Midterm Flashcards

1
Q
An atypical rib which has a prominent tubercle for attachment of scalenius anterior muscle:
A. 4th rib   
B. 2nd rib   
C. 1st rib   
D. 10th rib   
E.  11th rib
A

B. 2nd rib

SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.
The 2nd rib is considered atypical because it has a prominent tubercle for attachment to scalenius anterior muscle

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2
Q
The appendiceal artery is a branch of:
A. Right colic artery   
B. Ileocolic artery   
C. Middle colic artery   
D. Jejuno-Ileal arteries   
E. Left colic artery
A

B. Ileocolic artery

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3
Q
The axillary artery becomes the brachial artery at what landmark?
A. Lower border of teres minor  
B. Lateral to pectoralis minor   
C. Lateral border of 1st rib   
D. Lower border of teres major   
E. Upper border of teres minor
A

D. Lower border of teres major

Brachial artery is the main arterial supply of the arm, it begins at the inferior border of teres major and divides to become ulnar and radial artery at the level of the neck of radius in the antecubital fossa.

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4
Q
Wrist injury that may cause carpal tunnel syndrome:
A. Lunate dislocation   
B. Scaphoid fracture   
C. Pisiform dislocation   
D. Hamate fracture   
E.  Base of 1st metacarpal fracture
A

A. Lunate dislocation

Lunate dislocation can cause distal median nerve injury that presents clinically as a Carpal tunnel syndrome.

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5
Q
In the GI tract, the cells found in the crypts of Lieberkuhn that secrete antibacterial enzymes are called:
A. Enterocytes   
B. Goblet cells   
C. Paneth cells   
D. Argentaffin cells   
E. Clara cells
A

C. Paneth cells

Enterocytes: columnar cells for absorption;
Goblet cells: mucin secretion;
Argentaffin cells: enteroendocrine cells;
Clara cells: secretes surfactant like material & enzyme which can detoxify

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6
Q

A patient presents at the ER with loss of pronation, ulnar deviation of the wrist during wrist flexion, and when attempting to make a fist, the index and middle fingers remain extended. What is the most appropriate injury to this case?
A. A midshaft fracture of the humerus
B. A supracondylar fracture of the humerus
C. A fracture of the hook of hamate
D. A fracture of the surgical neck of the humerus
E. A fracture in the lateral epicondyle of the humerus

A

B. A supracondylar fracture of the humerus

Midshaft fracture: Radial nerve injury;
Supracondylar fracture: Median nerve injury;
Fracture of hook of hamate: distal Ulnar nerve injury; Fracture of surgical neck of humerus: Axillary nerve injury;
Fracture in medial epicondyle of humerus: proximal Ulnar nerve lesion.

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7
Q
At the ER, a 40 year old woman complains of weakness in lateral rotation of the thigh. This is likely due to paralysis of what muscle?
A. Pectineus   
B. Gracilis  
C. Gluteus medius   
D. Obturator internus   
E. Tensior fascia lata
A

D. Obturator internus

SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE:
Pectineus: assists with medial rotation of the thigh;
Gracilis: adducts the thigh, flexes leg and helps rotate it medially;
Gluteus medius & minimus: abductor and medial rotator of the thigh;
Tensor fascia lata: abducts, medially rotates and flexes thigh

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8
Q
A thoracic surgeon plans to remove the right middle lobar (secondary) bronchus along with its lung tissues. Which of the following bronchopulmonary segments might have been affected by malignancy?
A. Superior and anterior   
B. Medial basal and lateral basal   
C. Anterior basal and posterior basal   
D. Anterior and posterior   
E. Medial and lateral
A

E. Medial and lateral

RIGHT LUNG:
Superior lobe:Apical, posterior, anterior;
Middle lobe: Lateral and medial;
Inferior lobe: Superior, anterior basal, medial basal, lateral basal, posterior basal.

LEFT LUNG:
Superior lobe: Apico-posterior, anterior, Superior/Inferior Lingular;
Inferior lobe: Superior, anterior basal, medial basal, lateral basal, posteror basal.

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9
Q

Each kidney is supplied by a renal artery and vein. Which is statement is TRUE?
A. The right renal vein is longer than the left renal vein.
B. The right renal artery is longer than the left renal artery.
C. The right renal vein receives the right gonadal vein
D. Only the right renal artery branches to become the right inferior suprarenal artery
E. The right renal artery traverse the IVC anteriorly

A

B. The right renal artery is longer than the left renal artery.

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10
Q
A 2 month-old boy needed a femoral tap for ABG determination. In what compartment of the femoral sheath will you aspirate?
A. Medial   
B. Anterior   
C. Posterior   
D. Lateral   
E. Inferior
A

D. Lateral

Compartments of the femoral sheath:
Lateral - femoral artery;
Intermediate - femoral vein;
Medial - femoral canal

*The femoral sheath does not enclose the femoral nerve.

