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Question 1
Correct
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A 35 year-old woman is undergoing thyroidectomy. The external laryngeal nerve may be injured whilst ligating this artery during the procedure due to its close relationship?
Your Answer: Superior thyroid artery
Explanation:The superior thyroid artery arises from the external carotid artery just below the level of the greater cornu of the hyoid bone and ends in the thyroid gland. This artery must be ligated at the thyroid when conducting a thyroidectomy. If the artery is severed, but not ligated, it will bleed profusely. In order to gain control of the bleeding, the surgeon may need to extend the original incision laterally to ligate the artery at its origin at the external carotid artery. The external laryngeal branch of the superior laryngeal nerve courses in close proximity to the superior thyroid artery, making it at risk for injury during surgery.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 2
Correct
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The line which divides the perineum into two triangles is connected to the?
Your Answer: Ischial tuberosities
Explanation:The perineum has it’s deep boundaries in front of the pubic arch and the arcuate ligament of the pubis, behind the tip of the coccyx and on either side of the inferior rami of the pubis and ischium and the sacrotuberous ligament. It also corresponds to the outlet of the pelvis. A line drawn transversely across, in front of the ischial tuberosities divides the space into two portions, the posterior contains the termination of the anal canal and the anterior, contains the external urogenital organs.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 3
Correct
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This structure divides the space between the lens and the cornea into the anterior and posterior chambers of the eye:
Your 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 4
Correct
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Which of the following will be affected by a lesion in the posterior column-medial lemniscus system?
Your 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 5
Correct
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Where is the mental foramen located?
Your Answer: In the mandible
Explanation:The mental foramen is found bilaterally on the anterior surface of the mandible adjacent to the second premolar tooth. The mental nerve and terminal branches of the inferior alveolar nerve and mental artery leave the mandibular canal through it.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 6
Incorrect
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A patient is unable to move their mandible to the left. Which muscle is affected in this case?
Your Answer: Left lateral pterygoid muscle
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 7
Incorrect
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During an operation to repair an indirect inguinal hernia, you are asked to indicate the position of the deep inguinal ring. You indicate this as being:
Your Answer: Medial to the inferior epigastric artery
Correct Answer: Above the midpoint of the inguinal ligament
Explanation:The deep inguinal ring is near the midpoint of the inguinal ligament, below the anterior superior iliac spine. It is lateral to the inferior epigastric artery. The superficial ring, however, is found above the pubic tubercle. The supravesical fossa is the space between the median and medial umbilical folds.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 8
Incorrect
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What is correct regarding the obturator artery?
Your Answer: It is a branch of the external iliac artery
Correct Answer: It is found in the medial compartment of the thigh
Explanation:The obturator artery is a branch of the internal iliac artery, which passes antero-inferiorly on the lateral wall of the pelvis, to the upper part of the obturator foramen. The posterior branch follows the posterior margin of the foramen and turns forward on the inferior ramus of the ischium. It also supplies an articular branch, which enters the hip joint through the acetabular notch, sending a branch along the ligamentum teres to the head of the femur. It is the main source of arterial supply to the medial compartment of the thigh
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 9
Correct
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A gymnast was admitted to hospital for investigation of a weakness in the extension and adduction of his arm. He had a previous penetrating wound in the area of the posterior axillary fold. Which of these muscles is the likely cause?
Your Answer: Latissimus dorsi
Explanation:All the criteria of this case points towards the latissimus dorsi. This muscle is greatly involved in extension, adduction and medial rotation of the arm and forms the posterior axillary fold which in this case was injured.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 10
Incorrect
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When the pitch of a sound increases, what is the physiological response seen in the listener?
Your Answer: The frequency of action potentials in auditory nerve fibres increases
Correct Answer: The location of maximal basilar membrane displacement moves toward the base of the cochlea
Explanation:An increase in the frequency of sound waves results in a change in the position of maximal displacement of the basilar membrane in the cochlea. Low pitch sound produces maximal displacement towards the cochlear apex and greatest activation of hair cells there. With an increasing pitch, the site of greatest displacement moves towards the cochlear base. However, increased amplitude of displacement, increase in the number of activated hair cells, increased frequency of discharge of units in the auditory nerve and increase in the range of frequencies to which such units respond, are all seen in increases in the intensity or a sound stimulus.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 11
Incorrect
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During clinic, a medical student conducts a physical examination on a teenage boy with a lump in the inguinal region. The lump is protruding from the superficial inguinal ring. The student correctly concluded that it was:
Your Answer: Definitely an indirect inguinal hernia
Correct Answer: Either a direct or an indirect inguinal hernia
Explanation:It is not possible to tell if an inguinal hernia is direct or indirect just by palpating it. Despite the fact that indirect inguinal hernias commonly come out of the superficial inguinal ring to enter the scrotum, direct inguinal hernia might still do this.
