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-ANATOMY-
Answers are at the bottom of the page
1. Which of
the following is a characteristic of the sternal angle?
Which space or cavity was opened when the surgeon reflected the muscles? A. axillary space B. infraspinatous fossa C. quadrangular space D. subdeltoid bursa E. triangular space
7. If I ligate the axillary artery at a point between the superior thoracic artery and the lateral thoracic artery, through what vessel would collateral circulation reach the distal portion of the axillary artery distal to the ligation?
A. circumflex humoral B. lateral thoracic C. subscapular D. profundi brachii E. posterior interosseous
8. Compression of the median nerve in the carpal tunnel affects which hand muscle(s)?
A. Dorsal interossei B. Flexor pollicis brevis C. Flexor pollicis longus D. Opponens digiti minimi E. Palmar interossei
9. Structures within the carpal tunnel include the:
A. Radial bursa B. Ulnar bursa C. Both D. Neither
10. Your patient presents with Aganglionic Megacolon. This disorder is caused by a failure of neural crest cells to properly migrate and innervate the Colon with autonomic nerve connection. Which of the following preganglionic sympathetic nerves would be most likely implicated in this disorder?
A.) Sciatic nerve B.) Phrenic nerve C.) Pelvic Splanchnic nerves D.) Greater, Lesser, Least Splanchnic nerves E.) Nerve fibers in the Pelvic plexus coming from the sacrum.
11. A frantic mother brings her 3 year old into the Emergency Department because he aspirated a small metal button off of his shirt. The button is most likely located in the following place:
A.) Left inferior lobe B.) Right middle lobe C.) Right inferior lobe D.) Coryna
12. A new member of the knife and gun club shows up in the ER with a deep laceration to the Axilla. Which of the following structures is least likely to be damaged during the stab wound?
A.) Brachial Artery B.) Anterior and Posterior Circumflex arteries C.) Medial Chord of the Brachial Plexus D.) Thoracoacromial Artery
13. Which of the following arteries which feed into the scapular anastamosis can be found on the inferior-lateral border of the scapula?
A.) Deep Scapular Artery B.) Suprascapular Artery C.) Dorsal Scapular Artery D.) Circumflex Scapular Artery
14. A football player presents to your clinic with a swollen index finger. When told to make a fist the young man can bend his index finger at the PIP but not at the DIP joint. Which tendon likely ruptured in the injury?
A.) Distal insertion of the extensor tendon. B.) Flexor Digitorum Profundus C.) Extensor Expansion Hood D.) Long Extensor Tendon E.) Flexor Digitorum Superficialis
15. What extraembryonic tissue is formed by cells that fuse together thus forming multinucleated invasive cells that protect the developing embryo from the maternal immune system?
A.) cytotrophoblast B.) syncitiotrophoblast C.) hypoblast D.) epiblast
16. Which of the following autonomic ganglia can not be found below the diaphram? (Yes I realize that you have not covered this area……but look back at Dr. Fritch’s autonomics lecture!!!)
A.) Superior Mesenteric Ganglion B.) Stellate Ganglion C.) Inferior Mesenteric Ganglion D.) Celiac Ganglion E.) Aorticorenal Ganglion 17. A 10 y/o child falls off his bike and fractures his humerus. A nerve is lesioned, which results in weakness in the ability to extend the hand at the wrist. There is also numbness in the skin over the anatomical snuffbox. Which of the following arteries that course with the affected nerve may be lacerated by the fracture? A. Axillary
A. Inability to shrug the
shoulder against resistance 19. A 25 y/o woman present with amenorrhea and vomiting. A urine beta human chorionic gonadotropin (BhCG) test confirms that she is pregnant. During which of the following embryonic stages did her conceptus most likely implant in the uterine wall? A. Bastocyst 20. A 30 y/o woman sustains head and neck trauma after a MVA. Examination reveals that she is unable to shrug her left shoulder or turn her head to the right. Which of the following structures has been damaged? A. Left CN XI 21. A 55 y/o woman with a history of severe depression presents to the ER with having cut deeply into the flexor surface of her wrist at the level of the carpal tunnel. She has no sensation on the palmar or dorsal aspects of the distal parts of her middle and index fingers and half of her ring finger. Which of the following has been compromised? A. Flexor carpi radialis
tendon 22. All of these are characteristic of Tetralogy of Fallot EXCEPT: a. Pulmonary Stenosis b. Ventral septal defect (VSD) c. Left ventricular hypertrophy d. Overriding aorta
23. Your patient presents to you with a mid-humerous fracture after a motor vehicle crash. What clinical manifestations will you observe?
a. Wrist drop b. Claw hand c. Hand of Benediction d. Peripheral neuropathy
24. A teenager presents to the emergency department complaining of wrist pain after falling off his skateboard. He has snuff-box tenderness. This concerns you because this bone is sometimes slow to heal because of its poor blood supply. What fracture do you suspect?
a. Scaphoid b. Trapezoid c. Capitate d. Trapezuim
25. The sympathetic nervous system has _______ preganglionic and _______ postganglionic axons and uses the neurotransmitter _________.
