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  • Question 1 - In adults, there are normally how many teeth: ...

    Correct

    • In adults, there are normally how many teeth:

      Your Answer: 32

      Explanation:

      In adults, there are 32 teeth, 16 in the upper jaw and 16 in the lower jaw. On each side in both upper and lower arches, there are two incisors, one canine, two premolars and three molar teeth.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      5
      Seconds
  • Question 2 - Which of the following statements concerning the facial nerve is INCORRECT? ...

    Incorrect

    • Which of the following statements concerning the facial nerve is INCORRECT?

      Your Answer: The facial nerve carries parasympathetic fibres to the lacrimal glands.

      Correct Answer: Forehead sparing in facial nerve palsy is indicative of a lower motor neuron lesion.

      Explanation:

      In facial nerve palsy, LMN damage will involve the forehead and there will be an inability to close the eyes due to paralysis of the orbicularis oculi or raise the eyebrows due to paralysis of the occipitofrontalis muscle.
      UMN damage causes sparing of the forehead as the occipitofrontalis and orbicularis oculi muscles have bilateral cortical representation.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      36.2
      Seconds
  • Question 3 - Where on the body is the radial artery pulsation best palpated? ...

    Incorrect

    • Where on the body is the radial artery pulsation best palpated?

      Your Answer: At the wrist just lateral to the palmaris longus tendon

      Correct Answer: At the wrist just lateral to the flexor carpi radialis tendon

      Explanation:

      The radial artery lies lateral to the large tendon of the flexor carpi radialis muscle and anterior to the pronator quadratus at the distal end of the radius. The flexor carpi radialis muscle is used as a landmark in locating the pulse.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      28.3
      Seconds
  • Question 4 - A patient presents with an adducted eye at rest which cannot abduct past...

    Correct

    • A patient presents with an adducted eye at rest which cannot abduct past the midline, which of the following cranial nerves is most likely to be affected:

      Your Answer: Abducens nerve

      Explanation:

      Abducens nerve palsies result in a convergent squint at rest (eye turned inwards) with inability to abduct the eye because of unopposed action of the rectus medialis. The patient complains of horizontal diplopia when looking towards the affected side. With complete paralysis, the eye cannot abduct past the midline.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      18.9
      Seconds
  • Question 5 - A 30-year old male is brought to the emergency room after a terrible...

    Incorrect

    • A 30-year old male is brought to the emergency room after a terrible fall during a photoshoot. The patient reported falling on his right forearm. There is evident swelling and tenderness on the affected area, with notable weakness of the flexor pollicis longus muscle. Radiographic imaging showed a fracture on the midshaft of the right radius.

      Which of the following nerves is most likely injured in the case above?

      Your Answer: The musculocutaneous nerve

      Correct Answer: The anterior interosseous nerve

      Explanation:

      Flexor pollicis longus receives nervous supply from the anterior interosseous branch of median nerve, derived from spinal roots C7 and C8.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      12.8
      Seconds
  • Question 6 - Which of the following occurs at the transverse thoracic plane: ...

    Correct

    • Which of the following occurs at the transverse thoracic plane:

      Your Answer: Bifurcation of the trachea

      Explanation:

      A way to help remember the structures transected by the transverse thoracic plane is CLAPTRAP:
      C: cardiac plexus
      L: ligamentum arteriosum
      A: aortic arch (inner concavity)
      P: pulmonary trunk
      T: tracheal bifurcation (carina)
      R: right-to-left movement of the thoracic duct (posterior to the oesophagus)
      A: azygos vein drains into superior vena cava
      P: pre-vertebral fascia and pre-tracheal fascia end

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      11.1
      Seconds
  • Question 7 - The medial and lateral pterygoid muscles are innervated by which of the following...

    Correct

    • The medial and lateral pterygoid muscles are innervated by which of the following nerves:

      Your Answer: Mandibular division of the trigeminal nerve

      Explanation:

      Both the medial and lateral pterygoids are innervated by the mandibular division of the trigeminal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      10
      Seconds
  • Question 8 - A 25-year-old athlete suffers an injury to the nerve that innervates the gluteus...