Femoral hernia goes through the femoral ring into the femoral canal (has nothing to do with the superficial inguinal ring).
Superficial inguinal lymph nodes lie in the superficial fascia parallel to the inguinal ligament; it would therefore feel more superficial and would not be mistaken for a hernia protruding through the inguinal ring.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 12
Incorrect
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The thyroid gland is a large ductless gland located in which part of the neck?
Your Answer: Digastric triangle
Correct Answer: Visceral space
Explanation:The thyroid gland is an endocrine gland in the neck, consisting of two lobes connected by an isthmus. It is situated at the front and sides of the neck in the visceral space.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 13
Correct
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The annular ligament in the forearm:
Your Answer: Encircles the head of the radius
Explanation:The annular ligament forms about four-fifths of the osseofibrous ring and is attached to the anterior and posterior margins of the radial notch. It is a strong band of fibres which encircles the head of the radius retaining it in contact with the radial notch of the ulna. When it comes to its upper border, it blends with the anterior and posterior ligament of the elbow.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 14
Correct
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A 25 year-old male patient was brought to the hospital due to a vehicular accident. A skull x-ray was done which revealed a fracture along the base of the middle cranial fossa. The patient has no sense of touch over the skin over his cheek and chin. Injury to the maxillary and the mandibular nerves is suspected. In which foramina do these two affected sensory branches leave the cranial cavity.
Your Answer: Foramen rotundum and foramen ovale
Explanation:The patient’s clinical manifestations suggests an injury to the maxillary and mandibular nerves. The maxillary branch (V2) of the trigeminal nerve (CN V) passes through and exits the skull via the pterygopalatine fossa and the foramen rotundum. At the base of the skull the foramen ovale (Latin: oval window) is one of the larger of the several holes (the foramina) that transmit nerves through the skull. The foramen ovale is situated in the posterior part of the sphenoid bone, posterolateral to the foramen rotundum. The following structures pass through foramen ovale: mandibular nerve, motor root of the trigeminal nerve, accessory meningeal artery (small meningeal or paradural branch, sometimes derived from the middle meningeal artery), lesser petrosal nerve, a branch of the glossopharyngeal nerve and an emissary vein connecting the cavernous sinus with the pterygoid plexus of veins. Occasionally it will also carry 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 15
Correct
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Which of the following structure forms the floor of the posterior triangle of the neck:
Your 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 16
Correct
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During a clinical rotation in the ENT clinic, you observe a flexible bronchoscopy. As the scope is passed down the trachea, you see a cartilaginous structure that resembles a ship's keel and separates the right and the left main stem bronchi. This structure is the:
Your Answer: Carina
Explanation:The carina (a keel-like cartilage) is found at the bifurcation of the trachea separating the right from the left main stem bronchi. It is a little more to the left than to the right.
The cricoid cartilage is the inferior and posterior cartilage of the larynx.
The costal cartilage on the other hand elongates the ribs anteriorly and contribute to the elasticity of the thoracic cage.
The pulmonary ligament is a fold of pleura located below the root of the lung.
Tracheal rings are rings of cartilage that support the trachea.
Peritracheal fascia is a layer of connective tissue that invests the trachea from the outside and is not visible on bronchoscopy.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 17
Correct
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Passing through the lesser sciatic foramen are the:
Your Answer: Pudendal nerve
Explanation:Structures that pass through the lesser sciatic foramen include:
– the pudendal nerve
– the nerve to obturator internus
– internal pudendal artery
– the tendon of obturator internus
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 18
Incorrect
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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: Leg
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 19
Correct
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Which of the following structures is not easily palpable?
Your 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 20
Incorrect
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During an appendicectomy in a 16 year old girl, the registrar initially did not find the appendix on entering the peritoneal cavity. She, however, remained calm as she knew she could find it by:
Your Answer: Palpating the ileocaecal valve and looking just above it
Correct Answer: Looking at the confluence of the taenia coli
Explanation:The vermiform appendix arises from the apex of the caecum. Although it has a constant base, it can pass in one of several directions such as upward behind the caecum, to the left behind the ileum and mesentery or downward into the lesser pelvis. It is retained in place by a peritoneal fold, the mesoenteriole derived from the left leaf of the mesentery. Taenia coli meet at the appendix which is the terminal portion of the caecum. The appendix is below the ileocecal valve, not above. It is not near the right colic artery (which supplies the ascending colon). It would not be found by removing a layer of the jejuno-ileum and is not in the pelvic brim.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 21
Incorrect
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The nasolacrimal duct is a membranous canal. It extends from the lower part of the lacrimal sac and drains into which structure?
