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  • Question 1 - Which of the following structure forms the floor of the posterior triangle of...

    Incorrect

    • Which of the following structure forms the floor of the posterior triangle of the neck:

      Your Answer: Investing fascia

      Correct 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
      90
      Seconds
  • Question 2 - A 58-year-old woman has had a headache, fever, lethargy and nausea for the...

    Correct

    • A 58-year-old woman has had a headache, fever, lethargy and nausea for the last 10 days. He undergoes a CT scan which reveals a lesion in his frontal lobe, which, after a biopsy, is found to be formed by granulation tissue with collagenisation, gliosis and oedema. What's the most likely diagnosis?

      Your Answer: Chronic brain abscess

      Explanation:

      A cerebral abscess can result from direct extension of cranial infections, penetrating head trauma, haematogenous spread, or for unknown causes. An abscess forms when an area of cerebral inflammation becomes necrotic and encapsulated by glial cells and fibroblasts. Oedema around the abscess can increase the intracranial pressure. Symptoms result from increased intracranial pressure and mass effects. In a CT scan, an abscess appears as an oedematous mass with ring enhancement.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      94
      Seconds
  • Question 3 - Which muscle in the neck divides the neck into two large triangles? ...

    Correct

    • Which muscle in the neck divides the neck into two large triangles?

      Your Answer: Sternocleidomastoid

      Explanation:

      The sternocleidomastoid muscle is an important landmark in the neck as it divides the neck into two; anterior and posterior triangles. These triangles help in the location of the structures of the neck including the carotid artery, head and neck lymph nodes, accessory nerve and the brachial plexus. It originates from the manubrium and medial portion of the clavicle and inserts on the mastoid process of the temporal bone, superior nuchal line. The sternocleidomastoid receives blood supply from the occipital artery and the superior thyroid artery. It is innervated by the accessory nerve (motor) and cervical plexus (sensory).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      9.7
      Seconds
  • Question 4 - A 60-year old patient having a history of cholelithiasis that led to recurrent...

    Correct

    • A 60-year old patient having a history of cholelithiasis that led to recurrent pain, bloating, nausea and vomiting, was scheduled for surgery to have the gallbladder removed. During the cholecystectomy, the registrar conducting the procedure accidentally punctured a blood vessel that lies immediately posterior to the omental foramen and blood filled the operating field. Which of the following blood vessels was likely punctured?

      Your Answer: Inferior vena cava

      Explanation:

      The omental foramen is the pathway that connects the greater peritoneal sac and the lesser peritoneal sac. The omental foramen is bordered posteriorly by the inferior vena cava. This is the blood vessel that would most likely be punctured.

      The aorta and its branch, the renal artery, lie postero-lateral to the omental foramen and are deeper than the inferior vena cava hence making them less likely to be injured.

      The hepatic portal vein, the hepatic artery and the superior mesenteric vein borders the omental foramen anteriorly and would not be injured by a jab on the posterior border of the omental foramen.

      Finally, the splenic artery is found in the splenorenal ligament that borders the omental foramen laterally to the left.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      89.4
      Seconds
  • Question 5 - Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of...

    Correct

    • Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of the popliteal fossa?

      Your 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.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      64.7
      Seconds
  • Question 6 - A medical intern wanting to perform her first thoracentesis (remove fluid from the...

    Correct

    • A medical intern wanting to perform her first thoracentesis (remove fluid from the pleural cavity) wishes to be reminded where to insert the needle to aspirate in order to avoid injuring the lung or neurovascular elements. Where is this place?

      Your Answer: The bottom of interspace 9 in the midaxillary line

      Explanation:

      Thoracentesis is performed in the costodiaphragmatic recess. The needle needs to be inserted below the level of the lungs to avoid injury to the lungs. At the paravertebral line, is between ribs 10 and 12, at the midaxillary line between ribs 8 and 10 and at the midclavicular line between interspaces 6 and 8. The needle should be inserted at the top of the rib (or the bottom of the interspace) to avoid damage to the neurovascular structures found below the rib running in the costal groove.

      The recommended location for the needle insertion varies depending upon the source. It is critical that the patient hold his or her breath to avoid piercing of the lung.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      57.9
      Seconds
  • Question 7 - 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
      24.5
      Seconds
  • Question 8 - Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be...

