment, unpalpable dorsalis pedis artery. A pulse is palpable behind the medial and lateral malleolus. Which compartment of the lower limb is affected with high intra-compartment pressure? & which artery is deficit of blood flow?

Anterior compartment & tibialis anterior artery (because tibialis anterior artery gives rise to dorsalis pedis, posterior tibial can be felt behind medial malleolus & peroneal artery can be felt behind lateral malleolus)

Overextension of the knee joint is prevented by the action of what?

Anterior cruciate ligament

A woman wearing high heels falls and twists her ankle. Which structure was most likely stretched?

Anterior talofibular ligament

Which structures are endangered by erosion from a gastric ulcer?

Anterior ulcer wouldn't endanger anything Posterior ulcer endangers gastroduodenal artery,

Which structures pass through the opening of the diaphragm at T12?

Aorta, thoracic duct, azygous veins

How is CSF absorbed from the body?

Arachnoid granulations

Pudendal nerve origin & course?

Arises from sacral plexus S2-S4 Descends & passes between piriformis and ischiococygeus muscle. Leaves pelvis through greater sciatic foramen, crosses sacrospinous ligament and reneters pelvis through lesser sciatic foramen then goes through pudendal canal

At what landmark do the ureters cross the pelvic brim?

At the bifurcation of the common iliac artery

A man who uses tools for a living develops pain and parasthesia in the right hand at night. The altered sensation is most evident on the palmar aspect of index and middle fingers. What else are you likely to see?

Atrophy of the thenar eminence

Patient is unable to raise their right arm, it hangs limply by their side. The muscles covering the shoulder show significant wasting. Which nerve is affected?

Axillary nerve

The axillary nerve: A) arises from the brachial plexus via medial cord B) supplies latissimus dorsi C) passes between latissimus dorsi & teres major D) supplies teres minor E) none of the above

Axillary nerve arises from posterior cord, latissimus dorsi is supplied by thoracodorsal nerve, axillary nerve passes through teres minor & teres major D) supplies teres minor

A 30-year-old woman complains of tingling and slight pain in her right hand; localised in her thumb, index, middle and lateral side of ring finger. The symptoms are worse at night or if she overworks. She complains of weakness in her grasp. Also, movements of her right thumb are not as strong as before. On examination, there is loss of power on certain movements of the thumb. She has impaired appreciation of light touch and pin pricks to the thumb, index, middle and lateral side of her ring finger, but sensation to her palm is not affected. Pressure and tapping over the flexor retinaculum causes tingling. Which muscle will be weak in this case? A) Adductor pollicis B) Abductor pollicis brevis C) Extensor pollicis brevis D) Dorsal interossei E) Palmer interossei

B

A middle-aged widow complains of burning pain, numbness and tingling in the hands which wakes her at night. She is slightly obese and there is some hypothenar wasting in the left hand. Sensation is abnormal around the little finger and ring finger. Which of the following is the most likely diagnosis? A) carpal tunnel syndrome B) ulnar nerve compression

B

Regarding the peritoneal ligaments of the spleen, which is incorrect? a. Phrenicosplenic ligament b. Pancreaticosplenic ligament c. Gastrosplenic ligament

B

The following nerves provide sensory innervation to the external ear except: A) facial nerve B) glossopharyngeal nerve C) vagus nerve

B

The thoracic oesophagus: A) lies anterior to the trachea B) is separated from the vertebral column at its lowest part by the thoracic duct and aorta C) is related to the right atrium D) is crossed anteriorly by the right bronchus E) enters the abdomen at the level of T8

B

With a lesion of the cerebellar hemisphere, when/where would one expect to see ataxia? A) at rest, but only when anxious or nervous B) On the ipsilateral side of the body only C) At rest, but not during voluntary movement D) On the contralateral side of the body only E) On both sides of the body

B

With regards to the hand and carpal region A) lumbricals extend metacarpophalangeal joints B) A dislocated lunate can damage the median nerve in the carpal tunnel C) the scaphoid bone articulates with the first metacarpal bone

B

A patient experiences radial deviation of the hand at the wrist when he flexes the wrist and altered sensation in the skin covering the hypothenar eminence. What is the most likely cause of these symptoms? A) Fracture of the scaphoid bone B) Fracture of the medial epicondyle of the humerus C) Fracture of surgical neck of the humerus D) Fracture of the distal end of the radius E) Anterior and inferior dislocation of the head of the humerus

B (ulnar nerve)

Obstruction of the middle cerebral artery just before it branches within the lateral sulcus causes paralysis of the opposite side of the body, most marked in the: A) Face, trunk and lower limb B) Face, trunk and upper limb C) Trunk and lower limb D) Upper limb E) Lower limb

B) Face, trunk and upper limb

An apical lung tumour has compressed structures that pass through the scalene interval and cross the first rib. This patient would most likely exhibit A) weakness in abduction at the shoulder B) Horner syndrome C) Weakness in protracting the scapula D) Hemidiaphragmatic weakness E) A babinski sign

B) Horner syndrome

A patient has a tiny, but exquisitely painful tumour under the nail of his right index finger. The surgeon wants to remove it under local anaesthetic block. Which of the following nerves should be blocked for this purpose? A) Axillary nerve B) median nerve C) radial nerve D) ulnar nerve E) musculocutaneous nerve

B) Median nerve

From the olfactory mucosa, the olfactory fibres pass to the olfactory bulb by the: a) anterior & posterior ethmoidal foramina b) cribriform plate of the ethmoid c) sphenopalatine foramen

B) cribriform plate of the ethmoid

Which bundle of white matter separates the thalamus from the putamen (and globus pallidus)? A) Uncinate fasciculus B) Internal capsule C) Corpus callosum D) Cerebral peduncle E) Arcuate fasciculus

B) internal capsule

Of the following statements about the rectum, which is TRUE? a) receives blood supply from only one artery b) it is an important anastamotic site for the portal and caval (systemic) venous systems c) its smooth muscle is innervated by somatic nerves d) it has no circular smooth muscle in its wall e) it is surrounded by peritoneum along its entire length

B) it is an important anastamotic site for the portal and systemic venous systems

Patient develops pain in their buttocks and tingling and numbness in their lower limb as a result of hypertrophy of the piriformis muscle. Which region of the lower limb is most likely to be the site of altered sensation? A) posterior thigh B) lateral leg C) medial thigh D) medial leg E) gluteal region

