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Question 1
Correct
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An operation to remove a segment of the oesophagus through a right thoracotomy is complicated when a tear develops in a large venous structure in the posterior mediastinum that empties into the superior vena cava. Which of the following structures is likely to be injured?
Your Answer: Azygos vein
Explanation:The azygos vein is formed by the union of the right subcostal veins and the ascending lumbar veins at the level of the 12th thoracic vertebra. It enters the thorax through the aortic hiatus to ascend in the posterior mediastinum and arching over the right main bronchus posteriorly at the root of the right lung to join the superior vena cava before it pierces the pericardium.
The basilic vein is a vein on the medial aspect of the arm that ascends to become the axillary vein.
The cephalic vein is also a vein of the arm.
The external jugular and brachiocephalic vein are not in the posterior mediastinum.
The median cubital vein is found in the cubital fossa of the arm.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 2
Incorrect
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Which statement is true regarding the diaphragmatic openings:
Your Answer: The azygos vein passes through the opening at T10
Correct Answer: The thoracic duct passes through the opening at T12
Explanation:The diaphragmatic openings are:
T8 – opening for the inferior vena cavaand the right phrenic nerve
T10 – opening for the oesophagusand the left gastric artery and vein
T12 – opening for the aorta, the thoracic duct and azygos vein.
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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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Where would you insert the needle when drawing blood from a patient's median cubital vein?
Your Answer: Anterior aspect of the elbow
Explanation:The correct answer is to insert it into the anterior aspect of the elbow. If you look at the venous drainage of the upper limb, you will find that there are two main veins, the basilic and the cephalic vein; the connecting branch between these two veins is the median cubital vein. and this vein passes via the cubital fossa which is on the anterior aspect of the forearm.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 4
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 5
Incorrect
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The pterion is clinically significant as it marks an area of weakness on the skull. What structure lies beneath it?
Your Answer: Confluence of sinuses
Correct Answer: Anterior branches of the middle meningeal artery
Explanation:The pterion is the area where four bones, the parietal, frontal, greater wing of sphenoid and the squamous part of the temporal bone meet. It overlies the anterior branch of the middle meningeal artery on the internal aspect of the skull. The pterion is the weakest part of the skull. Slight trauma to this region can cause extradural hematoma.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 6
Correct
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Injury to which of the following arteries is likely to affect the blood supply to the seminal vesicles?
Your Answer: Middle rectal
Explanation:Ligation of middle rectal artery is most likely to affect the blood supply of seminal vesicles since arteries supplying the seminal vesicles are derived from the middle and inferior vesical and middle rectal arteries.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 7
Incorrect
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A 25 year old male patient who had sustained a stab wound in the middle of the posterior aspect of the left thigh, was discharged from hospital after dressing and antibiotic prophylaxis. Later on the patient developed bleeding through the wound and upon review, the source was discovered to be an artery that is the direct source of the medial and lateral circumflex arteries. Which is this artery that was injured?
Your Answer: First perforating artery
Correct Answer: Profunda femoris artery
Explanation:The medial and lateral circumflex arteries are direct branches of the Profunda femoris artery otherwise also known as the deep artery of the thigh. The Profunda femoris artery arises from the femoral artery just below the inguinal ligament (approximately 2-5cm below it).
The following are the branches of the deep artery of the thigh:
Lateral circumflex femoral artery
Medial circumflex femoral artery
Perforating arteries
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 8
Incorrect
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While conducting a physical examination of a patient, the GP passed a finger down the edge of the medial crus of the superficial inguinal ring and felt a bony prominence deep to the lateral edge of the spermatic cord. What was this bony prominence?
Your Answer: Iliopectineal line
Correct Answer: Pubic tubercle
Explanation:At the superficial inguinal ring, the pubic tubercle would be felt as a bony prominence lateral to the edge of the spermatic cord. This tubercle is the point of attachment of the inguinal ligament that makes up the floor of the inguinal canal.
Pecten pubis is the ridge on the superior surface of the superior pubic ramus and the point of attachment of the pectineal ligament.
The pubic symphysis is the joint between the two pubic bones and the iliopubic eminence is a bony process on the pubis found near the articulation of the pubis and the ilium.
The iliopectineal line is formed by the arcuate line of the ilium and the pectineal line of the pubis. It is the line that marks the transition between the abdominal and pelvic cavity.
The sacral promontory is found on the posterior wall of the pelvis and would not be felt through the inguinal ring.
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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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During an operation to repair a hiatal hernia, the coeliac branch of the posterior vagal trunk is injured. This damage would affect muscular movements as well as some secretory activities of the gastrointestinal tract. Which gastrointestinal segment is LEAST likely to be affected?
Your Answer: Sigmoid colon
Explanation:The vagus nerve supplies the parasympathetic fibres to the abdominal structures that are receive arterial supply from the coeliac trunk or superior mesenteric artery i.e. up to the transverse colon. The end of the transverse colon and the gastrointestinal structures distal to this point receive parasympathetic innervation from the pelvic splanchnic nerves and blood from the inferior mesenteric artery(IMA). The ascending colon, caecum, jejunum and ileum would all, thus, be affected by this damage. Sigmoid colon would not be affected.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 10
Correct
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The following joint has an anastomotic circulation that is provided by branches of the brachial artery:
Your Answer: Elbow joint
Explanation:The arterial anastomoses of the elbow joint is contributed by branches of the brachial artery and the Profunda brachii artery. The brachial artery gives off the superior ulnar collateral artery and the inferior collateral artery. On the other hand, the Profunda brachii gives off the radial and medial recurrent arteries.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 11
Correct
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The primary somatosensory cortex is located in the:
Your Answer: Postcentral gyrus
Explanation:The primary somatic sensory cortex is located in the postcentral gyrus and is the largest cortical receiving area for information from somatosensory receptors. Through corticocortical fibres, it then sends the information to other areas of the neocortex and further analysis takes place in the posterior parietal association cortex.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 12
Correct
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An old man was diagnosed with squamous cell carcinoma with axillary lymph node metastasis. The doctor said he will excise the tumour and remove all axillary lymph nodes lateral to the edge of the pectoralis minor muscle. One of the following axillary lymph nodes won't be removed by this procedure. Which is it?
Your Answer: Apical
Explanation:The apical lymph node group won’t be removed which include 20 to 30 lymph nodes.
Axillary lymph nodes are grouped according to location. The lateral group, the anterior to pectoral group, the posterior or subscapular group, the central group, and the medial or apical group. The lateral, pectoral, and subscapular groups are found lateral to the pectoralis minor muscle. The central group is situated directly under that muscle. Thus, if all lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed, all the above four groups will be removed. The apical group won’t be removed which is situated medial to the medial edge of the pectoralis minor muscle.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 13
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 14
Correct
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The lateral thoracic artery:
Your 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 15
Correct
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A 26-year old man is brought to the A&E with a stab wound to the chest. The wound is in a part of the left lung that might partially fill the costomediastinal recess in full respiration. Where did the weapon strike this man?
Your Answer: Lingula
Explanation:During full inspiration, the lingual-of the left lung partially fills the costomediastinal recess. If the apex of the lung is fully filled with air, it would occupy the copula (the part of the pleura that extends above the first rib). The hilum is part of the lung where the neurovascular structures that form the root of the lung enter and leave the lung and doesn’t expand on inspiration. The middle lobe can expand to fill the costomediastinal recess, however, the middle lobe is on the right lung. The inferior lobe, during full inspiration, might fill the costodiaphragmatic recess.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 16
Incorrect
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During a street fight a boy sustained a laceration below the elbow. It was a deep cut that led to profuse bleeding from an artery situated on the supinator muscle immediately below the elbow. The vessel most likely to have been injured is?
Your Answer: Anterior ulnar recurrent artery
Correct Answer: Radial recurrent artery
Explanation:The radial recurrent artery is situated on the supinator muscle then passing between the brachialis and the brachioradialis muscles. It originates from the radial artery and ends by anastomosing with the terminal part of the Profunda brachii.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 17
Correct
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The third branch of the maxillary artery lies in which fossa?
