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  • Question 1 - While inspecting the caecum, what structure will be identified at the point at...

    Incorrect

    • While inspecting the caecum, what structure will be identified at the point at which all the taeniae coli converge?

      Your Answer: Ileocaecal valve

      Correct Answer: Appendix base

      Explanation:

      The taeniae coli are the three outer muscular bands of the cecum, ascending colon, transverse colon, and descending colon.

      The taeniae coli converge at the base of the appendix in the cecum where they form a complete longitudinal layer. In the ascending and descending colon, the bands are located anteriorly, posteromedially, and posterolateral.

    • This question is part of the following fields:

      • Anatomy
      36.9
      Seconds
  • Question 2 - A cannula is inserted into the cephalic vein of a 30-year-old man. Which...

    Incorrect

    • A cannula is inserted into the cephalic vein of a 30-year-old man. Which of the following structures does the cephalic vein pass through?

      Your Answer:

      Correct Answer: Clavipectoral fascia

      Explanation:

      The cephalic vein is one of the primary superficial veins of the upper limb. The superficial group of upper limb veins begin as an irregular dorsal arch on the back of the hand.

      The cephalic vein originates in the anatomical snuffbox from the radial side of the arch and travels laterally up, within the superficial fascia to join the basilic vein via the median cubital vein at the elbow.

      Near the shoulder, it passes between the deltoid and pectoralis major muscles. It pierces the coracoid membrane (continuation of the clavipectoral fascia) to terminate in the axillary vein’s first part.

    • This question is part of the following fields:

      • Anatomy
      0
      Seconds
  • Question 3 - A 28-year-old girl complained of severe abdominal pain and hematemesis and was rushed...

    Incorrect

    • A 28-year-old girl complained of severe abdominal pain and hematemesis and was rushed into the emergency department. She has an increased heart rate of 120 beats per minute and blood pressure of 90/65. She has a history of taking Naproxen for her Achilles tendinopathy. On urgent endoscopy, she is diagnosed with a bleeding peptic ulcer.

      The immediate treatment is to permanently stop the bleeding by performing embolization of the left gastric artery via an angiogram.

      What level of the vertebra will be used as a radiological marker for the origin of the artery that supplies the left gastric artery during the angiogram?

      Your Answer:

      Correct Answer: T12

      Explanation:

      The left gastric artery is the smallest branch that originates from the coeliac trunk—the coeliac trunk branches of the abdominal aorta at the vertebral level of T12.

      The left gastric artery runs along the superior portion of the lesser curvature of the stomach. A peptic ulcer that is serious enough to erode through the stomach mucosa into a branch of the left gastric artery can cause massive blood loss in the stomach, leading to hematemesis. The patient also takes Naproxen, a non-steroidal anti-inflammatory drug that is a common cause for peptic ulcers in otherwise healthy patients.

      The left gastric artery is responsible for 85% of upper GI bleeds. In cases refractory to initial treatment, angiography is sometimes needed to embolise the vessel at its origin and stop bleeding. During an angiogram, the radiologist will enter the aorta via the femoral artery, ascend to the level of the 12th vertebrae and then enter the left gastric artery via the coeliac trunk.

      The important landmarks of vessels arising from the abdominal aorta at different levels of vertebrae are:

      T12 – Coeliac trunk

      L1 – Left renal artery

      L2 – Testicular or ovarian arteries

      L3 – Inferior mesenteric artery

      L4 – Bifurcation of the abdominal aorta

    • This question is part of the following fields:

      • Anatomy
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      Seconds
  • Question 4 - Lisa is a 75-year-old female rushed into the emergency department by first-aid responders....

    Incorrect

    • Lisa is a 75-year-old female rushed into the emergency department by first-aid responders. The ambulance team give a history of vomiting, homonymous hemianopia, weakness of the left upper and lower limb, and dysphasia. Lisa adds that she has a headache that keeps worsening.

      Lisa takes Warfarin as she is a known case of atrial fibrillation. Her INR is 4.3 despite the ideal target being 2-3.
      CT scan of the head suggests anterior cerebral artery haemorrhage.

      What areas of the brain are affected by an anterior cerebral artery stroke?