B) lateral leg Sciatic nerve doesn't provide any sensory in the thigh, but splits into common peroneal & tibial. Superficial peroneal does lateral leg

A patient underwent extraction of right impacted wisdom tooth under local anaesthesia. At the end of the procedure, he felt numbness on the right side of the tongue. This is due to involvement of which of the following nerves? A) facial nerve B) lingual nerve C) inferior alveolar nerve D) glossopharyngeal nerve E) hypoglossal nerve

B) lingual nerve

Which part of the brainstem does the trigeminal nerve exit from? A) midbrain B) pons C) medulla

B) pons

Your patient has been diagnosed with jugular foramen syndrome, which is caused by a tumour compressing nerves passing through the jugular foramen. Which of the following autonomic deficits is the patient most likely to present with A) loss of sweating on the side of the face B) reduction in parotid gland secretions C) dilated pupil D) an eye that is dry and red E) a ptosis

B) reduction in parotid gland secretions

DRE of the prostate gland can reveal all of the following features about the prostate EXCEPT? A) softness when normal B) it is not palpable C) firmness when hypertrophied D) warmth when inflamed E) tenderness when inflamed

B.

Embryologically, spleen is developed within the: a. Septum transversum b. Dorsal mesogastrium c. Ventral mesogastrium

B. dorsal mesogastrium

In comparison to the ileum, the jejenum: a. Is located in the lower right quadrant of the abdomen b. Has longer vasa recta c. Has less arcades

B. has longer vasa recta (because more absorption happens in jejenum)

A man is stabbed in the left lower neck. Some minutes later, he starts to suffer from shortness of breath. A CXR shows elevated left hemidiaphragm. What is the most likely cause of this radiological sign? a. Collapse of left lung b. Injury to the phrenic nerve c. Paralysis of whole diaphragm d. Large left sided haemothorax e. Injury to vagus nerve

B. injury to the phrenic nerve Increased air around a collapsed lung, or a left sided haemothorax would actually push left hemidiaphragm down

The arch of the aorta is connected to the pulmonary trunk by the a. Ligamentum venosum b. Ligamentum arteriosum c. Ligamentum spinosum

B. ligamentum arteriosum

Embryologically, mammary glands are: a. Modified sebaceous glands b. Modified sweat glands c. Mesodermal in origin

B. modified sweat glands

Which of the following is not a direct branch of the coeliac trunk? a. Left gastric artery b. Right gastro-omental artery c. Splenic artery

B. right gastroomental artery

Which of the following regarding the heart is true? a. The inferior border of the heart is formed mainly by the left ventricle b. The coronary sinus drains into the right atrium c. The pulmonary vein carries blood from the right ventricle

B. the coronary sinus drains into the right atrium The inferior border of the heart is actually formed by the right ventricle, and the pulmonary vein carries blood from the lungs to the left ventricle

Regarding the external acoustic meatus: A. It consists of cartilage only B. The lateral 1/3 is cartilage, the medial 2/3 is bone C. The lateral 2/3 is cartilage, the medial 1/3 is bone

B. the lateral 1/3 is cartilage, the medial 2/3 is bone

A young man sustains fractures of his right 5th and 6th ribs. The intercostal neurovascular bundles are vulnerable to be damaged in such an injury. What is the position of the intercostal neurovascular bundle here? a. Between the external intercostal and subcostal muscles b. Between the internal intercostal and innermost intercostal muscles c. Just above the rib d.Deep to the endothoracic fascia

B: between the internal intercostal & innermost intercostal muscles

The arch of the aorta gives off the: a. Right common carotid artery b. Left subclavian artery c. Coronary arteries

B: the left subclavian artery It gives off brachiocephalic trunk, not right common carotid. & It's the ascending aorta, not the arch, that gives off coronary arteries

Pain from the diaphragm might be referred to the right shoulder. Why?

Because both of these regions are supplied by the C4,C5,C6 nerve roots (except another anatomy tute said C3,C4,C5???)

Why is it important to know the surface anatomy of the cervical dome of pleura before neck vein catheterisation?

Because it is an area of unprotected pleura. The apex of the cervical pleura is 2.5cm above the clavicle and extends from the junction of medial and middle third of the clavicle to the sterno-clavicular joint. The neck veins (subclavian, internal jugular) for catheterisation are anterior to this part of the pleura. A pneumothorax or haemothorax can occur from inadvertent injury to this part of the pleura. (Other unprotected areas: right costo-sternal region, & right & left costo-vertebral regions)

Where would a patient experience pain/tenderness with ethmoidal sinusitis?

Behind the eyes & sides of the upper part of the nose

Where would a patient experience pain/tenderness with sphenoidal sinusitis?

Behind the eyes, top of the head, over the mastoid process, back of the head

Where is the inferior end of the adult human spinal cord (i.e. the caudal tip of the conus medullaris)?

Between L1 & L2 vertebrae

At the area of the sacroiliac joints, the ureters cross what?

Bifurcation of the common iliac arteries

What makes up the portal triad?

Bile duct, hepatic artery, portal vein

What are the relations of the anterior vagina?

Bladder and urethra

Cutting the common peroneal nerve at the level of the upper border of the tibial condyle will result in: A) anasthesia of the sole of the foot B) inability to plantar flex the foot against resistance c) inability to dorsiflex the foot against resistance

C

Destruction of the right optic tract between the right lateral geniculate nucleus and the right occipital lobe results in: A) Blindness in the right eye B) Blindness in the right visual field of both eyes C) Blindness in the left visual field of the right eye and the left visual field of the left eye D) Blindness in the right visual field of the right eye and the left visual field of the left eye E) Blindness in the left visual field of the right eye and the right visual field of the left eye

C

In a patient with a skull base fracture extending to the jugualr foramen, which of the following nerves will NOT be involved? a) Glossopharyngeal nerve b) spinal accessory nerve c) hypoglossal nerve

C

Which of the following arteries contributes to the anterior circulation of the brain? A) Posterior cerebral artery B) Superior cerebellar artery C) Middle cerebral artery D) Vertebral arteries E) Basilar artery

C

Which of the following events at midway of the arm is true? A) radial nerve moves to posterior arm compartment B) ulnar nerve moves to anterior arm compartment C) basilic vein penetrates through deep fascia D) Brachial artery becomes anterior to median nerve E) median nerve moves lateral to brachial artery

C

With regards to the rectum, which of the following is true? A) it has tenia coli B) the sensation from the rectum is carried by the somatic nerves C) the venous drainage is to the portal vein D) the external iliac lymph nodes receive lymphatics from the rectum