26. The parasympathetic nervous system has _______ preganglionic and _______ postganglionic axons and uses the neurotransmitter _________.
27. Which of the following is true regarding the cords of the brachial plexus?
A) They are direct derivatives of the anterior rami. B) Related to the subclavian artery C) Lie behind (posterior) to the pectoralis minor m. D) Supply innervation to all of the muscles of the upper limb E) All of the above are true statements
28. This embryologic condition is due to a blind ending of the esophagus preventing the fetus from swallowing amniotic fluid and returning it to the mother via placental circulation, ultimately resulting in excess amniotic fluid:
A. Polyhydroaminos due to esophageal atreasia with esophagotrachial fistula B. Congential diaphragmatic hernia C. Spina bifida D. Cryptorchidism E. Hiatal Hernia
29. Shaping mesenchymal condensations into cartilage is part of what process?
A. Bone formation B. Muscle formation C. Joint formation D. lung formation E. Heart formation
30. Hyperthermia, Cadmium, and other agents influencing general cell metabolism are all associated with:
A. Normal, healthy baby B. Neurological defects in utero C. Teratogens that cause limb defects D. Prenatal vitamins
31. The cell bodies of the presynpatic neurons in the Sympathetic division are found:
A. Cardio plexus B. Anterior roots of spinal nerves C. ONLY in the IML D. In either the IML or the gray matter of the spinal cord
32. What component of the embryo heart is part neural crest (ectodermal) derived and part splanchnic mesoderm?
A. Aortic Sac B. Primitive Venticle C. Bulbar ridges D. Sinus Venosus
33. Atraial Septal Defects result in what direction of shunting?
A. Right to Left B. Left to Right C. Top to Bottom D. There is no shunting involved in ASD's
34. What is the only structure that remains of the left sinus horn?
A. Right Ventricle B. Left Atrium C. Coronary Sinus D. Aortic Sac
35. With pulmonary valvular atresia, what is the only route for blood to get to the lungs? A. Ductus Arteriosus B. Pulmonary Vein C. Superior Vena Cava D. Pulmonary Artery
36. A newborn is found to have a patent foramen ovale, ventricular septal defect, hypoplastic right ventricle, hypertrophy of left ventricle and a patent ductus arteriosus; what is your diagnosis?
A. Teratology of Fallot B. Aortic valvular atresia C. Tricuspid Atresia D. DeGeorge Syndrome
37. Which of the following cell layers is not derived from the ectoderm? a) Ectoderm b) Endoderm c) Mesoderm d) All three are derived from the ectoderm e) None of the above
38. Which of the following cell layers contain primordial germ cells during week 4-6 of embryonic development?
a) Ectoderm b) Mesoderm c) Endoderm d) All of the above e) None of the above
39. What forms the internal carotid artery?
a) Arch III b) Arch IV c) Dorsal aorta d) Sprout of Arch III e) a + c f) a + d
40. An cyanotic infant was delivered in the emergency room. You found out that her great vessels were transposed and that her ductus arteriosis is needed to be kept open in order to survive. Which of the following drugs is contraindicated?
a) Indomethacin b) Prostaglandins c) Albuterol d) Aldosterone e) Vasopressin
41. A neonate presents in the ER with tachypenia, sweating, pallor, and lack of weight gain. You notice that the baby appears cyanotic and after listening to the heart beat detect a murmur. You, the clever 3rd year med student think back to your Dr. Brauer lectures and suspect a cardiac defect. A echocardiogram reveals RV hypertrophy, but no pulmonary vessel stenosis. What two conditions would you suspect?
A. pulmonary Valvular Atresia and Persistent truncus arteriosis B. Tetralogy of Fallot and Ventricular septal defect C. VSD and Pulmonary Valvular Atresia D. VSD and Persistent Truncus Arteriosis
42. A patient presents at your office complaining of weakness in his hands and numbness on the back of his hand. The rest of his history is unremarkable except he drinks 10-12 beers each Friday and Saturday night and finds himself falling asleep in chairs (So maybe a CAGE would be good). Upon examination the patient reveals wrist drop with decreased extension in his hand and fingers unless supinated and numbness on the back of his hand into digits 1-4. You suspect:
A. Hypothyroidism B. Erb Duschenne C. Saturday Night Palsy (Radial neuropathy) D. Klumpke's Palsy
43. A patient arrives at your clinic complaining of sore throat and runny nose. Upon further physical exam you find that the patient’s blood pressures to be higher in the arms then in the legs. Aside from the cold, what other problem might the patient have?
44. A one year old febrile infant presents to you ER. You notice that the patient has “unique” facial features and you hear a murmur while listening to the heart. The parents also tell you that the infant has had reoccurring infections. What underlying problem do you suspect this patient to have?
