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  • Question 1 - Which lymph nodes are likely to be enlarged in a patient who has...

    Incorrect

    • Which lymph nodes are likely to be enlarged in a patient who has malignant growth involving the anus?

      Your Answer: Pararectal

      Correct Answer: Superficial inguinal

      Explanation:

      The lymphatics from the anus, skin of the perineum and the scrotum end in the superficial inguinal nodes. In case of a malignant growth of the anus, the superficial inguinal lymph nodes would most likely be enlarge.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      16.5
      Seconds
  • Question 2 - Choose the most correct answer regarding the common peroneal nerve. ...

    Correct

    • Choose the most correct answer regarding the common peroneal nerve.

      Your 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.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      26.5
      Seconds
  • Question 3 - A 28 year gang member was shot in the chest. The bullet hit...

    Incorrect

    • A 28 year gang member was shot in the chest. The bullet hit a vessel that courses horizontally across the mediastinum. Which of the following vessels is it likely to be?

      Your Answer: Right brachiocephalic vein

      Correct Answer: Left brachiocephalic vein

      Explanation:

      The superior vena cava that empties blood into the right atrium is formed by the right and the left brachiocephalic veins. Hence, the left brachiocephalic has to course across the mediastinum horizontally to join with its right ‘counterpart’. The left subclavian artery and vein being lateral to the mediastinum do not cross the mediastinum while the left jugular and the common carotid artery course vertically.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      39.8
      Seconds
  • Question 4 - A 38 year-old man falls on an outstretched hand. X-rays indicate an anterior...

    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: Scaphoid

      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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      11.1
      Seconds
  • Question 5 - A 25 year old male patient who had sustained a stab wound in...

    Incorrect

    • A 25 year old male patient who had sustained a stab wound in the middle of the posterior aspect of the left thigh, was discharged from hospital after dressing and antibiotic prophylaxis. Later on the patient developed bleeding through the wound and upon review, the source was discovered to be an artery that is the direct source of the medial and lateral circumflex arteries. Which is this artery that was injured?

      Your Answer: Obturator artery

      Correct Answer: Profunda femoris artery

      Explanation:

      The medial and lateral circumflex arteries are direct branches of the Profunda femoris artery otherwise also known as the deep artery of the thigh. The Profunda femoris artery arises from the femoral artery just below the inguinal ligament (approximately 2-5cm below it).

      The following are the branches of the deep artery of the thigh:

      Lateral circumflex femoral artery

      Medial circumflex femoral artery

      Perforating arteries

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      34
      Seconds
  • Question 6 - A ‘claw hand’ is usually associated with injury to which of the following...

    Correct

    • A ‘claw hand’ is usually associated with injury to which of the following nerves?

      Your 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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      3.4
      Seconds
  • Question 7 - Which muscle is responsible for directing the gaze downward when the eye is...

    Incorrect

    • Which muscle is responsible for directing the gaze downward when the eye is abducted?

      Your Answer: Inferior oblique muscle

      Correct Answer: Inferior rectus muscle

      Explanation:

      The inferior rectus muscle is a muscle in the orbit. As with most of the muscles of the orbit, it is innervated by the inferior division of oculomotor nerve (Cranial Nerve III). It depresses, adducts, and helps laterally rotate the eye.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      13
      Seconds
  • Question 8 - A 36-year-old woman suddenly suffers from a generalized seizure. She was previously healthy....

    Incorrect

    • A 36-year-old woman suddenly suffers from a generalized seizure. She was previously healthy. An emergency CT scan reveals a mass in the posterior fossa, with distortion of the lateral ventricles. After removing the tumour, the biopsy reveals it contains glial fibrillary acidic protein (GEAP). What's the most likely diagnosis?