    Incorrect

    • A 25-year-old athlete suffers an injury to the nerve that innervates the gluteus minimus muscle.

      Which of the following nerves innervates the gluteus minimus muscle?

      Your Answer: Femoral nerve

      Correct Answer: Superior gluteal nerve

      Explanation:

      Gluteus minimus is the smallest muscle of the glutei. It is located just beneath the gluteus medius muscle. Gluteus minimus predominantly acts as a hip stabilizer and abductor of the hip.
      The superior gluteal nerve innervates the gluteus minimus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      13.6
      Seconds
  • Question 9 - Which of the following is most likely affected in De Quervain's tenosynovitis? ...

    Incorrect

    • Which of the following is most likely affected in De Quervain's tenosynovitis?

      Your Answer: Extensor pollicis longus

      Correct Answer: Extensor pollicis brevis

      Explanation:

      De Quervain tenosynovitis is named after the Swiss surgeon, Fritz de Quervain, who first described it in 1895. It is a condition which involves tendon entrapment affecting the first dorsal compartment of the wrist. With this condition thickening of the tendon sheaths around the abductor pollicis longus and extensor pollicis brevis develops where the tendons pass in through the fibro-osseous tunnel located along the radial styloid at the distal wrist. Pain is exacerbated by thumb movement and radial and ulnar deviation of the wrist.

      The estimated prevalence of de Quervain tenosynovitis is about 0.5% in men and 1.3% in women with peak prevalence among those in their forties and fifties. It may be seen more commonly in individuals with a history of medial or lateral epicondylitis. Bilateral involvement is often reported in new mothers or child care providers in whom spontaneous resolution typically occurs once lifting of the child is less frequent.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7
      Seconds
  • Question 10 - Which nerve supplies the muscle flexor hallucis longus? ...

    Incorrect

    • Which nerve supplies the muscle flexor hallucis longus?

      Your Answer: Deep peroneal nerve

      Correct Answer: Tibial nerve

      Explanation:

      Flexor hallucis longus is innervated by the tibial nerve, composed of spinal roots L4, L5, S1, S2, and S3.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8.7
      Seconds
  • Question 11 - The common bile duct drains into the duodenum in which of the following...

    Incorrect

    • The common bile duct drains into the duodenum in which of the following regions:

      Your Answer: Duodenojejunal flexure

      Correct Answer: Second part of the duodenum

      Explanation:

      As the common bile duct descends, it passes posterior to the first part of the duodenum before joining with the pancreatic duct from the pancreas, forming the hepatopancreatic ampulla (ampulla of Vater) at the major duodenal papilla, located in the second part of the duodenum. Surrounding the ampulla is the sphincter of Oddi, a collection of smooth muscle which can open to allow bile and pancreatic fluid to empty into the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      78.1
      Seconds
  • Question 12 - Which of the following statements about lithium treatment is FALSE: ...

    Incorrect

    • Which of the following statements about lithium treatment is FALSE:

      Your Answer: A serum-lithium concentration of 0.4 – 1 mmol/litre is therapeutic.

      Correct Answer: Concomitant treatment with NSAIDs decreases serum-lithium concentration.

      Explanation:

      Lithium levels are raised by NSAIDs because renal clearance is reduced. Lithium is a small ion (74 Daltons) with no protein or tissue binding and is therefore amenable to haemodialysis. Lithium is freely distributed throughout total body water with a volume of distribution between 0.6 to 0.9 L/kg, although the volume may be smaller in the elderly, who have less lean body mass and less total body water. Steady-state serum levels are typically reached within five days at the usual oral dose of 1200 to 1800 mg/day. The half-life for lithium is approximately 18 hours in adults and 36 hours in the elderly.
      Lithium is excreted almost entirely by the kidneys and is handled in a manner similar to sodium. Lithium is freely filtered but over 60 percent is then reabsorbed by the proximal tubules.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      23604.5
      Seconds
  • Question 13 - Which of the following is most likely to cause a bitemporal hemianopia: ...

