CLINICAL ANATOMY for MEDICAL STUDENTS By SNELL 6th edition ANATOMY QUESTIONS Choose the best answer: P 201 1. The superior boundary of the epiploic foramen: A. free border of the lesser omentum containing the portal triad B. inferior vena cava C. caudate process of the caudate lobe of the liver D. first portion of the duodenum P 260 2. Less likely to produce ascites: A. hepatic cirrhosis C. gastritis B. cancer of the ovary D. congestive hear failure P 265 3. Important factor in the production of an ulcer in the anterolateral wall of the first part of the duodenum: A. acid chime squired as the stomach empties B. high level of pepsin C. bile secretion after food intake D. digestive enzymes excreted out by the pancreas P 266 4. Which of the following does not contribute to why the appendix is prone to infection: A. it has a large amount of lymphoid tissue in its wall B. the lumen has a tendency to become obstructed by hardened intestinal contents C. it is supplied by a long small artery that does not anastomose with any other artery D. it is a long narrow blind-ended tube which encourages stasis of large bowel contents P 266 5. Occurring at points where the circular muscle is weakest. Where the blood vessels pierce the muscles, herniation of the lining mucosa through the circular muscle between taenia coli occurs: A. volvulus B. intussusception C. diverticulosis D. achalasia P 274 6. Which is not true regarding aneurysm of the abdominal aorta: A. usually occur below the origin of the renal arteries B. majority result from atherosclerosis which weakens the wall C. occur most commonly in elderly women D. large aneurysms should be surgically excised and replaced with a graft P 274 7. Common cause of colic, EXCEPT: A. compression of the inferior vena cava B. intestinal obstruction C. passage of gallstone in the biliary duct D. passage of the stone in the ureter P 264 8. Total gastrectomy for gastric cancer does not include the removal of: A. lower end of esophagus C. head of the pancreas B. first part of duodenum D. spleen P 149 9. Herniorrhaphy of an indirect inguinal hernia constitute the repair of the floor of the inguinal canal, the floor is formed by: A. internal oblique C. lateral umbilical ligament B. inguinal ligament D. external oblique P 834 10. While doing a spinal tap, the spinal needle is inserted in between the: A. L1 and L2 vertebrae C. L3 and L4 vertebrae B. L2 and L3 vertebrae D. L4 and L5 vertebrae P 144 11. The cresenteric inferior border of the posterior rectus sheath: A. Spigelian line C. semilunar line B. arcuate line of Douglas D. linea alba P 197 16. Intraperitoneal organ: A. lower third of rectum C. kidney B. jejunum D. pancreas P 532 19. The femoral ring: A. is the medial opening of the inguinal canal B. is the base of the femoral canal C. forms the medial border of the Hesselbach’s triangle D. contains the spermatic cord 1
P 638 21. In the neck: A. the anterior rami of the C1-C4 spinal nerves supply the skin antero-laterally B. the investing layer of the deep cervical fascia forms the stylomandibular ligament C. the pretracheal fascia is attached superiorly to the hyoid bone D. all of the above are correct P 644 22. Forms the floor of both the submental and the digastric triangle: A. hyoglossus B. thyrohyoid C. mylohyoid D. geniohyoid P 643 23. Surgical procedures at the digastric triangle could possibly injure the following nerves, except: A. vagus nerve C. hypoglossal nerve B. spinal accessory nerve D. glossopharyngeal nerve P 791 24. In doing cricothyroidotomy, hemorrhage can occur from accidental injury to branches of: A. thyroidea ima artery C. superior thyroid artery B. superficial cervical artery D. external laryngeal artery P 795 25. In doing stellate ganglion block, the needle of the anesthetic syringe is inserted through the skin over the carotid tubercle; this carotid tubercle is a part of: A. cricoid cartilage B. 1st rib C. hyoid bone D. 6th cervical vertebra P 805 26. Due to the close proximity of their drainages in the nasal cavity, frontal sinusitis nearly always involves this sinus: A. maxillary C. anterior ethmoidal B. posterior ethmoidal D. sphenoidal P 664 27. The trigeminal nerve provides sensory innervation to the face except for a small area which is supplied by the: A. zygomaticotemporal nerve C. great auricular nerve B. lesser occipital nerve D. auriculotemporal nerve P 675 28. On its way to the tongue, the chorda tympani: A. passes through the mastoid wall of the tympanic cavity B. enters the infratemporal fossa through the petrotympanic fissure C. join a branch of the posterior division of mandibular nerve D. all of the above are correct P 691 29. In the living subject, the foramen lacerum of the cranial fossa is closed inferiorly by cartilage and fibrous tissue; above this closed inferior opening, foramen lacerum receives the: A. carotid canal C. foramen cecum B. condylar canal D. inferior orbital fissure P 705 30. The artery supplying the “leg area” of the cerebral cortex: A. is the biggest branch of the internal carotid artery B. passes in the longitudinal fissure of the cerebrum C. is a component of the circulus arteriosus D. all of the above are correct P 665 32. The sensory nerve supplying the tip of the nose is the distal continuation of the: A. infraorbital nerve C. anterior ethmoidal nerve B. long sphenopalatine nerve D. buccal nerve P 713 33. The following extraocular muscle is supplied by the most slender cranial nerve: A. superior oblique B. superior rectus C. lateral rectus D. none P 724 34. The retina extends anteriorly as far as the: A. ora serrata B. ciliary processes C. iris D. limbus P 727 35. True regarding the walls of the middle ear: A. the inferior wall transmits a branch from glossopharyngeal nerve B. the roof separates the middle ear from the temporal lobe of cerebrum C. the posterior wall contains the origin of stapedius D. all of the above are correct P 805 37. Epistaxis usually occur upon rupture of the anastomosing branches of: A. greater palatine and sphenopalatine arteries B. sphenopalatine and superior labial arteries C. greater palatine and maxillary arteries D. facial and superior labial arteries P 747 38. The vestibular ligaments of the larynx represent the inferior margin of the: A. fibroelastic membrane of the larynx C. quadrangular membrane B. cricothyroid ligament D. false vocal cords 2
P 796 40. Frey’s syndrome is due to damage to the following nerves: A. auriculotemporal and zygomaticotemporal B. zygomaticotemporal and zygomaticofacial C. great auricular and auriculotemporal D. chorda tympani and buccal branch of facial nerve P 236 41. In the pelvic cavity, the ureter turns medially to enter the urinary bladder at the level of: A. greater sciatic foramen C. ischial spine B. sacral promontory D. upper border of symphysis pubis P 306 42. In the Caldwell-Moloy pelvic classification, a transversely wide pelvis is: A. gynecoid B.platypelloid C. android D. anthropoid P 317 43. Components of anorectal ring, except: A. internal anal sphincter C. puborectalis B. external anal sphincter (deep part) D. valves of Houston P 298 44. The following branches of internal iliac artery pass through the greater sciatic foramen, except: A. superior gluteal B. inferior gluteal C. internal pudendal D. obturator 45. In the pelvic cavity, this structure lies at the apex of the V-shaped root of the sigmoid mesocolon: A. left ureter C. superior rectal artery B. origin of the internal iliac artery D. sacral promontory P 286 46. Boundaries of pelvic inlet, except: A. sacral promontory B. symphysis pubis C. ischial spine D. arcuate line P 323 49. Voluntary control of micturition is done at the level of: A. internal urethral meatus C. fossa navicularis B. urogenital diaphragm D. apex of the urinary bladder P 363 50. The pudendal nerve: A. has 3 major branches in the perineum B. passes out from the pelvic cavity via the lesser sciatic foramen C. enters the perineum via the greater sciatic foramen D. none of the above is correct 51. Which of the following components of the respiratory tract wall increase/s in amount from trachea to alveoli: A. cilia B. elastic fibers C. smooth muscle D. cartilage 52. The presence of iron deposits in the cytoplasm of which of the following lung cell type is a diagnostic feature of congestive heart failure: A. Goblet cell C. dust cell B. pneumocyte Type II D. Clara cell 53. In hypersensitivity reactions, this cell functions as an antigen-presenting cell in the skin: A. keratinocyte B. Langerhan’s cell C. melanocytes D. Merkel’s cell 54. Which of the following cell types comprises the visceral layer of Bowmann’s capsule affected in glomerular filtration disorders: A. endothelial cell C. mesangial cell B. juxtaglomerular cell D. podocyte 55. Which of the following hormone is most likely affected in hypothalamic tumors: A. ADH B. ACTH C. FSH D. TSH A. aorta C. thoracic duct B. medium sized artery D. vena cava 57. Diarrhea may result if which of the following organs fails to carry out its primary role in absorbing water from the feces: A. anal canal B. colon C. jejenum D. ileum 58. Increase aqueous humor of the eye is due to the secretion by: A. ciliary epithelium C. Schlemm’s canal B. choriocapillary layer D. corneal endothelium P 504 59. Contraction of the muscles of the forearm that commonly follows fractures of the distal end of the humerus or fractures of the radius and ulna: A. compartment syndrome of the forearm B. Dupuytren’s contracture C. Volkmann’s ischemic contracture D. Bontonniera deformity 3
P 501 60. Fracture of the distal end of the radius which occurs from a fall on the back of the hand: A. Colle’s fracture C. Monteggia’s fracture B. Smith’s fracture D. Bennett’s fracture P 495 61. A young boy sustained a superficial laceration in front of his right wrist which was bleeding profusely. He had sensory loss over the palmar aspect of the medial 1 ½ fingers but normal sensation on the back of these fingers over the middle and proximal phalanges. Which of the following statements about the patient is true: A. the radial artery was cut in front of the flexor retinaculum B. the loss of skin sensation was caused by the injury to the ulnar nerve as it crossed infront of the flexor retinaculum C. there was no sensory loss in the palm of the hand because the palmar cutaneous branch of the ulnar nerve was cut D. this will lead to carpal tunnel syndrome P 412 62. Which of the following is not part of the rotator cuff muscles: A. infraspinatus B. subscapularis C. supraspinatus D. teres major 63. Tennis elbow is characterized by pain and tenderness over the lateral epicondyle of the humerus. It is caused by: A. repeated friction between the anconeus and abductor pollicis longus B. partial tearing of the extensor muscles from the lateral epicondyle of the humerus C. supracondylar fracture of the humerus D. dislocation of the elbow joint P 489 64. Klumpke’s palsy is characterized by: A. upper lesion of the brachial plexus C. Waiter’s tip position B. lower lesions of the brachial plexus D. excessive traction or tearing of C5 & C6 P 485 65. Which blood vessel passes along the deltopectoral groove: A. axillary artery C. cephalic vein B. suprascapular artery D. basilica vein P 561 66. Nerve supply of the anterior fascial compartment of the leg: A. deep peroneal nerve C. posterior tibial nerve B. superficial peroneal nerve D. sciatic nerve P 622 68. A 17 year old boy was crossing a busy street when he was bumped by a car on the lateral part of his right knee. X-ray showed a fracture of the head of the fibula. The patient was seen to be dragging his right foot and catches his toes on the ground as he walks. Which of the following explains this: A. the patient injured his common peroneal nerve B. the medial meniscus was injured C. skin sensation on the posterior leg is lost D. the patient will not be able to plantarflex his right foot P 581 69. The dostalis pedis artery lies between the tendons of extensor hallucis longus and: A. peroneus tertius C. extensor digitorum brevis B. extensor digitorum longus D. extensor hallucis brevis P 595 70. Arch of the foot which consists of the bases of the metatarsal bones and the cuboid and the 3 cuneiform bones: A. medial longitudinal arch C. transverse arch B. lateral longitudinal arch D. posterior arch P 129 75. Pain in myocardial infarction is referred to the areas of distribution of the following spinal nerves: A. C2 – C4 B. C5 – C6 C. T1 – T4 D. T5 – T9 P 111 76. In what division of the mediastinum is thoracic duct to the duct to the left side of the vertebral column: A. superior B. inferior C. middle D. posterior P 130 78. A patient with cancer of esophagus develops hoarseness. This is suggestive of direct invasion of the following structures: A. larynx C. left recurrent laryngeal nerve B. nasal cords D. bronchus P 106 81. Sound of closure of the cardiac valve is heard best over the sternal end of right 4th intercostal space: A. aortic B. pulmonic C. ventral D. tricuspid P 106 82. Apex beat has the some auscultation area as the following heart valve: A. aortic B. mitral C. pulmonic D. tricuspid 4