      Your Answer: Meningioma

      Correct Answer: Astrocytoma

      Explanation:

      Astrocytomas are primary intracranial tumours derived from astrocyte cells of the brain. They can arise in the cerebral hemispheres, in the posterior fossa, in the optic nerve and, rarely, in the spinal cord. These tumours express glial fibrillary acidic protein (GFAP). In almost half of cases, the first symptom of an astrocytoma is the onset of a focal or generalised seizure. Between 60% and 75% of patients will have recurrent seizures during the course of their illness. Secondary clinical sequelae may be caused by elevated intracranial pressure (ICP) cause by the direct mass effect, increased blood volume, or increased cerebrospinal fluid (CSF) volume. CT will usually show distortion of the third and lateral ventricles, with displacement of the anterior and middle cerebral arteries. Histological diagnosis with tissue biopsy will normally reveal an infiltrative character suggestive of the slow growing nature of the tumour.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      21.1
      Seconds
  • Question 9 - Which of the following muscles is solely contained in the anterior triangle of...

    Correct

    • Which of the following muscles is solely contained in the anterior triangle of the neck and divides the anterior triangle into three smaller triangles?

      Your Answer: Digastric

      Explanation:

      The digastric muscle is a small muscle located under the jaw. It lies below the body of the mandible, and extends, in a curved form, from the mastoid process to the symphysis menti. The digastric divides the anterior triangle of the neck into three smaller triangles:

      – The submaxillary triangle, bounded above by the lower border of the body of the mandible and a line drawn from its angle to the sternocleidomastoid, below by the posterior belly of the digastric and the stylohyoid and in front by the anterior belly of the digastric

      – The carotid triangle, bounded above by the posterior belly of the digastric and stylohyoid, behind by the sternocleidomastoid and below by the omohyoid

      – The suprahyoid or submental triangle, bounded laterally by the anterior belly of the digastric, medially by the midline of the neck from the hyoid bone to the symphysis menti and inferiorly by the body of the hyoid bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8.5
      Seconds
  • Question 10 - A 45-year old male patient with a long history of alcoholism developed liver...

    Correct

    • A 45-year old male patient with a long history of alcoholism developed liver cirrhosis that has led to portal hypertension. Which of the following plexuses of veins is most likely dilated in this patient?

      Your Answer: Haemorrhoidal plexus

      Explanation:

      The haemorrhoidal plexus or also known as the rectal plexus is a venous plexus that surrounds the rectum. This venous plexus in males communicates anteriorly with the vesical plexus and uterovaginal plexus in females. This venous plexus forms a site of free communication between the portal and systemic venous systems. In the case of portal hypertension this plexus would most likely dilate due to the increased pressure.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      795.7
      Seconds
  • Question 11 - A patient is diagnosed with a tumour of the parotid gland. During surgical...

    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: Main trunk of cranial nerve VIII

      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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      25.2
      Seconds
  • Question 12 - During an operation to repair an aortic coarctation in a neonate, a surgeon...

    Incorrect

    • During an operation to repair an aortic coarctation in a neonate, a surgeon accidentally cuts the first aortic intercostal arteries as he mobilised the descending aorta. Which one of the following structure might be deprived of its primary source of blood supply following this injury?

      Your Answer: Left bronchus

      Correct Answer: Right bronchus

      Explanation:

      The right bronchus is supplied by one right bronchial artery that may branch from one of the left bronchial arteries or from the right 3rd posterior intercostal artery (this is the first intercostal artery that arises from the aorta). Damage to this artery might stop blood supply to the main bronchus. Intercostal arteries that go to the first and the second interspaces originate from the highest intercostal artery such that blood supply to either of these spaces would not be interfered with.

      The left bronchus receives blood from 2 left bronchial arteries which are direct branches from the descending aorta.

      Fibrous pericardium is the sac that contains the heart. Its blood supply is not a major concern.

      Visceral pericardium receives its blood supply from the coronary vessels.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      18.1
      Seconds
  • Question 13 - A patient at the time of her second delivery opted for a bilateral...

    Incorrect

    • A patient at the time of her second delivery opted for a bilateral pudendal nerve block. In order to inject the anaesthetic agent near the pudendal nerve a anaesthetic consultant had to insert a finger into the vagina and press laterally to palpate which landmark?