      Your Answer:

      Correct Answer: Frontal and parietal lobes

      Explanation:

      The anterior cerebral artery supplies the midline portion of the frontal lobe and the superior medial parietal lobe of the brain. It also supplies the front four-fifths of the corpus callosum and provides blood to deep structures such as the anterior limb of the internal capsule, part of the caudate nucleus, and the anterior part of the globus pallidus.

      The cerebral hemispheres are supplied by arteries that make up the Circle of Willis. The Circle of Willis is formed by the anastomosis of the two internal carotid arteries and two vertebral arteries.

      Clinically, the internal carotid arteries and their branches are often referred to as the anterior circulation of the brain. The anterior cerebral arteries are connected by the anterior communicating artery. Near their termination, the internal carotid arteries are joined to the posterior cerebral arteries by the posterior communicating arteries, completing the cerebral arterial circle around the interpeduncular fossa, the deep depression on the inferior surface of the midbrain between the cerebral peduncles.

      The middle cerebral artery supplies part of the frontal, temporal and parietal lobes.

      The posterior cerebral artery supplies the occipital lobe.

    • This question is part of the following fields:

      • Anatomy
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  • Question 5 - A 32-year-old man has multiple stab wounds to his abdomen and is rushed...

    Incorrect

    • A 32-year-old man has multiple stab wounds to his abdomen and is rushed into the emergency. Resuscitative measures are performed, but the patient remains hypotensive.

      Emergency laparotomy is performed, and it reveals a vessel is bleeding profusely at a certain level of lumbar vertebrae. The vessel is the testicular artery and is ligated.

      At which lumbar vertebrae is the testicular artery identified?

      Your Answer:

      Correct Answer: L2

      Explanation:

      The important landmarks of vessels arising from the abdominal aorta at different levels of vertebrae are:

      T12 – Coeliac trunk

      L1 – Left renal artery

      L2 – Testicular or ovarian arteries

      L3 – Inferior mesenteric artery

      L4 – Bifurcation of the abdominal aorta

    • This question is part of the following fields:

      • Anatomy
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  • Question 6 - An 80-year-old man has a swelling in his left groin with moderate pain...

    Incorrect

    • An 80-year-old man has a swelling in his left groin with moderate pain and discomfort complaints. Diagnosed with an inguinal hernia, he is scheduled for elective surgery to repair the defect.

      Of the following, which nerve runs in the inguinal canal and is at risk of being damaged during surgery?

      Your Answer:

      Correct Answer: Ilioinguinal nerve

      Explanation:

      The inguinal canal is a passage in the lower anterior abdominal wall just above the inguinal ligament. It transmits the following structures:
      1. genital branch of genitofemoral nerve
      2. ilioinguinal nerve
      3. spermatic cord (males only)
      4. round ligament of the uterus (females only)

      The ilioinguinal is a direct branch of the first lumbar nerve. The ilioinguinal nerve enters the inguinal canal via the abdominal musculature (and not through the deep (internal) inguinal ring) and exits through the superficial (or external) inguinal ring.

      The openings for the other nerves in the answer options are:
      Sciatic nerve – exits the pelvis via the greater sciatic foramen
      Obturator nerve – descends into pelvis via the obturator foramen
      Femoral nerve – descends from the abdomen through the pelvis behind the inguinal canal

      The Iliohypogastric nerve also arises from the first lumbar root with the ilioinguinal nerve but pierces the transversus abdominis muscle posteriorly, just above the iliac crest, and continues anteriorly between the transversus abdominis and the internal abdominal oblique muscles.

    • This question is part of the following fields:

      • Anatomy
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  • Question 7 - The structure most likely to be damaged during cannulation of the subclavian vein...

    Incorrect

    • The structure most likely to be damaged during cannulation of the subclavian vein is?

      Your Answer:

      Correct Answer: Subclavian artery

      Explanation:

      The subclavian artery lies behind and partly above the subclavian vein. 3-4% of the time, it can be inadvertently cannulated during cannulation of the subclavian vein

      Because of its anatomical position, putting pressure on the subclavian artery is impossible so arresting bleeding with pressure when it is punctured is not viable.

