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  • Question 1 - A dental surgeon infiltrates local anaesthetic at the mandibular foramen to carry out...

    Correct

    • A dental surgeon infiltrates local anaesthetic at the mandibular foramen to carry out a block of the right inferior alveolar nerve. Which of the following might occur as a result of the procedure?

      Your Answer: Numbness of the lower teeth on the right side

      Explanation:

      The inferior alveolar nerve supplies all the teeth of the respective hemimandible. It transverses the inferior alveolar canal and is a branch of the trigeminal nerve’s mandibular division. Therefore, in this case, the teeth of the right hemimandible will be numb.

    • This question is part of the following fields:

      • Anatomy
      24.3
      Seconds
  • Question 2 - Where would you visualise the azygous lobe on an antero-posterior (A-P) chest X-ray?...

    Correct

    • Where would you visualise the azygous lobe on an antero-posterior (A-P) chest X-ray?

      Your Answer: Right upper zone

      Explanation:

      The azygos lobe is usually well seen on the chest radiograph, where it is limited by the azygos fissure, a fine, convex (relative to the mediastinum) line that crosses the apex of the right lung.

    • This question is part of the following fields:

      • Anatomy
      2.6
      Seconds
  • Question 3 - A young female who carries the abnormal RET oncogene has her recurrent laryngeal...

    Correct

    • A young female who carries the abnormal RET oncogene has her recurrent laryngeal nerve accidentally divided during a thyroidectomy. Which clinical features are likely to result from this?

      Your Answer: The larynx is anaesthetised inferior to the vocal cord on the affected side

      Explanation:

      The recurrent laryngeal nerve (RLN) innervates all of the intrinsic muscles of the larynx except for the cricothyroid muscle, which is innervated by the superior laryngeal nerve (SLN).Patients with unilateral vocal fold paralysis present with postoperative hoarseness or breathiness. The presentation is often subacute. At first, the vocal fold usually remains in the paramedian position, creating a fairly normal voice. Definite vocal changes may not manifest for days to weeks. The paralyzed vocal fold atrophies, causing the voice to worsen. Other potential sequelae of unilateral vocal-fold paralysis are dysphagia and aspiration.Bilateral vocal-fold paralysis may occur after total thyroidectomy, and it usually manifests immediately after extubation. Both vocal folds remain in the paramedian position, causing partial airway obstruction. Patients with bilateral vocal-fold paralysis may present with biphasic stridor, respiratory distress, or both. On occasion, the airway is sufficient in the immediate postoperative period despite the paralyzed vocal folds. At follow-up, such patients may present with dyspnoea or stridor with exertion.

    • This question is part of the following fields:

      • Anatomy
      2.7
      Seconds
  • Question 4 - A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp...

    Correct

    • A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp object punctured the portion of the parietal pleura that extends above the first rib. What is the name of this portion of the parietal pleura?

      Your Answer: Cupola

      Explanation:

      Endothoracic fascia: the connective tissue (fascia) that is between the costal parietal pleura and the inner wall of the chest wall.
      Costomediastinal recess: the point where the costal pleura becomes mediastinal pleura.
      Costodiaphragmatic recess: is the lowest point of the pleural sac where the costal pleura becomes diaphragmatic pleura.
      Cupola: the part of the parietal pleura that extends above the first rib level into the root of the neck.
      Costocervical recess: this is a made-up term.
      Peritracheal fascia: a layer of connective tissue that invests the trachea.

    • This question is part of the following fields:

      • Anatomy
      2.2
      Seconds
  • Question 5 - A 17 year old patient, who reports to the clinic following an apparent...

    Incorrect

    • A 17 year old patient, who reports to the clinic following an apparent transient ischaemic attack, is demonstrated to have a small right homonymous hemianopia with partial sparing of central vision.Where is the lesion most likely to have occurred?

      Your Answer: Optic tract

      Correct Answer: Occipital cortex

      Explanation:

      The most common cause of homonymous hemianopia (HH) is a stroke. In this condition there is bitemporal field loss. Lesions posterior to the optic chiasm, in the brain parenchyma are most likely to be the cause of the HH. In this case the retention of central vision indicates that the area of injury may be in the occipital cortex, sparing the occipital pole. The occipital pole receives sensory fibres from the macular, and has a dual blood supply protecting it from total infarction. Lesions of the optic tract can be ruled out as these cause total vision loss in the affected eye. Parietal or temporal nerve lesions cause affect the inferior and superior parts of the visual field respectively causing homonymous quadrantinopias.

    • This question is part of the following fields:

      • Anatomy
      22.6
      Seconds
  • Question 6 - A 10-year-old boy sustained a fracture of his right elbow, which damaged the...

