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Question 1
Correct
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Which of the following movements does the iliacus muscle produce?
Your Answer: Flexion of the thigh at the hip joint
Explanation:The iliacus flexes the thigh at the hip joint when the trunk is stabilised. It flexes the trunk against gravity when the body is supine.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 2
Correct
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The muscles of the soft palate (other than the tensor veli palatini) are innervated by which of the following nerves:
Your Answer: Vagus nerve
Explanation:All of the muscles of the soft palate are innervated by the vagus nerve (from the pharyngeal plexus), except for the tensor veli palatini, which is innervated by a branch of the mandibular nerve.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 3
Correct
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A patient suffers a lower limb fracture that causes damage to the nerve that innervates peroneus longus.Peroneus longus receives its innervation from which of the following nerves? Select ONE answer only.
Your Answer: Superficial peroneal nerve
Explanation:Peroneus brevis is innervated by the superficial peroneal nerve.Peroneus longus is innervated by the superficial peroneal nerve.Peroneus tertius is innervated by the deep peroneal nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 4
Incorrect
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A 26-year-old man is involved in a motorcycle accident that results in an open fracture of his tibia and fibula. The nerve that innervates peroneus tertius is damaged as a consequence of his injuries.Peroneus tertius receives its innervation from which of the following nerves? Select ONE answer only.
Your Answer: Superficial peroneal nerve
Correct Answer: Deep peroneal nerve
Explanation:Peroneus brevis is innervated by the superficial peroneal nerve.Peroneus longus is innervated by the superficial peroneal nerve.Peroneus tertius is innervated by the deep peroneal nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 5
Incorrect
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Regarding aspirin at analgesic doses, which of the following statements is CORRECT:
Your Answer: The analgesic dose is smaller than the antiplatelet dose.
Correct Answer: It is contraindicated in patients with severe heart failure.
Explanation:Aspirin (at analgesic doses) is contraindicated in severe heart failure. Aspirin irreversibly inhibits cyclooxygenase (COX) enzymes resulting in decreased production of prostaglandins (which can lead to irritation of the gastric mucosa). The analgesic dose is greater than the antiplatelet dose, and taken orally it has a duration of action of about 4 hours. Clinical features of salicylate toxicity in overdose include hyperventilation, tinnitus, deafness, vasodilatation, and sweating.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 6
Incorrect
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A patient with a stab wound to the axilla arrives to the emergency department. You notice weakness in elbow flexion and forearm supination during your assessment. Which of these nerves has been affected:
Your Answer: Radial nerve
Correct Answer: Musculocutaneous nerve
Explanation:The musculocutaneous nerve is relatively protected in the axilla, hence injury to it is uncommon. A stab wound in the axilla is the most prevalent source of damage. Because of the activities of the pectoralis major and deltoid, the brachioradialis, and the supinator muscles, arm flexion and forearm flexion and supination are diminished but not completely lost. Over the lateral part of the forearm, there is a lack of sensation.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 7
Correct
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If a lesion is observed in Broca's area, which function is expected to become affected?
Your Answer: Formation of words
Explanation:The primary functions of the Broca area are both language production and comprehension. While the exact role in the production is still unclear, many believe that it directly impacts the motor movements to allow for speech. Although originally thought to only aid in speech production, lesions in the area can rarely be related to impairments in the comprehension of language. Different regions of the Broca area specialize in various aspects of comprehension. The anterior portion helps with semantics, or word meaning, while the posterior is associated with phonology, or how words sound. The Broca area is also necessary for language repetition, gesture production, sentence grammar and fluidity, and the interpretation of others’ actions.Broca’s aphasia is a non-fluent aphasia in which the output of spontaneous speech is markedly diminished and there is a loss of normal grammatical structure. Specifically, small linking words, conjunctions, such as and, or, and but, and the use of prepositions are lost. Patients may exhibit interjectional speech where there is a long latency, and the words that are expressed are produced as if under pressure. The ability to repeat phrases is also impaired in patients with Broca’s aphasia. Despite these impairments, the words that are produced are often intelligible and contextually correct. In pure Broca’s aphasia, comprehension is intact.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 8
Incorrect
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Which of the following is NOT a typical feature of lithium toxicity:
Your Answer: Ataxia
Correct Answer: Miosis
Explanation:Features of toxicity include:Increasing gastrointestinal disturbances (vomiting, diarrhoea, anorexia)Visual disturbancesPolyuria and incontinenceMuscle weakness and tremorTinnitusCNS disturbances (dizziness, confusion and drowsiness increasing to lack of coordination, restlessness, stupor)Abnormal reflexes and myoclonusHypernatraemiaWith severe overdosage (serum-lithium concentration > 2 mmol/L) seizures, cardiac arrhythmias (including sinoatrial block, bradycardia and first-degree heart block), blood pressure changes, electrolyte imbalance, circulatory failure, renal failure, coma and sudden death may occur.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 9
Incorrect
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A 33-year-old woman demonstrates right-sided superior homonymous quadrantanopia upon visual field testing. A diagnosis of a brain tumour has been established.Which of the following anatomical points in the visual pathway has the lesion occurred?
