anatomy mcqs mcem

ANATOMY

MCQs

MCEM

Question id: 2051

#1 Concerning the distal end of the radius:

a)

It articulates with the scaphoid, lunate and triquetral.

b)

It has two non-articular surfaces and two articular surfaces.

c)

The radiocarpal ligaments attach to both the volar and dorsal surfaces.

d)

Extensor pollicis longus lies medial to the dorsal tubercle of Lister.

Explanations:

a) F. The triquetral articulates directly with the fibrocartilage between the radius and ulna.

b) F. It has three non-articular surfaces and two articular surfaces.

c) T. The statement is true.

d) T. The statement is true.

Question id: 2279

#2 The following structures pass under the inguinal ligament:

a)

The superficial femoral artery.

b)

The femoral branch of the genitofemoral nerve.

c)

The femoral nerve.

d)

The long saphenous vein.

Explanations:

a) F. The statement is false.

b) T. The following structures pass under the inguinal ligament:

Tendon of psoas major

Femoral branch of genitofemoral nerve

Femoral nerve


d) F. The great saphenous vein (long saphenous vein) terminates approximately 3 cm

below the inguinal ligament.

Question id: 2052

#3 Regarding the pulp space:

a)

It contains fat and fibrous tissue.

b)

It contains the deep flexor tendon.

c)

Infection causes pain that is worse at night.

d)

Infection may lead to osteomyelitis of the entire terminal phalanx.

Explanations:

a) T. The statement is true.

b) F. The deep flexor tendon is separated from the pulp space by the deep fascia.

c) T. Pain is throbbing in nature and worse at night.

d) F. The proximal part of the terminal phalanx is not affected as the space is distal.

Question id: 2292

#4 Regarding the anterior triangle of the neck:

a)

The apex is formed by the union of sternocleidomastoid and trapezius.

b)

It is bordered anteriorly by the midline of the neck.

c)

It is bordered superiorly by the mandible.

d)

It contains the submandibular gland.

Explanations:

a) F. This is the apex of the posterior triangle of the neck. The anterior triangle of the neck

is inverted with its apex the inferior boundary. The boundaries of the anterior triangle are:

Superiorly (base): inferior border of the mandible

Inferiorly (apex): jugular notch of the manubrium sterni

Anteriorly: midline of the neck from the chin to the jugular notch

Posteriorly: anterior margin of sternocleidomastoid

b) T. The statement is true.


d) T. The contents of the anterior triangle of the neck include:

Muscles: digastric, stylohyoid, mylohyoid, geniohyoid, sternohyoid, omohyoid, thyrohyoid,

sternothyroid and platysma

Veins: internal jugular, facial, retromandibular, anterior jugular and external jugular veins

Arteries: carotid sheath and branches of external carotid artery

Nerves: nerve to mylohyoid and ansa cervicalis

Bones: hyoid and larynx bones

Glands: thyroid and parathyroids

Other structures: lymph nodes, submandibular gland, trachea and oesophagus

Question id: 2259

#5 Regarding the appendix:

a)

Is located at the surface marking of McBurneys point.

b)

Its base has a constant position.

c)

It is on average 10 cm in length.

d)

It has its own mesentery.

Explanations:

a) T. The appendix is located at McBurneys point, which is two-thirds of the way between

the anterior superior iliac spine and the umbilicus.

b) T. The base of the appendix has a constant position on the posteromedial wall of the

caecum where the 3 taenia coli meet.


d) T. The appendix has a triangular shaped mesentery that descends behind the ileum and

has the appendicular artery in its free border.

Question id: 2265

#6 The appendix:

a)

Is attached to the posteromedial aspect of the caecum.

b)

Is pelvic in 5% of the population.

c)

Has taenia coli.

d)

Has no mesentery.

Explanations:

a) T. The appendix is attached to the posteromedial aspect of the caecum below the

ileocaecal valve.

b) F. The position of the appendix is variable:

75% are retrocaecal or retrocolic

20% are pelvic

5% are preilieal or retroileal

c) F. The taenia coli converge at the base of the appendix and there are none on the

appendix.

d) F. The appendix has a mesentery, which contains the appendicular artery.

Question id: 2296

#7 The left common carotid artery:

a)

Lies antero-medial to the left vagus nerve in the neck.

b)

Lies posterior to the prevertebral fascia in the neck.

c)

Gives off the left inferior thyroid artery.

d)

Arises directly from the aortic arch.

Explanations:


b) F. The left common carotid artery lies anterior to the prevertebral fascia in the neck.

c) F. The left inferior thyroid artery arises from the left thyrocervical trunk.


Question id: 2060

#8 Regarding the thenar eminence:

a)

All of the muscles are innervated by the radial nerve.

b)

Abductor pollicis brevis is the most proximal muscle of the thenar group.

c)

Flexor pollicis brevis flexes the thumb.

d)

Opponens pollicis lies superficial to abductor pollicis brevis.

Explanations:

a) F. The muscles of the thenar eminence are innervated by the median nerve.


c) T. Flexor pollicis brevis flexes the thumb curling it into the palm.

d) F. Opponens pollicis lies deep to abductor pollicis brevis.

Question id: 2210

#9 Surface markings of the great vessels:

a)

The ascending aorta begins at the level of the lower border of the left 3rd costal cartilage.

b)

The arch of the aorta ends at the sternal end of the left 2nd costal cartilage.

c)

The descending thoracic aorta begins at the sternal end of the left 2nd costal cartilage.

d)

The superior vena cava is formed in the right 1st intercostal space just inferior to the 1st costal

cartilage.

Explanations:





Question id: 2118

#10 Regarding the medial thigh muscles:

a)

Adductor longus assists with internal rotation of the hip.

b)

Adductor brevis assists with hip flexion.

c)

Adductor magnus is partly supplied by the sciatic nerve

d)

Obturator externus internally rotates the hip.

Explanations:

a) F. Adductor longus only acts to adduct the hip. Pectineus, gracilis, tensor fascia latae,

gluteus maximus and gluteus minimus all contribute to internal rotation of the hip.

b) T. Adductor brevis adducts and flexes the hip.

c) T. The adductor part of adductor magnus is supplied by the obturator nerve and the

hamstring part is supplied by the sciatic nerve.

d) F. Obturator externus externally rotates the hip.

Question id: 2168

#1 Regarding the tibial nerve:

a)

It is a branch of the femoral nerve.

b)

It passes through the adductor hiatus.

c)

It terminates beneath the extensor retinaculum.

d)

It lies posterior to the lateral malleolus.

Explanations:

a) F. The tibial nerve is a branch of the sciatic nerve.

b) F. The adductor hiatus is the termination of the adductor canal. It is a gap between the

adductor magnus muscle and the femur that allows the passage of the femoral vessels from the

anterior thigh to the posterior thigh and then into the popliteal fossa.

c) F. The tibial nerve descends through the popliteal fossa and lies on popliteus. It then

runs inferiorly on tibialis posterior with the posterior tibial vessels and passes into the foot by

running posterior to the medial malleolus. It terminates beneath the flexor retinaculum by

dividing into the medial and lateral plantar nerves.

d) F. The statement is false.

Question id: 2088

#2 Regarding the spinal cord:

a)

The spinal cord extends the entire length of the vertebral column.

b)

The spinal cord is approximately 43-45cm long.

c)

The coccygeal nerve leaves the spinal cord at the level of the conus medullaris.

d)

The filum terminale consists of two parts and gives support to the spinal cord.

Explanations:

a) F. The spinal cord extends from the occipital bone to L1/L2.



d) T. It gives longitudinal support to the spinal cord and consists of the filum terminale

internum and the filum terminale externum.

Question id: 2175

#3 Regarding the foot and ankle:

a)

Peroneus longus inserts into the base of the 1st metatarsal.

b)

Tibialis anterior attaches to the base of the 5th metatarsal.

c)

There are two cuneiform bones in each foot.

d)

The central part of the plantar fascia forms the plantar aponeurosis.

Explanations:

a) T. Peroneus longus inserts into the base of the 1st metatarsal and the medial cuneiform.

b) F. Tibialis anterior inserts into the medial and inferior surfaces of the medial cuneiform

and the base of the 1st metatarsal.

c) F. There are three cuneiform bones in each foot: the lateral, intermediate and medial

cuneiforms.


Question id: 2194

#4 Anatomical considerations when performing needle thoracocentesis:

a)

It should be performed in the 2nd intercostal space in the mid-axillary line.

b)

The neurovascular bundle lies high in the intercostal space.

c)

The nerve in the most superior structure in the neurovascular bundle.

d)

The artery is the most inferior structure in the neurovascular bundle.

Explanations:

a) F. Needle thoracocentesis should be performed in the 2nd intercostal space in the mid-

clavicular line.


c) F. The neurovascular bundle from most superior to most inferior has the order of vein,

artery, nerve (mnemonic: V A N).


