Answer Test 1xz

1.

ANSWER: A. The 1st and 2nd posterior intercostal arteries arise from the supreme (highest) intercostal artery, a branch of the costocervical trunk of the subclavian artery. The lower 9 arteries arise from the back of the thoracic aorta and are also called aortic intercostals.

2.

ANSWER: Letter A is a true statement because the azygos vein transports deoxygenated blood starting from the posterior walls of the thorax and abdomen into the superior vena cava vein.

3.

Letter A is wrong because intercostal nerves do not arise directly from the spinal cord. They are anterior divisions of the thoracic spinal nerves from T1 to T11. Letter B is wrong. The 1st two nerves supply fibers to the upper limb, the next four supply parts of the thorax, the lower five supply the parts of the thorax and abdomen. The 7th intercostal nerve terminates at the xyphoid process, at the lower end of the sternum. The 10th intercostal nerve terminates at the umbilicus. The twelfth (subcostal) thoracic is distributed to the abdominal wall and groin. Letter C is wrong. They are both motor and sensory.The intercostal nerves send pain and other sensations to and from the chest. Pressure in the abdominal wall from torn muscles, scarring or other irregularities in the internal anatomy can pinch the intercostal nerve. When the intercostal nerve is compressed or damaged, intercostal NEURALGIA results, felt as sharp pain in the ribs, chest or abdomen. Answer therefore is Letter D. Each nerve is connected with the adjoining ganglion of the sympathetic trunk by a gray and a white ramus communicans.

4.

This board question is erroneous and misleading. All of the above choices are wrong. The lower (inferior) thoracic aperture is bounded by T12, lower 2 pairs of ribs (11th & 12th pairs of ribs), lower 4 costal cartilages, and the xiphisternal joint (not the manubrium of the sternum!) In contrast, the upper (superior) thoracic aperture (clinically called thoracic outlet and anatomically known as thoracic inlet) is bounded by T1 posteriorly, the 1st pair of ribs laterally, the 1st costal cartilage of the first rib, and the superior border of the manubrium anteriorly.

5.

ANSWER: Letter A. Mnemonic is DATES: Descending aorta, Azygous vein and hemiazygos vein, Thoracic duct, Esophagus, Sympathetic trunk.

6.

ANSWER: C. The visceral pleura is innervated specifically by autonomic nerves from the pulmonary plexuses formed by several strong trunks of the vagus nerve. In contrast, the parietal pleura is innervated by letter A the phrenic nerve (for the mediastinal & diaphragmatic parietal pleura) and by the intercostal nerves (for the costal parietal pleura).

7.

ANSWER: Letter B is wrong. It carries deoxygenated blood from the heart to the lungs. Letter C is wrong because the pulmonary trunk bifurcates approximately at the level of T5, which is at the level of the inferior margin of the carina. Letter A is also wrong because the posterior boundary of the transverse pericardial sinus is the superior vena cava. The answer is Letter D. The anterior boundary of the posterior pericardial sinus is the pulmonary trunk.

8.

ANSWER: D. The right principal (main) bronchus, because it is wider, shorter, and more vertical in direction than the left.

9.

ANSWER: This PRC question is erroneous. The choices above A, B, and C are branches of the arch of the aorta and not branches of the ascending aorta. The only branches of the ascending aorta are the two coronary arteries which supply the heart.

10. ANSWER: B.

Letter A is wrong because the esophageal hiatus is located approximately at level of the tenth thoracic vertebra (T10). Letters C & D are wrong because the esophageal hiatus transmits not only the esophagus but also the vagus nerve, the left inferior phrenic vessels, and some small esophageal arteries from left gastric vessels

11. ANSWER: C. The right half of the body ABOVE the diaphragm, like the right arm and the right side of the chest, neck and head, and lower left lobe of the lung, are drained collectively by the RIGHT LYMPHATIC DUCT.

12. This PRC board question is erroneous. I have never heard of anterior ciliary nerve, unless of course it refers to anterior ethmoidal nerve which also arises from the ophthalmic division of the trigeminal nerve. Yun siguro ang ibig sabihin ng board question - anterior ethmoidal nerve - which in that case would make their answer of ALL OF THE ABOVE correct. Letters A & B are correct. The cornea is one of the most sensitive tissues of the body as it is densely innervated with sensory nerve fibers via the ophthalmic division of the trigeminal nerve by way of 70–80 long ciliary nerves and short ciliary nerves.

