Anatomy Answer Key

*1. A patient with an isolated occulomor nerve paralysis would present with the following findings on the affected side A) constricted pupils C) weakness of eyelid closure B) eyelid deviated laterally D) all of the above MPL .5 2. Reproductive adaptations noted in the female true pelvis include the following EXCEPT A) greater pubic angle C) longer pelvic cavity B) wider sacrosciatic notches D) cylindrical pelvic cavity MPL .5 *3.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 C) thoracodorsal B) radial D) medial pectoral MPL .25 4.During the proliferative phase of the menstrual cycle, one can observe that A) the endometrium thickens largely because of edema B) glycogen disappears in the basal cytoplasm of the glandular epithelium C) there is a two to threefold increase in the thickness of the endometrium D) the endometrial glands become quite tortuous MPL 1 5. Bile formed by hepatic cells is first secreted into the A) bile canaliculi C) space of Disse B) bile ducts D) hepatic duct MPL 1 6. A patient with an isolated injury to the mandibular division of the trigeminal nerve would present with A A) atrophy of the temporalis muscle on the affected side B) flattened nasao-labial fold on the affected side B C) numbness of the cheek on the affected side D)A and C only MPL .5 7. The landmark structure noted during the dissection of the gluteal area A) gluteus medius C) quadratus femoris B) piriformis D) obturator externus MPL 1

8.Semen is composed of products produced by all of the following EXCEPT the A) seminiferous tubules C) bulbourethral glands B) seminal vesicles D) rete testis MPL 1 *9. True ribs include A) 5th

B) 7th

C) 8th

D) A and B

MPL .5 *10. 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 MPL .25 *11. The primary hip flexor is the A) sartorius B) rectus femoris

C) iliopsoas

D) pectineus

MPL 1 *12. The following secretions are correctly attached 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 MPL .5 13. A patient presented with complete paralysis of one side of the face with intact lacrimation and taste sensation (anterior 2/3 of tongue) The cranial nerve involved in this case most probably has a tension at the level of the A) internal auditory meatus C) sytlomastoid foramen B) geniculate ganglion D) external auditory meatus MPL .25 *14. This structure is highly vulnerable in surgical manipulation of the ductus arteriosus A) esophagus C) left vagus nerve B) left bronchus D) left recurrent laryngeal nerve MPL .5

15. The three types of granulocytes usually can be distinguished best under the light microscope on the basis of A) nuclear morphology and cell size B) nuclear morphology only C) cell size only D) staining reaction of cytoplasmic granules MPL 1 *16. The liver is anatomically divided into right and left unequal halves along the fissure of the A) ligamentum venosum C) falciform ligament B) inferior vena cava D) porta hepatic MPL 1 17. Both skeletal and smooth muscle can be found in the muscularis externa of the A) stomach C) colon B) duodenum D) esophagus MPL 1 *18. This structure is highly vulnerable in cancerous growth in R pulmonary hilum and posterior mediastinum A) trachea C) vagus nerve B) superior intercostal vein D) pulmonary ligament MPL .5 19. During erection of the penis, the volume of the blood occupying the spaces of the cavernous sinuses is increased by A) contraction of the musculature of the dorsal artery of the penis B) relaxation of the musculature of the dorsal artery of the penis C) contraction of the musculature of the helicine arteries D) relaxation of the musculature of the helicine arteries MPL .5 *20.The granules found in the cells of the adrenal medulla consist of A) hydrocortisone C) epinephrine B) glucocorticoids D) mineralocorticoids MPL 1 21. The deep perineal space in the male contains each of the following EXCEPT A) membranous urethra C) bulbourethral glands B) prostate gland D) sphincter urethrae muscle MPL 1