    Correct

    • Which of the following is most likely to cause a bitemporal hemianopia:

      Your Answer: Pituitary adenoma

      Explanation:

      A bitemporal hemianopia is most likely due to compression at the optic chiasm. This may be caused by pituitary tumour, craniopharyngioma, meningioma, optic glioma or aneurysm of the internal carotid artery. A posterior cerebral stroke will most likely result in a contralateral homonymous hemianopia with macular sparing.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      19.9
      Seconds
  • Question 14 - You note that the prostate of a 60-year-old patient is enlarged during the...

    Incorrect

    • You note that the prostate of a 60-year-old patient is enlarged during the examination. You suspect BPH. Anatomically, the prostate has four main lobes. Which of the lobes is affected by benign prostatic hypertrophy?

      Your Answer: Fibromuscular zone

      Correct Answer: Median lobe

      Explanation:

      Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is characterized by an enlarged prostate gland.

      The prostate is divided into four major lobes. The median lobe is the most commonly affected by benign prostatic enlargement, resulting in urethral obstruction and urine symptoms.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      28.2
      Seconds
  • Question 15 - A patient complains of headache and visual loss. CT scan demonstrates a lesion...

    Incorrect

    • A patient complains of headache and visual loss. CT scan demonstrates a lesion of the temporal lobe. What type of visual field defect would you most expect to see in this patient:

      Your Answer: Contralateral homonymous hemianopia

      Correct Answer: Contralateral homonymous superior quadrantanopia

      Explanation:

      Axons from the lateral geniculate nucleus (LGN) carry visual information, via the upper and lower optic radiations, to the visual cortex in the occipital lobe:
      The upper optic radiation carries fibres from the superior retinal quadrants (corresponding to the inferior visual field quadrants) and travels through the parietal lobe to reach the visual cortex.
      The lower optic radiation carries fibres from the inferior retinal quadrants (corresponding to the superior visual field quadrants) and travels through the temporal lobe to reach the visual cortex of the occipital lobe.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      29
      Seconds
  • Question 16 - A patient suffers a stab wound to the neck. The entry point of...

    Incorrect

    • A patient suffers a stab wound to the neck. The entry point of the blade is situated within the posterior triangle of the neck.
      Which of the following muscles is most likely to be involved? Select ONE answer only.

      Your Answer: Trapezius

      Correct Answer: Anterior scalene

      Explanation:

      The anterior triangle is the triangular area of the neck found anteriorly to the sternocleidomastoid muscle. It is formed by the anterior border of sternocleidomastoid laterally, the median line of the neck medially and by the inferior border of the mandible superiorly. The apex of the anterior triangle extends towards the manubrium sterni. The anterior triangle contains:
      Muscles: thyrohyoid, sternothyroid, sternohyoid muscles
      Organs: thyroid gland, parathyroid glands, larynx, trachea, esophagus, submandibular gland, caudal part of the parotid gland
      Arteries: superior and inferior thyroid, common carotid, external carotid, internal carotid artery (and sinus), facial, submental, lingual arteries
      Veins: anterior jugular veins, internal jugular, common facial, lingual, superior thyroid, middle thyroid veins, facial vein, submental vein, lingual veins
      Nerves: vagus nerve (CN X), hypoglossal nerve (CN XII), part of sympathetic trunk, mylohyoid nerve

      The posterior triangle is a triangular area found posteriorly to the sternocleidomastoid muscle. It has three borders; anterior, posterior and inferior borders. The anterior border is the posterior margin of the sternocleidomastoid muscle. The posterior border is the anterior margin of the trapezius muscle, while the inferior border is the middle one-third of the clavicle. The investing layer of deep cervical fascia and integument forms the roof of the space, while the floor is covered with the prevertebral fascia along with levator scapulae, splenius capitis and the scalene muscles. The inferior belly of omohyoid subdivides the posterior triangle into a small supraclavicular, and a large occipital, triangle.
      Contents:
      Vessels: the third part of the subclavian artery, suprascapular and transverse cervical branches of the thyrocervical trunk, external jugular vein, lymph nodes
      Nerves: accessory nerve (CN XI), the trunks of the brachial plexus, fibers of the cervical plexus
      Of the muscles listed in the options, only the anterior scalene is situated within the posterior triangle of the neck.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      28.7
      Seconds
  • Question 17 - A 70-year old male is taken to the Emergency Room after suffering a...

