2017 Flashcards

1
Q

Which of the following statements concerning the knee is CORRECT?
A) Meniscal coverage of the respective tibial plateau is greater on the medial side
B) ‘Dashboard’ injuries, where the tibia is forced posteriorly on the femur, frequently injure the anterior cruciate ligament
C) The posterolateral band of the anterior cruciate ligament is tightest in knee extension
D) The deep portion of the tibial collateral ligament is the main restraint to valgus
E) The medial meniscus is more mobile than the lateral meniscus

A

C

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2
Q

Regarding the knee region, which statement is FALSE?
A) Contraction of biceps femoris long and short head can laterally rotate the tibia
B) Popliteus contraction laterally rotates the femur on the fixed tibia
C) Semitendinosus contraction can produce medial rotation of the tibia on the femur
D) Sartorius contraction can produce lateral rotation of the tibia on the femur
E) Semimembranosus contraction can produce medial rotation of the tibia on the femur

A

D (i’ve got a note saying that sartorius provides resistance to external rotation so i think sartorius does medial rotation)

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3
Q

The three muscles that attach as the pes anserinus on the anteromedial tibia are the
A) gracilis, semitendinosus, semimembranosus
B) sartorius, adductor magnus, semitendinosus
C) gracilis, adductor longus, semitendinosus
D) sartorius, gracilis, semitendinosus
E) sartorius, gracilis, semimembranosus

A

D

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4
Q

Which statement concerning the patellofemoral joint is FALSE?
A) The patella increases the moment arm of the quadriceps muscle group for knee extension
B) With increasing knee flexion, the contact area on the patella moves toward the apex
C) The patella glides distally on the femur during knee flexion
D) The lateral femoral condyle protrudes anteriorly and resists lateral subluxation of the patella
E) During knee flexion from 0 to 90 degrees, the contact area between the patella and femur increases

A

not sure but defs isn’t C

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5
Q
Which of the following does NOT provide support for the medial longitudinal arch of the foot? 
A) fibularis longus
B) abductor hallucis
C) tibialis posterior
D) long plantar ligament
E) spring ligament
A

D (supports lateral)

also similar question in 2018

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6
Q

Foot pronation
A) is linked to tibial internal rotation at the subtalar joint
B) occurs immediately prior to push-off, so that the foot is rigid to transfer force
C) is triplanar motion combining dorsiflexion, eversion and adduction
D) is produced by tibialis posterior contraction
E) increases the height of the navicular

A

?? (not C- bc abduction)
A??
also similar to 2018 question

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7
Q

Which of the following statements concerning intervertebral discs is INCORRECT?
A) Each vertebral endplate consists of hyaline cartilage and collagen fibres from the annulus fibrosus
B) All of the annulus fibrosus fibres of an intervertebral disc are aligned in the same direction
C) Posterolateral uncovertebral clefts in the cervical region facilitate axial rotation range of motion
D) Cervical intervertebral discs possess a thick arrangement of annulus fibrosus fibres anteriorly
E) The orientation of fibres within successive lamellae of the annulus fibrosus is approximately 65 degrees to the vertical

A

i think B but could be wrong

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8
Q

Which of the following is INCORRECT regarding RIGHT cervical axial rotation?
A) The atlanto-axial articulation contributes at least 50% of the range of movement
B) The alar ligaments are the predominant limitation to axial rotation at the C1/2 motion segment
C) The occiput and C1 vertebra move together as a unit
D) The total range of right cervical rotation is greater than that of the thoracic or lumbar vertebral regions
E) The right inferior articular facet of C1 glides forward on the right superior articular facet of C2

A

D or E?