    Correct

    • A 10-year-old boy sustained a fracture of his right elbow, which damaged the ulnar nerve behind the medial epicondyle of the humerus. A month later, he still has a total ulnar nerve paralysis. Which of the following can be observed on examination?

      Your Answer: Inability to grip a sheet of paper between his fingers when the hand is placed flat on the table

      Explanation:

      Among the given options, the inability to grip a sheet of paper between his fingers when the hand is placed flat on the table is the feature of ulnar nerve injury. Rationale:The ulnar nerve (usually) supplies sensation to the skin of the fifth and the ulnar side of the fourth finger, front and back. Following the injury of the nerve, the following functions are impaired:- There is a sympathetic interruption, with the absence of sweating in the affected area. – The thenar muscles are supplied by the median nerve and are therefore spared. – The ulnar nerve also supplies the muscles of the hypothenar eminence. – Although the ring and little fingers are held in the clawed position when the nerve is injured at the wrist, a high lesion paralyses the long flexors to these two fingers and results in the loss of this sign. The test for paralysis of the palmar interossei, supplied by the ulnar nerve, is the inability to adduct the fingers and thus to be unable to grip a sheet of paper between them.

    • This question is part of the following fields:

      • Anatomy
      2.1
      Seconds
  • Question 7 - A 16 year old girl fractured a bone in her left foot. Upon...

    Correct

    • A 16 year old girl fractured a bone in her left foot. Upon examination the clinician discovered that the fracture affected the insertion of the peroneus brevis muscle. Which of the following bones was most likely affected?

      Your Answer: Base of the fifth metatarsal

      Explanation:

      The peroneus brevis muscle originates from the lower two-thirds of the lateral body of the fibula and has inserts at the base of the fifth metatarsal. Fractures to this bone are common and can be due to infection, trauma, overuse and repetitive use.

    • This question is part of the following fields:

      • Anatomy
      1.7
      Seconds
  • Question 8 - A young male sustains a skull-base fracture at the middle cranial fossa which...

    Correct

    • A young male sustains a skull-base fracture at the middle cranial fossa which injures his right abducent (VI) nerve.Which signs are most likely to be present on clinical examination?

      Your Answer: The patient is unable to deviate his right eye laterally

      Explanation:

      Cranial nerve VI, also known as the abducent nerve, innervates the ipsilateral lateral rectus (LR), which functions to abduct the ipsilateral eye. Patients usually present with an isolated abduction deficit, binocular horizontal diplopia, worse in the distance, and esotropia in primary gaze. Patients also may present with a head-turn to maintain binocularity and binocular fusion and to minimize diplopiaExamination for a sixth nerve palsy involves documenting the presence or absence of papilledema, examining the ocular motility, evaluating the eyelids and pupils, and excluding involvement of other cranial nerves (e.g., V, VII, VIII).

    • This question is part of the following fields:

      • Anatomy
      11
      Seconds
  • Question 9 - An 8 year old male child presents with an injury to his right...

    Correct

    • An 8 year old male child presents with an injury to his right brachial plexus in a motor vehicle accident. Clinical examination reveals a right shoulder weakness when it comes to abduction and flexion of the forearm. His lateral aspect of the right upper arm seems to have some sensory loss as well. All reflexes are present except for the right biceps and brachioradial ones. What is the level of brachial plexus injury?

      Your Answer: C5,6 root

      Explanation:

      Upper brachial plexus roots innervate the proximal muscles of the shoulder and the upper arm. In this particular case, only these areas are affected, suggesting that the levels of brachial plexus injury are at roots C5-C6.

    • This question is part of the following fields:

      • Anatomy
      32.2
      Seconds
  • Question 10 - An 12 year old boy presents with a 2 day history of a...

    Correct

    • An 12 year old boy presents with a 2 day history of a tree climbing accident in which a small branch gave way, leaving him suspended by one arm. He can move his arm into any position but is unable to use his hand effectively.Which of the following structures has he most likely damaged in the accident?

      Your Answer: The T1 nerve root

      Explanation:

      The boy is most likely to have sustained an injury to his brachial plexus as a result of upward traction of his arm for an extended period of time. We can rule out the topmost nerve roots of the brachial plexus, C6 and C7 as these supply the larger muscles of the arm responsible for moving the shoulder, the elbow and the wrist. The anatomical structure affected is therefore the T1 nerve root which is responsible for movement of the muscles in the hand. This type of injury is called a Klumpke’s Palsy, which is the result of a hyper-abducted trauma to the arm, damaging the C8 and T1 nerve roots. While the radial and ulnar nerve also innervate the hand, the history given points to Klumpkeā€™s palsy as the best explanation for this mechanism of injury.

    • This question is part of the following fields:

      • Anatomy
      16.5
      Seconds

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