    Incorrect

    • A 70-year old male is taken to the Emergency Room after suffering a traumatic fall while showering. Upon physical examination, the attending physician noted a hyperextended neck, 1/5 muscle strength in both upper extremities, 4/5 muscle strength in both lower extremities, and variable loss in sensation. The patient is placed in the wards for monitoring. For the next 24 hours, anuria is noted.

      Which of the following spinal cord injuries is the most likely diagnosis?

      Your Answer: Anterior cord syndrome

      Correct Answer: Central cord syndrome

      Explanation:

      Central cord syndrome is the most common type of incomplete cord injury and almost always occurs due to a traumatic injury. It results in motor deficits that are worse in the upper extremities as compared to the lower extremities. It may also cause bladder dysfunction (retention) and variable sensory deficits below the level of injury.

      The majority of these patients will be older and present with symptoms after a fall with hyperextension of their neck. On examination, patients will have more significant strength impairments in the upper extremities (especially the hands) compared to the lower extremities. Patients often complain of sensory deficits below the level of injury, but this is variable. Pain and temperature sensations are typically affected, but the sensation of light touch can also be impaired. The most common sensory deficits are in a cape-like distribution across their upper back and down their posterior upper extremities. They will often have neck pain at the site of spinal cord impingement.

      Bladder dysfunction (most commonly urinary retention) and priapism can also be signs of upper motor neuron dysfunction. The sacral sensation is usually preserved, but the clinician should assess the rectal tone to evaluate the severity of the compression.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      26.2
      Seconds
  • Question 18 - A 52-year old male comes to the out-patient department for a groin mass...

    Incorrect

    • A 52-year old male comes to the out-patient department for a groin mass that protrudes when standing. The patient notes that it is reducible when lying down. On physical examination, there is presence of a cough impulse. The initial assessment is hernia. Further investigation reveals that the mass lies lateral to the epigastric vessels.

      Among the types of hernia, which is the most likely diagnosis of the case above?

      Your Answer: Direct inguinal hernia

      Correct Answer: Indirect inguinal hernia

      Explanation:

      Inguinal hernias can present with an array of different symptoms. Most patients present with a bulge in the groin area, or pain in the groin. Some will describe the pain or bulge that gets worse with physical activity or coughing. Symptoms may include a burning or pinching sensation in the groin. These sensations can radiate into the scrotum or down the leg. It is important to perform a thorough physical and history to rule out other causes of groin pain. At times an inguinal hernia can present with severe pain or obstructive symptoms caused by incarceration or strangulation of the hernia sac contents. A proper physical exam is essential in the diagnosis of an inguinal hernia. Physical examination is the best way to diagnose a hernia. The exam is best performed with the patient standing. Visual inspection of the inguinal area is conducted first to rule out obvious bulges or asymmetry in groin or scrotum. Next, the examiner palpates over the groin and scrotum to detect the presence of a hernia. The palpation of the inguinal canal is completed last. The examiner palpates through the scrotum and towards the external inguinal ring. The patient is then instructed to cough or perform a Valsalva manoeuvre. If a hernia is present, the examiner will be able to palpate a bulge that moves in and out as the patient increases intra abdominal pressure through coughing or Valsalva.

      Groin hernias are categorized into 2 main categories: inguinal and femoral.

      Inguinal hernias are further subdivided into direct and indirect. An indirect hernia occurs when abdominal contents protrude through the internal inguinal ring and into the inguinal canal. This occurs lateral to the inferior epigastric vessels. The hernia contents may extend into the scrotum, and can be reduced superiorly then superolaterally. A direct inguinal hernia is protrusion of abdominal contents through the transversalis fascia within Hesselbach’s triangle. The borders of Hesselbach’s triangle are the inferior epigastric vessels superolaterally, the rectus sheath medially, and inguinal ligament inferiorly.

