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Question 1
Correct
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The uterine artery arises from the?
Your Answer: Internal iliac artery
Explanation:The uterine artery arises from the anterior division of the internal iliac artery and runs medially on the levator ani towards the uterine cervix.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 2
Correct
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upon stroking the plantar surface of a patient's foot, extension of toes was noted. This is likely to be accompanied with:
Your Answer: Spasticity
Explanation:An upper motor neuron lesion affects the neural pathway above the anterior horn cell or motor nuclei of the cranial nerves, whereas a lower motor neurone lesion affects nerve fibres travelling from the anterior horn of the spinal cord to the relevant muscles. An upper motor neurone lesions results in the following:
– Spasticity in the extensor muscles (lower limbs) or flexor muscles (upper limbs).
– ‘clasp-knife’ response where initial resistance to movement is followed by relaxation
– Weakness in the flexors (lower limbs) or extensors (upper limbs) with no muscle wasting
– Brisk tendon jerk reflexes
– Positive Babinski sign (on stimulation of the sole of the foot, the big toe is raised rather than curled downwards)
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This question is part of the following fields:
- Neurology
- Physiology
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Question 3
Correct
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A 55- year old male patient with cancer of the head of the pancreas was to undergo whipple's operation to have the tumour removed. During the surgery, the surgeon had to ligate the inferior pancreaticoduodenal artery to stop blood supply to the head of the pancreas. Which of the following arteries does the inferior pancreaticoduodenal artery branch from?
Your Answer: Superior mesenteric artery
Explanation:The inferior pancreaticoduodenal artery is a branch of the superior mesenteric artery or from the first intestinal branch of the superior mesenteric artery. Once given off, it runs to the right between the pancreatic head and the duodenum and then ascends to form an anastomosis with the superior pancreaticoduodenal artery.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 4
Correct
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During thymectomy the surgeon accidentally nicks a vein that lies just posterior to the thymus. Which of the following vessels is likely to be injured?
Your Answer: Left brachiocephalic vein
Explanation:The thymus is located superficially in the anterior mediastinum. The left brachiocephalic vein courses through the mediastinum to join the right brachiocephalic vein and form the superior vena cava on the right side of the thorax. The left brachiocephalic vein, being superficial, courses just deep to the thymus so that it may be susceptible to compression by an adjacent tumour. The left pulmonary vein, left bronchial vein and right pulmonary artery are deep, and enter and exit the lung at its root, thus are not near the thymus. The right superior intercostal vein drains the 2nd to the 4th intercostal spaces and drains into the arch of the azygos vein. It is not, therefore, closely related with the thymus.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 5
Correct
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Whipple's procedure involves mobilizing the head of the pancreas. As the surgeon does this, he must be careful to avoid injury to a key structure that is found lying behind the head of the pancreas. Which vital structure is this?
Your Answer: Common bile duct
Explanation:The posterior relations of the head of the pancreas include: the inferior vena cava, the common bile duct, the renal veins, the right crus of the diaphragm and the aorta.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 6
Correct
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In relation to the muscles of facial expression, It is true to say:
Your Answer: They are in the same subcutaneous plane as the platysma muscle
Explanation:The facial muscles generally originate from the facial bones and attach to the skin, in the same plane as the platysma muscle. They are all innervated by cranial nerve VII (the facial nerve). The occipitofrontalis muscle consists of two parts: The occipital belly, near the occipital bone, and the frontal belly, near the frontal bone.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 7
Correct
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The gluteus medius muscle:
Your Answer: Is supplied by the superior gluteal nerve
Explanation:The gluteus medius is situated on the outer surface of the pelvis. It arises from the outer surface of the ilium between the iliac crest and posterior gluteal line above and the anterior gluteal line below. The gluteus medius is supplied by the fourth and fifth lumbar and first sacral nerves through the superior gluteal nerve
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 8
Correct
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A 20-year old college student was diagnosed with meningitis that had developed due to an acute cavernous sinus thrombosis from an ear infection. Which of the following superficial venous routes is the usual path that an infected blood clot takes to reach the cavernous sinus?
Your Answer: Facial vein
Explanation:The facial vein is the usual communication between the cavernous sinus and the pterygoid sinus. It is through this vein that an infected clot can travel to the cavernous sinus and cause infection. The pterygoid plexus is a venous plexus that is situated between the temporalis muscle and lateral pterygoid muscle, and partly between the two pterygoid muscles. The pterygoid plexus is connected to the facial vein by the deep facial vein. This connection is what makes this area where this sinus and the facial vein are located a danger zone. The danger zone or triangle of the face is the area from the corners of the mouth to the nose bridge. The sinus connection in this area makes it possible for infection to reach the cavernous sinus and at times cause meningitis.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 9
Incorrect
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Which muscle originates from the common flexor tendon of the forearm?
Your Answer: Flexor digitorum profundus
Correct Answer: Flexor digitorum superficialis
Explanation:The medial epicondyle of the humerus is the site of origin of this group of muscles of the forearm. It originates from the medial epicondyle of the humerus by a common tendon. Fibres from the deep fascia of the forearm, near the elbow and septa, pass from this fascia between the muscles. These muscles include the pronator teres, palmaris longus, flexor carpi radialis, flexor carpi ulnaris and flexor digitorum superficialis.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 10
Correct
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One of the following structures is contained in the anterior compartment of the lower leg. Which is it?
Your Answer: Extensor hallucis muscle
Explanation:The lower leg is made up of four fascial compartments separated from one another by septa that contain the muscles of the lower leg. The four compartments are ; anterior, lateral, deep posterior and superficial posterior compartments.
These are the compartments and there contents:
i) Anterior compartment: Tibialis anterior muscle, extensor hallucis longus muscle, extensor digitorum longus muscle, peroneus tertius muscles, deep fibular nerve and anterior tibial blood vessels
ii) Lateral compartment: Fibularis longus muscle, brevis muscles and superficial fibular nerve
iii) Deep posterior compartment: Tibialis posterior m., flexor hallucis longus m., flexor digitorum longus m. ,popliteus m. , tibial nerve, posterior tibial artery and posterior tibial vessels such as the fibular artery.
iv) Superficial posterior compartment: Gastrocnemius m., soleus m., plantaris m., medial sural cutaneous nerve
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 11
Incorrect
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During a radical mastectomy for advanced breast cancer, the surgeon injured the long thoracic nerve. Which among the following muscles is likely to be affected?
Your Answer:
Correct Answer: Serratus anterior
Explanation:The long thoracic nerve innervates the serratus anterior muscle which holds the scapula forward and balances the rhomboids and the trapezius muscles which retract the scapula. Injury to this nerve results in a ‘winged scapula’ with a posterior protrusion.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 12
Incorrect
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A lesion involving the suprachiasmatic nucleus of hypothalamus is likely to affect:
Your Answer:
Correct Answer: Regulation of circadian rhythm
Explanation:The suprachiasmatic nucleus (SCN) in the hypothalamus is responsible for controlling endogenous circadian rhythms and destruction of the SCN leads to a loss of circadian rhythm.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 13
Incorrect
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A cerebellar tremor can be differentiated from a Parkinsonian tremor in that:
Your Answer:
Correct Answer: It only occurs during voluntary movements
Explanation:Cerebellar disease leads to intention tremors, which is absent at rest and appears at the onset of voluntary movements. In comparison, Parkinson’s tremor is present at rest. Frequency of tremor is a less reliable means to differentiate between the two as the oscillation amplitude of the tremor is not constant throughout a voluntary action.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 14
Incorrect
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The normal location of the major duodenal papilla:
Your Answer:
Correct Answer: Descending part of the duodenum
Explanation:The major duodenal papilla is on the descending portion of the duodenum on the medial side, about 7-10cm from the pylorus. The pancreatic ducts and the common bile ducts unite and open by a common orifice on the summit of the duodenal papilla.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 15
Incorrect
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Identify which of the following muscles acts on two joints?
Your Answer:
Correct Answer: Sartorius
Explanation:The sartorius muscle, the longest muscle in the body, is one of the two jointed or biarticular muscles. It originates from the anterior superior iliac spine and part of the notch between the anterior superior iliac spine and anterior inferior iliac spine and crosses both the hip joint and the knee joint. At the hip joint the sartorius flexes and rotates the thigh at the hip joint and flexes the leg at the knee joint.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 16
Incorrect
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A urologist makes a transverse suprapubic incision to retrieve a stone from the urinary bladder. Which of the following abdominal wall layers will the surgeon NOT traverse?
Your Answer:
Correct Answer: Posterior rectus sheath
Explanation:Pfannenstiel incision (a transverse suprapubic incision) is made below the arcuate line. Thus, there is no posterior layer of the rectus sheath here, only the transversalis fascia lines the inner layer of the rectus abdominis. The layers traversed include: skin, superficial fascia (fatty and membranous), deep fascia, anterior rectus sheath, rectus abdominis muscle, transversalis fascia, extraperitoneal connective tissue and peritoneum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 17
Incorrect
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Which of the following arteries, if ligated, will most likely affect blood supply to the pancreas?
Your Answer:
Correct Answer: Superior mesenteric
Explanation:The pancreas is a glandular organ in the body that produces important hormones such as insulin and glucagon. Its blood supply is from branches of the coeliac artery, superior mesenteric artery and the splenic artery. These are the arteries that if ligated, would affect blood supply to the pancreas.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 18
Incorrect
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The cranial nerves of the brain provide motor and sensory innervation to the structures of the head and neck. Which of the following cranial nerves provide only motor innervation?
Your Answer:
Correct Answer: Abducens
Explanation:The cranial nerves emerge directly from the brain and the brain stem. They provide sensory, motor or both motor and sensory innervation. Here is a summary of the cranial nerves and their function:
Olfactory – Purely sensory
Optic – Sensory
Oculomotor – Mainly motor
Trochlear – Motor
Trigeminal – Both sensory and motor
Abducens – Mainly motor
Facial – Both sensory and motor
Vestibulocochlear – Mostly sensory
Glossopharyngeal – Both sensory and motor
Vagus – Both sensory and motor
Accessory – Mainly motor
Hypoglossal – Mainly motor
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 19
Incorrect
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The superior ulnar collateral artery is a direct branch of this artery:
Your Answer:
Correct Answer: Brachial
Explanation:The brachial artery gives rise to a small branch at the middle of the arm, which is the superior collateral artery. It descends accompanied by the ulnar nerve and anastomoses with the posterior ulnar recurrent and inferior ulnar collateral.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 20
Incorrect
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A 25-year-old football player suffers severe head trauma during a game. Physical examination reveals a decerebrate posture and bilateral papilledema. A CT scan reveals marked diffuse cerebral oedema. This condition will be most severe in which component of the brain?
Your Answer:
Correct Answer: White matter
Explanation:The greatest amount of salt and water increase with cerebral oedema occurs within the white matter. Any swelling from oedema, haemorrhage or haematoma increases the intracranial pressure (ICP). As the ICP increases, the cerebral perfusion decreases and brain tissue can become ischaemic, even leading to brain death.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 21
Incorrect
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A medical intern wanting to perform her first thoracentesis (remove fluid from the pleural cavity) wishes to be reminded where to insert the needle to aspirate in order to avoid injuring the lung or neurovascular elements. Where is this place?
Your Answer:
Correct Answer: The bottom of interspace 9 in the midaxillary line
Explanation:Thoracentesis is performed in the costodiaphragmatic recess. The needle needs to be inserted below the level of the lungs to avoid injury to the lungs. At the paravertebral line, is between ribs 10 and 12, at the midaxillary line between ribs 8 and 10 and at the midclavicular line between interspaces 6 and 8. The needle should be inserted at the top of the rib (or the bottom of the interspace) to avoid damage to the neurovascular structures found below the rib running in the costal groove.
The recommended location for the needle insertion varies depending upon the source. It is critical that the patient hold his or her breath to avoid piercing of the lung.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 22
Incorrect
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The surgical registrar is doing an exploratory laparotomy on a 35 year old lady of African descent with tuberculous of the abdomen and suspected perforation. The small bowel is matted due to adhesions and it is difficult to differentiate the ileum from the jejunum. Which of the following features is typical of the jejunum?
Your Answer:
Correct Answer: It has sparse aggregated lymph nodules
Explanation:The jejunum has a wider diameter, is thicker and more vascularized, hence of a deeper colour compared to the ileum. The valvulae conniventes (circular folds) of its mucous membranes are large and thick and its villi are larger than those in the ileum. The jejunum also has sparse aggregates of lymph nodules and most of its part occupies the umbilical and left iliac regions whilst the ileum is mostly in the umbilical, hypogastric, right iliac and pelvic regions.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 23
Incorrect
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The circle of Willis is one of the cerebrovascular safeguards comprised of the left and the right posterior communicating artery. Which of the following arteries in the brain is connected to the posterior cerebral artery by these posterior communicating arteries?
Your Answer:
Correct Answer: Internal carotid artery
Explanation:The Circle of Willis is an anastomosis of cerebral arteries that are located at the base of the brain. The Circle of Willis is one of the important safeguards that ensure back up of blood supply to parts of the brain in case of any cerebrovascular accident. The Circle of Willis is made up of an anterior portion of arteries including; the anterior cerebral arteries. The anterior cerebral arteries are connected to the posterior portion of the circle of Willis by the anterior communicating artery. The posterior portion is made up of the posterior cerebral artery which branch off from the basilar artery. The posterior cerebral artery are connected to the anterior portion of the circle of Willis by the posterior communicating artery. The posterior communicating artery connects the posterior cerebral artery to the internal carotid artery. The circle of Willis receives blood supply from the left and right internal carotid arteries that continues as the middle cerebral artery and posteriorly from the two vertebral arteries that join to form the basilar artery.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 24
Incorrect
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From which fascia of the pelvic wall muscle does the levator ani muscle arise?
Your Answer:
Correct Answer: Obturator internus
Explanation:The levator ani muscle arises from the posterior surface of the superior ramus of the pubis lateral to the symphysis, behind the inner surface of the spine of the ischium and between these points from the obturator internus fascia. It is attached to the inner surface of the side of the lesser pelvic cavity, supports the viscera in the cavity and surrounds the various structures that pass through it.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 25
Incorrect
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During a laparoscopic surgery, the surgeon visualizes the medical umbilical folds on the deep surface of the anterior abdominal wall. What causes the medial umbilical folds?
Your Answer:
Correct Answer: Obliterated umbilical arteries
Explanation:The medial umbilical ligament is a structure found on the deep surface of the anterior abdominal wall and is covered by the medial umbilical folds. It is a paired structure that represents the remnants of the fetal umbilical artery. They have no role in humans after birth other than to be used as a landmark for exploring the medial inguinal fossa during laparoscopic inguinal hernia repair.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 26
Incorrect
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When inserting a chest drain anteriorly into the second intercostal space, one must identify the second costal cartilage by palpating which landmark?
Your Answer:
Correct Answer: Sternal angle
Explanation:The sternal angle is the site for identification of the second rib as the second rib is attached to the sternum at this point.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 27
Incorrect
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A patient gives a history of dull discomfort in her abdomen associated with pain that she points to be on her right shoulder and right scapula. The following organs are most likely to be source of her pain:
Your Answer:
Correct Answer: Liver, duodenum and gallbladder
Explanation:Referred pain is felt at a point away from the source of the pain or the unpleasant sensation. It arises when a nerve is damaged or compressed at a point but the pain is felt at another site that is the territory of that nerve. Common abdominal causes of referred pain to the shoulder and the shoulder blade are the liver, duodenum and gall bladder.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 28
Incorrect
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A 24-year old patient diagnosed with a direct inguinal hernia was scheduled for surgery to have the hernia repaired. The hernia was discovered to be protruding through the Hesselbach's triangle (inguinal triangle). Which of the following blood vessels that is a branch of the external iliac artery forms the lateral border of this triangle?
