Anatomy III Midterm Review

Question 1

All of the following can be palpated or percussed except: 
A. frontal sinuses, 
B. maxillary sinuses, 
C. mastoid process, 
D. sphenoid sinuses

Answer 1

Sphenoid sinuses

Question 2

While performing a complete PE on a 20 y/o, you palpate a small nttp nodular midline mass that is located superior to the thyroid gland. Dx?

Answer 2

Thyroglossal duct cyst

Question 3

Atrophy of the gastrocnemius and soleus muscles is associated w/ herniation of which IV discs?

Answer 3

L5-S1

Question 4

All can be visually observed when mouth is closed except:
A. oral candidiasis,
B. uvular deviation d/t injury to CN X,
C. pharyngeal tonsillar hypertrophy,
D. geographic tongue assoc w/ psoriasis

Answer 4

Pharyngeal tonsillar hypertrophy

Question 5

26 y/o male construction worker is brought to the ED after traumatic accident where a steel beam dropped onto the top of his head.    Which of the following fractures is most likely caused by his injury?
A. Type I fx of C2 vertebra
B.  Burst fx of C1 vertebra
C. Compression fx of C7 vertebra
D. Pedicle fx of C3 vertebra

Answer 5

Burst fx of C1 vertebra

Question 6

20 y/o female restrained driver sustained an apparent cervical spine hyperextension injury after a rear-end collision while at a stop light. Rad exam reveals several cervical vertebral body fractures and rupture of adjacent vertebral ligament. What ligament most likely ruptured during this hyperextension injury?

Answer 6

Anterior longitudinal ligament

Question 7

35 y/o police officer shot in back and develops Brown-Séquard syndrome (hemisection of spinal cord) @ level of T5 on right. What neuro findings would you expect on PE?

Answer 7

Impaired proprioception and vibration sensation on the right

Question 8

26 y/o male presents to PCP w/ painful rash that worsened over last 2 days. PE reveals vesicular rash that is restricted to a band spanning from the spine around the right flank anteriorly to abruptly stop at the midline umbilicus. Dx w/ shingles. Which nerve is most likely involved?

Answer 8

T10

Question 9

Which of the following conditions is characterized clinically by combined UMN and LMN symptoms?
A.  Subacute combined degneration
B. ALS
C. Polymyelitis
D. Vit B12 deficiency

Answer 9

ALS

Question 10

Bone marking of groove defined as?

Answer 10

Elongated depression or furrow

Question 11

All are actions of SNS except:
A.  Tachycardia
B. Ejaculation
C. Inhibition of urination
D. Bronchial smooth muscle contraction

Answer 11

Bronchial smooth muscle contraction

Question 12

CN XI can be found in which triangle of the neck?

Answer 12

Posterior cervical

Question 13

Dural venous confluence of sinuses is the meeting place for all of the following except:
A. Superior sagittal sinus
B. Straight sinus
C. Frontal sinus
D. Occipital sinus

Answer 13

Frontal sinus

Question 14

During a LP, all are traversed by the spinal needle except:
A. Supraspinous ligament
B. Ligamentum flavum
C. Interspinous ligament
D. Posterior longitudinal ligament

Answer 14

Posterior longitudinal ligament

Question 15

Which of the following can result from acute otitis media?
A. Mastoiditis
B. Meningitis
C. Facial nerve paralysis
D. All over the above

Answer 15

All of the above

Question 16

All are possible complications of osteoporosis except:
A. Vertebral compression fractures
B. Kyphosis
C. Distal radius fracture
D. Osteoid osteoma of the femur

Answer 16

Osteoid osteoma of the femur

Question 17

Of all the meningeal spaces, which is a "real" space (i.e. not a space that becomes a space pathologically)
A. Epidural space
B. Subdural space
C. Subarachnoid space
D. All are "real" spaces

Answer 17

Subarachnoid space

Question 18

26 y/o male undergoes surgical resection of a papillary carcinoma of the thyroid. Post-op, he is noted to have hoarseness of the voice. What nerve was most likely injured during surgery?

Answer 18

Recurrent laryngeal nerve

Question 19

What are the primary curvatures of the vertebral column in an adult?

Answer 19

Thoracic and sacral kyphoses

Question 20

The basal ganglia include?

Answer 20

Caudate + putamen, subthalamic nucleus, substantia nigra

Question 21

A homonymous hemianopsia can be caused by a lesion in which of the following parts of the vision pathway?
A. Left optic nerve
B. Right optic tract
C. Left lateral geniculate body
D. Center of the optic chiasm

Answer 21

Right optic tract

Question 22

Loss of sensation at the level of the nipples reflects damage to what nerve?