      A femoral hernia is a protrusion into the femoral ring. The borders of the femoral ring are the femoral vein laterally, Cooper’s ligament posteriorly, the iliopubic tract/inguinal ligament anteriorly and lacunar ligament medially.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      17.1
      Seconds
  • Question 19 - If a patient dislocated his right shoulder and has been referred to the...

    Incorrect

    • If a patient dislocated his right shoulder and has been referred to the orthopaedic outpatient department for a follow-up after a successful reduction, which of the following is the most important position for him to avoid holding his arm in until he is seen in the clinic?

      Your Answer: Arm at 45 degrees to side with palm down

      Correct Answer: Arm at 90 degrees to side with palm up

      Explanation:

      The arm should be placed in a poly-sling that should be worn for about two weeks. A physiotherapist may give gentle movements for the arm to help in reducing stiffness and in relieving the pain. It is important that the patient must avoid positions that could cause re-dislocation.
      The most important position to avoid is the arm being held out at 90 degrees to the side with the palm facing upwards, especially if a force is being applied.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      22.5
      Seconds
  • Question 20 - Damage to this nerve affects the flexor digitorum longus. ...

    Incorrect

    • Damage to this nerve affects the flexor digitorum longus.

      Your Answer: Deep peroneal nerve

      Correct Answer: Tibial nerve

      Explanation:

      Like all muscles in the deep posterior compartment of the leg, flexor digitorum longus muscle is innervated by branches of the tibial nerve (root value L5, S1 and S2) which is a branch of sciatic nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8.5
      Seconds
  • Question 21 - Regarding the brachioradialis muscle, which of the following statements is true? ...

    Correct

    • Regarding the brachioradialis muscle, which of the following statements is true?

      Your Answer: It assists with supination of the forearm at the radioulnar joints

      Explanation:

      Brachioradialis is a fusiform muscle located in the lateral part of the posterior forearm. Along with extensor carpi radialis brevis and extensor carpi radialis longus, it comprises the radial group of forearm muscles, which belong to the superficial layer of posterior forearm muscles. Although anatomically part of the posterior forearm muscles, which are known to be forearm extensors, brachioradialis’ fibre orientation enables it to rather flex the forearm, and aids in supination of the forearm at the radioulnar joint.

      The brachioradialis muscle originates from the upper two-thirds of the lateral supracondylar ridge of humerus and the anterior surface of the lateral intermuscular septum of the arm. It slides over the lateral surface of the elbow joint, entering the anterolateral cubital area. The muscle fibres course inferiorly down the radial part of the anterior forearm, forming a thick tendon in approximately the middle of the forearm. This tendon then traverses the remainder of the forearm, inserting near the wrist, just proximal to the styloid process of radius.

      Brachioradialis is innervated by the radial nerve (from the root values C5-C6) that stems from the posterior cord of the brachial plexus. Blood supply to the brachioradialis muscle comes from branches of the radial artery, radial recurrent artery and the radial collateral branch of the deep brachial artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      4.9
      Seconds
  • Question 22 - A 45-year old man presented to the emergency room with complains of chest...

    Incorrect

    • A 45-year old man presented to the emergency room with complains of chest pain and breathlessness. Upon history taking and examination, it was discovered that he had a right-sided spontaneous pneumothorax and had a failed attempt at pleural aspiration. The pneumothorax is still considerable in size, but he remains breathless. A Seldinger chest drain was inserted but it started to drain frank blood shortly after.

      Which of the following complications is most likely to have occurred?

      Your Answer: Pulmonary laceration

      Correct Answer: Intercostal artery laceration

      Explanation:

      Injury to the intercostal artery (ICA) is an infrequent but potentially life-threatening complication of all pleural interventions.

      Traditional anatomy teaching describes the ICA as lying in the intercostal groove, protected by the flange of the rib. This is the rationale behind the recommendation to insert needles just above the superior border of the rib. Current recommendations for chest drain insertion suggest that drains should be inserted in the ‘safe triangle’ in order to avoid the heart and the mediastinum and be above the level of the diaphragm.