    Correct

    • 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.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      21.7
      Seconds
  • Question 9 - A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates...

    Correct

    • A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates one of his tablets into his lungs. In which bronchopulmonary segments is it most likely to end up?

      Your Answer: Superior segmental bronchus of the right inferior lobe

      Explanation:

      Inhaled objects are more likely to enter the right lung for several reasons. First the right bronchus is shorter, wider and more vertical than the left bronchus. Also, the carina (a ridge-like structure at the point of tracheal bifurcation) is set a little towards the left. The superior segmental bronchus branches posteriorly off the intermediate bronchus or the inferior lobe bronchus and is thus more likely to receive the foreign body that enters the right main bronchus. The lingula is only found on the left lung. The terminal bronchiole is a very small space almost impossible for the tablet to lodge here.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      31.8
      Seconds
  • Question 10 - Lateral medullary syndrome, also known as Wallenberg's syndrome is a neurological condition caused...

    Incorrect

    • Lateral medullary syndrome, also known as Wallenberg's syndrome is a neurological condition caused by ischaemia in the lateral part of the medulla oblongata and is commonly associated with numerous neurological symptoms. Which of the following arteries when occluded leads to this condition?

      Your Answer: Anterior spinal

      Correct Answer: Posterior inferior cerebellar

      Explanation:

      The lateral medullary syndrome or Wallenberg’s disease is also known as posterior inferior cerebellar artery syndrome (PICA). This syndrome is a clinical manifestation of the occlusion of the posterior cerebellar artery that results in symptoms of infarction of the lateral medullary oblongata. Other arteries that contribute to blood flow in to this region such are the vertebral artery, superior middle cerebellar and inferior medullary arteries can also result to this syndrome when occluded.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      36.9
      Seconds
  • Question 11 - A lesion involving the lateral geniculate nucleus of the thalamus is likely to...

    Incorrect

    • A lesion involving the lateral geniculate nucleus of the thalamus is likely to affect:

      Your Answer: Taste

      Correct Answer: Vision

      Explanation:

      The lateral geniculate nucleus (LGN) of the thalamus is the primary processor of visual information in the central nervous system. The LGN receives information directly from the retina and sends projections directly to the primary visual cortex. The LGN likely helps the visual system focus its attention on the most important information.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      62.9
      Seconds
  • Question 12 - The dilator pupillae muscle is innervated by postganglionic sympathetic fibres. Where do the...

    Incorrect

    • The dilator pupillae muscle is innervated by postganglionic sympathetic fibres. Where do the postganglionic sympathetic fibres originate?

      Your Answer: Trigeminal ganglion

      Correct Answer: Superior cervical ganglion

      Explanation:

      The postganglionic sympathetic axons are derived from the superior cervical ganglion and innervate the eye and lacrimal gland allowing for vasoconstriction of the iris and sclera, pupillary dilation, widening of the palpebral fissure, and a reduction in tear production.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      65.7
      Seconds
  • Question 13 - A cerebellar tremor can be differentiated from a Parkinsonian tremor in that: ...

    Correct

    • A cerebellar tremor can be differentiated from a Parkinsonian tremor in that:

      Your Answer: It only occurs during voluntary movements

      Explanation:

      Cerebellar disease leads to intention tremors, which is absent at rest and appears at the onset of voluntary movements. In comparison, Parkinson’s tremor is present at rest. Frequency of tremor is a less reliable means to differentiate between the two as the oscillation amplitude of the tremor is not constant throughout a voluntary action.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      57.7
      Seconds
  • Question 14 - The specialist registrar, while performing the repair of an infrarenal abdominal aortic aneurysm,...

    Correct

    • The specialist registrar, while performing the repair of an infrarenal abdominal aortic aneurysm, decides not to re-implant the inferior mesenteric artery into the repaired abdominal aorta. She says that an anastomotic artery running along the border of the large intestine is good enough to supply blood to the territory of the inferior mesenteric artery. Which vessel is she referring to?