Answer 22

T4

Question 23

Syringomyelia is characterized by a syrinx (pathological tubular cavity) which expands around the central canal and damages the anterior white commissure. What clinical finding would you expect?
A. Ipsilateral loss of pain sensation and DTR
B. Contralateral loss of proprioception
C. Bilateral loss of pain and temperature sensation
D. Flaccid paralysis

Answer 23

Bilateral loss of pain and temperature sensation

Question 24

After a car crash, 26 y/o man presents w/ HA + midback px.  Rad exam reveals trauma to thoracic spine and bleeding from anterior and posterior internal vertebral venous plexuses.  Where is the blood most likely accumulating?
A. Epidural space
B. Lumbar triangle
C. Subarachnoid space
D. Subdural space

Answer 24

Epidural space

Question 25

``` Which of the following back muscles can be visualized when the upper extremities are elevated? A. Rhomboid + teres major B. Trapezius C. Latissimus dorsi D. All of the above ```

Answer 25

All of the above

Question 26

The hangman fracture refers to?

Answer 26

Fracture of the pars interarticularis of C2 d/t abrupt hyperextension

Question 27

``` With swallowing, all of the following visibly rise and then fall to their resting positions except: A. Thyroid cartilage B. Cricoid cartilage C, Thyroid gland D. Hyoid bone ```

Answer 27

Hyoid bone

Question 28

CSF drains from the 4th ventricle into?

Answer 28

The central canal

Question 29

In determining the correct level of entry of a spinal needle for an LP, palpating the superior iliac crests and following the interconnecting supracristal plane will most readily guide you to which structure?

Answer 29

L4 vertebral body

Question 30

64 y/o man w/ hx of HTN + DMT2 is brought into ED w/ sudden onset of right-sided hemiplegia, conjugate eye deviation toward the left, and a difficulty initiating speech. Infarction of what vessel most likely caused his current clinical situation?

Answer 30

Upper division of left middle cerebral artery

Question 31

64 y/o male w/ hx of HTN + DMT2 is brought into ED w/ sudden onset of right-sided hemiplegia, conjugate eye deviation toward the left, and a difficulty initiating speech. Based on symptoms, what region is most likely involved?

Answer 31

Broca's area

Question 32

``` 22 y/o woman brought into ED after MVA. Restrained driver of car going 50 mph that crashed into rear of another car. Driver-side airbag did not deploy. Her head jerked forward, impacting the steering wheel, and then jerked backward, impacting the headrest. She remained conscious during the entire event. She c/o runny nose and states she cannot smell anything properly. Which of the following is the most likely cause of her current sx? A. Fx of temporal bone B. Basilar skull fx C. Fx of cribiform plate D. Epidural hematoma ```

Answer 32

Fx of cribiform plate

Question 33

22 y/o woman brought into ED after MVA. Restrained driver of car going 50 mph that crashed into rear of another car. Driver-side airbag did not deploy. Her head jerked forward, impacting the steering wheel, and then jerked backward, impacting the headrest. She remained conscious during the entire event. She c/o runny nose and states she cannot smell anything properly. What is the explanation for the runny nose?

Answer 33

CSF leak

Question 34

24 y/o man brought to ED after being attacked outside bar. Says some person came up to him and hit him on the left side of his head w/ a baseball bat. Police happened to pass by and interrupt the attack. One officer thought he had a mild concussion but still recommended he go to the ED. PE revealed contusion over left temporal bone. He was completely conscious + had appropriate mentation. He was discharged w/ analgesics and advised to return if he felt worse. His roommate came home the next day and found the pt face down on the floor non-responsive. Most likely diagnosis? A. Subdural hematoma causing uncal herniation B. SAH causing herniation through foramen magnum C. ICH of the medulla oblongata D. Epidural hematoma from the middle meningeal artery which continued bleeding

Answer 34

Epidural hematoma from the middle meningeal artery which continued bleeding

Question 35

``` Decussation of the pyramids of the medulla involves which of the following? A. Descending corticospinal fibers B. Ascending spinothalamic fibers C. Descending cerebellospinal fibers D. Ascending dorsal column fibers ```

Answer 35

Descending corticospinal fibers

Question 36

Damage to the right oculomotor nerve (CN III) would result in which of the following: A. Upward and inward mvt of R eye d/t unopposed action of the right medial rectus and inferior oblique muscles B. Constriction of the right pupil d/t increased tone of the constrictor pupillae muscle C. Downward and outward mvt of the right eye d/t unopposed action of the right superior oblique and lateral rectus muscles D. Ptosis of the right eyelid d/t inhibition of the orbicularis oris muscles

Answer 36

Downward and outward mvt of the right eye d/t unopposed action of the right superior oblique and lateral rectus muscles

Question 37

42 y/o obese woman presents to the ED c/o severe headache "worst of my life!" Began 1 hr ago and has been unrelenting despite taking acetaminophen and ibuprofen. Admits to smoking crystal meth earlier in the day. Afebrile + BP of 180/100 w/ pulse of 100bp. She is exhibiting some neck and back px as well, but no chest pain. CT scan demonstrates a SAH in the right sylvian fissure. What is a possible dreaded complication of her condition?

Answer 37

Cerebral ischemia secondary to vasospasm