P 86 83. Composed the medial and lateral bronchopulmonary segments: A. superior lobar C. middle lobar B. apical bronchopulmonary segment D. inferior lobar P 65 84. The cardiac area of dullness extends as far left as the: A. midclavicular line C. anterior axillary line B. parasternal line D. midaxillary line P 64 85. At what reference line in the thorax would you find the lower border of the lung and its visceral pleura at the lower border of the 8th rib: A. midclavicular B. anterior axillary C. mid axillary D. scapular line P 66 86. The base of an adult female breast extends up to the following: A. lower border of clavicle C. 2nd rib st B. 1 rib D. 3rd rib P 64 87. A stab wound in an the anterior chest wall just to the right of sternum at 4th ICS would most likely injure the following structure: A. superior vena cava C. right ventricle B. right atrium D. inferior vena cava P 800 89. A 48 year old female teacher was admitted to the hospital and diagnosed on a CT scan to have a thrombosis of pontine vessels supplying the medial left sector of caudal pons. Expected neurologic findings of the patient would be: A. ipsilateral hemiplegia C. inability to close the right eye B. inability of the left eye to look laterally D. dysphagia
CLINICAL NEUROANATOMY for MEDICAL STUDENTS By SNELL 5th edition P 175 90. Initial manifestation of syringomyelia at the level of C6 – T1 involves: A. flaccid paralysis at the level of injury B. positive Babinski reflex on the ipsilateral side C. bilateral loss of pain and temperature at the upper extremities D. bilateral proprioceptive loss P 170 92. “Upper motor neuron lesions” involving the spinal cord can be produced by the damage to the: A. spinothalamic tract D. spinocerebellar tract B. posterior columns E. Lissauer’s tract C. corticospinal tract
CLINICAL NEUROANATOMY for MEDICAL STUDENTS By SNELL 5th edition P 287 94. Stimulation of the middle frontal cortex (area *) of the cerebral cortex would most likely produce: A. contraction of the muscles of the contralateral leg B. visual agnosis C. auditory hallucination D. conjugate eye movements
CLINICAL ANATOMY for MEDICAL STUDENTS By SNELL 6th edition P 322 95. The inferior angle of the trigone of the urinary bladder has opening/s for: A. urethra B. ureters C. renal papilla D. ejaculatory ducts P 375 96. Attached to the central tendon of perineum: A. bulbospongiosus C. superficial transverse perineal muscle B. external anal sphincter D. A,B,C P363 98. The pudendal nerve and/or its branches have the following characteristics, EXCEPT: A. traverse the pudendal (Alcock’s) canal B. enter the perineum through the lesser sciatic foramen C. give origin to the posterior scrotal nerves 5
D. supply the ischiocavernosus muscle E. arise from S1, 2 and 3 spinal nerves P 335 100. The broad ligament contains all of the following , EXCEPT the: A. round ligament of the ovary D. uterine tubes B. uterine artery E. ureters C. round ligament of the uterus
Given a clinical scenario, identify the structure involved Application 1. A 60 year old man consults at your clinic with the complain of occasional deep-seated retrosternal discomfort radiating to the left shoulder, 2 months duration, associated with exertion. Upon auscultation, you take note of bradycardia and dysrthmia. By incidence, the slowly occluding vessel would be the: A. Coronary sinus B. Right Coronary artery C. Circumflex artery D. Anterior Descending artery Answer B. (Clinical Anatomy, 7th ed. R. Snell, p. 117, Clinical scenario Application) 2. A 70 year old chronic hypertensive patient consults with you regarding difficulty of swallowing solid food, 3 months duration. You proceed to request for a chest X-ray and note of a 0.7 cardiothoracic ratio. As far as the heart is concerned, the best explanation you can give the patient regarding her swallowing difficulty is: A. Impingement of the vagus nerve by an overriding ascending aorta B. Compression of the thoracis esophagus by an enlarged left atrium C. Compression of the recurrent laryngeal nerve underneath the aorta D. Overly stretched pericardiophrenic and pericardiosternal ligaments, compromising swallowing Answer B. (Clinical Anatomy, 7th ed. R. Snell, p. 113, Clinical scenario Application) 3. In the emergency evacuation of a massive hemopericardium compromising cardiac and systemic circulation, the best and safest area to make your access incision en route to the pericardial cavity is via: A. 5th left ICS immediately lateral to the sternum B. 7th left ICS immediately lateral to the sternum C. 6th left ICS 10 cm from the midsternal line D. Immediately subxiphoidal Answer D. (Clinical Anatomy, 7th ed. R. Snell, p. 107, Clinical scenario Application) Recall 1. A 70 year old male suffered massive myocardial infarction involving the right coronary artery. With your recent knowledge, want part/s of the heart does the right coronary artery supplies? A. SA node D. right ventricle B. AV node E. All of the above C. right atrium Answer E. (Clinical Anatomy, 7th ed. R. Snell, p. 117, Clinical scenario Recall) 2. Which of the following nerve will most likely to be injured in surgical repair of a patent ductus arteriosus? A. right phrenic C. left phrenic B. right recurrent laryngeal D. left recurrent laryngeal Answer D. (Clinical Anatomy, 7th ed. R. Snell, p. 117, Clinical scenario Recall) 3. If blood regurgitates back in the right atrium during systole. Which of the following valve is most likely to be damaged? A. Mitral C. aortic B. Tricuspid D. pulmonic th Answer B. (Clinical Anatomy, 7 ed. R. Snell, p. 117, Clinical scenario Recall)
Identify anatomic landmarks used in Physical examination Recall 1. In the auscultation of heart valves, what valve is heard best behind the right half of the sternum opposite the 4th intercostal space? 6
A. Tricuspid valve B. Mitral valve C. Pulmonary valve D. Aortic valve Answer: A (page 122) 2. The lower border of the heart is formed mainly by what structure? A. Right ventricle B. Left ventricle C. Right atrium D. Left atrium Answer: A (Page 111)
Given a laboratory finding/ radiographic finding, identify the structure involved X-ray findings Recall 1. An 80 year old presents to your clinic with the complaint of easy fatigability. Upon auscultation of the left upper sternal border you note a systolic murmur. On X-ray of the chest, you observe a cardiothoracic ratio of .60 with mainly right ventricular enlargement. These findings point to: A. Aortic stenosis B. Pulmonary insufficiency C. Aortic insufficiency D. Pulmonary stenosis Answer D. (Clinical Anatomy, 7th ed. R. Snell, p. 112, X-ray findings Recall) X-ray findings Application 1. A 40 year old male comes to you regarding dizziness and occasional chest pain. Upon auscultation you note a land apical murmur. X-rays of the chest reveal normal cardio-thoracic ratio. This finding point to a: A. Aortic valve incompetence B. Mitral valve stenosis C. Pulmonary stenosis D. Tricuspid valve stenosis Answer B. (Clinical Anatomy, 7th ed. R. Snell, p. 115, X-ray findings Application) Recall 1. Which of the following structures prevents the spread of urine inferiorly to the thigh in case of ruptured penile urethra due to straddle injury? A. Camper’s fascia C. conjoint tendon B. Scarpa’s fascia D. rectus sheath Answer B.(Clinical Anatomy, 7th ed. R. Snell, p. 155, Clinical notes) 2. Which of the following structures protects an abdominal viscus from herniation into the inguinal triangle? A. inguinal ligament C. rectus abdominis muscle B. conjoint tendon D. lacunar ligament th Answer B.(Clinical Anatomy, 7 ed. R. Snell, p. 196, Clinical notes) 3. The triangle of Calot is used to identify the: A. hepatic artery proper C. cystic duct B. bile duct D. cystic artery Answer D. 1. The Celiac artery arises from the abdominal aorta approximately at the level of: A. T6 B. T8 C. T10 D. T12 Answer: D (Page 261)
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Application 1. A 25 year old female was hit on her left side by a car and thrown about 10 feet. Aside from multiple fractures, the patient was diagnosed to have internal bleeding upon initial physical exam. What organ was most likely injured? A. Liver B. Kidneys C. Intestines D. Spleen Answer: D (Page294)
Given a laboratory finding/ radiographic finding, identify the structure involved Application 1. Swallowed gas within the proximal GIT will almost always collect in this region, as appreciated on antero-posterior X-ray views of the abdomen: A. Esophageal hiatus C. cardia B. Fundus D. pylorus th Answer B. (Clinical Anatomy, 7 ed. R. Snell, p. 234, X-ray findings Application)
Identify anatomic landmarks used in Physical examination Recall 1. What part of the posterior cranial fossa occupies the central area of the floor and transmits the Medulla oblongata? A. Cerebellar fossa B. Tentorium cerebelli C. Foramen magnum D. Foramen rotundum Answer: C (Page 799) Application 1. A 20-year old male was involved in a riot and was allegedly hit by a baseball bat at the back of the head. What injury would the patient sustain? A. Rupture of the Middle meningeal artery B. A large tear in the Circle of Willis C. Tearing of the Superior cerebral veins D. Rupture of the Lenticulostriate artery Answer: C (807) 2. A 15-year old girl consulted because of a growing abscess on the side of her nose. The following statements are true, Except: A. The blood in the facial vein is unable to spread upward because of the presence of valves. B. The danger area is drained by the facial vein C. Cavernous sinus thrombosis can occur by the spread of infection by the venous blood D. The facial vein communicates with the cavernous sinus via the superior and inferior ophthalmic veins Answer: A (Page 820)
Given a laboratory finding/ radiographic finding, identify the structure involved Application 1. Ischemia due to thrombosis in the anterior spinal artery would affect the following sensory modalities of that particular spinal segment, EXCEPT: A. pain C. temperature B. light touch D. proprioception th Answer D. (Clinical Anatomy, 7 ed. R. Snell, p. 945, Clinical notes)