45. Which of the following layers contributes to the formation of the parietal peritoneum?
46. What is the most common congenital defect?
47. All of the following statements concerning gray communicating rami are correct EXCEPT
a) they contain preganglionic sympathetic fibers b) they are found at all spinal cord levels c) they contain general visceral efferent fibers d) they contain postganglionic sympathetic fibers e) they are gray because they contain no myelinated fibers
48. Postganglionic sympathetic cholinergic fibers innervate the
a) sweat glands b) lacrimal glands c) ductus deferens d) trigone of the urinary bladder e) detrusor muscle
49. The foramen ovale in the fetal heart is located in the:
a. Right atrium b. Left atrium c. Interventricular septum d. Interatrial septum e. Pulmonary trunk
50. The pacemaker of the heart is the:
a. Sinoatrial node b. Atrioventricular node c. Sinoventricular node d. Purkinje fibers
51. The thickest layer of the heart is the:
a. Epicardium b. Pericardium c. Myocardium d. None of the above
52. The scalenes and sternocleidomastoids are predominantly involved in:
a. Active inspiration b. Active expiration c. Quiet inspiration d. Quiet expiration
53. Which of the following vessels carry oxygenated blood to the fetus from the placenta?
a) Umbilical arteries b) Umbilical veins c) Vitelline arteries d) Vitelline veins e) Common cardinal arteries f) Common cardinal veins
54. A 17 year old pregnant female present to your clinic. She has a history of malnutrition, especially on folic acid. An ultrasound suggest large amount of amniotic fluid. Further testing revealed an elevated level of alpha-fetoprotein. What defects does the child most like have?
a) Anencephaly b) DiGeorge Syndrome c) Ventral Septal Defects d) Hirsprung Disease e) Spina bifida occulta
55. The proximal part of the Aorta is derived from which of the following?
a) Aortic arch III b) Aortic arch VI c) Bulbus Cordis d) Truncus Arteriosus e) Sinus Venosus
56. What of the following is derived from the intermediate mesoderm?
a) Heart b) Lungs c) Spleen d) Kidneys and Gonads e) Liver
57. Between which two layer is the embryonic mesoderm located?
a) Epiblast and hypoblast b) Syntiotrophoblast and cytotrophoblast c) Syntiotrophoblast and endometrium d) Heuser’s membrane and syntiotrophoblast e) Heuser’s membrane and cytotrophoblast
58. Failure to form the left aortic arch 5 would result in: a) lack of a left common carotid artery b) lack of a left subclavian artery c) nothing d) spontaneous abortion
59. All of the following are characteristics of Tetralogy of Fallot EXCEPT: a) Pulmonary stenosis b) Persistant truncus arteriosis c) Ventricular septal defect d) hypertrophy
60. A persistent atrioventricular canal is seen typically in which disease? a) Fragile X Syndrome b) Autism c) Praeder-Willi Syndrome, aka, Chris Gibson disease d) Down’s Syndrome
61.
Transposition of the great vessels is not compatible with life unless
which of the following conditions is associated with this anomaly? A. aortic
valve stenois
62. What
embryologic structure becomes the hepatic vein?
64. The biceps brachii muscle is classified as what type of muscle?
A. Flat B. Fusiform C. Unipenate D. Multipenate
65. A 34 year old female arrives in the emergency department after injuring her right upper extremity after a fall. She states that she fell forward onto an outstretched right hand that was described as being in a wrist extended and abducted position. What injury is potentially the most worrisome in terms of healing?
A. Sprain to the flexor retinaculum B. Fracture of the 2nd metacarpal C. Fracture of the scaphoid D. Fracture of the distal trapezoid
66. Which of these muscles depress the scapula?
A. upper trapezius B. deltoid C. pectoralis minor D. supraspinatus
67. Which lymph nodes are the closest in proximity to the carina?
A. Inferior deep cervical nodes B. Inferior tracheal bronchial nodes C. Pulmonary nodes D. Aortic arch nodes
68. Radial head dislocations are often seen when?
A. M1 students injure there radial collateral ligaments trying to hemostat one another B. Baseball players repetitively throw fastballs C. Falling on an extended elbow D. Picking up a child by one arm over their head.
69. At what level is the sternal angle located at?
A. T4-5 IV disc B. T2 C. T3 D. T10
70. A person presents to you office with a massive right apical lung tumor. Where might the patient be feeling numbness?
A. The lateral palmer surface as well as the entire tips of index and ring finger. B. Both the palmer and dorsal surfaces of the medial part of the hand, including the entire digiti minimi. C. A roughly trapezoid shaped patch over the lateral aspect of the shoulder. D. A thin strip of skin running down the back side of the arm.
ANSWERS:
him, “I told you there was no measure to how fast and how hard I would bring this fight to your doorstep.”
better not dial the wrong number anymore, because Chuck reminded you that he does not sleep, he waits.
of blood to the palmar arches.
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