C

With regards to the shoulder joint: A) axillary nerve injury impairs adduction B) supraspinatus muscle is on its anterior aspect C) stability is dependent on the rotator cuff muscles

C

Your registrar is discussing a case of hydrocephalus and asked you which statements below about the circulation of CSF is accurate? A) CSF flows directly from one lateral ventricle through an aperture in the septum pellucidum into the other lateral ventricle B) CSF flows into the subarachnoid space via apertures in the third ventricle C) CSF flows from the lateral ventricles through the interventricular foramina of Monro into the third ventricle D) CSF is absorbed back into the venous system through the choroid plexus E) Blockage of aqueduct of Sylvius produces communicating hydrocephalus

C

With regards to joint aspirations/injections, which of the following approaches has been described correctly? A) shoulder from superior aspect B) knee from posterior aspect C) knee from anterior aspect medial to patella D) ankle below the medial malleolus E) Ankle below the lateral malleolus

C Site of knee aspiration: either medial or lateral aspect of patella Site of shoulder aspiration: 1cm down & out from acromion process (posteriorly) Site of ankle aspiration: either above lateral malleolus or in between lateral malleolus & extensor digitorum longus Site of elbow aspiration: inside the "safety triangle" lateral epicondyle +head of radius + olecranon process

Which of the following statements regarding the spleen is INCORRECT? a. Lies in left upper quadrant of abdomen b. Largest single mass of lymphoid tissue in body c. Splenic vein is more tortuous than splenic artery

C is false

In males, the vas deferens: A) crosses the ureters posteriorly B) run along the ureters C) cross the ureters anteriorly

C) cross the ureters anteriorly

Which of the following cranial nerve nuclei is found in the medulla oblongata? A) Chief (main, principal) sensory nucleus of the trigeminal complex B) Edinger-Westphal nucleus C) Hypoglossal nucleus D) facial motor nucleus E) Oculomotor nucleus

C) hypoglossal nucleus

Anteriorly, hip capsule is attached to the: A) trochanteric fossa B) base of neck C) intertrochanteric line D) spiral line E) trochanteric crest

C) intertrochanteric line Line of attachment of capsule anteriorly is important because it carries certain blood vessels arising from femoral artery that supply head of the femur

General sensation from the anterior 2/3rd of the tongue is carried by the: A) chorda tympani branch of the facial nerve B) lingual branch of the facial nerve C) lingual branch of the mandibular nerve

C) lingual branch of the mandibular nerve

A 25 y/o man was struck in the face during a fight. He is brought to ED when he can no longer close his mouth. Pain is intense in the right side of his jaw, and bloodstained saliva drips from his mouth. The patient indicates that he cannot feel the skin of his chin or lower lip on the side of the fracture. Radiology reveals a mandibular fracture. The posterior part of the mandible may be displaced superiorly by contractions of which muscle? A) Digastric B) Buccinator C) Masseter D) Lateral pterygoid E) orbicularis oris

C) masseter

In regards to ectopic pregnancy: A) cervical ectopic is the most common subtype B) history of PID is associated with decreased risk C) most reliable sign is evidence of an extra-uterine gestational sac on u/s D) is never associated with a pseudo-gestational sac

C) most reliable sign is evidence of an extra-uterine gestational sac. Most common is tubal pregnancy in fallopian tube, history of PID increases risk, is often associated with a pseudo-gestational sac

A man has compressed an internal iliac artery branch. Which of the following structures will not need collateral circulation to maintain blood supply? A) bladder B) prostate C) testis D) uterus E) corpus spongiosum

C) testis

Which of the following arteries is the most common for a coronary artery occlusion? a. Right coronary artery b. Posterior interventricular artery c. Anterior interventricular artery (LAD)

C. LAD

An incision made through the skin parallel to the prevailing direction of the connective tissue fibres usually will: a. Tend to gape b. Heal with a prominent scar c. Coincide with Langer's lines of cleavage

C. coincide with langer's lines of cleavage

Splenic vein and inferior mesenteric vein combine to form the: a. Hepatic vein b. Hepatic portal vein c. None of above

C. none of the above- it's still called the splenic vein

An aneurysm in the arch of aorta could affect all of the following structures EXCEPT a. Left recurrent laryngeal nerve b. Left vagus nerve c. Right bronchus

C. right bronchus

Which one of the following is a branch of the splenic artery? a. Right gastroomental artery b. Left gastric artery c. Short gastric arteries

C. short gastric arteries

With regard to the middle ear, which of the following is true? A. The foot plate of the stapes is attached to the round window B. The chords tympani nerve travels along the medial wall C. The tensor tympani is attached to the malleus

C. the tensor tympani is attached to the malleus

Which of the following is true? a. Hairs and nails are derivatives of the dermis b. Sweat glands and sebaceous glands are mesodermal in origin c. There are no sebaceous glands on the palms

C. there are no sebaceous glands on the palms (hair and nails are derivatives of the epidermis, and sweat glands & sebaceous glands are ectodermal)

At which vertebral level does the trachea commence in the neck?

C6

The vertebral artery is a branch of the subclavian artery. Through the transverse foramen of which cervical vertebra does it initially ascent through?

C6

Which imaging modality shows renal stones best?

CT KUB

Where does the superior opthalmic vein drain into?

Cavernous sinus

What is CSF produced by?

Choroid plexus

The carotid sheath extends from the base of the skull to the root of the neck. The inferior part of the sheath contains what?

Common carotid artery, internal jugular vein & vagus nerve

27 y/o man sustained an undisplaced mid-shaft fracture of left tibia. Was put in a log leg cast & sent home. Overnight he represented to the ED with increased pain in his leg & parasthesia in his toes. What is this condition called? Can you offer anatomical reasons for this condition?

Compartment syndrome- tissue swelling -> decreased perfusion to capillaries --> ischemia

What is the roof of the nasal fossa mainly formed by?

Cribriform plate of ethmoid bone

What are the contents of the cystohepatic triangle?