      One of the consequences of subclavian vein cannulation (1%) is pleural puncture leading to a pneumothorax. This is because the apical pleura is inferior and caudal to the subclavian vein.

    • This question is part of the following fields:

      • Anatomy
      0
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  • Question 8 - An older woman has been brought into the emergency department with symptoms of...

    Incorrect

    • An older woman has been brought into the emergency department with symptoms of a stroke. A CT angiogram is performed for diagnosis, which displays narrowing in the artery that supplies the right common carotid. Which of the following artery is the cause of stroke in this patient?

      Your Answer:

      Correct Answer: Brachiocephalic artery

      Explanation:

      The arch of aorta gives rise to three main branches:
      1. Brachiocephalic artery
      2. Left common carotid artery
      3. Left subclavian artery

      The brachiocephalic artery then gives rise to the right subclavian artery and the right common carotid artery.

      The right common carotid artery arises from the brachiocephalic trunk posterior to the sternoclavicular joint.

      The coeliac trunk is a branch of the abdominal aorta.
      The ascending aorta supplies the coronary arteries.

    • This question is part of the following fields:

      • Anatomy
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  • Question 9 - Which compound is secreted only from the adrenal medulla? ...

    Incorrect

    • Which compound is secreted only from the adrenal medulla?

      Your Answer:

      Correct Answer: Adrenaline

      Explanation:

      The adrenal medulla comprises chromaffin cells (pheochromocytes), which are functionally equivalent to postganglionic sympathetic neurons. They synthesize, store and release the catecholamines noradrenaline (norepinephrine) and adrenaline (epinephrine) into the venous sinusoids.
      The majority of the chromaffin cells synthesize adrenaline.

    • This question is part of the following fields:

      • Anatomy
      0
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  • Question 10 - A 30-year-old man has been stabbed in an area of the groin that...

    Incorrect

    • A 30-year-old man has been stabbed in an area of the groin that contains the femoral triangle. He will undergo explorative surgery.

      Which of the following makes the lateral wall of the femoral triangle?

      Your Answer:

      Correct Answer: Sartorius

      Explanation:

      The femoral triangle is a wedge-shaped area found within the superomedial aspect of the anterior thigh. It is a passageway for structures to leave and enter the anterior thigh.

      Superior: Inguinal ligament
      Medial: Adductor longus
      Lateral: Sartorius
      Floor: Iliopsoas, adductor longus and pectineus

      The contents include: (medial to lateral)
      Femoral vein
      Femoral artery-pulse palpated at the mid inguinal point
      Femoral nerve
      Deep and superficial inguinal lymph nodes
      Lateral cutaneous nerve
      Great saphenous vein
      Femoral branch of the genitofemoral nerve

    • This question is part of the following fields:

      • Anatomy
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  • Question 11 - At which of the following location is there no physiological oesophageal constriction? ...

    Incorrect

    • At which of the following location is there no physiological oesophageal constriction?

      Your Answer:

      Correct Answer: Lower oesophageal sphincter

      Explanation:

      The oesophagus is a muscular tube that connects the pharynx to the stomach. It begins at the lower border of the cricoid cartilage and C6 vertebra. It ends at T11.

      The oesophagus has physiological constrictions at the following levels:
      1. Cervical constriction: Pharyngo-oesophageal junction (15 cm from the incisor teeth) produced by the cricopharyngeal part of the inferior pharyngeal constrictor muscle
      2. Thoracic constrictions:
      i. where the oesophagus is first crossed by the arch of the aorta (22.5 cm from the incisor teeth)
      ii. where the oesophagus is crossed by the left main bronchus (27.5 cm from the incisor teeth)
      3. Diaphragmatic constriction: where the oesophagus passes through the oesophageal hiatus of the diaphragm (40 cm from the incisor teeth)

      Awareness of these constrictions is important for clinical purposes when it is required to pass instruments through the oesophagus into the stomach or when viewing radiographs of patients’ oesophagus.

    • This question is part of the following fields:

      • Anatomy
      0
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  • Question 12 - Regarding nerve supply to the vocal cords, which of the following provides sensation...

    Incorrect

    • Regarding nerve supply to the vocal cords, which of the following provides sensation to the area above the vocal cords?