      The safe triangle is formed anteriorly by the lateral border of the pectoralis major, laterally by the lateral border of the latissimus dorsi, inferiorly by the line of the fifth intercostal space and superiorly by the base of the axilla. Imaging guidance also aids in the safety of the procedure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      26.2
      Seconds
  • Question 23 - An 11-year-old boy was brought to the emergency room due to fever and...

    Incorrect

    • An 11-year-old boy was brought to the emergency room due to fever and pain in the ears. Upon physical examination, it was observed that the mastoid area is erythematous and there is a presence of a boggy, tender mass. A diagnosis of acute mastoiditis was made.

      Which of the following parts of the temporal bone is most likely involved?

      Your Answer: Styloid process

      Correct Answer: Petrous part

      Explanation:

      Mastoiditis is the inflammation of a portion of the temporal bone referred to as the mastoid air cells. The mastoid air cells are epithelium lined bone septations that are continuous with the middle ear cavity.

      The temporal bone is composed of four parts: the mastoid process, the petrous pyramid, the squamous, and tympanic portions. The mastoid process and the petrous pyramid are the portions of particular interest because of the prevalence of suppurations within these parts of the temporal bone.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      7.6
      Seconds
  • Question 24 - Regarding the abductor pollicis longus, which of the following statements is true? ...

    Incorrect

    • Regarding the abductor pollicis longus, which of the following statements is true?

      Your Answer:

      Correct Answer: It extends the thumb at the carpometacarpal joint

      Explanation:

      Abductor pollicis longus is a muscle found in the posterior compartment of the forearm. It is one of the five deep extensors in the forearm, along with the supinator, extensor pollicis brevis, extensor pollicis longus and extensor indicis.

      Abductor pollicis longus is innervated by the posterior interosseous nerve (C7, C8), which is a continuation of the deep branch of the radial nerve. The radial nerve is a branch of the posterior cord of the brachial plexus.

      Blood supply to the abductor pollicis longus muscle comes from the interosseous branches of the ulnar artery.

      Acting alone or with abductor pollicis brevis, abductor pollicis longus pulls the thumb away from the palm. More specifically, it produces (mid-) extension and abduction of the thumb at the first metacarpophalangeal joint. This action is seen in activities such as bowling and shovelling.

      Working together with the long and short extensors of the thumb, the muscle also helps to fully extend the thumb at the metacarpophalangeal joint. This action is important for loosening the hand grip, for example, when letting go of objects previously being held. Abductor pollicis longus also helps to abduct the hand (radial deviation) at the radiocarpal joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 25 - Which extraocular muscle is entrapped in a patient with a blowout fracture? ...

    Incorrect

    • Which extraocular muscle is entrapped in a patient with a blowout fracture?

      Your Answer:

      Correct Answer: Inferior rectus

      Explanation:

      A blowout fracture is an isolated fracture of the orbital walls without compromise of the orbital rims. The common mechanisms are falls, high-velocity ball-related sports, traffic accidents, and interpersonal violence.

      The frontal, ethmoidal, sphenoid, zygomatic, and lacrimal bones form the bony structures of the orbit. Medially, the maxillary and the lacrimal bone form the lacrimal fossa. Together with the lamina papyracea of the ethmoid bone, they form the medial wall. The sphenoid bone forms the posterior wall and houses the orbital canal. Lateral to the orbital canal lies the superior orbital fissure housing cranial nerves III, IV, V, and VI. The zygomatic bone forms the lateral wall. Superior and inferior borders are the frontal and maxillary bones. Located around the globe of the eye and attached to it are 6 extraocular muscles; the 4 rectus muscles and the superior and inferior oblique muscles. The fat and connective tissue around the globe help to reduce the pressure exerted by the extraocular muscles.

      The goal of treatment is to restore aesthetics and physiological function. The problem with orbital blowout fractures is that the volume of the orbit can be increased, resulting in enophthalmos and hypoglobus. In addition, the orbital tissue and inferior rectus muscle can become trapped by the bony fragments leading to diplopia, limitation of gaze, and tethering. Finally, the orbital injury can lead to retinal oedema, hyphema, and significant loss of vision.

      While some cases may be managed with conservative care, others may require some type of surgical intervention.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 26 - A patient is referred to the Medicine Department for complaints of unilateral hearing...