13. ANSWER: C. The inferior division of the oculomotor nerve innervates the Inferior rectus, inferior oblique, and the medial rectus What made Letter A wrong is that Superior oblique is innervated by the Trochlear nerve, and the lateral rectus by the abducens nerve. What made Letter B wrong is that the Superior rectus is innervated by the superior branch of the oculomotor nerve.

14. ANSWER: A. By the way guys, another common board question is, "What is the only rectus muscle with a single blood supply?" Of course maraming rectus from head to leg, pero the answer is the Lateral rectus muscles of the eye. The blood supply is from the LACRIMAL ARTERY. (feeling ko naglelecture uli ako sa inyo.) 15. ANSWER: D. On the back of the neck, and frequently extending on to its lateral surfaces, is a shallow groove for the transverse atlantal ligament (transverse ligament of the atlas) which retains the odontoid process in position. 16. ANSWER: C. On either side of the laryngeal orifice is a recess, termed the piriform sinus/fossa (also piriform recess), which is bounded medially by the aryepiglottic fold, laterally by the thyroid cartilage and hyothyroid membrane. The fossae are involved in speech. (Inaantok nako.) 17. Anatomically, the apical ligament may be absent in 20% of cadaver specimens. In those cadavers with the apical ligament present it was found to arise anterior to the tip of the odontoid (usually from a small coronal groove located there) and insert into the anterior rim of the foramen magnum at the base (midpoint). The apical ligament is a small aggregation of elastic fibers surrounding a core of NOTOCHORDAL RENMANT – essentially it represents a rudimentary nucleus pulposus that is the remnant of notochord seen at other vertebral levels.

18. ANSWER: This PRC board question is erroneous. Only A & C are correct answers. Letter B is wrong because the Sternohyoid muscle, as the name implies, arises from the posterior border of the medial end of the clavicle, the posterior sternoclavicular ligament, and the upper and posterior part of the manubrium sterni. Then it passes upward and medially, and is inserted by short tendinous fibers into the lower border of the body of the hyoid bone. Technically, Letter A is correct because the first part of the inferior constrictor of the pharynx arises from the OBLIQUE LINE on the side of the lamina. Letter C is correct because the Sternothryroid arises from the posterior surface of the manubrium sterni, below the origin of the Sternohyoideus, and from the edge of the cartilage of the first rib, and sometimes that of the second rib, and it is inserted into the OBLIQUE LINE on the lamina of the thyroid cartilage.

19. ANSWER: B. The anterior ethmoidal nerve innervates the anterior portion of the nasal septum. But if the question asks about innervation of the nasal septum mucosa, the answer would be Letter D, the chief sensory supply to the inferior 2/3 of the mucous membrane of the nasal septum. 20. ANSWER: D. The branches of the facial artery supplies the vestibule of the nose no matter how bien ancho it is. 21. ANSWER: D. This board question is misleading because of the word "MOST" in the question. Sensory innervation of the supratentorial dura mater is via small meningeal branches of the trigeminal nerve (V1 or ophthalmic, V2 or maxillary, and V3 or mandiular). The innervation for the infratentorial dura mater are upper cervical nerves. 22. Through the hiatus semilunaris the middle meatus communicates with a curved passage termed the infundibulum, which communicates in front with the ANTERIOR ETHMOIDAL SINUS and in >50% of skulls it is continued upward as the NASOFRONTAL DUCT into the frontal air-sinus. Below the bulla ethmoidalis and hidden by the uncinate process of the ethmoid is the opening of the MAXILLARY SINUS (ostium maxillare).