Cystic artery, lymph nodes

A fracture of the neck of the fibula damaged the common peroneal nerve. Which of the following would NOT be seen? A) the foot remains plantar flexed B) loss of sensations on the dorsum of the foot C) failure to evert the foot D) loss of sensation on the sole E) failure to dorsiflex the foot

D

A patient has been suspected to have gonococcal arthritis of right knee. The doctor aspirating the joint inserts needle at the lateral aspect of the patella. Through which of the following structures does the needle pass? A) fibular collateral ligament B) iliotibial tract C) rectus femoris D) patellar retinaculum E) biceps femoris

D

Liver is attached to the anterior abdominal wall by what? A) lesser omentum B) coronary ligament C) triangular ligament D) falciform ligament E) greater omentum

D

Which of the following cranial nerve nuclei is found in the midbrain? A) cochlear nuclei B) dorsal motor nucleus of vagus C) abducens nuclei D) occulomotor nuclei

D

With regards to perforation of a chronic duodenal ulcer, which of the following statements is true? A) an anterior ulcer is associated with acute peritonitis due to leakage of duodenal contents into the lesser sac B) an anterior ulcer is associated with severe bleeding due to erosion of the right gastric artery C) a posterior ulcer is associated with severe bleeding due to erosion of the left gastro-omental artery D) a posterior ulcer is associated with severe bleeding due to erosion of the gastroduodenal artery

D

You are assisting in a laparotomy. The surgeon asks you to distinguish the ileum from the rest of the small bowel. What anatomic feature would help you do this? A) ileum has thicker wall than jejenum B) ileum like caecum is retroperitoneal C) ileum unlike jejenum has taenia coli D) the mesentery has more arterial arcades in the ileal mesentery E) the ileum has haustrations

D

An aneurysm that has been detected at the juncture of the anterior cerebral artery and the anterior communicating artery on the right has caused a visual field defect. What might visual field testing reveal? A) macular sparing B) a right nasal hemianopia C) a left homonymous hemianopia D) a bitemporal hemianopia E) A right homonymous hemianopia

D) Bitepmoral hemianopia

A tumour has compressed structures traversing the superior orbital foramen. Where is the patient most likely to experience pain and altered sensation A) mucosa of the nasal cavity B) mucosa of the nasopharynx C) skin over the maxilla D) skin of the anterior scalp and dorsum of the nose E) mucosa of the oral cavity

D) Skin of the anterior scalp and dorsum of the nose

Patient has severe trauma to lateral part of their left leg just below the knee. He drags his left toe when he walks and cannot feel the dorsum of his foot. Which of the following would still be intact? A) dorsiflexion B) inversion C) eversion D) cutaneous sensation of the medial leg E) cutaneous sensation between great toe and second toe

D) cutaneous sensation of the medial leg Because the nerve that has been affected is the common peroneal nerve- superficial peroneal does dorsiflexion and eversion (peroneal longus and brevis), deep peroneal does inversion (tibialis anterior and posterior) and cutaneous sensation between great toe and second toe Cutaneous sensation of medial leg is done by femoral, so won't be affected

Anasthesia of the pudendal nerve will result in all except: A) decreased ability to voluntarily control urine flow B) decreased ability to voluntarily control faecal flow C) decreased sensation to penis or clitoris D) decreased contraction of destrusor muscle E) decreased sensation to anal triangle

D) decreased contraction of detrusor muscle

A lawyer suffers a bad fall that results in head trauma. His motor, sensory and language skills are intact after the incident, and he has no visual problems. In the following weeks, he begins to lose interest in his work and doesn't seem to care much about his family. The trauma most likely affected the: A) temporal lobe B) parietal lobe C) occipital lobe D) frontal lobe

D) frontal lobe

Identify the false statement about the peritoneal cavity: A) its lowest and deepest part is the rectouterine pouch B) it is bounded superiorly by the diaphragm C) it is a closed sac in the male D) it is a closed sac in the female E) pain from its parietal layer is focal and sharp

D) it is a closed sac in the female It is not a closed sac because fallopian tubes open up into peritoneal cavity

A tumour in the superior orbital foramen erodes through the floor of the orbit. Where will the surgeon find the tumour? A) sphenoid sinus B) nasal cavity C) oral cavity D) maxillary sinus E) ethmoid sinus

D) maxillary sinus

A 32 y/o male presents to ED following direct blow to the medial aspect of his left knee during soccer. On examination, you look at the left kneecap ad noticed it's displaced laterally. Which of the following is most likely cause of the displacement? A) he has torn lateral patellar retinaculum B) he has ruptured patellar tendon C) Torn anterior cruciate ligament D) Rupture of vastus medialis muscle E) this is from rupture of vastus lateralis muscle

D) rupture of vastus medialis 2 factors hold patella in place: size of lateral femoral condyle & vastus medialis

Following a MVA, a 33 y/o man sustained a fracture of the face and orbit. He had facial lacerations, a dilated right pupil with loss of most eye movements on the right eye. A fracture that traverses which of the following would explain his findings in the right eye? A) Foramen rotundum B) Foramen ovale C) Foramen spinosum D) Superior orbital fissure E) Inferior orbital fisure

D) superior orbital fissure

Patient fell on an outstretched hand and has dislocated a carpal bone. They don't seek treatment, and several weeks later begin to exhibit signs of nerve compression. The patient is most likely to present with which of the following? A) wrist drop B) clawing of ring and index fingers C) inability to spread and opposite the fingers D) weakness in the ability to oppose the thumb E) pain on the palmar aspects of the ring and little fingers

D) weakness in ability to oppose the thumb Because fall on outstretched hand most commonly affects lunate which moves anteriorly and compresses median nerve in carpal tunnel. Median nerve does lateral two lumbricals, opponens pollicus, abductor pollicis brevis, flexor pollicis brevis and thenar eminence.

Which of the following is true with regard to the diaphragm? a. The centre is muscular and the periphery is tendinous b. The diaphragm is pierced by the oesophagus at T8 c. The diaphragm is pierced by the inferior vena cava at T10 d. The right dome is higher than the left

D: the right dome is higher than the left due to the liver

Inability to hold a piece of paper firmly between the extended middle and extended ring fingers probably indicates injury to which nerve?

Deep branch of ulnar nerve

Muscles of the anterior compartment of the lower leg are innervated primarily by which nerve?

Deep peroneal nerve

The dorsal 1st interspace of the foot is supplied by which nerve?

Deep peroneal nerve (sits with dorsalis pedis)

A patient has suffered a fracture of the humerus. Which muscle is most likely to have been weakened?

Deltoid

The visceral surface of the spleen is related to all of the following structures except a. Diaphragm b. Tail of pancreas c. Stomach d. Splenic flexure of the colon e. left kidney

Diaphragm

What is the anatomical explanation for a patient with left apical lobe lung cancer complaining of pain in the left little finger and partial drooping of the left upper eyelid?