Your Answer: Pterygopalatine fossa
Explanation:The maxillary artery supplies deep structures of the face. It branches from the external carotid artery just deep to the neck of the mandible. It is divided into three portions:
– The first or mandibular portion (or bony portion) passes horizontally forward, between the neck of the mandible and the sphenomandibular ligament.
– The second or pterygoid portion (or muscular portion) runs obliquely forward and upward under cover of the ramus of the mandible, on the surface of the lateral pterygoid muscle; it then passes between the two heads of origin of this muscle and enters the fossa.
– The third portion lies in the pterygopalatine fossa in relation to the pterygopalatine ganglion. This is considered the terminal branch of the maxillary artery. Branches from the third portion includes: the sphenopalatine artery, descending palatine artery, infraorbital artery, posterior superior alveolar artery, artery of pterygoid canal, pharyngeal artery, middle superior alveolar artery and anterior superior alveolar artery.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 18
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 19
Correct
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A 55-year old patient with signs and symptoms of internal haemorrhage was brought in for emergency surgery to control the bleeding. Angiography results revealed an advanced duodenal tumour that had perforated the blood vessel immediately behind the first part of the duodenum. Which of the following is the most likely blood vessel that was ruptured by the cancer?
Your Answer: Gastroduodenal artery
Explanation:The gastroduodenal artery is the artery that lies just behind the first portion of the duodenum. The gastroduodenal artery would be the most likely artery to be perforated by a cancer in this area. The perforation is as a result of the spillage of the acidic content of the chyme in the duodenum. All the other blood vessels in the list would less likely be affected by the gastric expellant from the duodenum. The coronary vein is located in the lesser curvature of the stomach. The inferior pancreaticoduodenal arcade is located inferiorly to the first part of the duodenum on the head of the pancreas. The hepatic artery proper is a branch of the common hepatic artery that is located superior to the first portion of the duodenum. The splenic vein arises from the spleen; it forms the portal vein by joining the superior mesenteric vein. It is laterally detached from the duodenum. Both the left gastric vein and the splenic vein are located superior to the first portion of the duodenum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 20
Correct
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The ostium of the maxillary sinus opens into which of the following structures?
Your Answer: Middle meatus
Explanation:The maxillary sinuses usually develop symmetrically. The maxillary sinus ostium drains into the infundibulum which joins the hiatus semilunaris and drains into the middle meatus.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 21
Incorrect
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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 hallucis longus, flexor digitorum longus
Correct 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 22
Correct
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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 23
Correct
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The mandibular nerve, which is the largest of the 3 divisions of the trigeminal nerve, exits the cranial cavity through which foramen?
Your Answer: Foramen ovale
Explanation:At the base of the skull the foramen ovale is one of the larger of the several holes that transmit nerves through the skull. The following structures pass through foramen ovale: mandibular nerve, motor root of the trigeminal nerve, accessory meningeal artery, lesser petrosal nerve, a branch of the glossopharyngeal nerve, emissary vein connecting the cavernous sinus with the pterygoid plexus of veins and occasionally the anterior trunk of the middle meningeal vein.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 24
Correct
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A man had noticed weakness in his left arm causing flexion of the elbow and supination of the forearm. Which nerve in this case was injured?
Your Answer: Musculocutaneous
Explanation:The musculocutaneous nerve supplies the biceps brachii and the brachialis muscles. The first one flexes the elbow and the shoulder. It is also involved in supination. The brachialis muscle flexes the forearm. The injury to the musculocutaneous nerve results in paralysis of these muscles.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 25
Incorrect
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The sciatic nerve does NOT supply which of the following muscles?
Your Answer: Quadratus femoris
Correct Answer: Obturator externus
Explanation:The sciatic nerve supplies both gemellae, quadratus femoris, semitendinosus, semimembranosus, both heads of the biceps femoris, the hamstring half of abductor magnus and obturator internus. Obturator externus is supplied by the obturator nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 26
Correct
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Which nodes are most likely to be enlarged in a patient complaining of a boil located on the labia majora?
Your Answer: Superficial inguinal
Explanation:The perineum, external genitalia, the labia majora and scrotum drain to the superficial inguinal lymph nodes. In a man, the testes do not drain to the superficial inguinal lymph nodes but rather travel in the spermatic cord and drain into the lumbar nodes. The lumbar nodes drain the internal pelvic organs. The sacral nodes drain the prostrate gland, uterus, vagina, rectum and posterior pelvic wall and the external iliac nodes in turn drain the lower limb. The internal iliac nodes drain the pelvis and gluteal region.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 27
Correct
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What is the most likely condition a new born infant is likely to suffer from, if he/she was born with incomplete fusion of the embryonic endocardial cushions?
Your Answer: An atrioventricular septal defect
Explanation:The endocardial cushions in the heart are the mesenchymal tissue that make up the part of the atrioventricular valves, atrial septum and ventricular septum. An incomplete fusion of these mesenchymal cells can cause an atrioventricular septal defect. The terms endocardial cushion defect, atrioventricular septal defect and common atrioventricular canal defect can be used interchangeably with one another.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 28
Correct
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A 60-year old patient presenting with squamous cell carcinoma of the anal canal was brought in to the oncology ward for chemotherapy. In which of the following lymph nodes of this patient would you likely find metastases?
Your Answer: Internal iliac
Explanation:The efferent lymphatics from the anal canal proceed to the internal iliac lymph nodes. This would most likely form the site of enlargement in the lymphatics.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 29
Correct
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Injury to this nerve may result in loss of sensation of the mandibular teeth and bone:
Your Answer: Inferior alveolar nerve
Explanation:The inferior alveolar nerve (sometimes called the inferior dental nerve) is a branch of the mandibular nerve, which is itself the third branch of the trigeminal nerve. The inferior alveolar nerves supply sensation to the lower teeth of the mandible.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 30
Correct
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Which of the following statements is true regarding the umbilical cord?
Your Answer: Is filled with jelly of Wharton
Explanation:The umbilical cord that connects the fetus to the placenta is about 50cm long. This tissue consists of the body stalk and vitelline duct. The former containing the allantoic diverticulum and the umbilical vessels. The latter contains the connection linking the digestive tube and the yolk sac. This cord is wrapped by stratum of ectoderm and gelatinous tissue or jelly of Wharton. The right umbilical vein plus the vitelline vessels and ducts disappear and this at birth the cord has three vessels which are the umbilical vein and two umbilical arteries.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 31
Correct
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upon stroking the plantar surface of a patient's foot, extension of toes was noted. This is likely to be accompanied with:
Your Answer: Spasticity
Explanation:An upper motor neuron lesion affects the neural pathway above the anterior horn cell or motor nuclei of the cranial nerves, whereas a lower motor neurone lesion affects nerve fibres travelling from the anterior horn of the spinal cord to the relevant muscles. An upper motor neurone lesions results in the following:
– Spasticity in the extensor muscles (lower limbs) or flexor muscles (upper limbs).
– ‘clasp-knife’ response where initial resistance to movement is followed by relaxation
– Weakness in the flexors (lower limbs) or extensors (upper limbs) with no muscle wasting
– Brisk tendon jerk reflexes
– Positive Babinski sign (on stimulation of the sole of the foot, the big toe is raised rather than curled downwards)
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This question is part of the following fields:
- Neurology
- Physiology
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Question 32
Correct
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A 25 year-old male patient was brought to the hospital due to a vehicular accident. A skull x-ray was done which revealed a fracture along the base of the middle cranial fossa. The patient has no sense of touch over the skin over his cheek and chin. Injury to the maxillary and the mandibular nerves is suspected. In which foramina do these two affected sensory branches leave the cranial cavity.
Your Answer: Foramen rotundum and foramen ovale
Explanation:The patient’s clinical manifestations suggests an injury to the maxillary and mandibular nerves. The maxillary branch (V2) of the trigeminal nerve (CN V) passes through and exits the skull via the pterygopalatine fossa and the foramen rotundum. At the base of the skull the foramen ovale (Latin: oval window) is one of the larger of the several holes (the foramina) that transmit nerves through the skull. The foramen ovale is situated in the posterior part of the sphenoid bone, posterolateral to the foramen rotundum. The following structures pass through foramen ovale: mandibular nerve, motor root of the trigeminal nerve, accessory meningeal artery (small meningeal or paradural branch, sometimes derived from the middle meningeal artery), lesser petrosal nerve, a branch of the glossopharyngeal nerve and an emissary vein connecting the cavernous sinus with the pterygoid plexus of veins. Occasionally it will also carry the anterior trunk of the middle meningeal vein.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 33
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 34
Correct
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Which of these laboratory findings will indicate a fetal neural tube defect when done between 15 and 20 weeks of pregnancy?