*22. Loss of extension of the knee would result from damage to the A) femoral nerve C) tibial and common fibular B) tibial nerve D) obturator nerve MPL .5 *23. Which of the following epithelia can usually be found in the normal female reproductive system? A) stratified squamous and simple columnar B) transitional and stratified squamous C) simple columnar and transitional D) simple columnar and pseudostratified MPL .5 24. By inserting the finger into the rectum, the following can be readily felt and examined A) enlarged seminal vesicles C) A and B B) prostate gland D) none of the above MPL .5 *25. The ventral rami of the brachial plexus are seen at the A) posterior cervical triangle C) submandibular triangle B) carotid triangle D) muscular triangle MPL .5 26. The function of the interstitial endocrine cells of the testis is to A) form acrosome B) secrete testosterone C) support the germinal epithelium D) supply nutrients to the sex cells MPL 1 27. The vermiform appendix is best located by following the A) anterior cecal artery B) descending branch of the right colic artery C) ileum to the ileocolic juncture D) teniae coli of the ascending colon MPL 1 *28. From which of the following sites is primary cancer most likely to metastasize to the lung by venous spread? A) ileum C) kidney B) appendix D) transverse colon

MPL .5 *29. Simple cuboidal epithelium is usually found in A) parietal layer of Bowman’s capsule B) descending limb of the loop of Henle C) rete testis D) single layer on the free surface of the ovary MPL 1 *30. The roof of the adductor canal is formed by the A) rectus femoris B) vastus medialis

C) adductor longus D) sartorius

MPL .5 31. Trauma to the sternocostal surface of the heart would more likely damage the A) right atrium C) left ventricle B) right ventricle D) left atrium MPL .5 *32. Interruption of blod flow in the internal iliac artery would affect blood flow to each of the following EXCEPT the A) medial thigh muscles B) ductus deferens C) lower abdominal wall and rectus abdominis muscle D) rectum MPL .5 *33. A child suspected of aspirating a small button is seen in the ER. While there is no complain of pain, there is frequent coughing. Physical examination showed absence of breath sounds. Aspirated small objects tend to lodge in the right inferior lobar bronchus for all the following reasons EXCEPT A) left main stem ( primary) bronchus is more horizontal B) right inferior lobar bronchus nearly continues the direction of the trachea C) right lung has no middle lobe D) right main stem(primary) bronchus is of greater diameter than the left MPL .25 34. This structure separates the perineum from the pelvic cavity A) ischiorectal fossa C) pelvic diaphragm B) urogenital diaphragm D) urogenital triangle MPL 1 35. Drug detoxification occurs in the

A) Golgi apparatus B) smooth endoplasmic reticulum

C) rough endoplasmic reticulum D) lysosomes

MPL 1 *36. The ligament that prevents C1 vertebrae from translating against C2 is A) alar ligament C) transverse ligament B) tentorial ligament D) posterior longitudinal ligament MPL .5 *37. The scala vestibuli of the inner ear communicates with the scala tympani via the A) modiolus C) cecum cupulare B) helicotrema D) aqueduct MPL .5 38. The Haversian canals of bone tissue A) contain chondrocytes B) are lined by cement lines C) form the central structure of a Haversian system D)run perpendicular to the long axis of the bone MPL 1 39. The hepatic portal vein is correctly described by each of the following EXCEPT A) it drains most of the venous blood from the gastrointestinal tract B) it forms by the confluence of the superior mesenteric and splenic veins C) it is located in the hepatoduodenal ligament D) it forms posterior to the head of the pancreas MPL .5 *40. The internal spermatic fascia is derived from the A) external oblique aponeurosis B) peritoneum C) transversus abdominis aponeurosis D) transversalis fascia MPL 1 41. The vagus nerve enters the abdominal cavity through the A) aortic hiatus C) sternocostal hiatus B) esophageal hiatus D) vena caval aperture MPL .5 42. The part of the uterine tube which is removed during fimbriectomy A) cornua C) ampulla

B) isthmus

D) infundibulum

MPL 1 43. Pressure developing deep to the flexor retinaculum would affect each of the following EXCEPT the A) median nerve B) ulnar nerve C) tendons of the flexor digitorum superficialis muscle D) tendons of the flexor pollicis longus muscle MPL .5 44. A patient enters the emergency room not being able to raise his foot. The nerve that is suspected to be damaged is the A) tibial C) obturator B) common fibular D) medial plantar MPL .5 45. Sinusoids are correctly described by each of the following EXCEPT A) they have a irregular tortuous lumen B) they are lined by endothelial cells C) they have a dense connective tissue wall D) they have no phagocytic elements MPL .5 46. The opening into the lesser sac is through the A) foramen of Bochdalek B) foramen of Winslow

