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  • Question 1 - An explorative laparotomy is done on a 23 year old following a gunshot...

    Incorrect

    • An explorative laparotomy is done on a 23 year old following a gunshot abdominal injury through the right iliac fossa. It is found that the ileocolic artery is severed and the bullet had perforated the caecum. From which branch does the ileocolic artery originate?

      Your Answer: Inferior mesenteric artery

      Correct Answer: Superior mesenteric artery

      Explanation:

      Ileocolic artery branches off from the superior mesenteric artery. It then divides to give a superior and inferior branch.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      31.9
      Seconds
  • Question 2 - A 20-year old gentleman was brought to the emergency department with headache and...

    Correct

    • A 20-year old gentleman was brought to the emergency department with headache and nausea for 2 days. He also complained of intolerance to bright light and loud sounds. Lumbar puncture showed glucose < 45 mg/dl, protein > 5 mg/dl and neutrophil leucocytosis. The likely diagnosis is:

      Your Answer: Meningitis

      Explanation:

      Diagnosis of meningitis can be carried out with examination of cerebrospinal fluid (CSF) with a lumbar puncture (LP). In a case of bacterial meningitis, the CSF analysis will show:

      – Opening pressure: > 180 mmH2O

      – White blood cell count: 10–10 000/μl with neutrophil predominance

      – Glucose: < 40 mg/dl – CSF glucose to serum glucose ratio: < 0.4 – Protein: > 4.5 mg/dl

      – Gram stain: positive in > 60%

      – Culture: positive in > 80%

      – Latex agglutination: may be positive in meningitis due to Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli and group B streptococci

      – Limulus, lysates: positive in Gram-negative meningitis

    • This question is part of the following fields:

      • Neurology
      • Physiology
      19.8
      Seconds
  • Question 3 - The nutcracker effect of the alimentary canal is described as a nutcracker-like compression...

    Incorrect

    • The nutcracker effect of the alimentary canal is described as a nutcracker-like compression caused by the aorta and the superior mesenteric arteries on a certain section of the alimentary canal leading to bowel obstruction. Which of the following parts of the alimentary canal is usually obstructed by this nutcracker compression of the two arteries?

      Your Answer: Jejunum

      Correct Answer: Duodenum

      Explanation:

      The ‘nutcracker effect’ is only seen in one part of the alimentary canal, and that is in the third part of the duodenum. This can happen when the superior mesenteric artery that passes across the duodenum and the aorta, posteriorly to the third part of the duodenum enlarges and starts compressing the duodenum. The result is an obstructed duodenum that inhibits passage of food.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      30.4
      Seconds
  • Question 4 - A urologist makes a transverse suprapubic incision to retrieve a stone from the...

    Incorrect

    • A urologist makes a transverse suprapubic incision to retrieve a stone from the urinary bladder. Which of the following abdominal wall layers will the surgeon NOT traverse?

      Your Answer: Rectus abdominis muscle

      Correct Answer: Posterior rectus sheath

      Explanation:

      Pfannenstiel incision (a transverse suprapubic incision) is made below the arcuate line. Thus, there is no posterior layer of the rectus sheath here, only the transversalis fascia lines the inner layer of the rectus abdominis. The layers traversed include: skin, superficial fascia (fatty and membranous), deep fascia, anterior rectus sheath, rectus abdominis muscle, transversalis fascia, extraperitoneal connective tissue and peritoneum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      21.1
      Seconds
  • Question 5 - During an appendicectomy in a 16 year old girl, the registrar initially did...

    Correct

    • During an appendicectomy in a 16 year old girl, the registrar initially did not find the appendix on entering the peritoneal cavity. She, however, remained calm as she knew she could find it by:

      Your Answer: Looking at the confluence of the taenia coli

      Explanation:

      The vermiform appendix arises from the apex of the caecum. Although it has a constant base, it can pass in one of several directions such as upward behind the caecum, to the left behind the ileum and mesentery or downward into the lesser pelvis. It is retained in place by a peritoneal fold, the mesoenteriole derived from the left leaf of the mesentery. Taenia coli meet at the appendix which is the terminal portion of the caecum. The appendix is below the ileocecal valve, not above. It is not near the right colic artery (which supplies the ascending colon). It would not be found by removing a layer of the jejuno-ileum and is not in the pelvic brim.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      28.4
      Seconds
  • Question 6 - Cranial nerve XII, the hypoglossal nerve, innervates which one of the following muscles...

    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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      16.6
      Seconds
  • Question 7 - On exploration of an axillary wound, a branch from the third part of...

    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: Thoracoacromial

      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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      14.3
      Seconds
  • Question 8 - A 20 year old is brought to the A&E after he fell from...

    Incorrect

    • A 20 year old is brought to the A&E after he fell from a moving cart. The boy has sustained blunt abdominal injury, and the there is a possibility of internal bleeding as the boy is in shock. An urgent exploratory laparotomy is done in the A&E theatre. On opening the peritoneal cavity, the operating surgeon notices a torn gastrosplenic ligament with a large clot around the spleen. Which artery is most likely to have been injured in this case?

      Your Answer: Splenic

      Correct Answer: Short gastric

      Explanation:

      The short gastric arteries branch from the splenic artery near the splenic hilum to travel back in the gastrosplenic ligament to supply the fundus of the stomach. Therefore, these may be injured in this case.

      The splenic artery courses deep to the stomach to reach the hilum of the spleen. It doesn’t travel in the gastrosplenic ligament although it does give off branches that do.

      The middle colic artery is a branch of the superior mesenteric artery that supplies the transverse colon.

      Gastroepiploic artery is the largest branch of the splenic artery that courses between the layers of the greater omentum to anastomose with the right gastroepiploic.

      Left gastric artery, a branch of the coeliac trunk. It supplies the left half of the lesser curvature.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      37.8
      Seconds
  • Question 9 - The primary motor cortex is located in the: ...

    Correct

    • The primary motor cortex is located in the:

      Your Answer: Precentral gyrus

      Explanation:

      The primary motor cortex is located in the dorsal part of the precentral gyrus and the anterior bank of the central sulcus. The precentral gyrus lies anterior to the postcentral gyrus and is separated from it by a central sulcus. Its anterior border is the precentral sulcus, while inferiorly it borders to the lateral fissure (Sylvian fissure).

    • This question is part of the following fields:

      • Neurology
      • Physiology
      9
      Seconds
  • Question 10 - A 70-year old man who is suspected to have a perforated colonic diverticulum...

    Correct

    • A 70-year old man who is suspected to have a perforated colonic diverticulum is explored in theatre through a midline incision. This incision will be through the:

      Your Answer: Linea alba

      Explanation:

      The linea alba is the point where this incision was made. It is a tendinous raphe in the midline of the abdomen extending between the xiphoid process and the symphysis pubis. It is placed between the medial borders of the recti and is formed by the blending of the aponeuroses of the external and internal obliques and transversi.

      The linea aspera is a vertical ridge on the posterior surface of the femur.

      The arcuate line is the inferior border of the posterior rectus sheath behind the rectus abdominis muscle.

      The semilunar line is the lateral margin of the rectus abdominis.

      The iliopectineal line is a line on the pelvic bones formed by the arcuate line of the ilium and the pectineal line of the pubis.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      19.4
      Seconds
  • Question 11 - Which is the CORRECT statement regarding the small intestine: ...

    Incorrect

    • Which is the CORRECT statement regarding the small intestine:

      Your Answer: Postganglionic sympathetic fibres to the jejunum and ileum arise from synapses with preganglionic sympathetic fibres located in the coeliac ganglion

      Correct Answer: The superior mesenteric artery courses between the body and uncinate process of the pancreas before the artery supplies the jejunum and ileum

      Explanation:

      The small intestine extends from the pylorus to the ileocecal valve where It ends in the large intestine. It is surrounded on the sides and above by the large intestine. It is related anteriorly with the greater omentum and abdominal wall. Is connected to the vertebral column by a fold of peritoneum or otherwise known as the mesentery. Is divided into three portions: the duodenum, jejunum and ileum. The jejunum and ileum are supplied by the superior mesenteric artery that courses between the body and uncinate process of the pancreas before it gives off intestinal branches.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      37.1
      Seconds
  • Question 12 - A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of...

    Correct

    • A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of a 25 - year old male patient, accidentally jabbed and injured a vital structure that lies anterior to the left suprarenal organ. Which of the following was the structure most likely injured?

      Your Answer: Pancreas

      Explanation:

      The adrenal (suprarenal) glands are organs of the endocrine system located on top of each of the kidneys. The left suprarenal gland, in question, is crescent in shape and slightly larger than the right suprarenal gland. It is posteriorly located to the lateral aspect of the head of the pancreas which is thus the most likely to be injured. The other organs like the duodenum, liver and the inferior vena cava are related to the right suprarenal gland. The spleen and the colon are not in close proximity with the left suprarenal gland and are not likely to be the organs injured.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      57.5
      Seconds
  • Question 13 - The muscle that depresses the glenoid fossa directly is the: ...

    Incorrect

    • The muscle that depresses the glenoid fossa directly is the:

      Your Answer: Supraspinatus

      Correct Answer: Pectoralis minor

      Explanation:

      Situated at the upper part of the thorax beneath the pectoralis major, is a thin pectoralis minor, triangular muscle. It originates from the third, fourth and fifth ribs, near the cartilage and from the aponeurosis which covers the intercostals. These fibres move upwards and laterally to join and form a flat tendon. This is inserted into the medial border and upper surface of the coracoid process of the scapula. Through this medial anterior thoracic nerve, fibres from the pectoralis minor are received from the eighth cervical and first thoracic nerves. This pectoralis minor pushes down on the point of the shoulder (glenoid fossa), drawing the scapula downward and medially towards the thorax which throws the inferior angle backwards.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      13.3
      Seconds
  • Question 14 - A 25-year-old football player suffers severe head trauma during a game. Physical examination...

