ANAT- Unit 1 BRS

A 44-year-old man with a stab wound was brought to the emergency department, and a physician found that the patient was suffering from a laceration of his right phrenic nerve. Which of the following conditions has likely occurred? (A) Injury to only GSE fibers (B) Difficulty in expiration (C) Loss of sensation in the fibrous pericardium and mediastinal pleura (D) Normal function of the diaphragm (E) Loss of sensation in the costal part of the diaphragm

(C) Loss of sensation in the fibrous pericardium and mediastinal pleura

A 29-year-old patient comes in; he cannot flex the distal interphalangeal (DIP) joint of the index finger. His physician determines that he has nerve damage from a supracondylar fracture. Which of the following conditions is also a symptom of this nerve damage? (A) Inability to flex the DIP joint of the ring finger (B) Atrophy of the hypothenar eminence (C) Loss of sensation over the distal part of the second digit (D) Paralysis of all the thumb muscles (E) Loss of supination

(C) Loss of sensation over the distal part of the second digit

A young toddler presents to her pediatrician with rather new onset of bowel and bladder dysfunction and loss of the lower limb function. Her mother had not taken enough folic acid (to the point of a deficiency) during her pregnancy. On examination, the child has protrusion of the spinal cord and meninges and is diagnosed with which of the following conditions? (A) Spina bifida occulta (B) Meningocele (C) Meningomyelocele (D) Myeloschisis (E) Syringomyelocele

(C) Meningomyelocele

A patient with Bennett fracture (a fracture of the base of the first metacarpal bone) experiences an impaired thumb movement. Which of the following intrinsic muscles of the thumb is most likely injured? (A) Abductor pollicis brevis (B) Flexor pollicis brevis (superficial head) (C) Opponens pollicis (D) Adductor pollicis (E) Flexor pollicis brevis (deep head)

(C) Opponens pollicis

An automobile body shop worker has his middle finger crushed while working on a transmission. Which of the following muscles is most likely to retain function? (A) Extensor digitorum (B) Flexor digitorum profundus (C) Palmar interosseous (D) Dorsal interosseous (E) Lumbrical

(C) Palmar interosseous

A 17-year-old boy with a stab wound received multiple injuries on the upper part of the arm and required surgery. If the brachial artery were ligated at its origin, which of the following arteries would supply blood to the profunda brachii artery? (A) Lateral thoracic (B) Subscapular (C) Posterior humeral circumflex (D) Superior ulnar collateral (E) Radial recurrent

(C) Posterior humeral circumflex

A crush injury of the vertebral column can cause the spinal cord to swell. Which structure would be trapped between the dura and the vertebral body by the swelling spinal cord? (A) Anterior longitudinal ligament (B) Alar ligament (C) Posterior longitudinal ligament (D) Cruciform ligament (E) Ligamentum nuchae

(C) Posterior longitudinal ligament

A 12-year-old boy walks in; he fell out of a tree and fractured the upper portion of his humerus. Which of the following nerves are intimately related to the humerus and are most likely to be injured by such a fracture? (A) Axillary and musculocutaneous (B) Radial and ulnar (C) Radial and axillary (D) Median and musculocutaneous (E) Median and ulnar

(C) Radial and axillary

11. The bronchogram of a 45-year-old female smoker shows the presence of a tumor in the eparterial bronchus. Which airway is most likely blocked? (A) Left superior bronchus (B) Left inferior bronchus (C) Right superior bronchus (D) Right middle bronchus (E) Right inferior bronchus

(C) Right superior bronchus

A radiologist examines posterior-anterior chest radiographs of a 27-year-old victim of a car accident. Which of the following structures forms the right border of the cardiovascular silhouette? (A) Arch of the aorta (B) Pulmonary trunk (C) SVC (D) Ascending aorta (E) Left ventricle

(C) SVC

A 54-year-old patient is implanted with an artificial cardiac pacemaker. Which of the following conductive tissues of the heart had a defective function that required the pacemaker? (A) Atrioventricular (AV) bundle (B) AV node (C) Sinoatrial (SA) node (D) Purkinje fiber (E) Moderator band

(C) Sinoatrial (SA) node

In a freak hunting accident, a 17-year-old boy was shot with an arrow that penetrated into his suboccipital triangle, injuring the suboccipital nerve between the vertebral artery and the posterior arch of the atlas. Which of the following muscles would be unaffected by such a lesion? (A) Rectus capitis posterior major (B) Semispinalis capitis (C) Splenius capitis (D) Obliquus capitis superior (E) Obliquus capitis inferior

(C) Splenius capitis

A 31-year-old roofer walks in with tenosynovitis resulting from a deep penetrated wound in the palm by a big nail. Examination indicates that he has an infection in the ulnar bursa. This infection most likely resulted in necrosis of which of the following tendons? (A) Tendon of the flexor carpi ulnaris (B) Tendon of the flexor pollicis longus (C) Tendon of the flexor digitorum profundus (D) Tendon of the flexor carpi radialis (E) Tendon of the palmaris longus

(C) Tendon of the flexor digitorum profundus

A patient has a torn rotator cuff of the shoulder joint as the result of an automobile accident. Which of the following muscle tendons is intact and has normal function? (A) Supraspinatus (B) Subscapularis (C) Teres major (D) Teres minor (E) Infraspinatus