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9
Q

The vertebral artery
A) turns abruptly posteriorly and medially as it emerges superiorly from the first cervical vertebra
B) provides the main blood supply to the frontal lobe
C) enters the cranium via the jugular foramen
D) arises from the axillary artery
E) travels through the transverse foramen of the seventh to first cervical vertebrae

A

A

same question in 2018

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10
Q
The main extensor of the cervical spine is
A) iliocostalis cervicis
B) longus cervicis
C) semispinalis cervicis
D) longissimus cervicis
E) splenius cervicis
A

E

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11
Q

Which of the following statements concerning the thoracic spine is INCORRECT?
A) The ratio of intervertebral disc height to vertebral body height is smallest in the thoracic region
B) Thoracic vertebral bodies are wedge shaped with the vertebral body height greater anteriorly than posteriorly
C) Zygapophyseal facet orientation is more vertical than that in the lower cervical spine
D) The line of gravity falls anterior to the transverse axis of motion of the thoracic spine
E) There is ipsilateral coupling of lateral flexion and axial rotation in the upper thoracic spine

A

B (anterior < posterior)

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12
Q

The iliolumbar ligament connects the
A) posterior lumbar vertebral bodies to the ilium
B) anterior vertebral body of L5 to the sacral promontory
C) transverse processes of L5 and the ilium
D) L5 spinous process to the ilium
E) L1 to L5 transverse processes to the ilium

A

C

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13
Q
The medial branch of the dorsal rami innervates all of the following EXCEPT
A) the posterior outer annulus
B) the zygapophyseal joint above
C) the zygapophyseal joint below
D) multifidus
E) interspinous muscle
A

A

same as 2018

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14
Q

Increased intra-abdominal pressure
A) decreases with contraction of the diaphragm
B) decreases the force required to displace lumbar vertebra
C) produces a lumbar flexion moment
D) decreases the stiffness of the lumbar vertebral column
E) increases the force required to flex the lumbar spine

A

E

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15
Q

Which of the following statements CORRECTLY describes the activity of the diaphragm in postural control of the trunk?
A) The diaphragm will maintain a strong contraction to provide trunk stability even when respiratory drive increases
B) Activity in the diaphragm is not associated with trunk control
C) Contraction of the diaphragm increases intra-thoracic pressure and stiffens the vertebral column
D) The diaphragm maintains a level of baseline contraction when performing fast, repetitive upper limb movements in standing
E) Activity in the diaphragm, without co-contraction of the abdominal muscles, can provide postural stability for the trunk

A

D i think??

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16
Q

Subconscious proprioception pathway
A) neurons from the facial muscles synapse in the facial nucleus
B) neurons travel through the middle cerebellar peduncle
C) neurons travel to the ventral posterior nucleus of the thalamus
D) second order neurons decussate in the midbrain
E) neurons entering the spinal cord below L2 travel in fasciculus gracilis

A

E

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17
Q
Which of the following would NOT be located in the tegmentum of the brainstem?
A) cranial nerve nuclei
B) corticospinal fibres
C) somatosensory fibres
D) reticular formation
E) extrapyramidal pathways
A

B or C (leaning towards B)

18
Q
A lesion in which one of the following sites would NOT affect the contralateral visual field of
BOTH eyes?
A) optic chiasm
B) primary visual cortex
C) optic radiation
D) optic tract
E) lateral geniculate nucleus
A

A (bitemporal)

19
Q

Which one of the following cranial nerve interactions INCORRECTLY lists the cranial nerves
involved?
A) Horizontal gaze to the left: left CN VI and right somatic CN III
B) Pupillary light reflex: CN II and parasympathetic CN III
C) Corneal blink reflex: CN III and CN VII
D) Accommodation reflex: CN II, somatic CN III and parasympathetic CN III
E) Vestibulo-ocular reflex: CN VIII, CN VI and CN III

A

C (should be CN V and CNVII)

20
Q

Which of the following statements concerning the vestibulo-ocular reflex is FALSE?
A) Interneurons from an abducens nucleus synapse with the contralateral oculomotor nucleus
B) The right vestibular neurons stimulate the right abducens nucleus
C) Interneurons travelling in the medial longitudinal fasciculus permit coordination between the abducens and oculomotor nuclei
D) Turning the head to the right is excitatory to the right vestibular nerve / nuclei
E) The vestibulo-ocular reflex helps us maintain a stable image on the retinae