Due to Pancoast syndrome (Horners + muscle weakness) Interrupts lower part of brachial plexus & sympathetic chain.

Which 2 parts of the digestive tract, due to their close relationship to the gallbladder, are likely to form adhesions to an inflamed gallbladder and as such may form cholecystoenteric fistulas? And which one of these sites may cause gallstone ileus?

Duodenum & transverse colon A gallbladder that is dilated & inflamed from impacted gallstone may develop adhesions with adjacent viscera & continued inflammation may ulcerate the boundaries resulting in 'cholecystoenteric' fistula A cholecystoenteric fistula would enable a large gallstone, incapable of passing through cystic duct, to enter digestive tract. once a large gallstone enters the small intestine it may become trapped at ileocecal valve, producing bowel obstruction (gallstone ileus). This wouldn't happen from a cholecystocolonic (transverse colon) fistula obviously

A young man suffered whiplash injury following a MVA. MRI of his cervical spine shows posterolateral herniation of nucleus pulposus between C5 & C6. Which neural structure is most likely to be injured? A) anterior ramus C5 B) posterior ramus C6 C) spinal cord D) spinal nerve C5 E) spinal nerve C6

E

During an abdominal paracentesis in the left lower quadrant 3cm above and two finger breadth medial to ASIS, the needle will pass through all of the following structures except: A) subcutaneous (fatty and fibrous layer) tissue B) external oblique muscle C) internal oblique muscle D) transversus abdominis muscle E) rectus abdominis muscle

E

With respect to the pancreas, which one of the following statements is correct? A) it is supplied by both the midgut and hindgut arteries B) the uncinate process is in contact with the spleen C) pancreatic pain is referred to the right shoulder D) the pancreas is in the anterior wall of the lesser sac E) cancer in the head of the pancreas can block the common bile duct

E

Concerning the hand & wrist: A) Lumbricals extend the metacarpophalangeal joints B) the pisiform bone is plapable on the lateral side of the wrist C) a dislocated trapezoid may damage the median nerve in the carpal tunnel D) A lesion of the ulnar nerve at the wrist results in inability to oppose the thumb E) The radial artery is the major contributor to the deep palmar arch

E Lumbricals do flexion of MCP & extension of PIP Median nerve controls opposition of the thumb Dislocated lunate damages median nerve Ulnar nerve supplies adductor pollicis but not opponens pollicis

A tumour in the superior mediastinum impinges upon the arch of the aorta and compresses a nerve. Which of the following is most likely to be observed in the patient? A) dysphagia B) Weakness in the ability to tense the vocal cord C) altered sensation in the larynx above the vocal cord D) weakness in ability to elevate the hyoid bone E) weakness in ability to abduct the vocal cord

E) Weakness in ability to abduct the vocal cord

In a uterine cancer, regional lymph nodes that drain the uterus include all of the following EXCEPT: a) lumbar lymph nodes b) external iliac lymph nodes c) internal iliac lymph nodes d) sacral lymph nodes e) inguinal lymph nodes

E) inguinal

Not being able to feel skin of chin or lower lip on the side of a mandibular fracture is due to laceration of branches of the: A) facial nerve B) cervical nerves C) great auricular nerve D) maxillary nerve E) mandibular nerve

E) mandibular nerve

34 y/o netball player presents to ED after a hard fall in the court in which she hit her head. On examination, no sensory deficits. However, her left arm and leg are uncoordinated, with finger displaying past pointing with an intention tremor. She also has difficulty in doing rapid alternating movements. Bleeding in which artery may have caused these symptoms? A) vertebral artery B) right middle cerebral artery C) left middle cerebral artery D) right posterior cerebral artery E) vertebral artery

E) vertebral artery Because this is a cerebellar issue

A patient complains of diplopia on an upward gaze following a blow out fracture damaging the inferior orbital wall. What is this diplopia often due to?

Entrapment of inferior rectus

CSF rhinorrhea is most likely to come from which fractured bone?

Ethmoid

To which nerve is the superior thyroid artery closely related?

External laryngeal nerve

Following transurethral resection of the prostate, urinary incontinence may result from damage of what?

External urethral sphincter

What is the stapedius muscle innervated by?

Facial nerve

What nerve is most likely to be damaged during a parotidectomy?

Facial nerve

Which cranial nerve can be affected during treatment of a mastoid abscess?

Facial nerve

What are structures that run in the parotid gland?

Facial nerve, retromandibular vein, external carotid artery terminating in the superficial temporal and maxillary arteries

What is the ischioanal fossa and what are its boundaries?

Fat-filled wedge shaped space located lateral to anal canal and inferior to pelvic diaphragm. Laterally: ischium, obturator internus Medially: levator ani, external anal sphincter Anteriorly: transversus perinei superficialis, urogenital diaphragm Posteriorly: glueus maximus, sacrotuberous ligament Superior: levator ani Inferior: skin Contains pudendal canal

Where does the great saphenous vein drain into?

Femoral vein

18 y/o in EC after MVA. Worsening left leg and ankle pain, difficulty walking. Leg deformation proximal to the ankle, and the distal 1/3rd of his leg was mottled and swollen. No palpable artery posterior to lateral malleolus. Xray showed fractures of tibia and fibula. Suspected left leg lateral compartment syndrome. In this case, which artery cannot be palpated?

Fibular artery

Flexion of the distal interphalangeal joint is due to the activity of which muscle?

Flexor digitorum profundus

Define choleliathisis

Formation of stones in the gall bladder

Which type of fracture of femur is most likely to result in avascular necrosis of the femoral head?

Fracture of neck of femur

A patient with known gallstones is admitted with one-day history of fever, intermittent right upper abdominal pain with jaundice. What is the best explanation for this?

Gallstone obstructing common bile duct

Patient died due to bleeding from a duodenal ulcer. Source of the bleeding is most likely from erosion of which artery?

Gastroduodenal artery

What is the anatomical explanation of a patient presenting with massive haematemesis and shock with a large ulcer on the posterior wall of the 1st part of the duodenum?

Gastroduodenal artery

What condition results from obstruction of drainage of the aqueous humour?

Glaucoma

What nerve provides taste sensation to posterior ⅓ of tongue?