Question id: 2023

#5 Damage to the median nerve at the wrist results in:

a)

Papal benediction on flexing the fingers.

b)

Wasting of the hypothenar muscles.

c)

Loss of sensation to the lateral 3 and a half digits.

d)

Loss of sensation over the 1st dorsal interosseus.

Explanations:

a) F. The long flexors are intact as they are supplied by the anterior interosseus branch

which arises in the forearm.

b) F. Median nerve lesions result in wasting of the thenar eminence except adductor

pollicis. The hyopthenar muscles are supplied by the ulnar nerve.

c) T. The median nerve supplies sensation to the lateral 3 and a half digits and the skin on

the radial side of the palm.

d) F. The radial nerve supplies sensation via a cutaneous branch to the area over the 1st

dorsal interosseus.

Question id: 2206

#6 Regarding the localization of myocardial infarction (MI):

a)

Septal MI involves the leftt circumflex artery.

b)

Lateral MI involves the right coronary artery.

c)

Inferior MI involves the right coronary artery in 80% of cases.

d)

Right ventricular MI involves the right circumflex artery.

Explanations:

a) F. The following types of MI involve the following coronary arteries:

Anterior MI left anterior descending artery

Septal MI left anterior descending artery

Lateral MI left circumflex artery

Inferior MI right coronary artery (80%) or left circumflex artery (20%)

Posterior MI left circumflex artery

Right ventricular MI right coronary artery

b) F. The statement is false.



Question id: 2122

#7 Regarding the profunda femoris artery:

a)

It is a branch of the femoral artery.

b)

It gives off the obturator artery.

c)

It runs medial and then posteriorly to the femoral artery.

d)

It gives off perforating branches that supply adductor magnus and the hamstrings.

Explanations:

a) T. The profunda femoris (deep femoral) artery is a branch of the femoral artery.

b) F. The obturator artery is a branch of the internal iliac artery.

c) F. Profunda femoris runs lateral and then posteriorly to the femoral artery.

d) T. Profunda femoris gives off perforating branches that supply adductor magnus and the

hamstrings.

Question id: 2163

#8 Regarding the neck of the femur:

a)

The capsule attaches anteriorly at the intertrochanteric line.

b)

The intertrochanteric crest lies posteriorly.

c)

Intertrochanteric fractures usually require management with hemi-arthroplasty.

d)

It is closely related to the obturator externus muscle.

Explanations:

a) T. Anteriorly the capsule attaches at the intertrochanteric line, posteriorly the lateral

half of the femoral neck is extracapsular.

b) T. The intertrochanteric line lies anteriorly and the intertrochanteric crest lies

posteriorly.

c) F. Intertrochanteric fractures do not disrupt the blood supply entering through the

retinacula on the neck and can therefore usually be managed with the placement of a dynamic

hip screw.

d) T. Obturator externus winds around the inferior aspect of the neck.

Question id: 2291

#9 Regarding the muscles of the orbit:

a)

Medial rectus is an adductor of the eye.

b)

Superior rectus moves the eye upwards and outwards.

c)

Superior oblique is innervated by the abducens nerve.

d)

Lateral rectus is innervated by the oculomotor nerve.

Explanations:

a) T. The medial rectus muscle adducts the eye, moving it inwards and towards the nose.

b) F. The superior rectus muscle moves the eye upwards (elevation) and inwards

(adduction).

c) F. The superior oblique muscle is innervated by the trochlear nerve.

d) F. The lateral rectus muscle is the only muscle innervated by the abducens nerve.

Question id: 2121

#10 Regarding the obturator nerve:

a)

It has a root value of L4-S1.

b)

Its anterior branch innervates obturator externus.

c)

Its posterior branch innervates adductor brevis.

d)

It lies deep to the external iliac vessels.

Explanations:

a) F. The root value of the obturator nerve is L2-L4.

b) F. Obturator externus is innervated by the posterior branch of the obturator nerve. The

anterior branch of the obturator nerve innervates adductor longus, adductor brevis, gracilis and

pectineus.

c) F. Adductor brevis is innervated by the anterior branch of the obturator nerve. The

posterior branch of the obturator nerve innervates obturator externus and adductor magnus.

d) T. The obturator nerve arises from the lumbar plexus, passes deep to the medial margin

of psoas major and then lies deep to the external iliac vessels.

Question id: 2104

#1 Regarding cervical vertebral fractures:

a)

The most common level of cervical vertebral fractures is C3.

b)

Hangman's fracture involves the pars interarticularis of C2.

c)

Atlanto-occipital dislocation is usually fatal.

d)

C1 rotary subluxation is most common in elderly patients with degenerative changes in their

cervical vertebrae.

Explanations:

a) F. The most common level of cervical vertebral fracture is C5. At C3 cervical vertebral

fractures are very uncommon as this is the most stable part of the cervical spine being

positioned between the vulnerable axis and C5/6 where the greatest amount of flexion and

extension can occur.

b) T. Hangman's fracture involves the posterior elements of C2 - the pars interarticularis

and pedicles. The mechanism of this injury is forcible hyperextension of the head with

distraction of the neck as occurred in judicial hangings.

c) T. Atlanto-occipital dislocation is usually fatal due to brainstem injury and apnoea or

severe neurological impairment.

d) F. C1 rotary subluxation is most common in children and may occur spontaneously or

following minor trauma. It can also occur in association with an upper respiratory tract

infection. It presents as persistent torticollis.

Question id: 2179

#2 The superior thoracic aperture (thoracic inlet) is bounded by:

a)

C7 posteriorly.

b)

The 1st pair of ribs laterally.

c)

The superior border of manubrium anteriorly.

d)

The costal cartilage of the 2nd rib anteriorly.

Explanations:

a) F. The boundaries of the thoracic inlet are:

Posteriorly T1

Anteriorly superior border of manubrium and the costal cartilage of the 1st rib

Laterally the 1st pair of ribs




Question id: 2290

#3 Regarding the muscles of the orbit:

a)

Levator palpabrae superioris is innverated by the trochlear nerve.

b)

Lateral rectus adducts the eye.

c)

Inferior oblique moves the upwards and outwards.

d)

Superior oblique loops through a fascial sling before attaching to the eyeball.

Explanations:

a) F. Levator palpabrae superioris is innverated by the oculomotor nerve.

b) F. The lateral rectus muscle abducts the eye, moving it outward and away from the

nose.

c) T. The inferior oblique muscle rotates the eye away from the nose (extorsion), moves

the eye upwards (elevation) and outwards (abduction).


Question id: 2230

#4 Regarding the following chest radiograph:

.

a)

The arrow on the right points to an eventration of the diaphragm.

b)

If the heart size is greater than 50% of the cardiothoracic ratio then cardiomegaly is present.

c)

The lingula of the upper lobe of the left lung wraps over the left ventricle.

d)

The right heart contour is the right lateral border of the right ventricle.

Explanations:

a) T. An eventration of the diaphragm is a disorder in which all or part of the diaphragm is

replaced by fibroelastic tissue. It gives rise to an abnormal elevation of the dome of the

diaphragm that is visible on chest radiograph.



d) F. The right heart contour is the right lateral border of the right atrium.

Question id: 2144

#5 Movements of the shoulder:

a)

Flexion is contributed to by pectoralis major.

b)

Extension is contributed to by latissimus dorsi.

c)

Internal rotation is contributed to by teres minor.

d)

External rotation is contributed to by subscapularis.

Explanations:

a) T. Shoulder flexion is performed by:

Pectoralis major

Coracobrachialis

Anterior fibres of deltoid

b) T. Shoulder extension is performed by:

Latissimus dorsi

Teres major

Posterior fibres of deltoid

c) F. Internal rotation of the shoulder is performed by:

Pectoralis major

Latissimus dorsi

Teres major

Anterior fibres of deltoid

Subscapularis

d) F. External rotation of the shoulder is performed by:

Infraspinatus

Teres minor

Posterior fibres of deltoid

Question id: 2222

#6 Regarding the inguinal ligament:

a)

It runs from the anterior superior iliac spine to the pubic tubercule.

b)

It is formed by the aponeurosis of internal oblique.

c)

It is continuous with the fascia lata of the thigh.

d)

It is the superior border of the femoral triangle.

Explanations:


b) F. It is formed by the aponeurosis of external oblique.



Question id: 2136

#7 The sciatic nerve:

a)

Leaves the pelvis through the greater sciatic foramen.

b)

Emerges from the lateral border of gluteus maximus.

c)

Supplies semimembranosus.

d)

Injury to the sciatic nerve results in impairment of flexion of the thigh and extension of the leg.