      Your Answer: Arcus tendineus levator ani

      Correct Answer: Ischial spine

      Explanation:

      The ischial spine is always palpated through the walls of the vagina when performing a transvaginal pudendal nerve block and can easily be palpated on the lateral wall of the vagina.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      11.9
      Seconds
  • Question 14 - A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp...

    Incorrect

    • 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: Costodiaphragmatic recess

      Correct 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
      • Thorax
      1403.8
      Seconds
  • Question 15 - A 35 year old male patient sustained a traumatic head injury. The patient...

    Incorrect

    • 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: Subarachnoid

      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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8.4
      Seconds
  • Question 16 - What is the innervation of the tensor tympani muscle? ...

    Incorrect

    • What is the innervation of the tensor tympani muscle?

      Your Answer: Chorda tympani nerve

      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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14.6
      Seconds
  • Question 17 - What is the name of the cutaneous branch of the posterior primary ramus...

    Incorrect

    • What is the name of the cutaneous branch of the posterior primary ramus of C2?

      Your Answer: Lesser occipital nerve

      Correct Answer: Greater occipital nerve

      Explanation:

      The dorsal primary ramus of the spinal nerve C2 is the greater occipital nerve which provides cutaneous innervation to the skin of the back of the head. The ventral primary ramus gives off the great auricular nerve, the lesser occipital nerve and the ansa cervicalis.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      10.2
      Seconds
  • Question 18 - This structure divides the space between the lens and the cornea into the...

    Incorrect

    • This structure divides the space between the lens and the cornea into the anterior and posterior chambers of the eye:

      Your Answer: The pupil

      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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14.7
      Seconds
  • Question 19 - Which of the following veins is prostate cancer most likely to metastasize through?...

    Incorrect

    • Which of the following veins is prostate cancer most likely to metastasize through?

      Your Answer: Basilic vein

      Correct Answer: Internal vertebral venous plexus

      Explanation:

      The internal vertebral veins are the most likely route of metastasis as they are valveless. They serve an important clinical role as they are the route of free travel for cancerous cells to other body structures. The other veins on the list have valves and would be the least likely routes for metastasis.

    • This question is part of the following fields:

      • Anatomy
      • Neurology
      10.3
      Seconds
  • Question 20 - During an OSCE exam a medical student is asked to locate the sternal...

    Incorrect

    • During an OSCE exam a medical student is asked to locate the sternal angle. The sternal angle is a land mark for locating the level of the:

      Your Answer: Costal margin

      Correct Answer: Second costal cartilage

      Explanation:

      The sternal angle, a key landmark used in the clinic for auscultating for heart sounds, is the point of attachment of the costal cartilage of rib 2 to the sternum. It thus corresponds to the location of the second rib. A horizontal plane through the sternal angle traverses the T4/T5 intervertebral disc and marks the inferior boundary of the superior mediastinum.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      6.1
      Seconds
  • Question 21 - The muscle that stabilizes the stapes is innervated by which of the following...

    Incorrect

    • The muscle that stabilizes the stapes is innervated by which of the following nerves?

      Your Answer: Cranial nerve VIII

      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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      21.2
      Seconds
  • Question 22 - What is the action of the muscle of the orbit that originates on...

    Correct

    • What is the action of the muscle of the orbit that originates on the lesser wing of the sphenoid bone, just above the optic foramen?

      Your Answer: Elevation of the upper eyelid

      Explanation:

      The levator palpebrae superioris is the muscle in the orbit that elevates the superior (upper) eyelid. The levator palpebrae superioris originates on the lesser wing of the sphenoid bone, just above the optic foramen and receives somatic motor input from the ipsilateral superior division of the oculomotor nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      27.8
      Seconds
  • Question 23 - A man had an injury to his right brachial plexus. After examination by...

    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: Axillary nerve

      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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      117.9
      Seconds
  • Question 24 - A 42 - year old male patient with an acute onset headache was...

