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Question 1
Correct
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During a procedure in the mediastinum, the surgeon accidentally injured a key structure that lies immediately anterior to the thoracic duct. Which structure is likely to be injured?
Your Answer: Oesophagus
Explanation:In the mid-thorax, the azygos vein, thoracic duct and aorta (in this order from right to the left) are all located posterior to the oesophagus. The superior vena cava, left internal jugular vein and trachea are not found in the mid thorax.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 2
Correct
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Whipple's procedure involves mobilizing the head of the pancreas. As the surgeon does this, he must be careful to avoid injury to a key structure that is found lying behind the head of the pancreas. Which vital structure is this?
Your Answer: Common bile duct
Explanation:The posterior relations of the head of the pancreas include: the inferior vena cava, the common bile duct, the renal veins, the right crus of the diaphragm and the aorta.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 3
Correct
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Which of the following foramen provides passage of the facial nerve?
Your Answer: Internal acoustic meatus
Explanation:The internal auditory meatus provides a passage through which the vestibulocochlear nerve, the facial nerve, and the labyrinthine artery (an internal auditory branch of the basilar artery) can pass from inside the skull to structures of the inner ear and face.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 4
Correct
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Which of the following structures carry part of the right bundle branch of the AV bundle?
Your Answer: Moderator band (septomarginal trabecula)
Explanation:The moderator band extends from the base of the anterior papillary muscle to the ventricular septum. It is the structure which carries part of the right AV bundle. Its role it to prevent overdistention of the ventricle.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 5
Correct
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An anatomy instructor is giving a demonstration of the right lung. Which of the statements about the right lung made by the demonstrator is correct?
Your Answer: Its upper lobar bronchus lies behind and above the right pulmonary artery
Explanation:The root of the lungs on both sides are similar in that the pulmonary veins are anterior and inferior while the bronchus is posterior. However, on the right side, the pulmonary arteries are anterior to the bronchus while on the left side the pulmonary arteries are superior to the bronchus. The lingual is only found on the left lung. The mediastinum is the space in the thorax between the two pleural sacs and does not contain any lung. The right lung, having three lobes, is slightly larger than the left lung. On both sides, the phrenic nerves passes in front of the root of the lung.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 6
Correct
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A 25 year old primi gravida lady was scheduled for a regular antenatal check up. During the vaginal exam of this lady, the registrar discovered a malignant growth on the anterior wall of her vagina. Which of the following structures, adjacent to the vagina, is likely to be involved as well?
Your Answer: Fundus of the bladder
Explanation:The fundus of the bladder is related anatomically to the anterior surface of the vagina and the urethra as well. If there was a malignant growth in the anterior surface of the vagina, then most likely the fundus of the bladder would be involved as well aspotentially the urethra.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 7
Correct
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What is expected from complete transection of the inferior gluteal nerve when it emerges from the greater sciatic foramen?
Your Answer: Extension of the thigh would be the action most affected
Explanation:As the inferior gluteal nerve emerges from the greater sciatic foramen below the piriformis muscle, it divides into branches and enters the gluteus maximus muscle which extends the femur and bends the thigh in line with the body.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 8
Correct
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During an appendicectomy in a 16 year old girl, the registrar initially did not find the appendix on entering the peritoneal cavity. She, however, remained calm as she knew she could find it by:
Your Answer: Looking at the confluence of the taenia coli
Explanation:The vermiform appendix arises from the apex of the caecum. Although it has a constant base, it can pass in one of several directions such as upward behind the caecum, to the left behind the ileum and mesentery or downward into the lesser pelvis. It is retained in place by a peritoneal fold, the mesoenteriole derived from the left leaf of the mesentery. Taenia coli meet at the appendix which is the terminal portion of the caecum. The appendix is below the ileocecal valve, not above. It is not near the right colic artery (which supplies the ascending colon). It would not be found by removing a layer of the jejuno-ileum and is not in the pelvic brim.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 9
Correct
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When inserting a chest drain anteriorly into the second intercostal space, one must identify the second costal cartilage by palpating which landmark?
Your Answer: Sternal angle
Explanation:The sternal angle is the site for identification of the second rib as the second rib is attached to the sternum at this point.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 10
Correct
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Which muscle is most likely to be affected following an injury to the thoracodorsal nerve (C6-C8)?
Your Answer: Latissimus dorsi
Explanation:Latissimus dorsi is a triangular, flat muscle that covers the lumbar region and the lower half of the thoracic region. It is supplied by the sixth, seventh and eighth cervical nerves through the thoracodorsal (long subscapular) nerve.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 11
Correct
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A 70-year old man presents to the surgical out patient clinic with a direct inguinal hernia on the right side. He had undergone and appendicectomy 6 months prior. The examining doctor correlated the development of the hernia to iatrogenic nerve injury that happened during the operation. Which nerve had been injured?
Your Answer: Ilioinguinal
Explanation:Direct inguinal hernias occur because of weakness in the abdominal muscles. The ilioinguinal nerve is important for innervating the muscles of the lower abdominal wall and damage during appendicectomy therefore prevents the man from being able to contract abdominal muscles to pull the falx inguinalis over the weak fascia.
The genitofemoral nerve innervates the cremaster muscle and injury to it would cause inability to elevate the testes.
The subcostal nerve and the ventral primary ramus of T10 innervate the muscles, skin and fascia of the upper abdominal wall.
The iliohypogastric nerve supplies the skin over the upper part of the buttock behind the area supplied by the subcostal nerve.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 12
Correct
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The gluteus medius muscle:
Your Answer: Is supplied by the superior gluteal nerve
Explanation:The gluteus medius is situated on the outer surface of the pelvis. It arises from the outer surface of the ilium between the iliac crest and posterior gluteal line above and the anterior gluteal line below. The gluteus medius is supplied by the fourth and fifth lumbar and first sacral nerves through the superior gluteal nerve
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 13
Correct
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A young girl injured her arm following a fall down the steps On examination, it was found that her left proximal radioulnar joint had dislocated and the annular ligament was stretched. This will make which movement extremely painful?
