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Anatomy Review

Questions

1. A patient with an isolated


oculomotor nerve paralysis
would present with the
following findings on the
affected
side
A) constricted pupils (+CNIII)
B) eyeball deviated laterally
(-CNIII)
C) weakness of eyelid closure (CNVII)
D) all of the above

MPL .5

2. Reproductive adaptations
noted in the female true pelvis
include the following EXCEPT
A) greater pubic
angle
B) wider sacrosciatic
notches
C) longer pelvic
cavity
D) cylindrical pelvic
cavity

*3.A high velocity bullet penetrates the


posterior aspect of the shoulder and
severely injures the origin of the posterior
cord of the brachial plexus. Each of the
following nerves might possible be affected
EXCEPT the
A) upper
subscapular
B) Radial
C) Thoracodorsal
D) medial
pectoral

Brachial Plexus
Cords
posterior

upper subscapular nn
thoracodorsal nn
lower subscapular nn
axillary nn
radial nn

lateral

lateral pectoral nn
musculocutaneous nn
lateral root of median nn

medial

medial pectoral nn
medial brachial cutaneous nn
medial antebrachial
cutaneous nn
ulnar nn
medial root of median nn

proliferative
phase of the
menstrual cycle,
one can observe
that

a. the endometrium
thickens largely
because of edema
b. glycogen disappears in
the basal cytoplasm of
the glandular epithelium
c. there is a two to
threefold increase in
the thickness of the
endometrium
d. the endometrial glands
become quite tortuous

5. Bile formed by hepatic cells


is first secreted into the
A) bile canaliculi
B) bile ducts
C) space of Disse
D) hepatic duct

6. A patient with an isolated injury to the


mandibular division of the trigeminal nerve
would present with
A) atrophy of the
temporalis
muscle on the
affected side
B) flattened nasolabial fold on the
affected side
C) numbness of the
cheek on the
affected side
D) A and C only

7. The landmark structure noted


during the dissection of the gluteal
area
A) gluteus medius
B) piriformis
C) quadratus femoris
D) obturator
externus

8.Semen is composed of products


produced by all of the following EXCEPT
the
A) seminiferous
tubules
B) seminal vesicles
C) bulbourethral
glands
D) rete testis

*9. True ribs include


A) 5th
B) 7th
C) 8th
D) A and B

*10. A patient was noted to have atrophy of


the temporalis and masseter muscles on one
side of the face. His corneal reflex on the
affected side was normal and he had no
sensory deficit in the cheek area. This
patient most probably has a lesion involving
the
a. mandibular
division of CN V
b. maxillary division of
CN V
c. ophthalmic division of
CN V
d. terminal branches of
CN VII

*11. The
primary hip
flexor is the

A) sartorius
B) rectus femoris
C) iliopsoas
D) pectineus

*12. The following secretions are correctly


attached with their cells of origin in every
pair EXCEPT
A) glucagon - pancreatic
alpha cells
B) intrinsic factor- parietal
cells of the stomach
C) insulin - pancreatic
beta cells
D) hydrochloric acid chief cells of the
stomach

Answer:
Parietal cells
produce gastric
acid
Chief cells produce
pepsinogen

13. A patient presented with complete


paralysis of one side of the face with intact
lacrimation and taste sensation (anterior 2/3
of tongue) The cranial nerve involved in this
case most probably has a tension at the
level of the
A) internal auditory
meatus
B) geniculate ganglion
C) sytlomastoid
foramen
D) external auditory
meatus

*14. This structure is


highly vulnerable in
surgical
manipulation of the
ductus arteriosus
A) Esophagus
B) left bronchus
C) left vagus nerve
D) left recurrent
laryngeal nerve

15. The three types of granulocytes usually


can be distinguished best under the light
microscope on the basis of
A) nuclear morphology
and cell size
B) nuclear morphology
only
C) cell size only
D) staining reaction of
cytoplasmic granules