Your Answer:
Correct Answer: Inferior epigastric
Explanation:The inguinal triangle is formed by the following structures; inguinal ligament at the base; inferior epigastric vessels laterally and the lateral border of the rectus sheath medially. This triangle (also known as Hesselebach’s triangle) is where direct inguinal hernias protrude. The inferior epigastric artery is this the branch of the external iliac artery being referred to. All the other blood vessels are branches of the internal iliac artery.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 29
Incorrect
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A 35 year old male patient sustained a traumatic head injury. The patient had loss of consciousness, woke up momentarily when he was in the emergency room but became drowsy and comatose a few hours after. CT scan of the brain showed accumulation of blood between the dura and the cranial bone on the left side of his head. What type of haemorrhage did the patient have?
Your Answer:
Correct Answer: Epidural
Explanation:Epidural hematoma, also known as epidural bleeding, is a type of traumatic brain injury (TBI) in which a build-up of blood occurs between the dura mater (the tough outer membrane of the central nervous system) and the skull. The spinal cord is also covered by a layer of dura mater, so epidural bleeds may also occur in the spinal column. Often due to trauma, the condition is potentially deadly because the build-up of blood may increase pressure in the intracranial space, compressing delicate brain tissue, and causing brain shift. The condition is present in one to three percent of head injuries. Around 15–20% of epidural hematomas are fatal.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 30
Incorrect
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Which of the following bones was most likely fractured following an injury in the medial side of the foot between the navicular behind and base of the first metatarsal in front?
Your Answer:
Correct Answer: First cuneiform
Explanation:The first cuneiform bone is the largest of the three cuneiforms. It is situated at the medial side of the foot, between the navicular behind and the base of the first metatarsal in front.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 31
Incorrect
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Which of the following structure forms the floor of the posterior triangle of the neck:
Your Answer:
Correct Answer: Prevertebral fascia
Explanation:The posterior triangle (or lateral cervical region) is a region of the neck which has the following boundaries:
Apex: Union of the sternocleidomastoid and the trapezius muscles at the superior nuchal line of the occipital bone
Anterior: Posterior border of the sternocleidomastoid muscle
Posterior: Anterior border of the trapezius
Base: Middle one third of the clavicle
Roof: Investing layer of the deep cervical fascia
Floor: The anterolateral portion of prevertebral fascia -
This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 32
Incorrect
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An intern is attempting to put in an arterial line in an ICU patients left foot. Which is the best site to feel for the pulsation of the dorsalis pedis artery in the foot?
Your Answer:
Correct Answer: Just lateral to the tendon of extensor hallucis longus
Explanation:The dorsalis pedis artery is the continuation of the anterior tibial artery. The pulse of the posterior tibial artery, which comes from the posterior compartment of the leg, may be felt behind the medial malleolus just lateral to the tendon of the extensor hallucis longus.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 33
Incorrect
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The following branch of the aorta is unpaired:
Your Answer:
Correct Answer: Coeliac artery
Explanation:Branches that stem from the abdominal aorta can be divided into three: the visceral branches, parietal branches and terminal branches. Of the visceral branches, the suprarenal, renal, testicular and ovarian arteries are paired while the coeliac artery and superior and inferior mesenteric arteries are unpaired. Of the parietal branches the inferior phrenic and lumbar arteries are paired while the middle sacral artery is unpaired. The terminal branches i.e. the common iliac arteries are paired.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 34
Incorrect
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A space defined by the teres major muscle, the teres minor muscle, long head of the triceps brachii muscle and surgical neck of the humerus contains the axillary nerve and the?
Your Answer:
Correct Answer: Posterior circumflex humeral artery
Explanation:This quadrangular space transmits the posterior circumflex humeral vessels and the axillary nerve.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 35
Incorrect
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Point of entry of the vagal trunk into the abdomen:
Your Answer:
Correct Answer: Oesophageal hiatus
Explanation:The oesophageal hiatus is located in the muscular part of the diaphragm a T10 and is above, in front and a little to the left of the aortic hiatus. It transmits the oesophagus, the vagus nerves and some small oesophageal arteries.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 36
Incorrect
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Which of the following arteries is the posterior branch of the external carotid artery?
Your Answer:
Correct Answer: Superficial temporal
Explanation:The external carotid artery is a branch of the common carotid artery that supplies parts of the neck, head and face. It branches off from the common carotid artery at the level of the thyroid cartilage. The external carotid, at the level of the mandible divides into the maxillary artery and the superficial temporal. The superficial temporal artery is the posterior branch of these two arteries. It starts off, somewhat, as a continuation of the external carotid artery at the substance of the parotid gland. Anterior cerebral and middle cerebral arteries are branches of the internal carotid artery.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 37
Incorrect
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An abdominal aortogram of a 59 year-old female with an abdominal aortic aneurysm shows occlusion of the inferior mesenteric artery. The patient, however, does not complain of any symptoms. Occlusion of the inferior mesenteric artery is rarely symptomatic because its territory is supplied by branches of the:
Your Answer:
Correct Answer: Middle colic artery
Explanation:The transverse colon is supplied by the middle colic artery which is a branch from the superior mesenteric artery. If the inferior mesenteric artery was occluded, branches from the middle colic may go to the marginal artery which supplies the descending colon, sigmoid colon and rectum.. Ileocolic and right colic arteries also branch from the superior mesenteric artery that supply the colon but the middle colic, which serves the more distal part of the colon is the better answer. The gastroduodenal artery branches off the common hepatic artery, which supplies part of the duodenum, pancreas and stomach. The splenic artery supplies the spleen, pancreas and curvature of the stomach.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 38
Incorrect
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A surgeon performing a laparoscopic repair of an inguinal hernia visualizes a loop of bowel protruding through the abdominal wall to form a direct inguinal hernia. When this is viewed from the side of the abdomen with a laparoscope, in which region would the hernial sac be?
Your Answer:
Correct Answer: Medial inguinal fossa
Explanation:In a direct inguinal hernia, visceral contents exit the abdomen through a weak point in the fascia in the medial inguinal fossa i.e. the area between the medial and lateral umbilical folds. Such a hernia doesn’t pass through the deep inguinal ring or the lateral inguinal fossa. Note that direct hernias can go through the superficial inguinal ring, although rarely. The supravesical fossa, between the median and medial umbilical folds, is formed by a peritoneal reflection from the anterior abdominal wall onto the bladder and the retrovesical fossa is the region behind the urinary bladder.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 39
Incorrect
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With respect to far accommodation, which of the following is a TRUE statement?
Your Answer:
Correct Answer: The ciliary muscles are relaxed
Explanation:Myopia or near-sightedness is a disease due to elongated eyeballs or too strong a lens. For far accommodation (focus of a distant object onto the retina), the lens needs to decrease its refractive power, or in other words, increase its focal length. This is done by relaxation of ciliary muscles which tightens the zonular fibres and flattening of the lens. Relaxation of the zonular fibres, rounding of the lens, shortening of the focal length and constriction of the pupil occurs during near accommodation.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 40
Incorrect
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Which of the following arteries, that runs on the superior aspect of the first part of the duodenum, forms the lower boundary of the epiploic foramen (also known as the foramen of Winslow)?
Your Answer:
Correct Answer: Hepatic
Explanation:The epiploic foramen is an important anatomical opening that allows for the communication between the greater peritoneal sac and the lesser peritoneal sac. Its boundaries are formed; superiorly by the caudate lobe of the liver, anteriorly by the hepatoduodenal ligament (containing the components of the portal triad), inferiorly by the first part of the duodenum and posteriorly by the peritoneum covering the inferior vena cava. The superior aspect of the first part of the duodenum, which forms the inferior boundary of the foramen of Winslow, forms the course of the hepatic artery before it ascends to the porta hepatis where it divides into its right and left branches.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 41
Incorrect
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The muscle which has an antagonistic action to the serratus anterior muscle and is one of the retractors of the scapula is the?
Your Answer:
Correct Answer: Rhomboid major
Explanation:Protraction is accomplished by the actions of the serratus anterior, pectoralis major, and pectoralis minor muscles. Retraction is accomplished by the actions of the trapezius, rhomboids, and latissimus dorsi muscles.
The rhomboid major arises from the second, third, fourth and fifth thoracic vertebrae. It is inserted into a narrow tendinous arch attached to the root of the spine of the scapula and the inferior angle. By its insertion in the inferior angle of the scapula, it acts on this angle and produces a slight rotation of the scapula on the side of the chest. It also retracts the scapula by working with the trapezius muscle.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 42
Incorrect
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Which foramen contains the vertebral artery?
Your Answer:
Correct Answer: Foramen magnum
Explanation:The foramen magnum is found in the most inferior part of the posterior cranial fossa. It is traversed by vital structures including the medulla oblongata. Its contents include the following: medulla oblongata, meninges, spinal root of the accessory nerve, vertebral arteries, anterior and posterior spinal arteries, tectorial membrane and alar ligaments.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 43
Incorrect
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The muscle that stabilizes the stapes is innervated by which of the following nerves?
Your Answer:
Correct Answer: Facial nerve
Explanation:The stapedius is the smallest skeletal muscle in the human body. At just over one millimetre in length, its purpose is to stabilize the smallest bone in the body, the stapes and is innervated by a branch of the facial nerve.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 44
Incorrect
-
Which nerve mediates the sensation to itch from the skin that is just over the base of the spine of your scapula?
Your Answer:
Correct Answer: Dorsal primary ramus of C7
Explanation:The first branches off spinal nerves are called the dorsal and ventral rami. The dorsal rami mediate sensation of the skin over the back and motor supply to the true muscles of the back whilst the ventral rami gives sensation to the skin over the limbs and the skin that is over the ventral side of the trunk. It also gives motor supply to the skeletal muscles of the neck, the trunk and extremities. Hence, itchiness of the part of the skin that is over the spine of the scapula would be mediated by the primary ramus of C7. Accessory nerve doesn’t have any sensory innervation.
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This question is part of the following fields:
- Anatomy
- Neurology
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Question 45
Incorrect
-
The circle of Willis is an arterial anastomosis in the base of the brain and is one of the cerebrovascular safeguards in the brain. Where is the circle of Willis contained?
Your Answer:
Correct Answer: Cisterna basalis
Explanation:Cisterns refers to a system of intercommunicating pools formed by the subarachnoid space at the base of the brain and around the brainstem. Cisterna basalis/basal cistern (interpeduncular cistern) is found at the base of the brain between the two temporal lobes and it contains the arterial circle of Willis. The lumbar cistern is contained in the spinal canal while the foramen magna refers to the opening at the base of the skull though which the spinal cord enters into the skull.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 46
Incorrect
-
A 27-year old lady is shot in the chest. The bullet enters superior to the upper edge of the clavicle. She had difficulty in breathing which is interpreted by the A&E physician as a likely indicator of a collapsed lung. If that is the case, what portion of the pleura is most likely to have been punctured?
Your Answer:
Correct Answer: Cupola
Explanation:The cupola is part of the pleura that extends above the first rib into the root of the lung. Most likely to injured in a stab above the level of the clavicle.
Costodiaphragmatic recess: the lowest extent of the pleural sac.
Pulmonary ligament: is a fold of pleura located below the root of the lung.
Mediastinal pleura: part of the pleura that lines the mediastinal cavity.
Hilar reflection is the part of the pleura where the visceral pleura of the lung reflects to become continuous with the parietal pleura.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 47
Incorrect
-
A 60-year old patient presenting with squamous cell carcinoma of the anal canal was brought in to the oncology ward for chemotherapy. In which of the following lymph nodes of this patient would you likely find metastases?
Your Answer:
Correct Answer: Internal iliac
Explanation:The efferent lymphatics from the anal canal proceed to the internal iliac lymph nodes. This would most likely form the site of enlargement in the lymphatics.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 48
Incorrect
-
Which name is given to the inferior fascia of the urogenital diaphragm?
Your Answer:
Correct Answer: Perineal membrane
Explanation:The urogenital fascia is mostly commonly referred to as the perineal membrane. This term refers to an anatomical fibrous membrane in the perineum. It is triangular in shape, and thus at times referred to as the triangular ligament. It is about 4 cm in depth. Its The perineal membrane’s apex is anterior and is separated from the arcuate pubic ligament by an oval opening for the passage of the deep dorsal vein of the penis. The lateral marginas of this triangular ligament are attached on either side to the inferior rami of the pubis and ischium, above the crus penis. Its base faces the rectum, and connects to the central tendinous point of the perineum. The pelvic fascia and Colle’s fascia is fused to the base of this triangle.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 49
Incorrect
-
A patient in the recovery ward after cardiac surgery is noticed to have a small effusion in the lowest extent of the pleural cavity, into which no lung tissue extends. What is the name of this part of the pleural cavity?
Your Answer:
Correct Answer: Costodiaphragmatic recess
Explanation:The costodiaphragmatic recess is the part of the pleural cavity where the costal pleura is in continuity with the diaphragmatic pleura. It forms the lowest extent of the pleural cavity.
Costomediastinal recess: a tiny recess that is anteriorly located, where the costal pleura becomes continuous with the mediastinal pleura.
The cupola is the pleural cavity that extends above the first rib.
The inferior mediastinum refers to the posterior, middle and anterior mediastinal divisions together.
The pulmonary ligament on the other hand, is a pleural fold that is situated beneath the root of the lung on the medial aspect of the lung.
Oblique pericardial sinus is not part of the pleural cavity.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 50
Incorrect
-
Which of these structures does NOT pass posterior to the medial malleolus?
Your Answer:
Correct Answer: Saphenous vein
Explanation:The saphenous vein passes anterior to the medial malleolus. The structures passing posterior, from nearest to furthest include: tibial, posterior tendon, flexor digitorum longus tendon, posterior tibial artery, posterior tibial vein, posterior tibial nerve and the flexor hallucis longus tendon.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 51
Incorrect
-
the action of the semimembranosus muscle is:
Your Answer:
Correct Answer: Extension of the hip and flexion of the knee
Explanation:the semimembranosus is situated at the back and medial side of the thigh. It arises from the upper and outer impression on the tuberosity of the ischium, above and lateral to the biceps femoris and semitendinosus. It is inserted mainly into the horizontal groove on the posterior medial aspect of the medial condyle of the tibia. it flexes the knee and assists in extension of the hip.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 52
Incorrect
-
What best describes the muscles of the posterior compartment of the leg?
Your Answer:
Correct Answer: One of the posterior compartment leg muscles laterally rotates the femur
Explanation:The muscles of the back of the leg are subdivided into two groups: superficial and deep. Superficial muscles include gastrocnemius, soleus and plantaris and are the chief extensors of the foot at the ankle joint. Deep muscles include the tibialis posterior, flexor hallucis longus, flexor digitorum longus and popliteus
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 53
Incorrect
-
A young man in a motor vehicle accident sustained a spinal injury at C8 level. What would likely be seen in this patient?