Your Answer: Increased alpha-fetoprotein
Explanation:Maternal serum screening during the second trimester is a non-invasive way of identifying women at increased risk of having children with a neural tube defect and should be offered to all pregnant women. The results are most accurate when the sample is taken between 15 and 20 weeks of gestation. Elevated levels of alpha-fetoprotein suggest open spina bifida, anencephaly, risk of pregnancy complications, or multiple pregnancy.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 35
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 36
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 37
Correct
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Prostatectomy carries a risk of loss of penile erection due to injury to the prostatic plexus responsible for an erection. From which nerves do these fibres originate?
Your Answer: Pelvic splanchnics
Explanation:Erection is a function of the parasympathetic nerves. Of the nerves listed, only the pelvic splanchnic nerves have parasympathetic fibres that innervate the smooth muscles and glands of the pelvic viscera.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 38
Incorrect
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In which of the following compartments of the femoral sheath is the femoral artery located?
Your Answer: Medial compartment
Correct Answer: Lateral compartment
Explanation:The femoral sheath also known as the crural sheath is made up of three compartments; lateral, intermediate and the medial. The femoral artery is contained in the lateral compartment of the femoral sheath while the femoral vein is in the intermediate compartment.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 39
Correct
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Which of the following structures, is the area in which the superior cerebral veins drain into?
Your Answer: Superior sagittal sinus
Explanation:The superior cerebral veins are predominantly located on the superior aspect of the brain. They are 8 to 12 in number and they drain the lateral, medial and superior aspects of the cerebral hemispheres.
These veins drain into the superior sagittal sinus, also known as the superior longitudinal sinus – which is located along the attached margin of the falx cerebri.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 40
Correct
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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 41
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 42
Incorrect
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Which of the following is true about myasthenia gravis?
Your Answer: Response of skeletal muscles to direct electrical stimulation is weakened
Correct Answer: Response of skeletal muscle to nerve stimulation is weakened
Explanation:An autoimmune disorder, myasthenia gravis leads to progressive muscle weakness. It occurs due to formation of antibodies against the nicotinic acetylcholine (ACh) receptor of the motor endplate, which leads to impaired neuromuscular transmission. Thus, nerve stimulation will lead to a weakened muscle response, but direct electrical stimulation will bring about a normal response. Diagnostic test includes improvement of muscle weakness by small doses of acetylcholinesterase inhibitors (physostigmine or edrophonium). However, a large dose of physostigmine worsens the weakness due to desensitisation of the endplate to persistent Ach. One of the investigative tools includes radiolabelled snake venom α-bungarotoxin. It is an in vitro study performed on muscle biopsy specimens and used to quantify the number of ACh receptors at the motor endplate.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 43
Correct
-
What forms the pelvic diaphragm?
Your Answer: Levator ani and coccygeus muscles
Explanation:The pelvic diaphragm is formed by the levator ani and the coccygeus muscles. The levator ani forms the greater part of the pelvic floor supporting the viscera in the pelvic cavity.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 44
Correct
-
A construction worker is brought to the A&E after a fall on site. The patient is conscious but complains of inability to feel his legs. A neurological examination reveals that he has no cutaneous sensation from his umbilicus to his toes. What is the likely level of the spinal cord that is injured?
Your Answer: T10
Explanation:The umbilicus has a relatively consistent position in humans and thus serves as an important land mark. The skin around the waist at the level of the umbilicus is supplied by the tenth thoracic spinal nerve (T10 dermatome).
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 45
Correct
-
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: 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 46
Incorrect
-
During an operation to repair an aortic coarctation in a neonate, a surgeon accidentally cuts the first aortic intercostal arteries as he mobilised the descending aorta. Which one of the following structure might be deprived of its primary source of blood supply following this injury?
Your Answer: First posterior intercostal space
Correct Answer: Right bronchus
Explanation:The right bronchus is supplied by one right bronchial artery that may branch from one of the left bronchial arteries or from the right 3rd posterior intercostal artery (this is the first intercostal artery that arises from the aorta). Damage to this artery might stop blood supply to the main bronchus. Intercostal arteries that go to the first and the second interspaces originate from the highest intercostal artery such that blood supply to either of these spaces would not be interfered with.
The left bronchus receives blood from 2 left bronchial arteries which are direct branches from the descending aorta.
Fibrous pericardium is the sac that contains the heart. Its blood supply is not a major concern.
Visceral pericardium receives its blood supply from the coronary vessels.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 47
Correct
-
A man had an injury to his right brachial plexus. After examination by the doctor they found that the diaphragm and the scapula were unaffected however the patient could not abduct his arm. When helped with abducting his arm to 45 degrees he was able to continue the movement. This means that he was unable to initiate abduction. Where is the likely site of injury?
Your Answer: Suprascapular nerve
Explanation:The loss of ability to initiate abduction means paralysis of the supraspinatus muscle. This muscle is supplied by the supraclavicular nerve.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 48
Correct
-
A 70-year old man had had a large indirect inguinal hernia for 3 years. He presents at the out patient clinic complaining of pain in the scrotum. There is, however, no evidence of obstruction or inflammation. You conclude that the hernial sac is most probably compressing the:
Your Answer: Ilioinguinal nerve
Explanation:The ilioinguinal nerve arises together with the iliohypogastric nerve from the first lumbar nerve to emerge from the lateral border of the psoas major muscle just below the iliohypogastric and passing obliquely across the quadratus lumborum and iliacus muscles. It perforates the transversus abdominis, near the anterior part of the iliac crest and communicates with the iliohypogastric nerve between the internal oblique and the transversus. It then pierces the internal oblique to distribute filaments to it and accompanying the spermatic cord through the subcutaneous inguinal ring, is distributed to the skin of the upper and medial parts of the thigh, the skin over the root of the penis and the upper part of the scrotum in man and to the skin covering the mons pubis and labium majus in the woman. As the ilioinguinal nerve runs through the inguinal canal, it could easily be compressed by a hernial sac.
The femoral branch of genitofemoral nerve provides sensory innervation of the upper medial thigh.
The femoral nerve innervates the compartment of the thigh and also has some cutaneous sensory branches to the thigh.
The iliohypogastric nerve innervates the skin of the lower abdominal wall, upper hip and upper thigh. The subcostal nerve innervates the skin of the anterolateral abdominal wall and the anterior scrotal nerve is a terminal branch of the ilioinguinal nerve.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 49
Incorrect
-
When the pitch of a sound increases, what is the physiological response seen in the listener?
Your Answer: The frequency of action potentials in auditory nerve fibres increases
Correct Answer: The location of maximal basilar membrane displacement moves toward the base of the cochlea
Explanation:An increase in the frequency of sound waves results in a change in the position of maximal displacement of the basilar membrane in the cochlea. Low pitch sound produces maximal displacement towards the cochlear apex and greatest activation of hair cells there. With an increasing pitch, the site of greatest displacement moves towards the cochlear base. However, increased amplitude of displacement, increase in the number of activated hair cells, increased frequency of discharge of units in the auditory nerve and increase in the range of frequencies to which such units respond, are all seen in increases in the intensity or a sound stimulus.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 50
Correct
-
A chest x ray of a patient reveals loculated fluid in the right chest, which can be easily aspirated if the needle is inserted through the body wall just above the 9th rib in the midaxillary line. Where is this fluid located?
Your 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.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 51
Correct
-
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 52
Correct
-
A ‘claw hand’ is usually associated with injury to which of the following nerves?