(C) Teres major

A newborn baby is readmitted to the hospital with hypoxia and upon testing is found to have pulmonary stenosis, dextraposition of the aorta, interventricular septal defect, and hypertrophy of the right ventricle. Which of the following is best described by these symptoms? (A) ASD (B) Patent ductus arteriosus (C) Tetralogy of Fallot (D) Aortic stenosis (E) Coarctation of the aorta

(C) Tetralogy of Fallot

During early development of the respiratory system, the laryngotracheal tube maintains communication with the primitive foregut. Which of the following embryonic structures is most likely responsible for partitioning these two embryonic structures? (A) Tracheoesophageal folds (B) Tracheoesophageal fistula (C) Tracheoesophageal septum (D) Laryngotracheal diverticulum (E) Laryngotracheal septum

(C) Tracheoesophageal septum

A 38-year-old woman with a long history of shoulder pain is admitted to a hospital for surgery. Which of the following muscles becomes ischemic soon after ligation of the superficial or ascending branch of the transverse cervical artery? (A) Latissimus dorsi (B) Multifidus (C) Trapezius (D) Rhomboid major (E) Longissimus capitis

(C) Trapezius

The attending faculty in the coronary intensive care unit demonstrates to his students a normal heart examination. The first heart sound is produced by near-simultaneous closure of which of the following valves? (A) Aortic and tricuspid (B) Aortic and pulmonary (C) Tricuspid and mitral (D) Mitral and pulmonary (E) Tricuspid and pulmonary

(C) Tricuspid and mitral

A 27-year-old man with cubital tunnel syn- drome complains of numbness and tingling in the ring and little finger and back and sides of his hand because of damage to a nerve in the tunnel at the elbow. Which of the following muscles is most likely to be paralyzed? (A) Flexor digitorum superficialis (B) Opponens pollicis (C) Two medial lumbricals (D) Pronator teres (E) Supinator

(C) Two medial lumbricals

A man is unable to hold typing paper be- tween his index and middle fingers. Which of the following nerves was likely injured? (A) Radial nerve (B) Median nerve (C) Ulnar nerve (D) Musculocutaneous nerve (E) Axillary nerve

(C) Ulnar nerve

Cerebrospinal fluid (CSF) is produced by vascular choroid plexuses in the ventricles of the brain and accumulated in which space?

(D)

Takes its origin from the left ventricle and ends at the sternal angle?

(D)

Which structure is crossed superiorly by the aortic arch and left pulmonary artery?

(D)

A patient complains of having pain with repeated movements of his thumb (claudication). His physician performs the Allen test and finds insufficiency of the radial artery. Which of the following conditions would be a result of the radial artery stenosis? (A) A marked decrease in the blood flow in the superficial palmar arterial arch (B) Decreased pulsation in the artery passing superficial to the flexor retinaculum (C) Ischemia of the entire extensor muscles of the forearm (D) A marked decrease in the blood flow in the princeps pollicis artery (E) A low blood pressure in the anterior interosseous artery

(D) A marked decrease in the blood flow in the princeps pollicis artery

An 8-year-old boy with ASD presents to a pediatrician. This congenital heart defect shunts blood from the left atrium to the right atrium and causes hypertrophy of the right atrium, right ventricle, and pulmonary trunk. Which of the following veins opens into the hypertrophied atrium? (A) Middle cardiac vein (B) Small cardiac vein (C) Oblique cardiac vein (D) Anterior cardiac vein (E) Right pulmonary vein

(D) Anterior cardiac vein

The police bring in a murder suspect who has been in a gunfight with a police officer. The suspect was struck by a bullet in the arm; his median nerve has been damaged. Which of the following symptoms is likely produced by this nerve damage? (A) Waiter's tip hand (B) Claw hand (C) Wrist drop (D) Ape Hand (E) Flattening of the hypothenar eminence

(D) Ape Hand

A cardiologist is on clinical rounds with her medical students. She asks them, "During the cardiac cycle, which of the following events occurs?" (A) AV valves close during diastole (B) Aortic valve closes during systole (C) Pulmonary valve opens during diastole (D) Blood flow in coronary arteries is maximal during diastole (E) Aortic valve closes at the same time as AV valve

(D) Blood flow in coronary arteries is maximal during diastole

During a breast examination of a 56-year- old woman, the physician found a palpable mass in her breast. Which of the following characteristics of breast cancer and its diagnosis is correct? (A) Elevated nipple (B) Polymastia (C) Shortening of the clavipectoral fascia (D) Dimpling of the overlying skin (E) Enlargement of the breast

(D) Dimpling of the overlying skin

A 24-year-old carpenter suffers a crush injury of his entire little finger. Which of the following muscles is most likely to be spared? (A) Flexor digitorum profundus (B) Extensor digitorum (C) Palmar interossei (D) Dorsal interossei (E) Lumbricals

(D) Dorsal interossei

A 17-year-old boy was involved in a gang fight, and a stab wound severed the white rami communicantes at the level of his sixth thoracic vertebra. This injury would result in degeneration of nerve cell bodies in which of the following structures? (A) Dorsal root ganglion and anterior horn of the spinal cord (B) Sympathetic chain ganglion and dorsal root ganglion (C) Sympathetic chain ganglion and posterior horn of the spinal cord (D) Dorsal root ganglion and lateral horn of the spinal cord (E) Anterior and lateral horns of the spinal cord