Your Answer: Supination
Explanation:Supination is the rotation of the forearm so that the palm of the hand faces anteriorly. This is performed by the biceps brachii and supinator of the extensor muscles of the thumb. The opposite action of moving the palm from an anterior-facing position to a posterior-facing position is called pronation. Pronation is performed by the pronator teres and pronator quadratus.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 14
Correct
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A patients sciatic nerve has been severed following a stab injury. What would be affected?
Your Answer: There would still be cutaneous sensation over the anteromedial surface of the thigh
Explanation:The sciatic nerve supplies nearly all of the sensation of the skin of the leg and the muscles of the back of the thigh, leg and foot. A transection of the sciatic nerve at its exit from the pelvis will affect all the above-mentioned functions except cutaneous sensation over the anteromedial surface of the thigh, which comes from the femoral nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 15
Correct
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A textbook of cardiac surgery explains that while doing a left pneumonectomy, a surgeon must be careful to avoid injury to a vital structure that leaves an impression on the mediastinal surface of the left lung. Which structure is it referring to?
Your Answer: Aortic arch
Explanation:Structures that leave an impression on the mediastinal surface of the left lung include: the oesophagus, subclavian artery, brachiocephalic vein, first rib, thymus, the heart, the diaphragm, descending aorta and arch of the aorta. The other structures form an impression on the mediastinal aspect of the right lung.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 16
Correct
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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: 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.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 17
Correct
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The muscle which has an antagonistic action to the serratus anterior muscle and is one of the retractors of the scapula is the?
Your Answer: Rhomboid major
Explanation:Protraction is accomplished by the actions of the serratus anterior, pectoralis major, and pectoralis minor muscles. Retraction is accomplished by the actions of the trapezius, rhomboids, and latissimus dorsi muscles.
The rhomboid major arises from the second, third, fourth and fifth thoracic vertebrae. It is inserted into a narrow tendinous arch attached to the root of the spine of the scapula and the inferior angle. By its insertion in the inferior angle of the scapula, it acts on this angle and produces a slight rotation of the scapula on the side of the chest. It also retracts the scapula by working with the trapezius muscle.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 18
Correct
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A 25-year-old football player suffers severe head trauma during a game. Physical examination reveals a decerebrate posture and bilateral papilledema. A CT scan reveals marked diffuse cerebral oedema. This condition will be most severe in which component of the brain?
Your Answer: White matter
Explanation:The greatest amount of salt and water increase with cerebral oedema occurs within the white matter. Any swelling from oedema, haemorrhage or haematoma increases the intracranial pressure (ICP). As the ICP increases, the cerebral perfusion decreases and brain tissue can become ischaemic, even leading to brain death.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 19
Correct
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Injury to this nerve will result to the loss of general sensory innervation of the lacrimal gland:
Your 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.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 20
Correct
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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: 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 21
Correct
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A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month ago, she fell from a staircase but only suffered mild head trauma. What is the most likely diagnosis in this case?
Your Answer: Chronic subdural haematoma
Explanation:A quarter to a half of patients with chronic subdural haematoma have no identifiable history of head trauma. If a patient does have a history of head trauma, it usually is mild. The average time between head trauma and chronic subdural haematoma diagnosis is 4–5 weeks. Symptoms include decreased level of consciousness, balance problems, cognitive dysfunction and memory loss, motor deficit (e.g. hemiparesis), headache or aphasia. Some patients present acutely. They usually result from tears in bridging veins which cross the subdural space, and may cause an increase in intracranial pressure (ICP).
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This question is part of the following fields:
- Neurology
- Pathology
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Question 22
Correct
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The thyrocervical trunk branches into which artery that passes upward and in front of the vertebral artery and longus colli muscle:
Your Answer: Inferior thyroid
Explanation:The inferior thyroid artery is an artery in the neck. It arises from the thyrocervical trunk and passes upward, in front of the vertebral artery and longus colli muscle.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 23
Correct
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A retroperitoneal structure is:
Your Answer: Pancreas
Explanation:Retroperitoneal structures are those that are found behind the peritoneum. They include: kidneys, suprarenal glands, bladder, ureter, inferior vena cava, rectum, oesophagus (part of it), part of the pancreas, 2nd, 3rd and 4th parts of the duodenum and ascending and descending parts of the colon.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 24
Correct
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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.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 25
Incorrect
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Which of the following arteries, that runs on the superior aspect of the first part of the duodenum, forms the lower boundary of the epiploic foramen (also known as the foramen of Winslow)?
Your Answer: Superior pancreaticoduodenal
Correct Answer: Hepatic
Explanation:The epiploic foramen is an important anatomical opening that allows for the communication between the greater peritoneal sac and the lesser peritoneal sac. Its boundaries are formed; superiorly by the caudate lobe of the liver, anteriorly by the hepatoduodenal ligament (containing the components of the portal triad), inferiorly by the first part of the duodenum and posteriorly by the peritoneum covering the inferior vena cava. The superior aspect of the first part of the duodenum, which forms the inferior boundary of the foramen of Winslow, forms the course of the hepatic artery before it ascends to the porta hepatis where it divides into its right and left branches.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 26
Correct
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A 39-year old female patient was diagnosed with a tumour of the left adrenal gland. The tumour, which is metastasizing to the adjacent tissues, has already extended to the left suprarenal vein. If the tumour is still spreading, which of the following veins will most likely be affected after the involvement of the left suprarenal vein?