C) foramen of Morgagni D) foramen transversarium

MPL .5 47.Damage to the obturator nerve on the lateral wall of the pelvis would affect the function of each of the following muscles EXCEPT the A) sartorius C) adductor longus B) gracilis D) pectineus MPL .5 48. When removing the right lung, the surgeon has to be careful to protect which of the following structures passing posterior to the root of the lung? A) hemiazygos vein C) right phrenic nerve B) right vagus nerve D) thoracic aorta MPL .5 49. Which muscle is responsible for expelling the last drops of urine in the male

A) sphincter urethrae B) bulbocavernosi

C) sphincter vesicae D) ischiocavernosi

MPL .5 50. At the hepatoduodenal ligament, the structure that occupies a medial location is the A) common bile duct C) inferior vena cava B) portal vein D) hepatic artery MPL 1 51. The thoracic duct enters the venous circulation at the junction of A) superior vena cava and right atrium B) left subclavian and left internal jugular vein C) left and right brachiocephalic vein D) right subclacian and right internal jugular vein MPL 1 52. The axillary artery may be ligated at this point without compromising the blood supply to the upper extremity A) proximal to the thyrocervical trunk B) distal to the subscapular artery C) between the thyrocervical trunk and subscapular artery D) none of the above MPL .25 53. Separates the submandibular triangle from the carotid triangle A) posterior belly of digastric C) sternohyoid B) omohyoid D) hyoid bone MPL 1 54. An occlusion of the superior mesenteric artery would result in necrosis of each of the following EXCEPT the A) ascending colon C) ileum B) rectum D) cecum MPL .5 55. Occupies the tracheoesophageal groove A) vagus nerve B) sympathetic trunk

C) recurrent laryngeal nerve D) phrenic nerve

MPL .5 56. A woman’s inability to supinate the forearm could result from an injury to which of the following pair of nerves A) axillary and radial C) radial and musculocutaneous

B) median and ulnar

D) suprascapular and axillary

MPL .5 57. Following tonsillectomy, a patient noted loss of general sensation and taste from the posterior one third of the tongue. It could be assumed that the injured nerve was a branch of the A) glossopharyngeal nerve C) lingual nerve B) facial nerve D) hypoglossal nerve MPL .25 58. The median cubital vein is a communication between the A) cephalic and basilic C) cephalic and axillary B) basilic and axillary D) axillary and subclavian MPL 59. Fenestrated capillaries have A) extremely attenuated areas of endothelium with pores B) thickened areas with pores C) diaphragm that have the same thickness as unit membranes D) pores that are evenly spaced over the entire surface of the endothelium MPL .5 *60. A severe blow to the side of the head could fracture which one of the following bones in the roof of the orbit? A) palatine C) frontal B) maxilla D) zygomatic MPL 1 61. Occupies a medial location within the carotid sheath A) internal jugular vein C) vagus nerve B) ansa cervicalis D) common carotid artery MPL .5 *62. Each of the following characterizes the levator ani muscles EXCEPT A) it forms the principal part of the pelvic diaphragm B) it separates the floor of the pelvis from the ischioanal fossa C) it arises from the inner surface of the superior ramus of the pubis D) it separates the superficial and deep inguinal spaces MPL.5 63. A basketball player who trips and falls, landing on his outstretched hand will most likely fractures which carpal bone? A) trapezium C) scaphoid