    Correct

    • A 25-year-old football player suffers severe head trauma during a game. Physical examination reveals a decerebrate posture and bilateral papilledema. A CT scan reveals marked diffuse cerebral oedema. This condition will be most severe in which component of the brain?

      Your Answer: White matter

      Explanation:

      The greatest amount of salt and water increase with cerebral oedema occurs within the white matter. Any swelling from oedema, haemorrhage or haematoma increases the intracranial pressure (ICP). As the ICP increases, the cerebral perfusion decreases and brain tissue can become ischaemic, even leading to brain death.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      37.9
      Seconds
  • Question 15 - Which statement is true regarding the diaphragmatic openings: ...

    Correct

    • Which statement is true regarding the diaphragmatic openings:

      Your 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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      30
      Seconds
  • Question 16 - The optic foramen, superior orbital fissure, foramen ovale, foramen rotundum and foramen sinosum...

    Correct

    • The optic foramen, superior orbital fissure, foramen ovale, foramen rotundum and foramen sinosum are all located on which bone at the base of the skull?

      Your Answer: Sphenoid

      Explanation:

      The sphenoid bone consists of two parts, a central part and two wing-like structures that extend sideways towards each side of the skull. It forms the base of the skull, and floor and sides of the orbit. On its central part lies the optic foramen. The foramen ovale, foramen spinosum and foramen rotundum lie on its great wing while the superior orbital fissure lies on its lesser wing.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      10.9
      Seconds
  • Question 17 - In the adult heart, the sinus venosus gives rise to the: ...

    Correct

    • In the adult heart, the sinus venosus gives rise to the:

      Your Answer: Coronary sinus

      Explanation:

      The sinus venosus is a large quadrangular cavity which precedes the atrium on the venous side of the chordate heart. It exists distinctly only in the embryonic heart (where it is found between the two venae cavae); however, the sinus venosus persists in the adult. In the adult, it is incorporated into the wall of the right atrium to form a smooth part called the sinus venarum, which is separated from the rest of the atrium by a ridge of fibres called the crista terminalis. The sinus venosus also forms the SA node and the coronary sinus.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      8.8
      Seconds
  • Question 18 - During laparoscopic surgery to repair a direct inguinal hernia in a 68-year old...

    Correct

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

      Your Answer: Medial umbilical ligament and inferior epigastric artery

      Explanation:

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

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      80.2
      Seconds
  • Question 19 - What is expected from complete transection of the inferior gluteal nerve when it...

    Incorrect

    • What is expected from complete transection of the inferior gluteal nerve when it emerges from the greater sciatic foramen?

      Your Answer: The adductor part of the adductor magnus muscle would be affected

      Correct Answer: Extension of the thigh would be the action most affected

      Explanation:

      As the inferior gluteal nerve emerges from the greater sciatic foramen below the piriformis muscle, it divides into branches and enters the gluteus maximus muscle which extends the femur and bends the thigh in line with the body.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      341.5
      Seconds
  • Question 20 - A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates...

    Incorrect

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

      Your Answer: Medial segmental bronchus of the right middle lobe

      Correct Answer: Superior segmental bronchus of the right inferior lobe

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      48
      Seconds
  • Question 21 - A surgeon trainee is assisting in an operation to ligate the ductus arteriosus....

    Incorrect

    • A surgeon trainee is assisting in an operation to ligate the ductus arteriosus. The consultant supervising explains that caution is required when placing a clamp on the ductus to avoid injury to an important structure immediately dorsal to it. To which structure is the consultant referring?

      Your Answer: Right Recurrent laryngeal nerve

      Correct Answer: Left recurrent laryngeal nerve

      Explanation:

      The left recurrent laryngeal nerve branches off the vagus and wraps around the aorta, posterior to the ductus arteriosus/ligamentum arteriosum from whence it courses superiorly to innervate the laryngeal muscles.

      Accessory Hemiazygous vein is on the left side of the body draining the posterolateral chest wall and emptying blood into the azygos vein.

      The left internal thoracic artery is branch of the left subclavian artery supplying blood to the anterior wall of the thorax.

      Left phrenic nerve is lateral to the vagus nerve.

      Thoracic duct: is behind the oesophagus, coursing between the aorta and the azygos vein in the posterior chest.

      Right recurrent laryngeal nerve: loops around the right subclavian artery and is not in danger in this procedure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      24.5
      Seconds
  • Question 22 - A tumour on the floor of the fourth ventricle is most likely to...

    Correct

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

      Your Answer: Abducent

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      122.5
      Seconds
  • Question 23 - During an operation to repair a hiatal hernia, the coeliac branch of the...

    Incorrect

    • 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: Caecum

      Correct 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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      73.8
      Seconds
  • Question 24 - A space defined by the teres major muscle, the teres minor muscle, long...

    Incorrect

    • A space defined by the teres major muscle, the teres minor muscle, long head of the triceps brachii muscle and surgical neck of the humerus contains the axillary nerve and the?

      Your Answer: Thoracodorsal nerve

      Correct Answer: Posterior circumflex humeral artery

      Explanation:

      This quadrangular space transmits the posterior circumflex humeral vessels and the axillary nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      157.1
      Seconds
  • Question 25 - A sudden loud sound is more likely to result in cochlear damage than...

    Incorrect

    • A sudden loud sound is more likely to result in cochlear damage than a slowly developing loud sound. This is because:

      Your Answer: A sudden sound directly damages the vestibular nerve

      Correct Answer: There is a latent period before the attenuation reflex can occur

      Explanation:

      On transmission of a loud sound into the central nervous system, an attenuation reflex occurs after a latent period of 40-80 ms. This reflex contracts the two muscles that pull malleus and stapes closer, developing a high degree of rigidity in the entire ossicular chain. This reduces the ossicular conduction of low frequency sounds to the cochlea by 30-40 decibels. In this way, the cochlea is protected from damage due to loud sounds (these are low frequency sounds) when they develop slowly.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      24.1
      Seconds
  • Question 26 - Which nerve lies immediately medial to the psoas major muscle? ...

    Incorrect

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

      Your Answer: Femoral

      Correct Answer: Obturator

      Explanation:

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

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

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

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

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

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

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      21.5
      Seconds
  • Question 27 - A patient is unable to move their mandible to the left. Which muscle...

    Incorrect

    • A patient is unable to move their mandible to the left. Which muscle is affected in this case?

      Your Answer: Right medial pterygoid muscle

      Correct Answer: Right lateral pterygoid muscle

      Explanation:

      Patients with paralysis of the right pterygoid muscle are unable to move their mandible laterally to the left.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14.7
      Seconds
  • Question 28 - A cerebellar tremor can be differentiated from a Parkinsonian tremor in that: ...

    Correct

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

      Your Answer: It only occurs during voluntary movements

      Explanation:

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

    • This question is part of the following fields:

      • Neurology
      • Physiology
      15.4
      Seconds
  • Question 29 - Inside the palatoglossal arch is a muscle. Which nerve innervates this muscle? ...

    Incorrect

    • Inside the palatoglossal arch is a muscle. Which nerve innervates this muscle?

      Your Answer: VIII

      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

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      13.5
      Seconds
  • Question 30 - Which of the following structures is not easily palpable? ...

    Incorrect

    • Which of the following structures is not easily palpable?

      Your Answer: Hyoid bone

      Correct Answer: Styloid process of the temporal bone

      Explanation:

      The styloid process is a thin, pointed process that projects antero-inferiorly from the base of the petrous temporal bone. It can vary in length from a short, stubby process to a slender, four to five centimetre rod. It forms from the cranial elements of the second pharyngeal arch. The tympanic plate of the temporal bone ensheathes the base of this process. The pointed, projecting portion of the process provides attachment to the stylohyoid and stylomandibular ligaments, and to three muscles – the styloglossus, stylohyoid, and stylopharyngeus. As the styloid process is covered by the various muscles, it is not easily palpable in live subjects.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8.6
      Seconds
  • Question 31 - The petrous part of the internal carotid artery is located inside of which...

    Incorrect

    • The petrous part of the internal carotid artery is located inside of which cranial bone?

      Your Answer: Sphenoid

      Correct Answer: Temporal

      Explanation:

      The petrous segment, or C2, of the internal carotid is that which is inside the petrous part of the temporal bone. This segment extends until the foramen lacerum. The petrous portion classically has three sections: an ascending, or vertical portion; the genu, or bend; and the horizontal portion.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      36.1
      Seconds
  • Question 32 - A 20 year lady is brought to the A&E following a road accident....

    Correct

    • A 20 year lady is brought to the A&E following a road accident. She is hypotensive and a CT scan of the abdomen reveals a shattered spleen. An emergency splenectomy is performed where the splenic artery is ligated right at its origin. Which of the following arteries will have a diminished blood flow owing to ligation of the splenic artery at its origin?

      Your Answer: Left gastroepiploic

      Explanation:

      Ligation of the splenic artery right at its point of origin should cut off blood flow in its branches. The following are the branches of the splenic artery: pancreatic branches, short gastric branches and left gastroepiploic arteries.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      31.8
      Seconds
  • Question 33 - A 45 years old women was diagnosed with breast cancer. After a radical...

    Correct

    • A 45 years old women was diagnosed with breast cancer. After a radical mastectomy to remove all axillary lymph nodes from her right breast, it was noticed that she had a winged scapula. Which nerve injury would explain this?

      Your Answer: Long thoracic nerve

      Explanation:

      The long thoracic nerve supplies the serratus anterior muscle. When this nerve is injured the muscle undergoes paralysis, which is seen clinically as winging of the scapula most apparent when the arm is lifted forward. The long thoracic nerve is greatly susceptible to injury during breast surgery because of its long and superficial course along the thorax from its origin, the brachial plexus, to the lower border of the serratus anterior muscle.