      Your Answer: Marginal

      Explanation:

      The marginal artery is a key anastomosis for the large intestine that runs around the border of the large intestine and is formed by the anastomosis of the branches of the ileocolic artery, right colic artery, middle colic artery, left colic artery and sigmoid artery. If a small artery is occluded, these branches allow blood to reach all segments of the colon.

      The arcades are anastomotic loops between the arteries that provide alternative pathways for blood flow. They are more prominent in the small intestine than the large intestine.

      Arteriae rectae are small branches that run from the marginal artery to reach the colon.

      The ileocolic artery is the branch of the superior mesenteric artery that supplies the caecum, appendix and terminal part of the ileum.

      The coronary arteries supply blood to the heart.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      41.7
      Seconds
  • Question 15 - A surgeon performing a laparoscopic repair of an inguinal hernia visualizes a loop...

    Incorrect

    • 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: Deep 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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      209
      Seconds
  • Question 16 - During laparoscopic surgery to repair a direct inguinal hernia in a 68-year old...

    Incorrect

    • During laparoscopic surgery to repair a direct inguinal hernia in a 68-year old man, the surgeon asked the registrar to look at the medial inguinal fossa to identify the direct inguinal hernia. To do so, she would have to look at the area that is between the:

      Your Answer: Inferior epigastric artery and urachus

      Correct Answer: Medial umbilical ligament and inferior epigastric artery

      Explanation:

      The medial umbilical fold is made by the medial umbilical ligament-which is the obliterated portion of the umbilical artery, while the lateral umbilical fold is a fold of peritoneum over the inferior epigastric vessels. The median umbilical fold is a midline structure made by the median umbilical ligament i.e. the obliterated urachus. The medial inguinal fossa is the space on the inner abdominal wall between the medial umbilical fold and the lateral umbilical fold. It is place in the abdominal wall where there is an area of weak fascia i.e. the inguinal triangle through which direct inguinal hernias break through. The lateral inguinal fossa on the other hand is a space lateral to the lateral umbilical fold. Indirect inguinal hernias push through this space.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      68.3
      Seconds
  • Question 17 - The thyroid gland is a large ductless gland located in which part of...

    Correct

    • The thyroid gland is a large ductless gland located in which part of the neck?

      Your 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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14.3
      Seconds
  • Question 18 - A tumour on the floor of the fourth ventricle is most likely to...

    Correct

    • A tumour on the floor of the fourth ventricle is most likely to compress which of the following cranial nerve nuclei?

      Your Answer: Abducent

      Explanation:

      The fourth ventricle, is a cavity of the brains ventricular system in which the cerebrospinal fluid is formed. This cavity is located behind the pons and upper half of the medulla oblongata. It extends from the cerebral aqueduct, to its connection to the third ventricle, and to the obex- which is the caudal tip of the fourth ventricle. The floor of the fourth ventricle consists of three parts – superior, intermediate and inferior. This inferior aspect of the floor of the fourth ventricle has the nucleus of the abducens nerve, CN VI which is looped over by the facial nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      31.5
      Seconds
  • Question 19 - A patient sustained an injury to the facial nerve after it emerges from...

    Correct

    • A patient sustained an injury to the facial nerve after it emerges from the stylomastoid foramen. What is the clinical impact of this injury?

      Your Answer: Facial expression

      Explanation:

      The facial nerve is the seventh of the twelve paired cranial nerves. It emerges from the brainstem between the pons and the medulla. It controls the muscles of facial expression and supplies taste fibres to the anterior two-thirds of the tongue. It also supplies preganglionic parasympathetic fibres to several head and neck ganglia. Its branches and distribution are as follows:

      Inside the facial canal (proximal to the stylomastoid foramen):

      – Greater petrosal nerve – provides parasympathetic innervation to the lacrimal gland, as well as special taste sensory fibres to the palate via the nerve of pterygoid canal

      – Nerve to stapedius – provides motor innervation for the stapedius muscle in the middle ear

      – Chord tympani – provides parasympathetic innervation to the submandibular and sublingual glands and special sensory taste fibres for the anterior two-thirds of the tongue

      Outside the skull (distal to the stylomastoid foramen):

      – Posterior auricular nerve – controls the movements of some of the scalp muscles around the ear

      – Five major facial branches (in the parotid gland), from top to bottom: temporal branch, zygomatic branch, buccal branch, marginal mandibular branch and cervical branch. From the description given above it is obvious that injury to the facial nerve distal to the stylomastoid foramen will affect facial expression.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      31.9
      Seconds
  • Question 20 - An episiotomy is indicated for a woman during a difficult vaginal delivery. Whilst...