Your Answer:
Correct Answer: The hypothenar muscles would be completely paralysed
Explanation:The eighth cervical nerve is one of the contributors of the ulnar nerve. The ulnar nerve supplies the hypothenar muscles which include the opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis, and palmaris brevis.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 54
Incorrect
-
A 32-year old gentleman came to the emergency department, complaining of progressively increasing weakness in his arms and legs over 5 days. On examination, there is symmetrical weakness on both sides of his face, along with weakness of the proximal and distal muscles of all four limbs. No loss of sensation noted. Deep tendon reflexes could not be elicited and plantar responses were downward. On enquiry, it was revealed that he had an upper respiratory tract infection 10 days ago. The likely diagnosis is:
Your Answer:
Correct Answer: Guillain–Barré syndrome
Explanation:Guillain–Barré syndrome (GBS) is an acute, autoimmune polyradiculoneuropathy which affects the peripheral nervous system and is usually triggered by an acute infectious process. 75% patients have a history of acute infection within the past 1–4 weeks, usually respiratory or gastrointestinal. immunisations have also been implicated. The most common form is acute inflammatory demyelinating polyneuropathy. It results in an ascending paralysis with complete loss of deep tendon reflexes. Treatment includes immunoglobulins and supportive care. However, the disease may be fatal due to severe pulmonary complications and dysautonomia.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 55
Incorrect
-
The vagus nerve passes through which of the following foramen?
Your Answer:
Correct Answer: Jugular foramen
Explanation:The jugular foramen is a large foramen in the base of the skull. It is located behind the carotid canal and is formed in front by the petrous portion of the temporal bone, and behind by the occipital bone. Cranial nerves IX, X, and XI and the internal jugular vein pass through the jugular foramen.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 56
Incorrect
-
During a splenectomy procedure of a 45-year old male patient with a bleeding ruptured spleen, the surgeon decided to clamp the splenic artery near the coeliac trunk to stop the bleeding. Which of the following organ/s parts will be least affected by the clamping?
Your Answer:
Correct Answer: Duodenum
Explanation:The duodenum is the only organ in the list that would not be affect by the clumping of the splenic artery as it is supplied by common hepatic artery (through the gastroduodenal artery) and the superior mesenteric artery (through the inferior pancreaticoduodenal artery). The splenic artery is the artery that supplies the spleen with oxygenated blood. The splenic artery before reaching the spleen also gives off branches that supply the stomach and the pancreas. The greater curvature and the fundus of the stomach is supplied the short gastric artery which branches off from the splenic artery. The left portion of the greater curvature of the stomach together with the greater omentum is supplied by the left gastro-omental artery of the splenic artery. The body and tail of the pancreas is supplied by branches of the splenic artery through the dorsal and superior pancreatic arteries and the caudal pancreatic arteries respectively.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 57
Incorrect
-
Which of the following foramen provides passage of the facial nerve?
Your Answer:
Correct Answer: Internal acoustic meatus
Explanation:The internal auditory meatus provides a passage through which the vestibulocochlear nerve, the facial nerve, and the labyrinthine artery (an internal auditory branch of the basilar artery) can pass from inside the skull to structures of the inner ear and face.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 58
Incorrect
-
The superior pancreaticoduodenal artery, the artery that supplies blood to the pancreas and the duodenum, is a branch of the:
Your Answer:
Correct Answer: Gastroduodenal artery
Explanation:The superior pancreaticoduodenal artery together with the right gastroepiploic artery form the two branches of the gastroduodenal artery which divides at the lower border of the duodenum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 59
Incorrect
-
A neurotransmitter of the nigrostriatal pathway is:
Your Answer:
Correct Answer: Dopamine
Explanation:Dopamine acts as a neurotransmitter in the brain, activating dopamine receptors. It is also a neurohormone released from the hypothalamus. It plays an important role in the reward system. It is believed that dopamine provides a teaching signal to parts of the brain responsible for acquiring new motor sequences (behaviours), by activation of dopamine neurons when an unexpected reward is presented. Loss of dopamine neurones in the nigrostriatal pathway causes Parkinson’s disease. In the frontal lobes, dopamine controls the flow of information from other areas of the brain, and thus, dopamine disorders in this region can cause a decline in neurocognitive functions, especially memory, attention and problem solving. Reduced dopamine concentrations in the prefrontal cortex are thought to contribute to attention-deficit disorder and some symptoms of schizophrenia. Dopamine is also the primary neuroendocrine regulator of the secretion of prolactin from the anterior pituitary gland. Dopamine is also commonly associated with the pleasure system of the brain. This plays a key role in understanding the mechanism of action of drugs (such as cocaine and the amphetamines), which seem to be directly or indirectly related to the increase of dopamine.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 60
Incorrect
-
Which of these foramen is located at the base of the skull and transmits the accessory meningeal artery?
Your Answer:
Correct Answer: Foramen ovale
Explanation:At the base of the skull the foramen ovale is one of the larger of the several holes that transmit nerves through the skull. The following structures pass through foramen ovale: mandibular nerve, motor root of the trigeminal nerve, accessory meningeal artery, lesser petrosal nerve, a branch of the glossopharyngeal nerve, emissary vein connecting the cavernous sinus with the pterygoid plexus of veins and occasionally the anterior trunk of the middle meningeal vein.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 61
Incorrect
-
A patient sustained an injury to the facial nerve after it emerges from the stylomastoid foramen. What is the clinical impact of this injury?
Your Answer:
Correct Answer: Facial expression
Explanation:The facial nerve is the seventh of the twelve paired cranial nerves. It emerges from the brainstem between the pons and the medulla. It controls the muscles of facial expression and supplies taste fibres to the anterior two-thirds of the tongue. It also supplies preganglionic parasympathetic fibres to several head and neck ganglia. Its branches and distribution are as follows:
Inside the facial canal (proximal to the stylomastoid foramen):
– Greater petrosal nerve – provides parasympathetic innervation to the lacrimal gland, as well as special taste sensory fibres to the palate via the nerve of pterygoid canal
– Nerve to stapedius – provides motor innervation for the stapedius muscle in the middle ear
– Chord tympani – provides parasympathetic innervation to the submandibular and sublingual glands and special sensory taste fibres for the anterior two-thirds of the tongue
Outside the skull (distal to the stylomastoid foramen):
– Posterior auricular nerve – controls the movements of some of the scalp muscles around the ear
– Five major facial branches (in the parotid gland), from top to bottom: temporal branch, zygomatic branch, buccal branch, marginal mandibular branch and cervical branch. From the description given above it is obvious that injury to the facial nerve distal to the stylomastoid foramen will affect facial expression.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 62
Incorrect
-
During an operation for a sigmoid colectomy the surgeon ligates the sigmoid arteries. From which artery do the sigmoid arteries branch?
Your Answer:
Correct Answer: Inferior mesenteric artery
Explanation:Sigmoid arteries are branches of the inferior mesenteric artery (IMA). Sigmoid artery gives off branches that supply the lower descending colon, the iliac colon and the sigmoid colon.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 63
Incorrect
-
A ‘claw hand’ is usually associated with injury to which of the following nerves?
Your Answer:
Correct Answer: Ulnar nerve
Explanation:A ‘claw hand’ is associated with injury to the ulnar nerve at the wrist affecting the interossei, lumbricals and hypothenar muscles of the hand. It is characterized by hypothenar eminence wasting, hyperextended metacarpophalangeal joints and flexed interphalangeal joints.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 64
Incorrect
-
The primary motor cortex is located in the:
Your Answer:
Correct Answer: Precentral gyrus
Explanation:The primary motor cortex is located in the dorsal part of the precentral gyrus and the anterior bank of the central sulcus. The precentral gyrus lies anterior to the postcentral gyrus and is separated from it by a central sulcus. Its anterior border is the precentral sulcus, while inferiorly it borders to the lateral fissure (Sylvian fissure).
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This question is part of the following fields:
- Neurology
- Physiology
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Question 65
Incorrect
-
During gastrectomy, the operating surgeon ligates the short gastric arteries along the greater curvature of the stomach. Where do the short gastric arteries branch from?
Your Answer:
Correct Answer: Splenic artery
Explanation:Short gastric arteries arise from the splenic artery at the end or from its terminal divisions. They are about 5 or 7 in number, passing from the left to the right in between the layers of the gastrosplenic ligament to be distributed along the greater curvature of the stomach.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 66
Incorrect
-
In the case of an injury to the sub sartorial canal, which of the following structures is most likely to be injured?
Your Answer:
Correct Answer: Nerve to vastus medialis
Explanation:The adductor canal (sub sartorial canal) is situated in the middle third of the thigh.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 67
Incorrect
-
A 60 year-old patient being treated for hypertension presents to the ED with swelling of the left upper limb due to poor venous return. On examination, it is found that an aneurysm of the ascending aorta is impinging on a large vein lying immediately anterosuperior to it. Which vein is it likely to be?
Your Answer:
Correct Answer: Left brachiocephalic
Explanation:Among the veins listed, only the left brachiocephalic vein is anterosuperior to the ascending aorta. The right brachiocephalic vein being on the right side would not be affected by the aortic aneurysm.
The azygos vein lies deep in the chest on the right side.
The internal thoracic vein lies interior to the anterior wall of the chest.
The left superior intercostal vein is close to the aortic arch, crossing it laterally. This vein drains the 2nd to 4th interspaces on the left side.
The Right internal jugular vein joins the right brachiocephalic vein which would not be affected by the aneurysm.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 68
Incorrect
-
Which of the following structures is not easily palpable?
Your Answer:
Correct Answer: Styloid process of the temporal bone
Explanation:The styloid process is a thin, pointed process that projects antero-inferiorly from the base of the petrous temporal bone. It can vary in length from a short, stubby process to a slender, four to five centimetre rod. It forms from the cranial elements of the second pharyngeal arch. The tympanic plate of the temporal bone ensheathes the base of this process. The pointed, projecting portion of the process provides attachment to the stylohyoid and stylomandibular ligaments, and to three muscles – the styloglossus, stylohyoid, and stylopharyngeus. As the styloid process is covered by the various muscles, it is not easily palpable in live subjects.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 69
Incorrect
-
A previously healthy 40-year-old housewife suddenly complains of a headache and loses consciousness. A CT scan reveals subarachnoid haemorrhage. Which of the following is the most probable cause?
Your Answer:
Correct Answer: Ruptured berry aneurysm
Explanation:Saccular aneurysms, also known as berry aneurysms, appear as a round outpouching and are the most common form of cerebral aneurysm. They are a congenital intracranial defect, and haemorrhage can occur at any age, but is most common between the ages of 40-65 years. A second rupture (rebleeding) sometimes occurs, most often within about 7 days of the first bleed.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 70
Incorrect
-
An explorative laparotomy is done on a 23 year old following a gunshot abdominal injury through the right iliac fossa. It is found that the ileocolic artery is severed and the bullet had perforated the caecum. From which branch does the ileocolic artery originate?
Your Answer:
Correct Answer: Superior mesenteric artery
Explanation:Ileocolic artery branches off from the superior mesenteric artery. It then divides to give a superior and inferior branch.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 71
Incorrect
-
A man was stabbed in the thigh following a bar brawl. A superficial vein was injured which terminates in the femoral vein. This superficial vein is?
Your Answer:
Correct Answer: Great saphenous
Explanation:The great saphenous vein is considered the longest vein in the body. It terminates in the femoral vein nearly 3cm below the inguinal ligament. It begins at the dorsum of the foot in the medial marginal vein and ascends at the medial side of the leg in relation with the saphenous nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 72
Incorrect
-
Which of these structures is most likely to be damaged if a patient loses consciousness days or weeks after an otherwise insignificant head trauma, especially in elderly patients?
Your Answer:
Correct Answer: Dural bridging vein
Explanation:A subdural haematoma is a type of hematoma, usually associated with traumatic brain injury, in which blood collects between the dura mater and the pia-arachnoid mater. Symptoms of subdural haemorrhage have a slower onset than those of epidural haemorrhages because the lower pressure veins bleed more slowly than arteries. These injuries are more common in elderly patients, especially those taking antiplatelet or anticoagulant drugs. Oedema and increased intracranial pressure are unusual.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 73
Incorrect
-
Regarding the long head of the biceps femoris, which of the following is correct?
Your Answer:
Correct Answer: It crosses two joints
Explanation:The long head of the biceps femoris arises from the lower and inner impression on the back of the tuberosity of the ischium. It inserts with the short head in an aponeurosis which becomes a tendon and this tendon is inserted into the lateral side of the head of the fibula and the lateral condyle of the tibia, thus crossing two joints.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 74
Incorrect
-
After severe injury of the upper limb following an accident. The humerus is injured as well as the nerve which innervates the muscles of the anterior compartment of the arm. Which nerve is injured?
Your Answer:
Correct Answer: Musculocutaneous
Explanation:The musculoskeletal nerve supplies the muscles of the anterior compartment of the arm including the coracobrachialis, biceps brachii and the greater part of the brachialis. This nerve derives its fibres from the fifth, sixth and seventh cervical nerves and arises from the lateral cord of the brachial plexus. It also provides a branch to the elbow joint.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 75
Incorrect
-
A 50-year old gentleman who suffered a stroke was brought to the emergency department by his relatives. The patient however denied the presence of paralysis of his left upper and lower limbs. What is the most likely site of the lesion in this patient?
Your Answer:
Correct Answer: Right posterior parietal cortex
Explanation:A large injury to the non-dominant parietal cortex can make the patient neglect or refuse to acknowledge the presence of paralysis on the contralateral side. This can also involve the perception of the external world. Smaller injuries in this area which involve the precentral gyrus (primary motor cortex) or postcentral gyrus (primary sensory cortex) cause contralateral spastic paralysis or contralateral loss of tactile sensation respectively. A lesion in posterior inferior gyrus of the dominant frontal lobe results in motor aphasia. Involvement of the posterior superior gyrus of the dominant frontal lobe produces sensory aphasia.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 76
Incorrect
-
What is the nerve supply of the muscle that is inserted onto the crest of the lesser tubercle of the humerus?
Your Answer:
Correct Answer: Lower subscapular
Explanation:The muscle is the subscapularis muscle which is supplied by the lower subscapular nerve.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 77
Incorrect
-
The following organs would be expected to lie within the right lower quadrant of the abdomen, assuming that the gastrointestinal tract is rotated normally:
Your Answer:
Correct Answer: Distal jejunum, caecum, vermiform appendix
Explanation:The abdomen is divided by theoretical anatomic lines into four quadrants. The median plane follows the linea alba and extends from the xiphoid process to the pubic symphysis and splits the abdomen in half. The transumbilical plane is a horizontal line that runs at the level of the umbilicus. This forms the upper right and left quadrants and the lower right and left quadrants. Structures in the right lower quadrant include: caecum, appendix, part of the small intestine, ascending colon, the right half of the female reproductive system, right ureter. Pain in this region is most commonly associated with appendicitis.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 78
Incorrect
-
Infection to all of the following will lead to enlargement of the superficial inguinal lymph nodes, except for:
Your Answer:
Correct Answer: Ampulla of the rectum
Explanation:The superficial inguinal lymph nodes form a chain immediately below the inguinal ligament. They receive lymphatic supply from the skin of the penis, scrotum, perineum, buttock and abdominal wall below the level of the umbilicus.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 79
Incorrect
-
The pattern of drainage of the lymphatic and venous systems of the anterior abdominal wall is arranged around a horizontal plane above which drainage is in a cranial direction and below which drainage is in a caudal direction. Which horizontal plane is being referred to?