    • This question is part of the following fields:

      • Anatomy
      • Breast
      17.3
      Seconds
  • Question 34 - A 50 year-old man, who sustained a head injury experienced sudden onset of...

    Incorrect

    • A 50 year-old man, who sustained a head injury experienced sudden onset of horizontal double vision. He is diagnosed with lateral rectus palsy. Which of the following nerves is affected in this condition?

      Your Answer: Oculomotor

      Correct Answer: Abducent

      Explanation:

      The lateral rectus muscle is one of the 6 extra-ocular muscles that control eye movements. It is responsible for abduction and is the only muscle that is innervated by the abducens nerve (CN VI).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      33.1
      Seconds
  • Question 35 - Regarding the long head of the biceps femoris, which of the following is...

    Incorrect

    • Regarding the long head of the biceps femoris, which of the following is correct?

      Your Answer: It will extend the leg at the knee

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      35.3
      Seconds
  • Question 36 - The following organs would be expected to lie within the right lower quadrant...

    Correct

    • The following organs would be expected to lie within the right lower quadrant of the abdomen, assuming that the gastrointestinal tract is rotated normally:

      Your Answer: Distal jejunum, caecum, vermiform appendix

      Explanation:

      The abdomen is divided by theoretical anatomic lines into four quadrants. The median plane follows the linea alba and extends from the xiphoid process to the pubic symphysis and splits the abdomen in half. The transumbilical plane is a horizontal line that runs at the level of the umbilicus. This forms the upper right and left quadrants and the lower right and left quadrants. Structures in the right lower quadrant include: caecum, appendix, part of the small intestine, ascending colon, the right half of the female reproductive system, right ureter. Pain in this region is most commonly associated with appendicitis.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      36.9
      Seconds
  • Question 37 - During a procedure to treat an ulcer in the first part of the...

    Correct

    • During a procedure to treat an ulcer in the first part of the duodenum, the most appropriate site to make the incision on the anterior abdominal wall to approach this ulcer would be the:

      Your Answer: Epigastric region

      Explanation:

      The abdomen is divided into nine regions for descriptive purposes. The epigastric region contains the first part of the duodenum, part of the stomach, part of the liver and pancreas. This would be the region that the surgeon would need to enter to access the ulcer.

      Typically, a midline incision in the epigastric region, extending from just below the xiphoid process down to the umbilicus, provides excellent access to the first part of the duodenum.

      The left inguinal region contains the sigmoid colon.

      The left lumbar region contains the descending colon and kidney.

      The right lumbar region contains the right kidney and descending colon.

      The right hypochondrial region contains part of the liver and gall bladder.

      The hypogastric region contains the urinary bladder and the rectum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      33.6
      Seconds
  • Question 38 - Mechanical distortion, and not K+ channels are responsible for distortion of which of...

    Incorrect

    • Mechanical distortion, and not K+ channels are responsible for distortion of which of the following structures?

      Your Answer: Sinoatrial (SA) node

      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).

    • This question is part of the following fields:

      • Neurology
      • Physiology
      42.7
      Seconds
  • Question 39 - Which of the following is the source of blood supply to the artery...

    Correct

    • Which of the following is the source of blood supply to the artery of the round ligament at the head of the femur?

      Your Answer: Obturator artery

      Explanation:

      The posterior branch of the obturator artery provides an articular branch to the head of the femur.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      23.6
      Seconds
  • Question 40 - What is the linea aspera: ...

    Correct

    • What is the linea aspera:

      Your Answer: Serves as an attachment for adductors of the thigh

      Explanation:

      The linea aspera is a prominent longitudinal ridge or crest on the middle third of the femur. It has a medial and a lateral lip and a narrow, rough, intermediate line. The vastus medialis arises from the medial lip of the linea aspera and has superior and inferior prolongations. The vastus lateralis takes origin from the lateral lip . The adductor magnus is inserted into the linea aspera. Two muscles are attached between the vastus lateralis and the adductor magnus: the gluteus maximus is inserted above and the short head of the biceps femoris arises below. Four muscles are inserted between the adductor magnus and the vastus medialis: the iliacus and pectineus superiorly, and the adductor brevis and adductor longus inferiorly.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      82.8
      Seconds
  • Question 41 - An old man was diagnosed with squamous cell carcinoma with axillary lymph node...

    Correct

    • 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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      399.6
      Seconds
  • Question 42 - From which fascia of the pelvic wall muscle does the levator ani muscle...

    Incorrect

    • From which fascia of the pelvic wall muscle does the levator ani muscle arise?

      Your Answer: Puborectalis

      Correct Answer: Obturator internus

      Explanation:

      The levator ani muscle arises from the posterior surface of the superior ramus of the pubis lateral to the symphysis, behind the inner surface of the spine of the ischium and between these points from the obturator internus fascia. It is attached to the inner surface of the side of the lesser pelvic cavity, supports the viscera in the cavity and surrounds the various structures that pass through it.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      32
      Seconds
  • Question 43 - During a case presentation, a 26 year old is said to have fractured...

    Incorrect

    • During a case presentation, a 26 year old is said to have fractured his pelvis and shattered his coccyx following a motorbike accident. It is mentioned that he is likely to have lacerated his middle sacral artery from this kind of injury. Where does the middle sacral artery branch from?

      Your Answer: Fourth lumbar artery

      Correct Answer: Abdominal aorta

      Explanation:

      The middle sacral artery arises from behind the aorta a little above the point of its bifurcation to descend down in front of L4,5, the sacrum and coccyx.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      92.4
      Seconds
  • Question 44 - In the case of an injury to the sub sartorial canal, which of...

    Incorrect

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

      Your Answer: Nerve to sartorius

      Correct Answer: Nerve to vastus medialis

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      184
      Seconds
  • Question 45 - Due to a plantarflexion–inversion ankle sprain, which is the first ligament to rupture?...

    Incorrect

    • Due to a plantarflexion–inversion ankle sprain, which is the first ligament to rupture?

      Your Answer: Talotibial ligament

      Correct Answer: Anterior talofibular ligament

      Explanation:

      The anterior talofibular ligament passes from the anterior margin of the fibular malleolus. It is the most commonly injured ligament, as part of the lateral ligament of the ankle.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      77.4
      Seconds
  • Question 46 - Which of the following will be affected by a lesion in the posterior...

    Correct

    • Which of the following will be affected by a lesion in the posterior column-medial lemniscus system?

      Your Answer: Fine touch

      Explanation:

      The posterior column–medial lemniscus (PCML) pathway is a sensory pathway that transmits fine touch and conscious proprioceptive information from the body to the brain. As the posterior columns are also known as dorsal columns, the pathway is also called the dorsal column–medial lemniscus system or DCML.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      12.2
      Seconds
  • Question 47 - Whipple's procedure involves mobilizing the head of the pancreas. As the surgeon does...

    Incorrect

    • Whipple's procedure involves mobilizing the head of the pancreas. As the surgeon does this, he must be careful to avoid injury to a key structure that is found lying behind the head of the pancreas. Which vital structure is this?

      Your Answer: Portal vein

      Correct Answer: Common bile duct

      Explanation:

      The posterior relations of the head of the pancreas include: the inferior vena cava, the common bile duct, the renal veins, the right crus of the diaphragm and the aorta.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      41.5
      Seconds
  • Question 48 - Which of these structures does NOT pass posterior to the medial malleolus? ...

    Incorrect

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

      Your Answer: Flexor digitorum longus tendon

      Correct Answer: Saphenous vein

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      23.1
      Seconds
  • Question 49 - A surgeon performing a Whipple's procedure, that involves mobilizing the head of the...

    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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      250.1
      Seconds
  • Question 50 - Which of the following arteries branch from the deep femoral artery and course...

    Correct

    • Which of the following arteries branch from the deep femoral artery and course between the pectineus and iliopsoas muscles?

      Your Answer: Medial femoral circumflex

      Explanation:

      The medial femoral circumflex artery is an artery in the upper thigh that supplies blood to the head and neck of the femur. It arises from the deep femoral artery and winds around the medial side of the femur. It passes first between pectineus and psoas major, and then between obturator externus and adductor brevis.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      70.1
      Seconds
  • Question 51 - Which of the following muscles is solely contained in the anterior triangle of...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      21.6
      Seconds
  • Question 52 - Which best describes the sartorius muscle? ...

    Correct

    • Which best describes the sartorius muscle?

      Your Answer: Will flex the leg at the knee joint

      Explanation:

      The sartorius muscle arises from tendinous fibres from the superior iliac spine. It passes obliquely across the thigh from lateral to medial and is inserted into the upper part of the medial side of the tibia. When the sartorius muscle contracts it will flex the leg at the knee joint.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      20.7
      Seconds
  • Question 53 - A surgeon performing a thymectomy to remove a malignant thymoma is careful to...

    Incorrect

    • A surgeon performing a thymectomy to remove a malignant thymoma is careful to avoid damaging an important nerve lying around the arch of the aorta. Which nerve is the surgeon trying to preserve?

      Your Answer: Left phrenic

      Correct Answer: Left Vagus

      Explanation:

      The left vagus nerve lies on the lateral surface of the aortic arch. The left recurrent laryngeal nerve arises from the vagus and loops around the arch of the aorta. This nerve is at risk of injury during surgery.

      The right and left phrenic nerves, being lateral to the vagus, do not loop around the arch of the aorta.

      The sympathetic trunks, both right and left, are located in the posterior chest; not near the aortic arch.

      The right vagus: not involved with the aortic arch.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      15.3
      Seconds
  • Question 54 - Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be...