23. ANSWER: C. The subarachnoid cavity communicates with the general ventricular cavity of the brain by three openings. One, the foramen of Magendie, wich is in the middle line at the inferior part of the roof of the fourth ventricle; and the other two are at the extremities of the lateral recesses of that ventricle, behind the upper roots of the glossopharyngeal nerves and are known as the foramina of Luschka. 24. ANSWER: A. Letter B is wrong. It should be ABOVE, not beneath the corpus callosum. Letter C is wrong because it drains into the straight sinuses. Letter D is wrong because the tentorium cerebelli covers the superior surface of the cerebellum, and supports the occipital lobes of the brain and not the great vein of Galen. 25. ANSWER: C. Structures LATERAL to cavernous sinus are the Trigeminal ganglion and the Uncus of the temporal lobe. Structures MEDIAL to the cavernous sinus are the Sphenoidal air sinus and the Hypophysis cerebri. 26. ANSWER: B. The anterior 3/4 of the floor of the nasal cavity is made up of the palatine process of the MAXILLARY BONE, whereas the posterior 1/4 is made up of the horizontal part of the PALATINE BONE. 27. ANSWER: D. The lingual nerve supplies general sensory somatic afferent innervation from the mucous membrane of the anterior 2/3 of the tongue. It also carries nerve fibers that are not part of the trigeminal nerve, including the chorda tympani nerve of the facial nerve, which provides special sensation (taste) to the anterior 2/3 part of the tongue as well as parasympathetic and sympathetic fibers. 28. ANSWER: B. Because the trigeminal ganglion lies in a shallow depression on the front of the petrous temporal bone near its apex. 29. ANSWER: C. Each of the sphenoidal air sinus opens into the roof of the nasal cavity via apertures on the posterior wall of the sphenoethmoidal recess directly above the choana. Letter A is wrong because the anterior portion of the inferior meatus presents the lower opening of the nasolacrimal canal. Letter B is wrong because the maxillary sinuses contain the opening into the middle meatus via the maxillary sinus ostia. Letter D is wrong because the superior meatus contains the sphenopalatine foramen posteriorly.

30. ANSWER: B. The auriculotemporal nerve passes medially to the neck of the mandible, gives off parotid branches and then turns superiorly, posterior to its head and moving anteriorly, gives off anterior branches to the anterior wall of the external auditory meautus. It then crosses over the root of the zygomatic process of the temporal bone, deep to the superficial temporal artery. 31. ANSWER: D The tensor tympani muscle is innervated by the medial pterygoid nerve from the mandibular nerve (V3)

32. ANSWER: B. The lesser superficial petrosal nerve consists of parasympathetic fibres. It leaves the tympanic plexus to synapse in the otic ganglion, and eventually provide parasympathetic innervation to the parotid gland. 33. Answer is D. Nosebleed. No comment. 34. The stapes (stirrup) ossicle bone of the MIDDLE EAR transmits sound waves to the fenestra ovalis (oval window) on the outside of the cochlea of the INNER EAR, which vibrates the perilymph (fluid) in the scala vestibuli (upper chamber of the cochlea), receiving the first sound waves in the middle ear. Letter B is wrong. The basilar membrane within the cochlea separates the scala media and the scala tympani. Reissner's membrane (vestibular membrane, vestibular wall) is a membrane inside the cochlea of the inner ear that separates scala media from scala vestibuli. Therefore, it is the Reissner's membrane that is located on one side of the scala vestibuli, and not the basilar membrane. Letter C is wrong. The scala vestibuli opens into the vestibule. Nearby is the opening of the narrow cochlear aqueduct, through which passes the PERILYMPHATIC DUCT (and NOT the cochlear canaliculus) which connects the interior of the cochlea with the subdural space in the posterior cranial fossa. Letter D is wrong. The endolymph that is found within the scala media (not the scala vestibuli) is continuous with the endolymph of the saccule, communicating through the ductus reuniens (not reunions).

35. The conjoint tendon is formed from the lower part transversus abdominis muscle as it inserts into the crest of the pubis and pectineal line immediately behind the superficial inguinal ring. It is usually conjoint with the tendon of the abdominal internal oblique muscle.

36. ANSWER: D. (Hesselbach) Letter D is correct. A direct inguinal hernia protrudes thru a weakened area in the transversalis fascia near the medial inguinal fossa within an anatomic region known as the inguinal or Hesselbach's triangle. Letter A would have been correct if it said "inguinal triangle" instead of "inguinal canal". QUIERE GAT YO CASTIGA ESTE EL QUIEN YA HACE CON ESTE QUESTION. "HESSELBACH" Y HINDE HASSELBACH. EL QUIEN YA DISCUBRI CON EL TRIANGLE SI DR. FRANZ KASPAR HESSELBACH, UN ALEMAN CIRUJANO Y ANATOMISTA EN 1800'S. OTRO TAMEN QUEL SI HASSELBACH. EL SUYO VERDADERO NOMBRE DAVID HASSELBACH, UN ACTOR DE "BAYWATCH" Y "KNIGHT RIDER" ANTES. TATA TAMEN LE DE DAVID ARCHULETA. 37. ANSWER: C.