    Correct

    • An episiotomy is indicated for a woman during a difficult vaginal delivery. Whilst the registrar was performing this procedure she made a median cut too far through the perineal body cutting the structure immediately posterior. Which structure is this?

      Your Answer: External anal sphincter

      Explanation:

      An episiotomy is an incision that is made whenever there is a risk of a tear during vaginal deliver. A posterolateral incision, as opposed to a median incision is preferred. Of the options given, the external anal sphincter lies right posterior to the perineal body. The sacrospinous and the sacrotuberous ligaments are deep in the perineum that they should not be involved in this.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      14.3
      Seconds
  • Question 21 - Which nerve lies immediately medial to the psoas major muscle? ...

    Incorrect

    • Which nerve lies immediately medial to the psoas major muscle?

      Your Answer: Ilioinguinal

      Correct Answer: Obturator

      Explanation:

      The obturator nerve is formed from the ventral divisions of the 2nd, 3rd and 4th lumbar nerves. It courses through the fibres of the psoas major and emerges from the medial border near the pelvic brim.

      The iliohypogastric nerve comes from the first lumbar nerve and emerges from the upper part of the lateral border of psoas major.

      The ilioinguinal nerve arises with the iliohypogastric nerve from the first lumbar nerve and also emerges from the lateral border of the psoas major muscle.

      The lateral femoral cutaneous nerve comes from the posterior division of the 2nd and 3rd lumbar nerves to emerge from the lateral border of the psoas major muscle near its middle.

      The femoral nerve also arises from the dorsal divisions, but of the 2nd, 3rd and 4th lumbar nerves and courses through the muscle fibres to emerge at the lower part of the lateral border.

      The coccygeal nerve doesn’t arise from the lumbar plexus but from the sacral plexus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      24.5
      Seconds
  • Question 22 - 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 pupils are constricted (accommodation response)

      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
      32.5
      Seconds
  • Question 23 - Below which level of the spinal cord will the inferior gluteal nerve be...

    Correct

    • Below which level of the spinal cord will the inferior gluteal nerve be unaffected?

      Your Answer: S3

      Explanation:

      The inferior gluteal nerve arises from the dorsal divisions of the fifth lumbar and first and second sacral nerves. According to this fact any lesion at or below the S3 will not affect the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      47.5
      Seconds
  • Question 24 - The normal location of the major duodenal papilla: ...

    Correct

    • The normal location of the major duodenal papilla:

      Your Answer: Descending part of the duodenum

      Explanation:

      The major duodenal papilla is on the descending portion of the duodenum on the medial side, about 7-10cm from the pylorus. The pancreatic ducts and the common bile ducts unite and open by a common orifice on the summit of the duodenal papilla.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      15.9
      Seconds
  • Question 25 - In the case of an injury to the sub sartorial canal, which of...

    Incorrect

    • In the case of an injury to the sub sartorial canal, which of the following structures is most likely to be injured?

      Your Answer: Obturator nerve

      Correct Answer: Nerve to vastus medialis

      Explanation:

      The adductor canal (sub sartorial canal) is situated in the middle third of the thigh.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      92.9
      Seconds
  • Question 26 - The left lateral pterygoid muscle is one of the muscles of mastication. When...

    Correct

    • The left lateral pterygoid muscle is one of the muscles of mastication. When acting alone, it will shift the mandible towards which direction?

      Your Answer: Laterally, to the right

      Explanation:

      The lateral pterygoid or external pterygoid is a muscle of mastication with two heads. It lies superiorly to the medial pterygoid. When acting alone, it will shift the mandible laterally and to the right.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      28.4
      Seconds
  • Question 27 - A 20-year old cyclist falls off a speeding bike and fractures a structure...

    Correct

    • A 20-year old cyclist falls off a speeding bike and fractures a structure that articulates with the tubercle of the 7th rib. Which structure is fractured?

