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Question 1
Correct
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A growing tumour is impinging on the lingual artery in the floor of the mouth. Which structure will experience decreased blood flow?
Your 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 2
Incorrect
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In which of the following compartments of the femoral sheath is the femoral artery located?
Your Answer: Intermediate compartment
Correct Answer: Lateral compartment
Explanation:The femoral sheath also known as the crural sheath is made up of three compartments; lateral, intermediate and the medial. The femoral artery is contained in the lateral compartment of the femoral sheath while the femoral vein is in the intermediate compartment.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 3
Incorrect
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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: Superior orbital fissure and foramen rotundum
Correct 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 4
Correct
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When you rest your elbows on a desk, what bony landmark of the upper limb are you resting on?
Your 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 5
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: Superficial inguinal ring
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 6
Correct
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Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be seen in:
Your Answer: Cerebellar disease
Explanation:The given symptoms are seen in diseases affecting the cerebellum. A cerebellar tremor is a slow tremor that occurs at the end of a purposeful movement. It is seen in cerebellar disease, such as multiple sclerosis or some inherited degenerative disorders and chronic alcoholism. Classically, tremors are produced in the same side of the body as a one-sided lesion. Cerebellar disease can also result in a wing-beating’ type of tremor called rubral or Holmes’ tremor – a combination of rest, action and postural tremors. Other signs of cerebellar disease include dysarthria (speech problems), nystagmus (rapid, involuntary rolling of the eyes), gait problems and postural tremor of the trunk and neck.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 7
Correct
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Which nuclei of the posterior grey column of the spinal cord are likely affected in a patient who has lost the sensation of pain and temperature?
Your Answer: Substantia gelatinosa
Explanation:Substantia gelatinosa is one of the nuclei in the posterior grey column along side other posterior grey column nuclei like the nucleus dorsalis, nucleus proprius, and posteromarginal nucleus. These nuclei are a collection of cells in the posterior grey area found in throughout the spinal cord. The substantia gelatinosa receives direct input from the dorsal nerve roots (sensory), especially from thermoreceptors and nociceptors (receptors for temperature and pain).
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This question is part of the following fields:
- Anatomy
- Neurology
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Question 8
Incorrect
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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: Cisterna pontis
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 9
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: Optic
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 10
Incorrect
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Which of the following foramina will the ophthalmic artery pass through in order to reach the eye?
Your Answer:
Correct Answer: Optic canal
Explanation:The optic foramen is the opening to the optic canal. The canal is located in the sphenoid bone; it is bounded medially by the body of the sphenoid and laterally by the lesser wing of the sphenoid. The superior surface of the sphenoid bone is bounded behind by a ridge, which forms the anterior border of a narrow, transverse groove, the chiasmatic groove (optic groove). The groove ends on either side in the optic foramen, which transmits the optic nerve and ophthalmic artery into the orbital cavity. Compared to the optic nerve, the ophthalmic artery is located inferolaterally within the canal.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 11
Incorrect
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A football player sustained an injury to his ankle. The wound went through the skin, subcutaneous tissue and flexor retinaculum. Which other structure passing under the retinaculum may be injured?
Your Answer:
Correct Answer: Tibial nerve
Explanation:The flexor retinaculum is immediately posterior to the medial malleolus. The structures that pass under the flexor retinaculum from anterior to posterior are: tendon of the tibialis posterior, flexor digitorum longus, posterior tibial artery (and vein), tibial nerve and tendon of flexor hallucis longus. The tibial nerve is the only one which lies behind the flexor retinaculum.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 12
Incorrect
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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 13
Incorrect
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Which of the following two cerebral veins join up to form the great cerebral vein, otherwise also known as the great vein of Galen?
Your Answer:
Correct Answer: Internal cerebral veins
Explanation:The great vein of Galen or great cerebral vein, is formed by the union of the internal cerebral veins and the basal veins of Rosenthal. This vein curves upwards and backwards along the border of the splenium of the corpus callosum and eventually drains into the inferior sagittal sinus and straight sinus at its anterior extremity.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 14
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:
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 15
Incorrect
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Regarding abduction of the digits of the hand, which of the following is correct?