(D) Dorsal root ganglion and lateral horn of the spinal cord

A 23-year-old jockey falls from her horse and complains of headache, backache, and weak- ness. Radiologic examination would reveal blood in which of the following spaces if the internal vertebral venous plexus was ruptured? (A) Space deep to the pia mater (B) Space between the arachnoid and dura maters (C) Subdural space (D) Epidural space (E) Subarachnoid space

(D) Epidural space

A 42-year-old woman with metastatic breast cancer is known to have tumors in the inter- vertebral foramina between the fourth and fifth cervical vertebrae and between the fourth and fifth thoracic vertebrae. Which of the following spinal nerves may be damaged? (A) Fourth cervical and fourth thoracic nerves (B) Fifth cervical and fifth thoracic nerves (C) Fourth cervical and fifth thoracic nerves (D) Fifth cervical and fourth thoracic nerves (E) Third cervical and fourth thoracic nerves

(D) Fifth cervical and fourth thoracic nerves

A patient comes in complaining that she cannot flex her proximal interphalangeal joints. Which of the following muscles appear(s) to be paralyzed on further examination of her finger? (A) Palmar interossei (B) Dorsal interossei (C) Flexor digitorum profundus (D) Flexor digitorum superficialis (E) Lumbricals

(D) Flexor digitorum superficialis

A 5-year-old girl is brought to the emergency department because of difficulty breath- ing (dyspnea), palpitations, and shortness of breath. Doppler study of the heart reveals an atrial septal defect (ASD). This malformation usually results from incomplete closure of which of the following embryonic structures? (A) Ductus arteriosus (B) Ductus venosus (C) Sinus venarum (D) Foramen ovale (E) Truncus arteriosus

(D) Foramen ovale

A 27-year-old mountain climber falls from a steep rock wall and is brought to the emergency department. His physical examination and computed tomography (CT) scan reveal dislocation fracture of the upper thoracic vertebrae. The fractured body of the T4 vertebra articulates with which of the following parts of the ribs? (A) Head of the third rib (B) Neck of the fourth rib (C) Tubercle of the fourth rib (D) Head of the fifth rib (E) Tubercle of the fifth rib

(D) Head of the fifth rib

A 34-year-old woman crashes into a tree during a skiing lesson and is brought to a hospital with multiple injuries that impinge the dorsal primary rami of several spinal nerves. Such lesions could affect which of the following muscles? (A) Rhomboid major (B) Levator scapulae (C) Serratus posterior superior (D) Iliocostalis (E) Latissimus dorsi

(D) Iliocostalis

A 27-year-old cardiac patient with an irregular heartbeat visits her doctor's office for examination. Where should the physician place the stethoscope to listen to the sound of the mitral valve? (A) Over the medial end of the second left intercostal space (B) Over the medial end of the second right intercostal space (C) In the left fourth intercostal space at the mid-clavicular line (D) In the left fifth intercostal space at the mid-clavicular line (E) Over the right half of the lower end of the body of the sternum

(D) In the left fifth intercostal space at the mid-clavicular line

A 44-year-old woman comes to her physician and complains of headache and backache. On examination, she is found to have fluid accumulated in the spinal epidural space be- cause of damage to blood vessels or meninges. Which of the following structures is most likely ruptured? (A) Vertebral artery (B) Vertebral vein (C) External vertebral venous plexus (D) Internal vertebral venous plexus (E) Lumbar cistern

(D) Internal vertebral venous plexus

A 31-year-old man was involved in a severe automobile accident and suffered laceration of the left primary bronchus. The damaged primary bronchus: (A) Has a larger diameter than the right primary bronchus (B) Often receives more foreign bodies than the right primary bronchus (C) Gives rise to the eparterial bronchus (D) Is longer than the right primary bronchus (E) Runs under the arch of the azygos vein

(D) Is longer than the right primary bronchus

A 62-year-old patient with pericardial effusion comes to a local hospital for aspiration of pericardial fluid by pericardiocentesis. The needle is inserted into the pericardial cavity through which of the following intercostal spaces adjacent to the sternum? (A) Right fourth intercostal space (B) Left fourth intercostal space (C) Right fifth intercostal space (D) Left fifth intercostal space (E) Right sixth intercostal space

(D) Left fifth intercostal space

A 27-year-old patient with Marfan syn- drome has an aneurysm of the aortic arch. This may compress which of the following structures? (A) Right vagus nerve (B) Left phrenic nerve (C) Right sympathetic trunk (D) Left recurrent laryngeal nerve (E) Left greater splanchnic nerve

(D) Left recurrent laryngeal nerve

A9-month-old girl was admitted to the children's hospital with tachypnea (fast breathing) and shortness of breath. Physical examination further exhibits tachycardia (fast heart rate), a bounding peripheral pulse, and her angio- graphs reveal a patent ductus arteriosus. Which of the following embryonic arterial structures is most likely responsible for the origin of the pat- ent ductus arteriosus? (A) Right fourth arch (B) Left fifth arch (C) Right fifth arch (D) Left sixth arch (E) Right sixth arch

(D) Left sixth arch

A 37-year-old man is brought to the emergency department complaining of severe chest pain. His angiogram reveals thromboses of both brachiocephalic veins just before entering the superior vena cava. This condition would most likely cause a dilation of which of the following veins? (A) Azygos (B) Hemiazygos (C) Right superior intercostal (D) Left superior intercostal (E) Internal thoracic

(D) Left superior intercostal

An elderly man at a nursing home is known to have degenerative brain disease. When cerebrospinal fluid (CSF) is withdrawn by lumbar puncture for further examination, which of the following structures is most likely penetrated by the needle? (A) Pia mater (B) Filum terminale externum (C) Posterior longitudinal ligament (D) Ligamentum flavum (E) Annulus fibrosus