Your Answer:
Correct Answer: Level of the umbilicus
Explanation:The umbilicus is a key landmark for the lymphatic and venous drainage of the abdominal wall. Above it, lymphatics drain into the axillary lymph nodes and the venous blood drains into the superior epigastric vein, into the internal thoracic vein. Below it, lymphatics drain into the superficial inguinal lymph nodes while venous blood drains into the inferior epigastric vein and the external iliac vein.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 80
Incorrect
-
The thoracic duct :
Your Answer:
Correct Answer: varies in length from 38 to 45 cm
Explanation:The thoracic duct is the main drainage of lymph in the body. It varies in length from 38 to 45 cm and extends from the second lumbar vertebra to the root of the neck.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 81
Incorrect
-
A 51-year old woman after undergoing a barium swallowing was discovered to be suffering from an oesophageal hiatal hernia. Which muscle fibres of the diaphragm border this hernia directly if the stomach herniates through an enlarged oesophageal hiatus?
Your Answer:
Correct Answer: Right crus
Explanation:The oesophageal hiatus is a natural fissure on the thoracic diaphragm that allows passage of the oesophagus and the vagal nerve. The oesophageal hiatus is located in one of the tendinous structures of the diaphragm that connect it to the spine which is known as the right crus. In case of an hiatal hernia, this diaphragmatic structure would be the one bordering the hernia as it is the structure that encircles the oesophageal hiatus.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 82
Incorrect
-
A surgeon trainee is assisting in an operation to ligate the ductus arteriosus. The consultant supervising explains that caution is required when placing a clamp on the ductus to avoid injury to an important structure immediately dorsal to it. To which structure is the consultant referring?
Your Answer:
Correct Answer: Left recurrent laryngeal nerve
Explanation:The left recurrent laryngeal nerve branches off the vagus and wraps around the aorta, posterior to the ductus arteriosus/ligamentum arteriosum from whence it courses superiorly to innervate the laryngeal muscles.
Accessory Hemiazygous vein is on the left side of the body draining the posterolateral chest wall and emptying blood into the azygos vein.
The left internal thoracic artery is branch of the left subclavian artery supplying blood to the anterior wall of the thorax.
Left phrenic nerve is lateral to the vagus nerve.
Thoracic duct: is behind the oesophagus, coursing between the aorta and the azygos vein in the posterior chest.
Right recurrent laryngeal nerve: loops around the right subclavian artery and is not in danger in this procedure.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 83
Incorrect
-
A 40-year old man sustained a deep laceration to the sole of his left foot. It was found that the belly of extensor digitorum muscle was lacerated and the lateral tarsal artery was severed. The lateral tarsal artery is a branch of the:
Your Answer:
Correct Answer: Dorsalis pedis artery
Explanation:The lateral tarsal artery arises from the dorsalis pedis, as the vessel crosses the navicular bone
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 84
Incorrect
-
Which of the following will show decreased hearing when tested by air conduction but normal hearing when tested by bone conduction?
Your Answer:
Correct Answer: Fibrosis causing fixation of the ossicles
Explanation:As the cochlea is embedded into bone, the vibrations from the bone are transmitted directly to the fluid in the cochlea. Hence, any damage to the ossicles or tympanic membrane will not show an abnormal result on bone conduction test.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 85
Incorrect
-
During laparoscopic surgery to repair a direct inguinal hernia in a 68-year old man, the surgeon asked the registrar to look at the medial inguinal fossa to identify the direct inguinal hernia. To do so, she would have to look at the area that is between the:
Your Answer:
Correct Answer: Medial umbilical ligament and inferior epigastric artery
Explanation:The medial umbilical fold is made by the medial umbilical ligament-which is the obliterated portion of the umbilical artery, while the lateral umbilical fold is a fold of peritoneum over the inferior epigastric vessels. The median umbilical fold is a midline structure made by the median umbilical ligament i.e. the obliterated urachus. The medial inguinal fossa is the space on the inner abdominal wall between the medial umbilical fold and the lateral umbilical fold. It is place in the abdominal wall where there is an area of weak fascia i.e. the inguinal triangle through which direct inguinal hernias break through. The lateral inguinal fossa on the other hand is a space lateral to the lateral umbilical fold. Indirect inguinal hernias push through this space.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 86
Incorrect
-
The muscle that forms the posterior wall of the axilla along with the scapula, subscapularis muscle and teres major muscle is the?
Your Answer:
Correct Answer: Latissimus dorsi
Explanation:The latissimus dorsi forms the posterior wall of the axilla along with the scapula. It is responsible for extension, adduction, transverse extension also known as horizontal abduction, flexion from an extended position, and (medial) internal rotation of the shoulder joint. It also has a synergistic role in extension and lateral flexion of the lumbar spine.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 87
Incorrect
-
A tumour on the floor of the fourth ventricle is most likely to compress which of the following cranial nerve nuclei?
Your Answer:
Correct Answer: Abducent
Explanation:The fourth ventricle, is a cavity of the brains ventricular system in which the cerebrospinal fluid is formed. This cavity is located behind the pons and upper half of the medulla oblongata. It extends from the cerebral aqueduct, to its connection to the third ventricle, and to the obex- which is the caudal tip of the fourth ventricle. The floor of the fourth ventricle consists of three parts – superior, intermediate and inferior. This inferior aspect of the floor of the fourth ventricle has the nucleus of the abducens nerve, CN VI which is looped over by the facial nerve.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 88
Incorrect
-
Which of the following muscles attach to the hyoid bone?
Your Answer:
Correct Answer: Middle pharyngeal constrictor
Explanation:The hyoid bone is a horseshoe-shaped bone situated in the anterior midline of the neck between the chin and the thyroid cartilage. A large number of muscles attach to the hyoid: Superiorly – the middle pharyngeal constrictor muscle, hyoglossus muscle, genioglossus, intrinsic muscles of the tongue and suprahyoid muscles. Inferiorly – the thyrohyoid muscle, omohyoid muscle and sternohyoid muscle.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 89
Incorrect
-
Regarding the venous drainage of the heart which of these is correct?
Your Answer:
Correct Answer: The great cardiac vein is the largest tributary of the coronary sinus and this vein starts at the apex of the heart and ascends with the anterior ventricular branch of the left coronary artery
Explanation:Most of the veins of the heart open into the coronary sinus. This is a wide venous channel, about 2.25 cm in length, situated in the posterior part of the coronary sulcus and covered by muscular fibres from the left atrium. Its tributaries are the great, small and middle cardiac veins, the posterior vein of the left ventricle and the oblique vein of the left atrium. The great cardiac vein is the largest tributary of the coronary sinus.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 90
Incorrect
-
During an exploratory laparotomy a herniation of bowel is identified between the lateral edge of the rectus abdominis, the inguinal ligament and the inferior epigastric vessels. These boundaries define the hernia as being a:
Your Answer:
Correct Answer: Direct inguinal hernia
Explanation:The boundaries given define the inguinal triangle which is the site for direct inguinal hernias. Indirect inguinal hernias occur lateral to the inferior epigastric vessels.
Femoral hernias protrude through the femoral ring, into the femoral canal.
Umbilical hernias protrude through a defect in the umbilical area.
Obturator hernias, occur through the obturator foramen. These are very rare.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 91
Incorrect
-
The posterior cord contains nerve fibres from which of the following levels of the spinal cord?
Your Answer:
Correct Answer: C5, C6, C7, C8 and T1
Explanation:THE correct answer is A. The posterior cord derives its fibres from the spinal nerves C5,C6,C7,C8,T1. This cord is formed from the fusion of the posterior divisions of the upper, lower, and middle trunks.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 92
Incorrect
-
Which statement is true regarding the diaphragmatic openings:
Your Answer:
Correct Answer: The thoracic duct passes through the opening at T12
Explanation:The diaphragmatic openings are:
T8 – opening for the inferior vena cavaand the right phrenic nerve
T10 – opening for the oesophagusand the left gastric artery and vein
T12 – opening for the aorta, the thoracic duct and azygos vein.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 93
Incorrect
-
A patient under went repair of a lingual artery aneurysm in the floor of the mouth. During surgical dissection from the inside of the mouth which muscle would you have to pass through to reach the main portion of the lingual artery?
Your Answer:
Correct Answer: Hyoglossus
Explanation:The lingual artery first runs obliquely upward and medialward to the greater horns of the hyoid bone. It then curves downward and forward, forming a loop which is crossed by the hypoglossal nerve, and passing beneath the digastric muscle and stylohyoid muscle it runs horizontally forward, beneath the hyoglossus, and finally, ascending almost perpendicularly to the tongue, turns forward on its lower surface as far as the tip, to become the deep lingual artery.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 94
Incorrect
-
Where do the seminal vesicles lie?
Your Answer:
Correct Answer: Base of the bladder and rectum
Explanation:The seminal vesicles are two lobulated membranous pouches situated between the fundus of the bladder and rectum and act as a reservoir for the semen and secrete a fluid that is added to the seminal fluid. Each sac is pyramidal in shape but they all vary in size not only in different individuals but also in the same individuals. The anterior surface is in contact with the fundus of the bladder, extending from near the termination of the ureter to the base of the prostate. Each vesicle consist of single tube, which gives off several irregular caecal diverticula. These separate coils and the diverticula are connected by fibrous tissue.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 95
Incorrect
-
The optic foramen, superior orbital fissure, foramen ovale, foramen rotundum and foramen sinosum are all located on which bone at the base of the skull?
Your Answer:
Correct Answer: Sphenoid
Explanation:The sphenoid bone consists of two parts, a central part and two wing-like structures that extend sideways towards each side of the skull. It forms the base of the skull, and floor and sides of the orbit. On its central part lies the optic foramen. The foramen ovale, foramen spinosum and foramen rotundum lie on its great wing while the superior orbital fissure lies on its lesser wing.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 96
Incorrect
-
Injury to this nerve may result in loss of sensation of the mandibular teeth and bone:
Your Answer:
Correct Answer: Inferior alveolar nerve
Explanation:The inferior alveolar nerve (sometimes called the inferior dental nerve) is a branch of the mandibular nerve, which is itself the third branch of the trigeminal nerve. The inferior alveolar nerves supply sensation to the lower teeth of the mandible.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 97
Incorrect
-
In order to arrest sudden bleeding during pericardiectomy that started after accidental injury to a major vasculature in the pericardium; the surgeon inserted his left index finger through the transverse pericardial sinus, pulled forward on the two large vessels lying ventral to his finger, and compressed these vessels with his thumb to control the bleeding. Which vessels were these?
Your Answer:
Correct Answer: Pulmonary trunk and aorta
Explanation:Transverse pericardial sinus: located behind two great vessels (aorta and pulmonary trunk) and in front of the superior vena cava and is accessed from above as in this case. The brachiocephalic trunk is located above the pericardium and the right pulmonary artery is above the pericardial reflections.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 98
Incorrect
-
Which among the following vertebrae marks the lowest extent of the superior mediastinum?
Your Answer:
Correct Answer: Fourth thoracic
Explanation:The superior mediastinum lies between the manubrium anteriorly and the upper vertebrae of the thorax posteriorly. Below, it is bound by a slightly oblique plane that passes backward from the sternal angle to the lower part of the body of T4 and laterally by the pleura.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 99
Incorrect
-
A patient presents with loss of pain and temperature sensation in the left leg. He is likely to have a lesion involving:
Your Answer:
Correct Answer: Right lateral spinothalamic tract
Explanation:The spinothalamic tract is a sensory pathway originating in the spinal cord that transmits information to the thalamus. There are two main parts of the spinothalamic tract: the lateral spinothalamic tract transmits pain and temperature and the anterior spinothalamic tract transmits touch (crude touch). The decussation of this pathway occurs at the level of the spinal cord. Hence, a unilateral lesion of the lateral spinothalamic tract causes contralateral loss of pain and temperature.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 100
Incorrect
-
During a surgical procedure involving the carotid artery, which nerve in the cervical plexus of nerves that is embedded in the carotid sheath is most susceptible to injury?
Your Answer:
Correct Answer: Ansa cervicalis
Explanation:The ansa cervicalis is a loop of nerves that are part of the cervical plexus. They lie superficial to the internal jugular vein in the carotid triangle. Branches from the ansa cervicalis innervate the sternohyoid, sternothyroid and the inferior belly of the omohyoid. The superior root of the ansa cervicalis is formed by a branch of spinal nerve C1. These nerve fibres travel in the hypoglossal nerve before leaving to form the superior root. The superior root goes around the occipital artery and then descends embedded in the carotid sheath. It sends a branch off to the superior belly of the omohyoid muscle and is then joined by the inferior root. The inferior root is formed by fibres from spinal nerves C2 and C3.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 101
Incorrect
-
The inferior palpebral nerve ascends behind the orbicularis oculi. What is the terminal branch of the inferior palpebral nerve?
Your Answer:
Correct Answer: Infraorbital nerve
Explanation:The inferior palpebral nerve is a branch of the maxillary nerve. It supplies the skin and conjunctiva of the lower eyelid.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 102
Incorrect
-
A patient underwent surgical excision of mass in the right carotid triangle. One day after the surgery patient complained of numbness of the skin over the right side of the neck. Injury to the cervical plexus of nerves is suspected. What is the possible nerve affected in this patient?
Your Answer:
Correct Answer: Transverse cervical
Explanation:The transverse cervical nerve (superficial cervical or cutaneous cervical) arises from the second and third spinal nerves, turns around the posterior border of the sternocleidomastoid and, passing obliquely forward beneath the external jugular vein to the anterior border of the muscle, it perforates the deep cervical fascia, and divides beneath the platysma into the ascending and descending branches. It provides cutaneous innervation to this area.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 103
Incorrect
-
An operation to remove a segment of the oesophagus through a right thoracotomy is complicated when a tear develops in a large venous structure in the posterior mediastinum that empties into the superior vena cava. Which of the following structures is likely to be injured?
Your Answer:
Correct Answer: Azygos vein
Explanation:The azygos vein is formed by the union of the right subcostal veins and the ascending lumbar veins at the level of the 12th thoracic vertebra. It enters the thorax through the aortic hiatus to ascend in the posterior mediastinum and arching over the right main bronchus posteriorly at the root of the right lung to join the superior vena cava before it pierces the pericardium.
The basilic vein is a vein on the medial aspect of the arm that ascends to become the axillary vein.
The cephalic vein is also a vein of the arm.
The external jugular and brachiocephalic vein are not in the posterior mediastinum.
The median cubital vein is found in the cubital fossa of the arm.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 104
Incorrect
-
A patient is brought to the accident and emergency department. He is said to have been involved in a mall explosion. Chest imaging reveals metal fragments in his thoracic cavity. He also has a pericardial effusion suggestive of a pericardial tear. An emergency thoracotomy is done which revealed a tear of the pericardium inferiorly. The surgeon began to explore for fragments in the pericardial sac with his hand from below the apex. He slips his fingers upward and to the right within the sac until they were stopped by the cul-de-sac formed by the pericardial reflection near the base of the heart. His finger tips were now in the:
Your Answer:
Correct Answer: Oblique pericardial sinus
Explanation:Transverse sinus: part of pericardial cavity that is behind the aorta and pulmonary trunk and in front of the superior vena cava separating the outflow vessels from the inflow vessels.