Explanations:

a) T. The sciatic nerve leaves the pelvis through the greater sciatic foramen inferior to

piriformis.

b) F. It runs deep to gluteus maximus and emerges from its inferior border.

c) T. The sciatic nerve supplies:

Biceps femoris

Semitendinosus

Semimembranosus

Adductor magnus

d) F. Injury to the sciatic nerve results in impairment of extension of the thigh and flexion

of the leg.

Question id: 2086

#8 Openings in the diaphragm:

a)

The opening in the diaphragm for the inferior vena cava lies at T8.

b)

The opening in the diaphragm for the aorta lies at T10.

c)

The opening in the diaphragm for the oespohagus lies at T12.

d)

The diaphragm transmits the thoracic duct at T8.

Explanations:


b) F. The opening in the diaphragm for the aorta lies at T12.

c) F. The opening in the diaphragm for the oespohagus lies at T10.

d) F. The diaphragm transmits the thoracic duct at T12.

Question id: 2089

#9 The following spinal nerves are correctly matched with their corresponding dermatomes:

a)

C7 The middle finger.

b)

T4 The nipple line.

c)

T8 The umbilicus.

d)

S4 and S5 The perianal region.

Explanations:

a) T. The key dermatomes are:

C5 The area over the deltoid

C6 The thumb

C7 The middle finger

C8 The little finger

T4 The nipple line

T8 The xiphisternum

T10 The umbilicus

T12 The symphysis pubis

L4 The medial aspect of the calf

L5 The webspace between the 1st and 2nd toe

S1 The lateral border of the foot

S3 The ischial tuberosity area

S4 and S5 The perianal region


c) F. The statement is false.


Question id: 2278

#10 The following structures pass under the inguinal ligament:

a)

The tendon of psoas major.

b)

The superficial epigastric vein.

c)

The great saphenous vein.

d)

The femoral nerve.

Explanations:

a) T. The following structures pass under the inguinal ligament:

Tendon of psoas major

Femoral branch of genitofemoral nerve

Femoral nerve

b) F. The superficial epigastric vein passes in front of the inguinal ligament.

c) F. The great saphenous vein (long saphenous vein) terminates approximately 3 cm

below the inguinal ligament.


Question id: 2216

#1 Regarding the triangular fibrocartilage complex (TFCC):

a)

It is formed in part by the ulnocarpal ligaments.

b)

It is important in load transmission across the radial aspect of the wrist.

c)

It can be palpated between extensor carpi radialis longus and brevis.

d)

Injury is most commonly caused by fall onto an outstretched hand.

Explanations:

a) T. The TFCC is formed by the triangular fibrocartilage discus (TFC), the radioulnar

ligaments (RULs) and the ulnocarpal ligaments (UCLs)

b) F. The primary functions of the TFCC are:

To cover the ulnar head by extending the articular surface of the distal radius

Load transmission across the ulnocarpal joint (ulnar aspect of wrist)

Stabilization of the distal radio-ulnar joint

c) F. The best place to palpate the TFCC is between extensor carpi ulnaris and flexor carpi

ulnaris.


Question id: 2040

#2 Regarding the carpal and palmar arches of the hand:

a)

The dorsal carpal arch is the anastomosis of the dorsal carpal branches of the radial and ulnar

arteries.

b)

The dorsal carpal arch gives off two dorsal metacarpal arteries.

c)

The deep palmar arch is formed mainly from the terminal part of the ulnar artery.

d)

The superficial palmar arch lies distal to the deep palmar arch.

Explanations:


b) F. The dorsal carpal arch gives off three dorsal metacarpal arteries.

c) F. The deep palmar arch is formed mainly from the terminal part of the radial artery

with a small contribution from the ulnar artery.


Question id: 2186

#3 Regarding the anatomy of respiration:

a)

The pump handle' action of the ribs increases the transverse diameter of the chest.

b)

The diaphragm is responsible for abdominal breathing.

c)

Forced inspiration requires the use of rectus abdominis.

d)

Forced expiration requires the use of the external and internal obliques.

Explanations:

a) F. The pump handle' action of the ribs is their forward and upward movement

increasing the antero-posterior diameter of the chest. The bucket handle' action of the ribs is

their upward and lateral movement increasing the transverse diameter of the chest.


c) F. Forced inspiration requires the use of the accessory muscles of respiration:

sternocleidomastoid, scalenes, pectoralis major, pectoralis minor and serratus anterior.

d) T. Forced expiration requires the use of: rectus abdominis, external and internal

obliques, transversus abdominis and latissimus dorsi.

Question id: 2148

#4 The following are the boundaries of the popliteal fossa:

a)

Superolaterally - semimembranosus and semitendinosus.

b)

Superomedially - biceps femoris.

c)

Inferomedially - medial head of gastrocnemius.

d)

Floor - popliteal surface of the femur.

Explanations:

a) F. The following are the boundaries of the popliteal fossa:

Superolaterally biceps femoris

Superomedially semimembranosus and semitendinosus

Inferomedially medial head of gastrconemius

Inferolaterally lateral head of gastrocnemius

Roof skin and fascia

Floor popliteal surface of femur, oblique popliteal ligament, fascia over popliteus




Question id: 2001

#5 Regarding the surface anatomy of the thoracic wall:

a)

The sternal angle lies at the level of the 1st pair of costal cartilages.

b)

The superior part of the costal margin is formed by the 7th costal cartilage.

c)

The lower border of pectoralis major at its attachment corresponds with the 4th rib.

d)

The apex of the lung is situated in the neck above the medial third of the clavicle.

Explanations:

a) F. The sternal angle lies at the level of the 2nd pair of costal cartilages.


c) F. The lower border of pectoralis major at its attachment corresponds with the 5th rib.


Question id: 2128

#6 The following structures pass through the foramen magnum:

a)

Medulla oblongata.

b)

Dura mater.

c)

Spinal arteries.

d)

Vertebral veins.

Explanations:

a) T. The following structures pass through the foramen magnum: Medulla oblongata,

spinal accessory nerve, vertebral arteries, the anterior and posterior spinal arteries, the

tectorial membrane and the alar ligaments.




Question id: 2211

#7 Regarding the anterior abdominal wall:

a)

The rectus abdominis is separated in the midline by the linea alba.

b)

The origin of external oblique is the 5th to 7th costal cartilages.

c)

Colle's fascia separates the skin from the superficial perineal pouch.

d)

Scarpa's fascia is attached to the deep fascia of the thigh 2.5 cm below the inguinal ligament.

Explanations:


b) F. The origin of external oblique is the outer surface of the lower 8 ribs.

c) T. Colle's fascia is the deep layer of the superficial fascia of the abdominal wall that

extends into the perineum. It separates the skin from the superficial perineal pouch.

d) T. Scarpa's fascia is the deep fibrous layer of the superficial fascia of the abdominal wall.

It is attached to the deep fascia of the thigh 2.5 cm below the inguinal ligament.

Question id: 2017

#8 Regarding the shoulder joint:

a)

Stability depends mainly upon the glenoid labrum.

b)

The subacromial bursa lies above the supraspinatus tendon.

c)

The rotator cuff comprises supraspinatus, infraspinatus, teres minor and subscapularis.

d)

Dislocation is most commonly posterior.

Explanations:

a) F. Stability depends mainly upon the 4 rotator cuff muscles.



d) F. Anterior dislocation accounts for 95-97% of shoulder dislocations.

Question id: 2208

#9 Regarding the pericardium:

a)

The outermost layer is the fibrous pericardium.

b)

The right phrenic nerve passes over the pericardium of the left ventricle.

c)

A pericardial effusion forms between the parietal and visceral pericardial layers.

d)

The visceral pericardium is continuous with the epicardium.

Explanations:

a) T. The pericardium has two layers, the outermost being the fibrous pericardium and the

innermost the serous pericardium.

b) F. The right phrenic nerve passes to the right of the pericardium, the left phrenic nerve

passes over the pericardium of the left ventricle.



Question id: 2232

#10 The anatomy of the respiratory tract:

a)

There are 25 bronchial generations.

b)

Generations 12-25 are known as the respiratory zone of the lungs.

c)

Bifurcation of the bronchi occurs at T6.

d)

The lungs are lined with transitional epithelium.

Explanations:

a) F. There are 23 bronchial generations. Generations 1-16 are the conducting zone and

generations 17-23 are the respiratory zone.


c) F. Bifurcation of the bronchi occurs at T4.

d) F. The lungs are lined with columnar ciliated epithelium

Question id: 2200

#1 Anatomy of the lungs:

a)

The right lung is larger than the left lung.

b)

The left lung is divided into two lobes by a transverse fissure.

c)

The azygous lobe is a congenital abnormality of the left lung.

d)

The horizontal fissure of the right lung is absent in 10%.