(D) Ligamentum flavum

A 75-year-old woman was admitted to a local hospital, and bronchograms and radio- graphs revealed a lung carcinoma in her left lung. Which of the following structures or char- acteristics does the cancerous lung contain? (A) Horizontal fissure (B) Groove for superior vena cava (SVC) (C) Middle lobe (D) Lingula (E) Larger capacity than the right

(D) Lingula

A 22-year-old patient received a stab wound in the chest that injured the intercostobrachial nerve. Which of the following conditions results from the described lesion of the nerve? (A) Inability to move the ribs (B) Loss of tactile sensation on the lateral aspect of the arm (C) Absence of sweating on the posterior aspect of the arm (D) Loss of sensory fibers from the second intercostal nerve (E) Damage to the sympathetic preganglionic fibers

(D) Loss of sensory fibers from the second intercostal nerve

An 83-year-old man with a typical coronary circulation has been suffering from an embolism of the circumflex branch of the left coronary artery. This condition would result in ischemia of which of the following areas of the heart? (A) Anterior part of the left ventricle (B) Anterior interventricular region (C) Posterior interventricular region (D) Posterior part of the left ventricle (E) Anterior part of the right ventricle

(D) Posterior part of the left ventricle

A 38-year-old homebuilder was involved in an accident and is unable to supinate his forearm. Which of the following nerves are most likely damaged? (A) Suprascapular and axillary (B) Musculocutaneous and median (C) Axillary and radial (D) Radial and musculocutaneous (E) Median and ulnar

(D) Radial and musculocutaneous

A 14-year-old boy falls on his outstretched hand and has a fracture of the scaphoid bone. The fracture is most likely accompanied by a rupture of which of the following arteries? (A) Brachial artery (B) Ulnar artery (C) Deep palmar arterial arch (D) Radial artery (E) Princeps pollicis artery

(D) Radial artery

A 37-year-old man is brought to the emergency department with a crushed second cervical vertebra (axis) that he suffered after a stack of pallets fell on him at work. Which of the following structures would be intact after the accident? (A) Alar ligament (B) Apical ligament (C) Semispinalis cervicis muscle (D) Rectus capitis posterior minor (E) Obliquus capitis inferior

(D) Rectus capitis posterior minor

A thoracentesis is performed to aspirate an abnormal accumulation of fluid in a 37-year- old patient with pleural effusion. A needle should be inserted at the midaxillary line between which of the following two ribs so as to avoid puncturing the lung? (A) Ribs 1 and 3 (B) Ribs 3 and 5 (C) Ribs 5 and 7 (D) Ribs 7 and 9 (E) Ribs 9 and 11

(D) Ribs 7 and 9

A 37-year-old patient with palpitation was examined by her physician, and one of the diagnostic records included a posterior-anterior chest radiograph. Which of the following comprises the largest portion of the sternocostal surface of the heart seen on the radiograph? (A) Left atrium (B) Right atrium (C) Left ventricle (D) Right ventricle (E) Base of the heart

(D) Right ventricle

A 29-year-old man comes in with a stab wound, cannot raise his arm above horizontal, and exhibits a condition known as "winged scapula." Which of the following structures of the brachial plexus would most likely be damaged? (A) Medial cord (B) Posterior cord (C) Lower trunk (D) Roots (E) Upper Trunk

(D) Roots

During an outbreak of meningitis at a local college, a 20-year-old student presents to a hospital emergency department complain- ing of headache, fever, chills, and stiff neck. On examination, it appears that he may have meningitis and needs a lumbar puncture or a spinal tap. Cerebrospinal fluid (CSF) is normally withdrawn from which of the following spaces? A) Epidural space (B) Subdural space (C) Space between the spinal cord and the pia mater (D) Subarachnoid space (E) Space between the arachnoid and dura maters

(D) Subarachnoid space

A 75-year-old patient has been suffer-ing from lung cancer located near the cardiac notch, a deep indentation on the lung. Which of the following lobes is most likely to be excised? (A) Superior lobe of the right lung (B) Middle lobe of the right lung (C) Inferior lobe of the right lung (D) Superior lobe of the left lung (E) Inferior lobe of the left lung

(D) Superior lobe of the left lung

The victim of an automobile accident has a destructive injury of the proximal row of carpal bones. Which of the following bones is most likely damaged? (A) Capitate (B) Hamate (C) Trapezium (D) Triquetrium (E) Trapezoid

(D) Triquetrium

A 31-year-old patient complains of sensory loss over the anterior and posterior surfaces of the medial third of the hand and the medial one and one-half fingers. He is diagnosed by a physician as having "funny bone" symptoms. Which of the following nerves is injured? (A) Axillary (B) Radial (C) Median (D) Ulnar (E) Musculocutaneous

(D) Ulnar

A 23-year-old woman who receives a deep cut to her ring finger by a kitchen knife is unable to move the metacarpophalangeal joint. Which of the following pairs of nerves was damaged? (A) Median and ulnar (B) Radial and median (C) Musculocutaneous and ulnar (D) Ulnar and radial (E) Radial and axillary

(D) Ulnar and radial

A man injuries his wrist on broken glass. Which of the following structures entering the palm superficial to the flexor retinaculum may be damaged? (A) Ulnar nerve and median nerve (B) Median nerve and flexor digitorum profundus (C) Median nerve and flexor pollicis longus (D) Ulnar artery and ulnar nerve (E) Ulnar nerve and flexor digitorum superficialis