B) capitate

D) hamate

MPL .5 64. Lymphatic nodules are found in each of the following EXCEPT A) lymph nodes C) tonsils B) thymus D) walls of urinary tract MPL 1 65. A spleen may be ruptured in traumatic injuries to the chest if these ribs are fractured and displaced A) 5th, 6th, 7th level of the posterior axillary line B) 7th, 8th , 9th level of the midaxillary line C) 9th, 10th, 11th level of the left posterior axillary line D) 10th, 11th, 12 anteriorly MPL .5 66. A diastolic murmur coming from a stenosed mitral valve in patient with RHD is best heard or auscultated at the A) 5th ICS left midclavicular line B) 4th ICS left parasternal border C) 2nd ICS left parasternal border D)4th ICS right parasternal border MPL .25 67. Surgically, it is important to locate which one of the following structures located immediately posterior to the second part of the duodenum A) transverse colon C) hilum of right kidney B) left lobe of the liver D) gallbladder MPL .5 68. Podocytes are associated with which of the following parts of the urinary system A) distal convoluted tubule C) major calyces B) thick limb of loop of Henle D) visceral layer of Bowmans capsule MPL .5 69. A baby sustained a lower brachial plexus injury due to traumatic childbirth (forceful pulling on the arm). The following is/are true statements regarding this type of injury A) results in loss of abduction, flexion and lateral rotation of the shoulder B) results in clawhand deformity C) leads to sensory deficit in the lateral aspect of the upper extremity D) all of the above MPL .25

70. Which of the following layers in the wall of a medium sized artery contains smooth muscle A) internal elastic membrane C) tunica adventitia B) external elastic membrane D) tunica media MPL 1 71. A lesion of the lingual nerve immediately after it receives the chorda tympani nerve could result in each of the following EXCEPT A) loss of sublingual gland secretion B) sensory loss from lower teeth C) loss of taste from anterior two thirds of the tongue D) loss of submandibular gland secretion MPL .5 72. The superior vena cava could be damaged by a stab wound deep to the A) right first costal cartilage C) right sternoclavicular joint B) right fourth costal cartilage D) left second costal cartilage MPL .5 73. All of the following statements concerning the uterus are correct EXCEPT A) the broad ligament reflects from the posterior surface of the uterus to the rectum to form the rectouterine pouch B) the round ligament connects the uterus to the ovary C) the broad ligament extends from the anterior surface of the uterus onto the bladder forming the vesicouterine pouch D) the uterine tubes enter the uterus in the superior border of the broad ligament MPL .5 *74. A 58-year-old man presented with a year history of chest pain. The attacks were increasing in frequency and were only relieved by rest. Cardiac catheterization revealed an area of occlusion of the circumflex branch of the left coronary artery. The damage to the heart would probably involve the A) left atrium and left ventricle C) right and left ventricles B) right atrium and left ventricle D) apex of the heart MPL .5 *75. A severe infection that obstructs the middle meatus would affect drainage from each of the following sinus EXCEPT the A) maxillary sinus C) nasolacrimal duct B) frontal sinus D) anterior ethmoid air cells MPL 1 76. Plicae circulares is most abundant in what part of the gastrointestinal tract A) duodenum C) ileum

B) jejunum

D) large intestine

MPL 1 77. A woman on her 3rd trimester of pregnancy developed paresthesia of the hands. She has difficulty in doing her cross-stitch hobby. Her most likely problem affects the A) median nerve C) radial nerve B) ulnar nerve D) axillary nerve MPL .5 78.A 9-year-old boy fell hitting his elbow. Physical examination showed weakness in wrist flexion and loss of adduction. Loss of sensation was noted on the medial side of his hand. What nerve was most probably injured A) musculocutaneous C) radial B) ulnar D) median MPL .5 79. Carcinoma of the _____part of the pancreas usually shows itself first by painless progression jaundice with enlargement and distention of the gall bladder A) head C) body B) neck D) tail MPL .5 80. Sperms found in these structures are capable of fertilizing ova A) seminiferous tubules C) ductuli efferentes B) rete testis D) epididymis MPL .5 81. A myocardial infarction that damages the heart muscle in the anterior two thirds of the interventricular septum would result primarily from occlusion of the A) posteiror interventricular artery B) marginal branch of the right coronary artery C) marginal branch of the left coronary artery D) anterior interventricular artery MPL .5 82. The horizontal fissure of the right lung separates the A) superior and middle lobe C) inferior and middle lobe B) superior and inferior lobe D) superior lobe from cardiac notch MPL 1 83. In Dupuytren’s contracture, the flexion of the MCP joints is actually due to