*16. The liver is anatomically divided into


right and left unequal halves along the
fissure of the
A) ligamentum
venosum
B) inferior vena cava
C) falciform
ligament
D) porta hepatic

17. Both skeletal and smooth muscle can be


found in the muscularis externa of the
A) Stomach
B) Duodenum
C) Colon
D) esophagus

Mid esophagus has


skeletal and
smooth muscles

*18. This structure is highly vulnerable in


cancerous growth in R pulmonary hilum and
posterior mediastinum
A) Trachea
B) superior
intercostal
vein
C) vagus
nerve
D) pulmonary
ligament

19. During erection of the penis, the volume


of the blood occupying the spaces of the
cavernous sinuses is increased by
a.
b.
c.
d.

contraction of the musculature of the dorsal artery of the penis


relaxation of the musculature of the dorsal artery of the penis
contraction of the musculature of the helicine arteries
relaxation of the musculature of the helicine arteries

*20.The granules found in the cells of the


adrenal medulla consist of
A) hydrocortisone
B) Glucocorticoid
s
C) Epinephrine
D)
mineralocortic
oids

21. The deep perineal space in the male


contains each of the following EXCEPT
A) membranous
urethra
B) prostate gland
C) bulbourethral
glands
D) sphincter urethrae
muscle

*22. Loss of
extension of the
knee would
result from
damage to the
A) femoral nerve
B) tibial nerve
C) tibial and common
fibular
D) obturator nerve

23. Which of the following epithelia can


usually be found in the normal female
reproductive system?
A) stratified
squamous and
simple columnar
B) transitional and
stratified
squamous
C) simple columnar
and transitional
D) simple columnar
and
pseudostratified

24. By inserting the finger into the rectum,


the following can be readily felt and
examined
A) enlarged seminal
vesicles
B) prostate gland
C) A and B
D) none of the above

25. The ventral rami of the brachial


plexus are seen at the
A) posterior
cervical triangle
B) carotid triangle
C) submandibular
triangle
D) muscular triangle

26. The function of the interstitial endocrine


cells of the testis is to
a. form acrosome
b. secrete
testosterone
c. support the
germinal
epithelium
d. supply nutrients to
the sex cells

27. The vermiform appendix is best located


by following the
A) anterior cecal artery
B) descending branch of
the right colic artery
C) ileum to the ileocolic
juncture
D) teniae coli of the
ascending colon

28. From which of the


following sites is
primary cancer most
likely to metastasize
to the lung by venous
spread?
A) Ileum
B) Appendix
C) Kidney
D) transverse colon

29. Simple cuboidal epithelium is


usually found in
a. parietal layer of
Bowmans capsule
b. descending limb of
the loop of Henle
c. rete testis
d. single layer on
the free surface
of the ovary

30. The roof of the adductor canal is formed


by the
A) rectus femoris
B) vastus medialis
C) adductor longus
D) sartorius

31. Trauma to the


sternocostal
surface of the
heart would more
likely damage the
A) right atrium
B) right ventricle
C) left ventricle
D) left atrium

32. Interruption of blood


flow in the internal iliac
artery would affect blood
flow to each of the
following EXCEPT the
a. medial thigh muscles
b.ductus deferens
c.lower abdominal wall
and rectus abdominis
muscle
d.rectum

*33. A child suspected of aspirating a small button


is seen in the ER. While there is no complain of
pain, there is frequent coughing. Physical
examination showed absence of breath sounds.
Aspirated small objects tend to lodge in the right
inferior lobar bronchus for all the following reasons
EXCEPT
a. left main stem ( primary)
bronchus is more
horizontal
b. right inferior lobar
bronchus nearly
continues the direction of
the trachea
c. right lung has no
middle lobe
d. right main stem(primary)
bronchus is of greater
diameter than the left