Given a patient problem, identify errors in development (germ cell, cell division, genetic disorders) Application 8
1. What congenital anomaly results from the failure of development of the spines and arches of one or more vertebra? A. Scoliosis B. Anencephaly C. Spina bifida D. Lordosis Answer: C (Page 953)
Given a clinical scenario, identify the structure involved Recall 1. Bone will be able to heal properly as long as which of the following structures remains intact? A. epiphysis C. medullary cavity B. endosteum D. periosteum Answer D. (Clinical Anatomy, 7th ed. R. Snell, p. 37, Clinical notes) 2. The muscle that initiates the first 15 degrees of shoulder abduction is the: A. trapezius C. subscapularis B. supraspinatus D. deltoid Answer B. (Clinical Anatomy, 7th ed. R. Snell, p. 490, Clinical notes) 3. Which of the following conditions is most likely to cause a loss of the median nerve function? A. Dupuytren’s contracture B. Carpal Tunnel syndrome C. Fracture of the spiral groove of the humerus D. Fracture of the anatomical neck of the humerus Answer B. (Clinical Anatomy, 7th ed. R. Snell, p.538 , Clinical scenario Recall) 4. Femoral neck fractures may disrupt which of the following vessels? A. femoral artery C. circumflex femoral artery B. deep femoral artery D. artery to the head of the femur Answer C. (Clinical Anatomy, 7th ed. R. Snell, p.628 , Clinical scenario Recall) 2. If the medial border of the cubital fossa is severed by a knife, which of the following structure most likely suffers damage? A. radial nerve C. pronator teres B. brachioradialis D. ulnar nerve Answer C. (Clinical Anatomy, 7th ed. R. Snell, p.521 , Clinical scenario Application) 3. To maintain balance and prevent the hips from tilting and sagging in the unsupported side of the pelvis while walking, the muscle involved is the: A. gluteus maximus C. piriformis B. gluteus medius D. quadratus femoris Answer B. (Clinical Anatomy, 7th ed. R. Snell, p.609 , Clinical scenario Application)
Identify anatomic landmarks used in Physical examination Recall 1. The bony protruberance on the dorsal aspect of the wrist is part of what bone? A. Radius B. Ulna C. Phalanges D. Metacarpals Answer: B (Page 468) Application 1. A patient suffering from “Wrist drop” is most likely caused by injury to the: A. Median nerve B. Ulnar nerve C. Radial nerve D. Lateral cutaneous nerve Answer: C (Page482) 2. A patient suffering from “Claw hand” is most likely caused by injury to the: A. Median nerve B. Ulnar nerve 9
C. Radial nerve D. Lateral cutaneous nerve Answer: B (Page482)
Given a laboratory finding/ radiographic finding, identify the structure involved Recall 1. Fractures of the surgical neck of the humerus will most likely injure which of the following nerves? A. musculocutaneous C. axillary B. median D. radial Answer C. (Clinical Anatomy, 7th ed. R. Snell, p. 468, Clinical notes) Application 1. Which of the following nerve is jeopardized in a fracture of the medial epicondyle (X-ray) of the humerus? A. Ulnar C. median B. Radial D. musculocutaneous Answer A. (Clinical Anatomy, 7th ed. R. Snell, p. 529, X-ray findings Application) Application 1. A knife wound immediately below the right 4th rib along the midclavicular line will most likely injure the following bronchopulmonary segment: A. apical and posterior segment C. medial basal and anterior basal B. medial and lateral segment D. posterior basal and lateral basal Answer B. (Clinical Anatomy, 7th ed. R. Snell, p. 72, 98, Clinical notes) 2. The driver of a van involved in a vehicular accident comes in with contusions in his anterior chest wall. On X-ray, you check for rib fractures. The most likely portion of the rib to be fractured is the: A. neck C. anterior to the costal angle B. attachments to its costal cartilages D. posterior to the costal angle Answer C. (Clinical Anatomy, 7th ed. R. Snell, p. 60, Clinical notes)
Identify anatomic landmarks used in Physical examination Recall 1. The costal margin is the lower boundary of the thorax. It is formed by the cartilages of the: A. 8th and 9th rib only B. 9th and 10th rib only C. 8th, 9th and 10th rib only D. 8th, 9th,10th rib and the ends of the 11th and 12th rib Answer: D (Page 67) 2. The trachea extends from the lower border of the cricoid cartilage in the neck to approximately the level of the: A. 10th thoracic vertebra B. Sternal angle C. Xiphisternal joint D. Suprasternal notch Answer: B (Page 71)
Given a laboratory finding/ radiographic finding, identify the structure involved Recall 1. An impalement injury at the area of the sternal angle would most likely injure the following structures, EXCEPT: A. T4/T5 IV disc C. carina B. ascending aorta D. larynx Answer D.
Given a clinical scenario, identify the structure involved Recall 10
1. Which of the following ligaments transmits the uterine artery as it supplies the uterus? A. round ligament C. cardinal ligament B. broad ligament D. uterosacral ligament th Answer C. (Clinical Anatomy, 7 ed. R. Snell, p. 392, Clinical notes) 2. Which of the following provide dynamic support to the uterus? A. position of the uterus relative to the uinary bladder C. uterosacral ligament B. transverse cervical ligament D. muscles of the pelvic diaphragm th Answer D. (Clinical Anatomy, 7 ed. R. Snell, p. 397, Clinical notes) Application 1. In females, the rectouterine pouch is best accessible to examination via: A rectal vault C. lateral vaginal fornix B. anterior vaginal fornix D. posterior vaginal fornix th Answer D. (Clinical Anatomy, 7 ed. R. Snell, p. 405, Clinical notes) 3. Prostatic cancer cells metastasize to the skull via the: A. pampiniform venous plexus C. lumbar nodes B vertebral venous plexus D. internal iliac nodes th Answer B. (Clinical Anatomy, 7 ed. R. Snell, p. 381, Clinical notes)
Identify anatomic landmarks used in Physical examination Recall 1. The normal anatomic position of the uterus is: A. Anteverted and anteflexed B. Retroverted and anteflexed C. Retroverted and retroflexed D. Anteverted and retroflexed Answer: A (Page 392) 1. A culdocentesis was performed on a 27-year old female suspected to have a ruptured ectopic pregnancy. She had a 10 week history of amenorrhea and presented with severe hypogastric pain. In culdocentesis, blood pools in the area of the rectouterine pouch because: A. It is the most dependent part of the entire peritoneal cavity B. The pouch lies anteriorly to the vagina C. The pouch has a direct contact with the uterine tubes D. All of the above Answer: A (Page 391)
Given a clinical scenario, identify the structure involved Recall 1. A 22 year old male was rushed to the emergency room semiconscious with multiple hematomas on the right lumbar area of the posterior abdominal wall, right gluteal region and right lateral area of the thigh. The organ most likely to be traumatized is the: A. Liver C. Pancreas B. Kidney D. Spleen Answer B. (Clinical Anatomy, 7th ed. R. Snell, p.279 , Clinical scenario Recall) 2. Having inserted approximately 11-12cm. of the catheter, you note some difficulty in insertion. The catheter tip is most probably in what part of the urinary system? A. Spongy urethra C. Prostatic urethra B. Membranous urethra D. Urinary bladder th Answer B. (Clinical Anatomy, 7 ed. R. Snell, p.436 , Clinical scenario Recall)
Identify anatomic landmarks used in Physical examination Recall 1. Relative anatomy of the kidney, EXCEPT: A. Retroperitoneal B. In the Paravertebral gutter 11
C. At the level of T10 and L1 vertebral bodies D. Right kidney is lower than the left Answer: C (Page 281) Application 1. A 55-year old man was diagnosed to have ureteric stones. With your knowledge in the anatomy of the ureters, the following are considered to be the anatomic narrowings, except: A. The pelviureteral junction B. Pass the level of L3 C. The pelvic brim D. Upon entering the urinary bladder Answer: B (Page 285) 2. The renal artery arises approximately from the level of the: A. L1 B. L2 C. L3 D. L4 Answer: B (Page 282)
Given a laboratory finding/ radiographic finding, identify the structure involved Recall 1. A 40 year old male complained of episode of severe pain which starts in the costovertebral angle radiating to the left scrotal area. His urinalysis showed microscopic RBCs. He is diagnosed to have ureterolithiasis (ureter stone). Blood in the urine is most likely to come from the following vessels, EXCEPT: A. Testicular C. Superior vesical B. Renal D. Left colic th Answer D. (Clinical Anatomy, 7 ed. R. Snell, p.284 , Lab findings Recall) Application 1. A KUB-IVP was done and showed a dilated left ureter from the renal pelvis up to the level of L4. You then suspect the uterolith to be lodged in the: A. renal pelvis C. ureterovesical junction B. pelvic brim D. bladder th Answer B. (Clinical Anatomy, 7 ed. R. Snell, p.286 , X-ray findings Application) 2. Which part of the pituitary gland is really a downward continuation of the hypothalamus? A. Neurohypophysis C. both B. Adenohypophysis D. neither Answer: A 3. Which of the following is NOT a part of neurohypophysis? A. pituitary stalk C. intermediate lobe B. posterior lobe D. all of the above Answer: C 7. The thyroid gland synthesizes the following hormones, EXCEPT for the: A. T3 C. calcitonin B. T4 D. melatonin Answer: D
Given a clinical scenario, identify the structure involved Application 1. You are manipulating the external ear canal of a 6 year old boy, attempting to remove an insect using a cotton bud. All of a sudden, the boy starts coughing continuously and the mother begins to show concern. You should assure her that this is merely due to: A. The insect beginning to enter the middle ear space B. Stimulation of branches of the vagus nerve 12
C. Beginning effusion within the middle ear cavity due to the presence of the insect D. None of the above Answer B. (Clinical Anatomy, 7th ed. R. Snell, p.834 , Clinical scenario Application) Recall 1. In chronic otitis media, the part of the ossicular chain that is usually first to undergo necrosis due to its poor blood supply is the: A. lenticular process of the incus B. stapes footplate C. capitulum of the stapes D. manubrium of the malleus Answer A. (Clinical Anatomy, 7th ed. R. Snell, p. 839, Clinical scenario Recall)
Identify anatomic landmarks used in Physical examination Recall 1. The optic nerve enters the orbit passing through the optic canal is accompanied by the: A. Ophthalmic artery B. Suspensory ligaments of the eye C. Ophthalmic vein D. Trochlear nerve Answer: A (Page 828) 2. What structure in the middle ear separates the tympanic cavity from the meninges and temporal lobe of the brain? A. Floor of the middle ear B. Anterior wall of the middle ear C. Tegmen tympani D. Mastoid antrum Answer: C (Page 834) Application 1. Inadequate treatment of otitis media can result in acute mastoiditis due to spread via what structure? A. Semicircular ducts B. Mastoid antrum C. Petrous bone D. Tegmen tympani Answer: B (Page 842)
Given a clinical scenario, identify the structure involved Histology 1. In an asthmatic person, you expect the peripheral blood smear to have higher than normal amount of: A. Basophils C. Lymphocytes B. Eosinophils D. Neutrophils Answer: B 2. In a person with multiple abscess formation due to bacterial infection, you expect the peripheral blood smear to show higher than normal values of: A. Basophils C. Lymphocytes B. Eosinophils D. Neutrophils Answer: D
Given a clinical scenario, identify the structure involved Histology 1. On surfaces constantly exposed to abrasion, such as the skin and esophagus, the most suitable epithelium that can afford protection is: A. simple squamous C. stratified squamous B. transitional D. pseudostratified Answer: C 13