    Correct

    • Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be seen in:

      Your Answer: Cerebellar disease

      Explanation:

      The given symptoms are seen in diseases affecting the cerebellum. A cerebellar tremor is a slow tremor that occurs at the end of a purposeful movement. It is seen in cerebellar disease, such as multiple sclerosis or some inherited degenerative disorders and chronic alcoholism. Classically, tremors are produced in the same side of the body as a one-sided lesion. Cerebellar disease can also result in a wing-beating’ type of tremor called rubral or Holmes’ tremor – a combination of rest, action and postural tremors. Other signs of cerebellar disease include dysarthria (speech problems), nystagmus (rapid, involuntary rolling of the eyes), gait problems and postural tremor of the trunk and neck.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      68.7
      Seconds
  • Question 55 - A 58-year-old woman has had a headache, fever, lethargy and nausea for the...

    Correct

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

      Your Answer: Chronic brain abscess

      Explanation:

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

    • This question is part of the following fields:

      • Neurology
      • Pathology
      14.5
      Seconds
  • Question 56 - Which of the following is a true statement regarding the pupil? ...

    Incorrect

    • Which of the following is a true statement regarding the pupil?

      Your Answer: Increase in sympathetic activity in fibres innervating the inner eye muscles during darkness results in pupil constriction

      Correct Answer: Phentolamine causes pupil constriction

      Explanation:

      A balance between the sympathetic tone to the radial fibres of the iris and parasympathetic tone to the pupillary sphincter muscle determines the pupil size. Phentolamine (α-adrenergic receptor blocker) causes pupillary constriction. Dilatation of the pupil occurs with increased sympathetic activity, decreased parasympathetic activity during darkness or block of muscarinic receptors by atropine.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      42.3
      Seconds
  • Question 57 - A man came to the hospital complaining of a sensation of pins and...

    Correct

    • A man came to the hospital complaining of a sensation of pins and needles in the dorsum of the thumb and digits 1 and 2. On further examination they found that he had weakness in wrist dorsiflexion and finger extension. Which nerve do you think is injured in this case?

      Your Answer: Radial

      Explanation:

      The radial nerve can be injured in multiple sites along its course in the upper limb, and each site has its own presentation. The major complaint is wrist drop which if high above the elbow, can cause numbness of the forearm and hand. It can last for several days or weeks. The most common site of compression for the radial nerve is at the proximal forearm in the area of the supinator muscles.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      34.9
      Seconds
  • Question 58 - The following joint has an anastomotic circulation that is provided by branches of...

    Incorrect

    • The following joint has an anastomotic circulation that is provided by branches of the brachial artery:

      Your Answer: Head of the humerus

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      177.9
      Seconds
  • Question 59 - A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which...

    Incorrect

    • A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which is the LEAST likely place to find the testis?

      Your Answer: Somewhere in the inguinal canal

      Correct Answer: Perineum

      Explanation:

      Embryologically the testes are retroperitoneal structures in the posterior abdominal wall, attached to the anterolateral abdominal wall by the gubernaculum. The gubernaculum ‘pulls’ the testes through the deep inguinal ring, inguinal canal and superficial inguinal ring and over the pelvic brim. The gubernaculum is preceded by the processus vaginalis that is derived from the peritoneum anterior to the testes. The processus vaginalis pushes the muscle and fascial layers. These eventually make up the canal and the spermatic cord, into the scrotum. The gubernaculum persists as the scrotal ligament while part of the processus vaginalis remains as a bursa-like sac i.e. the tunica vaginalis testes. The testes therefore could be caught in any one of these places along its path of descending. The testes are never in the perineum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      36.9
      Seconds
  • Question 60 - If your EEG shows waves with a frequency range of 8-12 Hz, the...

    Correct

    • If your EEG shows waves with a frequency range of 8-12 Hz, the waves most likely to be seen are:

      Your Answer: Alpha

      Explanation:

      Electroencephalography (EEG) is the neurophysiological measurement of the electrical activity of the brain. It is done by placing electrodes on the scalp or subdurally. In reality, the electrical currents are not measured, but rather the voltage differences between different parts of the brain. Four major types of EEG activity are recognized, which are alpha, beta, delta and theta.

      Alpha waves, also known as Berger’s waves ranges in frequency from 8-12 Hz. Best detected with eyes closed, alpha waves are characteristic of a relaxed, alert state of consciousness. An alpha-like normal variant called mu is sometimes seen over the motor cortex (central scalp) and attenuates with movement or, rather, with the intention to move.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      5.5
      Seconds
  • Question 61 - Injury to this nerve will result to the loss of general sensory innervation...

    Incorrect

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

      Your Answer: Oculomotor nerve

      Correct Answer: Ophthalmic nerve

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      31.4
      Seconds
  • Question 62 - The inferior palpebral nerve ascends behind the orbicularis oculi. What is the terminal...

    Incorrect

    • The inferior palpebral nerve ascends behind the orbicularis oculi. What is the terminal branch of the inferior palpebral nerve?

      Your Answer: Facial nerve

      Correct Answer: Infraorbital nerve

      Explanation:

      The inferior palpebral nerve is a branch of the maxillary nerve. It supplies the skin and conjunctiva of the lower eyelid.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      45.8
      Seconds
  • Question 63 - Which of the following structures is derived from the dorsal mesogastrium of the...

    Incorrect

    • Which of the following structures is derived from the dorsal mesogastrium of the stomach during the development of the gut?

      Your Answer: Lesser omentum

      Correct Answer: Greater omentum

      Explanation:

      In a developing foetus, the stomach has two mesogastria from which most of the abdominal ligaments develop. These two mesogastria are the; ventral mesogastrium and the dorsal mesogastrium. During the embryological development of the gut, different organs develop in each mesogastrium; the spleen and pancreas in the dorsal mesogastrium while the liver in the ventral mesogastrium (with their associated ligaments). In the dorsal mesogastrium the following structures develop; the greater omentum (containing the gastrophrenic ligament and the gastrocolic ligament), gastrosplenic ligament, mesentery, splenorenal ligament and phrenicocolic ligament. The structures that develop from the ventral mesogastrium include the; lesser omentum (containing the hepatoduodenal ligament and the hepatogastric ligament) in association with the liver; the coronary ligament (left triangular ligament, right triangular ligament and hepatorenal ligament) and the falciform ligament (round ligament of liver and ligamentum venosum within).

      There are also folds that develop from the dorsal mesogastrium which include; umbilical folds, supravesical fossa, medial inguinal fossa, lateral umbilical fold, lateral inguinal fossa and Ileocecal fold.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      74.1
      Seconds
  • Question 64 - In which situation is a stretch reflex such as knee jerk likely to...

    Correct

    • In which situation is a stretch reflex such as knee jerk likely to be exaggerated?

      Your 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.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      27.9
      Seconds
  • Question 65 - A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp...

    Correct

    • A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp object punctured the portion of the parietal pleura that extends above the first rib. What is the name of this portion of the parietal pleura?

      Your Answer: Cupola

      Explanation:

      Endothoracic fascia: the connective tissue (fascia) that is between the costal parietal pleura and the inner wall of the chest wall.

      Costomediastinal recess: the point where the costal pleura becomes mediastinal pleura.

      Costodiaphragmatic recess: is the lowest point of the pleural sac where the costal pleura becomes diaphragmatic pleura.

      Cupola: the part of the parietal pleura that extends above the first rib level into the root of the neck.

      Costocervical recess: this is a made-up term.

      Peritracheal fascia: a layer of connective tissue that invests the trachea.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      269.2
      Seconds
  • Question 66 - Production of pain is most likely associated with: ...

    Incorrect

    • Production of pain is most likely associated with:

      Your Answer: Bradykinin

      Correct Answer: Substance P

      Explanation:

      Substance P is a short-chain polypeptide that functions as a neurotransmitter and as a neuromodulator, and is thus, a neuropeptide. It has been linked with pain regulation, mood disorders, stress, reinforcement, neurogenesis, respiratory rhythm, neurotoxicity, nausea and emesis. It is also a potent vasodilator as it brings about release of nitric oxide from the endothelium. Its release can also cause hypotension.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      5.5
      Seconds
  • Question 67 - A lesion involving the lateral portion of the dorsal columns at the level...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      104.9
      Seconds
  • Question 68 - Which structure holds the duodenojejunal flexure in place? ...

    Incorrect

    • Which structure holds the duodenojejunal flexure in place?

      Your Answer: Hepatoduodenal ligament

      Correct Answer: Suspensory ligament (of Treitz)

      Explanation:

      The duodenum is connected to the diaphragm by the suspensory ligament called the ligament of Treitz. It is a slip of skeletal muscle from the right crus of the diaphragm and a fibromuscular band of smooth muscle from the 3rd and 4th parts of the duodenum. It is an important landmark, used to divide the gastrointestinal tract into the upper and lower parts. Contraction of this ‘ligament’ leads to opening of the duodenojejunal flexure allowing the flow of chyme.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      34
      Seconds
  • Question 69 - In relation to the muscles of facial expression, It is true to say:...

    Incorrect

    • In relation to the muscles of facial expression, It is true to say:

      Your Answer:

      Correct Answer: They are in the same subcutaneous plane as the platysma muscle

      Explanation:

      The facial muscles generally originate from the facial bones and attach to the skin, in the same plane as the platysma muscle. They are all innervated by cranial nerve VII (the facial nerve). The occipitofrontalis muscle consists of two parts: The occipital belly, near the occipital bone, and the frontal belly, near the frontal bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 70 - Prostatectomy carries a risk of loss of penile erection due to injury to...

    Incorrect

    • 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:

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds
  • Question 71 - Infection to all of the following will lead to enlargement of the superficial...

    Incorrect

    • Infection to all of the following will lead to enlargement of the superficial inguinal lymph nodes, except for:

      Your Answer:

      Correct Answer: Ampulla of the rectum

      Explanation:

      The superficial inguinal lymph nodes form a chain immediately below the inguinal ligament. They receive lymphatic supply from the skin of the penis, scrotum, perineum, buttock and abdominal wall below the level of the umbilicus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 72 - After a cerebral infarction, which of these histopathogical findings is most likely to...