Explanations:

a) T. The right lung is slightly larger than the left lung.

b) F. The right lung is divided into three lobes by the oblique and horizontal fissures. The

left lung is divided into two lobes by an oblique fissure.

c) F. The azygous lobe is a rare congenital abnormality of the upper lobe of the right lung.

It arises from an anomalous lateral course of the azygous vein in a pleural septum within the

upper lobe.

d) T. The horizontal fissure of the right lung is incomplete in 60% and absent in 10%.

Question id: 2110

#2 Regarding the femoral nerve:

a)

It lies medial to the femoral artery.

b)

Its nerve roots are L1 and L2.

c)

It overlies the psoas major muscle.

d)

Its anterior division gives off the branch to vastus medialis.

Explanations:

a) F. The femoral nerve lies lateral to the femoral artery and vein.

b) F. The nerve roots of the femoral nerve are L2-L4.

c) F. The femoral nerve is formed in the abdomen within the psoas major muscle and

descends through the fibres of it and emerges at the lower part of its lateral border. It overlies

the iliacus muscle.

d) F. The anterior division of the femoral nerve gives off the anterior cutaneous branches

and the branches to pectineus and sartorius. The posterior division gives off branches to rectus

femoris, vastus lateralis, vastus medialis and vastus intermedius.

Question id: 2183

#3 The following veins pass through the superior thoracic aperture (thoracic inlet):

a)

Internal jugular veins.

b)

Axillary veins.

c)

Subclavian veins.

d)

Brachiocephalic veins.

Explanations:

a) T. The following veins pass through the thoracic inlet:

Internal jugular veins

Subclavian veins

Brachiocephalic veins




Question id: 2030

#4 Muscles of the arm:

a)

Triceps brachii is the chief extensor of the forearm.

b)

Anconeus assists biceps in flexing the forearm.

c)

Anconeus is innervated by the musculocutaneous nerve.

d)

Triceps is innervated by the radial nerve.

Explanations:


b) F. Anconeus assists triceps in extending the forearm.

c) F. Anconeus is innervated by the radial nerve.


Question id: 2137

#5 Regarding the hip joint:

a)

It is a synovial joint.

b)

The capsule attaches anteriorly to the trochanteric line of the femur.

c)

The capsular fibres carry the blood supply to the femoral head.

d)

Approximately 30% of the population have a psoas bursa.

Explanations:

a) T. The hip is a synovial ball and socket joint.

b) T. The attachments of the capsule are:

Superiorly to the acetabular margin

Anteriorly to the trochanteric line of the femur and to the bases of the trochanters

Posteriorly to the femur 1cm above the trochanteric crest


d) F. A psoas bursa is an outpouching of synovial membrane through a defect in the

anterior capsular wall under the psoas tendon. It is present in approximately 10% of the

population.

Question id: 2085

#6 Openings in the diaphragm:

a)

The opening in the diaphragm for the inferior vena cava lies at T6.

b)

The diaphragm transmits the right phrenic nerve at T8.

c)

The opening in the diaphragm for the oespohagus lies at T12.

d)

The diaphragm transmits the hemiazygous veins at T12.

Explanations:

a) F. The opening in the diaphragm for the inferior vena cava lies at T8.


c) F. The opening in the diaphragm for the oespohagus lies at T10.


Question id: 2011

#7 Regarding the breast:

a)

75% of lymph drains to the axillary lymph nodes.

b)

Ligaments of Astley Cooper connect the pectoral fascia to the skin.

c)

Venous drainage of the breast is mainly to the axillary vein.

d)

Physiologocal gynaecomastia is normal in the neonatal period.

Explanations:




d) T. Newborn babies can have gynaecomastia, which is the result of maternal oestrogens,

and the gynaecomastia resolves after a few weeks.

Question id: 2054

#8 Regarding volar plate injuries of the finger:

a)

They are caused by forced hyper-flexion injuries.

b)

Sequelae include instability and Swan neck deformity.

c)

The volar plates are only found in the interphalangeal joints

d)

The volar plate ligaments act to limit hyperextension

Explanations:

a) F. They result from forced hyper-extension injuries

b) T. Sequelae include stiffness, subluxation, instability and Swan neck deformity.

c) F. They are found in both the metacarpophalangeal and interphlangeal joints


Question id: 2187

#9 Regarding the anatomy of respiration:

a)

The bucket handle' action of the ribs increases the antero-posterior diameter of the chest.

b)

The diaphragm is responsible for abdominal breathing.

c)

Forced inspiration requires the use of sternocleidomastoid.

d)

Forced expiration requires the use of pectoralis minor.

Explanations:

a) F. The pump handle' action of the ribs is their forward and upward movement

increasing the antero-posterior diameter of the chest. The bucket handle' action of the ribs is

their upward and lateral movement increasing the transverse diameter of the chest.


c) T. Forced inspiration requires the use of the accessory muscles of respiration:

sternocleidomastoid, scalenes, pectoralis major, pectoralis minor and serratus anterior.

d) F. Forced expiration requires the use of: rectus abdominis, external and internal

obliques, transversus abdominis and latissimus dorsi.

Question id: 2003

#10 Regarding the acromioclavicular joint:

a)

The joint is stabilised by 2 ligaments.

b)

The commonest mechanism of injury is via a fall on the outstretched hand.

c)

A grade 1 AC joint injury involves a complete tear to the coracoacromial ligament.

d)

A grade 2 AC joint injury involves a complete tear to the acromioclavicular ligament.

Explanations:

a) F. The joint is stabilised by 3 ligaments: the acromioclavicular, coracoacromial and

coracoclavicular ligament.

b) F. Injury to the acromioclavicular joint usually follows a direct fall onto the shoulder.

c) F. A grade 1 injury involves a simple sprain to the AC joint.

d) T. A grade 2 injury involves a complete tear to the acromioclavicular ligament

accompanied by a sprain to the coraclavicular ligament.

Question id: 2061

#1 Regarding the hypothenar emince:

a)

It comprises a group of muscles that control the motion of the little finger.

b)

The muscles are innervated by the ulnar nerve.

c)

Opponens digiti minimi lies on the medial side of the group on the palmar surface.

d)

Abductor digiti minimi inserts into the base of the proximal phalanx of the 5th finger.

Explanations:



c) F. From lateral to medial on the palmar surface the muscles lie in this order: Opponens

digiti minimi, flexor digiti minimi, abductor digiti minimi.


Question id: 2270

#2 The inferior mesenteric artery:

a)

Arises from the aorta at the vertebral level of L1.

b)

Supplies the spleen.

c)

Gives rise to the superior rectal artery.

d)

The territory of its distribution is equivalent to that of the embryonic hindgut.

Explanations:

a) F. The inferior mesenteric artery arises from the aorta at the vertebral level of L3.

b) F. The spleen is supplied by the splenic artery, which is a branch of the coeliac axis.

c) T. The branches of the inferior mesenteric artery are:

Left colic artery (supplies the descending colon)

Sigmoid branches (supplies the sigmoid colon)

Superior rectal artery (supplies the rectum)


Question id: 2055

#3 Regarding volar plate injuries of the finger:

a)

They are caused by forced hyper-flexion injuries.

b)

Sequelae include instability and Swan neck deformity.

c)

The volar plates are only found in the interphalangeal joints.

d)

The volar plate ligaments act to limit hyperextension.

Explanations:

a) F. they result from forced hyper-extension injuries.

b) T. Sequelae include stiffness, subluxation, instability and Swan neck deformity.

c) F. They are found in both the metacarpophalangeal and interphlangeal joints.

d) T.The statement is true.

Question id: 2158

#4 The superficial peroneal nerve innverates the following muscles:

a)

Peroneus brevis.

b)

Peroneus tertius.

c)

Peroneus longus.

d)

Tibialis anterior.

Explanations:

a) T. The superficial peroneal nerve innervates peroneus longus and peroneus brevis.

b) F. Peroneus tertius is innervated by the deep peroneal nerve.


d) F. Tibialis anterior is innervated by the deep peroneal nerve.

Question id: 2185

#5 Regarding the diaphragm:

a)

The left crus arises from L1 to L3.

b)

It has 3 arcuate ligaments.

c)

Innervation is from cervical nerves C3, 4 and 5.

d)

The central tendon fuses above with the pericardium.

Explanations:

a) F. The right crus arises from L1 to L3 whilst the left crus arises from L1 and L2 only.

b) F. There are 5 arcuate ligaments: 2 lateral, 2 medial and the median arcuate ligaments.

c) T. The diaphragm is innervated by the phrenic nerve, which is formed from cervical

nerves C3, 4 and 5. (mnemonic: C3,4,5 keeps the diaphragm alive')


Question id: 2113

#6 Regarding the blood supply to the lower limb:

a)

The main branch of the femoral artery is the profunda femoris.

b)

The popliteal artery is a continuation of the femoral artery.

c)

The anterior tibial artery arises from the popliteal artery.

d)

The fibular (peroneal) artery is a branch of the anterior tibial artery.