Your Answer: Left renal vein
Explanation:The suprarenal veins or also known as the veins of Warshaw, are the veins that receive blood from the suprarenal glands. These veins receive blood from the medullary venous plexus and the cortex of the adrenal glands (suprarenal glands). They are two in number – the left and the right suprarenal veins. The right suprarenal vein drains into the inferior vena cava while the left suprarenal vein drains into the left renal vein. This therefore means that in the case of a metastasizing tumour involving the left suprarenal vein, the tumour will most likely extend from the left suprarenal vein to the left renal vein into which it drains.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 27
Correct
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A 45-year old male patient with a long history of alcoholism developed liver cirrhosis that has led to portal hypertension. Which of the following plexuses of veins is most likely dilated in this patient?
Your Answer: Haemorrhoidal plexus
Explanation:The haemorrhoidal plexus or also known as the rectal plexus is a venous plexus that surrounds the rectum. This venous plexus in males communicates anteriorly with the vesical plexus and uterovaginal plexus in females. This venous plexus forms a site of free communication between the portal and systemic venous systems. In the case of portal hypertension this plexus would most likely dilate due to the increased pressure.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 28
Correct
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At which cervical level does the common carotid artery bifurcate into the internal and external carotid arteries?
Your Answer: C4
Explanation:The common carotid arteries are present on the left and right sides of the body. These arteries originate from different sources, but follow symmetrical courses. The right common carotid originates in the neck from the brachiocephalic trunk; the left from the aortic arch in the thorax. These split into the external and internal carotid arteries at the upper border of the thyroid cartilage, at around the level of the fourth cervical vertebra.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 29
Correct
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Destruction of the ventromedial nucleus of the hypothalamus will result in:
Your 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 30
Correct
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A terrorist running away from the police was shot in the back. The bullet hit his left lung halfway between its apex and the diaphragmatic surface. Which part of the lung was most likely to be injured?
Your Answer: Inferior lobe
Explanation:The oblique fissure of the left lung is so sharp that the posterior surface of the left lung is mostly composed of the inferior lobe so that the point halfway between the apex and the diaphragmatic surface of the lung would result in injury to the inferior lobe.
The hilum is the point on the medial surface of the lung where the structures that form the root of the lung enter and leave the lung.
The lingual on the other hand is part of the superior lobe of the left lung and it is part of the anterior and superior sides of the lung.
The middle lobe is only found on the right lung.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 31
Correct
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From which fascia of the pelvic wall muscle does the levator ani muscle arise?
Your Answer: Obturator internus
Explanation:The levator ani muscle arises from the posterior surface of the superior ramus of the pubis lateral to the symphysis, behind the inner surface of the spine of the ischium and between these points from the obturator internus fascia. It is attached to the inner surface of the side of the lesser pelvic cavity, supports the viscera in the cavity and surrounds the various structures that pass through it.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 32
Correct
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Which muscle originates from the common flexor tendon of the forearm?
Your Answer: Flexor digitorum superficialis
Explanation:The medial epicondyle of the humerus is the site of origin of this group of muscles of the forearm. It originates from the medial epicondyle of the humerus by a common tendon. Fibres from the deep fascia of the forearm, near the elbow and septa, pass from this fascia between the muscles. These muscles include the pronator teres, palmaris longus, flexor carpi radialis, flexor carpi ulnaris and flexor digitorum superficialis.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 33
Correct
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A specialist registrar was performing the bi-lateral surgical removal of the adrenal glands. He first removed the left adrenal gland before moving on to the right one. However, the registrar noticed that the removal of the right adrenal gland would be a challenge because of an overlying structure. What was this structure that overlies the right suprarenal glad?
Your Answer: Inferior vena cava
Explanation:The adrenal glands or the suprarenal glands are small glands that are found on top of each of the kidneys. They are retroperitoneal glands. The right adrenal gland is found on top of the right kidney and is closely associated with the inferior vena cava as it directly drains into this large vein. In the case where the right adrenal gland is to be surgically removed, the inferior vena cava might prove a problem to manoeuvre as it overlies the right suprarenal gland. The other blood vessels such as the aorta, right renal, superior mesenteric, splenic artery and the hepatic vein as well as the right crus are not closely associated with either of the suprarenal glands.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 34
Correct
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Which of the following arteries, if ligated, will most likely affect blood supply to the pancreas?
Your Answer: Superior mesenteric
Explanation:The pancreas is a glandular organ in the body that produces important hormones such as insulin and glucagon. Its blood supply is from branches of the coeliac artery, superior mesenteric artery and the splenic artery. These are the arteries that if ligated, would affect blood supply to the pancreas.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 35
Correct
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During a surgical procedure involving the carotid artery, which nerve in the cervical plexus of nerves that is embedded in the carotid sheath is most susceptible to injury?
Your Answer: Ansa cervicalis
Explanation:The ansa cervicalis is a loop of nerves that are part of the cervical plexus. They lie superficial to the internal jugular vein in the carotid triangle. Branches from the ansa cervicalis innervate the sternohyoid, sternothyroid and the inferior belly of the omohyoid. The superior root of the ansa cervicalis is formed by a branch of spinal nerve C1. These nerve fibres travel in the hypoglossal nerve before leaving to form the superior root. The superior root goes around the occipital artery and then descends embedded in the carotid sheath. It sends a branch off to the superior belly of the omohyoid muscle and is then joined by the inferior root. The inferior root is formed by fibres from spinal nerves C2 and C3.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 36
Correct
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Muscles and tendons in the planter region of the foot mainly take blood supply from:
Your Answer: Posterior tibial artery
Explanation:The posterior tibial artery is the main source of blood supply to the posterior compartment of the leg.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 37
Incorrect
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An old man presented with atrophy of the thenar eminence despite the sensation over it still being intact. What is the injured nerve in this case?
Your Answer: Ulnar nerve
Correct Answer: Median nerve
Explanation:Atrophy of the thenar muscles means injury to the motor supply of these muscles. The nerve that sends innervation to it is the median nerve. But the median nerve does not provide sensory innervation to the overlying skin so sensation is spared.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 38
Correct
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Which among the following vertebrae marks the lowest extent of the superior mediastinum?