    Incorrect

    • After a cerebral infarction, which of these histopathogical findings is most likely to be found?

      Your Answer:

      Correct Answer: Liquefactive necrosis

      Explanation:

      The brain has a high lipid content and typically undergoes liquefaction with ischaemic injury, because it contains little connective tissue but high amounts of digestive enzymes.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
      Seconds
  • Question 73 - A retroperitoneal structure is: ...

    Incorrect

    • A retroperitoneal structure is:

      Your Answer:

      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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 74 - A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month...

    Incorrect

    • A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month ago, she fell from a staircase but only suffered mild head trauma. What is the most likely diagnosis in this case?

      Your Answer:

      Correct Answer: Chronic subdural haematoma

      Explanation:

      A quarter to a half of patients with chronic subdural haematoma have no identifiable history of head trauma. If a patient does have a history of head trauma, it usually is mild. The average time between head trauma and chronic subdural haematoma diagnosis is 4–5 weeks. Symptoms include decreased level of consciousness, balance problems, cognitive dysfunction and memory loss, motor deficit (e.g. hemiparesis), headache or aphasia. Some patients present acutely. They usually result from tears in bridging veins which cross the subdural space, and may cause an increase in intracranial pressure (ICP).

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
      Seconds
  • Question 75 - Which statement is true about the inferior sagittal sinus? ...

    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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 76 - What is the innervation of the laryngeal mucosa inferior to the true vocal...

    Incorrect

    • What is the innervation of the laryngeal mucosa inferior to the true vocal cord?

      Your Answer:

      Correct Answer: Recurrent laryngeal nerve

      Explanation:

      Motor innervation to all other muscles of the larynx and sensory innervation to the subglottis is by the recurrent laryngeal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 77 - With respect to far accommodation, which of the following is a TRUE statement?...

    Incorrect

    • With respect to far accommodation, which of the following is a TRUE statement?

      Your Answer:

      Correct Answer: The ciliary muscles are relaxed

      Explanation:

      Myopia or near-sightedness is a disease due to elongated eyeballs or too strong a lens. For far accommodation (focus of a distant object onto the retina), the lens needs to decrease its refractive power, or in other words, increase its focal length. This is done by relaxation of ciliary muscles which tightens the zonular fibres and flattening of the lens. Relaxation of the zonular fibres, rounding of the lens, shortening of the focal length and constriction of the pupil occurs during near accommodation.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 78 - What is the arterial sequence for an analgesic to reach the latissimus dorsi...

    Incorrect

    • What is the arterial sequence for an analgesic to reach the latissimus dorsi muscle assuming that your starting point is at the subclavian vein?

      Your Answer:

      Correct Answer: Subclavian – axillary – subscapular – thoracodorsal

      Explanation:

      Assuming our starting point is the subclavian artery, the analgesic continues in the same vessel into the axillary artery, as it passes into the axilla. The axillary artery at the lower border of the subscapularis gives rise to the subcapsular artery which is considered the largest branch of the axillary artery. This circumflex scapular branch distributes a serratus branch before entering the substance of the muscle as the thoracodorsal artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 79 - What intrinsic muscle of the larynx is responsible for the tensing of the...

    Incorrect

    • What intrinsic muscle of the larynx is responsible for the tensing of the vocal cords?

      Your Answer:

      Correct Answer: Cricothyroid muscle

      Explanation:

      The cricothyroid muscle is the only tensor muscle of the larynx aiding with phonation. It attaches to the anterolateral aspect of the cricoid and the inferior cornu and lower lamina of the thyroid cartilage. Its action tilts the thyroid forward to help tense the vocal cords.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 80 - Which muscle in the neck divides the neck into two large triangles? ...

    Incorrect

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

      Your Answer:

      Correct Answer: Sternocleidomastoid

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 81 - If a 55-year old gentleman who has suffered a stroke, develops a tremor...

    Incorrect

    • If a 55-year old gentleman who has suffered a stroke, develops a tremor in his fingers that worsens on reaching for an object, what part of his brain is likely to be involved?

      Your Answer:

      Correct Answer: Cerebellum

      Explanation:

      The cerebellum plays an important role in the integration of sensory perception and motor output. Multiple neural pathways link the cerebellum with the motor cortex and the spinocerebellar tract. The cerebellum uses the constant feedback on body position to fine-tune the movements and integrates these pathways. The patient described here has a characteristic cerebellar tremor that is a slow, broad tremor of the extremities and occurs at the end of a purposeful movement.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 82 - A 45 year old lady has been diagnosed with Friedreich's ataxia that has...

    Incorrect

    • A 45 year old lady has been diagnosed with Friedreich's ataxia that has affected her medial group of nuclei in the anterior horn of the spinal cord. Which of the following structures will have their muscles affected?

      Your Answer:

      Correct Answer: Axial muscles

      Explanation:

      The cells in the anterior horn can be arranged in the following three main groups: medial, lateral and central. The medial group of nuclei in the anterior horn of the spinal cord are located along the entire length of the spinal cord and are responsible for the innervation of the axial muscles of the body ( muscles of the head and neck region). Thus this disease will most likely affect the functioning of the muscles of the head and neck.

    • This question is part of the following fields:

      • Anatomy
      • Neurology
      0
      Seconds
  • Question 83 - Which of the following veins is prostate cancer most likely to metastasize through?...

    Incorrect

    • Which of the following veins is prostate cancer most likely to metastasize through?

      Your Answer:

      Correct Answer: Internal vertebral venous plexus

      Explanation:

      The internal vertebral veins are the most likely route of metastasis as they are valveless. They serve an important clinical role as they are the route of free travel for cancerous cells to other body structures. The other veins on the list have valves and would be the least likely routes for metastasis.

    • This question is part of the following fields:

      • Anatomy
      • Neurology
      0
      Seconds
  • Question 84 - Which of the following structure contains the parasympathetic pre-ganglionic nucleus that innervates the...

    Incorrect

    • Which of the following structure contains the parasympathetic pre-ganglionic nucleus that innervates the iris sphincter muscle and the ciliary muscle?

      Your Answer:

      Correct Answer: Edinger–Westphal nucleus

      Explanation:

      The Edinger–Westphal nucleus (accessory oculomotor nucleus) is the parasympathetic pre-ganglionic nucleus that innervates the iris sphincter muscle and the ciliary muscle.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 85 - The muscle that stabilizes the stapes is innervated by which of the following...

    Incorrect

    • The muscle that stabilizes the stapes is innervated by which of the following nerves?

      Your Answer:

      Correct Answer: Facial nerve

      Explanation:

      The stapedius is the smallest skeletal muscle in the human body. At just over one millimetre in length, its purpose is to stabilize the smallest bone in the body, the stapes and is innervated by a branch of the facial nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 86 - When one is silently counting, what part of his brain will show increased...

    Incorrect

    • When one is silently counting, what part of his brain will show increased regional cerebral blood flow (rCBF)?

      Your Answer:

      Correct Answer: Supplementary motor area

      Explanation:

      Regional cerebral blood flow (rCBF) increases in the superior speech cortex (supplementary motor area) during periods of silent counting, whereas speaking aloud will do so in the motor cortex and medial temporal lobe, along with the superior speech cortex.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 87 - The Carpal tunnel does NOT contain: ...

    Incorrect

    • The Carpal tunnel does NOT contain:

      Your Answer:

      Correct Answer: Flexor carpi ulnaris

      Explanation:

      The contents of the carpal tunnel include:

      – Median nerve

      – Flexor digitorum supervicialis

      – Flexor digitorum profundus

      – Flexor policis longus

      – Flexor carpi radialis

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 88 - A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is...

    Incorrect

    • A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is most likely to be irritated in this patient?

      Your Answer:

      Correct Answer: Left recurrent laryngeal

      Explanation:

      Tracheobronchial lymph nodes are located at the bifurcation of the trachea and are in three groups i.e. the right superior, left superior and inferior. The aorta arches over the left bronchus near the point of tracheal bifurcation. Thus, the nerves that are closely associated with the aorta might be irritated if these nodes become inflamed. The left recurrent laryngeal nerve is such a nerve. The phrenic nerves, both the left and the right, are lateral and thus would not be affected. The right recurrent nerve loops around the right subclavian artery and is distant from this area. The right vagus artery is not associated with the aorta and the sympathetic chain is located in the posterior chest parallel to the vertebra, also not associated with the tracheobronchial tree.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 89 - During an exploratory laparotomy in a 22 year-old man shot in the abdomen,...

    Incorrect

    • During an exploratory laparotomy in a 22 year-old man shot in the abdomen, the operating doctor discovers the large bowel is perforated. Which of the following characteristics of the bowel enabled the surgeon to identify it as the large bowel?

      Your Answer:

      Correct Answer: Epiploic appendages

      Explanation:

      The large intestine doesn’t have a continuous layer of longitudinal muscle. Instead, it has three strips of longitudinal muscle called taenia coli. The large intestine is covered with omental appendages that are fat filled. It is also folded into sacculations called haustrations. Serosa is a general term for the outermost coat or serous layer of a visceral structure that lies in the body cavities of the abdomen or thorax.

      Complete circular folds are only found in the small intestine.

      Valvulae conniventes or valves of Kerckring are the circular folds which are large valvular flaps projecting into the lumen of the small bowel.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 90 - Thalamic syndrome will most likely result in: ...

    Incorrect

    • Thalamic syndrome will most likely result in:

      Your Answer:

      Correct Answer: Hyperaesthesia

      Explanation:

      Signs and symptoms of thalamic syndrome include contralateral hemi anaesthesia, burning or aching sensation in one half of a body (hyperaesthesia), often accompanied by mood swings.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 91 - Which of the cranial nerves is responsible for touch sensation on the skin...