A

B

21
Q

Which of the following statements regarding pain is CORRECT?
A) The amount of pain experienced relates directly to the amount of nociception
B) Central sensitisation refers to the decreased threshold for activation of C fibres
C) Peripheral sensitisation results partly from a decreased threshold for the activation of nociceptors
D) C fibre free nerve endings are involved in the precise localisation of the pain source
E) Activity in the large diameter sensory fibres does not affect the perception of pain

A

?? idk where we learnt about pain so if someone could tell me that would be appreciated xx

22
Q

Which of the following statements concerning pain is INCORRECT?
A) Increased sensitivity of the wide dynamic range neuron is proportional to the amount of input from the A delta fibres
B) Fast pain involves the stimulation of A delta free nerve endings by intense mechanical or thermal stimuli
C) C fibres mostly synapse in superficial lamina
D) When stimulated, C fibres release substance P at the site of injury
E) Activity in the large diameter sensory fibres modifies the perception of pain

A

?? idk where we learnt about pain so if someone could tell me that would be appreciated xx

23
Q

Which of the following statements regarding pain is FALSE?
A) The reticular formation does not receive input from ascending nociceptive pathways, but rather its input is from the cerebral cortex
B) Ascending nociceptive afferents that synapse in the superior colliculus are involved in directing our gaze toward the site of injury
C) Cortical input can modulate activity of both the thalamic nuclei and of the descending neurons to the dorsal horn
D) The spinothalamic pathway to the ventral posterolateral (VPL) nucleus encodes for the localisation and quality of pain
E) Projection neurons from the periaqueductal grey to the dorsal horn influence activity in the nociceptive specific and wide dynamic range neurons

A

A

24
Q

The limbic systems includes which of the following structures?
A) amygdala, hippocampus, precentral gyrus
B) amygdala, occipital lobe, insula
C) fornix, fimbria, corpus callosum
D) dentate gyrus, mammillary bodies, Papez circuit
E) hypothalamus, hippocampus, dentate gyrus, calcarine fissure

A

D??

25
Q
Which of the following is NOT a primary function of the entorhinal cortex?
A) processing of visual information
B) sending signals to the dentate gyrus
C) acquiring spatial learning
D) being involved in coordination
E) being involved in learning and memory
A

A?? (similar to 2018)

26
Q

A person with anterograde amnesia caused by the disruption of the Papez circuit will
A) remember a new phone number
B) not remember how to ride a bike
C) not remember family members
D) not remember a person that she/he was introduced to few minutes ago
E) forget how to use a pen

A

D

27
Q

Which of the following axonal paths is NOT a part of the route taken by the majority of
corticospinal axons?
A) pyramidal decussation
B) crus cerebri
C) posterior limb of the internal capsule
D) lateral funiculus of spinal cord
E) anterior limb of the internal capsule

A

E

28
Q

Which of the following is one of the roles of the tectospinal tract?
A) controls flexor muscles of the upper limbs
B) controls reflex movements of the head, neck and upper limbs
C) regulates prefrontal cortical neurons
D) controls flexor muscles of the lower limbs
E) stabilises the head during rotational movement of the body

A

E (same as 2018)

29
Q

Decerebrate rigidity arises from upper motor neuron lesions below the midbrain. Which of the
following symptoms BEST describe this?
A) extension of upper and lower limbs
B) flexion of upper and lower limbs
C) extension of upper limbs and flexion of lower limbs
D) flexion of upper limbs and extension of lower limbs
E) flexion of the left leg

A

A

30
Q
Which of the following nuclei is NOT found within the midbrain?
A) substantia nigra pars compacta
B) substantia nigra pars reticulata
C) inferior colliculus
D) inferior olivary
E) red nucleus
A

D

31
Q

Describe FIVE (5) anatomical differences (apart from the size of the bones) between the leg, ankle and foot region, as compared to the forearm, wrist and hand region.