Your Answer: Fourth thoracic
Explanation:The superior mediastinum lies between the manubrium anteriorly and the upper vertebrae of the thorax posteriorly. Below, it is bound by a slightly oblique plane that passes backward from the sternal angle to the lower part of the body of T4 and laterally by the pleura.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 39
Incorrect
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Which lymph nodes are likely to be enlarged in a patient who has malignant growth involving the anus?
Your Answer: Internal iliac
Correct Answer: Superficial inguinal
Explanation:The lymphatics from the anus, skin of the perineum and the scrotum end in the superficial inguinal nodes. In case of a malignant growth of the anus, the superficial inguinal lymph nodes would most likely be enlarge.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 40
Correct
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Which of the following clinical signs will be demonstrated in a case of Brown-Séquard syndrome due to hemisection of the spinal cord at mid-thoracic level?
Your Answer: Ipsilateral spastic paralysis, ipsilateral loss of vibration and proprioception (position sense) and contralateral loss of pain and temperature sensation beginning one or two segments below the lesion
Explanation:Brown–Séquard syndrome results due to lateral hemisection of the spinal cord and results in a loss of motricity (paralysis and ataxia) and sensation. The hemisection of the cord results in a lesion of each of the three main neural systems: the principal upper motor neurone pathway of the corticospinal tract, one or both dorsal columns and the spinothalamic tract. As a result of the injury to these three main brain pathways the patient will present with three lesions. The corticospinal lesion produces spastic paralysis on the same side of the body (the loss of moderation by the upper motor neurons). The lesion to fasciculus gracilis or fasciculus cuneatus results in ipsilateral loss of vibration and proprioception (position sense). The loss of the spinothalamic tract leads to pain and temperature sensation being lost from the contralateral side beginning one or two segments below the lesion. At the lesion site, all sensory modalities are lost on the same side, and an ipsilateral flaccid paralysis.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 41
Correct
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The parasympathetic fibres of the oculomotor nerve was impinged due to a growing tumour. The function of which of the following structures will be affected?
Your Answer: Ciliary muscle
Explanation:The oculomotor nerve is the third cranial nerve (CNIII). It offers motor and parasympathetic innervation to many of the ocular structures. The motor fibres innervate a number of the extraocular muscles. While the parasympathetic fibres supply the sphincter pupillae and the ciliary muscles of the eye, and the sympathetic fibres innervates the superior tarsal muscles.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 42
Correct
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Where does the ejaculatory duct open into?
Your Answer: Prostatic urethra
Explanation:There are two ejaculatory ducts, one on either side of the midline. Each ejaculatory duct is formed by the union of the duct from the seminal vesicles with the ductus deferens. They start at the base of the prostate and run forward and downward between the middle and lateral lobes and along the side of the prostatic utricle to end in the prostatic urethra.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 43
Correct
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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.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 44
Correct
-
During clinic, a medical student conducts a physical examination on a teenage boy with a lump in the inguinal region. The lump is protruding from the superficial inguinal ring. The student correctly concluded that it was:
Your Answer: Either a direct or an indirect inguinal hernia
Explanation:It is not possible to tell if an inguinal hernia is direct or indirect just by palpating it. Despite the fact that indirect inguinal hernias commonly come out of the superficial inguinal ring to enter the scrotum, direct inguinal hernia might still do this.
Femoral hernia goes through the femoral ring into the femoral canal (has nothing to do with the superficial inguinal ring).
Superficial inguinal lymph nodes lie in the superficial fascia parallel to the inguinal ligament; it would therefore feel more superficial and would not be mistaken for a hernia protruding through the inguinal ring.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 45
Correct
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The fundus of the stomach receives blood supply from the same artery as the greater curvature of the stomach. Which of the following arteries when ligated will disrupt blood supply to the fundus of the stomach through this artery?
Your Answer: Splenic
Explanation:The fundus of the stomach along with the greater curvature of the stomach receive blood supply from the short gastric artery. The short gastric artery arises from the end of the splenic artery. The ligation of the splenic artery therefore would cause a disruption of blood supply to the fundus of the stomach.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 46
Correct
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Which of the following will show decreased hearing when tested by air conduction but normal hearing when tested by bone conduction?
Your Answer: Fibrosis causing fixation of the ossicles
Explanation:As the cochlea is embedded into bone, the vibrations from the bone are transmitted directly to the fluid in the cochlea. Hence, any damage to the ossicles or tympanic membrane will not show an abnormal result on bone conduction test.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 47
Correct
-
Where is the mental foramen located?
Your Answer: In the mandible
Explanation:The mental foramen is found bilaterally on the anterior surface of the mandible adjacent to the second premolar tooth. The mental nerve and terminal branches of the inferior alveolar nerve and mental artery leave the mandibular canal through it.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 48
Correct
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Which is the correct statement regarding gonadal venous drainage:
Your Answer: The left ovarian vein drains into the left renal vein
Explanation:Spermatic or testicular veins arise from the posterior aspect of the testis and receive tributaries from the epididymis. Upon uniting, they form the pampiniform plexus that makes up the greater mass of the spermatic cord. The vessels that make up this plexus rise up the spermatic cord in front of the ductus deferens. They then unite, below the superficial ring, to form three or four veins that traverse the inguinal canal and enter the abdomen through the deep inguinal ring. They further unite to form 2 veins that ascend up the psoas major muscle behind the peritoneum each lying on either side of the testicular artery. These further unite to form one vein that empties on the right side of the inferior vena cava at an acute angle and on the left side into the renal vein, at a right angle. The left testicular vein courses behind the iliac colon and is thus exposed to pressure from the contents of this part of the bowel. The ovarian vein is the equivalent of the testicular vein in women. They form a plexus in the broad ligament near the ovary and uterine tube and communicate with the uterine plexus. They drain into similar vessels as in a man.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 49
Correct
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A patient who has used NSAIDS for many years presents to the A&E with symptoms of acute haemorrhagic shock. An emergency endoscopy is done that shows that a duodenal ulcer has perforated the posterior wall of the first part of the duodenum. Which artery is most likely to be the cause of the haemorrhage?