34. This structure


separates the
perineum from the
pelvic cavity
A)ischiorectal fossa
B)urogenital diaphragm
C)pelvic diaphragm
D)urogenital triangle

35. Drug detoxification


occurs in the
A)Golgi apparatus
B)smooth
endoplasmic
reticulum
C)rough endoplasmic
reticulum
D)lysosomes

36. The ligament that


prevents C1 vertebrae
from translating against
C2 is
A)alar ligament
B)tentorial ligament
C)transverse ligament
D)posterior longitudinal
ligament

37. The scala vestibuli


of the inner ear
communicates with
the scala tympani
via the
A)Modiolus
B)Helicotrema
C)cecum cupulare
D) aqueduct

38. The Haversian canals


of bone tissue
A) contain chondrocytes
B) are lined by cement
lines
C) form the central
structure of a
Haversian system
D)run perpendicular to
the long axis of the
bone

39. The hepatic portal


vein is correctly
described by each of
the following EXCEPT
a. it drains most of the
venous blood from the
gastrointestinal tract
b.it forms by the
confluence of the
superior mesenteric
and splenic veins
c. it is located in the
hepatoduodenal
ligament
d.it forms posterior to
the head of the
pancreas

40. The internal


spermatic fascia is
derived from the
a.external oblique
aponeurosis
b.Peritoneum
c.transversus abdominis
aponeurosis
d.transversalis fascia

41. The vagus nerve enters


the abdominal cavity
through the
A)aortic hiatus
B)esophageal hiatus
C)sternocostal hiatus
D)vena caval aperture

42. The part of the


uterine tube which
is removed during
fimbriectomy
A)Cornua
B)Isthmus
C)Ampulla
D)infundibulum

43. Pressure
developing deep to the
flexor retinaculum
would affect each of
the following EXCEPT
the
A) median nerve
B) ulnar nerve
C) tendons of the flexor
digitorum superficialis
muscle
D) tendons of the flexor
pollicis longus muscle

44. A patient enters


the emergency
room not being able
to raise his foot. The
nerve that is
suspected to be
damaged is the
A)Tibial
B)common fibular
C)Obturator
D) medial plantar

45. Sinusoids are


correctly described by
each of the following
EXCEPT
a. they have a irregular
tortuous lumen
b. they are lined by
endothelial cells
c. they have a dense
connective tissue wall
d. they have no
phagocytic
elements

46. The opening into


the lesser sac is
through the
A)foramen of Bochdalek
B)foramen of
Winslow
C)foramen of Morgagni
D) foramen
transversarium

47.Damage to the obturator


nerve on the lateral wall
of the pelvis would affect
the function of each of
the following muscles
EXCEPT the
A)Sartorius (femoral n)
B)Gracilis
C)adductor longus
D)Pectineus (femoral n, occl
obturator n)

48. When removing


the right lung, the
surgeon has to be
careful to protect
which of the
following structures
passing posterior to
the root of the lung?
A)hemiazygos vein
B)right vagus nerve
C)right phrenic nerve
D)thoracic aorta

49. Which muscle is


responsible for
expelling the last drops
of urine in the male
A)sphincter urethrae
B)bulbocavernosi
C)sphincter vesicae
(internal urethral
sphincter)
D)Ischiocavernosi
Bulbospongiosus
constricts around the
bulb of the penis to
express last drop of
urine from urethra

50. At the
hepatoduodenal
ligament, the
structure that
occupies a medial
location is the
A)common bile duct
B)portal vein
C)inferior vena cava
D)hepatic artery

51. The thoracic duct enters


the venous circulation at
the junction of
A) superior vena cava and
right atrium
B) left subclavian and left
internal jugular vein
C) left and right
brachiocephalic vein
D) right subclavian and right
internal jugular vein

52. The axillary artery


may be ligated at this
point without
compromising the blood
supply to the upper
extremity