    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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 92 - A construction worker is brought to the A&E after a fall on site....

    Incorrect

    • 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:

      Correct 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).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 93 - Which of the following muscles is innervated by the inferior branch of the...

    Incorrect

    • Which of the following muscles is innervated by the inferior branch of the right recurrent laryngeal nerve?

      Your Answer:

      Correct Answer: Posterior cricoarytenoid

      Explanation:

      The posterior cricoarytenoid muscle, which is the sole abductor of the vocal folds, receives its innervation from the inferior laryngeal nerve which is a continuation of the recurrent laryngeal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 94 - In the human body, veins often run a course parallel to the artery...

    Incorrect

    • In the human body, veins often run a course parallel to the artery that has the same name. Which of the following listed veins doesn't run parallel to the artery of the same name?

      Your Answer:

      Correct Answer: Inferior mesenteric

      Explanation:

      The inferior mesenteric artery and inferior mesenteric vein don’t run in tandem because the vein is part of the portal venous system-draining into the splenic vein which drains into the hepatic portal vein. The inferior mesenteric artery is a branch of the descending aorta at the level of L3. The inferior mesenteric vein and artery, however, drain the same region i.e. the descending and sigmoid colon and rectum.

      Superior epigastric vessels course together and are the continuation of the internal thoracic artery and vein.

      Superficial circumflex iliac vessels course together in the superficial fat of the abdominal wall.

      Superior rectal vessels are the terminal ends of the inferior mesenteric vessels, located on the posterior surface of the rectum.

      The ileocolic artery and vein are branches off the superior mesenteric vessels. Both course in the mesentery, supplying/draining the caecum, appendix, terminal portion of the ileum. The inferior epigastric vessels run together.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 95 - A young man in a motor vehicle accident sustained a spinal injury at...

    Incorrect

    • A young man in a motor vehicle accident sustained a spinal injury at C8 level. What would likely be seen in this patient?

      Your Answer:

      Correct Answer: The hypothenar muscles would be completely paralysed

      Explanation:

      The eighth cervical nerve is one of the contributors of the ulnar nerve. The ulnar nerve supplies the hypothenar muscles which include the opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis, and palmaris brevis.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 96 - Choose the most correct answer regarding the common peroneal nerve. ...

    Incorrect

    • Choose the most correct answer regarding the common peroneal nerve.

      Your Answer:

      Correct Answer: It gives rise to the nerve that supplies the anterior compartment leg muscles

      Explanation:

      The common peroneal nerve divides beneath the peroneus longus muscle and gives off articular and lateral sural cutaneous nerves which supply muscular branches to the muscles of the anterior compartment of the leg which are the tibialis anterior, extensor digitorum, peroneus tertius and extensor hallucis longus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 97 - A medical officer was shown an X ray with barium contrast and was...

    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:

      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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 98 - upon stroking the plantar surface of a patient's foot, extension of toes was...

    Incorrect

    • upon stroking the plantar surface of a patient's foot, extension of toes was noted. This is likely to be accompanied with:

      Your Answer:

      Correct 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)

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 99 - An infant, 5 weeks and 6 days old born with a large sub-aortic...

    Incorrect

    • An infant, 5 weeks and 6 days old born with a large sub-aortic ventricular septal defect, is prepared for pulmonary artery banding through a left thoracotomy (the child is not fit for a surgical closure). The surgeon initially passes his index finger immediately behind two great arteries in the pericardial sac to mobilise the great arteries in order to pass the tape around the pulmonary artery. Into which space is the surgeon's finger inserted?

      Your Answer:

      Correct Answer: Transverse pericardial sinus

      Explanation:

      Cardiac notch: is an indentation on the left lung of the heart.

      Coronary sinus: a venous sinus on the surface of the heart (the posterior aspect) that receives blood from the smaller veins that drain the heart.

      Coronary sulcus: a groove on the heart between the atria and ventricles.

      Transverse pericardial sinus: located behind the aorta and pulmonary trunk and anterior to the superior vena cava.

      Oblique pericardial sinus: located behind the left atrium. Accessed from the inferior side (or the apex) of the heart upwards.

      Horizontal pericardial sinus: this is a made-up term.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 100 - An old woman complains of a lack of sensation halfway down the anterior...

    Incorrect

    • An old woman complains of a lack of sensation halfway down the anterior surface of the thigh. The cause of this:

      Your Answer:

      Correct Answer: Would result from damage to the nerve that innervates the pectineus muscle

      Explanation:

      The pectineus is supplied by the second, third and fourth lumbar nerves through the femoral nerve and by the third lumbar through the accessory obturator when it exists. The anterior surface of the thigh receives its innervation from the femoral nerve as well, thus this is the nerve most likely to be injured

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 101 - Destruction of the ventromedial nucleus of the hypothalamus will result in: ...

    Incorrect

    • Destruction of the ventromedial nucleus of the hypothalamus will result in:

      Your Answer:

      Correct Answer: Loss of satiety

      Explanation:

      The ventromedial nucleus of the hypothalamus is divided into an anterior and a superior part. The anterior part controls the female sexual drive, whereas the superior part is responsible for satiety. Destruction of the superior part of the nucleus will result in overeating, as no signal tells the body that it is satisfied.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 102 - The Brunner glands secrete an alkaline product that helps maintain an optimal pH...

    Incorrect

    • The Brunner glands secrete an alkaline product that helps maintain an optimal pH for pancreatic enzyme activity. Where are these glands located?

      Your Answer:

      Correct Answer: Submucosa of the duodeneum

      Explanation:

      The Brunner glands are located in the submucosa of the duodenum. These glands are connected to the interstitial lumen by ducts that open into certain crypts. They secrete an alkaline product that protects the duodenal mucosa from the acidic chyme and helps achieve an optimal pH for the enzymes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 103 - What is the innervation of the tensor tympani muscle? ...

    Incorrect

    • What is the innervation of the tensor tympani muscle?

      Your Answer:

      Correct Answer: Trigeminal nerve

      Explanation:

      The tensor veli palatini is innervated by the medial pterygoid nerve, a branch of mandibular nerve, the third branch of the trigeminal nerve (CN V3) – the only muscle of the palate not innervated by the pharyngeal plexus, which is formed by the vagal and glossopharyngeal nerves.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 104 - Which of the following tumours has the best prognosis following surgery? ...

    Incorrect

    • Which of the following tumours has the best prognosis following surgery?

      Your Answer:

      Correct Answer: Schwannoma

      Explanation:

      Schwannomas are histologically benign neoplasms that arise from nerve sheaths, most commonly from sensory nerve roots. They are generally contained within a capsule, and so can be surgically removed without injuring the associated nerve root. They are histologically benign and less than 1% become malignant.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
      Seconds
  • Question 105 - A 45 year-old female presents with a drooping eyelid. During examination, the same...

    Incorrect

    • A 45 year-old female presents with a drooping eyelid. During examination, the same pupil of the patient is found to be dilated. Which nerve could be involve in this case?

      Your Answer:

      Correct Answer: Oculomotor nerve

      Explanation:

      The oculomotor nerve controls most of the eye muscles. It also controls the constriction of the pupils and thickening of the lens of the eye. This can be tested in two main ways. By moving a finger toward a person’s face to induce accommodation, their pupils should constrict or shining a light into one eye should result in equal constriction of the other eye. The neurons in the optic nerve decussate in the optic chiasm with some crossing to the contralateral optic nerve tract. This is the basis of the swinging-flashlight test. Loss of accommodation and continued pupillary dilation can indicate the presence of a lesion of the oculomotor nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 106 - A patient sustained an injury to the facial nerve after it emerges from...

    Incorrect

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

      Your Answer:

      Correct Answer: Facial expression

      Explanation:

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

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

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

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

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

      Outside the skull (distal to the stylomastoid foramen):

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

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

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 107 - When inserting a chest drain anteriorly into the second intercostal space, one must...

    Incorrect

    • When inserting a chest drain anteriorly into the second intercostal space, one must identify the second costal cartilage by palpating which landmark?

      Your Answer:

      Correct Answer: Sternal angle

      Explanation:

      The sternal angle is the site for identification of the second rib as the second rib is attached to the sternum at this point.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 108 - The muscle that forms the posterior wall of the axilla along with the...

    Incorrect

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

      Your Answer:

      Correct Answer: Latissimus dorsi

      Explanation:

      The latissimus dorsi forms the posterior wall of the axilla along with the scapula. It is responsible for extension, adduction, transverse extension also known as horizontal abduction, flexion from an extended position, and (medial) internal rotation of the shoulder joint. It also has a synergistic role in extension and lateral flexion of the lumbar spine.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 109 - During a procedure in the mediastinum, the surgeon accidentally injured a key structure...

    Incorrect

    • During a procedure in the mediastinum, the surgeon accidentally injured a key structure that lies immediately anterior to the thoracic duct. Which structure is likely to be injured?

      Your Answer:

      Correct Answer: Oesophagus

      Explanation:

      In the mid-thorax, the azygos vein, thoracic duct and aorta (in this order from right to the left) are all located posterior to the oesophagus. The superior vena cava, left internal jugular vein and trachea are not found in the mid thorax.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 110 - Internal haemorrhoids are painless and only sensitive to stretch. They are formed from...

    Incorrect

    • Internal haemorrhoids are painless and only sensitive to stretch. They are formed from folds of the mucous membrane and the submucosa of the anal canal which contain varicose branches of the:

      Your Answer:

      Correct Answer: Superior rectal vein

      Explanation:

      Internal haemorrhoids are formed by varicosities of the branches of the superior rectal vein.

      External haemorrhoids are formed by varicosities of the branches of the inferior rectal vein.

    • This question is part of the following fields:

      • Anatomy
      • Colorectal
      0
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  • Question 111 - A 20-year old college student was diagnosed with meningitis that had developed due...