SIMPLE MULTIPLE CHOICE. CHOOSE THE BEST ANSWER. UPPER LIMB 1. A spiral fracture in the middle to distal third of the humerus may injure this structure: a. axillary artery c. radial artery b. radial nerve d. axillary nerve Chapter 9 Page 439 THORAX 2. Chest radiograph taken during the inspiratory phase of respiration will show a vertically elongated cardiac shadow because : a. the heart is compressed by the expanded lungs b. the fibrous pericardium is adherent to the mediastinal pleura c. parietal pericardium is fused to the central tendon of the diaphragm d. of increased intrathoraic pressure Chapter 3 Page 105 3. The hormone calcitonin is produced by what particular endocrine cell? a. thyrocyte c. parafollicular cells b. chief cell of the parathyroid d. oxyntic cells of the prathyroid Chapter Page 4. Surfactant production is a function of which of the following cells of the pulmonary system? a. pneumocytes type I c. endothelium b. pneumocytes type II d. Clara cells Chapter 3 Page 100 5. The following are features of the right primary bronchus, EXCEPT that: a. It is shorter c. it is more vertical b. It is narrower d. It has 3 branches Chapter 3 Page 90 6. The blood supply of the heart are branches of: a. ascending aorta c. thoraic aorta b. arch of aorta d. bronchial artery Chapter 3 Page 117 7. A blood clot detached from the right ventricular wall will likely cause obstruction to the blood vessel that supply the following organ: a. lungs c. brain b. kidney d. liver Chapter 3 Page 112 8. Deoxygenated blood from the fetus is brough back to the maternal circulation through the following blood vessels a. ductus venosus c. umbilical artery b. umbilical vein d. vitteline vein Chapter 3 Page 111 9. Sternal angle of Louis refers to a a. depression at the upper border of the sternum b. joint between manubrium and body of sternum c. joint between body and xiphoid process of sternum d. junction of 1st rib, clavicle and manubrium sterni Chapter 2 Page 67 HEAD AND NECK
14
10.The following intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve EXCEPT the: a. oblique arytenoid c. thyroarytenoid b. cricothyroid d. posterior cricoarytenoid Chapter 16 Page 869 11.ACTH is release by released by the pituitary gland through the influence of: a. thalamus c. hypothalamus b. cerebellum d. basal ganglia Chapter Page 12.Parathyroid hormone stimulates this cell to increase the blood calcium level: a. Osteoclast c. chondroblast b. Osteoblast d. chondrocyte Chapter 11 Page 747 13.Thyroid hormones, T3 and T4 are secreted by what cell of thyroid gland? a. acidophil c. follicular b. basophil d. parafollicular Chapter 11 Page 745 14.The veins which drain the tongue, tonsils and the rest of the oral cavity all drain in the: a. external jugular vein c. external carotid vein b. internal jugular vein d. external carotid vein Chapter 11 Page 847 15.The nerve supply for general sensations of the mucous membrane covering the anterior two thirds of the tongue is the: a. glossopharyngeal nerve c. lingual nerve b. hypoglossal nerve d. chorda tympani branch of facial nerve Chapter 11 Page 847 ABDOMEN 16.Which of the following arteries supplies the lower part of the greater curvature of the stomach? a. left gastric artery c. left gastroepiploic artery b. right gastric artery d. right gastroepiploic artery Chapter 5 Page 237 17.The submucosallayer is seen in the following organs of the digestive system EXCEPT: a. oesophagus c. large intestines b. gallbladder d. duodenum Chapter Page 18.Which of the following structures is NOT a component of the portal triad of the liver? a. bile ductile c. central vein b. hepatic arteriole d. portal vein Chapter 5 Page 266 19.Which cell consist monocyte – marcophage system of the liver? a. Ito cells c. Kupffer cells b. Fibroblast in the space of Disse d. hepatocytes Chapter Page 20.The cells of zona glomerulosa of adrenal cortex procedure what hormone that influences the electrolyte and water balance of the body? a. cortisone c. aldosterone b. vasopressin d. epinephrine Chapter 4 Page 217 21.The renal facia is derived from the fascia of the abdominal wall
15
a. lumbodorsal b. transversalis Chapter 5 Page 281
c. psoas d. diaphragmatic
22.Which of the following organs is located anterior to the right kidney? a. Pancreas c. duodenum b. Jejunum d. spleen Chapter 5 Page 281 23.The arrangement of the structures in the renal pedicle from anterior to posterior is: a. vein, artery, ureter c. ureter, vein artery b. artery, vein ureter d. vein, ureter, artery Chapter 6 Page 357 24.Which of the following statement regarding the bladder is NOT true? a. It’s a muscular receptacle for storage of urine b. The empty bladder in adults is located entirely in the pelvis c. It’s posterior wall is also its base d. It is an intraperitoneal organ Chapter 6 Page 357 25.The blood vessels that conveys 70% of blood to the liver is the: a. hepatic artery c. hepatic vein b. portal vein d. inferior vena cava Chapter 5 Page 267 26.Among the following tributaries, which vein joins the splenic vein to form the portal vein a. left gastric vein c. right gastric vein b. inferior mesenteric vein d. superior mesenteric vein Chapter 5 Page 277 27.Which of the following represents an internal difference between the small and large intestines? a. Longitudinal muscle arrangement c. plicae circulares b. Appendices epiploicae d. intestinal sasculation Chapter 5 Page 265 28.The part of the duodenum which is posterior to the fundus of the gallbladder, right hepatic lobe and transverse colon and anterior to the hilium of the right kidney is: a. duodenal cap (superior) c. transverse part b. descending part d. ascending part Chapter 5 Page 245 29.The structure along the gastrointetinal tract that is formed from the most caudal protion of the foregut and the most cephalic end of the midgut is the: a. gastroesophageal junction c. iloececal junction b. duodenum d. left colic flexure Chapter 5 Page 239 PERINEUM AND PELVIS 30.The endocrine part of the testis that secretes the hormone Testosterone? a. sertoli cells c. spermatocyte b. Lyedig cells d. spermatogonia Chapter 8 Page 448 31.The integrity of the blood-testis barrier is a function of which cell of the male reproductive tract? a. sertoli cells c. germinal epithelium b. Leydg cells d. spermatozoons Chapter 8 Page 469
16
32.After traumatic rupture of penile urethra distal to urogenital diaphragm, urine would likely extravasate to the: a. scrotum c. anal triangle b. posterior abdominal wall d. deep perineal pouch Chapter 8 Page 437 33.Fertilization of an egg by a sperm normally occurs at the: a. infusdibulum of the fallopian tube c. isthmus of the fallopian tube b. ampulla of the fallopian tube d. entrauterine portion of the fallopian tube Chapter 7 Page 344 34.The structure that maintains the normal position of the uterus is the: a. broad ligament c. peritoneum b. round ligament d. ureter Chapter 4 Page 392 35.The vas deferens end by joining the ducts of the: a. epididymis c. bulbourethral glands b. prostate gland d. seminal vesicles Chapter 4 Page 176 36.Which of the following parts of the male reproductive system is supplied by a branch of the abdominal aorta? a. epididymis c. seminal vesicles b. vas deferens d. prostate gland Chapter 4 Page 179 37.The narrowest part of the male urethra is the: a. Prostatic c. spongy b. membranous d. external orifice Chapter 8 Page 436 38.When doing hysterctomy one should be careful in cutting the following ligaments because it contains the ovarian artery and veins and may cause bleeding if anadvertently cut a. broad ligaments c. round ligaments b. suspensory ligaments d. ovarian ligaments Chapter 4 Page 397 39.This uterine ligament extends from the utherus to the labia majora a. transverse cervical ligament c. round ligament b. uterosacral ligament d. broad ligament Chapter 7 Page 394 INTRODUCTION TO BASIC ANATOMIC STRUCTURES 40.The endothelium of capillaries is well adapted for the function of exchange of gases and nutrients because it is made up of what type of epithelium? a. stratified c. transsitional b. psuedostratified d. simple Chapter 1 Page 21 41.The main cell in connective tissue involved in tissue repair: a. plasma cell c. fibroblast b. mast cell d. adipose cell Chapter Page 42.The type of specialized connective tissue which has a rigid consistency due to disposition of inorganic salts: a. cartilage c. myeloid b. bone d. blood Chapter Page
17
BACK 43.The spinal cord is anchored vertically to the coccyx by the: a. denticulate ligament c. filum terminale b. cauda equina d. ligamentum flavum Chapter 12 Page 143 44.The fasciculus cuneatus is found at this spinal cord segment: a. lumbar c. sacral b. thoracic d. cervical Chapter 12 Page 941 45.The lateral coticospinal tract carry these impulses to the effector organs: a. motor c. sysmpathetic b. sensory d. parasympathetic Chapter Page 46.Pain and temperature impulses on the left sole ascends to the thalamic are via: a. ipsilateral lateral spinothalamic tract c. ipsilateral posterior column b. contralateral lateral spinothalamic tract d. contralateral posterior column Chapter 11 Page 810 47.Loss of pain ad temperature sensation at the level of the umbilicus points to a lesion at this cord level: a. T10 c. T8 b. L2 d. T12 Chapter Page 48.The fiber tract that coordinates the functions of cranial nevers II, IV and VI: a. medial lemniscus c. medial longitudal fasciculus b. fasciculus gracilis d. lateral lemniscus Chapter Page 49.The efferent nucleus of the pupillary light reflex is: a. lateral geniculate body c. Edinger-Westpal b. oculomotor nucleus d. trouchlear nucleus Chapter Page 50.CSF flows from the 3rd ventricle to the 4th ventricle via: a. Formina of Monro c. cerebral aqueduct b. Foramina of Magendie d. Foramina of Luschka Chapter 12 Page 947 51.Pain and temperature sensation from the head is received in the brainstrem by the: a. mesencphalic nucleus of V c. motor nucleus of V b. trigeminal spinal nucleus d. nucleus ambigous Chapter Page Source: Clinical Anatomy Richard S. Snell 7th Edition (Lippincott Williams & Wilkins)
7. Postoperative hoarseness after thyroidectomy results if one of the recurrent nerves is accidentally cut while ligating which of the following vessels? A. superior thyroid artery C. superior thyroid vein B. inferior thyroid artery D. middle thyroid vein Page 746 9. Which of the following nerves is the largest branch of the lumbar plexus and supplies all the muscles of the anterior fascial compartment of the thigh? A. femoral 18