Explanations:

a) T. The main branch of the femoral artery is the profunda femoris (deep femoral artery).

It arises from the lateral side of the femoral artery within the femoral triangle.

b) T. The popliteal artery is a continuation of the femoral artery.

c) T. The anterior tibial artery arises from the popliteal artery.

d) F. The fibular (peroneal) artery is a branch of the posterior tibial artery.

Question id: 2248

#7 Regarding the celiac trunk:

a)

It arises from the aorta at the level of L1.

b)

It has 3 main divisions.

c)

The left gastric artery gives rise to the oesophageal branch.

d)

The splenic artery gives rise to the cystic artery.

Explanations:

a) T. The coeliac trunk (coeliac axis) arises from the aorta anterior to L1, shortly after entering

the abdominal cavity through the diaphragm.

b) T. The coeliac trunk has 3 main divisions:

Left gastric artery, which branches into:

- Oesophageal branch

- Hepatic branch

Common hepatic artery, which branches into:

- Proper hepatic artery

- Right gastric artery

- Gastroduodenal artery

- Cystic artery

Splenic artery, which branches into:

- Dorsal pancreatic artery

- Short gastric arteries

- Left gastro-omental artery

- Greater pancreatic artery



Question id: 2020

#8 The brachial artery:

a)

Begins at the inferior border of teres minor.

b)

Divides into the ulnar and radial arteries beneath the bicipital aponeurosis.

c)

Venae comitantes accompany the artery.

d)

Damage to the brachial artery can result in Volkmann's ischaemic contracture.

Explanations:

a) F. The brachial artery is a continuation of the axillary artery and commences at the

inferior border of teres major.



d) T. Volkmann's conracture is caused by obstruction or damage of the brachial artery and

results in ischaemia and contracture of the forearm flexor muscles, specifically flexor digitorum

profundus and flexor pollicis longus. It is commonly caused by supracondylar fractures of the

humerus.

Question id: 2177

#9 Regarding the skeleton of the thoracic wall:

a)

The first rib is the broadest and shortest of the ribs.

b)

The sternal angle is located opposite the second pair of costal cartilages.

c)

The manubrium lies at the level of T5 and T6 vertebrae.

d)

The 1st rib articulates with T1.

Explanations:



c) F. The manubrium lies at the level of T3 and T4 vertebrae.


Question id: 2294

#10 Regarding the posterior triangle of the neck:

a)

It is bordered anteriorly by the posterior border of sternocleidomastoid.

b)

It is bordered inferiorly by the jugular notch.

c)

It contains the internal jugular vein.

d)

It contains the spinal root of the accessory nerve.

Explanations:

a) T. The boundaries of the posterior triangle of the neck are:

Superiorly (apex): the union of sternocleidomastoid and trapezius at the occiput

Inferiorly (base): middle third of clavicle

Anteriorly: posterior border of sternocleidomastoid

Posteriorly: anterior border of trapezius

b) F. The jugular notch forms the inferior border of the anterior triangle of the neck.

c) F. The internal jugular vein is within the anterior triangle of the neck.

d) T. The contents of the posterior triangle of the neck include:

Muscles: Inferior belly of omohyoid, the scalenes, splenius and levator scapulae

Veins: terminal part of external jugular vein

Arteries: third part of subclavian, transverse cervical and suprascapular arteries

Nerves: spinal root of accessory nerve (CN XI), branches of cervical plexus, root and trunks of

brachial plexus, phrenic nerve

Other structures: lymph nodes

Question id: 2165

#1 Anatomy of the calf:

a)

Gastrocnemius is innervated by nerve roots L4 and L5.

b)

There is frequently a sesamoid bone in the medial head of the gastrocnemius muscle.

c)

Plantaris assists in plantar-flexion of the ankle.

d)

Gastrocnemius is supplied by the sural arteries.

Explanations:

a) F. Gastrocnemius is innervated by the tibial nerve and specifically nerve roots S1 and S2.

b) F. There is frequently a sesamoid bone called the fabella lying in the lateral head of the

gastrocnemius muscle. It is present in 10-30% of the population and can be mistaken for a loose

body or an osteophyte.

c) T. Plantaris assists gastrocnemius in plantar-flexion of the ankle and flexion of the knee.

d) T. The sural arteries are two large branches arising from the popliteal artery that supply

gastrocnemius, soleus and plantaris.

Question id: 2033

#2 The median nerve:

a)

Supplies adductor pollicis.

b)

Always supplies flexor pollicis brevis.

c)

Reliably supplies sensation to the pulp of the index finger.

d)

Arises from both medial and lateral cords of the brachial plexus.

Explanations:

a) F. The deep branch of the ulnar nerve supplies adductor pollicis. The median nerve

supplies the other muscles of the thenar eminence - flexor pollicis brevis, abductor pollicis

brevis and opponens pollicis.

b) F. It is mostly innervated by the median nerve but sometimes is innervated by the ulnar

nerve.

c) T. The median nerve supplies sensation to the radial 3 and a half digits.


Question id: 2221

#3 Regarding the inguinal canal:

a)

It transmits the inferior epigastric vessels.

b)

The superficial inguinal ring is a V shaped defect in internal oblique.

c)

An indirect inguinal hernia passes through the superficial inguinal ring.

d)

A direct inguinal hernia is covered by the internal spermatic fascia.

Explanations:

a) F. The inguinal canal transmits the spermatic cord in the male and the round ligament in

the female. It transmits the ilioinguinal nerve in both sexes.

b) F. The superficial inguinal ring is a V shaped defect in external oblique.

c) F. An indirect inguinal hernia passes through the deep inguinal ring. A direct inguinal

hernia passes through the posterior wall of the canal through Hasselbach's triangle.

d) F. Indirect inguinal hernias are covered by the internal spermatic fascia.

Question id: 2091

#4 Regarding the great saphenous vein:

a)

It is the longest vein in the body.

b)

It commences at the medial end of the dorsal venous arch of the foot.

c)

It passes posterior to the lateral malleolus with the sural nerve.

d)

It passes through the saphenous opening in the fascia lata to enter the femoral vein.

Explanations:

a) T. It commences at the medial end of the dorsal venous arch of the foot and ends in the

groin.


c) F. It passes anterior to the medial malleolus.


Question id: 2143

#5 Movements of the hip:

a)

Internal rotation is contributed to by the gemeli.

b)

Pectineus contributes to internal rotation with the leg adducted.

c)

Hip abduction is contributed to by gracilis.

d)

Flexion is predominantly preformed by rectus femoris.

Explanations:

a) F. The gemelli contribute to external rotation. Internal rotation of the hip is performed

by the following muscles:

Gluteus medius

Gluteus minimus

Tensor fasciae latae

Pectineus (with leg abducted)

b) F. Pectineus contributes to internal rotation of the hip with the leg abducted.

c) F. Gracilis contributes to hip adduction. Hip abduction is performed by:

Gluteus medius

Gluteus minimus

Tensor fasciae latae.

d) F. Hip flexion is predominantly performed by iliacus and psoas. Rectus femoris, Sartorius

and pectineus contribute to a lesser degree.

Question id: 2263

#6 Regarding the sigmoid colon:

a)

It is approximately 10 cm in length.

b)

It has no mesentery.

c)

It has no taenia coli.

d)

Its root crosses the external iliac vessels.

Explanations:

a) F. The sigmoid colon is approximately 40 cm in length.

b) F. The sigmoid colon has a mesentery that can be extensive and allows it to hang down

into the pelvis.

c) F. Taenia coli extend to the rectosigmoid junction.

d) T. The root of the sigmoid colon crosses the left ureter and the external iliac vessels.

Question id: 2075

#7 Surface anatomy:

a)

The first palpable spinous process lies at C6.

b)

The inferior border of the scapula lies at T7.

c)

The sternum runs from T3-T6.

d)

The sacral dimples lie at S2.

Explanations:

a) F. The first palpable spinous process lies at C7.


c) F. The sternum runs from T5-T8.


Question id: 2199

#8 Anatomy of the lungs:

a)

The left lung is larger than the right lung.

b)

The anterior border of the left lung has a notch produced by the heart.

c)

The lingula of the left lung lies adjacent to the oblique fissure.

d)

The right lung is divided into three lobes.

Explanations:

a) F. The right lung is slightly larger than the left lung.

b) T. This is the cardiac notch.

c) T. The lingula of the left lung is the equivalent of the middle lobe of the right lung and

lies between the cardiac notch and the oblique fissure.

d) T. The right lung is divided into three lobes by the oblique and horizontal fissures. The

left lung is divided into two lobes by an oblique fissure.