Oblique pericardial sinus: is behind the left atrium where the visceral pericardium reflects onto the pulmonary veins and the inferior vena cava. Sliding a finger under the heart will take you to this sinus.
Coronary sinus: large vein that drains the heart into the right atrium. Located on the surface of the heart.
Coronary sulcus: groove on the heart demarcating the atria from the ventricles.
Costomediastinal recess: part of the pleural sac where the costal pleura transitions to become the mediastinal pleura.
Sulcus terminalis: a groove between the right atrium and the vena cava.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 105
Incorrect
-
The third branch of the maxillary artery lies in which fossa?
Your Answer:
Correct Answer: Pterygopalatine fossa
Explanation:The maxillary artery supplies deep structures of the face. It branches from the external carotid artery just deep to the neck of the mandible. It is divided into three portions:
– The first or mandibular portion (or bony portion) passes horizontally forward, between the neck of the mandible and the sphenomandibular ligament.
– The second or pterygoid portion (or muscular portion) runs obliquely forward and upward under cover of the ramus of the mandible, on the surface of the lateral pterygoid muscle; it then passes between the two heads of origin of this muscle and enters the fossa.
– The third portion lies in the pterygopalatine fossa in relation to the pterygopalatine ganglion. This is considered the terminal branch of the maxillary artery. Branches from the third portion includes: the sphenopalatine artery, descending palatine artery, infraorbital artery, posterior superior alveolar artery, artery of pterygoid canal, pharyngeal artery, middle superior alveolar artery and anterior superior alveolar artery.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 106
Incorrect
-
A 40 year old patient with an history of obesity has been diagnosed with meralgia parasthetica. The condition was discovered to be caused by the pinching of the lateral femoral cutaneous nerve. Injuries at what spinal levels usually affect this nerve?
Your Answer:
Correct Answer: L2, L3
Explanation:The lateral femoral cutaneous nerve of the thigh arises from the dorsal division of the lumbar plexus of the second and the third lumbar nerves (L2 – L3). Spinal injuries at this level are likely to affect the lateral femoral cutaneous nerve. The lateral femoral cutaneous nerve innervates the skin on the lateral aspect of the thigh.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 107
Incorrect
-
Which of the following is a fact worth noting about the development of the spleen?
Your Answer:
Correct Answer: It develops in the dorsal mesogastrium
Explanation:The spleen in the human embryo arises in week 5 of intrauterine life. It appears as a proliferating mesenchyme above the pancreas. The spleen is one the organs that develops in the dorsal mesogastrium. When the stomach changes its position during development, the spleen is made to move behind the stomach and stays in contact with the left kidney. The spleen is found within the peritoneum of the abdominal cavity thus it is an intraperitoneal organ.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 108
Incorrect
-
The prostatic plexus of nerves contains nerve fibres that innervate penile tissue allowing for erection. From which of the following nerves do these fibres originate?
Your Answer:
Correct Answer: Pelvic splanchnics
Explanation:Pelvic splanchnic nerves are examples of the parasympathetic nerves that innervate the smooth muscle and glands of the pelvic viscera. They are also the nerves contributing fibres to the prostatic plexus which innervate penile erectile tissue.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 109
Incorrect
-
A 20-year old gentleman was brought to the emergency department with headache and nausea for 2 days. He also complained of intolerance to bright light and loud sounds. Lumbar puncture showed glucose < 45 mg/dl, protein > 5 mg/dl and neutrophil leucocytosis. The likely diagnosis is:
Your Answer:
Correct Answer: Meningitis
Explanation:Diagnosis of meningitis can be carried out with examination of cerebrospinal fluid (CSF) with a lumbar puncture (LP). In a case of bacterial meningitis, the CSF analysis will show:
– Opening pressure: > 180 mmH2O
– White blood cell count: 10–10 000/μl with neutrophil predominance
– Glucose: < 40 mg/dl – CSF glucose to serum glucose ratio: < 0.4 – Protein: > 4.5 mg/dl
– Gram stain: positive in > 60%
– Culture: positive in > 80%
– Latex agglutination: may be positive in meningitis due to Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli and group B streptococci
– Limulus, lysates: positive in Gram-negative meningitis
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This question is part of the following fields:
- Neurology
- Physiology
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Question 110
Incorrect
-
A 45 year old lady has been diagnosed with Friedreich's ataxia that has affected her medial group of nuclei in the anterior horn of the spinal cord. Which of the following structures will have their muscles affected?
Your Answer:
Correct Answer: Axial muscles
Explanation:The cells in the anterior horn can be arranged in the following three main groups: medial, lateral and central. The medial group of nuclei in the anterior horn of the spinal cord are located along the entire length of the spinal cord and are responsible for the innervation of the axial muscles of the body ( muscles of the head and neck region). Thus this disease will most likely affect the functioning of the muscles of the head and neck.
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This question is part of the following fields:
- Anatomy
- Neurology
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Question 111
Incorrect
-
Which best describes the sartorius muscle?
Your Answer:
Correct Answer: Will flex the leg at the knee joint
Explanation:The sartorius muscle arises from tendinous fibres from the superior iliac spine. It passes obliquely across the thigh from lateral to medial and is inserted into the upper part of the medial side of the tibia. When the sartorius muscle contracts it will flex the leg at the knee joint.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 112
Incorrect
-
The transverse colon has two curvatures known as the colic flexures on each side of its lateral ends, the right and left. The left colic flexure found on the side of the descending colon is attached to an organ superiorly by a mesenteric ligament. Which organ is this?
Your Answer:
Correct Answer: Spleen
Explanation:The left colic flexure is the bend of the transverse colon as it continues to form the descending colon on the left upper quadrant. The spleen is located on the superior aspect of the left colic flexure. It is commonly referred to as the splenic flexure because of its relation o the spleen superiorly.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 113
Incorrect
-
After a cerebral infarction, which of these histopathogical findings is most likely to be found?
Your Answer:
Correct Answer: Liquefactive necrosis
Explanation:The brain has a high lipid content and typically undergoes liquefaction with ischaemic injury, because it contains little connective tissue but high amounts of digestive enzymes.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 114
Incorrect
-
The thyrocervical trunk branches into which artery that passes upward and in front of the vertebral artery and longus colli muscle:
Your Answer:
Correct Answer: Inferior thyroid
Explanation:The inferior thyroid artery is an artery in the neck. It arises from the thyrocervical trunk and passes upward, in front of the vertebral artery and longus colli muscle.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 115
Incorrect
-
A 50 year old male point was diagnosed with tennis elbow that became worse after he started playing basket ball over the last three months. He was admitted to the orthopaedic ward to have elbow braces fitted. What type of synovial joint is the elbow joint?
Your Answer:
Correct Answer: Hinge
Explanation:The elbow joint is one of the many synovial joints in the body. This joint is an example of the hinge joint as the humerus is received into the semilunar notch of the ulna and the capitulum of the humerus articulates with the fovea on the head of the radius, together acting as a hinge in one plane.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 116
Incorrect
-
Choose the most correct answer regarding the common peroneal nerve.
Your Answer:
Correct Answer: It gives rise to the nerve that supplies the anterior compartment leg muscles
Explanation:The common peroneal nerve divides beneath the peroneus longus muscle and gives off articular and lateral sural cutaneous nerves which supply muscular branches to the muscles of the anterior compartment of the leg which are the tibialis anterior, extensor digitorum, peroneus tertius and extensor hallucis longus.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 117
Incorrect
-
What are some of the derivatives of the second pharyngeal arch?
Your Answer:
Correct Answer: Stylohyoid muscle
Explanation:Also known as the hyoid arch, it forms the side and front of the neck. From its cartilage develops the styloid process, stylohyoid ligament and lesser cornu of the hyoid bone. The muscular derivatives include the muscles of facial expression, stapedius, stylohyoid and the posterior belly of the digastric. All these are innervated by cranial nerve VII but migrate into the area of the mandibular arch.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 118
Incorrect
-
A 30 year old gym coach presented to the surgical out patient clinic with a lump in the inguinal region. He was booked for surgery, during which, the surgeon opened the inguinal region and found a hernial sac with a small segment of intestine projecting through the abdominal wall. It was located just above the inguinal ligament and lateral to the inferior epigastric vessels. What type of hernia was this?
Your Answer:
Correct Answer: An indirect inguinal hernia
Explanation:An indirect inguinal hernia exits the abdominal cavity lateral to the inferior epigastric vessels and enters the inguinal canal through the deep inguinal ring. These are the most common types of hernias often caused by heavy weigh lifting. Direct inguinal hernias exit the abdominal cavity medial to the inferior epigastric vessels through weak fascia.
Congenital inguinal hernias are indirect hernias that occur due to persistence of the processus vaginalis.
Femoral hernias occur when abdominal viscera push through the femoral ring in the femoral canal.
Incisional hernia occurs after surgery when the omentum or organ protrudes through a previous site of incision.
Obturator hernia are a very rare type of hernia where the pelvic or abdominal contents protrude through the obturator foramen.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 119
Incorrect
-
A 60-year old patient having a history of cholelithiasis that led to recurrent pain, bloating, nausea and vomiting, was scheduled for surgery to have the gallbladder removed. During the cholecystectomy, the registrar conducting the procedure accidentally punctured a blood vessel that lies immediately posterior to the omental foramen and blood filled the operating field. Which of the following blood vessels was likely punctured?
Your Answer:
Correct Answer: Inferior vena cava
Explanation:The omental foramen is the pathway that connects the greater peritoneal sac and the lesser peritoneal sac. The omental foramen is bordered posteriorly by the inferior vena cava. This is the blood vessel that would most likely be punctured.
The aorta and its branch, the renal artery, lie postero-lateral to the omental foramen and are deeper than the inferior vena cava hence making them less likely to be injured.
The hepatic portal vein, the hepatic artery and the superior mesenteric vein borders the omental foramen anteriorly and would not be injured by a jab on the posterior border of the omental foramen.
Finally, the splenic artery is found in the splenorenal ligament that borders the omental foramen laterally to the left.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 120
Incorrect
-
A 20-year old cyclist falls off a speeding bike and fractures a structure that articulates with the tubercle of the 7th rib. Which structure is fractured?
Your Answer:
Correct Answer: Transverse process of vertebra T7
Explanation:A rib tubercle is a projection that is postero-inferior and lateral to the neck of a rib which articulates with the transverse process of the corresponding vertebra i.e. of the same number. Therefore, the tubercle of rib 7 articulates with the transverse process of T7 vertebra. The head of the rib 7, on the other hand, articulates with the 6th vertebra superiorly and the 7th vertebra inferiorly.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 121
Incorrect
-
This structure divides the space between the lens and the cornea into the anterior and posterior chambers of the eye:
Your Answer:
Correct Answer: The iris
Explanation:The iris divides the space between the lens and the cornea into an anterior and a posterior chamber. The anterior cavity is filled with watery aqueous fluid, and the posterior cavity with a gel-like vitreous fluid. The anterior chamber of the eye is bounded in front by the posterior surface of the cornea; behind by the front of the iris and the central part of the lens. The posterior chamber is a narrow gap behind the peripheral part of the iris and in front of the suspensory ligament of the lens and the ciliary processes.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 122
Incorrect
-
Destruction of the ventromedial nucleus of the hypothalamus will result in:
Your Answer:
Correct Answer: Loss of satiety
Explanation:The ventromedial nucleus of the hypothalamus is divided into an anterior and a superior part. The anterior part controls the female sexual drive, whereas the superior part is responsible for satiety. Destruction of the superior part of the nucleus will result in overeating, as no signal tells the body that it is satisfied.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 123
Incorrect
-
Which of the following will be affected by a lesion in the posterior column-medial lemniscus system?
Your Answer:
Correct Answer: Fine touch
Explanation:The posterior column–medial lemniscus (PCML) pathway is a sensory pathway that transmits fine touch and conscious proprioceptive information from the body to the brain. As the posterior columns are also known as dorsal columns, the pathway is also called the dorsal column–medial lemniscus system or DCML.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 124
Incorrect
-
A surgeon ligates the left middle suprarenal artery while carrying out a left adrenalectomy. Where does the left middle suprarenal artery originate?
Your Answer:
Correct Answer: Abdominal aorta
Explanation:Middle suprarenal arteries arise from either side of the abdominal aorta, opposite the superior mesenteric artery.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 125
Incorrect
-
The posterior boundary of the carotid triangle is bounded by which of the following muscles?
Your Answer:
Correct Answer: Sternocleidomastoid
Explanation:The carotid triangle is a portion of the anterior triangle of the neck. It is bounded superiorly by the posterior belly of the digastric muscle, antero-inferiorly by the superior belly of omohyoid and posteriorly by the sternocleidomastoid. The floor is formed by the thyrohyoid, hyoglossus, middle and inferior pharyngeal constrictors and the roof is formed by the skin, superficial fascia, platysma and deep fascia.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 126
Incorrect
-
Which one of the following is a derivative of the midgut?
Your Answer:
Correct Answer: Caecum
Explanation:The primary intestinal loop is formed from the midgut which gives rise to the distal half of the duodenum, the jejunum, ascending colon, proximal two thirds of the transverse colon and the ileum.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 127
Incorrect
-
A patient who has used NSAIDS for many years presents to the A&E with symptoms of acute haemorrhagic shock. An emergency endoscopy is done that shows that a duodenal ulcer has perforated the posterior wall of the first part of the duodenum. Which artery is most likely to be the cause of the haemorrhage?
Your Answer:
Correct Answer: Gastroduodenal
Explanation:The gastroduodenal artery is a branch of the hepatic artery and descends near the pylorus between the first part of the duodenum and the neck of the pancreas to divide at the lower border of the duodenum into the right gastroepiploic and pancreaticoduodenal arteries. Before it divides, it gives off a few branches to the pyloric end of the stomach and to the pancreas. The artery that is most likely involved in this situation is the gastroduodenal artery since it is posterior to the first part of the duodenum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 128
Incorrect
-
When a patient is standing erect, pleural fluid would tend to accumulate in which part of the pleural space?
Your Answer:
Correct Answer: Costodiaphragmatic recess
Explanation:The costo-diaphragmatic recess is the lowest extent of the pleural cavity or sac. Any fluid in the pleura will by gravity accumulate here when a patient is standing erect.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 129
Incorrect
-
A 20 year old is brought to the A&E after he fell from a moving cart. The boy has sustained blunt abdominal injury, and the there is a possibility of internal bleeding as the boy is in shock. An urgent exploratory laparotomy is done in the A&E theatre. On opening the peritoneal cavity, the operating surgeon notices a torn gastrosplenic ligament with a large clot around the spleen. Which artery is most likely to have been injured in this case?
Your Answer:
Correct Answer: Short gastric
Explanation:The short gastric arteries branch from the splenic artery near the splenic hilum to travel back in the gastrosplenic ligament to supply the fundus of the stomach. Therefore, these may be injured in this case.
The splenic artery courses deep to the stomach to reach the hilum of the spleen. It doesn’t travel in the gastrosplenic ligament although it does give off branches that do.
The middle colic artery is a branch of the superior mesenteric artery that supplies the transverse colon.
Gastroepiploic artery is the largest branch of the splenic artery that courses between the layers of the greater omentum to anastomose with the right gastroepiploic.