    Incorrect

    • A 42 - year old male patient with an acute onset headache was brought in to the emergency department with suspicion of a subarachnoid haemorrhage (SAH). The SHO on call decided to have a diagnostic lumbar puncture after computed topography scan failed to support the suspicion. To perform a successful lumbar puncture without causing injury to the spine, which anatomical landmark should guide the SHO to locate the fourth vertebra for insertion of the spinal needle?

      Your Answer: Coccyx

      Correct Answer: Iliac crest

      Explanation:

      The safest spinal level for conducting a lumbar puncture, is at the level of the fourth lumbar vertebra. The anatomical landmark used to locate the fourth lumbar vertebra (L4), is the iliac crest. The needle can safely be inserted either above or below L4. The conus medullaris is at the level of the border of L1 and L2 so L4 is safely distant from it.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      16.2
      Seconds
  • Question 25 - An operation to resect a tumour of the right lung was stopped as...

    Incorrect

    • An operation to resect a tumour of the right lung was stopped as the chest surgeon said that the tumour was crossing the oblique fissure. Which structures are separated by the oblique fissure of the right lung?

      Your Answer: Lower lobe from lingual

      Correct Answer: Lower lobe from both upper and middle lobes

      Explanation:

      The oblique fissure on the right lung separates the lower lobe from both the middle and upper lobe. The lingual is only found on the left lung and is part of the upper lobe.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      13.9
      Seconds
  • Question 26 - A 25-year-old football player suffers severe head trauma during a game. Physical examination...

    Incorrect

    • 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: Dura

      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.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      21.7
      Seconds
  • Question 27 - With respect to far accommodation, which of the following is a TRUE statement?...

    Incorrect

    • With respect to far accommodation, which of the following is a TRUE statement?

      Your Answer: The lens is rounded

      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.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      8.7
      Seconds
  • Question 28 - After a car accident, a 30-year-old woman is alert and only has minor,...

    Incorrect

    • After a car accident, a 30-year-old woman is alert and only has minor, superficial injuries. 2 hours later, she becomes unconscious and a CT scan reveals a convex, lens-shaped haemorrhage over the right parietal region. The most likely diagnosis is:

      Your Answer: Brain concussion

      Correct Answer: Epidural haematoma

      Explanation:

      Epidural haematomas are usually caused by arterial bleeding, classically due to damage to the middle meningeal artery by a temporal bone fracture. Symptoms develop within minutes to several hours after the injury and consist of increasing headache, decreased level of consciousness, hemiparesis and pupillary dilation with loss of light reactivity. Around 15–20% of epidural hematomas are fatal.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      16
      Seconds
  • Question 29 - An X ray of a 60 year old male brought to the accident...

    Incorrect

    • An X ray of a 60 year old male brought to the accident and emergency following a fall down stairs shows a fractured olecranon process of the right ulna with the line of fracture passing through the superior surface, disrupting a muscle. Which among the following muscles was most likely injured?

      Your Answer: Brachialis

      Correct Answer: Triceps brachii

      Explanation:

      The superior surface of the olecranon process forms an attachment for the insertion of the triceps brachii on the posterior aspect. It also has a minor transverse groove for the attachment of part of the posterior ligament of the elbow on the anterior aspect.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      165.7
      Seconds
  • Question 30 - A machine worker fractured the medial epicondyle of his right humerus resulting in...

    Incorrect

    • A machine worker fractured the medial epicondyle of his right humerus resulting in damage to an artery running with the ulnar nerve posterior to the medial epicondyle. The artery injured is the?

      Your Answer: Middle collateral

      Correct Answer: Superior ulnar collateral

      Explanation:

      The superior ulnar collateral artery runs posterior to the medial epicondyle of the humerus, accompanied by the ulnar nerve. This artery arises from the brachial artery near the middle of the arm and ends under the flexor carpi ulnaris muscle by anastomosing with two arteries: the posterior ulnar recurrent and inferior ulnar collateral.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      10
      Seconds
  • Question 31 - Which of the following muscles attach to the hyoid bone? ...

    Incorrect

    • Which of the following muscles attach to the hyoid bone?