    Incorrect

    • A 20-year old college student was diagnosed with meningitis that had developed due to an acute cavernous sinus thrombosis from an ear infection. Which of the following superficial venous routes is the usual path that an infected blood clot takes to reach the cavernous sinus?

      Your Answer:

      Correct Answer: Facial vein

      Explanation:

      The facial vein is the usual communication between the cavernous sinus and the pterygoid sinus. It is through this vein that an infected clot can travel to the cavernous sinus and cause infection. The pterygoid plexus is a venous plexus that is situated between the temporalis muscle and lateral pterygoid muscle, and partly between the two pterygoid muscles. The pterygoid plexus is connected to the facial vein by the deep facial vein. This connection is what makes this area where this sinus and the facial vein are located a danger zone. The danger zone or triangle of the face is the area from the corners of the mouth to the nose bridge. The sinus connection in this area makes it possible for infection to reach the cavernous sinus and at times cause meningitis.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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      Seconds
  • Question 112 - During an operation to repair an indirect inguinal hernia, it is noticed that...

    Incorrect

    • During an operation to repair an indirect inguinal hernia, it is noticed that the hernial sac is protruding out of the superficial inguinal ring. The superficial inguinal ring is an opening in which structure?

      Your Answer:

      Correct Answer: External abdominal oblique aponeurosis

      Explanation:

      The superficial inguinal ring is an opening in the aponeurosis of the external oblique just above and lateral to the pubic crest. The opening is oblique and corresponds to the fibres of the aponeurosis. It is bound inferiorly by the pubic crest, on either side by the margins of the opening in the aponeurosis and superiorly by the curved intercrural fibres.

      The inferior crus is formed by the portion of the inguinal ligament that is inserted into the pubic tubercle.

      The falx inguinalis is made of arching fibres of the transversalis fascia and the internal abdominal oblique muscle. It forms the posterior wall of the inguinal canal.

      The internal abdominal oblique forms the root of the inguinal canal.

      Scarpa’s and Camper’s fascia are the membranous and fatty layers, respectively of subcutaneous fascia.

      Transversalis fascia covers the posterior surface of the rectus abdominis muscle inferior to the arcuate line.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
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  • Question 113 - Which is the correct superficial to deep order of structures that would be...

    Incorrect

    • Which is the correct superficial to deep order of structures that would be affected following a knife wound to the lateral aspect of the knee?

      Your Answer:

      Correct Answer: skin, fibular collateral ligament, popliteus muscle tendon, lateral meniscus

      Explanation:

      Skin, fibular collateral ligament, popliteus muscle tendon and lateral meniscus is the correct order of structures covering the lateral aspect of the knee joint from a superficial to deep.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 114 - Which of these illnesses is most likely to precede Guillain-Barré syndrome? ...

    Incorrect

    • Which of these illnesses is most likely to precede Guillain-Barré syndrome?

      Your Answer:

      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.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
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  • Question 115 - The annular ligament in the forearm: ...

    Incorrect

    • The annular ligament in the forearm:

      Your Answer:

      Correct Answer: Encircles the head of the radius

      Explanation:

      The annular ligament forms about four-fifths of the osseofibrous ring and is attached to the anterior and posterior margins of the radial notch. It is a strong band of fibres which encircles the head of the radius retaining it in contact with the radial notch of the ulna. When it comes to its upper border, it blends with the anterior and posterior ligament of the elbow.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
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  • Question 116 - The normal location of the major duodenal papilla: ...

    Incorrect

    • The normal location of the major duodenal papilla:

      Your Answer:

      Correct Answer: Descending part of the duodenum

      Explanation:

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

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
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  • Question 117 - Structures passing through the foramen magnum do NOT include the: ...

    Incorrect

    • Structures passing through the foramen magnum do NOT include the:

      Your Answer:

      Correct Answer: Vagus nerve

      Explanation:

      Structures passing through the foramen magnum include the medulla, meninges, tectorial membrane, anterior spinal artery, vertebral artery and spinal branches of the accessory nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
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  • Question 118 - Which of the following statements regarding the femoral artery is CORRECT? ...

    Incorrect

    • Which of the following statements regarding the femoral artery is CORRECT?

      Your Answer:

      Correct Answer: It has the femoral nerve lying lateral to it

      Explanation:

      The femoral artery begins immediately behind the inguinal ligament, midway between the anterior superior spine of the ilium and the symphysis pubis. The first 4 cm of the vessel is enclosed, together with the femoral vein, in a fibrous sheath (the femoral sheath). The femoral nerve lies lateral to this.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 119 - the action of the semimembranosus muscle is: ...

    Incorrect

    • the action of the semimembranosus muscle is:

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
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  • Question 120 - A 32-year old gentleman came to the emergency department, complaining of progressively increasing...

    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:

      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.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
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  • Question 121 - Which nuclei of the posterior grey column of the spinal cord are likely...

    Incorrect

    • Which nuclei of the posterior grey column of the spinal cord are likely affected in a patient who has lost the sensation of pain and temperature?

      Your Answer:

      Correct Answer: Substantia gelatinosa

      Explanation:

      Substantia gelatinosa is one of the nuclei in the posterior grey column along side other posterior grey column nuclei like the nucleus dorsalis, nucleus proprius, and posteromarginal nucleus. These nuclei are a collection of cells in the posterior grey area found in throughout the spinal cord. The substantia gelatinosa receives direct input from the dorsal nerve roots (sensory), especially from thermoreceptors and nociceptors (receptors for temperature and pain).

    • This question is part of the following fields:

      • Anatomy
      • Neurology
      0
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  • Question 122 - A recognised side-effect of prefrontal leukotomy is: ...

    Incorrect

    • A recognised side-effect of prefrontal leukotomy is:

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 123 - Rapid Eye Movement (REM) sleep is typically associated with: ...

    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.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 124 - A lesion involving the lateral geniculate nucleus of the thalamus is likely to...

    Incorrect

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

      Your Answer:

      Correct Answer: Vision

      Explanation:

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

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
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  • Question 125 - The operating surgeon notices a structure lying alongside a herniated mass whilst repairing...

    Incorrect

    • The operating surgeon notices a structure lying alongside a herniated mass whilst repairing an indirect inguinal hernia in a female patient. Which structure could this be?

      Your Answer:

      Correct Answer: Round ligament of the uterus

      Explanation:

      The main structure traversing the inguinal canal in women is the round ligament. In men, it is the spermatic cord.

      The iliohypogastric nerve innervates the abdominal wall and runs between the transversus abdominis and internal oblique muscles before piercing the internal oblique at the anterior superior iliac spine to run between the internal and external obliques.

      The inferior epigastric artery is between the peritoneum and the transversus abdominis creating the lateral umbilical fold.

      The ovarian artery and the ovarian vein are branches from the descending aorta and inferior vena cava that supply the ovary in the pelvic cavity.

      The pectineal ligament is a thick fascial layer over the pectineal line of the pubis. It doesn’t traverse the canal.

      The broad ligament if found on the lateral sides of the uterus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 126 - What is the chief ligament preventing posterior sliding of the tibia on the...

    Incorrect

    • What is the chief ligament preventing posterior sliding of the tibia on the femur ?

      Your Answer:

      Correct Answer: Posterior cruciate

      Explanation:

      The posterior cruciate ligament is attached to the posterior intercondyloid fossa of the tibia and the lateral and front part of the medial condyle of the femur. It resists sliding of the tibia posteriorly.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
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  • Question 127 - All the following statements are FALSE regarding the ophthalmic division of the trigeminal...

    Incorrect

    • All the following statements are FALSE regarding the ophthalmic division of the trigeminal nerve, except:

      Your Answer:

      Correct Answer: The ophthalmic nerve is the smallest branch of the trigeminal nerve

      Explanation:

      The ophthalmic nerve is the smallest of the three trigeminal divisions. The cutaneous branches of the ophthalmic nerve supply the conjunctiva, the skin over the forehead, the upper eyelid, and much of the external surface of the nose.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
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  • Question 128 - During work up for a 29 year-old lady who complained of chest pain,...

    Incorrect

    • During work up for a 29 year-old lady who complained of chest pain, a computed tomography showed a large mass in the posterior mediastinum. Which among the following structures could be involved?

      Your Answer:

      Correct Answer: Lymph nodes

      Explanation:

      Boundaries of the posterior mediastinum include:

      Superior: a plane through the sternal angle and T4/5

      Inferior: the diaphragm

      Anterior: the middle mediastinal structures

      Posterior the spinal cord.

      Structures in the posterior mediastinum include the descending thoracic aorta, the azygos system, oesophagus, thoracic duct and lymph nodes. The great vessels and structures at the root of the lung are part of the middle mediastinum. In this case, the lymph nodes is the correct answer.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 129 - A CT-scan report of a patient with gastric carcinoma shows that the lymph...

    Incorrect

    • A CT-scan report of a patient with gastric carcinoma shows that the lymph nodes around the coeliac trunk are enlarged. The coeliac trunk:

      Your Answer:

      Correct Answer: Gives rise to the splenic, left gastric and common hepatic arteries

      Explanation:

      The coeliac trunk is a branch of the aorta arising just below the aortic hiatus of the diaphragm to pass nearly horizontally forward to divide into 3 large branches i.e. the left gastric, the hepatic and the splenic arteries. Occasionally it may give off one of the inferior phrenic arteries. It is covered by the lesser omentum and on the right side bordered by the right coeliac ganglion and the cardiac end of the stomach. Inferiorly it is bordered by the upper border of the pancreas and splenic vein. The embryonic midgut is supplied by the superior mesenteric artery.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 130 - During an exploratory laparotomy of an acute abdomen, the surgeon identified an inflamed...