      Your Answer: Transverse process of vertebra T7

      Explanation:

      A rib tubercle is a projection that is postero-inferior and lateral to the neck of a rib which articulates with the transverse process of the corresponding vertebra i.e. of the same number. Therefore, the tubercle of rib 7 articulates with the transverse process of T7 vertebra. The head of the rib 7, on the other hand, articulates with the 6th vertebra superiorly and the 7th vertebra inferiorly.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      25.2
      Seconds
  • Question 28 - A pedestrian sustained a left fibula fractured following a hit-and-run. X-rays showed that...

    Correct

    • A pedestrian sustained a left fibula fractured following a hit-and-run. X-rays showed that there was a transverse fracture of the upper end of the fibula. It was manifested clinically by inability to flex his foot at the ankle joint plus weak extension of the phalanges. What nerve is suspected to be injured in such a case?

      Your Answer: Deep peroneal

      Explanation:

      The deep peroneal nerve supplies the muscles allowing for flexion of the foot at the ankle joint, namely the tibialis anterior and peroneus tertius muscles. The peroneus tertius, peroneus brevis, and peroneus longus evert the foot, whereas the tibialis anterior and tibialis posterior invert the foot. Fibres of the deep peroneal nerve originate from L4, L5, and S1.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      34.5
      Seconds
  • Question 29 - An abdominal aortogram of a 59 year-old female with an abdominal aortic aneurysm...

    Correct

    • An abdominal aortogram of a 59 year-old female with an abdominal aortic aneurysm shows occlusion of the inferior mesenteric artery. The patient, however, does not complain of any symptoms. Occlusion of the inferior mesenteric artery is rarely symptomatic because its territory is supplied by branches of the:

      Your Answer: Middle colic artery

      Explanation:

      The transverse colon is supplied by the middle colic artery which is a branch from the superior mesenteric artery. If the inferior mesenteric artery was occluded, branches from the middle colic may go to the marginal artery which supplies the descending colon, sigmoid colon and rectum.. Ileocolic and right colic arteries also branch from the superior mesenteric artery that supply the colon but the middle colic, which serves the more distal part of the colon is the better answer. The gastroduodenal artery branches off the common hepatic artery, which supplies part of the duodenum, pancreas and stomach. The splenic artery supplies the spleen, pancreas and curvature of the stomach.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      74.6
      Seconds
  • Question 30 - Which of these structures does NOT pass posterior to the medial malleolus? ...

    Correct

    • Which of these structures does NOT pass posterior to the medial malleolus?

      Your Answer: Saphenous vein

      Explanation:

      The saphenous vein passes anterior to the medial malleolus. The structures passing posterior, from nearest to furthest include: tibial, posterior tendon, flexor digitorum longus tendon, posterior tibial artery, posterior tibial vein, posterior tibial nerve and the flexor hallucis longus tendon.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      29.2
      Seconds
  • Question 31 - Following a posterolateral thoracotomy, a surgeon may wish to infiltrate local anaesthetic above...

    Correct

    • Following a posterolateral thoracotomy, a surgeon may wish to infiltrate local anaesthetic above and below the incision to block the nerves supplying the thoracic wall. This wall is innervated by?

      Your Answer: Intercostal nerves

      Explanation:

      Intercostal nerves are the ventral primary rami of spinal nerves T1–T11. They give branches which supply the thoracic wall.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      21.7
      Seconds
  • Question 32 - In an anatomy demonstration, the instructor asked one of the medical students to...

    Correct

    • In an anatomy demonstration, the instructor asked one of the medical students to pass his index finger inferior to the root of the left lung. The student notices that his finger is blocked by a structure. Which structure do you think is responsible for this?

      Your Answer: Pulmonary ligament

      Explanation:

      The pulmonary ligament is dual layer of pleura stretching from the inferior part of the hilar reflection toward the diaphragm.

      The costodiaphragmatic recess is the cavity at the inferior border of the lung where the costal pleura becomes the diaphragmatic pleura.

      The cupola: is part of the pleura that extends superiorly above the first rib and has no association with the root of the lung.

      Inferior vena cava is located in the mediastinum, not near the root of the lung.