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11
Q
The pelvic diaphragm includes the following muscles, EXCEPT?
A. Ischiococcygeus   
B. Coccygeus   
C. Puborectalis   
D. Pubococcygeus   
E. Iliococcygeus
A

A. Ischiococcygeus

The pelvic diaphragm is made of:

1) Levator ani: Puborectalis, Pubococcygeus, Iliococcygeus
2) Coccygeus

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12
Q
The contents of the axilla including axillary vein, axillary artery and brachila plexus is covered by the axillary fascia, which is derived from?
A. Prevertebral layer   
B. Investing layer   
C. Pretracheal layer   
D. Carotid sheath   
E. Pectoral sheath
A

A. Prevertebral layer

SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE: The axillary fascia derived from the lateral prolongation of the prevertebral fascia extending up to the elbow.

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13
Q

Infection in the deep perineal space would most likely affect which of the following structures?
A. Ischiocavernosus
B. Superficial transverse perineal muscle
C. Levator ani muscle
D. Sphincter urethrae
E. Bulbospongiosus

A

D. Sphincter urethrae

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14
Q
If there is an abnormal fluid accumulation within the pleural cavity, the following are areas where you can perform thoracentesis, EXCEPT:
A. 6th or 7th ICS, midclavicular line   
B. 8th or 9th ICS, midaxillary line   
C.10th of 11th ICS scapular line    
D. 8th or 9th ICS, midsternal line   
E. None of the above
A

D. 8th or 9th ICS, midsternal line

Lines of pleural reflection:
MCL: 6th-8th rib;
MAL: 8th-10th rib;
Midsternal line: 10th-12th rib

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15
Q
Muscle of mastication that depresses the mandible:
A. Temporalis muscle   
B. Masseter   
C. Lateral pterygoid muscle   
D. Buccinator   
E. Zygomaticus
A

C. Lateral pterygoid muscle

Muscles of mastication that closes the jaw - Temporalis, Masseter, Medial pterygoid;

Lateral pterygoid - opens jaw.

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16
Q
Levator glandulae thyroidea is attached to what part of the thyroid gland?
A. Right lobe   
B. Left lobe   
C. Pyramidal lobe   
D. Isthmus   
E. Superior lobe
A

C. Pyramidal lobe

Levator glandulae thyroidea is a fibrous or muscular band which frequently connects the pyramidal lobe to the hyoid bone

17
Q

A 55 year old complains of substernal chest pain associated with diaphoresis and dyspnea. If this patient has a typical coronary circulation, a blood clot blocking the circumflex branch of the LCA would affect which area of the heart musculature?
A. Anterior part of the left ventricle
B. Anterior interventricular region
C. Posterior interventricular region
D. Posterior part of the left ventricle
E. Apex of the heart

A

D. Posterior part of the left ventricle

Blood supply of the heart:
LA and LV: circumflex branch of LCA;
Interventricular septum and apex:anterior interventricular branch of LCA;
RV: Anterior interventricular artery and marginal branch of RCA;
RA: RCA.

18
Q

During a summer basketball tournament game, a 25 year old shooting guard received a severe blow to the head that fractured his optic canal. Which of the following pairs of structures are most likely damaged?
A. Optic nerve and opthalmic vein
B. Optic nerve and opthalmic artery
C. Opthalmic nerve and opthalmic vein
D. Opthalmic nerve and opthalmic artery
E. Opthalmic artery and opthalmic vein

A

B. Optic nerve and opthalmic artery

Optic canal: CN II and opthalmic artery;
Superior orbital fissure: CN III, CN IV, CN VI, opthalmic nerve (V1), opthalmic vein;
Foramen rotundum: maxillary nerve (V2);
Foramen ovale: mandibular nerve (V3);
Foramen spinosum: middle meningeal artery

19
Q

A 27 year old male had a motorcycle accident. A right hemisection of T10-T11 was discovered in MRI. You would expect the following?
A. Loss of pain sensation at the left umbilicus
B. Loss of 2-point discrimination on the left thigh
C. Loss of crude touch sensation on the left knee
D. Loss of fast vibration sense on the left foot
E. Loss of thermal sensation at right hip

A

A. Loss of pain sensation at the left umbilicus

A spinal cord hemisection or Brown-Sequard syndrome results to an ipilateral upper and lower motor neuron lesion, contralateral loss of pain & temperature, and ipsilateral loss of proprioception

20
Q
Dopamenergic neurons in the substantia nigra is derived from?
A. Diencephalon   
B. Telencephalon   
C. Mesencephalon   
D. Metencephalon   
E. Myelencephalon
A

C. Mesencephalon

SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE: 
Telencephalon: Cerebrum; 
Diencephalon: Thalamus; 
Mesencephalon: Midbrain; 
Metencephalon: Pons, Cerebellum; 
Myelencephalon: Medulla.