Your Answer: Ulnar nerve
Explanation:A ‘claw hand’ is associated with injury to the ulnar nerve at the wrist affecting the interossei, lumbricals and hypothenar muscles of the hand. It is characterized by hypothenar eminence wasting, hyperextended metacarpophalangeal joints and flexed interphalangeal joints.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 53
Incorrect
-
The tympanic membrane is a thin semi-transparent membrane that separates the tympanic cavity from the bottom of the external acoustic meatus. The interior of the tympanic membrane is innervated by which of the following cranial nerves?
Your Answer: Olfactory
Correct Answer: Glossopharyngeal
Explanation:The glossopharyngeal nerve, known as the ninth cranial nerve (CN IX), is a mixed nerve that carries afferent sensory and efferent motor information. The glossopharyngeal nerve has five distinct general functions:
– The branchial motor (special visceral efferent), supplies the stylopharyngeus muscle.
– The visceral motor (general visceral efferent), provides parasympathetic innervation of the parotid gland via the otic ganglion.
– The visceral sensory (general visceral afferent), carries visceral sensory information from the carotid sinus and carotid body.
– The general sensory (general somatic afferent), provides general sensory information from the inner surface of the tympanic membrane, upper pharynx (GVA), and the posterior one-third of the tongue.
– The visceral afferent (special visceral afferent), provides taste sensation from the posterior one-third of the tongue, including the circumvallate papillae.
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This question is part of the following fields:
- Anatomy
- Head & Neck
-
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Question 54
Incorrect
-
A 35 year old male patient sustained a traumatic head injury. The patient had loss of consciousness, woke up momentarily when he was in the emergency room but became drowsy and comatose a few hours after. CT scan of the brain showed accumulation of blood between the dura and the cranial bone on the left side of his head. What type of haemorrhage did the patient have?
Your Answer: Subdural
Correct Answer: Epidural
Explanation:Epidural hematoma, also known as epidural bleeding, is a type of traumatic brain injury (TBI) in which a build-up of blood occurs between the dura mater (the tough outer membrane of the central nervous system) and the skull. The spinal cord is also covered by a layer of dura mater, so epidural bleeds may also occur in the spinal column. Often due to trauma, the condition is potentially deadly because the build-up of blood may increase pressure in the intracranial space, compressing delicate brain tissue, and causing brain shift. The condition is present in one to three percent of head injuries. Around 15–20% of epidural hematomas are fatal.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 55
Correct
-
A swimmer was struggling to finish his training following an injury to his right arm. On further examination it was found that any movements involving adduction, medial rotation and extension of her arm were particularly weak. Which nerve in this case was damaged?
Your Answer: Thoracodorsal
Explanation:Weakness on these particular movements indicate that there is a problem with the latissimus dorsi muscle. This muscle is very important particularly in swimming movements and is supplied by the thoracodorsal nerve.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 56
Incorrect
-
A surgeon performing a Whipple's procedure, that involves mobilizing the head of the pancreases, accidentally injured a structure immediately posterior to the neck of the pancrease which bled out. Which structure is most likely to have been injured?
Your Answer: Coeliac artery
Correct Answer: Superior mesenteric artery
Explanation:The structure immediately posterior to the neck of the pancreas is the superior mesenteric vein. The neck of the pancreas lies anterior to the superior mesenteric vein, which joins with the splenic vein to form the portal vein.
The superior mesenteric artery (SMA) is also located in proximity to the neck of the pancreas. Specifically, the SMA emerges from the abdominal aorta just below the level of the pancreas and passes posterior to the neck of the pancreas before it descends into the mesentery to supply the intestines. Thus, both the superior mesenteric vein and the superior mesenteric artery are key vascular structures related to the posterior aspect of the neck of the pancreas.
Bleeding out would suggest an arterial injury.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 57
Correct
-
A 38 year-old man falls on an outstretched hand. X-rays indicate an anterior dislocation of one of the carpal bones. Which carpal bone is most commonly dislocated?
Your Answer: Lunate
Explanation:The scaphoid bone is the most commonly fractured carpal bone and has an increased risk of avascular necrosis.
The lunate is the most commonly dislocated carpal bone. The displaced bone may compress the median nerve in the carpal tunnel.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 58
Correct
-
A 60 year-old patient being treated for hypertension presents to the ED with swelling of the left upper limb due to poor venous return. On examination, it is found that an aneurysm of the ascending aorta is impinging on a large vein lying immediately anterosuperior to it. Which vein is it likely to be?
Your Answer: Left brachiocephalic
Explanation:Among the veins listed, only the left brachiocephalic vein is anterosuperior to the ascending aorta. The right brachiocephalic vein being on the right side would not be affected by the aortic aneurysm.
The azygos vein lies deep in the chest on the right side.
The internal thoracic vein lies interior to the anterior wall of the chest.
The left superior intercostal vein is close to the aortic arch, crossing it laterally. This vein drains the 2nd to 4th interspaces on the left side.
The Right internal jugular vein joins the right brachiocephalic vein which would not be affected by the aneurysm.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 59
Incorrect
-
A retroperitoneal structure is:
Your Answer: Vermiform appendix
Correct 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 60
Correct
-
The posterior cord contains nerve fibres from which of the following levels of the spinal cord?
Your Answer: C5, C6, C7, C8 and T1
Explanation:THE correct answer is A. The posterior cord derives its fibres from the spinal nerves C5,C6,C7,C8,T1. This cord is formed from the fusion of the posterior divisions of the upper, lower, and middle trunks.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 61
Correct
-
A recognised side-effect of prefrontal leukotomy is:
Your Answer: Confusion
Explanation:Used previously as a treatment for psychiatric disorders, prefrontal leucotomy severs the connection between the prefrontal cortical association area and the thalamus. This leads to functional isolation of the prefrontal and orbitofrontal association cortex. Thus, along with the desired reduction in anger and frustration, undesirable side effects included changes in mood and affect, as well as confusion.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 62
Incorrect
-
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: Radial deviation of the wrist
Correct 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 63
Incorrect
-
The circle of Willis is one of the cerebrovascular safeguards comprised of the left and the right posterior communicating artery. Which of the following arteries in the brain is connected to the posterior cerebral artery by these posterior communicating arteries?
Your Answer: Anterior cerebral artery
Correct Answer: Internal carotid artery
Explanation:The Circle of Willis is an anastomosis of cerebral arteries that are located at the base of the brain. The Circle of Willis is one of the important safeguards that ensure back up of blood supply to parts of the brain in case of any cerebrovascular accident. The Circle of Willis is made up of an anterior portion of arteries including; the anterior cerebral arteries. The anterior cerebral arteries are connected to the posterior portion of the circle of Willis by the anterior communicating artery. The posterior portion is made up of the posterior cerebral artery which branch off from the basilar artery. The posterior cerebral artery are connected to the anterior portion of the circle of Willis by the posterior communicating artery. The posterior communicating artery connects the posterior cerebral artery to the internal carotid artery. The circle of Willis receives blood supply from the left and right internal carotid arteries that continues as the middle cerebral artery and posteriorly from the two vertebral arteries that join to form the basilar artery.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 64
Incorrect
-
Where is the foramen ovale located?
Your Answer: Ethmoid
Correct Answer: Sphenoid
Explanation:The foramen ovale is an oval shaped opening in the middle cranial fossa located at the posterior base of the greater wing of the sphenoid bone, lateral to the lingula. It transmits the mandibular division of the trigeminal nerve (CN Vc), accessory meningeal artery, emissary veins between the cavernous sinuses and pterygoid plexus, otic ganglion, and occasionally the nervus spinosus and lesser petrosal nerve.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 65
Correct
-
An abdominal aortogram shows occlusion of the inferior mesenteric artery. Which of the following segments of bowel is most likely to have preserved arterial supply?
Your Answer: Caecum
Explanation:The inferior mesenteric artery supplies blood to the end of the transverse colon and all distal structures in the gastrointestinal tract i.e. splenic flexure, descending colon, sigmoid colon and rectum would all be deprived of blood if it were occluded. The caecum receives blood from the superior mesenteric artery so it would not be affected.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 66
Incorrect
-
Which of the following muscles is solely contained in the anterior triangle of the neck and divides the anterior triangle into three smaller triangles?