    Incorrect

    • A patient is referred to the Medicine Department for complaints of unilateral hearing loss, tinnitus and facial numbness. Upon further investigation, an acoustic neuroma is given as the final diagnosis.

      Which of the following nerves is least likely to be affected in acoustic neuroma?

      Your Answer:

      Correct Answer: Trochlear nerve

      Explanation:

      Acoustic neuroma is also called vestibular schwannoma (VS), acoustic neuroma, vestibular neuroma or acoustic neurofibroma. These are tumours that evolve from the Schwann cell sheath and can be either intracranial or extra-axial. They usually occur adjacent to the cochlear and vestibular nerves and most often arise from the inferior division of the latter. Anatomically, acoustic neuroma tends to occupy the cerebellopontine angle. About 5-10% of cerebellopontine angle (CPA) tumours are meningiomas and may occur elsewhere in the brain. Bilateral acoustic neuromas tend to be exclusively found in individuals with type 2 neurofibromatosis.

      The following nerves may be affected due to nerve compression:

      Facial nerve: usually minimal with late presentation except for very large tumours. Depending on the degree of engagement of the nerve, the symptoms may include twitching, increased lacrimation and facial weakness.

      Trigeminal Nerve: paraesthesia in the trigeminal distribution, tingling of the tongue, impairment of the corneal reflex, and less commonly pain which may mimic typical trigeminal neuralgia.

      Glossopharyngeal and Vagus nerves: palatal paresis, hoarseness of voice and dysphagia

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 27 - The most important nerves for inversion of the foot are: ...

    Incorrect

    • The most important nerves for inversion of the foot are:

      Your Answer:

      Correct Answer: Tibial and deep fibular nerve

      Explanation:

      Inversion of the foot is achieved by the tibialis anterior which is innervated by the deep fibular nerves, and the tibialis posterior muscles which is innervated by the tibial nerve respectively.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 28 - Which of the following is first-line for management of status epilepticus: ...

    Incorrect

    • Which of the following is first-line for management of status epilepticus:

      Your Answer:

      Correct Answer: Intravenous lorazepam

      Explanation:

      First-line treatment is with intravenous lorazepam if available. Intravenous diazepam is effective but it carries a high risk of thrombophlebitis so should only be used if intravenous lorazepam is not immediately available. Absorption of diazepam from intramuscular injection or from suppositories is too slow for treatment of status epilepticus. When facilities for resuscitation are not immediately available or if unable to secure immediate intravenous access, diazepam can be administered as a rectal solution or midazolam oromucosal solution can be given into the buccal cavity.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 29 - What type of visual field defect are you most likely to see in...

    Incorrect

    • What type of visual field defect are you most likely to see in a lesion of the parietal optic radiation:

      Your Answer:

      Correct Answer: Contralateral homonymous inferior quadrantanopia

      Explanation:

      A lesion of the parietal optic radiation will result in a contralateral homonymous inferior quadrantanopia.
      A lesion of the temporal optic radiation will result in a contralateral homonymous superior quadrantanopia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 30 - The least likely feature expected to be seen in a lesion of the...

    Incorrect

    • The least likely feature expected to be seen in a lesion of the frontal lobe is which of the following?

      Your Answer:

      Correct Answer: Loss of two-point discrimination

      Explanation:

      Lesions in different areas give rise to different symptoms.
      Lesions of the parietal lobe give rise to loss of two-point discrimination.
      Lesions to Broca’s area give rise to expressive dysphasia results from damage
      Lesions to the primary motor cortex give rise to contralateral weakness of the face and arm.
      Lesions to the prefrontal cortex give rise to personality change.
      Lesions to the frontal eye field give rise to conjugate eye deviation towards side of lesion.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
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SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (12/21) 57%
Head And Neck (3/4) 75%
Cranial Nerve Lesions (1/2) 50%
Upper Limb (1/5) 20%
Thorax (1/2) 50%
Lower Limb (2/4) 50%
Abdomen (1/1) 100%
Central Nervous System (4/5) 80%
Pharmacology (1/2) 50%
Passmed