Your Answer: Upper optic radiation
Correct Answer: Lower optic radiation
Explanation:Homonymous quadrantanopia is not a disease; it is a clinical finding that points towards a lesion of the optic radiations coursing through the temporal lobe.Homonymous superior quadrantanopia is caused by damage to the contralateral inferior parts of the posterior visual pathway: the inferior optic radiation (temporal Meyer loop), or the inferior part of the occipital visual cortex below the calcarine fissure.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 10
Incorrect
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A 21-year-old student presents to the minors area of your Emergency Department with a laceration on his external nose that occurred during sparring in a kickboxing class. The area is bleeding profusely and will require suturing. Pressure is being applied. The laceration extends through some of the nasal muscles.Motor innervation of the nasal muscles of facial expression is provided by which of the following ? Select ONE answer only.
Your Answer: Trigeminal nerve
Correct Answer: Facial nerve
Explanation:The facial nerve (the labyrinthine segment) is the seventh cranial nerve, or simply CN VII. It emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue.Motor innervation of the nasal muscles of facial expression is provided by the facial nerve (CN VII).
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 11
Incorrect
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In which of the following cases is intravenous phenytoin contraindicated?
Your Answer: Renal impairment
Correct Answer: Second degree heart block
Explanation:Phenytoin Contraindications include:HypersensitivitySinus bradycardiaSinoatrial blockSecond and third degree A-V blockAdams-Stokes syndromeConcurrent use with delavirdineHistory of prior acute hepatotoxicity attributable to phenytoin
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 12
Incorrect
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A 30-year old male is taken to the emergency room after suffering a blunt trauma to the abdomen. He is complaining of severe abdominal pain, however all his other vital signs remain stable. A FAST scan is performed to assess for hemoperitoneum.If hemoperitoneum is present, it is most likely to be observed in which of the following areas?
Your Answer: Spleen
Correct Answer: Liver
Explanation:The Focused Assessment with Sonography in Trauma (FAST) is an ultrasound protocol developed to assess for hemoperitoneum and hemopericardium. Numerous studies have demonstrated sensitivities between 85% to 96% and specificities exceeding 98%.The FAST exam evaluates four regions for pathologic fluid: (1) the right upper quadrant, (2) the subxiphoid (or subcostal) view, (3) the left upper quadrant, and (4) the suprapubic region.The right upper quadrant (RUQ) visualizes the hepatorenal recess, also known as Morrison’s pouch, the right paracolic gutter, the hepato-diaphragmatic area, and the caudal edge of the left liver lobe. The probe is positioned in the sagittal orientation along the patient’s flank at the level of the 8 to 11 rib spaces. The hand is placed against the bed to ensure visualization of the retroperitoneal kidney. The RUQ view is the most likely to detect free fluid with an overall sensitivity of 66%. Recent retrospective evidence suggests the area along the caudal edge of the left lobe of the liver has the highest sensitivity, exceeding 93%.
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This question is part of the following fields:
- Abdomen And Pelvis
- Anatomy
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Question 13
Incorrect
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A patient suffers a stab wound to the neck. The entry point of the blade is situated within the posterior triangle of the neck.Which of the following muscles is most likely to be involved? Select ONE answer only.