B. sciatic C. obturator D. deep peroneal Page 621 10. A 50 year old male patient sustains an injury to the lateral aspect of the right knee. Due to the heavy impact on the injured area the nerve most likely to be injured is likely to produce: A. plantar flexion C. dorsiflexion B. knee flexion D. foot enversion Page 653, 655-660 11. The safest area to administer intramuscular medications in the gluteal area is at the A. upper inner quadrant C. lower inner quadrant B. upper outer quadrant D. lower outer quadrant Page 608 12. The medial umbilical fold in the posterior surface of the anterior abdominal wall covers the A. internal epigastric vessels C. obliterated umbilical artery B. remnant of the urachus D. linea alba Page 352 13. Which of the following is an example of a saddle joint? A. carpometacarpal joint of the thumb B. metacarpophalangeal joint of the index finger C. shoulder joint D. wrist joint Page 17 15. All of the following statements about the adrenal gland are correct EXCEPT: A. They are retroperitoneal organs. B. Both adrenal veins drain into the inferior vena cava. C. The superior adrenal arteries are branches of the inferior phrenic arteries. D. They are innervated predominantly by preganglionic sympathetic fibers. Page 290-291 16. Which is an INCORRECT statement about an intervertebral disc? A. during aging, fluid within the nucleus pulposus is replaced by fibrocartilage B. atlanto-axial joint possesses no disc C. nucleus pulposus is most likely to herniate in an anterolateral direction D. disc are thickest in the lumbar region Page 929-932 17. After extensive surgical dissection in the posterior cervical triangle, drooping of the skin in the neck was noted postoperatively. This is due to injury of what nerve? A. trigeminal C. spinal accessory B. hypoglossal D. facial Page 771-773 18. Not found in the CNS A. astrocytes B. Schwann cell
C. bipolar cells D. oligodendrocytes 19
Page 330 Bloom and Fawcett 24. Which of the following structures does not form the anterior surface of the heart? A. right ventricle B. right atrium C. left ventricle D. left atrium Page 110 26. An occlusion of the superior mesenteric artery would result in necrosis of of each of the following EXCEPT the: A. ascending colon B. rectum C. cecum D. ileum Page 261 27. Space between the cornea and the iris and lens A. anterior chamber B. posterior chamber C. vitreous cavity D. aqueos humor Page 831-832 28. A severe infection that obstructs the middle meatus would affect drainage from each of the following sinuses EXCEPT the A. maxillary sinus B. frontal sinus C. nasolacrimal duct D. anterior ethmoid air cells Page 860 29. A patient is unable to taste a piece of sugar placed on the anterior part of the tongue.which cranial nerve is likely to have a lesion? A. hypoglossal nerve B. vagus nerve C. glossopharyngeal nerve D. facial Page 904 30. When a patient attempts protrusion of the tongue,the tongue deviates to the right. This would indicate damage to which of the following nerves? A. right glossopharyngeal B. left accessory C. right hypoglossal D. left hypoglossal Page 910 31. If a patient presented with a permanently dilated pupil, which one of the following nerves could be assumed to be involved? A. optic B. sympathetic trunk C. ophthalmic 20
D. occulomotor Page 903 33. Damage to the anatomic snuffbox might be expected to injure the A. ulnar nerve B. median nerve C. ulnar artery D. radial artery Page 533 34. Following a tonsillectomy, a patient noted loss of general sensation and taste from the posterior 1/3 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. vagus nerve Page 904 35. A stab wound on the neck which injures the spinal root of CN XI results to the following signs and symptoms EXCEPT: A loss of pain sensation on the shoulder and upper chest B. drooping of the shoulder C. inability to elevate the shoulder D. weakness and atrophy of the trapezius Page 909-910
38. The cerebral aqueduct is located in the A. cerebrum C. midbrain B. diencephalons D. pons Page 810 41. This histologic structure of the duodenum that neutralizes the highly acidic content of the stomach: A. crypts of Leiberkuhn’s C. Brunner’s gland B. microvilli D. glycocalyx Page 633-635 Bloom and Fawcet 42. Extensor compartment of the leg A. anterior compartment B. lateral compartement
C. peroneal compartment D. posterior compartment
Page 660 43. The thoracic duct passes through the diaphragm through the A. aortic hiatus C. caval foramen B. esophageal hiatus D. sternocostal hiatus Page 62-64 44. Posterior to the neck of the pancreas this vessel is formed A. inferior vena cava C. portal vein 21
B. celiac trunk
D. thoracic duct
Page 262-263 45. The sternal angle is a useful landmark in counting the intercostal space and it corresponds to the level of A. 1st costal cartilage C. 3rd costal cartilage nd th B. 2 costal cartilage D. 4 costal cartilage Page 67 47. Damage to the anterior division of the middle meningeal artery may results into what type of intracranial hemorrhage A. extradural hemorrhage C. subdural hemorrhage B. subarachnoid hemorrhage D. cerebral hemorrhage Page 897 48. Granular leukocytes EXCEPT: A. neutrophil B. basophil
C. monocyte D. eosinophil
Page 129 Bloom and Fawcett 50. Clinical findings of epistaxis, cerebrospinal rhinorrhea or exophthalmos is due to fracture of the A. anterior cranial fossa C. posterior cranial fossa B. middle cranial fossa D. none of the above Page 798 802 51. The structure that serves as a landmark in doing pudendal block anesthesia through a transvaginal approach is the: A. iliac crest C. ischial spine B. ischial tuberosity D. sacral promontory Page 339 423 53. To what vein does the left ovarian vein drain into? A. renal C. portal B. IVC D. iliac vein Page386 55. In doing thoracentesis, which of the following layers is not penetrated by the needle? A. intercostal muscles C. superficial fascia B. endothoracic D. visceral pleura Page 61 59. The powerful extension of the thigh required when one is standing from the sitting position is the function of the A. gluteus maximus muscle B. psoas major muscle C. piriformis muscle D. iliacus muscle 22
Page 603 60. The osseous labyrinth of the internal ear consists of the A. vestibule B. sacculus C. semicircular duct D. utriculus Page 842 63. The main venous drainage of the heart is the A. great cardiac vein B. coronary sinus
C. azygos vein D. inferior vena cava
Page 121 65. 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 nasao-labial fold on the affected side C. numbness of the cheek on the affected side D. A and C only Page 768 66. For a soccer player to have a strong kick he must develop his A. hamstring muscles C. quadriceps femoris B. pes anserinus muscles D. gluteal muscles Page 624 68. A massive infarction of the heart involving the septum, apex, ventricle (left) is likely due to obstruction of the: A. right coronary artery C. L-ant. descending artery B. circumflex artery D. right interventricular\ Page 119-120 70. Fate of the Graafian follicle immediately after ovulation A. corpus luteum B. atretic follicle C. corpus albicans D. none of the above Page 825-826 Bloom and Fawcett 71. Following a hard blow to the anterior shoulder, a weakness of the flexion of the arm at the shoulder joint would suggest damage to which of the following muscles? A. rhomboid major B. supraspinatus C. pectoralis minor D. biceps brachii Page 500 505 72. Loss of function of the muscles of the posterior compartment of the leg and the sole of the foot is associated with paralysis of A. tibial nerve B. common fibular nerve 23
C. deep fibular nerve D. superficial fibular nerve Page 662 73. All of the following forms the boundary of the perineum, EXCEPT: A. pubic symphysis C. coccyx B. ischial tuberosities D. sacrospinous ligaments Page 416 76. Which of the following muscles will be paralyzed if there is a lesion of the ulnar nerve? A. medial two lumbricals and opponens pollicis B. palmar interossei and adductor pollicis C. dorsal interossei & lateral two lumbricals D. medial and lateral lumbricals Page 546 77. In males, the mucus-secreting glands found within the deep perineal pouch are the: A. seminal cuneatus C. Cowper's glands B. Skene's glands D. prostate glands Page 435 79. The following is a subdivision of the posterior triangle of the neck A. Digastric C. Subclavian B. Submental D. Carotid Page 730 81. The gastrohepatic ligament attaches to this part of the stomach A. fundus C. lesser curvature B. greater curvature D. none of the above Page 219 82. The following are sources of blood supply of the stomach; EXCEPT: A. right gastric artery C. hepatic proper artery B. left gastric artery D splenic artery Page 237
83. Lateral wall of middle ear: A. tympanic membrane B. tegmen tympani
C. carotid wall D. ventricular wall
Page 834 84. Paranasal sinus that communicates with the nasal cavity through its opening in the superior meatus: A. posterior ethmoidal C. frontal B. anterior ethmoidal D. sphenoid Page 863-864
85. This bone forms part of the nasal septum: A. sphenoid B. nasal bone
C. ethmoid D. frontal
Page 790 24
89. The dorsalis pedis artery is a terminal branch of the A. anterior tibial artery C. peroneal artery B. posterior tibial artery D. saphenous artery Page 627 90. Structure that is easily damaged/cut during abdominal hysterectomy A. obturator nerve C. internal iliac artery B. ureter D. umbilical artery Page397 93. A 47 y.o. man was riding his motorcycle when a jaywalker suddenly crossed his path. His sudden brake and turn caused him to lose control and he subsequently fell hitting the pavement with his head and shoulder. On examination his upper limb hung limply on the side, medially rotated and forearm pronated. Diagnosis: Erb-Duchenne Palsy. Which statement is true regarding Erb-Duchenne Palsy? A. involves upper brachial plexus B. caused by excessive abduction of the arm C. there is no paralysis of the arm muscles D. skin sensation of the whole arm is intact Page 577 94. All of the following vessels are part of the Circle of Willis EXCEPT: A. Posterior communicating artery B. Anterior cerebral artery C. Lateral striate arteries D. Posterior cerebral arteries Page 814 96. Motor nerve supply of the face A. VI B.VII
C. VIII D. X
Page 771-772 97. The origin of the axillary vein : A. basilic vein B. subclavian vein
C. vena comitantes of brachial art. D. A & C
Page 477 98. The junction between the anterior 2/3 and posterior 1/3 of the tongue is marked by the A. circumvallate C. palatopharyngeal fold B. sulcus terminalis D. glossoepiglottic fold Page 846 100. In the cardiac silhouette of a radiograph the right border of the heart is formed by: A. right ventricle C. left atrium B. right atrium D. pulmonary trunk Reference:
Clinical Anatomy for Medical Students by Richard Snell, 7th ed. 25
A
2
Transection of the costocervical artery will disrupt blood flow to this artery A. 2nd posterior intercostal B. 3rd posterior intercostal C. 2nd anterior intercostal D. 3rd anterior intercostal MPL:0.25
56
B
3
Apex beat of the heart is normally located at the left A. 4th intercostal space B. 5th intercostal space C. 3rd intercostal space D. 6th intercostal space MPL:1
70
B
4
Penetrating stab wound at the root of the neck will likely injure the A. arch of aorta B. apex of lung C. azygous vein D. trachea MPL:0.5
74
B
5
This structure is located between 2 adjacent bronchopulmonary segments A. segmental bronchus B. segmental vein C. segmental artery D. segmental autonomic nerves MPL:0.25
97
C
6
Embolus that forms in the left ventricle will may enter the ff: structure EXCEPT A. arch of aorta B. brachiocephalic artery C. left pulmonary artery D. right subclavian artery MPL:1
121
B
7
Injury or disruption of the moderator band will also disrupt this part of the conducting system A. atrio-ventricular node B. right bundle branch C. left bundle branch D. D. Purkinje fibers MPL:0.5
116
B
9
The delay in impulse conduction thru the AV node is necessary A. to strengthen contraction of atrium B. adequate filling of the ventricles C. prevent turbulent flow D. allow coronary blood flow MPL:0.25
116
C
10
Malignant tumors of the mediastinum will result in A. pneumothorax B. paralysis of intercostal muscles C. paralysis of diaphragm D. pnemomediastinum MPL:0.5
133
A
13Rectus sheath hematoma sustained from trauma to the abdomen results from injury 164 to this vessel A. inferior epigastric artery B. deep circumflex iliac vein C. superficial epigastric artery D. superficial epigastric vein MPL:0.33
A
14