Glossopharyngeal nerve

This is a specimen of a metastatic melanoma in a rib. This patient had a malignant melanoma in his right great toe. Describe anatomical pathway of spread of tumour from toe to rib

Haematogenous spread IIV -> RA -> RV -> pulmonary arteries -> lungs -> pulmonary veins -> LA -> LV -> aorta -> direct posterior intercostal arteries

In making an incision to correct a hydrocoele, which is the last layer to be incised before the fluid in the hydrocoele is reached? And what are the layers of the testes?

Hydrocele is accumulation of fluid around the testicle. Usually caused by fluid secretion into the tunica vaginalis, therefore the last layer to be incised is parietal layer of tunica vaginalis. Layers: external spermatic fascia, cremasteric musce, internal spermastic fascia, parietal layer of tunica vaginalis, and then tunica albuginea

Explain the referred pain from the abdomen to the shoulder blade with regards to the gall bladder?

If the inflammation involves the related parietal peritoneum of the diaphragm, pain may also be felt on the right shoulder area. This is because innervation of the visceral peritoneum of diaphragm is C3,C4,C5 which is also the innervation of skin over right shoulder. In the case of the gallbladder, referred pain is due innervation by phrenic nerve which is same spinal segment as supraclavicular nerve (C3,C4)

After surgical repair of a hernia, patient experiences numbness in skin on the anterior aspect of the scrotum. What nerve was lesioned?

Ilioinguinal

Define cholestasis

Impaired bile flow due to impairment of secretion or obstruction in flow

Where does the third ventricle lie?

In between right and left thalamus

In what procedure & how can a urologist cause a pneumothorax?

In the region of the left and right costo-vertebral angle during operations on the kidney (unprotected pleura there, as well as cervical pleura & right costo-sternal)

What does hypomastia mean?

Incomplete breast development

Define cholangitis

Infection of the bile ducts

What prevents the cephalad movement of a horseshoe kidney?

Inferior mesenteric artery

Define cholecystitis

Inflammation of the gallbladder

Lymphatic drainage of lower part of the anal canal?

Inguinal lymph nodes

Where does the vestibulocochlear nerve exit from?

Internal acoustic meatus

Where does the opthalmic artery arise from?

Internal carotid artery

The blood supply to the bladder (superior and inferior vesical arteries) are branches of what?

Internal iliac artery

Lymphatic drainage of prostate gland?

Internal iliac lymph nodes

What are the two lateral ventricles connected to the third ventricle via?

Interventricular foramen (of Monro)

Is the spleen an intraperitoneal, extraperitoneal or retroperitoneal organ?

Intraperitoneal (for retroperitoneal remember SADPUCKER: suprarenal glands, aorta, duodenum 2nd & 3rd part, pancreas, ureters, colon ascending & descending, kidneys, esophagus, rectum)

What are the anterior and posterior chamber of aqueous humour separated by?

Iris

What is the epiploic foramen & what are its boundaries?

Is the passage between the lesser and greater sac Anterior- free edge of lesser omentum Posterior- Inferior Vena Cava Superior- CAUDATE lobe of the liver Inferior- 1st part of duodenum

An obstetrician is doing a nerve block. What structure does she need to palpate to perform this procedure?

Ischial spine

What is the perineal body formed by?

It is a wedge-shaped muscle that serves as an anchor for the muscles, fascia and ligaments of the pelvis. Formed by superficial transverse perineal muscles, posterior edge of the deep transverse perineal muscle, external anal sphincter, bulbospongiosus and levator ani

What is the surface marking of the parotid duct?

It lies in the line between the intertragic notch of the auricle and the midpoint of the philtrum

Through which foramen do cranial nerves IX, X and XI exit from

Jugular foramen

What level does the superior mesenteric artery arise from the abdominal aorta?

L1

Superior mesenteric artery arises from which level?

L1 Coeliac trunk: T12 SMA: L1 Gonadal: L2 IMA: L3 Bifurcation: L4

Where does the right crus of the diaphragm arise from?

L1-L3 & their intervertebral discs

What level does the inferior mesenteric artery arise from the abdominal aorta?

L3 Coeliac trunk- T12 SMA- L1 Gonadal arteries- L2 IMA- L3 Bifurcation- L4

At what level does the abdominal aorta bifurcate?

L4

A deviated tip of tongue to the right with atrophy on the right is a sign of an UMN or LMN lesion?

LMN

Which muscles does the median nerve supply in the hand?

LOAF Lateral 2 lumbricals Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis

What is the action of the SCM muscle

Lateral flexion of neck when acting unilaterally Extension of neck when acting bilaterally

Which of the following structures lies anterior to the stomach? a. Tail of the pancreas b. Left lobe of the liver c. Left adrenal gland

Left lobe of the liver

A middle-aged man with cancer involving the left lung develops a hoarse or breathy voice. A CT scan of the chest shows enlargement of the left hilar lymph nodes. Which structure is being affected by the enlarged nodes to cause the voice change?

Left recurrent laryngeal nerve

What nerve hooks around the ligamentum arteriosum?

Left recurrent laryngeal nerve

Which renal vein is longer?

Left vein longer because IVC is on the right

Where do the left and right gonadal veins drain?

Left- left renal vein Right- IVC

Where does blood supply to the internal capsule come from?

Lenticulostriate arteries (branch of the middle cerebral artery)

What forms the pelvic diaphragm?

Levator ani (puborectalis, iliococcygeus, pubococcygeus) & coccygeus muscles

The lateral cord of the brachial plexus: A) gives rise to the ulnar nerve B) is formed by the anterior division of the lower trunk C) supplies the lateral rotators of the humerus D) gives rise to the musculocutaneous nerve E) supplies the long head of the triceps muscle

Lily- lateral pectoral nerve Loves- lateral root of median nerve Me- musculocutaneous nerve Lateral rotators of humerus: infraspinatus & teres minor

What is the right kidney related anteriorly to?

Liver

Winging of the scapula is caused by damage to which nerve?

Long thoracic nerve (C5,6,7)

Where does the axillary artery become the brachial artery?

Lower border of teres major

Where does lymphatic drainage of kidneys go?

Lumbar (aortic) lymph nodes

Lymphatic drainage of the ovaries?

Lumbar (aortic/preaortic) lymph nodes

Lymphatic drainage of the testes?

Lumbar (aortic/preaortic) lymph nodes

A patient develops clawing of the fourth and fifth digits secondary to nerve injury. Which muscle has been weakened?

Lumbricals

What lies in cubital fossa from medial to lateral?

M- median nerve B- brachial artery B- biceps tendon S- superficial branch of radial nerve

What is the order of bony ossicles from most external to internal?