(D) Ulnar artery and ulnar nerve

A 25-year-old soldier suffers a gunshot wound on the lower part of his back and is unable to move his legs. A neurologic examination and magnetic resonance imaging (MRI) scan reveal injury of the cauda equina. Which of the following is most likely damaged? (A) Dorsal primary rami (B) Ventral primary rami (C) Dorsal roots of the thoracic spinal nerves (D) Ventral roots of the sacral spinal nerves (E) Lumbar spinal nerves

(D) Ventral roots of the sacral spinal nerves

During a snowstorm, a 52-year-old man is brought to the emergency department after a multiple car accident. Which of the following conditions is produced by a force that drives the trunk forward while the head lags behind in a rear-end automobile collision? (A) Scoliosis (B) Hangman fracture (C) Meningomyelocele (D) Whiplash injury (E) Herniated disk

(D) Whiplash injury

Receives oxygenated blood via pulmonary veins?

(E)

When the internal vertebral venous plexus is ruptured, venous blood may spread into which tissue and space?

(E)

Which structure branches into the bronchial arteries?

(E)

A 78-year-old patient presents with an advanced cancer in the posterior mediastinum. The surgeons are in a dilemma as to how to manage the condition. Which of the following structures is most likely damaged? (A) Brachiocephalic veins (B) Trachea (C) Arch of the azygos vein (D) Arch of the aorta (E) Hemiazygos vein

(E) Hemiazygos vein

A 69-year-old man has an abnormally increased curvature of the thoracic vertebral column. Which of the following conditions is the most likely diagnosis? (A) Lordosis (B) Spina bifida occulta (C) Meningocele (D) Meningomyelocele (E) Kyphosis

(E) Kyphosis

Coronary angiographs of a 44-year-old male patient reveal an occlusion of the circumflex branch of the left coronary artery. This patient has been suffering from myocardial infarction in which of the following areas? (A) Right and left ventricles (B) Right and left atria (C) Interventricular septum (D) Apex of the heart (E) Left atrium and ventricle

(E) Left atrium and ventricle

A 33-year-old patient is suffering from a sudden occlusion at the origin of the descending (thoracic) aorta. This condition would most likely decrease blood flow in which of the following intercostal arteries? (A) Upper six anterior (B) All of the posterior (C) Upper two posterior (D) Lower anterior (E) Lower six anterior

(E) Lower six anterior

A 35-year-old man walks in with a stab wound to the most medial side of the proximal portion of the cubital fossa. Which of the following structures would most likely be damaged? (A) Biceps brachii tendon (B) Radial nerve (C) Brachial artery (D) Radial recurrent artery (E) Median nerve

(E) Median nerve

An 18-year-old girl is thrust into the steering wheel while driving and experiences difficulty in expiration. Which of the following muscles is most likely damaged? (A) Levator costarum (B) Innermost intercostal muscle (C) External intercostal muscle (D) Diaphragm (E) Muscles of the abdominal wall

(E) Muscles of the abdominal wall

A 16-year-old patient has weakness flexing the metacarpophalangeal joint of the ring finger and is unable to adduct the same finger. Which of the following muscles is most likely paralyzed? (A) Flexor digitorum profundus (B) Extensor digitorum (C) Lumbrical (D) Dorsal interosseous (E) Palmar interosseous

(E) Palmar interosseous

A 20-year-old man fell from the parallel bar during the Olympic trial. A neurologic examination reveals that he has a lesion of the lateral cord of the brachial plexus. Which of the following muscles is most likely weakened by this injury? (A) Subscapularis (B) Teres major (C) Latissimus dorsi (D) Teres minor (E) Pectoralis major

(E) Pectoralis major

A 26-year-old heavyweight boxer was punched on his mandible, resulting in a slight subluxation (dislocation) of the atlantoaxial joint. The consequence of the injury was decreased range of motion at that joint. What movement would be most affected? (A) Extension (B) Flexion (C) Abduction (D) Adduction (E) Rotation

(E) Rotation

A 12-year-old boy was admitted to a local hospital with a known history of heart problems. His left ventricular hypertrophy could result from which of the following conditions? (A) A constricted pulmonary trunk (B) An abnormally small left AV opening (C) Improper closing of the pulmonary valves (D) An abnormally large right AV opening (E) Stenosis of the aorta

(E) Stenosis of the aorta

A patient comes in with a gunshot wound and requires surgery in which his thoracoacromial trunk needs to be ligated. Which of the following arterial branches would maintain normal blood flow? (A) Acromial (B) Pectoral (C) Clavicular (D) Deltoid (E) Superior thoracic

(E) Superior thoracic

A middle-aged coal miner injures his back after an accidental explosion. His magnetic resonance imaging (MRI) scan reveals that his spinal cord has shifted to the right because the lateral extensions of the pia mater were torn. Function of which of the following structures is most likely impaired? (A) Filum terminale internum (B) Coccygeal ligament (C) Denticulate ligament (D) Choroid plexus (E) Tectorial membrane

(C) Denticulate ligament

A 21-year-old patient with a stab wound reveals a laceration of the right vagus nerve proximal to the origin of the recurrent laryngeal nerve. Which of the following conditions would most likely result from this lesion? (A) Contraction of bronchial muscle (B) Stimulation of bronchial gland secretion (C) Dilation of the bronchial lumen (D) Decrease in cardiac rate (E) Constriction of coronary artery