Your Answer: Omohyoid
Correct Answer: Digastric
Explanation:The digastric muscle is a small muscle located under the jaw. It lies below the body of the mandible, and extends, in a curved form, from the mastoid process to the symphysis menti. The digastric divides the anterior triangle of the neck into three smaller triangles:
– The submaxillary triangle, bounded above by the lower border of the body of the mandible and a line drawn from its angle to the sternocleidomastoid, below by the posterior belly of the digastric and the stylohyoid and in front by the anterior belly of the digastric
– The carotid triangle, bounded above by the posterior belly of the digastric and stylohyoid, behind by the sternocleidomastoid and below by the omohyoid
– The suprahyoid or submental triangle, bounded laterally by the anterior belly of the digastric, medially by the midline of the neck from the hyoid bone to the symphysis menti and inferiorly by the body of the hyoid bone.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 67
Incorrect
-
A patient who complained of pain on the lower left side of the back had an x-ray done which confirmed a hernia passing posterolaterally, just superior to the iliac crest. Where is this hernia passing through?
Your Answer: Triangle of auscultation
Correct Answer: Lumbar triangle
Explanation:The lumber triangle is bound medially by the border of the latissimus dorsi, laterally by the external abdominal oblique and by the iliac crest inferiorly. This is exactly where the hernia that is described is located.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 68
Incorrect
-
Atrial septal defect (ASD) is most likely to be due to incomplete closure of which one of the following structures:
Your Answer: Ligamentum arteriosum
Correct Answer: Foramen ovale
Explanation:Atrial septal defect is a congenital heart defect that results in a communication between the right and left atria of the heart and may involve the interatrial septum. It results from incomplete closure of the foramen ovale which is normally open during fetal life and closes just after birth.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 69
Incorrect
-
During an operation for a sigmoid colectomy the surgeon ligates the sigmoid arteries. From which artery do the sigmoid arteries branch?
Your Answer: Middle colic artery
Correct Answer: Inferior mesenteric artery
Explanation:Sigmoid arteries are branches of the inferior mesenteric artery (IMA). Sigmoid artery gives off branches that supply the lower descending colon, the iliac colon and the sigmoid colon.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 70
Incorrect
-
Which of these illnesses is most likely to precede Guillain-Barré syndrome?
Your Answer: Systemic lupus erythematosus
Correct Answer: Viral pneumonia
Explanation:Guillain–Barré syndrome (GBS) is characterized by a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system. In about two-thirds of patients, the syndrome begins 5 days to 3 weeks after an infectious disease, surgery or vaccination. Infection is the trigger in over 50% of patients; common pathogens include Campylobacter jejuni, enteric viruses, herpesviruses (including cytomegalovirus and those causing infectious mononucleosis) and Mycoplasma species. The underlying mechanism involves an autoimmune disorder in which the body’s immune system mistakenly attacks the peripheral nerves and damages their myelin insulation, although the cause for this is still unknown.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 71
Correct
-
Cranial nerve XII, the hypoglossal nerve, innervates which one of the following muscles in the list?
Your Answer: Hyoglossus
Explanation:The cranial nerve XII, hypoglossal nerve, innervates all the intrinsic and extrinsic muscles of the tongue except the palatoglossus. The muscles of the tongue innervated by this nerve include the extrinsic muscles; hyoglossus, styloglossus, genioglossus and the intrinsic muscles; superior longitudinal, inferior longitudinal, vertical and transverse muscles. The salpingopharyngeus, palatoglossus and the palatopharyngeus muscles are innervated by the vagus nerve. The stylopharyngeus muscle is innervated by the glossopharyngeal nerve (CN IX). The mylohyoid muscle is innervated by the inferior alveolar nerve, a branch of the mandibular nerve. Finally, the geniohyoid muscle is innervated by the olfactory nerve (CN I) via the hypoglossal nerve.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 72
Incorrect
-
A 55- year old male patient with cancer of the head of the pancreas was to undergo whipple's operation to have the tumour removed. During the surgery, the surgeon had to ligate the inferior pancreaticoduodenal artery to stop blood supply to the head of the pancreas. Which of the following arteries does the inferior pancreaticoduodenal artery branch from?
Your Answer: Splenic artery
Correct Answer: Superior mesenteric artery
Explanation:The inferior pancreaticoduodenal artery is a branch of the superior mesenteric artery or from the first intestinal branch of the superior mesenteric artery. Once given off, it runs to the right between the pancreatic head and the duodenum and then ascends to form an anastomosis with the superior pancreaticoduodenal artery.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 73
Incorrect
-
A 30 year old gym coach presented to the surgical out patient clinic with a lump in the inguinal region. He was booked for surgery, during which, the surgeon opened the inguinal region and found a hernial sac with a small segment of intestine projecting through the abdominal wall. It was located just above the inguinal ligament and lateral to the inferior epigastric vessels. What type of hernia was this?
Your Answer: An obturator hernia
Correct Answer: An indirect inguinal hernia
Explanation:An indirect inguinal hernia exits the abdominal cavity lateral to the inferior epigastric vessels and enters the inguinal canal through the deep inguinal ring. These are the most common types of hernias often caused by heavy weigh lifting. Direct inguinal hernias exit the abdominal cavity medial to the inferior epigastric vessels through weak fascia.
Congenital inguinal hernias are indirect hernias that occur due to persistence of the processus vaginalis.
Femoral hernias occur when abdominal viscera push through the femoral ring in the femoral canal.
Incisional hernia occurs after surgery when the omentum or organ protrudes through a previous site of incision.
Obturator hernia are a very rare type of hernia where the pelvic or abdominal contents protrude through the obturator foramen.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 74
Incorrect
-
A 60 year old female patient who has suffered an embolic stroke that affected her middle cerebral artery as revealed by a CT scan is likely to exhibit which of the following neurologic conditions?
Your Answer: Bitemporal hemianopia
Correct Answer: Contralateral hemiplegia
Explanation:The middle cerebral artery is a major artery that supplies blood to the cerebrum. It continues from the internal carotid artery up into the lateral sulcus. The middle cerebral artery mainly supplies the lateral aspect of the cerebral cortex, anterior aspect of the temporal lobes and the insular cortices.
Functional areas supplied by this vein are as follows:
The motor and pre-motor areas
The somato-sensory
Auditory areas
Motor speech
Sensory speech
Pre-frontal area
Occlusion of the middle cerebral artery results in:
i) A severe contralateral hemiplegia, most marked in the upper extremity and face
ii) A contralateral sensory impairment worse in the upper part of the body.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 75
Correct
-
Which muscle would be affected most following injury to the transverse cervical artery?
Your Answer: Trapezius
Explanation:The latissimus dorsi receives blood from the thoracodorsal artery, the supraspinatus receives its blood from the suprascapular artery, the levator scapulae and the rhomboids are supplied by the dorsal scapular artery and the transverse cervical artery supplies blood to the trapezius.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 76
Incorrect
-
When conducting an exploratory laparotomy procedure of a patient diagnosed with a bleeding ulcer of the lesser curvature of the stomach, which artery in this patient are you most likely to ligate to control the bleeding?
Your Answer: Gastroduodenal
Correct Answer: Left gastric
Explanation:The lesser curvature of the stomach is supplied by the left gastric artery along with the right gastric artery. These two arteries are the ones to most likely be ligated if bleeding was to be stopped at the lesser curvature of the stomach. The splenic artery branches from the celiac branch and supplies the spleen. The left gastro-omental, the right and left gastroepiploic arteries supply the greater curvature.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 77
Incorrect
-
A neurotransmitter of the nigrostriatal pathway is:
Your Answer: Gamma-aminobutyric acid (GABA)
Correct Answer: Dopamine
Explanation:Dopamine acts as a neurotransmitter in the brain, activating dopamine receptors. It is also a neurohormone released from the hypothalamus. It plays an important role in the reward system. It is believed that dopamine provides a teaching signal to parts of the brain responsible for acquiring new motor sequences (behaviours), by activation of dopamine neurons when an unexpected reward is presented. Loss of dopamine neurones in the nigrostriatal pathway causes Parkinson’s disease. In the frontal lobes, dopamine controls the flow of information from other areas of the brain, and thus, dopamine disorders in this region can cause a decline in neurocognitive functions, especially memory, attention and problem solving. Reduced dopamine concentrations in the prefrontal cortex are thought to contribute to attention-deficit disorder and some symptoms of schizophrenia. Dopamine is also the primary neuroendocrine regulator of the secretion of prolactin from the anterior pituitary gland. Dopamine is also commonly associated with the pleasure system of the brain. This plays a key role in understanding the mechanism of action of drugs (such as cocaine and the amphetamines), which seem to be directly or indirectly related to the increase of dopamine.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 78
Incorrect
-
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: Common hepatic
Correct 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 79
Incorrect
-
Which is the correct statement regarding gonadal venous drainage:
Your Answer: The right and left ovarian or testicular veins drain into the same vessel
Correct 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 80
Incorrect
-
Which Statement is true of the brachial plexus?