Malleus, incus, stapes

What are the structures passing through the carpal tunnel?

Median nerve, 4 tendons of flexor digitorum profundus, 4 tendons of flexor digitorum superficialis, & flexor pollicis longus tendon

Why do people with darker skin have darker skin

Melanocytes produce more pigments

Where is the substantia nigra located?

Midbrain

The splenic vein and superior mesenteric vein meet behind what structure

Neck of pancreas

The splenic vein and superior mesenteric vein meet together behind which structure?

Neck of the pancreas

Which bone forms medial wall of the orbit?

Orbital plate of ethmoid bone +maxilla, lacrimal & sphenoid bones Roof: Frontal bone & lesser wing of sphenoid Lateral: Zygomatic bone & greater wing of sphenoid Floor: maxilla, palatine & zygomatic bones

Where are the first group of lymph nodes around the aorta that directly drain the ovaries?

Origin of the gonadal arteries

What does the suspensory ligament of the ovary connect?

Ovary to the lateral abdominal wall

The hypoglossal nerve innervates all muscles of the tongue except what?

Palatoglossus muscle (which is innervated by the vagus nerve)

What group of lymph nodes would you expect testicular cancer to metastasise to first?

Para-aortic lymph nodes

Where do ureteric stones often cause obstruction?

Pelvic brim, pelvoureteric junction (PUJ) & vesicoureteric junction (VUJ)

Which muscles contract during the valsalva maneuver to help increase intra-abdominal pressure?

Pelvic diaphragm

What is inserted into the lateral side of the base of the 5th metatarsal?

Peroneus brevis

Which muscles evert the foot?

Peroneus longus, peroneus brevis, peroneus tertius

Which of the vaginal fornices is the deepest?

Posterior fornix

Which vaginal fornix is the most common site of perforation by a surgical instrument?

Posterior fornix

Shortened left lower limb that is adducted and medially rotated indicates what?

Posterior hip dislocation (abducted & laterally rotated is NOF fracture)

What is the posterior fornix related to?

Pouch of douglas (rectouterine pouch)

Testicular torsion occurs because of dysfunction of which structure?

Processus vaginalis

Which blood vessel gives rise to a branch that is a major source of arterial blood supply to the head and neck of the femur?

Profunda femoral artery

Midshaft femur fracture most likely to injure which artery?

Profunda femoris

What innervates prostate gland and what else do those nerves do?

Prostatic plexus Also distributed to the corpora cavernosa of the urethra and penis, allowing erection & to seminal vesicles

Where does the ejaculatory duct open into?

Prostatic urethra

Which coronary artery when occluded is most likely to cause heart block?

RCA

A 50-year-old woman had a motor vehicle accident two days ago. She complains to the doctor at the Emergency that she feels some numbness around her thumb. Physical examination shows a flexed thumb, which cannot be extended. Which of the following nerves is likely to be damaged?

Radial nerve

What are the relations of the posterior vagina?

Rectum

What are structures at the angle of louis?

Rib 2, T4 Arch of the aorta, tracheal bifurcation, pulmonary trunk, left recurrent laryngeal nerve, azygous veins, nerves, thoracic duct

Which kidney is usually lower?

Right

27 y/o male stabbed front of chest 1cm in length depth of 3cm just above right 3rd costal cartilage near sternal margin. Which structure most likely damaged?

Right internal thoracic artery

A 6-year old girl is seen to develop a spasmodic cough and wheeze while eating peanuts. At the ED it is suspected that she has inhaled a peanut. Where in the respiratory tract is the peanut most likely to lodge?

Right lower lobe bronchus

Your female patient has suffered a stroke. She has difficulty copying simple diagrams, even though she hears and understands your requests to do so. You notice that she only has makeup on the right side of her face and doesn't seem to know where her left hand is in space. Which blood vessel might have been occluded to cause these symptoms?

Right middle cerebral artery

What does the right recurrent laryngeal nerve hook around?

Right subclavian artery

A football player is felled whilst turning to kick the ball. He experiences pain in his knee, which becomes swollen 30 minutes later. On examination the findings are of a diffusely swollen knee joint with excessive forward sliding of the tibia on the femur. What is the most likely diagnosis?

Ruptured anterior cruciate ligament

Which dermatome supplies the lateral side of the foot?

S1

The pes anserina includes the distal portions of which 3 muscles?

SGT Sartorius, gracilis & semitendinosus

What is the carpal bone that can be felt in the anatomical snuff box?

Scaphoid

The hepatopancreatic ampulla (of Vater) opens into which part of the duodenum?

Second part

Damage to the long thoracic nerve paralyses which muscle?

Serratus anterior

The muscle pair which ASSISTS in elevating the arm above the head is?

Serratus anterior & trapezius

What are the layers moving from external surface of scrotum to the testis?

Skin, dartos fascia and muscle, external spermatic fascia, cremaster muscle, internal spermatic fascia, tunica vaginalis, tunica albuginea

What is the left kidney related anteriorly to?

Spleen

Splenic vein and inferior mesenteric vein combine to form what?

Splenic vein

What is the most common type of brain herniation?

Subfalcine herniation (under the falx cerebri)

Axillary artery has progressively occluded deep to pectoralis minor muscle. Which pair of blood vessels would most likely provide significant collateral circulation around the blockage?

Subscapular and suprascapular artery

Skin of the lower lateral aspect of the leg, front of the ankle and dorsum of the foot shows sensory loss. Which nerve is most likely implicated?

Superficial peroneal nerve

Why does maxillary sinusitis cause toothache?

Superior alveolar nerves (branch of the maxillary nerve) supply the maxillary teeth and the mucous membrane of the maxillary sinus so infection & inflammation of mucosa of sinus can come w sensation of toothache in the molar teeth

Which structure usually leaves above the piriformis muscle?

Superior gluteal nerve

The CT scan of an elderly patient with epigastric pain revealed malignant tumour involving the uncinate process of the pancreas. Which vessel would most likely be occluded by this tumour?

Superior mesenteric artery

The arachnoid granulations allow CSF to drain into what?

Superior sagittal sinus

What is the first branch of the external carotid artery?

Superior thyroid artery

The long head of the biceps tendon attaches to?

Supraglenoid tubercle of the glenoid fossa

Define cholecystectomy

Surgical removal of the gallbladder

Which structures contains the ovarian artery and vein?

Suspensory ligament of the ovary

At which vertebral level does the lumbosacral enlargement occur?