(C) Dilation of the bronchial lumen

A mother with diabetes gives birth to a baby who is diagnosed as having dextroposition of the aorta and the pulmonary trunk with cyanosis and shortness of breath. Which of the following structures is required to remain patent until surgical correction of the deformity? (A) Umbilical arteries (B) Umbilical vein (C) Ductus arteriosus (D) Ductus venosus (E) Sinus venosus

(C) Ductus arteriosus

A 39-year-old woman with headaches presents to her primary care physician with a possible herniated disk. Her magnetic resonance imaging (MRI) scan reveals that the posterolateral protrusion of the intervertebral disk between L4 and L5 vertebrae would most likely affect nerve roots of which of the following spinal nerves? (A) Third lumbar nerve (B) Fourth lumbar nerve (C) Fifth lumbar nerve (D) First sacral nerve (E) Second sacral nerve

(C) Fifth lumbar nerve

A secretary comes in to your office com- plaining of pain in her wrists from typing all day. You determine that she likely has carpal tunnel syndrome. Which of the following conditions would help you determine the diagnosis? (A) Inability to adduct the little finger (B) Inability to flex the DIP joint of the ring finger (C) Flattened thenar eminence (D) Loss of skin sensation of the medial one and one-half fingers (E) Atrophied adductor pollicis muscle

(C) Flattened thenar eminence

A patient with a deep stab wound in the middle of the forearm has impaired movement of the thumb. Examination indicates a lesion of the anterior interosseous nerve. Which of the following muscles is paralyzed? (A) Flexor pollicis longus and brevis (B) Flexor pollicis longus and opponens pollicis (C) Flexor digitorum profundus and pronator quadratus (D) Flexor digitorum profundus and superficialis (E) Flexor pollicis brevis and pronator quadratus

(C) Flexor digitorum profundus and pronator quadratus

A 27-year-old patient presents with an inability to draw the scapula forward and downward because of paralysis of the pectoralis minor. Which of the following would most likely be a cause of his condition? (A) Fracture of the clavicle (B) Injury to the posterior cord of the brachial plexus (C) Fracture of the coracoid process (D) Axillary nerve injury (E) Defects in the posterior wall of the axilla

(C) Fracture of the coracoid process

A 23-year-old man received a gunshot wound, and his greater splanchnic nerve was destroyed. Which of the following nerve fibers would be injured? (A) General somatic afferent (GSA) and pre-ganglionic sympathetic fibers (B) General visceral afferent (GVA) and post- ganglionic sympathetic fibers (C) GVA and preganglionic sympathetic fibers (D) General somatic efferent (GSE) and post- ganglionic sympathetic fibers (E) GVA and GSE fibers

(C) GVA and preganglionic sympathetic fibers

A 32-year-old patient who weighs 275 lb comes to the doctor's office. On the surface of the chest, the physician is able to locate the apex of the heart: (A) At the level of the sternal angle (B) In the left fourth intercostal space (C) In the left fifth intercostal space (D) In the right fifth intercostal space (E) At the level of the xiphoid process of the sternum

(C) In the left fifth intercostal space

A 27-year-old stuntman is thrown out of his vehicle prematurely when the car used for a particular scene speeds out of control. His spinal cord is crushed at the level of the fourth lumbar spinal segment. Which of the following structures would most likely be spared from destruction? (A) Dorsal horn (B) Ventral horn (C) Lateral horn (D) Gray matter (E) Pia mater

(C) Lateral horn

A 27-year-old pianist with a known carpal tunnel syndrome experiences difficulty in finger movements. Which of the following intrinsic muscles of her hand is paralyzed? (A) Palmar interossei and adductor pollicis (B) Dorsal interossei and lateral two lumbricals (C) Lateral two lumbricals and opponens pollicis (D) Abductor pollicis brevis and palmar interossei (E) Medial two and lateral two lumbricals

(C) Lateral two lumbricals and opponens pollicis

A 21-year-old woman walks in with a shoulder and arm injury after falling during horse- back riding. Examination indicates that she cannot adduct her arm because of paralysis of which of the following muscles? (A) Teres minor (B) Supraspinatus (C) Latissimus dorsi (D) Infraspinatus (E) Serratus anterior

(C) Latissimus dorsi

After an automobile accident, a back muscle that forms the boundaries of the triangle of auscultation and the lumbar triangle receives no blood. Which of the following muscles might be ischemic? (A) Levator scapulae (B) Rhomboid minor (C) Latissimus dorsi (D) Trapezius (E) Splenius capitis

(C) Latissimus dorsi

A 37-year-old house painter fell from a ladder and fractured his left third rib and the structures with which it articulated. Which of the following structures would most likely be damaged? (A) Manubrium of the sternum (B) Body of the second thoracic vertebra (C) Spinous process of the third thoracic vertebra (D) Body of the fourth thoracic vertebra (E) Transverse process of the second thoracic vertebra

(B) Body of the second thoracic vertebra

A 27-year-old baseball player is hit on his forearm by a high-speed ball during the World Series, and the muscles that form the floor of the cubital fossa appear to be torn. Which of following groups of muscles have lost their functions? (A) Brachioradialis and supinator (B) Brachialis and supinator (C) Pronator teres and supinator (D) Supinator and pronator quadratus (E) Brachialis and pronator teres