A) proximal to the
thyrocervical trunk

B) distal to the
subscapular artery

C) between the
thyrocervical trunk
and subscapular
artery

D) none of the above

53. Separates the


submandibular
triangle from the
carotid triangle
A)posterior belly of
digastric
B)Omohyoid
C)sternohyoid
D) hyoid bone

54. An occlusion of
the superior
mesenteric artery
would result in
necrosis of each of
the following
EXCEPT the
A)ascending colon
B)Rectum
C)Ileum
D)cecum

55. Occupies the


tracheoesophageal
groove
A)vagus nerve
B)sympathetic trunk
C)recurrent
laryngeal nerve
D)phrenic nerve

56. A womans inability


to supinate the forearm
could result from an
injury to which of the
following pair of nerves
A)axillary and radial
B)median and ulnar
C)radial (supinator,
brachioradialis)and
musculocutaneous
(biceps)
D) suprascapular and
axillary

57. Following tonsillectomy,


a patient noted loss of
general sensation and
taste from the posterior
one third of the tongue. It
could be assumed that
the injured nerve was a
branch of the
A)glossopharyngeal
nerve
B)facial nerve
C)lingual nerve
D)hypoglossal nerve

58. The median cubital


vein is a communication
between the
A)cephalic and basilic
B)basilic and axillary
C)cephalic and axillary
D) axillary and subclavian

59. Fenestrated capillaries


have
A) extremely attenuated
areas of endothelium with
pores
B) thickened areas with pores
C) diaphragm that have the
same thickness as unit
membranes
D) pores that are evenly
spaced over the entire
surface of the endothelium

60. A severe blow to the


side of the head could
fracture which one of
the following bones in
the roof of the orbit?
A)Palatine
B)Maxilla
C)Frontal
D)zygomatic

61. Occupies a medial


location within the
carotid sheath
A)internal jugular vein
B)ansa cervicalis
C)vagus nerve
D) common carotid
artery

62. Each of the following


characterizes the levator
ani muscles EXCEPT
a. it forms the principal part
of the pelvic diaphragm
b. it separates the floor of the
pelvis from the ischioanal
fossa
c. it arises from the inner
surface of the superior
ramus of the pubis
d. it separates the
superficial and deep
inguinal spaces

63. A basketball
player who trips and
falls, landing on his
outstretched hand will
most likely fractures
which carpal bone?
A)trapezium
B)Capitate
C)Scaphoid
D)hamate

Some Lovers Try


Positions That
They Can't
Handle

64. Lymphatic nodules


are found in each of
the following
EXCEPT
A)lymph nodes
B)Thymus
C)Tonsils
D)walls of urinary
tract

65. A spleen may be


ruptured in traumatic
injuries to the chest if
these ribs are fractured
and displaced
A) 5th, 6th, 7th level of the
posterior axillary line
B) 7th, 8th , 9th level of the
midaxillary line
C) 9th, 10th, 11th level of
the left posterior
axillary line
D) 10th, 11th, 12 anteriorly

66. A diastolic murmur


coming from a stenosed
mitral valve in patient
with RHD is best heard or
auscultated at the
A)5th ICS left
midclavicular line
B)4th ICS left parasternal
border
C)2nd ICS left parasternal
border
D)4th ICS right parasternal
border

67. Surgically, it is
important to locate which
one of the following
structures located
immediately posterior to
the second part of the
duodenum
A)transverse colon
B)left lobe of the liver
C)hilum of right kidney
D)gallbladder

68. Podocytes are


associated with which of
the following parts of the
urinary system
A)distal convoluted tubule
B)thick limb of loop of Henle
C)major calyces
D)visceral layer of
Bowmans capsule

69. A baby sustained a


lower brachial plexus
injury due to traumatic
childbirth (forceful
pulling on the arm). The
following is/are true
statements regarding
this type of injury
A) results in loss of
abduction, flexion and
lateral rotation of the
shoulder
B) results in clawhand
deformity (c8, t1;
ulnar>median)
C) leads to sensory deficit
in the lateral aspect of
the upper extremity
D) all of the above