Lymphatic drainage of uterine CORNU: To the superficial inguinal lymph nodes via lymphatics of the round ligament. Lymphatic drainage of uterine FUNDUS: To the para-aortic lymph nodes via ovarian vessels. Lymphatic drainage of uterine BODY: To the internal then external iliac lymph nodes via the uterine vessels. Lymphatic drainage of uterine ISTHMUS & CERVIX: Two groups of lymphatics: >Primary groups: Paracervical, parametrial, obturator, internal and external iliac nodes. >Secondary groups: Common iliac, para-aortic, and lateral sacral lymph nodes. 38. ANSWER: D.

The testicular vein (or spermatic vein), the male gonadal vein, carries deoxygenated blood from its corresponding to the inferior vena cava or one of its tributaries. It is the male equivalent of the ovarian vein and is the venous counterpart of the testicular artery: It is a paired vein, with one supplying each testis:

>the right testicular vein generally joins the INFERIOR VENA CAVA. >the left testicular vein, unlike the right one, joins the LEFT RENAL VEIN instead of the inferior vena cava. 39. ANSWER: A. Mnemonics LMNOPQRST. L - Lateral arcuate ligament M - Medial arcuate ligament N - Nerves (Subcostal, Iliohypogastric, Ilioinguinal) O - Oh, diaphragm. P - Psoas major Q - Quadratus lumborum R - Ribs (11th (left kidney) and 12 (right kidney)) S - Subcostal vessels T - Tranversus abdominis 40. ANSWER: A

The omental foramen (Epiploic foramen, foramen of Winslow, or foramen epiploicum), is the passage of communication, or foramen, between the greater sac (general cavity (of the abdomen)), and the lesser sac. It has the following borders: 1.anterior: the free border of the lesser omentum, known as the hepatoduodenal ligament. This has two layers and within these layers are the common bile duct, hepatic artery, and hepatic portal vein. 2. posterior: the peritoneum covering the inferior vena cava 3. superior: the peritoneum covering the caudate lobe of the liver 4. inferior: the peritoneum covering the commencement of the duodenum and the hepatic artery, the latter passing forward below the foramen before ascending between the two layers of the lesser omentum. 5. left lateral: gastrosplenic ligament and splenorenal ligament

41. ANSWER: D. The splenorenal ligament (or lienorenal ligament, or phrenicolienal ligament ), is derived from the peritoneum, where the wall of the general peritoneal cavity comes into contact with the omental bursa between the left kidney and the spleen; the lienal vessels (SPLENIC ARTERY and VEIN) pass between its two layers. It contains the TAIL OF THE PANCREAS, the only intraperitoneal portion of the pancreas.

42. ANSWER: B Mnemonic for contents of broad ligament is : BROAD B – Bundle (ovarian neurovascular bundle – uterine artery) R – Round ligament O – Ovarian ligament A – Artifacts (vestigial structures) D – Duct (oviduct, fallopian tubes)

43. ANSWER: D In the GIT only the duodenum and the ascending colon possess NO mesentery. Even the appendix has a mesentery of its own.

44. ANSWER: This PRC question is erroneous. NO CORRECT ANSWER FROM THE CHOICES Because the hepatic portal vein is formed by the joining of the superior mesenteric and splenic veins. The portal vein receives blood from the inferior mesegastric vein, gastric vein, and the cystic vein. Ano ba yan. Nakaka high blood.

45. ANSWER: ERRONEOUS PRC QUESTION YA TAMEN??? A & B are correct because during development the ventral pancreatic bud fuses with the much

larger dorsal pancreatic bud. At this point of fusion, the main ducts of the ventral and dorsal pancreatic buds fuse, forming the duct of Wirsung, the main pancreatic duct.

46. ANSWER: B The esophageal opening/hiatus is a hole in the diaphragm through which the esophagus and the vagus nerve passes. It is located in the right crus of the diaphragm. It is located approximately at level of the tenth thoracic vertebra (T10). 47. ANSWER: B My Rectum begins as a continuation of sigmoid colon at the level of 3rd sacral vertebra. I don't know about other people's rectums.

48. ANSWER: D. .Referred pain from gallbladder disease is to the right shoulder and the right scapula. 49. ANSWER: B The inferior vena cava is on the right of the abdominal aorta, and the left renal vein which is a branch of the inferior vena cava crosses anterior to the abdominal aorta to drain the left kidney

50. Answer is D. No comment. I don't like bladders