Left gastric artery, a branch of the coeliac trunk. It supplies the left half of the lesser curvature.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 130
Incorrect
-
Question 131
Incorrect
-
The midgut loop, also called the primary intestinal loop in a developing embryo, is formed when the midgut bends around which of the following arteries?
Your Answer:
Correct Answer: Superior mesenteric
Explanation:In a developing foetus, the midgut develops to form most of the intestines. During this development process, the midgut usually bends around the superior mesenteric artery and forms what is referred to as the midgut loop.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 132
Incorrect
-
A man had an injury to his right brachial plexus. After examination by the doctor they found that the diaphragm and the scapula were unaffected however the patient could not abduct his arm. When helped with abducting his arm to 45 degrees he was able to continue the movement. This means that he was unable to initiate abduction. Where is the likely site of injury?
Your Answer:
Correct Answer: Suprascapular nerve
Explanation:The loss of ability to initiate abduction means paralysis of the supraspinatus muscle. This muscle is supplied by the supraclavicular nerve.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 133
Incorrect
-
A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates one of his tablets into his lungs. In which bronchopulmonary segments is it most likely to end up?
Your Answer:
Correct Answer: Superior segmental bronchus of the right inferior lobe
Explanation:Inhaled objects are more likely to enter the right lung for several reasons. First the right bronchus is shorter, wider and more vertical than the left bronchus. Also, the carina (a ridge-like structure at the point of tracheal bifurcation) is set a little towards the left. The superior segmental bronchus branches posteriorly off the intermediate bronchus or the inferior lobe bronchus and is thus more likely to receive the foreign body that enters the right main bronchus. The lingula is only found on the left lung. The terminal bronchiole is a very small space almost impossible for the tablet to lodge here.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 134
Incorrect
-
The collaborative effort of the lateral pterygoid muscles produces which action on the jaw?
Your Answer:
Correct Answer: Protrude the mandible
Explanation:The combined effort of the lateral pterygoid muscles results in the protrusion of the mandible. The lateral pterygoid muscle is a muscle of mastication located superiorly to the medial pterygoid muscle and has two heads. The superior head originates on the infratemporal surface and infratemporal crest of the greater wing of the sphenoid bone, and the inferior head on the lateral surface of the lateral pterygoid plate. The insertion of this muscle is on the front margin of the articular disc of the temporomandibular joint. The unilateral contraction of the pterygoid muscle results in the laterotrusion of the mandible. It is important to note that the lateral pterygoid muscle is the only muscle of mastication that can open the jaw.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 135
Incorrect
-
A 6 year-old boy is brought to you coughing. He is suspected to have aspirated a Lego piece which he was seen playing with. Where would you expect the piece to be?
Your Answer:
Correct Answer: Right main bronchus
Explanation:Inhaled objects are more likely to enter the right lung for several reasons. First the right bronchus is shorter, wider and more vertical than the left bronchus. Also, the carina (a ridge-like structure at the point of tracheal bifurcation) is set a little towards the left. The terminal bronchiole is a very small space and impossible for the seed to lodge here.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 136
Incorrect
-
Which of the deep fasciae located in the anterolateral abdominal wall form the inguinal ligament?
Your Answer:
Correct Answer: External abdominal oblique aponeurosis
Explanation:The inguinal ligament is the inferior border of the aponeurosis of the external oblique abdominis and extends from the anterior superior iliac spine to the pubic tubercle from whence it is reflected backward and laterally to attach to the pectineal line and form the lacunar ligament.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 137
Incorrect
-
The specialist registrar, while performing the repair of an infrarenal abdominal aortic aneurysm, decides not to re-implant the inferior mesenteric artery into the repaired abdominal aorta. She says that an anastomotic artery running along the border of the large intestine is good enough to supply blood to the territory of the inferior mesenteric artery. Which vessel is she referring to?
Your Answer:
Correct Answer: Marginal
Explanation:The marginal artery is a key anastomosis for the large intestine that runs around the border of the large intestine and is formed by the anastomosis of the branches of the ileocolic artery, right colic artery, middle colic artery, left colic artery and sigmoid artery. If a small artery is occluded, these branches allow blood to reach all segments of the colon.
The arcades are anastomotic loops between the arteries that provide alternative pathways for blood flow. They are more prominent in the small intestine than the large intestine.
Arteriae rectae are small branches that run from the marginal artery to reach the colon.
The ileocolic artery is the branch of the superior mesenteric artery that supplies the caecum, appendix and terminal part of the ileum.
The coronary arteries supply blood to the heart.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 138
Incorrect
-
During the fetal stage, the mesonephric tubules gives rise to the?
Your Answer:
Correct Answer: Wolffian duct
Explanation:The development of the kidney proceeds through a series of successive phases, each marked by the development of a more advanced kidney: the pronephros, mesonephros, and metanephros. The development of the pronephric duct proceeds in a cranial-to-caudal direction. As it elongates caudally, the pronephric duct induces nearby intermediate mesoderm in the thoracolumbar area to become epithelial tubules called mesonephric tubules. Each mesonephric tubule receives a blood supply from a branch of the aorta, ending in a capillary tuft analogous to the glomerulus of the definitive nephron. The mesonephric tubule forms a capsule around the capillary tuft, allowing for filtration of blood. This filtrate flows through the mesonephric tubule and is drained into the continuation of the pronephric duct, now called the mesonephric duct or Wolffian duct. The nephrotomes of the pronephros degenerate while the mesonephric duct extends towards the most caudal end of the embryo, ultimately attaching to the cloaca.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 139
Incorrect
-
In the human body, veins often run a course parallel to the artery that has the same name. Which of the following listed veins doesn't run parallel to the artery of the same name?
Your Answer:
Correct Answer: Inferior mesenteric
Explanation:The inferior mesenteric artery and inferior mesenteric vein don’t run in tandem because the vein is part of the portal venous system-draining into the splenic vein which drains into the hepatic portal vein. The inferior mesenteric artery is a branch of the descending aorta at the level of L3. The inferior mesenteric vein and artery, however, drain the same region i.e. the descending and sigmoid colon and rectum.
Superior epigastric vessels course together and are the continuation of the internal thoracic artery and vein.
Superficial circumflex iliac vessels course together in the superficial fat of the abdominal wall.
Superior rectal vessels are the terminal ends of the inferior mesenteric vessels, located on the posterior surface of the rectum.
The ileocolic artery and vein are branches off the superior mesenteric vessels. Both course in the mesentery, supplying/draining the caecum, appendix, terminal portion of the ileum. The inferior epigastric vessels run together.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 140
Incorrect
-
During work up for a 29 year-old lady who complained of chest pain, a computed tomography showed a large mass in the posterior mediastinum. Which among the following structures could be involved?
Your Answer:
Correct Answer: Lymph nodes
Explanation:Boundaries of the posterior mediastinum include:
Superior: a plane through the sternal angle and T4/5
Inferior: the diaphragm
Anterior: the middle mediastinal structures
Posterior the spinal cord.
Structures in the posterior mediastinum include the descending thoracic aorta, the azygos system, oesophagus, thoracic duct and lymph nodes. The great vessels and structures at the root of the lung are part of the middle mediastinum. In this case, the lymph nodes is the correct answer.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 141
Incorrect
-
What is the most likely condition a new born infant is likely to suffer from, if he/she was born with incomplete fusion of the embryonic endocardial cushions?
Your Answer:
Correct Answer: An atrioventricular septal defect
Explanation:The endocardial cushions in the heart are the mesenchymal tissue that make up the part of the atrioventricular valves, atrial septum and ventricular septum. An incomplete fusion of these mesenchymal cells can cause an atrioventricular septal defect. The terms endocardial cushion defect, atrioventricular septal defect and common atrioventricular canal defect can be used interchangeably with one another.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 142
Incorrect
-
A mechanic sustained a deep laceration to his right cubital fossa which resulted in him unable to move the proximal radioulnar joint of his right arm. Which muscles was affected?
Your Answer:
Correct Answer: Pronator teres
Explanation:The correct answer is the pronator teres muscle. This muscle arises from 2 heads of origin: the humerus and ulnar. Between the 2 heads is the site of entrance of median nerve to the forearm. This muscle acts on the proximal radio-ulnar joint to rotate the radius on the ulna, otherwise known as pronation. It also assists in forearm flexion if the radius is fixed.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 143
Incorrect
-
A tumour growing in the posterior mediastinum is found in a 40-year-old man who presented to the out patient clinic with chest pain. Such a tumour is likely to compress the following structure:
Your Answer:
Correct Answer: Oesophagus
Explanation:The boundaries of the posterior mediastinum are: the superiorly through the sternal angle and T4/5, inferiorly, the diaphragm, anteriorly, by the middle mediastinal structures and posteriorly by the spinal cord. Structures in the posterior mediastinum include the descending thoracic aorta, the azygos system, oesophagus, thoracic duct and lymph nodes. The great vessels and structures at the root of the lung are part of the middle mediastinum. The oesophagus is the only structure in the posterior mediastinum among the choices.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 144
Incorrect
-
Below which level of the spinal cord will the inferior gluteal nerve be unaffected?
Your Answer:
Correct Answer: S3
Explanation:The inferior gluteal nerve arises from the dorsal divisions of the fifth lumbar and first and second sacral nerves. According to this fact any lesion at or below the S3 will not affect the inferior gluteal nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 145
Incorrect
-
In a neurological exam on a robbery with violence victim, it was discovered that the victim had lost sense of touch to the skin over her cheek and chin (maxilla and mandible region). Where are the cell bodies of the nerve that is responsible for touch sensations of this region located?
Your Answer:
Correct Answer: Cranial nerve V ganglion
Explanation:The skin over the cheek and the maxilla are innervated by the trigeminal nerve (CN V). The trigeminal nerve has three major branches and it is the largest cranial nerve. The three branches of the trigeminal nerve are; the ophthalmic nerve, the maxillary nerve and the mandibular nerve. The trigeminal nerves ganglion is a sensory nerve ganglion know as the trigeminal ganglion (also referred to as the Gasser’s ganglion or the semilunar ganglion). It is contained in the dura matter in a cavity known as the Meckel’s cave, which covers the trigeminal impression near the apex of the petrous part of the temporal bone.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 146
Incorrect
-
A 58-year-old woman has had a headache, fever, lethargy and nausea for the last 10 days. He undergoes a CT scan which reveals a lesion in his frontal lobe, which, after a biopsy, is found to be formed by granulation tissue with collagenisation, gliosis and oedema. What's the most likely diagnosis?
Your Answer:
Correct Answer: Chronic brain abscess
Explanation:A cerebral abscess can result from direct extension of cranial infections, penetrating head trauma, haematogenous spread, or for unknown causes. An abscess forms when an area of cerebral inflammation becomes necrotic and encapsulated by glial cells and fibroblasts. Oedema around the abscess can increase the intracranial pressure. Symptoms result from increased intracranial pressure and mass effects. In a CT scan, an abscess appears as an oedematous mass with ring enhancement.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 147
Incorrect
-
A victim of mob justice was brought to the A & E with a stab wound in the anterior chest 2 cm lateral to the left sternal border. He underwent an emergency thoracotomy that revealed clots in the pericardium, with a puncture wound in the right ventricle. To evacuate the clots from the pericardial cavity the surgeon slipped his hand behind the heart at its apex. He extended his finger upwards until its tip was stopped by a line of pericardial reflection which forms the:
Your Answer:
Correct Answer: Oblique pericardial sinus
Explanation:Transverse sinus: part of pericardial cavity that is behind the aorta and pulmonary trunk and in front of the superior vena cava separating the outflow vessels from the inflow vessels.
Oblique pericardial sinus: is behind the left atrium where the visceral pericardium reflects onto the pulmonary veins and the inferior vena cava. Sliding a finger under the heart will take you to this space.
Cardiac notch: indentation of the ‘of the heart’ on the superior lobe of the left lung.
Hilar reflection: the reflection of the pleura onto the root of the lung to continue as mediastinal pleura.
Costomediastinal recess: part of the pleural sac where the costal pleura transitions to become the mediastinal pleura.
Sulcus terminalis: a groove between the right atrium and the vena cava
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 148
Incorrect
-
A surgeon performing a Whipple's procedure, that involves mobilizing the head of the pancreases, accidentally injured a structure immediately posterior to the neck of the pancrease which bled out. Which structure is most likely to have been injured?
Your Answer:
Correct Answer: Superior mesenteric artery
Explanation:The structure immediately posterior to the neck of the pancreas is the superior mesenteric vein. The neck of the pancreas lies anterior to the superior mesenteric vein, which joins with the splenic vein to form the portal vein.
The superior mesenteric artery (SMA) is also located in proximity to the neck of the pancreas. Specifically, the SMA emerges from the abdominal aorta just below the level of the pancreas and passes posterior to the neck of the pancreas before it descends into the mesentery to supply the intestines. Thus, both the superior mesenteric vein and the superior mesenteric artery are key vascular structures related to the posterior aspect of the neck of the pancreas.
Bleeding out would suggest an arterial injury.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 149
Incorrect
-
You observe a procedure to harvest the left internal thoracic (mammary) artery to be used as a graft for coronary artery bypass surgery. The left internal thoracic artery is mobilised from the inside of the chest wall and divided near the caudal end of the sternum. After dividing the internal thoracic artery at its distal end, the specialist registrar asks you to name the artery that will now have increased blood supply so that adequate blood flow is maintained to the rectus abdominis on the left side. What would your answer be?
Your Answer:
Correct Answer: Inferior epigastric artery
Explanation:The rectus abdominis muscle is supplied by the superior epigastric artery which is a branch of the internal thoracic artery. If the internal thoracic artery is thus ligated, blood would no longer flow to it. However, the superior epigastric artery communicates with the inferior epigastric artery (a branch of the external iliac artery). This means that blood could flow from the external iliac, to the inferior epigastric, to the superior epigastric to the rectus abdominis.
The superficial circumflex iliac artery and the superficial epigastric are two superficial branches of the femoral artery and do not supply the deep branches of the abdomen.
The deep circumflex iliac artery travels along the iliac crest on the inner surface of the abdominal wall; being too lateral it doesn’t supply blood to the rectus abdominis.
The distal portions of the umbilical arteries are obliterated in adults to form the medial umbilical folds.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 150
Incorrect
-
When you rest your elbows on a desk, what bony landmark of the upper limb are you resting on?
Your Answer:
Correct Answer: Olecranon process of the ulna
Explanation:At the upper and back part of the ulna, there exists a curved eminence which is the olecranon process. This process lodges in the olecranon fossa of the humerus. It’s posterior surface is subcutaneous and this triangular area is what you rest your elbow upon.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 151
Incorrect
-
What is the arterial sequence for an analgesic to reach the latissimus dorsi muscle assuming that your starting point is at the subclavian vein?
Your Answer:
Correct Answer: Subclavian – axillary – subscapular – thoracodorsal
Explanation:Assuming our starting point is the subclavian artery, the analgesic continues in the same vessel into the axillary artery, as it passes into the axilla. The axillary artery at the lower border of the subscapularis gives rise to the subcapsular artery which is considered the largest branch of the axillary artery. This circumflex scapular branch distributes a serratus branch before entering the substance of the muscle as the thoracodorsal artery.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 152
Incorrect
-
A 19 year old male patient exhibiting signs of shock was brought to the casualty after he had fallen from the 3rd floor of a building. An examination carried out revealed tenderness on the left mid-posterior axillary line and low blood pressure. Further palpation revealed a large swelling that protruded downward and medially below the left costal margin. X-rays showed that the 9th and the 10th ribs were fractured near their angles. Considering these results, which abdominal organ was likely injured by the fractured ribs.
