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Question 1
Correct
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A 52-year-old male who is a known case of leukaemia visits the day unit for a blood transfusion. Five days later, he presents to the emergency department with a temperature of 38.5°C, and erythematous cutaneous eruptions.
What is the most likely explanation?Your Answer: Graft-versus-host disease
Explanation:This is transfusion-associated graft-versus-host disease (GvHD) occurring in an immunosuppressed patient. It can occur 4–30 days after a transfusion and follows a subacute pathway. Patients may also have diarrhoea and abnormal liver function tests. Management involves steroid therapy.
Acute transfusion reactions present during or within 24 hours of a blood transfusion. The most frequent clinical features are fever, chills, pruritus, or urticaria, which typically resolve promptly without specific treatment or complications. Other signs occurring in temporal relationship with a blood transfusion such as severe dyspnoea, pyrexia, or loss of consciousness may be the first indication of a more severe, potentially fatal reaction.
Transfusion reactions may be immune-mediated and non-immune-mediated. GvHD is a condition that might occur after an allogeneic transplant. The donated blood cells view the recipient’s body as foreign and attacks it. Immunosuppressed patients who receive white blood cells from another person are at increased risk of developing GvHD.
There are two forms of the disease:
1. Acute graft-versus-host disease (aGvHD): usually presents with skin and/or liver and/or gut involvement.
2. Chronic graft-versus-host disease (cGvHD).The diagnosis is clinical and usually one of exclusion; however, biopsy of affected tissues may be helpful in unclear cases.
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This question is part of the following fields:
- Post-operative Management And Critical Care
- Principles Of Surgery-in-General
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Question 2
Incorrect
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Which of the deep fasciae located in the anterolateral abdominal wall form the inguinal ligament?
Your Answer:
Correct Answer: External abdominal oblique aponeurosis
Explanation:The inguinal ligament is the inferior border of the aponeurosis of the external oblique abdominis and extends from the anterior superior iliac spine to the pubic tubercle from whence it is reflected backward and laterally to attach to the pectineal line and form the lacunar ligament.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 3
Incorrect
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Structures passing through the foramen magnum do NOT include the:
Your Answer:
Correct Answer: Vagus nerve
Explanation:Structures passing through the foramen magnum include the medulla, meninges, tectorial membrane, anterior spinal artery, vertebral artery and spinal branches of the accessory nerve.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 4
Incorrect
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What will the destruction of endoplasmic reticulum stop?
Your Answer:
Correct Answer: Synthesis of proteins
Explanation:The rough endoplasmic reticulum is the factory for the manufacturing of proteins. It contains ribosomes attached to it and transports proteins that are destined for membranes and secretions. The rough ER is connected to the nuclear envelope and to the cisternae of the Golgi apparatus by vesicles that shuttle between the two compartments.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 5
Incorrect
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A 53-year-old male undergoes an elective right hemicolectomy. A stapled ileocolic anastomosis is constructed. Eight hours later he becomes tachycardic and passes approximately 600ml of dark red blood per rectum. Which of the following processes is the most likely explanation for what happened?
Your Answer:
Correct Answer: Anastomotic staple line bleeding
Explanation:Complications related to stapled anastomoses include bleeding, device failure, and anastomotic failure, which include stricture or leak.
Stricture: Patient discomfort, need for additional procedures
Bleeding: Hemodynamic implications, difficult intraoperative visualization
Anastomotic leak: Increase in local recurrence, decreased overall survival, sepsis, need for diverting ostomy, increased hospital cost, increased use of hospital resources, decreased quality of life.
Anastomotic bleeding is a common complication of stapled anastomoses, and it can lead to hemodynamic instability and anaemia, sometimes requiring transfusion or additional procedures. To this end, there are efforts aimed at reducing staple line haemorrhage by using buttressing techniques. -
This question is part of the following fields:
- Principles Of Surgery-in-General
- Surgical Technique And Technology
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Question 6
Incorrect
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Which of the following statements regarding the femoral artery is CORRECT?
Your Answer:
Correct Answer: It has the femoral nerve lying lateral to it
Explanation:The femoral artery begins immediately behind the inguinal ligament, midway between the anterior superior spine of the ilium and the symphysis pubis. The first 4 cm of the vessel is enclosed, together with the femoral vein, in a fibrous sheath (the femoral sheath). The femoral nerve lies lateral to this.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 7
Incorrect
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The thyroid gland is a large ductless gland located in which part of the neck?