Question id: 2069

#9 Regarding the muscles of the hand:

a)

Extensor pollicis longus extends the distal phalanx of the thumb joint.

b)

Abductor digiti minimi abducts the little finger.

c)

Abductor pollicis brevis helps oppose the thumb.

d)

Opponens pollicis rotates the thumb laterally.

Explanations:



c) T. Abductor pollicis brevis abducts the thumb and helps to oppose it.

d) F. Opponens pollicis opposes the thumb towards the palm and rotates it medially.

Question id: 2129

#10 The foramen magnum transmits the following structures:

a)

The internal carotid arteries.

b)

The tectorial membrane.

c)

The vertebral veins.

d)

The spinal accessory nerve.

Explanations:

a) F. The statement is false.

b) T. The following structures pass through the foramen magnum: Medulla oblongata,

spinal accessory nerve, vertebral arteries, the anterior and posterior spinal arteries, the

tectorial membrane and the alar ligaments.



Question id: 2073

#1 Vertebral levels:

a)

The larynx becomes the trachea at C7.

b)

The descending thoracic aorta commences at T6.

c)

The origin of the celiac axis lies at L1.

d)

The abdominal aorta bifurcates into the common iliac arteries at L2.

Explanations:

a) F. The larynx becomes the trachea at C6.

b) F. The descending thoracic aorta commences at T4.


d) F. The abdominal aorta bifurcates into the common iliac arteries at L4.

Question id: 2180

#2 The inferior thoracic aperture is bounded by:

a)

T10 posteriorly.

b)

11th and 12th ribs laterally.

c)

The xiphisternal joint anteriorly.

d)

The 5th and 6th costal cartilages anteriorly.

Explanations:

a) F. The boundaries of the inferior thoracic aperture are:

Posteriorly T12

Anteriorly 7th to the 10th costal cartilages and the xiphisternal joint

Laterally 11th and 12th ribs




Question id: 2224

#3 The following are relations of the inguinal canal:

a)

Anteriorly conjoint tendon.

b)

Posteriorly transversalis fascia.

c)

Superiorly lacunar ligament.

d)

Inferiorly external oblique.

Explanations:

a) F. The following are the relations of the inguinal canal:

Anteriorly skin, Camper's fascia, Scarpa's fascia, aponeurosis of external oblique, superficial

inguinal ring (medial 1/3 of canal)

Posteriorly transversalis fascia, conjoint tendon, deep inguinal ring (lateral 1/3 of canal)

Superiorly internal oblique, tranversus abdominis, medial crus of external oblique

Inferiorly inguinal ligament, lacunar ligament (medial 1/3 of canal), iliopubic tract (lateral 1/3

of canal)




Question id: 2204

#4 Regarding the thymus:

a)

Is divided into a central medulla and a peripheral cortex.

b)

T cell lymphopoiesis stops after puberty.

c)

Lymphoid cells are at their greatest concentration in the medulla.

d)

The arterial supply to the thymus is derived only from the superior and inferior thyroid arteries.

Explanations:


b) F. The thymus atrophies at puberty and the stroma is replaced by adipose tissue.

Despite this a small amount of residual T cell lymphopoiesis continues throughout adult life.

c) F. Lymphoid cells are at their greatest concentration in the cortex.

d) F. The arterial supply to the thymus is derived from the internal thoracic artery and the

superior and inferior thyroid arteries.

Question id: 2169

#5 The tibial nerve:

a)

Is a branch of the sciatic nerve.

b)

Descends through the popliteal fossa.

c)

It lies anterior to the medial malleolus.

d)

Terminates by dividing into the medial and lateral plantar nerves.

Explanations:


b) T. The tibial nerve descends through the popliteal fossa and lies on popliteus. It then

runs inferiorly on tibialis posterior with the posterior tibial vessels and passes into the foot by

running posterior to the medial malleolus. It terminates beneath the flexor retinaculum by

dividing into the medial and lateral plantar nerves.



Question id: 2266

#6 The following viscera are matched with the correct dermatomal location of referred pain

originating from them:

a)

Diaphragm: ipsilateral shoulder tip.

b)

Pancreas: T5-T6.

c)

Gallbladder: T7-T9.

d)

Kidney: T8-T9.

Explanations:

a) T. The following viscera are matched with the correct dermatomal location of referred pain

originating from them:

Diaphragm: ipsilateral shoulder tip

Heart: T1-T5 (left arm and hand)

Oesophagus: T5-T6

Stomach: T6-T9 (chest and substernal area)

Pancreas: T6-T10

Liver and gallbladder: T7-T9

Small intestine: T9-T10

Large intestine: T11-T12

Rectum: S2-S4 (sacrum, lower back and dorsum of leg)

Ovaries: T10-T11 (periumbilical area)

Uterus: S1-S2 (lower back)

Prostate: T10-T12 (periumbilical area, penis and scrotum)

Kidneys: T10-L1 (lower back and umbilical area)




Question id: 2056

#7 Regarding Gamekeeper's thumb:

a)

It is caused by a varus force to the metacarpophlangeal joint.

b)

It can be associated with an avulsion fracture to the distal portion of the proximal phalanx of

the thumb.

c)

Results in weakness of pinch grasp.

d)

It is a tear of the radial collateral ligament of the thumb.

Explanations:

a) F. It is caused by forced abduction or hyperextension of the proximal phalanx of the

thumb which results in a valgus force to the MCP joint.

b) F. It can be associated with an avulsion fracture to the proximal portion (at the ulnar

base) of the proximal phalanx of the thumb.

c) T. The main features of Gamekeeper's thumb are instability of the MCP joint and

weakness of pinch grasp.

d) F. It is a tear of the ulnar collateral ligament of the thumb.

Question id: 2016

#8 Surface anatomy:

a)

The lowest part of the scapula correlates with T7.

b)

The upper border of the liver correlates with T6.

c)

The manubrium sterni correlates with T4/T5.

d)

The umbilicus correlates with L2/L3.

Explanations:



c) F. The manubrium sterni is the broad, upper part of the sternum that articulates with

the clavicles and the cartilages of the first pair of ribs. It correlates with T3/T4. The manubrio-

sternal joint (also known as the sternal angle or the 'angle of Louis') correlates with T4/T5.

d) F. The umbilicus lies at L3/L4.

Question id: 2182

#9 The following arteries pass through the superior thoracic aperture (thoracic inlet):

a)

Internal carotid arteries.

b)

Common carotid arteries.

c)

Subclavian arteries.

d)

Brachial arteries.

Explanations:

a) F. The following arteries pass through the thoracic inlet:

Left and right common carotid arteries

Left and right subclavian arteries




Question id: 2237

#10 Regarding the spermatic cord:

a)

The external spermatic fascia is derived from the external oblique aponeurosis.

b)

It contains 2 arteries.

c)

It contains the genital branch of the genitofemoral nerve.

d)

It contains Cloquets node.

Explanations:

a) T. The spermatic cord contains 3 layers of fascia:

External spermatic fascia derived from the external oblique aponeurosis

Cremasteric fascia from derived from the internal oblique aponeurosis

Internal spermatic fascia derived from the transversalis fascia

b) F. The spermatic cord contains 3 arteries:

Testicular artery

Cremasteric artery

Artery to the vas deferens

c) T. The spermatic cord contains 2 nerves:

Genital branch of the genitofemoral nerve

Sympathetic nerves

d) F. Cloquets node lies within the femoral canal. The Spermatic cord contains 3 other

structures:

Vas deferens

Pampiniform plexus of veins

Lymphatics

Question id: 2234

#1 Regarding the testes:

a)

The right testis lies at a lower level than the left in most men.

b)

The testes are covered with the tunica albuginea.

c)

The average testicular volume is 50 cm3.

d)

The testicular arteries arise from the renal arteries.

Explanations:

a) F. The left testis lies at a lower level than the right within the scrotum in most men.


c) F. The average testicular volume is 18 cm3.

d) F. The testicular arteries arise directly from the aorta at the level of the renal vessels.

Question id: 2207

#2 Regarding the pericardium:

a)

The outermost layer is the serous pericardium.

b)

The serous pericardium is divided into two layers.

c)

The parietal pericardium is continuous with the epicardium.

d)

The visceral pericardium extends to the beginning of the great vessels.

Explanations:

a) F. The pericardium has two layers, the outermost being the fibrous pericardium and the

innermost the serous pericardium.

b) T. The serous pericardium is divided into two layers, the parietal pericardium, which is

fused to the fibrous pericardium and the visceral pericardium, which is part of the epicardium.

c) F. The visceral pericardium is continuous with the epicardium.


Question id: 2114

#3 Regarding the femoral triangle:

a)

The superior border is formed by the inguinal ligament.

b)

The roof is formed by the transversalis fascia.

c)

It contains the deep inguinal lymph nodes.

d)

It contains the femoral nerve.