Your Answer: The suprascapular nerve is a branch of the lower trunk
Correct Answer: The posterior cord continues as the axillary nerve
Explanation:The lateral cord continues as the musculocutaeous nerve.
The medial cord continues as the ulnar nerve.
The posterior cord continues as the radial nerve and the axillary nerve.
The nerve to subclavius muscle is a branch of the C6 root.
The suprascapular nerve is a branch from the upper trunk.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 81
Incorrect
-
Which one of the following muscles is innervated by the facial nerve?
Your Answer: Anterior belly of digastric
Correct 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 82
Incorrect
-
Inside the palatoglossal arch is a muscle. Which nerve innervates this muscle?
Your Answer: VII
Correct Answer: X
Explanation:The palatoglossal arch contains the palatoglossal muscle which is innervated by the vagus nerve which is the tenth cranial nerve. So the correct answer is X
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 83
Incorrect
-
Following a lacerating injury along the anterior border of the trapezius muscle in the neck, a man has the point of his shoulder (scapula) sagging and he has difficulty with full abduction of his arm. Which nerve is most likely injured?
Your Answer: Medial cutaneous nerve of the arm
Correct Answer: Accessory (cranial nerve XI)
Explanation:Injury to the accessory nerve denervates the trapezius muscle so that the person will no longer be able to raise the acromion of the shoulder. The dorsal scapular nerve supplies the rhomboids i.e. major and minor and the levator scapulae so that injury to this nerve weakens retraction of the scapula. The greater occipital nerve is responsible for sensation of the posterior scalp. The axillary nerve innervates the deltoid muscle which is responsible for abduction of the arm and the suprascapular nerve is responsible for rotating the humerus laterally. Cutaneous nerves supply the skin.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 84
Incorrect
-
All the following arteries contribute to the blood supply of the hip joint except:
Your Answer: Lateral femoral circumflex
Correct Answer: Pudendal
Explanation:The blood supply to the hip joint is from two main arteries, the medial circumflex femoral and lateral circumflex femoral arteries. These are branches of the deep artery of the thigh, which itself is a branch of the femoral artery. There is contribution of blood supply from the inferior gluteals, foveal and obturator arteries.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 85
Incorrect
-
Which of the following muscles winds around the pterygoid hamulus?
Your Answer: Palatopharyngeus
Correct Answer: Tensor veli palatini
Explanation:The tensor veli palatini tenses the soft palate and by doing so, assists the levator veli palatini in elevating the palate to occlude and prevent entry of food into the nasopharynx during swallowing. It arises by a flat lamella from the scaphoid fossa at the base of the medial pterygoid plate, from the spina angularis of the sphenoid and from the lateral wall of the cartilage of the auditory tube. Descending vertically between the medial pterygoid plate and the medial pterygoid muscle, it ends in a tendon which winds around the pterygoid hamulus, being retained in this situation by some of the fibres of origin of the medial pterygoid muscle. Between the tendon and the hamulus is a small bursa. The tendon then passes medialward and is inserted onto the palatine aponeurosis and the surface behind the transverse ridge on the horizontal part of the palatine bone.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 86
Correct
-
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 87
Incorrect
-
Regarding abduction of the digits of the hand, which of the following is correct?
Your Answer: Adduction of the digits will be affected by carpal tunnel syndrome
Correct Answer: All of the adductors of the digits take at least part of their attachments from metacarpal bones
Explanation:Lying on the palmer surfaces of the metacarpal bones are four palmar interossei which are smaller than the dorsal interossei. Arising from the entire length of the metacarpal bone of one finger, is a palmar interosseous, which is inserted into the side of the base of the first phalanx and the aponeurotic expansion of the extensor digitorum communis tendon to the same finger. All the interossei are innervated by the eighth cervical nerve, through the deep palmar branch of the ulnar nerve. The palmar interossei adducts the fingers to an imaginary line drawn longitudinally through the centre of the middle finger.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 88
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 89
Correct
-
A 50 year old male point was diagnosed with tennis elbow that became worse after he started playing basket ball over the last three months. He was admitted to the orthopaedic ward to have elbow braces fitted. What type of synovial joint is the elbow joint?
Your Answer: Hinge
Explanation:The elbow joint is one of the many synovial joints in the body. This joint is an example of the hinge joint as the humerus is received into the semilunar notch of the ulna and the capitulum of the humerus articulates with the fovea on the head of the radius, together acting as a hinge in one plane.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 90
Incorrect
-
A 32-year old gentleman came to the emergency department, complaining of progressively increasing weakness in his arms and legs over 5 days. On examination, there is symmetrical weakness on both sides of his face, along with weakness of the proximal and distal muscles of all four limbs. No loss of sensation noted. Deep tendon reflexes could not be elicited and plantar responses were downward. On enquiry, it was revealed that he had an upper respiratory tract infection 10 days ago. The likely diagnosis is:
Your Answer: Polymyositis
Correct Answer: Guillain–Barré syndrome
Explanation:Guillain–Barré syndrome (GBS) is an acute, autoimmune polyradiculoneuropathy which affects the peripheral nervous system and is usually triggered by an acute infectious process. 75% patients have a history of acute infection within the past 1–4 weeks, usually respiratory or gastrointestinal. immunisations have also been implicated. The most common form is acute inflammatory demyelinating polyneuropathy. It results in an ascending paralysis with complete loss of deep tendon reflexes. Treatment includes immunoglobulins and supportive care. However, the disease may be fatal due to severe pulmonary complications and dysautonomia.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 91
Incorrect
-
A medical officer was shown an X ray with barium contrast and was asked to distinguish the small from the large bowel. Which of the following features listed is CORRECT?
Your Answer: Circular smooth muscle layer in the wall
Correct Answer: Circular folds of the mucosa
Explanation:Distinguishing features include:
1. Three strips of longitudinal muscle-taenia coli- on the wall instead of a continuous surrounding longitudinal muscle that is seen in the small intestine
2. The colon has bulges called haustra that are not on the small bowel.
3. The surface of the colon is covered with fatty omental appendages. Both the colon and the small intestine have similar circular smooth muscle layer, serosa. Peyer’s patches are lymphoid tissues that are not visible on X ray with barium contrast.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 92
Incorrect
-
What best describes the muscles of the posterior compartment of the leg?
Your Answer: A-It crosses two joints
Correct Answer: One of the posterior compartment leg muscles laterally rotates the femur
Explanation:The muscles of the back of the leg are subdivided into two groups: superficial and deep. Superficial muscles include gastrocnemius, soleus and plantaris and are the chief extensors of the foot at the ankle joint. Deep muscles include the tibialis posterior, flexor hallucis longus, flexor digitorum longus and popliteus
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 93
Incorrect
-
An ultrasound report of a 35-year old female patient revealed that she had cancer of the pancreas and presented with subsequent severe obstructive jaundice. In which part of this was woman's pancreas was the tumour most likely located?
Your Answer: Tail
Correct Answer: Head
Explanation:The pancreas is divided into five parts; the head, body, neck, tail, and the uncinate process. Of the five parts, tumours located at the head of the pancreas in most instances cause obstruction of the common bile duct more often than tumours in the other parts of the pancreas. This is because the common bile duct passes through the head of the pancreas from the gallbladder and the liver (it is formed where the cystic and the hepatic bile duct join) to empty bile into the duodenum. This biliary obstruction leads to accumulation of bile in the liver and a consequent bilirubinaemia (raised levels of blood bilirubin). This results in jaundice. The pancreas is not divided into lobes.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 94
Incorrect
-
A 19 year old male patient exhibiting signs of shock was brought to the casualty after he had fallen from the 3rd floor of a building. An examination carried out revealed tenderness on the left mid-posterior axillary line and low blood pressure. Further palpation revealed a large swelling that protruded downward and medially below the left costal margin. X-rays showed that the 9th and the 10th ribs were fractured near their angles. Considering these results, which abdominal organ was likely injured by the fractured ribs.