      Your Answer:

      Correct Answer: Internal branch of superior laryngeal nerve

      Explanation:

      The laryngeal folds are comprised of two types of folds; the vestibular fold and the vocal fold. The vocal folds are mobile, and concerned with voice production. They are formed by the mucous membrane covering the vocal ligament. They are avascular, hence, are white in colour.

      The internal branch of the superior laryngeal nerve provides sensation above the vocal cords. Lesions to this nerve may lead to loss of sensation above the vocal cords and loss of taste on the epiglottis.

      The recurrent laryngeal nerve supplies the lateral and posterior cricoarytenoid, the thyroarytenoid. It also provides sensation below the vocal cords. Lesions to this nerve may cause respiratory obstruction, hoarseness, inability to speak and loss of sensation below the vocal cords.

      The external branch of the superior laryngeal nerve supplies the cricothyroid muscle.

      The glossopharyngeal nerve contains both sensory and motor components, and provides somatic innervation to the stylopharyngeus muscle, visceral motor innervation to the parotid gland, and carries afferent sensory fibres from the posterior third of the tongue, pharynx and tympanic cavity.

    • This question is part of the following fields:

      • Anatomy
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  • Question 13 - This vertebrae can be easily differentiated from the rest because of its prominent...

    Incorrect

    • This vertebrae can be easily differentiated from the rest because of its prominent spinous process.

      Your Answer:

      Correct Answer: C7

      Explanation:

      The spinous process is the part of a vertebrae that is directed posteriorly.

      Typical cervical vertebra have spinous processes that are small and bifid, except for C7, which has a long and prominent spinous process.

    • This question is part of the following fields:

      • Anatomy
      0
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  • Question 14 - Concerning the trachea, which of these is true? ...

    Incorrect

    • Concerning the trachea, which of these is true?

      Your Answer:

      Correct Answer: In an adult is approximately 15 cm long

      Explanation:

      In an adult, the trachea is approximately 15 cm long. It extends at the level of the 6th cervical vertebra, from the lower border of the cricoid cartilage.

      The trachea terminates between T4 and T6 at the carina or bronchial bifurcation. This variation is because of changes during respiration.

      The trachea has 16-20 C-shaped cartilaginous rings that maintain its patency.

      The trachea is first of the 23 generations of air passages in the tracheobronchial tree (not 25), from the trachea to the alveoli..

      The inferior thyroid arteries which are branches of the thyrocervical trunk, arise from the first part of the subclavian artery and supplies the trachea.

    • This question is part of the following fields:

      • Anatomy
      0
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  • Question 15 - Of the following, which is NOT a branch of the external carotid artery?...

    Incorrect

    • Of the following, which is NOT a branch of the external carotid artery?

      Your Answer:

      Correct Answer: Mandibular artery

      Explanation:

      The external carotid artery has eight important branches:
      1. Superior thyroid artery
      2. Ascending pharyngeal artery
      3. Lingual artery
      4. Facial artery
      5. Occipital artery
      6. Posterior auricular artery
      7. Maxillary artery (terminal branch)
      8. Superficial temporal artery (terminal branch)

      There is no mandibular artery but the first part of the maxillary artery is called the mandibular part as it is posterior to the lateral pterygoid muscle.
      The maxillary artery is divided into three portions by its relation to the lateral pterygoid muscle:
      first (mandibular) part: posterior to the lateral pterygoid muscle
      second (pterygoid or muscular) part: within the lateral pterygoid muscle
      third (pterygopalatine) part: anterior to the lateral pterygoid muscle

    • This question is part of the following fields:

      • Anatomy
      0
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  • Question 16 - A 25-year-old man, has been scheduled for a splenectomy. For this procedure, he...

    Incorrect

    • A 25-year-old man, has been scheduled for a splenectomy. For this procedure, he requires a urethral catheter.

      Where does resistance first occur during the insertion of a catheter?

      Your Answer:

      Correct Answer: Membranous urethra

      Explanation:

      The membranous urethra is the shortest part of the urethra and the least dilatable part of it.

      This is as a result of it being surrounded by the external urethral sphincter which is made up of striated muscle and controls voluntary urine flow from the bladder to the urethra.

    • This question is part of the following fields:

      • Anatomy
      0
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