Explanations:

a) T. The borders of the femoral triangle can be remembered by the mnemonic 'SAIL'(The

femoral triangle is shaped like the sail of a ship):

Laterally - Sartorius

Medially - Adductor longus

Laterally - Inguinal Ligament

b) F. The roof of the femoral triangle is formed by the fascia lata.

c) T. The contents of the femoral triangle are: femoral nerve, femoral branch of the

genitofemoral nerve, lateral cutaneous nerve of the thigh, femoral artery, femoral vein and the

femoral canal which contains the deep inguinal lymph nodes.


Question id: 2082

#4 The following structures lie at the vertebral level of L1:

a)

The ligament of Treitz.

b)

The origin of the celiac axis.

c)

The pancreatic neck.

d)

The pylorus of the stomach.

Explanations:

a) F. The ligament of Treitz lies at L2.

b) F. The origin of the celiac axis is at T12.



Question id: 2268

#5 Regarding the blood supply of large intestine:

a)

The superior mesenteric artery arises from the aorta superior to the origin of the coeliac axis.

b)

The artery of Drummond is formed by the anastamosis of the inferior mesenteric artery and the

celiac trunk.

c)

The superior mesenteric artery supplies the pancreas.

d)

The inferior mesenteric artery supplies the intestine from the splenic flexure to the upper part

of the rectum.

Explanations:

a) F. The superior mesenteric artery arises from the aorta inferior to the origin of the celiac

axis.

b) F. The artery of Drummond (the marginal artery of the colon) is formed by the

anastomsis of the superior and inferior mesenteric arteries.

c) T. The superior mesenteric supplies blood to the intestine from the lower part of the

duodenum until the splenic flexure and the pancreas.

d) T. The inferior mesenteric artery supplies the intestine from the splenic flexure to the

upper part of the rectum.

Question id: 2043

#6 Regarding the anatomical snuffbox:

a)

The proximal border is formed by the styloid process of the radius.

b)

The posterior border is formed by the tendon of extensor pollicis longus.

c)

Contains the basilic vein.

d)

The radial artery enters the anatomical snuffbox passes over both the scaphoid and trapezium

within it.

Explanations:



c) F. The anatomical snuffbox contains trapezium, scaphoid, the radial artery and the

cephalic vein.

d) T. The radial artery enters the anatomical snuffbox by passing under abductor pollicis

longus and extensor pollicis brevis and crosses both the trapezium and scaphoid bones within

it.

Question id: 2120

#7 The anterior branch of the obturator nerve innervates the following muscles:

a)

Obturator externus.

b)

Adductor magnus.

c)

Adductor longus.

d)

Gracilis.

Explanations:

a) F. Obturator externus is supplied by the posterior branch of the obturator nerve.

b) F. Adductor magnus is supplied by the posterior branch of the obturator nerve.

c) T. The anterior branch of the obturator nerve innervates adductor longus, adductor

brevis, gracilis and pectineus.


Question id: 2218

#8 The following structures lie deep to the extensor retinaculum of the foot:

a)

Peroneus longus.

b)

Extensor hallucis longus.

c)

Tibialis anterior.

d)

Deep peroneal nerve.

Explanations:

a) F. The order of the structures that pass deep to the extensor retinaculum of the foot can

be remembered by using the mnemonic The Himalayas Are Never Dry Places'. From medial to

lateral they are:

Tibialis anterior

extensor Hallucis longus

Anterior tibial artery

deep peroneal Nerve

Digitorum longus

Peroneus tertius




Question id: 2039

#9 The axilla contains:

a)

The cords of the brachial plexus.

b)

The long thoracic nerve in its posterior wall.

c)

The latissimus dorsi muscle in its posterior wall.

d)

The superior thoracic artery.

Explanations:


b) F. The long thoracic nerve lies on the medial wall and supplies serratus anterior.

c) T. The posterior wall of the axilla is formed by the scapula, subscapularis, teres major

and latissimus dorsi.


Question id: 2192

#10 The following structures are transmitted through the diaphragm at the level of T8:

a)

The inferior vena cava.

b)

The right phrenic nerve.

c)

The oesophagus.

d)

The left gastric vein.

Explanations:

a) T. The following structures are transmitted through the diaphragm at the level of T8:

The inferior vena cava

The right phrenic nerve


c) F. The oesophagus is transmitted at the level of T10.

d) F. The left gastric artery and vein are transmitted at the level of T10.

Question id: 2154

#1 Regarding meniscal injuries:

a)

The menisci are particularly prone to flexion and rotation injuries.

b)

The knee usually swells immediately.

c)

The menisci are attached to the tibial intercondylar area by their horns.

d)

A positive Cooper's sign indicates a meniscal tear.

Explanations:

a) T. The menisci are particularly prone to flexion and rotation injuries, usually via a twisting

mechanism.

b) F. Patients often complain of feeling a pop' immediately as the tear occurs. Most patients

can then still walk and weight bear. The knee then tends to swell gradually over the next 48-72

hours. Common symptoms include:

Pain

Stiffness and swelling

Locking of the knee

Knee giving way'

Reduced range of motion of the knee

c) T. Both menisci are C-shaped with the medial meniscus being larger. They are attached to

the tibial intercondylar area by their horns and around their periphery by the small coronary

ligaments.

d) T. Cooper's sign is positive in over 90% of meniscal tears. Cooper's sign is present if a patient

complains of joint line pain in the affected knee when turning over at night and changing position of

their legs. It is thought that the meniscal tear causes pain as the torn fragment is torqued between

the femur and the tibia and pain is felt as it pulls on the joint capsule. This test helps to differentiate

from arthritic pain, which is more common with weight bearing.

Question id: 2153

#2 The Garden classification for neck of femur fractures

a)

Stage I fractures include valgus impacted fractures.

b)

Stage II fractures are partially displaced.

c)

Stage III fractures are complete.

d)

The trabeculae appear normally aligned with stage IV fractures.

Explanations:

a) T. Stage I fractures are undisplaced incomplete fractures of the neck and include valgus

impacted fractures.

b) F. Stage II fractures are complete fractures of the neck without displacement.

c) T. Stage III fractures are complete fractures of the neck with partial displacement. The

fragments are still connected by the posterior retinacular attachment.

d) T. Stage IV fractures are complete fractures of the neck with full displacement. The

proximal fragment is free and lies correctly in the acetabulum so that the trabeculae appear

normally aligned.

Question id: 2038

#3 The radial nerve:

a)

Is the principal branch of the posterior cord of the brachial plexus.

b)

Is the main nerve supply to the extensor compartments of the arm and forearm.

c)

Supplies sensation to the palmar aspect of the radial 3 and a half digits.

d)

Gives rise to the anterior interosseous nerve.

Explanations:



c) F. It supplies sensation to the back of the arm and the dorsum of the hand.

d) F. The anterior interosseus nerve arises from the median nerve. The posterior

interosseus nerve is a continuation of the deep branch of the radial nerve.

Question id: 2240

#4 Regarding the peritoneum:

a)

The visceral layer lines the contained organs.

b)

Approximately 50 mls of serous fluid lies between the visceral and parietal peritoneum.

c)

It is lined by simple squamous epithelium.

d)

The mesentery is the single layer of parietal peritoneum that suspends the jejenum and ileum

from the posterior wall of the abdomen.

Explanations:

a) T. The peritoneum consists of a parietal layer that lines the abdominal and pelvic walls

and a visceral layer that covers the contained organs.

b) T. The space between the two layers is referred to as the peritoneal cavity and contains

approximately 50 mls of serous fluid that allows the two layers to slide freely over one another.

c) T. It is lined by simple squamous epithelium (mesothelium).

d) F. The mesentery is the double layer of visceral peritoneum that suspends the jejenum

and ileum from the posterior wall of the abdomen.

Question id: 2223

#5 The following are relations of the inguinal canal:

a)

Anteriorly Scarpas fascia.

b)

Posteriorly internal oblique.

c)

Superiorly transversus abdominis.

d)

Inferiorly inguinal ligament.

Explanations:

a) T. The following are the relations of the inguinal canal:

Anteriorly skin, Camper's fascia, Scarpa's fascia, aponeurosis of external oblique, superficial

inguinal ring (medial 1/3 of canal)

Posteriorly transversalis fascia, conjoint tendon, deep inguinal ring (lateral 1/3 of canal)

Superiorly internal oblique, tranversus abdominis, medial crus of external oblique

Inferiorly inguinal ligament, lacunar ligament (medial 1/3 of canal), iliopubic tract (lateral 1/3

of canal)




Question id: 2202

#6 Anatomy of the bronchi and bronchopulmonary segments:

a)

The right main bronchus lies in front of the pulmonary artery.

b)

Each lung has 10 bronchopulmonary segments.

c)

The right main bronchus gives off no branches until it enters the hilum of the lung.

d)

The terminal bronchioles are lined with simple columnar epithelium cells.