70. Which of the


following layers in
the wall of a
medium sized artery
contains smooth
muscle
A)internal elastic
membrane
B)external elastic
membrane
C)tunica adventitia
D)tunica media

71. A lesion of the


lingual nerve
immediately after it
receives the chorda
tympani nerve could
result in each of the
following EXCEPT
loss of sublingual gland
secretion
sensory loss from
lower teeth
loss of taste from
anterior two thirds of
the tongue
loss of submandibular
gland secretion

72. The superior


vena cava could be
damaged by a stab
wound deep to the
A)right first costal
cartilage
B)right fourth costal
cartilage
C)right sternoclavicular
joint
D)left second costal
cartilage

73. All of the following statements


concerning the uterus are
correct EXCEPT
a. the broad ligament reflects
from the posterior surface of
the uterus to the rectum to
form the rectouterine pouch
b.the round ligament
connects the uterus to the
ovary
c. the broad ligament extends
from the anterior surface of the
uterus onto the bladder forming
the vesicouterine pouch
d. the uterine tubes enter the
uterus in the superior border of
the broad ligament

74. A 58-year-old man


presented with a year history
of chest pain. The attacks
were increasing in frequency
and were only relieved by
rest. Cardiac catheterization
revealed an area of occlusion
of the circumflex branch of
the left coronary artery. The
damage to the heart would
probably involve the
A)left atrium and left
ventricle
B)right atrium and left ventricle
C)right and left ventricles
D)apex of the heart

75. A severe infection


that obstructs the
middle meatus would
affect drainage from
each of the following
sinus EXCEPT the
A)maxillary sinus
B)frontal sinus
C)nasolacrimal duct
D)anterior ethmoid air
cells

76. Plicae circulares is


most abundant in
what part of the
gastrointestinal tract
A)Duodenum
B)jejunum
C)Ileum
D)large intestine

77. A woman on her 3rd


trimester of pregnancy
developed paresthesia
of the hands. She has
difficulty in doing her
cross-stitch hobby. Her
most likely problem
affects the
A)median nerve
B)ulnar nerve
C)radial nerve
D)axillary nerve

78.A 9-year-old boy fell


hitting his elbow.
Physical examination
showed weakness in
wrist flexion and loss
of adduction. Loss of
sensation was noted
on the medial side of
his hand. What nerve
was most probably
injured
A)Musculocutaneous
B)Ulnar
C)Radial
D)median

79. Carcinoma of the


_____part of the
pancreas usually shows
itself first by painless
progression jaundice
with enlargement and
distention of the gall
bladder
A)Head
B)Neck
C)Body
D)tail

80. Sperms found in


these structures are
capable of fertilizing
ova
A)seminiferous tubules
B)rete testis
C)ductuli efferentes
D) epididymis

81. A myocardial infarction


that damages the heart
muscle in the anterior two
thirds of the
interventricular septum
would result primarily from
occlusion of the
A) posterior interventricular
artery
B) marginal branch of the
right coronary artery
C) marginal branch of the left
coronary artery
D) anterior
interventricular artery

82. The horizontal


fissure of the right
lung separates the
A)superior and
middle lobe
B)superior and
inferior lobe
C)inferior and middle
lobe
D) superior lobe from
cardiac notch

83. In Dupuytrens contracture,


the flexion of the MCP joints
is actually due to
A) compression of the median
nerve at the wrist, leading to
atrophy of the muscles of
opposition
B) inflammation of the
synovium of the long flexor
tendons, leading to scarring
C) atrophy of the lumbrical
muscles due to disuse
D) fibrosis of the digital
slips of the palmar
aponeurosis

84. It would be difficult


for a gallbladder
infection to easily reach
which one of the
following viscera
A)Liver
B)third part of the
duodenum
C)cystic duct
D)transverse colon