      Your Answer: Trapezius

      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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      19.2
      Seconds
  • Question 32 - Due to a plantarflexion–inversion ankle sprain, which is the first ligament to rupture?...

    Incorrect

    • Due to a plantarflexion–inversion ankle sprain, which is the first ligament to rupture?

      Your Answer: Talotibial ligament

      Correct Answer: Anterior talofibular ligament

      Explanation:

      The anterior talofibular ligament passes from the anterior margin of the fibular malleolus. It is the most commonly injured ligament, as part of the lateral ligament of the ankle.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      13.6
      Seconds
  • Question 33 - A patient presents with loss of fine touch and sense of proprioception in...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      6.4
      Seconds
  • Question 34 - Injury to this nerve will affect the function of the palatoglossus and levator...

    Incorrect

    • Injury to this nerve will affect the function of the palatoglossus and levator veli palatini muscles:

      Your Answer: Cranial nerve IX

      Correct Answer: Cranial nerve X

      Explanation:

      The vagus nerve (cranial nerve X) innervates both the palatoglossus and levator veli palatini muscles.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      17.7
      Seconds
  • Question 35 - A lesion involving the lateral portion of the dorsal columns at the level...

    Incorrect

    • A lesion involving the lateral portion of the dorsal columns at the level of the nape of the neck will most likely affect:

      Your Answer: Sweating of the ipsilateral face

      Correct Answer: Vibratory sensations from the ipsilateral arm

      Explanation:

      At the level mentioned in the question, the lateral portion of dorsal columns comprises of the fasciculus cuneatus. Axons carrying the sensations of touch, vibration and proprioception from the ipsilateral arm enter the spinal cord and ascend in the fasciculus cuneatus, synapsing in the nucleus cuneatus of the caudal medulla. Secondary neurons from this nucleus give rise to internal arcuate fibres, which decussate and ascend to the thalamus as the medial lemniscus. Tertiary neurons from there project to the ipsilateral somatosensory cortex. Thus, any damage to the fasciculus cuneatus will result in a deficit in tactile, proprioceptive and vibratory sensations in the ipsilateral arm, and not the contralateral arm.

      Fine motor control of the fingers is mainly carried by the ipsilateral lateral corticospinal tract in the lateral funiculus of the cord. Motor control of the contralateral foot is carried by the ipsilateral corticospinal tract in the lateral funiculus of the cord. Lack of sweating of the face could be produced by interruption of sympathetic innervation. Proprioception from the ipsilateral leg is carried by the fasciculus gracilis in the medial part of the dorsal columns.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      30.7
      Seconds
  • Question 36 - What is the arterial sequence for an analgesic to reach the latissimus dorsi...

    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: Subclavian – axillary – supreme thoracic – intercostals

      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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      14.9
      Seconds
  • Question 37 - A tumour growing in the posterior mediastinum is found in a 40-year-old man...

    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: Pulmonary trunk

      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.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      10.6
      Seconds
  • Question 38 - A previously healthy 40-year-old housewife suddenly complains of a headache and loses consciousness....

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      10.8
      Seconds
  • Question 39 - All the following arteries contribute to the blood supply of the hip joint...

    Incorrect

    • All the following arteries contribute to the blood supply of the hip joint except:

      Your Answer: Femoral

      Correct Answer: Pudendal

      Explanation:

      The blood supply to the hip joint is from two main arteries, the medial circumflex femoral and lateral circumflex femoral arteries. These are branches of the deep artery of the thigh, which itself is a branch of the femoral artery. There is contribution of blood supply from the inferior gluteals, foveal and obturator arteries.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      15
      Seconds
  • Question 40 - A young man was thrown from a vehicle in a collision. He landed...

    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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (14/32) 44%
Pelvis (0/2) 0%
Lower Limb (2/4) 50%
Thorax (1/6) 17%
Upper Limb (5/7) 71%
Head & Neck (5/12) 42%
Neurology (4/8) 50%
Pathology (2/4) 50%
Physiology (1/3) 33%
Passmed