(B) Brachialis and supinator

A 45-year-old woman presents with a tumor confined to the posterior mediastinum. This could result in compression of which of the following structures? (A) Trachea (B) Descending aorta (C) Arch of the aorta (D) Arch of the azygos vein (E) Phrenic nerve

(B) Descending aorta

A 23-year-old man complains of numb- ness on the medial side of the arm following a stab wound in the axilla. On examination, he is diagnosed with an injury of his medial brachial cutaneous nerve. In which of the following structures are the cell bodies of the damaged nerve involved in numbness located? (A) Sympathetic chain ganglion (B) Dorsal root ganglion (C) Anterior horn of the spinal cord (D) Lateral horn of the spinal cord (E) Posterior horn of the spinal cord

(B) Dorsal root ganglion

After a 26-year-old man's car was broadsided by a large truck, he is brought to the emergency department with multiple fractures of the transverse processes of the cervical and upper thoracic vertebrae. Which of the following muscles might be affected? (A) Trapezius (B) Levator scapulae (C) Rhomboid major (D) Serratus posterior superior (E) Rectus capitis posterior major

(B) Levator scapulae

A 7-day-old baby is diagnosed as having congenital neonatal emphysema, which is caused by collapsed bronchi because of failure of bronchial cartilage development. Bronchial cartilages are derived from which of the following derivations? (A) Ectoderm (B) Mesoderm (C) Endoderm (D) Proctodeum (E) Neuroectoderm

(B) Mesoderm

A 19-year-old man came to the emergency department, and his angiogram exhibited that he was bleeding from the vein that is accompanied by the posterior interventricular artery. Which of the following veins is most likely ruptured? (A) Great cardiac vein (B) Middle cardiac vein (C) Anterior cardiac vein (D) Small cardiac vein (E) Oblique veins of the left atrium

(B) Middle cardiac vein

A 37-year-old patient with severe chest pain, shortness of breath, and congestive heart failure was admitted to a local hospital. His coronary angiograms reveal a thrombosis in the circumflex branch of the left coronary artery. Which of the following conditions could result from the blockage of blood flow in the circumflex branch? (A) Tricuspid valve insufficiency (B) Mitral valve insufficiency (C) Ischemia of AV node (D) Paralysis of pectinate muscle (E) Necrosis of septomarginal trabecula

(B) Mitral valve insufficiency

A 25-year-old man with congenital abnormalities at birth has a lesion of the dorsal scapular nerve, making him unable to adduct his scapula. Which of the following muscles is most likely paralyzed? (A) Semispinalis capitis (B) Rhomboid major (C) Multifidus (D) Rotator longus (E) Iliocostalis

(B) Rhomboid major

During a domestic dispute, a 16-year-old boy receives a deep stab wound around the superior angle of the scapula near the medial border, which injures both the dorsal scapular and spinal accessory nerves. Such an injury could result in paralysis or weakness of which of the following muscles? (A) Trapezius and serratus posterior superior (B) Rhomboid major and trapezius (C) Rhomboid minor and latissimus dorsi (D) Splenius cervicis and sternocleidomastoid (E) Levator scapulae and erector spinae

(B) Rhomboid major and trapezius

A 62-year-old woman who is a heavy smoker has advanced lung cancer that spread into her right posterior intercostal space posterior to the midaxillary line. If cancer cells are carried in the venous drainage, they would travel first to which of the following veins? (A) SVC (B) Right superior intercostal vein (C) Right brachiocephalic vein (D) Azygos vein (E) Hemiazygos vein

(B) Right superior intercostal vein

A 24-year-old woman comes to a hospital to deliver her baby. Her obstetrician uses a caudal anesthesia during labor and childbirth to block the spinal nerves in the epidural space. Local anesthetic agents are most likely injected via which of the following openings? (A) Intervertebral foramen (B) Sacral hiatus (C) Vertebral canal (D) Dorsal sacral foramen (E) Ventral sacral foramen

(B) Sacral hiatus

Becomes hypertophied as a result of the pulmonary stenosis?

(C)

Contains the septomarginal trabecula?

(C)

Dorsal and ventral roots of the lower lumbar and sacral nerves are lacerated. Which structure is most likely damaged?

(C)

Stenosis of which structure may produce left ventricular hypertrophy?

(C)

The left coronary artery arises from which structure?

(C)

A 56-year-old patient recently suffered a myocardial infarction in the area of the apex of the heart. The occlusion by atherosclerosis is in which of the following arteries? (A) Marginal artery (B) Right coronary artery at its origin (C) Anterior interventricular artery (D) Posterior interventricular artery (E) Circumflex branch of the left coronary artery

(C) Anterior interventricular artery

A 57-year-old woman comes into her physician's office complaining of fever, nausea, vomiting, and the worst headache of her life. Tests and physical examination suggest hydrocephalus (widening ventricles) resulting from a decrease in the absorption of cerebrospinal fluid (CSF). A decrease of flow in the CSF through which of the following structures would be responsible for these findings? (A) Choroid plexus (B) Vertebral venous plexus (C) Arachnoid villi (D) Internal jugular vein (E) Subarachnoid trabeculae

(C) Arachnoid villi

A 21-year-old patient has a lesion of the upper trunk of the brachial plexus (Erb-Duchenne paralysis). Which of the following is the most likely diagnosis? (A) Paralysis of the rhomboid major (B) Inability to elevate the arm above the horizontal (C) Arm tending to lie in medial rotation (D) Loss of sensation on the medial side of the arm (E) Inability to adduct the thumb