Your Answer: Left kidney
Correct Answer: Spleen
Explanation:The spleen, left kidney, stomach, the splenic flexure of the colon and the suprarenal glands are all in the same quadrant- the left upper quadrant. However, the spleen is the most readily injured organ when there is fracture to the 10th, 11th and the 12th ribs because of its close association with these ribs. This patient exhibits a great indication of a ruptured spleen (tenderness on the left mid and posterior axillary line). The spleen is a thin capsulated organ with a spongy parenchyma, allowing it to bleed profusely in the event of injury. The liver, head of the pancreas and the duodenum are all in the right upper quadrant.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 95
Incorrect
-
The surgical registrar is doing an exploratory laparotomy on a 35 year old lady of African descent with tuberculous of the abdomen and suspected perforation. The small bowel is matted due to adhesions and it is difficult to differentiate the ileum from the jejunum. Which of the following features is typical of the jejunum?
Your Answer: It has thinner and fewer vascular coats
Correct Answer: It has sparse aggregated lymph nodules
Explanation:The jejunum has a wider diameter, is thicker and more vascularized, hence of a deeper colour compared to the ileum. The valvulae conniventes (circular folds) of its mucous membranes are large and thick and its villi are larger than those in the ileum. The jejunum also has sparse aggregates of lymph nodules and most of its part occupies the umbilical and left iliac regions whilst the ileum is mostly in the umbilical, hypogastric, right iliac and pelvic regions.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 96
Incorrect
-
In a splenectomy procedure, special care is emphasized on the preservation of the tail of the pancreas that is closely associated with the spleen to avoid post operative pancreatic fistula. As a general surgeon conducting a splenectomy where are you most likely to find the tail of the pancreas in the abdominal cavity?
Your Answer: Falciform ligament
Correct Answer: Splenorenal ligament
Explanation:The tail of the pancreas is the only intraperitoneal part of the pancreas and is found contained in the splenorenal ligament of the peritoneal cavity. The splenorenal ligament is derived from the peritoneum where the wall of the general peritoneal cavity connects to the omental bursa between the spleen and the left kidney. This ligament contains the splenic vessels and the tail of the pancreas.
The gastrocolic ligament stretches from the greater curvature of the stomach to the transverse colon, connecting the two.
The gastrosplenic ligament is derived from the greater omentum and is the structure that connects the stomach to the hilum of the spleen. The gastrosplenic ligament continues from the splenic flexure of the colon to the diaphragm and acts as a support to the spleen.
The transverse colon is connected to the abdominal wall by the mesocolon ligament.
The falciform ligament on the other hand, attaches the liver to the ventral wall of the abdomen.
The hepatoduodenal ligament connects the porta hepatis of the liver to the superior part of the duodenum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 97
Incorrect
-
What is the nerve supply to the muscles of the lateral compartment of the leg ?
Your Answer: Tibial nerve
Correct Answer: Superficial peroneal nerve
Explanation:The peroneus longus and peroneus brevis in the lateral compartment of the leg take nerve supply from the superficial peroneal nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 98
Incorrect
-
Which one of the following is a derivative of the midgut?
Your Answer:
Correct 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 99
Incorrect
-
A 45 year old female had a stroke and was diagnosed with a homonymous hemianopsia. Which of the following structures was likely affected?
Your Answer:
Correct Answer: Optic radiation
Explanation:Hemianopia or hemianopsia, is the loss of vision of half of the eye or loss of half the visual field. Homonymous hemianopia is the loss of vision or blindness on half of the same side of both eyes (visual field) – either both lefts of the eyes or both rights of the eyes. This condition is mainly caused by cerebrovascular accidents like a stroke that affects the optic radiation.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 100
Incorrect
-
A 35 year old patient presenting with haematemesis, heart burn and bloody stool was diagnosed with a duodenal ulcer that had eroded the gastroduodenal artery. The patient was then rushed into theatre for an emergency procedure to control the haemorrhage. If the surgeon decided to ligate the gastroduodenal artery at its origin, which of the following arteries would most likely experience retrograde blood flow from collateral sources as a result of the ligation?
Your Answer:
Correct Answer: Right gastroepiploic
Explanation:In the stomach and around the duodenum, there are many arterial anastomoses. Ligation of the gastroduodenal artery would result in the retrograde flow of blood from the left gastroepiploic artery to the right gastroepiploic artery. The blood flows into the right gastroepiploic artery, a branch of the gastroduodenal artery from the left gastroepiploic artery that branches from the splenic artery. This retrograde blood flow is aimed at providing alternate blood flow to the greater curvature of the stomach.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 101
Incorrect
-
On exploration of an axillary wound, a branch from the third part of the axillary artery was found to be transected. Which of the following arteries would have been likely injured?
Your Answer:
Correct Answer: Anterior circumflex humeral
Explanation:The axillary artery gives off many branches from the first, second, or third parts along its course. The third part of the axillary artery gives off 3 branches: the subscapular, anterior and posterior circumflex humeral arteries.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 102
Incorrect
-
After a car accident, a 30-year-old woman is alert and only has minor, superficial injuries. 2 hours later, she becomes unconscious and a CT scan reveals a convex, lens-shaped haemorrhage over the right parietal region. The most likely diagnosis is:
Your Answer:
Correct Answer: Epidural haematoma
Explanation:Epidural haematomas are usually caused by arterial bleeding, classically due to damage to the middle meningeal artery by a temporal bone fracture. Symptoms develop within minutes to several hours after the injury and consist of increasing headache, decreased level of consciousness, hemiparesis and pupillary dilation with loss of light reactivity. Around 15–20% of epidural hematomas are fatal.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 103
Incorrect
-
Which statement is true about the inferior sagittal sinus?
Your Answer:
Correct Answer: Is formed between two layers of meningeal dura
Explanation:The inferior sagittal sinus is also known as the inferior longitudinal sinus. It courses along the inferior border of the falx cerebri, superior to the corpus callosum. It is cylindrical in shape and increases in size as it passes backward ending in the straight sinus. It receives blood from the deep and medial aspects of the cerebral hemispheres and drains into the straight sinus.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 104
Incorrect
-
A football player sustained an injury to his ankle. The wound went through the skin, subcutaneous tissue and flexor retinaculum. Which other structure passing under the retinaculum may be injured?
Your Answer:
Correct Answer: Tibial nerve
Explanation:The flexor retinaculum is immediately posterior to the medial malleolus. The structures that pass under the flexor retinaculum from anterior to posterior are: tendon of the tibialis posterior, flexor digitorum longus, posterior tibial artery (and vein), tibial nerve and tendon of flexor hallucis longus. The tibial nerve is the only one which lies behind the flexor retinaculum.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 105
Incorrect
-
A chest x ray is ordered for a 39 year old man who presents with a history of a cough and weight loss for over a month. It shows a rounded opacity in the pleural cavity near the cardiac notch. The opacity is most likely to be in the:
Your Answer:
Correct Answer: Costomediastinal recess
Explanation:The costomediastinal recess is the point where the costal pleura becomes the mediastinal pleura, located right next to the cardiac notch.
The cupola: part of the parietal pleura that extends above the first rib to the root of the lung.
Hilum: located on the medial surface of the lung where neurovascular structures enter and leave the lung.
Pulmonary ligament: pleural fold found below the root of the lung, is a point of continuity between the visceral and mediastinal pleura.
Costodiaphragmatic recess: the lowest extent of the pleural cavity.
Superior mediastinum: part of the mediastinum that contains the great vessels leaving and entering the heart.
The cardiac notch is in the inferior mediastinum.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 106
Incorrect
-
A mechanic sustained a deep laceration to his right cubital fossa which resulted in him unable to move the proximal radioulnar joint of his right arm. Which muscles was affected?