      Left pulmonary veins being part of the root of the lung, would not block access to behind the lung. Costomediastinal recess is the part of the pleura where the costal pleura become the mediastinal pleura.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      42.3
      Seconds
  • Question 33 - A 60-year old man with a left-sided indirect inguinal hernia underwent emergency surgery...

    Correct

    • A 60-year old man with a left-sided indirect inguinal hernia underwent emergency surgery to relieve large bowel obstruction resulting from a segment of the bowel being strangulated in the hernial sac. The most likely intestinal segment involved is:

      Your Answer: Sigmoid colon

      Explanation:

      The sigmoid colon is the most likely segment involved as it is mobile due to the presence of the sigmoid mesocolon. The descending colon, although on the left side, is a bit superior and is also retroperitoneal. The ascending colon and caecum are on the right side of the abdomen. The rectum is too inferior to enter the deep inguinal ring and the transverse colon is too superior to be involved.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      17.3
      Seconds
  • Question 34 - The anatomical course of the phrenic nerve passes over the following muscle in...

    Correct

    • The anatomical course of the phrenic nerve passes over the following muscle in the neck?

      Your Answer: Anterior scalene

      Explanation:

      The phrenic nerve originates in the neck between C3-C5, mostly C4 spinal root. It enters the thoracic cavity past the heart and lungs to the diaphragm. In the neck, this nerve begins at the lateral border of the anterior scalene muscle, its course then continues inferiorly on the anterior aspect of the anterior scalene muscle as it moves towards the diaphragm.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      37.7
      Seconds
  • Question 35 - The middle meningeal artery is the largest among the arteries that supplies that...

    Correct

    • The middle meningeal artery is the largest among the arteries that supplies that dura mater of the brain. The middle meningeal artery is a branch of the?

      Your Answer: Maxillary artery

      Explanation:

      The middle meningeal artery is the largest of the three (paired) arteries that supply the meninges.

      The middle meningeal artery is a large arterial branch of the maxillary artery which is a terminal branch of the external carotid artery. Upon originating, the middle meningeal artery passes through the foramen spinosum. In the skull, it courses in the middle cranial fossa where it provides several branches.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14.3
      Seconds
  • Question 36 - Injury to this nerve will result to the loss of general sensory innervation...

    Incorrect

    • Injury to this nerve will result to the loss of general sensory innervation of the lacrimal gland:

      Your Answer: Oculomotor nerve

      Correct Answer: Ophthalmic nerve

      Explanation:

      The lacrimal glands are paired, almond-shaped exocrine glands, that secrete the aqueous layer of the tear film. The lacrimal nerve, derived from the ophthalmic nerve, supplies the sensory component of the lacrimal gland. The greater petrosal nerve, derived from the facial nerve, supplies the parasympathetic autonomic component of the lacrimal gland.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      46.2
      Seconds
  • Question 37 - Which nerve mediates the sensation to itch from the skin that is just...

    Correct

    • Which nerve mediates the sensation to itch from the skin that is just over the base of the spine of your scapula?

      Your Answer: Dorsal primary ramus of C7

      Explanation:

      The first branches off spinal nerves are called the dorsal and ventral rami. The dorsal rami mediate sensation of the skin over the back and motor supply to the true muscles of the back whilst the ventral rami gives sensation to the skin over the limbs and the skin that is over the ventral side of the trunk. It also gives motor supply to the skeletal muscles of the neck, the trunk and extremities. Hence, itchiness of the part of the skin that is over the spine of the scapula would be mediated by the primary ramus of C7. Accessory nerve doesn’t have any sensory innervation.

    • This question is part of the following fields:

      • Anatomy
      • Neurology
      34.4
      Seconds
  • Question 38 - The muscle that forms the posterior wall of the axilla along with the...

    Correct

    • The muscle that forms the posterior wall of the axilla along with the scapula, subscapularis muscle and teres major muscle is the?

      Your 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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      12.4
      Seconds
  • Question 39 - A 7-month-old abandoned baby with congenital non-communicating hydrocephalus is hosted by a clinic...

    Correct

    • A 7-month-old abandoned baby with congenital non-communicating hydrocephalus is hosted by a clinic at its new-born hostel. A CT scan of the baby's brain reveals what might be a blockage of the ventricular system between the third and the fourth ventricles. Which of the following is the most likely blocked structure?