Your Answer:
Correct Answer: Spleen
Explanation:The spleen, left kidney, stomach, the splenic flexure of the colon and the suprarenal glands are all in the same quadrant- the left upper quadrant. However, the spleen is the most readily injured organ when there is fracture to the 10th, 11th and the 12th ribs because of its close association with these ribs. This patient exhibits a great indication of a ruptured spleen (tenderness on the left mid and posterior axillary line). The spleen is a thin capsulated organ with a spongy parenchyma, allowing it to bleed profusely in the event of injury. The liver, head of the pancreas and the duodenum are all in the right upper quadrant.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 153
Incorrect
-
A patient is unable to move their mandible to the left. Which muscle is affected in this case?
Your Answer:
Correct Answer: Right lateral pterygoid muscle
Explanation:Patients with paralysis of the right pterygoid muscle are unable to move their mandible laterally to the left.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 154
Incorrect
-
A 70-year old man had had a large indirect inguinal hernia for 3 years. He presents at the out patient clinic complaining of pain in the scrotum. There is, however, no evidence of obstruction or inflammation. You conclude that the hernial sac is most probably compressing the:
Your Answer:
Correct Answer: Ilioinguinal nerve
Explanation:The ilioinguinal nerve arises together with the iliohypogastric nerve from the first lumbar nerve to emerge from the lateral border of the psoas major muscle just below the iliohypogastric and passing obliquely across the quadratus lumborum and iliacus muscles. It perforates the transversus abdominis, near the anterior part of the iliac crest and communicates with the iliohypogastric nerve between the internal oblique and the transversus. It then pierces the internal oblique to distribute filaments to it and accompanying the spermatic cord through the subcutaneous inguinal ring, is distributed to the skin of the upper and medial parts of the thigh, the skin over the root of the penis and the upper part of the scrotum in man and to the skin covering the mons pubis and labium majus in the woman. As the ilioinguinal nerve runs through the inguinal canal, it could easily be compressed by a hernial sac.
The femoral branch of genitofemoral nerve provides sensory innervation of the upper medial thigh.
The femoral nerve innervates the compartment of the thigh and also has some cutaneous sensory branches to the thigh.
The iliohypogastric nerve innervates the skin of the lower abdominal wall, upper hip and upper thigh. The subcostal nerve innervates the skin of the anterolateral abdominal wall and the anterior scrotal nerve is a terminal branch of the ilioinguinal nerve.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 155
Incorrect
-
What is the chief ligament preventing posterior sliding of the tibia on the femur ?
Your Answer:
Correct Answer: Posterior cruciate
Explanation:The posterior cruciate ligament is attached to the posterior intercondyloid fossa of the tibia and the lateral and front part of the medial condyle of the femur. It resists sliding of the tibia posteriorly.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 156
Incorrect
-
Which of the following statements is true regarding the umbilical cord?
Your Answer:
Correct Answer: Is filled with jelly of Wharton
Explanation:The umbilical cord that connects the fetus to the placenta is about 50cm long. This tissue consists of the body stalk and vitelline duct. The former containing the allantoic diverticulum and the umbilical vessels. The latter contains the connection linking the digestive tube and the yolk sac. This cord is wrapped by stratum of ectoderm and gelatinous tissue or jelly of Wharton. The right umbilical vein plus the vitelline vessels and ducts disappear and this at birth the cord has three vessels which are the umbilical vein and two umbilical arteries.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 157
Incorrect
-
An old woman complains of a lack of sensation halfway down the anterior surface of the thigh. The cause of this:
Your Answer:
Correct Answer: Would result from damage to the nerve that innervates the pectineus muscle
Explanation:The pectineus is supplied by the second, third and fourth lumbar nerves through the femoral nerve and by the third lumbar through the accessory obturator when it exists. The anterior surface of the thigh receives its innervation from the femoral nerve as well, thus this is the nerve most likely to be injured
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 158
Incorrect
-
A 70-year old man presents to the surgical out patient clinic with a direct inguinal hernia on the right side. He had undergone and appendicectomy 6 months prior. The examining doctor correlated the development of the hernia to iatrogenic nerve injury that happened during the operation. Which nerve had been injured?
Your Answer:
Correct Answer: Ilioinguinal
Explanation:Direct inguinal hernias occur because of weakness in the abdominal muscles. The ilioinguinal nerve is important for innervating the muscles of the lower abdominal wall and damage during appendicectomy therefore prevents the man from being able to contract abdominal muscles to pull the falx inguinalis over the weak fascia.
The genitofemoral nerve innervates the cremaster muscle and injury to it would cause inability to elevate the testes.
The subcostal nerve and the ventral primary ramus of T10 innervate the muscles, skin and fascia of the upper abdominal wall.
The iliohypogastric nerve supplies the skin over the upper part of the buttock behind the area supplied by the subcostal nerve.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 159
Incorrect
-
Which of the following arteries branch from the deep femoral artery and course between the pectineus and iliopsoas muscles?
Your Answer:
Correct Answer: Medial femoral circumflex
Explanation:The medial femoral circumflex artery is an artery in the upper thigh that supplies blood to the head and neck of the femur. It arises from the deep femoral artery and winds around the medial side of the femur. It passes first between pectineus and psoas major, and then between obturator externus and adductor brevis.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 160
Incorrect
-
A drug abuser developed an infection which spread from the dorsum of the hand to the medial side of the arm along the course of the large cutaneous vein. Which vein is involved?
Your Answer:
Correct Answer: Basilic
Explanation:The basilic vein is one of two veins found in the forearm, the other is the cephalic vein. These veins originate from the deep venous arch of the hand. The cephalic vein ascends along the lateral side of the forearm, and the basilic vein runs up the medial side of the forearm.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 161
Incorrect
-
The dura mater is a thick membrane that is the outermost of the three layers of the meninges. Which of the following foramen transmits the dura mater?
Your Answer:
Correct Answer: Foramen magnum
Explanation:The foramen magnum is found in the most inferior part of the posterior cranial fossa . It is traversed by vital structures including the medulla oblongata . Its contents include the following: medulla oblongata, meninges (arachnoid, dura and pia mater), spinal root of the accessory nerve, vertebral arteries, anterior and posterior spinal arteries, tectorial membrane and alar ligaments .
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 162
Incorrect
-
A patient is diagnosed with a tumour of the parotid gland. During surgical removal of the gland, which artery is vulnerable to injury?
Your Answer:
Correct Answer: External carotid artery
Explanation:The external carotid artery is a major artery of the head and neck. It arises from the common carotid artery when it splits into the external and internal carotid artery. It supplies blood to the face and neck. The external carotid artery begins opposite the upper border of the thyroid cartilage and, taking a slightly curved course, passes upward and forward and then inclines backward to the space behind the neck of the mandible, where it divides into the superficial temporal and internal maxillary arteries. It rapidly diminishes in size in its course up the neck, owing to the number and large size of the branches given off from it. At its origin, this artery is more superficial and placed nearer the midline than the internal carotid and is contained within the carotid triangle. The external carotid artery is covered by the skin, superficial fascia, platysma, deep fascia and anterior margin of the sternocleidomastoid. It is crossed by the hypoglossal nerve, by the lingual, ranine, common facial and superior thyroid veins; and by the digastric and stylohyoid; higher up it passes deeply into the substance of the parotid gland, where it lies deep to the facial nerve and the junction of the temporal and internal maxillary veins. It is here that it is in danger during surgery of the parotid gland.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 163
Incorrect
-
The tensor villi palatini muscle is a broad thin, ribbon-like muscle in the head that tenses the soft palate. Which of the following structures is associated with the tensor villi palatini muscle?
Your Answer:
Correct Answer: The hamulus of the medial pterygoid plate
Explanation:The pterygoid hamulus is a hook-like process at the lower extremity of the medial pterygoid plate of the sphenoid bone around which the tendon of the tensor veli palatini passes.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 164
Incorrect
-
The Carpal tunnel does NOT contain:
Your Answer:
Correct Answer: Flexor carpi ulnaris
Explanation:The contents of the carpal tunnel include:
– Median nerve
– Flexor digitorum supervicialis
– Flexor digitorum profundus
– Flexor policis longus
– Flexor carpi radialis
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 165
Incorrect
-
Where would you insert the needle when drawing blood from a patient's median cubital vein?
Your Answer:
Correct Answer: Anterior aspect of the elbow
Explanation:The correct answer is to insert it into the anterior aspect of the elbow. If you look at the venous drainage of the upper limb, you will find that there are two main veins, the basilic and the cephalic vein; the connecting branch between these two veins is the median cubital vein. and this vein passes via the cubital fossa which is on the anterior aspect of the forearm.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 166
Incorrect
-
Which statement is true about the inferior sagittal sinus?
Your Answer:
Correct Answer: Is formed between two layers of meningeal dura
Explanation:The inferior sagittal sinus is also known as the inferior longitudinal sinus. It courses along the inferior border of the falx cerebri, superior to the corpus callosum. It is cylindrical in shape and increases in size as it passes backward ending in the straight sinus. It receives blood from the deep and medial aspects of the cerebral hemispheres and drains into the straight sinus.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 167
Incorrect
-
An old man was diagnosed with squamous cell carcinoma with axillary lymph node metastasis. The doctor said he will excise the tumour and remove all axillary lymph nodes lateral to the edge of the pectoralis minor muscle. One of the following axillary lymph nodes won't be removed by this procedure. Which is it?
Your Answer:
Correct Answer: Apical
Explanation:The apical lymph node group won’t be removed which include 20 to 30 lymph nodes.
Axillary lymph nodes are grouped according to location. The lateral group, the anterior to pectoral group, the posterior or subscapular group, the central group, and the medial or apical group. The lateral, pectoral, and subscapular groups are found lateral to the pectoralis minor muscle. The central group is situated directly under that muscle. Thus, if all lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed, all the above four groups will be removed. The apical group won’t be removed which is situated medial to the medial edge of the pectoralis minor muscle.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 168
Incorrect
-
A patient who underwent emergency appendicectomy complains of having numbness (paraesthesia) of the skin at the pubic region. Which nerve was most likely injured in the operation?
Your Answer:
Correct Answer: Iliohypogastric
Explanation:The iliohypogastric nerve comes from L1 and emerges from the upper part of the lateral border of the psoas major. It then crosses obliquely in front of the quadratus lumborum to the iliac crest where it perforates the posterior part of transversus abdominis and divides between that muscle and the internal oblique into a lateral and an anterior cutaneous branch. This provides sensory innervation to the skin of the lower abdominal wall, upper hip and upper thigh.
The genitofemoral nerve also comes from the lumbar plexus that innervates the skin of the anterior scrotum or labia majora and upper medial thigh.
The subcostal nerve is the ventral primary ramus of T12 providing sensory innervation to the anterolateral abdominal wall in an area superior to the pubic region.
A spinal nerve owing to their deep location would not have been injured in the procedure.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 169
Incorrect
-
A victim of assault in a domestic violence is stabbed in the left chest. The tip of the pen knife entered the pleural space just above the cardiac notch. Luckily the lung was spared as it would only occupy this space during deep inspiration. Which of these structures was pierced by the knife?
Your Answer:
Correct Answer: Costomediastinal recess
Explanation:The costomediastinal recess is located immediately next to the cardiac notch. The medial aspect of the superior lobe of the left lung, when fully inflated expands to this place. The lung wouldn’t enter the anterior or the posterior mediastinum which are found between the two pleural cavities.
The costodiaphragmatic recess is the lowest extent of the pleural cavity where the inferior lobes of the lungs would expand into in deep inhalation.
The cupola, is the part of the pleural cavity that extends above the first rib into the root of the neck. The superior most part of the superior lobe of the lung might extend into this part.
Pulmonary ligament: pleural fold that is located below the root of the lung where the visceral pleura and the mediastinal pleura are in continuity.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 170
Incorrect
-
You are asked to help a junior medical student studying anatomy to identify the left lung. Which of the following features found only in the left lung will you use the identify it?
Your Answer:
Correct Answer: Cardiac notch
Explanation:Oblique fissure: is found on both the left and the right lungs. It separates the upper from the lower lobes in both lungs and the middle lobe from the lower lobe in the right lung(which has three lobes.)
The superior lobar bronchus is found in both lungs.
Cardiac notch: found only on the left lung.
Horizontal fissure: a deep groove separating the middle lobe from the upper lobe of the right lung is absent on the left lung.
Diaphragmatic surface: refers to the part of the lung, both the left and the right, that is in contact with the diaphragm.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 171
Incorrect
-
Which of the following statements regarding aqueous humour is correct?
Your Answer:
Correct Answer: Is the only source of nutrients for the lens of the eye
Explanation:The aqueous humour is a transparent, watery fluid similar to plasma, but containing low protein concentrations. It is secreted from the ciliary epithelium and fills both the anterior and the posterior chambers of the eye. It maintains the intraocular pressure and inflates the globe of the eye. It is this hydrostatic pressure which keeps the eyeball in a roughly spherical shape and keeps the walls of the eyeball taut. It provides nutrition (e.g. amino acids and glucose) for the avascular ocular tissues; posterior cornea, trabecular meshwork, lens, and anterior vitreous. It may serve to transport ascorbate into the anterior segment to act as an antioxidant agent. The presence of immunoglobulins indicate its role in immune response to defend against pathogens.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 172
Incorrect
-
A CT-scan report of a patient with gastric carcinoma shows that the lymph nodes around the coeliac trunk are enlarged. The coeliac trunk:
Your Answer:
Correct Answer: Gives rise to the splenic, left gastric and common hepatic arteries
Explanation:The coeliac trunk is a branch of the aorta arising just below the aortic hiatus of the diaphragm to pass nearly horizontally forward to divide into 3 large branches i.e. the left gastric, the hepatic and the splenic arteries. Occasionally it may give off one of the inferior phrenic arteries. It is covered by the lesser omentum and on the right side bordered by the right coeliac ganglion and the cardiac end of the stomach. Inferiorly it is bordered by the upper border of the pancreas and splenic vein. The embryonic midgut is supplied by the superior mesenteric artery.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 173
Incorrect
-
From which source does the lingual artery originate?
Your Answer:
Correct Answer: External carotid
Explanation:The lingual artery arises from the external carotid between the superior thyroid artery and facial artery. It can be located easily on the lower surface of the tongue. The terminal branch of the lingual artery is the deep lingual artery. On its course the lingual artery gives off side branches: dorsal lingual branches that supply the dorsum of the tongue till the epiglottis; sublingual artery that supplies the sublingual gland.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 174
Incorrect
-
A young girl injured her arm following a fall down the steps On examination, it was found that her left proximal radioulnar joint had dislocated and the annular ligament was stretched. This will make which movement extremely painful?
Your Answer:
Correct Answer: Supination
Explanation:Supination is the rotation of the forearm so that the palm of the hand faces anteriorly. This is performed by the biceps brachii and supinator of the extensor muscles of the thumb. The opposite action of moving the palm from an anterior-facing position to a posterior-facing position is called pronation. Pronation is performed by the pronator teres and pronator quadratus.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 175
Incorrect
-
Which of the following structures, is the area in which the superior cerebral veins drain into?