Your Answer: Gastroduodenal
Explanation:The gastroduodenal artery is a branch of the hepatic artery and descends near the pylorus between the first part of the duodenum and the neck of the pancreas to divide at the lower border of the duodenum into the right gastroepiploic and pancreaticoduodenal arteries. Before it divides, it gives off a few branches to the pyloric end of the stomach and to the pancreas. The artery that is most likely involved in this situation is the gastroduodenal artery since it is posterior to the first part of the duodenum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 50
Correct
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Which is the correct order of tendons passing from medial to lateral-posterior to the medial malleolus?
Your Answer: Posterior tibial, flexor digitorum longus, flexor hallucis longus
Explanation:The correct order of structures is the tendon of tibialis posterior, tendon of flexor digitorum longus, posterior tibial artery (and vein), tibial nerve and tendon of flexor hallucis longus.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 51
Correct
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A 45 year old lady has been diagnosed with Friedreich's ataxia that has affected her medial group of nuclei in the anterior horn of the spinal cord. Which of the following structures will have their muscles affected?
Your Answer: Axial muscles
Explanation:The cells in the anterior horn can be arranged in the following three main groups: medial, lateral and central. The medial group of nuclei in the anterior horn of the spinal cord are located along the entire length of the spinal cord and are responsible for the innervation of the axial muscles of the body ( muscles of the head and neck region). Thus this disease will most likely affect the functioning of the muscles of the head and neck.
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This question is part of the following fields:
- Anatomy
- Neurology
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Question 52
Correct
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Regarding the long head of the biceps femoris, which of the following is correct?
Your Answer: It crosses two joints
Explanation:The long head of the biceps femoris arises from the lower and inner impression on the back of the tuberosity of the ischium. It inserts with the short head in an aponeurosis which becomes a tendon and this tendon is inserted into the lateral side of the head of the fibula and the lateral condyle of the tibia, thus crossing two joints.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 53
Correct
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Which muscle is responsible for directing the gaze downward when the eye is abducted?
Your Answer: Inferior rectus muscle
Explanation:The inferior rectus muscle is a muscle in the orbit. As with most of the muscles of the orbit, it is innervated by the inferior division of oculomotor nerve (Cranial Nerve III). It depresses, adducts, and helps laterally rotate the eye.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 54
Correct
-
After a cerebral infarction, which of these histopathogical findings is most likely to be found?
Your Answer: Liquefactive necrosis
Explanation:The brain has a high lipid content and typically undergoes liquefaction with ischaemic injury, because it contains little connective tissue but high amounts of digestive enzymes.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 55
Correct
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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.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 56
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.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 57
Correct
-
A machine worker fractured the medial epicondyle of his right humerus resulting in damage to an artery running with the ulnar nerve posterior to the medial epicondyle. The artery injured is the?
Your Answer: Superior ulnar collateral
Explanation:The superior ulnar collateral artery runs posterior to the medial epicondyle of the humerus, accompanied by the ulnar nerve. This artery arises from the brachial artery near the middle of the arm and ends under the flexor carpi ulnaris muscle by anastomosing with two arteries: the posterior ulnar recurrent and inferior ulnar collateral.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 58
Incorrect
-
A CT-scan of the lung shows a tumour crossing the minor (horizontal) fissure. This fissure separates:
Your Answer: The lower lobe from both the middle and upper lobes
Correct Answer: The middle lobe from the upper lobe
Explanation:The horizontal fissure separates the upper lobe from the middle lobe. The oblique fissure on the other hand separates the lower lobe from both the middle and upper lobes. The lingula is found only on the left lung.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 59
Correct
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Which of the following arteries branch from the deep femoral artery and course between the pectineus and iliopsoas muscles?
Your Answer: Medial femoral circumflex
Explanation:The medial femoral circumflex artery is an artery in the upper thigh that supplies blood to the head and neck of the femur. It arises from the deep femoral artery and winds around the medial side of the femur. It passes first between pectineus and psoas major, and then between obturator externus and adductor brevis.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 60
Correct
-
A surgeon performing a thymectomy to remove a malignant thymoma is careful to avoid damaging an important nerve lying around the arch of the aorta. Which nerve is the surgeon trying to preserve?
Your Answer: Left Vagus
Explanation:The left vagus nerve lies on the lateral surface of the aortic arch. The left recurrent laryngeal nerve arises from the vagus and loops around the arch of the aorta. This nerve is at risk of injury during surgery.
The right and left phrenic nerves, being lateral to the vagus, do not loop around the arch of the aorta.
The sympathetic trunks, both right and left, are located in the posterior chest; not near the aortic arch.
The right vagus: not involved with the aortic arch.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 61
Correct
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A patient presents with loss of pain and temperature sensation in the left leg. He is likely to have a lesion involving:
Your Answer: Right lateral spinothalamic tract
Explanation:The spinothalamic tract is a sensory pathway originating in the spinal cord that transmits information to the thalamus. There are two main parts of the spinothalamic tract: the lateral spinothalamic tract transmits pain and temperature and the anterior spinothalamic tract transmits touch (crude touch). The decussation of this pathway occurs at the level of the spinal cord. Hence, a unilateral lesion of the lateral spinothalamic tract causes contralateral loss of pain and temperature.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 62
Correct
-
When a patient is standing erect, pleural fluid would tend to accumulate in which part of the pleural space?