      Your Answer: Cerebral aqueduct

      Explanation:

      The drainage of cerebral spinal fluid from the third ventricle to the fourth ventricle is carried out by the cerebral aqueduct. The cerebral aqueduct is the narrowest passageway in the entire ventricular system and thus forms the most common site of blockage of flow of cerebrospinal fluid. The interventricular foramen allows passage of CSF to the third ventricle. The foramen of Luschka and Magendie are located on the fourth ventricle and allow passage of CSF to the subarachnoid space from the ventricular system. The pontine cistern is a space located on the ventral aspect of the pons. The cisterna magna is an opening on the subarachnoid space between the pia matter and the arachnoid.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      27.2
      Seconds
  • Question 40 - Both the arytenoid muscles and the lateral cricoarytenoid muscles perform this action on...

    Incorrect

    • Both the arytenoid muscles and the lateral cricoarytenoid muscles perform this action on the glottis:

      Your Answer: Relaxation

      Correct Answer: Adduction

      Explanation:

      Both the arytenoid and the cricoartenoid muscles close the glottis. The lateral cricoarytenoid muscles extend from the lateral cricoid cartilage to the muscular process of the arytenoid cartilage. By rotating the arytenoid cartilages medially, these muscles adduct the vocal cords and thereby close the rima glottidis. The arytenoid muscle adducts or approximates the arytenoid cartilages, and thus closes the aperture of the glottis.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      22
      Seconds
  • Question 41 - What is the nerve supply of the muscle that is inserted onto the...

    Incorrect

    • What is the nerve supply of the muscle that is inserted onto the crest of the lesser tubercle of the humerus?

      Your Answer: Long thoracic

      Correct Answer: Lower subscapular

      Explanation:

      The muscle is the subscapularis muscle which is supplied by the lower subscapular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      59.8
      Seconds
  • Question 42 - Rapid eye movement (REM) sleep is likely to be affected by a lesion...

    Correct

    • Rapid eye movement (REM) sleep is likely to be affected by a lesion in the:

      Your Answer: Pons

      Explanation:

      Rapid eye movement (REM) sleep is also known as paradoxical sleep, as the summed activity of the brain’s neurons is quite similar to that during waking hours. Characterised by rapid movements of the eyes, most of the vividly recalled dreams occur during this stage of sleep. The total time of REM sleep for an adult is about 90–120 min per night.

      Certain neurones in the brainstem, known as REM sleep-on cells, which are located in the pontine tegmentum, are particularly active during REM sleep and are probably responsible for its occurrence. The eye movements associated with REM are generated by the pontine nucleus with projections to the superior colliculus and are associated with PGO (pons, geniculate, occipital) waves.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      7.8
      Seconds
  • Question 43 - Injury of the ventral rami at this cervical spinal level will result in...

    Correct

    • Injury of the ventral rami at this cervical spinal level will result in paralysis of the rectus capitis anterior muscle:

      Your Answer: C1, C2

      Explanation:

      The rectus capitis anterior is a short, flat muscle, situated immediately behind the upper part of the longus capitis. It is also known as the obliquus capitis superior. It aids in flexion of the head and the neck. Nerve supple is from C1 and C2.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      29.8
      Seconds
  • Question 44 - The vagus nerve passes through which of the following foramen? ...

    Correct

    • The vagus nerve passes through which of the following foramen?

      Your Answer: Jugular foramen

      Explanation:

      The jugular foramen is a large foramen in the base of the skull. It is located behind the carotid canal and is formed in front by the petrous portion of the temporal bone, and behind by the occipital bone. Cranial nerves IX, X, and XI and the internal jugular vein pass through the jugular foramen.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      38.8
      Seconds
  • Question 45 - What are the derivatives of the first brachial arch? ...

    Correct

    • What are the derivatives of the first brachial arch?