85. After leaving the


trabecular sinuses of a
lymph node, lymph
passes directly into the
A)afferent lymphatic
vessels
B)efferent lymphatic
vessels
C)subscapular sinuses
D)medullary sinuses

86. A vertical incision


through the midline
of the anterior
abdominal wall will
traverse the
A)rectus abdominis
B)external oblique
C)internal oblique
D)linea alba

87. The contents of


an indirect inguinal
hernia enters the
inguinal canal
______ to the
inferior epigastric
artery
A)Lateral
B)Medial
C)Inferior
D)none of the above

88. A penetrating knife


wound to the posterior
shoulder in the
quadrangular space would
damage the axillary nerve
and the
A)anterior circumflex
humeral artery
B)posterior circumflex
humeral artery
C)subscapular artery
D)superior thoracic artery

89.A tumor involving


the fifth to twelfth
thoracic vertebrae
could affect each of
the following
structures in the
posterior mediastinum
EXCEPT the
A)thoracic duct
B)phrenic nerve
C)azygos vein
D)descending aorta

90. Damage to
the anatomic
snuffbox
might be
expected to
injure the
A)ulnar nerve
B)capitate bone
C)ulnar artery
D)radial
artery

91. The cerebral


arterial circle (circle
of Willis) is formed
by branches of the
internal carotid
artery and the
A)external carotid
artery
B)vertebral artery
C)basilar artery
D)middle meningeal
artery

92. AS a result of an
injury to the ulnar
nerve in the arm, all
of the following
changes in the hand
will be noted EXCEPT
A) sensory loss on the
little finger and one
half of the ring finger
B) the thumb is
strongly adducted
C) loss of flexion of the
distal interphalangeal
joints of the fourth
and fifth digits
D) marked wasting in
the hypothenar
eminence

For questions 93-95


A 63 year old woman shows
a fine, pill-rolling tremor in
both upper extremities, with
tremors at rest. There is an
overall poverty of
movements. The patients
gait is shuffling and motor
performance is delayed.

93. The most likely


diagnosis is
A)Wilsons disease
B)Parkinsons
disease
C)Benedikts
syndrome
D)Liver-brain disease

94. Dysfunction of
this structure is
implicated in the
above disease
A) substantia
gelatinosa
B) red nucleus
C) substantia nigra
D) cerebellum

95. Treatment
involves
administration of
A)Dopamine
B)Ldihydroxyphenylal
anine (levodopa)
C)Acetylcholine
D)serotonin

96. The powerful


extension of the
thigh required
when one is
standing from a
sitting position is
the function of the
A)gluteus
maximus
B)iliacus muscle
C)psoas major
D)piriformis

97. Ejaculatory fluid


is composed of
products produced
by all of the
following EXCEPT
the
A)seminiferous
tubules
B)seminal vesicles
C)bulbourethral
glands
D)rete testis

98. Respiratory distress


syndrome occurs most
commonly because
a. too few mature alveoli
have developed
b. surfactant production
is insufficient
c. the lungs are partially
filled with amniotic fluid
d. type I alveolar epithelial
cells produce a greatly
thickened basement
membrane

For question 99-100



A 55-year-old woman
complained of numbness in the
legs, which spread to involve
her hands. There were sudden
sharp pains, variable in
location, but usually localized
to one or the other leg. On
examination, her pupils were of
unequal size. Argyll-Robertson
pupils and Rombergs sign
were present. Although the
patients strength was normal
she was areflexic in all limbs.

Prostitutes pupils,
accommodate but not
react

99. The most likely


diagnosis is
A)Brown Sequard
syndrome
B)tabes dorsalis
C)multiple sclerosis
D)meningiona

Syphilis

100. Above findings is


the result of
a. degeneration of
posterior columns
b. upper motor neuron
damage
c. cerebellar disease
d. degeneration of
basal ganglia

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