Your Answer: Costodiaphragmatic recess
Explanation:The costo-diaphragmatic recess is the lowest extent of the pleural cavity or sac. Any fluid in the pleura will by gravity accumulate here when a patient is standing erect.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 63
Correct
-
The transverse colon has two curvatures known as the colic flexures on each side of its lateral ends, the right and left. The left colic flexure found on the side of the descending colon is attached to an organ superiorly by a mesenteric ligament. Which organ is this?
Your Answer: Spleen
Explanation:The left colic flexure is the bend of the transverse colon as it continues to form the descending colon on the left upper quadrant. The spleen is located on the superior aspect of the left colic flexure. It is commonly referred to as the splenic flexure because of its relation o the spleen superiorly.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 64
Correct
-
A young man came to the emergency room after an accident. The anterior surface of his wrist was lacerated with loss of sensation over the thumb side of his palm. Which nerves have been damaged?
Your Answer: Median
Explanation:The median nerve provides cutaneous innervation to the skin of the palmar radial three and a half fingers. Also the site of injury indicates that the medial nerve may have been injured as it passes into the hand by crossing over the anterior wrist.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 65
Correct
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A lesion involving the lateral geniculate nucleus of the thalamus is likely to affect:
Your 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.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 66
Correct
-
Which organs amongst these are the derivatives of the endoderm?
Your Answer: Epithelial part of the tympanic cavity
Explanation:Endoderm derivatives include the epithelium of the following: gastrointestinal tract and its glands, glandular cells of the liver and pancreases, urachus and urinary bladder, pharynx, trachea and alveoli, part of the tonsils, thyroid and parathyroid, tympanic cavity and thymus and part of the anterior pituitary gland.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 67
Correct
-
The thoracic duct :
Your Answer: varies in length from 38 to 45 cm
Explanation:The thoracic duct is the main drainage of lymph in the body. It varies in length from 38 to 45 cm and extends from the second lumbar vertebra to the root of the neck.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 68
Correct
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The gastrosplenic ligament also known as the gastrolienal ligament is the structure that connects the greater curvature of the stomach to the hilum of the spleen. Which of the following arteries would most likely be injured if a surgeon accidentally tore this ligament?
Your Answer: Short gastric
Explanation:The short gastric arteries arise from the end of the splenic arteries and form five to seven branches. The short gastric arteries inside the gastrosplenic ligament from the left to the right, supply the greater curvature of the stomach. The hepatic artery proper runs inside the hepatoduodenal ligament. The right gastric artery and the left gastric artery are contained in the hepatogastric ligament. The caudal pancreatic artery branches off from the splenic artery and supplies the tail of the pancreas. The middle colic artery supplies the transverse colon. The splenic artery does not travel in the gastrosplenic ligament and so it would not be damaged by a tear to this ligament.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 69
Incorrect
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The lateral thoracic artery:
Your Answer: Accompanies the thoracodorsal nerve to the serratus anterior muscle
Correct Answer: Accompanies the long thoracic nerve to the serratus anterior muscle
Explanation:The thoracic nerve, along with the lateral thoracic artery, follow the pectoralis minor to the side of the chest which supplies the serratus anterior and the pectoralis. It then sends branches across the axilla to the axillary glands and subscapularis. The pectoral branch of the thoraco-acromial anastomoses with the internal mammary, subscapular and intercostal arteries, which in women, supply an external mammary branch.
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This question is part of the following fields:
- Anatomy
- Breast
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Question 70
Correct
-
A correct statement about the RECTUM:
Your Answer: It is an important anastomotic site for the portal and caval (systemic) venous systems
Explanation:The rectum is part of the gastrointestinal tract that is continuous above with the sigmoid colon and below with the anal canal. It contains both longitudinal and circular smooth muscles. These are supplied by the enteric nervous system. It is about 12 cm long. It has no sacculations comparable with those of the colon. It has three permanent transverse folds called the valves of Houston. The peritoneum is related to the upper two thirds of the rectum only whereas the lower part is not covered by peritoneum. It is supplied by the superior rectal (hemorrhoidal) branch of the inferior mesenteric artery and the median sacral artery that is a direct branch from the abdominal aorta. It is drained by veins that begin as a plexus that surround the anus. These veins form anastomoses with the portal system (portocaval anastomoses).
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 71
Correct
-
A patient sustained an iatrogenic injury to one of the structures passing through the deep inguinal ring. This was during an operation to repair an inguinal hernia. Which structure is most likely to be injured?
Your Answer: Round ligament of the uterus
Explanation:The deep inguinal ring transmits the spermatic cord in the man and the round ligament of the uterus in the female. It is bound below and medially by the inferior epigastric vessels (so these don’t go through it).
The ilioinguinal nerve, although it courses through the inguinal canal, does not pass through it.
The iliohypogastric nerves run between the internal oblique and transversus abdominis in the abdominal wall, piercing the internal oblique at the anterior superior iliac spine to travel just deep to the external oblique.
The inferior epigastric artery runs between the transversus abdominis and the peritoneum forming the lateral umbilical fold.
The medial umbilical ligament is the obliterated umbilical artery that it lies within the medial umbilical fold of peritoneum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 72
Correct
-
the action of the semimembranosus muscle is:
Your Answer: Extension of the hip and flexion of the knee
Explanation:the semimembranosus is situated at the back and medial side of the thigh. It arises from the upper and outer impression on the tuberosity of the ischium, above and lateral to the biceps femoris and semitendinosus. It is inserted mainly into the horizontal groove on the posterior medial aspect of the medial condyle of the tibia. it flexes the knee and assists in extension of the hip.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 73
Correct
-
During an exploratory laparotomy in a 22 year-old man shot in the abdomen, the operating doctor discovers the large bowel is perforated. Which of the following characteristics of the bowel enabled the surgeon to identify it as the large bowel?