      Your Answer: Gives rise to the sphenomandibular ligament

      Explanation:

      The first brachial arch (mandibular) gives rise to the mandibular and maxillary processes. Muscles and bones of this process originate within the arch’s mesoderm. The first arch cartilage (Meckel’s) ossifies to form the incus and malleus of the middle ear. Its perichondrium gives rise to he sphenomandibular ligament and through intermembraneous ossification after the mandible forms, the rest of the cartilage disappears. Muscles of the first arch include: mylohyoid, tensor tympany and palati, temporalis, masseter and lateral pterygoids and the anterior belly of the epigastric. This first arch is supplied by the trigeminal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      44.3
      Seconds
  • Question 46 - A computer tomography guided needle biopsy is done on a patient with a...

    Incorrect

    • A computer tomography guided needle biopsy is done on a patient with a cystic swelling in the left chest. The radiologist inserted the biopsy needle into the 9th intercostal space along the mid axillary line to aspirate the swelling and obtain tissue for histological diagnosis. In which space is the swelling most likely to be?

      Your Answer: Costomediastinal recess

      Correct Answer: Costodiaphragmatic recess

      Explanation:

      The costodiaphragmatic recess is the lowest point of the pleural sac where the costal pleura becomes the diaphragmatic pleura. At the midclavicular line, this is found between ribs 6 and 8; at the paravertebral lines, between ribs 10 and 12 and between ribs 8 and 10 at the midaxillary line.

      The cardiac notch: is an indentation of the heart on the left lung, located on the anterior surface of the lung.

      Cupola: part of the parietal pleura that extends above the first rib.

      Oblique pericardial sinus: part of the pericardial sac located posterior to the heart behind the left atrium.

      Costomediastinal recess: a reflection of the pleura from the costal surface to the mediastinal surface, is on the anterior surface of the chest.

      The inferior mediastinum: is the space in the chest occupied by the heart.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      34.8
      Seconds
  • Question 47 - The dura mater is a thick membrane that is the outermost of the...

    Correct

    • The dura mater is a thick membrane that is the outermost of the three layers of the meninges. Which of the following foramen transmits the dura mater?

      Your Answer: Foramen magnum

      Explanation:

      The foramen magnum is found in the most inferior part of the posterior cranial fossa . It is traversed by vital structures including the medulla oblongata . Its contents include the following: medulla oblongata, meninges (arachnoid, dura and pia mater), spinal root of the accessory nerve, vertebral arteries, anterior and posterior spinal arteries, tectorial membrane and alar ligaments .

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      10.1
      Seconds
  • Question 48 - The pattern of drainage of the lymphatic and venous systems of the anterior...

    Correct

    • The pattern of drainage of the lymphatic and venous systems of the anterior abdominal wall is arranged around a horizontal plane above which drainage is in a cranial direction and below which drainage is in a caudal direction. Which horizontal plane is being referred to?

      Your Answer: Level of the umbilicus

      Explanation:

      The umbilicus is a key landmark for the lymphatic and venous drainage of the abdominal wall. Above it, lymphatics drain into the axillary lymph nodes and the venous blood drains into the superior epigastric vein, into the internal thoracic vein. Below it, lymphatics drain into the superficial inguinal lymph nodes while venous blood drains into the inferior epigastric vein and the external iliac vein.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      26.4
      Seconds
  • Question 49 - The line which divides the perineum into two triangles is connected to the?...

    Correct

    • 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.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      16.4
      Seconds
  • Question 50 - A lady presents to the out patient clinic with a painful boil on...

    Incorrect

    • A lady presents to the out patient clinic with a painful boil on the skin of her mons pubis. Which nerve supplies the skin of the mons pubis?

      Your Answer: Ilioinguinal

      Correct Answer: Anterior labial

      Explanation:

      Anterior labial branch is the terminal branch of the ilioinguinal nerve that innervates the skin of the mons pubis in women and the skin of the anterior scrotum in men.

      The femoral branch of genitofemoral nerve innervates the upper medial thigh.

      The iliohypogastric innervates muscles of the abdominal wall.

      The subcostal nerve innervates muscles of the abdominal wall and the skin of the lower abdominal wall.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      30.5
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (31/43) 72%
Head & Neck (11/16) 69%
Neurology (6/8) 75%
Pathology (2/2) 100%
Abdomen (6/10) 60%
Lower Limb (4/5) 80%
Thorax (5/6) 83%
Physiology (3/5) 60%
Pelvis (2/2) 100%
Upper Limb (1/2) 50%
Embryology (1/1) 100%
Passmed