T11-L2

32 y/o man presents with pain and swelling after sustaining a lateral blow to the knee while playing football. On examination, his knee is swollen medially but is not particularly painful. There is instability with valgus stress. The ballottment test is negative. Lachman's test is negative. No joint line tenderness. Diagnosis?

Tear of medial collateral ligament

What are the branches of the facial nerve?

Temporal, zygomatic, buccal, marginal mandibular & cervical branches

Avascular necrosis of the femoral head is a known complication of surgical neck of femur fracture. What is the anatomical explanation?

The artery that goes to the head of the femur is medial circumflex artery from profunda femoris Medial femoral circumflex artery gives rise to epiphyseal arteries & Posterior superior retinaculuar arteries which pass through capsule & supply femoral head

What does the mastoid antrum communicate with?

The middle ear (The mastoid antrum is an air space in the petrous portion of the temporal bone, communicating posteriorly with the mastoid cells and anteriorly with the epitympanic recess of the middle ear via the entrance to the mastoid antrum. These air spaces function as sound receptors, provide voice resonance, act as acoustic insulation and dissipation, provide protection from physical damage and reduce the mass of the cranium)

In a patient with pleurisy, why might they complain of pain in the upper abdomen?

The parietal pleura is supplied by the intercostal nerves, so referred pain in the dermatomes of the upper abdomen. Lower intercostal nerves supply the anterior abdominal wall

What is the pericardium of the heart innervated by?

The phrenic nerve

How can a chylothorax occur following neck vein catheterisation on the left side?

The thoracic duct (drains lymph from everything below diaphragm and left side of head, neck & upper limb) goes into posterior mediastinum at level of sternal angle, then goes up and drains into left jugulo-subclavian angle. This may be injured in this procedure leading to leakage of lymph (chyle) into the left pleural cavity. On the right side: right lymphatic duct (right side of thorax, right upper limb, right head and neck) also drains into right jugulo-subclavian angle.

The median umbilical ligament represents the remnant of the embryonic what?

The urachus (represents allantois- canal that drains the urinary bladder of the fetus that joins and runs within the umbilical cord)

What does the median nerve in the hand supply?

Thenar eminence, first and second lumbricals, opponens pollicis, abductor pollicis brevis, flexor pollicis brevis

In approximately 3-10% of people, a small unpaired artery arises from the brachiocephalic trunk or from arch of aorta. Which artery is it?

Thyroid ima artery

Altered sensation in the sole of the foot and weakness in plantar flexion indicates lesion of which nerve?

Tibial nerve

Which muscles perform the inversion of the foot?

Tibialis anterior & tibialis posterior

Which structure helps prevent uterine prolapse after a normal vaginal delivery

Transverse cervical ligament

What is the gold standard investigation for orchitis?

U/S

Which nerves supply the skin of the palm?

Ulnar and median nerves

Fracture of the medial epicondyle of the humerus may damage which nerve?

Ulnar nerve

The adductor pollicis muscle is innervated by which nerve?

Ulnar nerve

12 y/o boy presents with severe pain in his elbow after a fall off his snowboard onto his outstretched hand. On examination, pain is worst medially. Which muscles & nerves are most likely to be damaged?

Ulnar nerve & flexor carpi radialis

What are the locations of the oesophageal sphincters

Upper oesophageal sphincter: at the junction between pharynx and oesophagus, produced by cricopharyngeus muscle Lower oesophageal sphincter (is a physiological sphincter, not a true anatomical sphincter): gastro-oesophageal junction to the left of T11 vertebra

Which structure lies anterior to common iliac artery?

Ureter

Between which 2 structures can the relationship be remembered as using the phrase water under the bridge in females?

Ureter and uterine artery

During pelvic examination of a 35 y/o woman, a tender mass is felt in the right lateral vaginal fornix. Inflammation of which structure best explains this finding?

Uterine tube

What is the posterior inferior cerebellar artery a branch of?

Vertebral artery

What is the inner ear innervated by?

Vestibulocochlear nerve

Why does moving around from side to side at night help relieve maxillary sinus congestion?

When mucous membrane of sinus is congested, the maxillary ostia are often obstructed. They're located high near the roof of the maxillary sinus, so with the head erect it's hard to drain. Because the ostia of the right and left sinuses lie on the medial sides (directed toward each other), when lying on one's side, only the upper sinuses (e.g. the right sinus is lying on the left side) drains. A cold or allergy involving both sinuses can result

Following facial injury, stimulation of the right cornea results in blinking of the left eye, but not the right. This is compatible with: a) right 7th nerve injury b) left 5th nerve injury c) both right and left 5th nerve injuries

a) right 7th nerve injury

A 70 year old woman presents with features of painless obstructive jaundice. Her gall bladder is enlarged & non-tender. Which of the following conditions is most likely? a. Cancer of the head of the pancreas b. Cancer of the body of the pancreas c. A stone obstructing common bile duct

a. cancer of the head of the pancreas

Which of the following is true about the breast anatomy? A) base of adult female breast overlies 2nd and 8th rib vertically B) breast is composed of 15-20 lobules C) breast lies in deep fascia D) nipple normally lies at T6 E) Is a modified eccrine gland

b) composed of 15-20 lobules -Horizontally, spans from lateral border of sternum to mid-axillary line. Vertically, spans from 2nd-6th intercostal cartilages -Lies superficial to pec major & serratus anterior on pec major fascia -Mammary gland is a modified sweat gland -Nipple lies at T4 Blood supply: internal thoracic artery

The motor supply to the detrusor muscle is from? a) Sympathetic supply (l1-2) B) parsympathetic supply (s2-4) C) pudendal nerve (S2-S4)

b) parasympathetic supply (S2-4)

The arch of the aorta gives off the: a. right common carotid b. left subclavian artery c. coronary artery d. right subclavian artery e. inferior thyroid artery

b. left subclavian artery

Which of the following muscles does the mandibular nerve (V3) innervate? A) stapedius b) stylohyoid c) tensor tympani

c) tensor tympani (facial does stylohyoid & stapedius)

define choledocholithiasis

gallstones within the common bile duct

Lymphatic drainage of the cervix?

iliac nodes

Which muscle does abducens nerve innervate?

lateral rectus

What is the bare area of the liver?

posterior section of the liver against the diaphragm that is bare without peritoneal covering

Where are the maxillary ostia (openings) located?

posteriorly and medially near the roof of the maxillary sinus