Your Answer: Epiploic appendages
Explanation:The large intestine doesn’t have a continuous layer of longitudinal muscle. Instead, it has three strips of longitudinal muscle called taenia coli. The large intestine is covered with omental appendages that are fat filled. It is also folded into sacculations called haustrations. Serosa is a general term for the outermost coat or serous layer of a visceral structure that lies in the body cavities of the abdomen or thorax.
Complete circular folds are only found in the small intestine.
Valvulae conniventes or valves of Kerckring are the circular folds which are large valvular flaps projecting into the lumen of the small bowel.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 74
Correct
-
Which one of the following muscles is innervated by the facial nerve?
Your Answer: Buccinator
Explanation:Buccinator is a muscle of facial expression and is therefore innervated by the facial nerve. The lateral pterygoid, masseter, anterior belly of digastric and temporalis are all muscles of mastication and therefore innervated by the mandibular division of the trigeminal nerve.
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This question is part of the following fields:
- Anatomy
- Head & Neck; Neurology
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Question 75
Correct
-
Identify which of the following muscles acts on two joints?
Your Answer: Sartorius
Explanation:The sartorius muscle, the longest muscle in the body, is one of the two jointed or biarticular muscles. It originates from the anterior superior iliac spine and part of the notch between the anterior superior iliac spine and anterior inferior iliac spine and crosses both the hip joint and the knee joint. At the hip joint the sartorius flexes and rotates the thigh at the hip joint and flexes the leg at the knee joint.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 76
Correct
-
A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of a 25 - year old male patient, accidentally jabbed and injured a vital structure that lies anterior to the left suprarenal organ. Which of the following was the structure most likely injured?
Your Answer: Pancreas
Explanation:The adrenal (suprarenal) glands are organs of the endocrine system located on top of each of the kidneys. The left suprarenal gland, in question, is crescent in shape and slightly larger than the right suprarenal gland. It is posteriorly located to the lateral aspect of the head of the pancreas which is thus the most likely to be injured. The other organs like the duodenum, liver and the inferior vena cava are related to the right suprarenal gland. The spleen and the colon are not in close proximity with the left suprarenal gland and are not likely to be the organs injured.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 77
Incorrect
-
An explorative laparotomy is done on a 23 year old following a gunshot abdominal injury through the right iliac fossa. It is found that the ileocolic artery is severed and the bullet had perforated the caecum. From which branch does the ileocolic artery originate?
Your Answer: Inferior mesenteric artery
Correct Answer: Superior mesenteric artery
Explanation:Ileocolic artery branches off from the superior mesenteric artery. It then divides to give a superior and inferior branch.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 78
Correct
-
All the following statements are FALSE regarding the ophthalmic division of the trigeminal nerve, except:
Your Answer: The ophthalmic nerve is the smallest branch of the trigeminal nerve
Explanation:The ophthalmic nerve is the smallest of the three trigeminal divisions. The cutaneous branches of the ophthalmic nerve supply the conjunctiva, the skin over the forehead, the upper eyelid, and much of the external surface of the nose.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 79
Correct
-
A sudden loud sound is more likely to result in cochlear damage than a slowly developing loud sound. This is because:
Your Answer: There is a latent period before the attenuation reflex can occur
Explanation:On transmission of a loud sound into the central nervous system, an attenuation reflex occurs after a latent period of 40-80 ms. This reflex contracts the two muscles that pull malleus and stapes closer, developing a high degree of rigidity in the entire ossicular chain. This reduces the ossicular conduction of low frequency sounds to the cochlea by 30-40 decibels. In this way, the cochlea is protected from damage due to loud sounds (these are low frequency sounds) when they develop slowly.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 80
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.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 81
Correct
-
During a surgical operation, whilst dissecting the mediastinal lymph nodes for a bronchogenic carcinoma of the right upper lobe bronchus, a patient's right sympathetic trunk is accidentally severed above the level of spinal nerve T1. Which function would be left intact in the affected region?
Your Answer: Voluntary muscle activity
Explanation:The sympathetic nervous system regulates vascular tone, dilation of pupils, arrector pili muscles, sweat production and visceral reflexes. Neurones that supply the voluntary muscles originate from the ventral horn of the spinal cord. If these nerves were thus damaged, these functions would be impaired. The sympathetic nervous system is not responsible for voluntary muscle activity.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 82
Correct
-
Which of the following arteries is the posterior branch of the external carotid artery?
Your Answer: Superficial temporal
Explanation:The external carotid artery is a branch of the common carotid artery that supplies parts of the neck, head and face. It branches off from the common carotid artery at the level of the thyroid cartilage. The external carotid, at the level of the mandible divides into the maxillary artery and the superficial temporal. The superficial temporal artery is the posterior branch of these two arteries. It starts off, somewhat, as a continuation of the external carotid artery at the substance of the parotid gland. Anterior cerebral and middle cerebral arteries are branches of the internal carotid artery.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 83
Correct
-
Rapid Eye Movement (REM) sleep is typically associated with:
Your Answer: Penile erections
Explanation:Normal sleep comprises of alternate cycles between slow-wave sleep (non-REM sleep) and REM sleep. REM sleep is characterized by increased metabolic brain activity and EEG desynchronization. Somnambulism (sleepwalking), enuresis (bedwetting) and night terrors all occur during slow-wave sleep or during arousal from slow-wave sleep. In comparison, REM sleep is characterized by hypotonia of major muscle groups (excluding ocular muscles), dreams, nightmares and penile erection.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 84
Correct
-
A 45 year-old female presents with a drooping eyelid. During examination, the same pupil of the patient is found to be dilated. Which nerve could be involve in this case?
Your Answer: Oculomotor nerve
Explanation:The oculomotor nerve controls most of the eye muscles. It also controls the constriction of the pupils and thickening of the lens of the eye. This can be tested in two main ways. By moving a finger toward a person’s face to induce accommodation, their pupils should constrict or shining a light into one eye should result in equal constriction of the other eye. The neurons in the optic nerve decussate in the optic chiasm with some crossing to the contralateral optic nerve tract. This is the basis of the swinging-flashlight test. Loss of accommodation and continued pupillary dilation can indicate the presence of a lesion of the oculomotor nerve.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 85
Correct
-
Which is the correct superficial to deep order of structures that would be affected following a knife wound to the lateral aspect of the knee?