The location of the superficial inguinal ring is A. external oblique aponeurosis B. internal oblique C. transversalis fascia D. Camper’s fascia MPL:0.33
172
26
D
15
An indirect inguinal hernia passes thru deep inguinal ring lateral to this structure 194 A. superficial epigastric artery B. deep circumflex iliac artery C. rectus abdominis D. inferior epigastric artery MPL:.0.5
C
16
This structure is located outside the femoral sheath A. femoral artery B. femoral vein C. femoral nerve D. lymphatic vessels MPL:0.33
624
B
18
Blunt trauma to the anterior abdominal wall will most likely injure this part of the duodenum A. first part ( superior) B. third part (horizontal) C. second part ( descending) D. 4th part ( ascending) MPL:0.25
243
C
19
This structure can be traced towards the base of the appendix and be used as a guide for looking for the appendix A. haustra B. appendices epiplocae C. taenia coli D. mesoappendix MPL:0.5
246
D
20The presence of mesocolon in this segment of large intestine also makes it prone 251 to volvulus A. ascending colon B. cecum C. descending colon D. sigmoid colon MPL:0.5
B
21
True regarding Meckel’s diverticulum A. it’s a pseudodiverticulum B. possess gastric mucousa C. located 20 ft. from the ileo-ceal valve D. due to persistence of urachus MPL:0.5
259
B
22
The quadrate lobe of the liver is located at A. between the ligamentum venosum and the inferior vena cava B. between the round ligament and the gallbladder bed C. behind the porta hepatis D. lateral to the falciform ligament MPL:0.5
265
C
23
The fundus of the gallbladder is located at the level of A. 7th costal cartilage B. 8th costal cartilage C. 9th costal cartilage D. 6t cartilage MPL:0.25
268
C
24
Most common origin of the cystic artery A. celiac artery B. left hepatic artery C. right hepatic artery D. gastroduodenal MPL:0.5
268
D
25
Which is NOT true regarding the blood supply of the pancreas A. inferior pancreatico-duodenal artery supplies the head B. venous drainage is to the portal vein C. splenic artery gives branches to the body D. origin of the superiorpancreaticoduodenal artery is the celiac artery MPL:1
275
27
C
26
Space in the kidney that receives the renal pelvis A. renal papilla B. major calyx C. renal sinus D. renal hilum MPL:0.5
281
C
27
Branch of the anterior division of the internal iliac artery A. Ilio-lumbar B. superior gluteal C. Inferior gluteal D. lateral sacral MPL:0.25
351
B
28
This nerve accompanies the lumbosacral trunk as it descends into the pelvis A. sciatic nerve B. obturator nerve C. pudendal nerve D. superior gluteal nerve MPL:0.25
350
A
29
Part of the urinary bladder that lie behind the upper border of the symphysis pubis A. Apex B. base C. neck D. lateral surface MPL:0.5
383
D
30
This is true regarding the relation of the prostate to other structures A. superiorly related to the uro-genital diaphragm B. inferiorly related to the perineal membrane C. anteriorly related to the levator ani D. posteriorly related to the Denonvillier’s fascia MPL:0.25
378
C
31
During hysterectomy the ureter is prone to injury at this level A. isthmus of the fallopian tube B. ovarian artery C. internal os D. body of the uterus MPL:0.25
397
D
32
Supports the middle part of the vagina A. pubocervical B. perineal body C. levator ani D. urogenital diaphragm MPL:0.33
403
A
33
Content of the carotid triangle of the neck A. hypoglossal nerve B. anterior belly of digastrics C. sternothyroid D. inferior belly of omohyoid MPL:0.5
735
D
34
The pulsation felt anterior to the crus of the helix of the ear is A. maxillary artery B. facial artery C. posterior auricular artery D. superficial temporal artery MPL:0.33
737
C
36
Branch of the maxillary division of trigeminal that supplies the skin of cheek and nose A. infratrochlear B. external nasal C. infraorbital D. mental nerve MPL:0.5
766
C
37
This is a muscle of mastication
775
28
A. buccinators B. risorius C. temporalis D. orbicularis oris MPL:0.5 B
38
Prevents posterior dislocation of the mandibular head A. tympanic plate B. lateral temporomandibular ligament C. articular disc D. sphenomandibular ligament MPL:0.25
783
C
41
Tear in the superior cerebral vein results in hemorrhage into the A. subarachnoid space B. epidural space C. subdural space D. intracerebral MPL:0.5
807
A
42
Lacerated wound up to the first layer of the foot will transect A. abductor digiti minimi B. quadrates plantae C. flexor digiti minimi D. adductor hallucis MPL:0.25
668
C
46
Most medially located structure in the femoral triangle A. femoral artery B. femoral nerve C. femoral lymph vessels D. femoral vein MPL:1
620
D
47
Derived from the lateral cord of the brachial plexus A. radial nerve B. median nerve C. ulnar nerve D. musculo-cutaneous nerve MPL:0.25
477
B
48
The thoracodorsal nerve is derived from this part of the brachial plexus A. superior trunk B. posterior cord C. roots of plexus D. medial cord MPL:0.25
480
B
49
Extra-occular muscle of the eye is innervated by the trochlear nerve A. lateral rectus B. superior oblique C. superior rectus D. inferior oblique MPL:0.5
824
C
52
The cell that secretes Calcitonin which lowers blood Calcium level by inhibiting the rate of decalcification of bone is: A. Follicular B. Principal C. Parafollicular D. Oxyphil MPL:0.5
315
D
54
The phase of the Menstrual cycle that coincides with the functional activity of the corpus luteum and primarily influenced by progesterone secretion: A. Menstrual B. Luteal C. Proliferative D. Secretory MPL:0.5
746
C
55
The properties of motility and ability to fertilize an oocyte are acquired by mature 703 sperm cell in what portion of Male reproductive system?
29
A. Ductus deferens B. Seminiferous tubules C. Epididymis D. Ejaculatory duct MPL:0.5 B
56
Destruction of these cells will lead to a clinical condition known as Multiple sclerosis: A. Astrocytes B. Oligodendrocytes C. Ependymal cells D. Schwann cells MPL:0.5
297
A
57
What cell forms part of the Blood – Testis barrier performing protective and Nutritive functions for the developing sperm cells? A. Sertoli B. Principal C. Leydig D. Spermatogonium MPL:0.5
334
B
58
The Stratum Functionalis of Endometrium that undergoes changes during 351 Menstrual cycle and is shed during Menstruation; is histologically and functionally made up of what layers? A. Stratum Compactum and Stratum Basalis B. Stratum Compactum and Stratum Spongiosum C. Stratum Basalis and Stratum Spongiosum D. Stratum Compactum, Stratum Spongiosum and Stratum Basalis MPL:1
D
59
The part of the Adrenal gland which secretes Aldosterone that functions in the control of blood pressure is: A. Adrenal medulla B. Zona Fasciculata C. Zona Reticularis D. Zona Glomerulosa MPL :0.33
C
60
Parkinson’s disease is a slowly progressive neurologic disorder caused by loss of Dopamine secreting cells in the _______________ of the brain. A. Red nucleus B. Globus pallidus C. Substantia nigra D. Putamen MPL:0.25
D
61
Second Meiotic division in the process of Oogenesis will only be completed if there is: A. Implantation B. Menstruation C. Ovulation D. Fertilization MPL:0.25
735
B
62
In cases of nerve fiber injury, what structure in the perikaryon will be decreased in number? A. Mitochondria B. Nissl body C. Golgi apparatus D. Ribosome MPL:0.25
314
C
63
Fertilization occurs in what segment of the Uterine tube? A. A.Infundibulum B. B.Isthmus C. Ampulla D. Intramural MPL:1
742
A
64
Glaucoma is a clinical condition resulting from increased intraocular pressure as a result of obstruction of the drainage or excessive secretion of Aqueous humor. The structure that secretes Aqueous humor is the:
798
665
292
30
A. Ciliary processes B. Corneal stroma C. Choroid D. Iris MPL:0.5 D
66
Infections of the membranous labyrinth will result to what clinical condition? A. Dizziness B. Conductive hearing loss C. Vertigo D. Sensorineural hearing loss MPL:0.5
832
C
67
In older men, calcified and concentric lamellated bodies known as Corpora Amylacea are seen in the alveoli of what gland? A. Pineal B. Pituitary C. Prostate D. Cowper’s MPL:1
709
B
68
Destruction of these cells in the Pancreas leads to increase blood glucose levels And presence of glucose in the urine, a condition known as Diabetes Mellitus. A. Alpha B. Beta C. Delta D. Sigma MPL:1
557
A
69
Retinal detachment involves separation of the neural retina from what structure? A. Pigment epithelium B. Descemet’s membrane C. Bruch’s membrane D. Corneal epithelium MPL:0.25
799
D
70
The smallest of the neuroglial cells that forms part of the Mononuclear phagocytic System is: A. Astrocyte B. Oligodendrocyte C. Ependyma D. Microglia MPL:1
C
71
Melatonin which regulates daily body rhythms and day /night cycle is secreted by 655 What endocrine gland? A. Pituitary B. Thyroid C. Pineal D. Adrenal MPL:0.5
A
72
Lack of menstruation during lactation and infertility exhibited by fully breast – feeding women is due to high levels of Prolactin which suppress secretion of: A. Luteinizing hormone B. Follicle – stimulating hormone C. Estrogen D. Progesterone MPL:0.33
763
C
74
In Grave’s disease, these cells are stimulated and increased in number and size leading to abnormal secretions of Thyroid hormones: A. Parafollicular B. Oxyphil C. Follicular D. Chief MPL:0.5
659
B
75
The secretions of this endocrine gland prepares the body for “ fight or flight” response: A. Adrenal cortex B. Adrenal medulla C. Anterior Pituitary
665
297
31
D. Posterior Pituitary MPL:0.5 D
93
What organ system contains transitional epithelium? A. A.Cardiovascular system B. Gastrointestinal system C. Nervous system D. Urinary system MPL:1
309
D
95
Which of the following gastric cells secretes pepsin? A. Betz cells B. Oxyntic cells C. Leydig’s cells D. Zymogenic cells MPL:0.5
255
D
96
Where is the impulse conducting system of the heart located? A. Endocardium B. Epicardium C. Myocardium D. Subendocardium MPL:0.5
D
99
Which of the following cells contains Barr bodies? Eosinophil Lymphocyte
344
50
Mast cell Segmenter MPL:0.25 D
100
What is the principal organelle involved in detoxification and conjugation of Noxious substances? A. Golgi apparatus B. Lysosome C. Mitochondrion D. Smooth endoplasmic reticulum MPL:0.5
39
2. Which of the following is NOT a feature of the superior vena cava? A. It has a valve at the atrial orifice. B. It is formed by the union of brachiocephalic veins. C. It conducts returning blood from the superior half of the body. D. Its atrial orifice is at the level of the right third costal cartilage. Answer: A, Clinical Anatomy, Richard S, Snell. 7th Ed., p111 3. An intern would like to auscultate the aortic valve. He should put his stethoscope at which of the following areas? A. right 2nd ICS, sternal margin C. right 5th ICS, sternal margin nd B. left 2 ICS, sternal margin D. 5th ICS, left midclavicular line Answer: A, Clinical Anatomy, Richard S, Snell. 7th Ed., p122 4. Which of the following veins drain directly into the right atrium? A. great cardiac C. smallest cardiac B. small cardiac D. posterior cardiac Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p121 7. Which of the following statements is TRUE of the tricuspid valve? A, It consists of 3 semilunar cusps. B. The bases of the cusps are attached to chordae tendinae. C. It guards the left atrio-ventricular orifice. D. The valve is open during diastole. Answer: D, Clinical Anatomy, Richard S, Snell. 7th Ed., p112 8. The baroreceptor within the wall of the internal carotid artery is the? A. aortic body C. carotid sinus B. carotid body D. glomus
32
Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p738 Basic Histology: Text and Atlas, Junqueira and Carneiro. 10th Ed., p225 9.