A) compression of the median nerve at the wrist, leading to atrophy of the muscles of opposition B) inflammation of the synovium of the long flexor tendons, leading to scarring C) atrophy of the lumbrical muscles due to disuse D. fibrosis of the digital slips of the palmar aponeurosis MPL .5 !84. It would be difficult for a gallbladder infection to easily reach which one of the following viscera A) liver C) cystic duct B) third part of the duodenum D) transverse colon MPL 1 85. After leaving the trabecular sinuses of a lymph node, lymph passes directly into the A) afferent lymphatic vessels C) subscapular sinuses B) efferent lymphatic vessels D) medullary sinuses MPL .5 86. A vertical incision through the midline of the anterior abdominal wall will traverse the A) rectus abdominis C) internal oblique B) external oblique D) linea alba MPL 1 87. The contents of an indirect inguinal hernia enters the inguinal canal ______ to the inferior epigastric artery A) lateral C) inferior B) medial D) none of the above MPL .5 88. A penetrating knife wound to the posterior shoulder in the quadrangular space would damage the axillary nerve and the A) anterior circumflex humeral artery C) subscapular artery B) posterior circumflex humeral artery D) superior thoracic artery MPL .5 *89.A tumor involving the fifth to twelfth thoracic vertebrae could affect each of the following structures in the posterior mediastinum EXCEPT the A) thoracic duct C) azygos vein B) phrenic nerve D) descending aorta MPL .5 90. Damage to the anatomic snuffbox might be expected to injure the

A) ulnar nerve B) capitate bone

C) ulnar artery D) radial artery

MPL 1 !91. The cerebral arterial circle (circle of Willis) is formed by branches of the internal carotid artery and the A) external carotid artery C) basilar artery B) vertebral artery D) middle meningeal artery MPL .5 92. AS a result of an injury to the ulnar nerve in the arm, all of the following changes in the hand will be noted EXCEPT A) sensory loss on the little finger and one half of the ring finger B) the thumb is strongly adducted C) loss of flexion of the distal interphalangeal joints of the fourth and fifth digits D) marked wasting in the hypothenar eminence MPL .5 For questions 93-95 A 63 year old woman shows a fine, pill-rolling tremor in both upper extremities, with tremors at rest. There is an overall poverty of movements. The patient’s gait is shuffling and motor performance is delayed. 93. The most likely diagnosis is A) Wilson’s disease B) Parkinson’s disease

C) Benedikt’s syndrome D) Liver-brain disease

MPL .5 94. Dysfunction of this structure is implicated in the above disease A) substantia gelatinosa C) substantia nigra B) red nucleus D) cerebellum MPL .25 95. Treatment involves administration of A) dopamine B) L-dihydroxyphenylalanine

C) acetylcholine D) serotonin

MPL .5 96. The powerful extension of the thigh required when one is standing from a sitting position is the function of the A) gluteus maximus C) psoas major B) iliacus muscle D) piriformis

MPL .5 *97. Ejaculatory fluid is composed of products produced by all of the following EXCEPT the A) seminiferous tubules C) bulbourethral glands B) seminal vesicles D) rete testis MPL .5 98. Respiratory distress syndrome occurs most commonly because A) too few mature alveoli have developed B) surfactant production is insufficient C) the lungs are partially filled with amniotic fluid D) type I alveolar epithelial cells produce a greatly thickened basement membrane MPL .5 For question 99-100 A 55-year-old woman complained of numbness in the legs, which spread to involve her hands. There were sudden sharp pains, variable in location, but usually localized to one or the other leg. On examination, her pupils were of unequal size. Argyll-Robertson pupils and Romberg’s sign were present. Although the patient’s strength was normal she was areflexic in all limbs. *99. The most likely diagnosis is A) Brown Sequard syndrome B) tabes dorsalis MPL .25 *100. Above findings is the result of A) degeneration of posterior columns A) upper motor neuron damage B) cerebellar disease C) degeneration of basal ganglia MPL .25

__

C) multiple sclerosis D) meningiona