Explanations:

a) F. The right pulmonary artery passes in front of the right main bronchus.


c) F. The right main bronchus gives off the upper lobe branch before entering the lung.

d) T. The terminal bronchioles are lined with simple columnar epithelium cells that contain

Clara cells, which secrete surfactant.

Question id: 2209

#7 Surface markings of the heart:

a)

The apex of the heart lies at the left 3rd left intercostal space in the mid-clavicular line.

b)

The pulmonary valve lies to the left of the sternum at the upper level of the 3rd costal cartilage.

c)

The mitral valve lies to the left of the sternum at the level of the 5th costal cartilage.

d)

The tricuspid valve lies to the right of the sternum at the level of the 4th costal cartilage.

Explanations:

a) F. The apex of the heart lies at the 5th left intercostal space in the mid-clavicular line.


c) F. The mitral valve lies to the left of the sternum at the level of the 4th costal cartilage.


Question id: 2074

#8 Vertebral levels:

a)

The cricoid cartilage lies at C6.

b)

The azygous veins enters the superior vena cava at T6.

c)

The pancreatic neck lies at L1.

d)

The pylorus of the stomach lies at L1.

Explanations:


b) F. The azygous vein enters the superior vena cava at T4.



Question id: 2161

#9 Regarding ankle injuries:

a)

Deltoid ligament injuries present with lateral ankle pain and swelling.

b)

Acute peroneal tendon injuries occur during ankle inversion injuries.

c)

Weber A ankle fractures are suprasyndesmotic.

d)

Gravity stress radiographs can be used to assess the integrity of the anterior talofibular

ligament.

Explanations:

a) F. The deltoid ligament, or medial collateral ligament, is a multi-banded ligament that

lies on the medial side of the ankle. It attaches proximally to the medial malleolus and fans out

distally to attach to the talus, calcaneus and navicular. It is damaged during pronation/eversion

trauma leading to forced external rotation and abduction of the ankle and presents with medial

ankle pain and swelling.

b) T. Injury to peroneus longus and/or brevis classically occur in one of two ways:

Ankle inversion injuries, which are often associated with anterior talofibular or calcaneofibular

ligament injuries.

Powerful contraction of the peroneal muscles with a forcefully dorsiflexed foot.

c) F. The Weber ankle fracture classification system is as follows:

Type A below the syndesmosis (usually stable)

Type B at the level of the syndesmosis (variable stability)

Type C above the level of the syndesmosis (usually unstable and require ORIF)

d) F. Gravity stress radiographs assess the integrity of the deltoid ligament in lateral

malleolar ankle fractures without talar shift.

Question id: 2171

#10 The following segmental nerve roots are correctly matched with their corresponding

myotomes:

a)

C5 Deltoid.

b)

L2 Knee extensors.

c)

L3,4 Ankle dorsiflexors.

d)

S1 Ankle plantar flexors.

Explanations:

a) T. The key myotomes are:

C5 Deltoid

C6 Wrist extensors

C7 Elbow extensors

C8 Finger flexors to middle finger (flexor digitorum profundus)

T1 Small finger abductors (abductor digiti minimi)

L2 Hip flexors (Iliopsoas)

L3, L4 Knee extensors

L4, L5 & S1 Knee flexion

L5 Ankle & big toe dorsiflexors

S1 Ankle plantar flexors




Question id: 2254

#1 Regarding Meckels diverticulum:

a)

It is typically situated 60 cm distal to the ileocaecal junction.

b)

It is approximately 5 cm in length.

c)

Diverticulitis is the commonest complication.

d)

Pancreatic mucosa may be present.

Explanations:

a) F. It is typically situated 60 cm proximal to the ileocaecal junction.


c) F. Intestinal obstruction and haemorrhage are the commonest complications.

Diverticulitis is less common. Secondary neoplasm may also occur rarely.

d) T. A Meckels diverticulum may contain both gastric and pancreatic mucosa. The

presence of either of these types of mucosa can result in haemorrhage.

Question id: 2028

#2 The ulnar nerve:

a)

Arises from the lateral cord of the brachial plexus.

b)

Lies lateral to brachial artery at the midpoint of the humerus.

c)

Has a root value of C8 / T1.

d)

Supplies the lateral 2 lumbricals.

Explanations:

a) F. The ulnar nerve arises from the medial cord of the brachial plexus.

b) F. The ulnar nerve lies medial to brachial artery at the midpoint of the humerus.


d) F. The ulnar nerve supplies flexor carpi ulnaris, the medial half of flexor digitorum

profundus, the hypothenar muscles, the interossei, adductor pollicis and the medial 2

lumbricals.

Question id: 2095

#3 Regarding dental development and anatomy:

a)

The adult human has 30 permanent teeth.

b)

The deciduous canines erupt at approximately 6-10 months of age.

c)

The permanent canines erupt at 7-8 years of age.

d)

The periodontal ligament attaches the tooth to the alveolar bone.

Explanations:

a) F. The adult human has 32 permanent teeth.

b) F. The deciduous incisors erupt at 6-10 months, deciduous canines at 16-20 months and

deciduous molars at 10-24 months.

c) F. The permanent incisors erupt at 7-8 years, permanent canines and premolars at 11-13

years and permanent molars at 6-25 years.


Question id: 2246

#4 The stomach:

a)

Blood supply is derived solely from the left and right gastric arteries.

b)

Lies posterior to the aorta.

c)

Posterior gastric carcinoma may erode into the pancreas.

d)

Is lined with stratified squamous epithelium.

Explanations:

a) F. The blood supply to the stomach is as follows:

Left gastric artery: derived from the coeliac trunk

Right gastric artery: derived from the hepatic artery

Left gastroepiploic artery: derived from the splenic artery

Right gastroepiploic artery: derived from the gastroduodenal branch of the hepatic artery

Short gastric arteries: derived from the splenic artery

b) F. The relations of the stomach are as follows:

Anteriorly: diaphragm, abdominal wall, left lobe of the liver

Posteriorly: diaphragm, aorta, spleen, left kidney, pancreas, transverse mesocolon, colon, lesser

sac of peritoneum

c) T. This can result in referred back pain with gastric carcinoma.

d) F. The gastric mucosa is covered with columnar epithelial cells that secrete mucous and

alkaline fluid which serve to protect the epithelium.

Question id: 2034

#5 Regarding the internal jugular vein:

a)

It is separated from the sympathetic chain by the prevertebral fascia.

b)

It lies anteromedial to the sympathetic chain.

c)

It is a continuation of the sigmoid sinus.

d)

The left vein is generally larger than the right.

Explanations:


b) F. The internal jugular vein lies anterolateral to the sympathetic chain.

c) T. The internal jugular vein is a continuation of the sigmoid sinus.

d) F. The left internal jugular vein is generally smaller than the right vein.

Question id: 2167


a)

Flexor hallucis longus is innervated by nerve roots L5 and S1.

b)

The superficial muscle group includes politeus and tibialis posterior.

c)

The tibial nerve lies close to the tibia below the soleus muscle.

d)

Proximal deep vein thrombosis is more frequently right sided.

Explanations:

a) F. Flexor hallucis longus is innervated by the tibial nerve and specifically nerve roots S2

and S3.

b) F. The muscles of the calf can be divided into two groups, superficial and deep. The

superficial group includes gastrocnemius, soleus and plantaris. The deep group includes

politeus, flexor hallucis longus, flexor digitorum longus and tibialis posterior.


d) F. The frequency of distal vein involvement exceeds that of proximal vein involvement in

patients with deep vein thrombosis (DVT). Proximal DVTs are more frequently left sided,

whereas distal DVTs have a more equal left to right distribution.

Question id: 2170

#7 The posterior tibial artery:

a)

Is a continuation of the femoral artery.

b)

Is accompanied by a deep vein throughout its course.

c)

Its pulse can be palpated posterior and inferior to the lateral mallelous of the ankle.

d)

Divides into the plantar and arcuate arteries.

Explanations:

a) F. The posterior tibial artery is a continuation of the popliteal artery.

b) T. It is accompanied by a deep vein, the posterior tibial vein, throughout its course.

c) F. The pulse of the posterior tibial artery can be palpated posterior and inferior to the

medial malleolus of the ankle.

d) F. The dorsalis pedis artery divides into the plantar and arcuate arteries. The posterior

tibial artery divides into the medial and lateral plantar arteries.

Question id: 2166


a)

Tibialis posterior flexes the knee.

b)

Popliteus is innervated by nerve roots L4, L5 and S1.

c)

The posterior tibial artery is derived from the popliteal artery.

d)

The frequency of proximal vein invol

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