(C) Arm tending to lie in medial rotation

A 57-year-old patient has a heart murmur resulting from the inability to maintain constant tension on the cusps of the AV valve. Which of the following structures is most likely damaged? (A) Crista terminalis (B) Septomarginal trabecula (C) Chordae tendinae (D) Pectinate muscle (E) Anulus fibrosus

(C) Chordae tendinae

A 47-year-old man with a known atrial fibrillation returns to see his cardiologist for follow-up of his cardiac health. The right atrium is important in this case because it: (A) Receives blood from the oblique cardiac vein (B) Is associated with the apex of the heart (C) Contains the SA node (D) Receives the right pulmonary vein (E) Is hypertrophied by pulmonary stenosis

(C) Contains the SA node

Into which structure does the azygos vein drain venous blood?

(A)

Lies on the right side of the aortic arch and ascending aorta?

(A)

Which structure may herniate through the annulus fibrosus, thereby impinging on the roots of the spinal nerve?

(A)

A neonate appears severely cyanotic and breathing rapidly. Cardiac echocardiogram reveals that the aorta lies to the right of the pul- monary trunk. Which of the following is most likely occurred during development? (A) AP septum failed to develop in a spiral fashion (B) Excessive resorption of septum primum (C) Pulmonary valve atresia (D) Persistent truncus arteriosus (E) Coarctation of the aorta

(A) AP septum failed to develop in a spiral fashion

A 32-year-old patient has a tension pneumothorax that can be treated with needle aspiration. To avoid an injury of the intercostal neurovascular bundle, the needle may be inserted in which of the following locations? (A) Above the upper border of the ribs (B) Deep to the upper border of the ribs (C) Beneath the lower border of the ribs (D) Between the external and internal intercostals (E) Through the transversus thoracis muscle

(A) Above the upper border of the ribs

A patient has a small but solid tumor in the mediastinum, which is confined at the level of the sternal angle. Which of the following structures would most likely be found at this level? (A) Bifurcation of the trachea (B) Beginning of the ascending aorta (C) Middle of the aortic arch (D) Articulation of the third rib with the sternum (E) Superior border of the superior mediastinum

(A) Bifurcation of the trachea

A patient bleeding from the shoulder secondary to a knife wound is in fair condition because there is vascular anastomosis around the shoulder. Which of the following arteries is most likely a direct branch of the subclavian artery that is involved in the anastomosis? (A) Dorsal scapular artery (B) Thoracoacromial artery (C) Circumflex scapular artery (D) Transverse cervical artery (E) Suprascapular artery

(A) Dorsal scapular artery

A 43-year-old female patient has been lying down on the hospital bed for more than 4 months. Her normal, quiet expiration is achieved by contraction of which of the following structures? (A) Elastic tissue in the lungs and thoracic wall (B) Serratus posterior superior muscles (C) Pectoralis minor muscles (D) Serratus anterior muscles (E) Diaphragm

(A) Elastic tissue in the lungs and thoracic wall

A patient with a stab wound receives a laceration of the musculocutaneous nerve. Which of the following conditions is most likely to have occurred? (A) Lack of sweating on the lateral side of the forearm (B) Inability to extend the forearm (C) Paralysis of brachioradialis muscle (D) Loss of tactile sensation on the arm (E) Constriction of blood vessels on the hand

(A) Lack of sweating on the lateral side of the forearm

A 16-year-old boy fell from a motorcycle, and his radial nerve was severely damaged because of a fracture of the midshaft of the humerus. Which of the following conditions would most likely result from this accident? (A) Loss of wrist extension leading to wrist drop (B) Weakness in pronating the forearm (C) Sensory loss over the ventral aspect of the base of the thumb (D) Inability to oppose the thumb (E) Inability to abduct the fingers

(A) Loss of wrist extension leading to wrist drop

A thoracic surgeon removed the right middle lobar (secondary) bronchus along with lung tissue from a 57 year-old heavy smoker with lung cancer. Which of the following broncho-pulmonary segments must contain cancerous tissues? (A) Medial and lateral (B) Anterior and posterior (C) Anterior basal and medial basal (D) Anterior basal and posterior basal (E) Lateral basal and posterior basal

(A) Medial and lateral

An 18-year-old boy involved in an automobile accident presents with an arm that cannot abduct. His paralysis is caused by damage to which of the following nerves? (A) Suprascapular and axillary (B) Thoracodorsal and upper subscapular (C) Axillary and musculocutaneous (D) Radial and lower subscapular (E) Suprascapular and dorsal scap

(A) Suprascapular and axillary

Can be removed in a surgical resection of a lobe to remove lung cancer on the diaphragmatic surface?

(B)

The spinal cord is crushed at the level of the upper part of the first lumbar vertebra. Which structure is most likely damaged?

(B)

Which structure is most likely to be removed by a pulmonary surgeon in a surgical resection of a lobe (lobectomy) to remove lung cancer in the apex of the right lung?

(B)

A 46-year-old patient comes to his doctor's office and complains of chest pain and headache. His computed tomography (CT) scan reveals a tumor located just superior to the root of the right lung. Blood flow in which of the following veins is most likely blocked by this tumor? (A) Hemiazygos vein (B) Arch of the azygos vein (C) Right subclavian vein (D) Right brachiocephalic vein (E) Accessory hemiazygos vein

(B) Arch of the azygos vein