Your Answer: Sternocleidomastoid
Correct Answer: Anterior scalene
Explanation:The anterior triangle is the triangular area of the neck found anteriorly to the sternocleidomastoid muscle. It is formed by the anterior border of sternocleidomastoid laterally, the median line of the neck medially and by the inferior border of the mandible superiorly. The apex of the anterior triangle extends towards the manubrium sterni. The anterior triangle contains:Muscles: thyrohyoid, sternothyroid, sternohyoid musclesOrgans: thyroid gland, parathyroid glands, larynx, trachea, esophagus, submandibular gland, caudal part of the parotid glandArteries: superior and inferior thyroid, common carotid, external carotid, internal carotid artery (and sinus), facial, submental, lingual arteriesVeins: anterior jugular veins, internal jugular, common facial, lingual, superior thyroid, middle thyroid veins, facial vein, submental vein, lingual veinsNerves: vagus nerve (CN X), hypoglossal nerve (CN XII), part of sympathetic trunk, mylohyoid nerveThe posterior triangle is a triangular area found posteriorly to the sternocleidomastoid muscle. It has three borders; anterior, posterior and inferior borders. The anterior border is the posterior margin of the sternocleidomastoid muscle. The posterior border is the anterior margin of the trapezius muscle, while the inferior border is the middle one-third of the clavicle. The investing layer of deep cervical fascia and integument forms the roof of the space, while the floor is covered with the prevertebral fascia along with levator scapulae, splenius capitis and the scalene muscles. The inferior belly of omohyoid subdivides the posterior triangle into a small supraclavicular, and a large occipital, triangle.Contents:Vessels: the third part of the subclavian artery, suprascapular and transverse cervical branches of the thyrocervical trunk, external jugular vein, lymph nodesNerves: accessory nerve (CN XI), the trunks of the brachial plexus, fibers of the cervical plexusOf the muscles listed in the options, only the anterior scalene is situated within the posterior triangle of the neck.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 14
Incorrect
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Which of the following is most likely to cause a homonymous hemianopia:
Your Answer: Pituitary adenoma
Correct Answer: Posterior cerebral artery stroke
Explanation:A posterior cerebral stroke will most likely result in a contralateral homonymous hemianopia with macular sparing.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 15
Incorrect
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A patient presents with an adducted eye at rest which cannot abduct past the midline, which of the following cranial nerves is most likely to be affected:
Your Answer: Oculomotor nerve
Correct Answer: Abducens nerve
Explanation:Abducens nerve palsies result in a convergent squint at rest (eye turned inwards) with inability to abduct the eye because of unopposed action of the rectus medialis. The patient complains of horizontal diplopia when looking towards the affected side. With complete paralysis, the eye cannot abduct past the midline.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 16
Incorrect
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Which of the following clinical features would you NOT expect to see in a tibial nerve palsy:
Your Answer:
Correct Answer: Weakened eversion of the foot
Explanation:Damage to the tibial nerve results in loss of plantarflexion of the ankle and weakness of inversion of the foot resulting in a shuffling gait, clawing of the toes and loss of sensation in its cutaneous distribution.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 17
Incorrect
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Which of the following occurs primarily to produce passive expiration:
Your Answer:
Correct Answer: Relaxation of diaphragm and external intercostal muscles
Explanation:Passive expiration is produced primarily by relaxation of the inspiratory muscles (diaphragm and external intercostal muscles) and the elastic recoil of the lungs. In expiration, depression of the sternal ends of the ribs (‘pump handle’ movement), depression of the lateral shafts of the ribs (‘bucket handle’ movement) and elevation of the diaphragm result in a reduction of the thorax in an anteroposterior, transverse and vertical direction respectively. This results in a decreased intrathoracic volume and increased intrathoracic pressure and thus air is forced out of the lungs.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 18
Incorrect
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Which of the following is NOT a typical cerebellar sign:
Your Answer:
Correct Answer: Resting tremor
Explanation:An intention tremor is characteristic of cerebellar dysfunction. Resting tremor may be seen in Parkinsonism.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 19
Incorrect
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Which lobe of the prostate gland is most commonly affected in prostatic carcinoma?
Your Answer:
Correct Answer: Posterior
Explanation:The periurethral portion of the prostate gland increases in size during puberty and after the age of 55 years due to the growth of non-malignant cells in the transition zone of the prostate that surrounds the urethra. Most cancers develop in the posterior lobe, and cancers in this location may be palpated during a digital rectal examination (DRE).
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This question is part of the following fields:
- Abdomen And Pelvis
- Anatomy
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Question 20
Incorrect
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A patient suffers a lower limb fracture that causes damage to the nerve that innervates peroneus brevis.Peroneus brevis receives its innervation from which of the following nerves? Select ONE answer only.
Your Answer:
Correct Answer: Superficial peroneal nerve
Explanation:Peroneus brevis is innervated by the superficial peroneal nerve.Peroneus longus is innervated by the superficial peroneal nerve.Peroneus tertius is innervated by the deep peroneal nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 21
Incorrect
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A 30-year-old carpenter presented to the emergency room with a laceration of his upper volar forearm. Upon further exploration and observation, it was revealed that the nerve that innervates the pronator teres muscle has been damaged. Which of the following nerves is most likely damaged in the case?