Injury to which of the following layers of the arterial wall would initiate plaque formation in atherosclerosis? A. basement membrane C. tunica adventitia B. smooth muscles of tunica media D. tunica intima Answer: D, Basic Histology: Text and Atlas, Junqueira and Carneiro. 10th Ed., p223 10.
During fetal circulation, blood from the pulmonary trunk goes to the aorta via the: A. ductus arteriosus C. foramen ovale B. ductus venosus D. umbilical vein Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p131 13. What structure passes through the esophageal hiatus of the diaphragm? A. azygos vein C. phrenic nerve B. thoracic duct D. vagus nerve Answer: D, Clinical Anatomy, Richard S, Snell. 7th Ed., p62 14. The blood vessel that bridges above the hilum of the RIGHT lung is the: A. aortic arch C. pulmonary artery B. azygos arch D. superior vena cava Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p94 15. Chest X-ray finding of a patient having difficulty of breathing showed blunting of the costodiaphragmatic angle. If the patient will undergo thoracentesis to evacuate pleural fluid, the physician should insert the needle at the midaxillary line: A. 6th ICS, midclavicular line, superior border of the lower rib B. 7th ICS, posterior axillary line, superior border of the lower rib C. 7th ICS, midaxillary line, inferior border of the upper rib D. 8th ICS, posterior to midaxillary line, inferior border of the upper rib Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p61 16. Bronchopulmonary segments are named after their corresponding: A. secondary bronchus C. pulmonary artery B. tertiary bronchus D. pulmonary vein Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p97 17. What structure does NOT pass through the diaphragmatic opening at T12 level? A. aorta C. esophagus B. azygous vein D. thoracic duct Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p62 18. The horizontal fissure of the right lung meets the oblique fissure on which line of orientation ? A. anterior axillary line C. midclavicular line B. midaxillary line D. right parasternal line Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p96
19. On deep inspiration, the tracheal bifurcation descends to which of the following vertebral levels? A. T2 C. T6 B. T4 D. T8 Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p90 20. A drunken man, sitting upright, aspirates a peanut. Into which of the following bronchopulmonary segments would it likely lodge? A. left inferior lingular C. right posterior basal B. left anteromedial basal D. right medial Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p93 21. Blood from the pulmonary arteries is eventually drained from the lungs primarily through the: A. azygos vein C. lymphatic system
33
B. bronchial vein D. pulmonary vein Answer: D, Clinical Anatomy, Richard S, Snell. 7th Ed., p100 24. An intern is trying to elicit the presence of corneal blink reflex on a patient. Which of the following cranial nerves is the afferent arm of this reflex? A. II C. V B. III D. VII Answer: C, Clinical Neuroanatomy, Richard S. Snell, 5th Ed., p337 26. A patient with tertiary syphilis has impairment of his sense of orientation and position in space. This is indicative of a damage to the: A. pyramidal tract C. antero-lateral spinothalamic tract B. dorsal column pathway D. corticospinal tract Answer: B, Clinical Neuroanatomy, Richard S. Snell, 5th Ed., p150 27. Special somatic afferent fibers are found in which of the following cranial nerves? A. II C. VIII B. VI D IX Answer: A, Clinical Neuroanatomy, Richard S. Snell, 5th Ed., p332 30. A blind-folded woman was made to guess the letter written on her palm. The secondorder neuron of the involved sensory pathway is located at the: A. dorsal horn C. nucleus cuneatus B. fasciculus cuneatus D. nucleus gracilis Answer: C, Clinical Neuroanatomy, Richard S. Snell, 5th Ed., p150-152 35. Which of the following statements is NOT TRUE about the ileum? A. It has fewer plicae circulares. B. It has fewer mesenteric arterial arcades. C. It has more fat. D. It has shorter vasa recta. Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p243-244 36. Which of the following best describes the inguinal canal? A. It is located parallel and above the lacunar ligament. B. It transmits the iliohypogastric nerve. C. The deep inguinal ring is located lateral to the inferior epigastric vessels. D. The superficial inguinal ring is a defect in the parietal peritoneum. Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p172-174 37. The duodenum is identified histologically by the presence of: A. Brunner’s glands C. Paneth cells B. Goblet cells D. Peyer’s patches Answer: A, Basic Histology: Text and Atlas, Junqueira and Carneiro. 10th Ed., p318 38. Choose the CORRECT statement about the Hesselbach’s triangle. A. It is the site of indirect inguinal hernia. B. The lateral boundary is formed by the inferior epigastric vessels. C. It transmits the spermatic cord. D. It is found below the inguinal ligament. Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p194-196 Atlas of Human Anatomy, Frank Netter, plate 243 39. Which of the following arteries may be eroded in a patient with perforated ulcer on the posterior wall of the first part of the duodenum? A. right gastric C. gastroduodenal B. right gastroepiploic D. splenic Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p243 41. Which of the following best describes the esophagus? A. It is lined by simple columnar epithelium. B. It is entirely made up of skeletal muscle. C. Mucus secreting glands are found in the lamina propria and submucosa. D. The abdominal portion is covered by adventitia. Answer: C, Basic Histology: Text and Atlas, Junqueira and Carneiro. 10th Ed., p299
34
42. The superior mesenteric and splenic veins unite at the region of the head of the pancreas to form the: A. hepatic vein C. portal vein B. azygos vein D. inferior vena cava Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p262-263 43. The superior mesenteric artery was inadvertently cut and ligated. Which of the following structures would NOT be devascularized? A. ascending colon C. descending colon B. jejunum D. appendix Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p261 44. At the outpatient clinic, a patient came in with an anal mass. On further examination, bilateral inguinal lymph nodes were palpated. This mass probably originates from which of the following structures? A. rectum C. lower anal canal B. upper anal canal D. sigmoid colon Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p420 45. While examining a patient with suspected appendicitis, there was tenderness noted on the right lower quadrant. This tenderness is due to irritation of which of the following structures? A. parietal peritoneum C. mesocolon B. visceral peritoneum D. A & C are correct Answer: A, Clinical Anatomy, Richard S, Snell. 7th Ed., p251 46. Which of the following structures arise from the midgut? A. pancreas C. duodenum B. liver D. stomach Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p253-257 47. Which of the following statements is TRUE about the sartorius? A. It roofs over the femoral triangle. B. It crosses both the hip and knee joints. C. It flexes the thigh but not the leg. D. It forms part of the triceps surae muscles. Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p621 48. Which tendon of the following muscles is tapped to illicit the knee-jerk reflex? A. quadriceps femoris C. sartorius B. tibialis anterior D. popliteus Answer: A, Clinical Anatomy, Richard S, Snell. 7th Ed., p624 49. A laboratory technician not aware of the gluteal anatomy gave his friend a flu shot at the lower aspect of the right gluteus. Afterwards, his friend noted decreased sensation over the anterolateral aspect of the right leg and foot. Also his right foot was noted to drop and drag to the floor. Which of the nerves was probably injured? A. common peroneal nerve C. sciatic nerve B. tibial nerve D. obturator nerve Answer: A, Clinical Anatomy, Richard S, Snell. 7th Ed., p711 50. Which of the following veins is often harvested as grafts for coronary arterial bypass procedures? A. cephalic C. lesser saphenous B. basilic D. great saphenous Answer: D, Clinical Anatomy, Richard S, Snell. 7th Ed., p618 51. A 20 year old patient sustains a deep cut on the volar surface of right wrist. Median nerve injury would affect which of the following muscles? A. medial lumbricals C. thenar B. dorsal interossei D. palmar interossei Answer : C, Clinical Anatomy, Richard S, Snell. 7th Ed., p482 52. Which of the following ligaments is traversed by the needle in performing a lumbar tap? A. posterior longitudinal C. cruciate B. anterior longitudinal D. ligamentum flavum
35
Answer: D, Clinical Anatomy, Richard S, Snell. 7th Ed., p948 53. When a person’s neck and trunk are flexed, as in preparation for a spinal tap, the spinous process of C7 becomes visible and it is for this reason that it is called: A. spina bifida C. vertebra prominens B. atlas D. intervertebral disc herniation Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p927 54. In patient with fracture of the middle humerus ; the following muscles will be denervated EXCEPT: A. triceps brachii C. extensior digitorum communis B. abductor pollicis brevis D. supinator Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p484 55. Which branch of the brachial plexus DOES NOT give off branch(es) to the upper arm and shoulder? A. musculocutaneous nerve C. radial nerve B. ulnar nerve D. circumflex nerve Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p483 56. Which of the following muscles of mastication protracts the jaw? A. masseter C. lateral pterygoid B. temporalis D. medial pterygoid Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p778 57. Which layer of the scalp contains the muscle responsible for raising the eyebrows in expression of surprise or horror? A. connective tissue C. loose areolar tissue B. aponeurotic layer D. pericranium Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., pp760-761 58. The flexor of the elbow joint found at the lateral fascial compartment of the forearm is: A. brachialis C. triceps brachii B. brachioradialis D. biceps brachii Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p536 59. Midline calcified bodies called corpora arenacea (brain sands) visible on skull radiograph are structures found in which of the following organs? A. Pineal gland C. Hypothalamus B. Hypophysis D. Epithalamus Answer: A, Basic Histology: Text and Atlas, Junqueira and Carneiro. 6th Ed., p421 67. For the “fight, fright, flight” response which of the following cells would secrete epinephrine? A. ganglion cells of the medulla C. chromaffin B. follicular cells of the thyroid D. pinealocytes Answer: C, Basic Histology: Text and Atlas, Junqueira and Carneiro. 10th Ed., p418-419 69. Which structure/s would most likely be injured if the doctor incorrectly incised the superior half of the tympanic membrane? A. promontory C. cone of light B. ossicles D. All of the above Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p834-835 70. Which of the following extraocular muscles are weak if a patient has difficulty looking straight down? A. superior oblique - inferior rectus B. medial rectus – superior oblique C. superior – inferior oblique D. lateral rectus – inferior oblique Answer: A, Clinical Anatomy, Richard S, Snell. 7th Ed., p829 71. Optic nerves are formed by axons of neurons found in the ___ layer of the retina. A. ganglion C. inner nuclear B. outer nuclear D. photoreceptor Answer: A, Basic Histology: Text and Atlas, Junqueira and Carneiro. 10th Ed., p476
36
73. Which of the following structures forms part of the vascular coat of the eyeball? A. choroid C. retina B. conjunctiva D. sclera Answer: A, Basic Histology: Text and Atlas, Junqueira and Carneiro. 10th Ed., pp470-472 74. Which of the following nerves subserve/s taste sensation from the posterior third of the tongue? A. Vagus C. Glossopharyngeal B. Facial D. All of the above Answer: C, Clinical Anatomy, Richard S, Snell. 7th Ed., p847 76. Which of the following diameters is the narrowest A-P diameter of the true pelvis? A. obstetric conjugate C. oblique B. interspinous D. posterior sagittal Answer: A, Clinical Anatomy, Richard S. Snell, 7th Ed., p334-337 77. Which of the following muscles is NOT incised during a median episiotomy done during vaginal delivery? A. Bulbocavernosus C. superficial transverse perineal B. external anal sphincter D. ischiocavernosus Answer: D, Clinical Anatomy, Richard S. Snell, 7th Ed., p438 79. Which of the following structures DOES NOT form the urogenital diaphragm? A. sphincter urethrae muscle B. perineal membrane C. deep transverse perineal muscle D. Colle’s fascia Answer: D, Clinical Anatomy, Richard S, Snell. 7th Ed., p435, p439 85. The modified smooth muscle cells in the tunica media of the afferent arteriole are called: A. macula densa C. juxtaglomerular cells B. mesangial cells D. juxtaglomerular apparatus Answer: C, Basic Histology: Text and Atlas, Junqueira and Carneiro. 10th Ed., p394 88. During dissection, M.C. noticed a dilated portion of the spongy urethra. This is the: A. external meatus C. urethral crest B. fossa navicularis D. veromontanum Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p436 89. Which of the following is related to the LEFT kidney anteriorly? A. duodenum C. 12th rib B. spleen D. ascending colon Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., pp281-283 90. Choose the CORRECT statement regarding the autonomic supply to the bladder. A. Sympathetic fibers come from S2, S3 & S4. B. Parasympathetic innervation promote emptying of the bladder. C. Both A & B D. Neither A nor B Answer: B, Clinical Anatomy, Richard S, Snell. 7th Ed., p375 91. Referred pain secondary to stones in the lower two-thirds of the ureter is LEAST likely to be felt in which area? A. Flank C. Thigh B. Anterior abdominal wall D. Groin Answer; B, Clinical Anatomy, Richard S, Snell. 7th Ed., p286 92. Gerota’s fascia(renal fascia) is an effective anatomic barrier which tends to confine pathological processes in the kidney except on which area? A. Superiorly C. Laterally B. Inferiorly D. Medially Answer: B, Atlas of Human Anatomy, Frank Netter, plate 328 95. Azurophilic granules are only produced in what stage of granulopoiesis? A. myeloblast C. myelocyte
37
B. promyelocyte D. metamyelocyte Answer: B, Basic Histology: Text and Atlas, Junqueira and Carneiro. 10th Ed., pp256-257 1. 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.