Your Answer:
Correct Answer: All of the adductors of the digits take at least part of their attachments from metacarpal bones
Explanation:Lying on the palmer surfaces of the metacarpal bones are four palmar interossei which are smaller than the dorsal interossei. Arising from the entire length of the metacarpal bone of one finger, is a palmar interosseous, which is inserted into the side of the base of the first phalanx and the aponeurotic expansion of the extensor digitorum communis tendon to the same finger. All the interossei are innervated by the eighth cervical nerve, through the deep palmar branch of the ulnar nerve. The palmar interossei adducts the fingers to an imaginary line drawn longitudinally through the centre of the middle finger.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 16
Incorrect
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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 17
Incorrect
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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 18
Incorrect
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During an inguinal hernia repair, an incision is made parallel to and 5cm above the inguinal ligament. The registrar is warned to look out for the inferior epigastric vessels to avoid damage. Between which layers of the abdominal wall is the registrar likely to find these vessels?
Your Answer:
Correct Answer: Transversus abdominis muscle and peritoneum
Explanation:The inferior epigastric vessels lie on the inner surface of the transversus abdominis muscle covered by the parietal peritoneum. This layer of peritoneum lies over the inferior epigastric vessels to make the lateral umbilical fold. Camper’s and Scarpa’s fascia are two layers of the superficial fascia, the fatty layer and the membranous layer respectively.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 19
Incorrect
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The muscles of the superficial posterior compartment of the leg insert into the:
Your Answer:
Correct Answer: Calcaneus
Explanation:The muscles of the superficial posterior compartment of the leg form the characteristic ‘calf’ shape of the posterior leg and include the gastrocnemius, soleus and plantaris. The gastrocnemius and soleus together form a muscular mass which is occasionally described as the triceps surae; its tendon of insertion is the tendo calcaneus. The tendo calcaneus is the thickest and strongest in the body and together with the tendon of the plantaris muscle is inserted into the posterior part of the calcaneus.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 20
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 21
Incorrect
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A patient had sudden complete loss of vision of the right eye. Fundoscopy showed the distinct cherry red spot on the retina. Which of the following arteries was occluded?
Your Answer:
Correct Answer: Central artery of the retina
Explanation:The central retinal artery supplies all the nerve fibres that form the optic nerve, which carries the visual information to the lateral geniculate nucleus of the thalamus. Thus if the central retinal artery gets occluded, there is complete loss of vision in that eye and the entire retina (with the exception of the fovea) becomes pale, swollen and opaque while the central fovea still appears reddish (this is because the choroid colour shows through). This is the basis of the famous Cherry red spot seen on examination of the retina on fundoscopy of a central retinal artery occlusion (CRAO).
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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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Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of the popliteal fossa?
Your Answer:
Correct Answer: Biceps femoris
Explanation:The popliteal fossa is located at the back of the knee. It is bounded laterally by the biceps femoris above and the plantaris and lateral head of the gastrocnemius below and medially by the semitendinosus and semimembranosus above and by the medial head of the gastrocnemius below.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 23
Incorrect
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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 24
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 25
Incorrect
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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 26
Incorrect
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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 27
Incorrect
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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 28
Incorrect
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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 29
Incorrect
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Regarding the extensor retinaculum of the wrist, which of these is CORRECT?
Your Answer:
Correct Answer: It prevents the tendons of the posterior compartment of the forearm from ‘bowstringing’ when the hand is extended at the wrist
Explanation:This extensor retinaculum, as the name indicates, holds the tendons of the extensors against the dorsal surface of the distal radius and ulna. Therefore, the correct answer is that it prevents bowstringing of the extensor tendons with wrist extension. It forms compartments between it and its bony attachment, and these compartments guide and hold the tendons.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 30
Incorrect
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Which of the following structures is affected or damaged when the 'anterior drawer test' is positive?
Your Answer:
Correct Answer: Anterior cruciate ligament
Explanation:The anterior drawer test is an important orthopaedic test that is used to test weakness of the anterior cruciate ligament. The test is done by having the patient sit in a supine position with his/her knees flexed at 90 degrees. An examiner stabilises the patients feet and softly pulls or pushes on the proximal tibia. The test is positive if there is translational movement of the tibia in relation to the femur, indicating a weakened anterior cruciate ligament. The anterior cruciate ligament prevents the tibia from sliding out in front 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