Your Answer:
Correct Answer: The median nerve
Explanation:Pronator teres syndrome (PTS) is caused by a compression of the median nerve (MN) by the pronator teres (PT) muscle in the forearm. The median nerve, C6 and C7, innervates the pronator teres.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 22
Incorrect
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Which of the following occurs at the transverse thoracic plane:
Your Answer:
Correct Answer: Bifurcation of the trachea
Explanation:A way to help remember the structures transected by the transverse thoracic plane is CLAPTRAP:C: cardiac plexusL: ligamentum arteriosumA: aortic arch (inner concavity)P: pulmonary trunkT: tracheal bifurcation (carina)R: right-to-left movement of the thoracic duct (posterior to the oesophagus)A: azygos vein drains into superior vena cavaP: pre-vertebral fascia and pre-tracheal fascia end
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 23
Incorrect
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You have been asked to give a tutorial on common upper limb neurology to a group of medical students. You use the example of a man falling from a balcony onto spiked fencing, sustaining a puncture wound to the axilla. This results in an injury to the musculocutaneous nerve. Which of the following clinical features would you LEAST expect to see in this patient:
Your Answer:
Correct Answer: Weakness of forearm pronation
Explanation:Flexion of the arm and flexion and supination of the forearm are weakened but not lost entirely due to the actions of the pectoralis major and deltoid, the brachioradialis and the supinator muscles respectively. There is loss of sensation over the lateral aspect of the forearm. Forearm pronation would not be affected as this is primarily produced by the pronator quadratus and pronator teres muscles, innervated by the median nerve.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 24
Incorrect
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A 44 year old woman sustains an injury to the median nerve at the elbow after falling awkwardly. Which of the following clinical features are you LEAST likely to see on examination:
Your Answer:
Correct Answer: Loss of flexion of the medial two digits
Explanation:Flexion of the index and middle fingers at the IPJs is lost due to paralysis of the flexor digitorum superficialis and the lateral half of the flexor digitorum profundus. Flexion of the MCPJs of the index and middle fingers are lost due to paralysis of the lateral two lumbrical muscles. Flexion of the ring and little fingers are preserved as these are supported by the medial half of the flexor digitorum profundus and the medial two lumbrical muscles, innervated by the ulnar nerve.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 25
Incorrect
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In adults, there are normally how many teeth:
Your Answer:
Correct Answer: 32
Explanation:In adults, there are 32 teeth, 16 in the upper jaw and 16 in the lower jaw. On each side in both upper and lower arches, there are two incisors, one canine, two premolars and three molar teeth.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 26
Incorrect
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Which of the following classes of drugs may predispose to lithium toxicity:
Your Answer:
Correct Answer: Thiazide diuretics
Explanation:Excretion of lithium may be reduced by thiazide diuretics, NSAIDs, and ACE inhibitors thus predisposing to lithium toxicity. Loop diuretics also cause lithium retention but are less likely to result in lithium toxicity.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 27
Incorrect
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A 38-year-old taxi driver sustained blunt force trauma to his anterior chest from the steering wheel of his car after falling asleep while driving headlong into an oncoming HGV lorry. Bruising around his sternum was observed, which appears to be the central point of impact. Which of the following structures is most likely injured by the blunt force trauma?
Your Answer:
Correct Answer: Right ventricle
Explanation:In its typical anatomical orientation, the heart has 5 surfaces formed by different internal divisions of the heart:Anterior (or sternocostal) – Right ventriclePosterior (or base) – Left atriumInferior (or diaphragmatic) – Left and right ventriclesRight pulmonary – Right atriumLeft pulmonary – Left ventricle
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 28
Incorrect
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An injury to the brachial plexus can cause Erb's palsy. The following is expected to happen to a patient suffering from this condition, except for which one:
Your Answer:
Correct Answer: Weakness of medial rotation of the arm
Explanation:Erb’s palsy can be caused by a traumatic force downward on the upper arm and shoulder that damages the upper root of the brachial plexus. The patient will lose shoulder abduction (deltoid, supraspinatus), shoulder external rotation (infraspinatus), and elbow flexion as a result of this condition (biceps, brachialis).
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 29
Incorrect
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In the emergency department, a 50-year-old female appears with a lack of sensation over the front two-thirds of her tongue. Taste and salivation are both present. The patient might have damage which of her nerves?
Your Answer:
Correct Answer: Lingual nerve
Explanation:The lingual nerve, a branch of the mandibular nerve, transmits sensation to the anterior two-thirds of the tongue. The chorda tympani, a branch of the facial nerve, transmits taste to the front two-thirds of the tongue as well as secretomotor innervation to the submandibular and sublingual glands. As a result, any damage to the lingual nerve can cause changes in salivary secretion on the affected side, as well as a loss of taste in the anterior two-thirds of the tongue and temporary or permanent sensory changes in the anterior two-thirds of the tongue and the floor of the mouth.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 30
Incorrect
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Which of the following statements concerning the facial nerve is INCORRECT?
Your Answer:
Correct Answer: Forehead sparing in facial nerve palsy is indicative of a lower motor neuron lesion.
Explanation:In facial nerve palsy, LMN damage will involve the forehead and there will be an inability to close the eyes due to paralysis of the orbicularis oculi or raise the eyebrows due to paralysis of the occipitofrontalis muscle.UMN damage causes sparing of the forehead as the occipitofrontalis and orbicularis oculi muscles have bilateral cortical representation.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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SESSION STATS - PERFORMANCE PER SPECIALTY