thoracodorsal
C.
radial
D.
medial pectoral
Page 477-480 2.
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
Page 766-768 3. The following secretions are correctly paired 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
Page 602-604, 695
10.
Tendinous center of the perineum which is an important structure in childbearing women
A. B. C. D.
sphincter urethrae muscle bulbospongiosus transverse perineal muscle perineal body
Page 394 Netter 7th edition
Bloom and Fawcett Textbook of Histology 12th ed (A)1. Neurologic examination of a 37-year old alcoholic man with clumsiness of his right hand revealed poor dorsiflexion of the hand at the wrist. He most likely injured his:
38
A. median nerve B. brachioradialis nerve C. musculocutaneous nerve D. radial nerve (A)4. Which of the following statement is true regarding transection of the optic nerve? A. direct pupillary light reflex would be unaffected B. the affected eye will be blind C. there would be bitemporal hemianopsia D. consensual light reflex would be lost on the affected eye ®5. Which of the following reflexes is a monosynaptic reflex? A. Achilles reflex B. pupillary light reflex C. corneal reflex D. extensor plantar reflex (I)7. Which of the following blood vessels would be most likely involved in patient showing homonymous hemianopsia with macular sparing? A. internal carotid artery B. posterior cerebral artery C. middle cerebral artery D. anterior cerebral artery ®8. Which of the following statements is true of the middle cerebral artery? A. it supplies the occipital and posterior portion of the temporal lobe B. it is the continuation of the internal carotid artery C. it supplies the portion of the motor cortex corresponding to the legs D. it gives rise to the medial striate artery ®9. Which of the following centers is located in the frontal lobe? A. Broca’s speech area B. Wernike’s speech area C. primary visual area D. primary auditory area (I)13. Above the arcuate line, the aponeurosis of this muscle splits to form the rectus sheath: A. external oblique B. internal oblique C. transversus abdominis D. rectus abdominis ®21. The common boundary between the true and false pelvis is the A. sacroiliac joint B. symphysis pubis C. anterior superior spine D. iliopectineal line ®25. Which of the following amino acids is needed by the epidermal melanocytes to produce melanin? A. valine B. tyrosine C. phenylalanine D. tryptophan ®27. The common sweat gland is structurally classified as A. simple acinar B. simple tubular C. simple coiled tubular D. simple branched tubular ®30. The interatrial communication in the fetus through which caval blood is shunted to the left atrium A. foramen ovale B. fossa ovalis C. ductus venosus D. sinus venosus ®31. It divides the atrium into a sinus venosus and auricle A. atrial septum B. musculo pectini C. crista terminals
39
D. tricuspid valve ®33. The visceral pericardium is also called the A. epicardium B. endocardium C. myocardium D. fibrous pericardium ®34. Which of the following cardiac tissues has the slowest conduction velocity? A. SA node B. AV node C. Purkinje fibers D. ventricular muscle fibers ®35. Valves are present in A. capillaries B. medium caliber veins C. lymphatic ducts D. venules ®38. The most active site for hemopoiesis in adults A. femur B. hip bones C. skull bones D. tibia ®39. T Lymphocyte differentiation occurs in the A. bone marrow B. lymph node C. thymus D. bursa equivalent in man ®40 The structure which is NOT composed of lymphoid tissue A. tonsils B. appendices epiploicae C. lymph node D. spleen ®41. Which of the following cells are responsible for antibody production? A. lymphocyte B. macrophage C. monocyte D.plasma cell ®44. The Hassal’s corpuscles of the thymus consist of A. densely packed T-lymphocytes B. concentric layers of epitheloid reticular cells C. clusters of multinucleated macrophages D. immature blood cells (I)45. The most active mobile leukocyte of the body A. basophil B. eosinophil C. neutrophil D. macrophage ®47. The epithelial lining of the pulmonary alveoli A. simple squamous B. simple columnar C. stratrified squamous non-keratinized D. pseudostratified columnar ciliated ®53. The motor nerve supply of the diaphragm is derived from A. vagus nerve B. long thoracic nerve C. thoracodorsal nerve D. phrenic nerve (A)57. The midgut loop normally herniates through the primitive umbilical ring into the extraembryonic coelom during week 6 of development. Failure of the intestinal loops to return to the abdominal cavity by week 11 results in the formation of A. omphalocoele B. anal agenesis C. ileal diverticulum D. intestinal stenosis ®59. The pharynx joins with the esophagus at the level of A. C3
40
B. C4 C. C5 D. C6 ®60. The valves of Houston are found in the A. ileocecal junction B. rectum C. pylorus D. ascending colon (A)61. A 40 year old male sustained from a motor vehicular accident resulting to fracture of the 9th to the 11th ribs left posterior. He is in hypovolemic shock.The most likely organ injured is the A. stomach B. liver C. spleen D. pancreas (A)63. A 30 year old female with history of 2 weeks fever developed peritonitis and was diagnosed as Typhoid Fever with perforation. The organ involved is the A. stomach B. duodenum C. jejunum D. ileum (I)65. The esophagus is related to which portion of the heart? A. right atrium B. left atrium C. right ventricle D. left ventricle ®66. The vein of Mayo is the anatomical landmark demarcating the A. esophagus and stomach B. stomach and duodenum C. duodenum and jejunum D. sigmoid and rectum ®67. The external hemorrhoidal plexus drains into the A. pudendal vein B. internal iliac vein C. middle rectal vein D. superior rectal vein ®68. Which is closely related to the fundus of the stomach? A. jejunum B. ileum C. sigmoid D. spleen ®69. The gastro-duodenal artery is a branch of the A. right gastro-epiploic B. hepatic C. superior mesenteric D. splenic ®71. As one proceeds outward from the renal medulla, the three separate functional layers of the adrenal cortex, in correct order, are A. zona reticularis, zona fasciculata then zona glomerulosa B. zona fasciculata, zona reticularis then zona glomerulosa C. zona glomerulosa, zona fasciculata then zona reticularis D. zona glomerulosa, zona reticularis then zona fasciculate ®72. The normal kidney of an average-sized adult man weighs approximately A. 150 gms B. 300 gms C. 600 gms D. 1,200 gms ®73. The location of the narrowest portion of the ureter A. ureteropelvic junction B. across the iliac vessels C. ureterovessical junction D. upper third ®75. The main blood supply of the prostate gland is the A. uperior prostatic artery B. median vesical artery C. inferior vesical artery
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D. superior vesical artery (A)76. A 28 year old man sustained a pelvic fracture due to a motorcycle accident. Which portion of the urethra was most likely injured? A. prostatic urethra B. membranous urethra C. bulbous urethra D. penile urethra ®77. The motor nerves supplying the urinary bladder come mostly from A. parasympathetic nerves B. pelvic nerves C. pudendal nerves D. sympathetic nerves ®79. The Darto’s layer beneath the skin of the penis is continuous with the superficial layer of the anterior abdominal wall fascia called the A. fascia lata B. camper’s fascia C. buck’s fascia D. scarpa’s fascia ®80. The dull whitish connective tissue covering of the ovary is called A. tunica albuginea B. theca externa C. zona pellucida D. corona radiata ®82. The right ovarian vein drains into the A. right renal vein B. hypogastric vein C. inferior vena cava D. common iliac vein ®83. Lymphatics from the vulva drain into the A. hypogastric nodes B. inguinal nodes C. para-aortic nodes D. common iliac nodes ®85. The layer of endometrium that remains to regenerate after menstruation A. compact layer B. spongy layer C. functional layer D. basal layer ®88. The male homologue of the Gartner’s duct of females A. epididymis B. inguinal ligament C. gubernaculum testis D. vas deferens (I)89. Which of the following statements concerning the development of the reproductive system in the female is correct? A. the clitoris is analogous to the penis B. the urethral folds fail to fuse C. the urethral folds form the labia minora D. All of the above ®92. Fructose, a source of energy for the spermatozoa, is primarily present in the secretions of A. seminal vesicle B. epididymis C. bulbourethral gland D. vas deferens ®97. In which bone is the inner ear located? A. sphenoid B. temporal C. parietal D. occipital ®98. Regarding the tympanic cavity, which of the following statements is/are true? A. an airfilled space in the petrous portion of the temporal bone B. communicates with the pharynx via the eustachian tube C. houses the incus, malleus and stapes D. All of the above ®99. All are supplied by the oculomotor nerve, EXCEPT
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A. superior rectus B. medial rectus C. inferior oblique D. lateral rectus ®100. The inability to focus horizontally or vertically is a problem inherent to the A. cornea B. lens C. vitreous humor D. retina
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