Your Answer:
Correct Answer: Pronator teres
Explanation:The correct answer is the pronator teres muscle. This muscle arises from 2 heads of origin: the humerus and ulnar. Between the 2 heads is the site of entrance of median nerve to the forearm. This muscle acts on the proximal radio-ulnar joint to rotate the radius on the ulna, otherwise known as pronation. It also assists in forearm flexion if the radius is fixed.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 107
Incorrect
-
Which of the following is a fact worth noting about the development of the spleen?
Your Answer:
Correct Answer: It develops in the dorsal mesogastrium
Explanation:The spleen in the human embryo arises in week 5 of intrauterine life. It appears as a proliferating mesenchyme above the pancreas. The spleen is one the organs that develops in the dorsal mesogastrium. When the stomach changes its position during development, the spleen is made to move behind the stomach and stays in contact with the left kidney. The spleen is found within the peritoneum of the abdominal cavity thus it is an intraperitoneal organ.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 108
Incorrect
-
At which cervical level does the common carotid artery bifurcate into the internal and external carotid arteries?
Your Answer:
Correct 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 109
Incorrect
-
Rapid Eye Movement (REM) sleep is typically associated with:
Your Answer:
Correct 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 110
Incorrect
-
In which situation is a stretch reflex such as knee jerk likely to be exaggerated?
Your Answer:
Correct Answer: In upper motor neuron lesion
Explanation:A stretch reflex is a monosynaptic reflex that causes muscle contraction in response to stretching within that muscle. The sensory apparatus in a muscle that are sensitive to stretch are the muscle spindles. The patellar (knee jerk) reflex is an example. In upper motor neuron lesions, the stretch reflexes tend to be brisk due to loss of inhibitory signals on gamma neurons through the lateral reticulospinal tract.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 111
Incorrect
-
A young boy fell from a tree, sustaining an injury to the elbow area and damaging the nerve behind the medial epicondyle of the humerus. What is the most likely result from that injury?
Your Answer:
Correct Answer: Flexion in the distal interphalangeal joint of digit 5
Explanation:The nerve injured in this situation is the ulnar nerve. It passes posterior to the medial epicondyle of the humerus before going between the two heads of the flexor carpi ulnaris muscle. This nerve supplies the muscles and skin of forearm and hand. At the level of medial epicondyle, the injury will led to paralysis in flexor carpi ulnaris and the ulnar half of the flexor digitorum profundus as well as the palmar interossei and hypothenar muscles in the hand. The correct answer will be that the boy will suffer from inability to flex the distal interphalangeal joint of digit 5
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 112
Incorrect
-
Which of the following foramina provides a passage through which the vestibulocochlear nerve, passes?
Your Answer:
Correct Answer: Internal acoustic meatus
Explanation:The internal auditory meatus is a canal within the petrous part of the temporal bone of the skull between the posterior cranial fossa and the inner ear. It 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 113
Incorrect
-
Which of the cranial nerves is responsible for touch sensation on the skin over the maxilla region and the mandible?
Your Answer:
Correct Answer: Trigeminal
Explanation:The sensation of the face is provided by the trigeminal nerve which is cranial nerve V. It is also responsible for other motor functions such as biting and chewing. The trigeminal nerve has three branches; the ophthalmic nerve (V1), the maxillary nerve((V2) and the mandibular nerve (V3). These three branches exit the skull through separate foramina, namely; the superior orbital fissure, the foramen rotundum and the foramen ovale respectively. The mnemonic for this is ‘Standing room only’. The sensory fibres of the maxillary nerve are distributed to the lower eyelid and cheek, the nares and upper lip, the upper teeth and gums, the nasal mucosa, the palate and roof of the pharynx, the maxillary, ethmoid and sphenoid sinuses, and parts of the meninges. The sensory fibres of the mandibular nerve are distributed to the lower lip, the lower teeth and gums, the floor of the mouth, the anterior two-thirds of the tongue, the chin and jaw (except the angle of the jaw, which is supplied by C2–C3), parts of the external ear, and parts of the meninges. The mandibular nerve carries touch/ position and pain/temperature sensation from the mouth. The sensory fibres of the ophthalmic nerve are distributed to the scalp and forehead, the upper eyelid, the conjunctiva and cornea of the eye, the nose (including the tip of the nose), the nasal mucosa, the frontal sinuses and parts of the meninges (the dura and blood vessels). The sensory fibres of the maxillary nerve are distributed to the lower eyelid and cheek, the nares and upper lip, the upper teeth and gums, the nasal mucosa, the palate and roof of the pharynx, the maxillary, ethmoid and sphenoid sinuses, and parts of the meninges.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 114
Incorrect
-
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:
Correct 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.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 115
Incorrect
-
Injury to the supraspinatus muscle will affect:
Your Answer:
Correct Answer: Initiation of abduction of the humerus
Explanation:This muscle arises from the medial two-thirds of the supraspinatus fossa and from the supraspinatus fascia. It is inserted into the highest impression on the greater tubercle of the humerus after passing over the upper part of the shoulder joint. It works with the deltoid to raise the arm from the side of the trunk and initiate abduction. It also assists in fixation of the head of the humerus in the glenoid cavity.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 116
Incorrect
-
Mechanical distortion, and not K+ channels are responsible for distortion of which of the following structures?
Your Answer:
Correct Answer: Pacinian corpuscle
Explanation:Pacinian corpuscles are a type of mechanoreceptor, sensitive to deep pressure, touch and high-frequency vibration. The Pacinian corpuscles are ovoid and about 1 mm long. In the centre of the corpuscle is the inner bulb, which is a fluid-filled cavity with a single afferent unmyelinated nerve ending. Any deformation in the corpuscle causes the generation of action potentials by opening of pressure-sensitive sodium ion channels in the axon membrane. This allows influx of sodium ions, creating a receptor potential (independent of potassium channels).
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This question is part of the following fields:
- Neurology
- Physiology
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Question 117
Incorrect
-
Which ectopic tissue is usually contained in the Meckel's diverticulum?
Your Answer:
Correct Answer: Gastric
Explanation:The Meckel’s diverticulum is a vestigial remnant of the omphalomesenteric duct. This structure is also referred to as the vitelline and contains two types of ectopic tissue, namely; gastric and pancreatic.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 118
Incorrect
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A lesion involving the lateral portion of the dorsal columns at the level of the nape of the neck will most likely affect:
Your Answer:
Correct Answer: Vibratory sensations from the ipsilateral arm
Explanation:At the level mentioned in the question, the lateral portion of dorsal columns comprises of the fasciculus cuneatus. Axons carrying the sensations of touch, vibration and proprioception from the ipsilateral arm enter the spinal cord and ascend in the fasciculus cuneatus, synapsing in the nucleus cuneatus of the caudal medulla. Secondary neurons from this nucleus give rise to internal arcuate fibres, which decussate and ascend to the thalamus as the medial lemniscus. Tertiary neurons from there project to the ipsilateral somatosensory cortex. Thus, any damage to the fasciculus cuneatus will result in a deficit in tactile, proprioceptive and vibratory sensations in the ipsilateral arm, and not the contralateral arm.
Fine motor control of the fingers is mainly carried by the ipsilateral lateral corticospinal tract in the lateral funiculus of the cord. Motor control of the contralateral foot is carried by the ipsilateral corticospinal tract in the lateral funiculus of the cord. Lack of sweating of the face could be produced by interruption of sympathetic innervation. Proprioception from the ipsilateral leg is carried by the fasciculus gracilis in the medial part of the dorsal columns.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 119
Incorrect
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A 28 year gang member was shot in the chest. The bullet hit a vessel that courses horizontally across the mediastinum. Which of the following vessels is it likely to be?
Your Answer:
Correct Answer: Left brachiocephalic vein
Explanation:The superior vena cava that empties blood into the right atrium is formed by the right and the left brachiocephalic veins. Hence, the left brachiocephalic has to course across the mediastinum horizontally to join with its right ‘counterpart’. The left subclavian artery and vein being lateral to the mediastinum do not cross the mediastinum while the left jugular and the common carotid artery course vertically.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 120
Incorrect
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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:
Correct 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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