Your Answer:
Correct Answer: Superior sagittal sinus
Explanation:The superior cerebral veins are predominantly located on the superior aspect of the brain. They are 8 to 12 in number and they drain the lateral, medial and superior aspects of the cerebral hemispheres.
These veins drain into the superior sagittal sinus, also known as the superior longitudinal sinus – which is located along the attached margin of the falx cerebri.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 176
Incorrect
-
A chef, whilst preparing food, cut her thumb with a knife. She transected the arteria princeps pollicis. This artery is a branch of the?
Your Answer:
Correct Answer: Radial artery
Explanation:The radial artery branches into the arteria princeps pollicis as it turns medially into the deep part of the hand. The arteria princeps pollicis is distributed to the skin and subcutaneous tissue of the thumb.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 177
Incorrect
-
Which of the following structures carry part of the right bundle branch of the AV bundle?
Your Answer:
Correct Answer: Moderator band (septomarginal trabecula)
Explanation:The moderator band extends from the base of the anterior papillary muscle to the ventricular septum. It is the structure which carries part of the right AV bundle. Its role it to prevent overdistention of the ventricle.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 178
Incorrect
-
A man had noticed weakness in his left arm causing flexion of the elbow and supination of the forearm. Which nerve in this case was injured?
Your Answer:
Correct Answer: Musculocutaneous
Explanation:The musculocutaneous nerve supplies the biceps brachii and the brachialis muscles. The first one flexes the elbow and the shoulder. It is also involved in supination. The brachialis muscle flexes the forearm. The injury to the musculocutaneous nerve results in paralysis of these muscles.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 179
Incorrect
-
A 38 year-old man falls on an outstretched hand. X-rays indicate an anterior dislocation of one of the carpal bones. Which carpal bone is most commonly dislocated?
Your Answer:
Correct Answer: Lunate
Explanation:The scaphoid bone is the most commonly fractured carpal bone and has an increased risk of avascular necrosis.
The lunate is the most commonly dislocated carpal bone. The displaced bone may compress the median nerve in the carpal tunnel.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 180
Incorrect
-
A correct statement about the RECTUM:
Your Answer:
Correct Answer: It is an important anastomotic site for the portal and caval (systemic) venous systems
Explanation:The rectum is part of the gastrointestinal tract that is continuous above with the sigmoid colon and below with the anal canal. It contains both longitudinal and circular smooth muscles. These are supplied by the enteric nervous system. It is about 12 cm long. It has no sacculations comparable with those of the colon. It has three permanent transverse folds called the valves of Houston. The peritoneum is related to the upper two thirds of the rectum only whereas the lower part is not covered by peritoneum. It is supplied by the superior rectal (hemorrhoidal) branch of the inferior mesenteric artery and the median sacral artery that is a direct branch from the abdominal aorta. It is drained by veins that begin as a plexus that surround the anus. These veins form anastomoses with the portal system (portocaval anastomoses).
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 181
Incorrect
-
A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is most likely to be irritated in this patient?
Your Answer:
Correct Answer: Left recurrent laryngeal
Explanation:Tracheobronchial lymph nodes are located at the bifurcation of the trachea and are in three groups i.e. the right superior, left superior and inferior. The aorta arches over the left bronchus near the point of tracheal bifurcation. Thus, the nerves that are closely associated with the aorta might be irritated if these nodes become inflamed. The left recurrent laryngeal nerve is such a nerve. The phrenic nerves, both the left and the right, are lateral and thus would not be affected. The right recurrent nerve loops around the right subclavian artery and is distant from this area. The right vagus artery is not associated with the aorta and the sympathetic chain is located in the posterior chest parallel to the vertebra, also not associated with the tracheobronchial tree.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 182
Incorrect
-
What is the innervation of the tensor tympani muscle?
Your Answer:
Correct Answer: Trigeminal nerve
Explanation:The tensor veli palatini is innervated by the medial pterygoid nerve, a branch of mandibular nerve, the third branch of the trigeminal nerve (CN V3) – the only muscle of the palate not innervated by the pharyngeal plexus, which is formed by the vagal and glossopharyngeal nerves.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 183
Incorrect
-
Which of the following structures lying posterior to the ovary are at risk of injury in excision of a malignant tumour in the right ovary?
Your Answer:
Correct Answer: Ureter
Explanation:The ovaries are two nodular structures situated one on either side of the uterus in relation to the lateral wall of the pelvis and attached to the back of the broad ligament of the uterus, lying posteroinferiorly to the fallopian tubes. Each ovary has a lateral and medial surface. The ureter is at greater risk of iatrogenic injury at this location.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 184
Incorrect
-
Regarding the posterior compartment of the leg, which is correct?
Your Answer:
Correct Answer: The muscles plantarflex the foot and are innervated by the tibial nerve
Explanation:The muscles of the back of the leg are subdivided into two groups: superficial and deep. Superficial muscles include gastrocnemius, soleus and plantaris. Deep muscles include tibialis posterior, flexor hallucis longus, flexor digitorum longus and popliteus. The superficial ( calf muscles) which are responsible for plantarflexion of the foot are supplied by the tibial nerve as follows: the gastrocnemius and soleus muscles are supplied by the first and second sacral nerves and the plantaris by the fourth and fifth lumbar and first sacral nerve (the tibial nerve).
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 185
Incorrect
-
A retroperitoneal structure is:
Your Answer:
Correct Answer: Pancreas
Explanation:Retroperitoneal structures are those that are found behind the peritoneum. They include: kidneys, suprarenal glands, bladder, ureter, inferior vena cava, rectum, oesophagus (part of it), part of the pancreas, 2nd, 3rd and 4th parts of the duodenum and ascending and descending parts of the colon.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 186
Incorrect
-
A young man was thrown from a vehicle in a collision. He landed on his head and shoulder tip, stretching the left side of his neck. A neurological examination revealed that the fifth and sixth cervical nerves had been torn from the spinal cord. What is the most obvious clinical manifestation of this?
Your Answer:
Correct Answer: Abduction
Explanation:In the case of injuries to the upper roots of the brachial plexus there is complete loss of abduction. The muscle performing this movement is the supraspinatus. This initiates the movement, followed by the deltoid muscle, which allows for complete abduction. Both these muscles are innervated by nerves originating from C5 and C6. The injury to these roots results in a condition named Erb-Duchenne’s palsy.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 187
Incorrect
-
A swimmer was struggling to finish his training following an injury to his right arm. On further examination it was found that any movements involving adduction, medial rotation and extension of her arm were particularly weak. Which nerve in this case was damaged?
Your Answer:
Correct Answer: Thoracodorsal
Explanation:Weakness on these particular movements indicate that there is a problem with the latissimus dorsi muscle. This muscle is very important particularly in swimming movements and is supplied by the thoracodorsal nerve.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 188
Incorrect
-
If your EEG shows waves with a frequency range of 8-12 Hz, the waves most likely to be seen are:
Your Answer:
Correct Answer: Alpha
Explanation:Electroencephalography (EEG) is the neurophysiological measurement of the electrical activity of the brain. It is done by placing electrodes on the scalp or subdurally. In reality, the electrical currents are not measured, but rather the voltage differences between different parts of the brain. Four major types of EEG activity are recognized, which are alpha, beta, delta and theta.
Alpha waves, also known as Berger’s waves ranges in frequency from 8-12 Hz. Best detected with eyes closed, alpha waves are characteristic of a relaxed, alert state of consciousness. An alpha-like normal variant called mu is sometimes seen over the motor cortex (central scalp) and attenuates with movement or, rather, with the intention to move.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 189
Incorrect
-
A patient presents with loss of fine touch and sense of proprioception in the lower part of the body (below T6). He is likely to have a lesion involving:
Your Answer:
Correct Answer: Gracile nucleus
Explanation:The gracile nucleus is located in the medulla oblongata and is one of the dorsal column nuclei involved in the sensation of fine touch and proprioception. It contains second-order neurons of the dorsal column–medial lemniscus system, that receive inputs from sensory neurones of the dorsal root ganglia and send axons that synapse in the thalamus.
The gracile nucleus and fasciculus carry epicritic, kinaesthetic and conscious proprioceptive information from the lower part of the body (below the level of T6 in the spinal cord). Similar information from the upper part of body (above T6, except for face and ear) is carried by the cuneate nucleus and fasciculus. The information from face and ear is carried by the primary sensory trigeminal nucleus.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 190
Incorrect
-
Which of these laboratory findings will indicate a fetal neural tube defect when done between 15 and 20 weeks of pregnancy?
Your Answer:
Correct Answer: Increased alpha-fetoprotein
Explanation:Maternal serum screening during the second trimester is a non-invasive way of identifying women at increased risk of having children with a neural tube defect and should be offered to all pregnant women. The results are most accurate when the sample is taken between 15 and 20 weeks of gestation. Elevated levels of alpha-fetoprotein suggest open spina bifida, anencephaly, risk of pregnancy complications, or multiple pregnancy.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 191
Incorrect
-
A 60-year old woman who has a left sided post-pneumonic effusion, was to have some pleural fluid aspirated for culture and sensitivity. If the medical intern in charge of the procedure decided to aspirate while the patient is sitting up on her bed, where in the pleural cavity would the fluid tend to accumulate?
Your Answer:
Correct Answer: Costodiaphragmatic recess
Explanation:The lowest part of the pleural cavity is the costodiaphragmatic recess and it the space in which the pleural fluid will accumulate when the patient sits up.
The cupola is part of the pleural cavity that extends into the root of the neck above the first rib.
The costomediastinal recess is the junction at which the costal pleura becomes the mediastinal pleura.
The middle mediastinum is the part of the mediastinum that is occupied by the heart.
The hilar reflection is the point where the mediastinal pleura is reflected to continue on as the visceral pleura.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 192
Incorrect
-
Which of the following muscles attaches to the pterygomandibular raphe?
Your Answer:
Correct Answer: Superior pharyngeal constrictor muscle
Explanation:The pterygomandibular raphé (pterygomandibular ligament) provides attachment on its posterior border to the superior pharyngeal constrictor and on its anterior border to the buccinator muscle.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 193
Incorrect
-
An old man presented with atrophy of the thenar eminence despite the sensation over it still being intact. What is the injured nerve in this case?
Your Answer:
Correct Answer: Median nerve
Explanation:Atrophy of the thenar muscles means injury to the motor supply of these muscles. The nerve that sends innervation to it is the median nerve. But the median nerve does not provide sensory innervation to the overlying skin so sensation is spared.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 194
Incorrect
-
Following nerve injury, paralysis of the quadriceps femoris muscle occurs. Which of the following movements will be affected?
Your Answer:
Correct Answer: Extension of the leg
Explanation:The quadriceps muscle is a great extensor of the thigh. Therefore, following nerve injury or cutting nerve supply to the quadriceps will affect extension of the thigh
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 195
Incorrect
-
A patient who following 20 years of working in the asbestos industry develops malignant mesothelioma and is scheduled for pleuropneumonectomy to remove the entire pleura and lung on the affected side. Which layer would provide a natural cleavage plane for surgical separation of the costal pleura from the thoracic wall?
Your Answer:
Correct Answer: Endothoracic fascia
Explanation:The endothoracic fascia is connective tissue that is between the costal parietal pleura and the inner aspect of the chest wall. Removing this layer of connective tissue would make it easy to separate the costal pleura from the thoracic wall.
Deep fascia: is not found around the lungs. It is a layer of connective tissue that invests a muscle or a group of muscles.
Parietal pleura: part of the pleura that lines the inner surface of the chest/thoracic cavity.
Visceral pleura: is the serous membrane that lines the surface of the lungs.
Transversus thoracis muscle fascia is associated only with the muscle transversus thoracis.
Peritracheal fascia: a layer of connective tissue that invests the trachea. It is not associated with the thoracic wall or the costal pleura.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 196
Incorrect
-
During a laparoscopic inguinal hernia repair, the surgeon finds an artery in the extraperitoneal connective tissue (preperitoneal fat) that courses vertically and just medial to the bowel as the bowel passes through the abdominal wall. Which artery is this?
Your Answer:
Correct Answer: Inferior epigastric
Explanation:The inferior epigastric artery comes from the external iliac artery just above the inguinal ligament to curve forward in the subperitoneal tissue and then ascend obliquely along the medial margin of the deep inguinal ring. It continues to ascend between the rectus abdominis and the posterior lamella of its sheath after piercing the fascia transversalis and passing anterior to the linea semicircularis. Finally it gives off numerous branches that anastomose above the umbilicus with the superior epigastric branch of the internal mammary artery and with the lower intercostal arteries. As this artery ascends obliquely upwards from its origin it lies along the lower medial margins of the deep inguinal ring and posterior to the start of the spermatic cord. It is found in the preperitoneal fat of the abdomen lying just superficial to the peritoneum and forms the lateral umbilical fold. Hernias that pass lateral to this are indirect and medial to this, direct hernias.
The deep circumflex artery travels along the iliac crest on the inner surface of the abdominal wall. It is very lateral to the abdominal wall and hernias would pass medial to it.
The superficial circumflex iliac, superficial epigastric, superficial external pudendal arteries are all superficial arteries found in the superficial fascia.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 197
Incorrect
-
A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month ago, she fell from a staircase but only suffered mild head trauma. What is the most likely diagnosis in this case?
Your Answer:
Correct Answer: Chronic subdural haematoma
Explanation:A quarter to a half of patients with chronic subdural haematoma have no identifiable history of head trauma. If a patient does have a history of head trauma, it usually is mild. The average time between head trauma and chronic subdural haematoma diagnosis is 4–5 weeks. Symptoms include decreased level of consciousness, balance problems, cognitive dysfunction and memory loss, motor deficit (e.g. hemiparesis), headache or aphasia. Some patients present acutely. They usually result from tears in bridging veins which cross the subdural space, and may cause an increase in intracranial pressure (ICP).
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This question is part of the following fields:
- Neurology
- Pathology
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Question 198
Incorrect
-
Which of the following foramina provides a passage through which the vestibulocochlear nerve, passes?
Your Answer:
Correct Answer: Internal acoustic meatus
Explanation:The internal auditory meatus is a canal within the petrous part of the temporal bone of the skull between the posterior cranial fossa and the inner ear. It provides a passage through which the vestibulocochlear nerve, the facial nerve, and the labyrinthine artery (an internal auditory branch of the basilar artery) can pass from inside the skull to structures of the inner ear and face.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 199
Incorrect
-
A growing tumour is impinging on the lingual artery in the floor of the mouth. Which structure will experience decreased blood flow?
Your Answer:
Correct Answer: The sublingual gland
Explanation:The paired sublingual glands are major salivary glands in the mouth. They are the smallest, most diffuse, and the only unencapsulated major salivary glands. They provide only 3-5% of the total salivary volume. The gland receives its blood supply from the sublingual and submental arteries. The sublingual artery is a branch of the lingual artery, thus damage to the lingual artery will decrease the blood flow to the sublingual gland.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 200
Incorrect
-
Which of the following is the source of blood supply to the artery of the round ligament at the head of the femur?
Your Answer:
Correct Answer: Obturator artery
Explanation:The posterior branch of the obturator artery provides an articular branch to the head of the femur.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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SESSION STATS - PERFORMANCE PER SPECIALTY