    Incorrect

    • During an exploratory laparotomy of an acute abdomen, the surgeon identified an inflamed Meckel's diverticulum. This is:

      Your Answer:

      Correct Answer: Is a site of ectopic pancreatic tissue

      Explanation:

      Meckel’s diverticulum is an outpouching of the small intestine. It usually occurs about 0.6 m (2 feet) before the junction with the caecum. It can be lined with the mucosa of the stomach and may ulcerate. It may also be lined by ectopic pancreatic tissue. It represents the remains of the vitelline duct in early fetal life.

      An abnormal persistence of the urachus is called a urachal fistula.

      Failure of the midgut loop to return to the abdominal cavity is called an omphalocele.

      Polyhydramnios is often caused by anencephaly or oesophageal fistula.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
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  • Question 131 - A CT scan of 65 year old male patient at an outpatient clinic...

    Incorrect

    • A CT scan of 65 year old male patient at an outpatient clinic suggested a bone tumour at the stylomastoid foramen. Which of the following cranial nerves is likely to be affected with this tumour?

      Your Answer:

      Correct Answer: VII

      Explanation:

      Cranial nerve VII, the facial nerve, is found in the internal acoustic canal and runs through this canal into the facial canal before exiting through the stylomastoid foramen. In the case of a bone tumour at the stylomastoid process, the facial nerve is the nerve that will most likely be affected.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
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  • Question 132 - Rapid eye movement (REM) sleep is likely to be affected by a lesion...

    Incorrect

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

      Your Answer:

      Correct Answer: Pons

      Explanation:

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

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

    • This question is part of the following fields:

      • Neurology
      • Physiology
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  • Question 133 - A surgeon performing a laparoscopic repair of an inguinal hernia visualizes a loop...

    Incorrect

    • A surgeon performing a laparoscopic repair of an inguinal hernia visualizes a loop of bowel protruding through the abdominal wall to form a direct inguinal hernia. When this is viewed from the side of the abdomen with a laparoscope, in which region would the hernial sac be?

      Your Answer:

      Correct Answer: Medial inguinal fossa

      Explanation:

      In a direct inguinal hernia, visceral contents exit the abdomen through a weak point in the fascia in the medial inguinal fossa i.e. the area between the medial and lateral umbilical folds. Such a hernia doesn’t pass through the deep inguinal ring or the lateral inguinal fossa. Note that direct hernias can go through the superficial inguinal ring, although rarely. The supravesical fossa, between the median and medial umbilical folds, is formed by a peritoneal reflection from the anterior abdominal wall onto the bladder and the retrovesical fossa is the region behind the urinary bladder.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 134 - The surgical registrar is doing an exploratory laparotomy on a 35 year old...

    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:

      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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 135 - Which one of the following groups of lymph nodes is most likely to...

    Incorrect

    • Which one of the following groups of lymph nodes is most likely to be inflamed due to paronychia involving the big toe?

      Your Answer:

      Correct Answer: Vertical group of superficial inguinal lymph nodes

      Explanation:

      Paronychia affecting the big toe will result in inflammation of the superficial inguinal lymph nodes as it drains lymph from the big toe.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 136 - The parasympathetic fibres of the oculomotor nerve was impinged due to a growing...

    Incorrect

    • 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:

      Correct 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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 137 - A patient in the recovery ward after cardiac surgery is noticed to have...

    Incorrect

    • A patient in the recovery ward after cardiac surgery is noticed to have a small effusion in the lowest extent of the pleural cavity, into which no lung tissue extends. What is the name of this part of the pleural cavity?

      Your Answer:

      Correct Answer: Costodiaphragmatic recess

      Explanation:

      The costodiaphragmatic recess is the part of the pleural cavity where the costal pleura is in continuity with the diaphragmatic pleura. It forms the lowest extent of the pleural cavity.

      Costomediastinal recess: a tiny recess that is anteriorly located, where the costal pleura becomes continuous with the mediastinal pleura.

      The cupola is the pleural cavity that extends above the first rib.

      The inferior mediastinum refers to the posterior, middle and anterior mediastinal divisions together.

      The pulmonary ligament on the other hand, is a pleural fold that is situated beneath the root of the lung on the medial aspect of the lung.

      Oblique pericardial sinus is not part of the pleural cavity.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 138 - What best describes the muscles of the posterior compartment of the leg? ...

    Incorrect

    • What best describes the muscles of the posterior compartment of the leg?

      Your Answer:

      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

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 139 - A 45-year old male patient with a long history of alcoholism developed liver...

    Incorrect

    • A 45-year old male patient with a long history of alcoholism developed liver cirrhosis that has led to portal hypertension. Which of the following plexuses of veins is most likely dilated in this patient?

      Your Answer:

      Correct Answer: Haemorrhoidal plexus

      Explanation:

      The haemorrhoidal plexus or also known as the rectal plexus is a venous plexus that surrounds the rectum. This venous plexus in males communicates anteriorly with the vesical plexus and uterovaginal plexus in females. This venous plexus forms a site of free communication between the portal and systemic venous systems. In the case of portal hypertension this plexus would most likely dilate due to the increased pressure.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds
  • Question 140 - Which of the following arteries is the posterior branch of the external carotid...

    Incorrect

    • Which of the following arteries is the posterior branch of the external carotid artery?

      Your Answer:

      Correct Answer: Superficial temporal

      Explanation:

      The external carotid artery is a branch of the common carotid artery that supplies parts of the neck, head and face. It branches off from the common carotid artery at the level of the thyroid cartilage. The external carotid, at the level of the mandible divides into the maxillary artery and the superficial temporal. The superficial temporal artery is the posterior branch of these two arteries. It starts off, somewhat, as a continuation of the external carotid artery at the substance of the parotid gland. Anterior cerebral and middle cerebral arteries are branches of the internal carotid artery.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 141 - When you rest your elbows on a desk, what bony landmark of the...

    Incorrect

    • When you rest your elbows on a desk, what bony landmark of the upper limb are you resting on?

      Your Answer:

      Correct Answer: Olecranon process of the ulna

      Explanation:

      At the upper and back part of the ulna, there exists a curved eminence which is the olecranon process. This process lodges in the olecranon fossa of the humerus. It’s posterior surface is subcutaneous and this triangular area is what you rest your elbow upon.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 142 - The uterine artery arises from the? ...

    Incorrect

    • The uterine artery arises from the?

      Your Answer:

      Correct Answer: Internal iliac artery

      Explanation:

      The uterine artery arises from the anterior division of the internal iliac artery and runs medially on the levator ani towards the uterine cervix.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds
  • Question 143 - The tympanic membrane is a thin semi-transparent membrane that separates the tympanic cavity...

    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:

      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.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 144 - A football player sustained an injury to his ankle. The wound went through...

    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.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 145 - A 60-year old woman who has a left sided post-pneumonic effusion, was to...

    Incorrect

    • A 60-year old woman who has a left sided post-pneumonic effusion, was to have some pleural fluid aspirated for culture and sensitivity. If the medical intern in charge of the procedure decided to aspirate while the patient is sitting up on her bed, where in the pleural cavity would the fluid tend to accumulate?

      Your Answer:

      Correct Answer: Costodiaphragmatic recess

      Explanation:

      The lowest part of the pleural cavity is the costodiaphragmatic recess and it the space in which the pleural fluid will accumulate when the patient sits up.

      The cupola is part of the pleural cavity that extends into the root of the neck above the first rib.

      The costomediastinal recess is the junction at which the costal pleura becomes the mediastinal pleura.

      The middle mediastinum is the part of the mediastinum that is occupied by the heart.

      The hilar reflection is the point where the mediastinal pleura is reflected to continue on as the visceral pleura.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 146 - A textbook of cardiac surgery explains that while doing a left pneumonectomy, a...

    Incorrect

    • A textbook of cardiac surgery explains that while doing a left pneumonectomy, a surgeon must be careful to avoid injury to a vital structure that leaves an impression on the mediastinal surface of the left lung. Which structure is it referring to?

      Your Answer:

      Correct Answer: Aortic arch

      Explanation:

      Structures that leave an impression on the mediastinal surface of the left lung include: the oesophagus, subclavian artery, brachiocephalic vein, first rib, thymus, the heart, the diaphragm, descending aorta and arch of the aorta. The other structures form an impression on the mediastinal aspect of the right lung.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 147 - Which foramen contains the vertebral artery? ...

    Incorrect

    • Which foramen contains the vertebral artery?

      Your Answer:

      Correct Answer: Foramen magnum

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 148 - Following a fracture in the fibula, an artery contained in a fibrous canal...

    Incorrect

    • Following a fracture in the fibula, an artery contained in a fibrous canal between tibialis posterior and flexor hallucis longus was lacerated. Which of the following arteries was injured?

      Your Answer:

      Correct Answer: Peroneal

      Explanation:

      The peroneal artery is deeply seated at the back of the fibular side of the leg, contained in a fibrous canal between the tibialis posterior and the flexor hallucis longus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds
  • Question 149 - An ultrasound report of a 35-year old female patient revealed that she had...

    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:

      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.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 150 - Following nerve injury, paralysis of the quadriceps femoris muscle occurs. Which of the...

    Incorrect

    • Following nerve injury, paralysis of the quadriceps femoris muscle occurs. Which of the following movements will be affected?

      Your Answer:

      Correct Answer: Extension of the leg

      Explanation:

      The quadriceps muscle is a great extensor of the thigh. Therefore, following nerve injury or cutting nerve supply to the quadriceps will affect extension of the thigh

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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SESSION STATS - PERFORMANCE PER SPECIALTY

Abdomen (8/21) 38%
Anatomy (21/54) 39%
Neurology (10/14) 71%
Physiology (8/12) 67%
Head & Neck (4/11) 36%
Upper Limb (2/6) 33%
Pathology (2/2) 100%
Embryology (1/1) 100%
Lower Limb (4/9) 44%
Thorax (1/4) 25%
Breast (1/1) 100%
Pelvis (0/1) 0%
Passmed