Your Answer: Maxillary sinus
Correct Answer: Inferior meatus
Explanation:The nasolacrimal duct carries tears from the lacrimal sac of the eye into the nasal cavity. The duct begins in the eye socket between the maxillary and lacrimal bones, from where it passes downwards and backwards. The opening of the nasolacrimal duct into the inferior nasal meatus of the nasal cavity is partially covered by a mucosal fold (valve of Hasner or plica lacrimalis). Excess tears flow through the nasolacrimal duct which drains into the inferior nasal meatus.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 22
Incorrect
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An ultrasound report of a 35-year old female patient revealed that she had cancer of the pancreas and presented with subsequent severe obstructive jaundice. In which part of this was woman's pancreas was the tumour most likely located?
Your Answer: Neck
Correct Answer: Head
Explanation:The pancreas is divided into five parts; the head, body, neck, tail, and the uncinate process. Of the five parts, tumours located at the head of the pancreas in most instances cause obstruction of the common bile duct more often than tumours in the other parts of the pancreas. This is because the common bile duct passes through the head of the pancreas from the gallbladder and the liver (it is formed where the cystic and the hepatic bile duct join) to empty bile into the duodenum. This biliary obstruction leads to accumulation of bile in the liver and a consequent bilirubinaemia (raised levels of blood bilirubin). This results in jaundice. The pancreas is not divided into lobes.
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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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Where is the foramen ovale located?
Your Answer: Zygomatic
Correct Answer: Sphenoid
Explanation:The foramen ovale is an oval shaped opening in the middle cranial fossa located at the posterior base of the greater wing of the sphenoid bone, lateral to the lingula. It transmits the mandibular division of the trigeminal nerve (CN Vc), accessory meningeal artery, emissary veins between the cavernous sinuses and pterygoid plexus, otic ganglion, and occasionally the nervus spinosus and lesser petrosal nerve.
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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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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: Superficial palmar arch
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 25
Correct
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Which name is given to the inferior fascia of the urogenital diaphragm?
Your 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 26
Incorrect
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When conducting an exploratory laparotomy procedure of a patient diagnosed with a bleeding ulcer of the lesser curvature of the stomach, which artery in this patient are you most likely to ligate to control the bleeding?
Your Answer: Short gastric
Correct Answer: Left gastric
Explanation:The lesser curvature of the stomach is supplied by the left gastric artery along with the right gastric artery. These two arteries are the ones to most likely be ligated if bleeding was to be stopped at the lesser curvature of the stomach. The splenic artery branches from the celiac branch and supplies the spleen. The left gastro-omental, the right and left gastroepiploic arteries supply the greater curvature.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 27
Incorrect
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Which one of the following muscles is innervated by the facial nerve?
Your Answer: Temporalis
Correct Answer: Buccinator
Explanation:Buccinator is a muscle of facial expression and is therefore innervated by the facial nerve. The lateral pterygoid, masseter, anterior belly of digastric and temporalis are all muscles of mastication and therefore innervated by the mandibular division of the trigeminal nerve.
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This question is part of the following fields:
- Anatomy
- Head & Neck; Neurology
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Question 28
Incorrect
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A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which is the LEAST likely place to find the testis?
Your Answer: At the deep inguinal ring
Correct Answer: Perineum
Explanation:Embryologically the testes are retroperitoneal structures in the posterior abdominal wall, attached to the anterolateral abdominal wall by the gubernaculum. The gubernaculum ‘pulls’ the testes through the deep inguinal ring, inguinal canal and superficial inguinal ring and over the pelvic brim. The gubernaculum is preceded by the processus vaginalis that is derived from the peritoneum anterior to the testes. The processus vaginalis pushes the muscle and fascial layers. These eventually make up the canal and the spermatic cord, into the scrotum. The gubernaculum persists as the scrotal ligament while part of the processus vaginalis remains as a bursa-like sac i.e. the tunica vaginalis testes. The testes therefore could be caught in any one of these places along its path of descending. The testes are never in the perineum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 29
Incorrect
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Following an accident, a man was unable to extend the wrist and metacarpophalangeal joints, despite sensation being intact. Which nerve was likely damaged?
Your Answer: Radial nerve
Correct Answer: Posterior interosseous nerve
Explanation:The posterior interosseous nerve which causes, what is known as the posterior interosseous nerve syndrome. The nerve is compressed before it bifurcates to form the medial and lateral branches. The compression is beyond the origin of the branches to the radial wrist extensors and the radial sensory nerve. The result of such a case is paralysis of the digital extensors and the extensor carpi ulnaris, resulting in dorsoradial deviation of the wrist.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 30
Correct
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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: 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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