Your Answer: skin, fibular collateral ligament, popliteus muscle tendon, lateral meniscus
Explanation:Skin, fibular collateral ligament, popliteus muscle tendon and lateral meniscus is the correct order of structures covering the lateral aspect of the knee joint from a superficial to deep.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 86
Correct
-
The following structures DO NOT lie between the layers of the mesosalpinx except for the?
Your Answer: Fallopian tube
Explanation:Mesosalpinx is the portion of the broad ligament that stretches from the fallopian tube to the ovary and contains the uterine tubes between it’s layers.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 87
Correct
-
Where do the seminal vesicles lie?
Your Answer: Base of the bladder and rectum
Explanation:The seminal vesicles are two lobulated membranous pouches situated between the fundus of the bladder and rectum and act as a reservoir for the semen and secrete a fluid that is added to the seminal fluid. Each sac is pyramidal in shape but they all vary in size not only in different individuals but also in the same individuals. The anterior surface is in contact with the fundus of the bladder, extending from near the termination of the ureter to the base of the prostate. Each vesicle consist of single tube, which gives off several irregular caecal diverticula. These separate coils and the diverticula are connected by fibrous tissue.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 88
Correct
-
Which one of the following is a derivative of the midgut?
Your Answer: Caecum
Explanation:The primary intestinal loop is formed from the midgut which gives rise to the distal half of the duodenum, the jejunum, ascending colon, proximal two thirds of the transverse colon and the ileum.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 89
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.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 90
Correct
-
A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which is the LEAST likely place to find the testis?
Your Answer: Perineum
Explanation:Embryologically the testes are retroperitoneal structures in the posterior abdominal wall, attached to the anterolateral abdominal wall by the gubernaculum. The gubernaculum ‘pulls’ the testes through the deep inguinal ring, inguinal canal and superficial inguinal ring and over the pelvic brim. The gubernaculum is preceded by the processus vaginalis that is derived from the peritoneum anterior to the testes. The processus vaginalis pushes the muscle and fascial layers. These eventually make up the canal and the spermatic cord, into the scrotum. The gubernaculum persists as the scrotal ligament while part of the processus vaginalis remains as a bursa-like sac i.e. the tunica vaginalis testes. The testes therefore could be caught in any one of these places along its path of descending. The testes are never in the perineum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 91
Incorrect
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An excision of a mass in the right parietal area of the head will be performed. In which layer of the scalp are the nerves and blood vessels located?
Your Answer: Loose areolar connective tissue
Correct Answer: Connective tissue
Explanation:The scalp is the anatomical area bordered by the face at the front, and by the neck at the sides and back. The scalp is usually described as having five layers:
1. The skin which contains numerous sebaceous glands and hair follicles.
2. The connective tissue, a dense subcutaneous layer of fat and fibrous tissue that lies beneath the skin, containing the nerves and vessels of the scalp.
3. The aponeurosis or galea aponeurotica, a tough layer of dense fibrous tissue which runs from the frontalis muscle anteriorly to the occipitalis posteriorly.
4. The loose areolar connective tissue layer provides an easy plane of separation between the upper three layers and the pericranium.
5. The pericranium is the periosteum of the skull bones and provides nutrition to the bone and the capacity for repair.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 92
Correct
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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.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 93
Correct
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When one is silently counting, what part of his brain will show increased regional cerebral blood flow (rCBF)?
Your Answer: Supplementary motor area
Explanation:Regional cerebral blood flow (rCBF) increases in the superior speech cortex (supplementary motor area) during periods of silent counting, whereas speaking aloud will do so in the motor cortex and medial temporal lobe, along with the superior speech cortex.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 94
Correct
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The muscle that stabilizes the stapes is innervated by which of the following nerves?
Your Answer: Facial nerve
Explanation:The stapedius is the smallest skeletal muscle in the human body. At just over one millimetre in length, its purpose is to stabilize the smallest bone in the body, the stapes and is innervated by a branch of the facial nerve.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 95
Correct
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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.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 96
Correct
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What are some of the derivatives of the second pharyngeal arch?
Your Answer: Stylohyoid muscle
Explanation:Also known as the hyoid arch, it forms the side and front of the neck. From its cartilage develops the styloid process, stylohyoid ligament and lesser cornu of the hyoid bone. The muscular derivatives include the muscles of facial expression, stapedius, stylohyoid and the posterior belly of the digastric. All these are innervated by cranial nerve VII but migrate into the area of the mandibular arch.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 97
Correct
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The annular ligament in the forearm:
Your Answer: Encircles the head of the radius
Explanation:The annular ligament forms about four-fifths of the osseofibrous ring and is attached to the anterior and posterior margins of the radial notch. It is a strong band of fibres which encircles the head of the radius retaining it in contact with the radial notch of the ulna. When it comes to its upper border, it blends with the anterior and posterior ligament of the elbow.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 98
Correct
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What is the likely course of a pulmonary embolism arising from the leg veins and ending in the apical segmental pulmonary artery that supplies the superior lobe of left lung?.
Your Answer: Inferior vena cava – right atrium – tricuspid valve – right ventricle – pulmonary trunk – left pulmonary artery – left superior lobar artery – left apical segmental artery
Explanation:A clot originating in the leg vein will go to the inferior vena cava, into the right atrium, through the tricuspid valve, into the right ventricle, through the pulmonary trunk, into the left pulmonary artery, into the left superior lobar artery and then finally reach the left apical segmental artery.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 99
Correct
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With respect to far accommodation, which of the following is a TRUE statement?
Your 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 100
Correct
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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 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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