A
  1. 7 tarsals in the foot vs 8 carpals in the hand
  2. talocrural joint vs radiocarpal joint: only talus articulates with tibia and fibula but scaphoid and lunate articulate with radius only
  3. midline = 2nd digit in foot, 3rd digit in hand
  4. the distal tibiofibular joint is syndesmosis (stability) whereas the distal radioulnar joint is synovial
  5. the proximal tibiofibular joint is a gliding joint whereas the proximal radioulnar joint is a pivot joint
32
Q

With regard to the lumbar spine, explain how the structure of the following muscles relates to
their function:
longissimus thoracis pars thoracis and iliocostalis lumborum pars thoracis

A

powerful extensor of the lumbar because of its vertical line of action, large PCSA and large posterior moment arm

33
Q

With regard to the lumbar spine, explain how the structure of the following muscles relates to
their function:
longissimus thoracis pars lumborum and iliocostalis lumborum pars lumborum

A
  • has a vertical line of action lateral to the axis = ipsilateral lateral flexion
  • has a vertical line of action posterior to the axis= extension
  • horizontal line of action = simultaneous posterior shear
34
Q

With regard to the lumbar spine, explain how the structure of the following muscles relates to
their function:
multifidus

A
  • vertical line of action and posterior position to axis = posterior sagittal rotation -> lumbar extension + maintains the lumbar lordosis
35
Q

With regard to the lumbar spine, explain how the structure of the following muscles relates to
their function:
rectus abdominis

A

??

36
Q

With regard to the lumbar spine, explain how the structure of the following muscles relates to
their function:
transversus abdominis

A

small PCSA, transverse/cylindrical line of action = increase IAP

37
Q

Primary, secondary and tertiary areas of the cerebral cortex are involved in processing somatosensory information. Identify the anatomical locations and describe the type of
processing that occurs at EACH area.

A

primary = prefrontal cortex

  • most rostral part of the frontal lobe
  • executive functions, motor expression of emotions and behaviour

secondary = PMC and
SMC
- SMC: located just rostral to the precentral sulcus but mostly on medial aspect of the hemipsheres; contributes to learning sequence of movement and bilateral coordination
- PMC: located just rostral to the precentral sulcus but on lateral surface of the hemispheres; integrates sesnory info into motor plans

tertiary= primary motor cortex

  • located in the precentral sulcus
  • execution of movements/motor output
38
Q
The anterolateral pathway and the dorsal column pathway are two major ascending pathways.
List FIVE (5) SIMILARITIES and FIVE (5) DIFFERENCES between the two pathways.
A

(similar to 2018)
similarities:
1. both encounter the dorsal root
2. need 3 neurons to reach conscious level
3. both go to corona radiata and internal capsule to terminate in the primary somatosensory cortex
4. both 2nd order neuron synapses in the ventral posterolateral (VPL) nuclei in the thalamus
5. both start at the periphery
differences:
1. different sensory modalities (DC= discriminative touch, pressure, vibratory sense and conscious proprioception; AL= nociception, temperature, crude touch)
2. AL goes from dorsal root to the dorsal horn but DC goes from dorsal root to the dorsal column
3. AL has slower and smaller neurons which are less myelinated (III+IV) where DC has larger and faster neurons which are more myelinated (1a, 1b, II)
4. DC = info coming from the right will ascend through the right spinal cord whereas AL= info coming from the right will travel though the left AL pathway
5. ??

39
Q

Parkinson’s disease is a hypokinetic disorder. Which part of the basal ganglia degenerates in this disease? How does this neuronal degeneration result in defects in the direct pathway of the
basal ganglia?

A
  • degeneration of substantia nigra pars compacta (SNc)

- it reduces the activity of the direct pathway leading to the inability to initiate desired motor programs

40
Q

Which parts of the cerebellum comprise the cerebrocerebellum? With the aid of a diagram, describe the inputs to the cerebrocerebellum and the efferent pathways from this part of the cerebellum. What symptoms could arise from a lesion to the cerebrocerebellum?

A
  • composed of lateral hemispheres and dentate nuclei
  • receives input from contralateral motor cortex
    (see notes for diagram)
  • cerebrocerebellar lesions cause limb ataxia