Your Answer:
Correct Answer: Visceral space
Explanation:The thyroid gland is an endocrine gland in the neck, consisting of two lobes connected by an isthmus. It is situated at the front and sides of the neck in the visceral space.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 8
Incorrect
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Chronic obstructive pulmonary disease (COPD) is likely to result in:
Your Answer:
Correct Answer: Respiratory acidosis
Explanation:COPD leads to respiratory acidosis (chronic). This occurs due to hypoventilation which involves multiple causes, such as poor responsiveness to hypoxia and hypercapnia, increased ventilation/perfusion mismatch leading to increased dead space ventilation and decreased diaphragm function.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 9
Incorrect
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A 30-year-old woman undergoes a laparotomy for a perforated duodenal ulcer and broad-spectrum antibiotics are administered. However, she develops hearing impairment postoperatively.
Which of the following agents is responsible for this adverse effect?Your Answer:
Correct Answer: Gentamicin
Explanation:Ototoxicity is a recognised adverse reaction with the aminoglycoside antibiotics.
Gentamicin belongs to a class of drugs known as aminoglycoside antibiotics. It is a broad-spectrum antibiotic that is most affective against aerobic gram-negative rods. Gentamicin acts by inhibiting bacterial protein synthesis. This creates a pool of inactive bacterial ribosomes that can no longer re-initiate and translate new proteins.
The hearing loss produced by gentamicin is known as gentamycin-induced ototoxicity. The antibiotic itself is not dangerous. It becomes toxic when it binds to iron in the blood and produces destructive chemical agents known as free radicals.
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This question is part of the following fields:
- Peri-operative Care
- Principles Of Surgery-in-General
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Question 10
Incorrect
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A 57-year-old male smoker noted a lump on his inner lip. Upon physical examination the lump measured more than 2 cm but less than 4 cm in its greatest dimension. He is diagnosed with squamous cell carcinoma of the lip. What is the stage of the patient's cancer according to the TNM staging for head and neck cancers?
Your Answer:
Correct Answer: T2
Explanation:Head and neck cancer is a group of cancers that starts within the mouth, nose, throat, larynx, sinuses, or salivary glands. The TNM staging system used for head and neck cancers is a clinical staging system that allows physicians to compare results across patients, assess prognosis, and design appropriate treatment regimens. The staging is as follows; Primary tumour (T): Tis: pre-invasive cancer (carcinoma in situ), T0: no evidence of primary tumour, T1: tumour 2 cm or less in its greatest dimension, T2: tumour more than 2 cm but not more than 4 cm, T3: tumour larger than 4 cm, T4: tumour with extension to bone, muscle, skin, antrum, neck, etc and TX: minimum requirements to assess primary tumour cannot be met. Regional lymph node involvement (N): N0: no evidence of regional lymph node involvement, N1: evidence of involvement of movable homolateral regional lymph nodes, N2: evidence of involvement of movable contralateral or bilateral regional lymph nodes, N3: evidence of involvement of fixed regional lymph nodes and NX: Minimum requirements to assess the regional nodes cannot be met. Distant metastases (M): M0: no evidence of distant metastases, M1: evidence of distant metastases and MX: minimum requirements to assess the presence of distant metastases cannot be met. Staging: Stage I: T1 N0 M0, Stage II: T2 N0 M0, Stage III: T2NOMO and T3N1MO, Stage IV: T4N1M0, any TN2M0, any TN3M0, any T and any NM1. The depth of infiltration is predictive of the prognosis. With increasing depth of invasion of the primary tumour, the risk of nodal metastasis increases and survival decreases. The patient in this scenario therefore has a T2 tumour.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 11
Incorrect
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A 28 year old man presents to his doctor with a painful mass underneath his left mandible. The mass has appeared over the previous week with the pain worsening as the lump has increased in size. On examination, a 3 cm mass underneath his mandible is seen but there is no associated lymphadenopathy. What is the most likely diagnosis?
Your Answer:
Correct Answer: Submandibular gland calculus
Explanation:Sialolithiasis (also termed salivary calculi, or salivary stones), is a condition where a calcified mass or sialolith forms within a salivary gland, usually in the duct of the submandibular gland (also termed Wharton’s duct).
Signs and symptoms are variable and depend largely upon whether the obstruction of the duct is complete or partial, and how much resultant pressure is created within the gland.
The development of infection in the gland also influences the signs and symptoms:
– Pain, which is intermittent, and may suddenly get worse before mealtimes, and then slowly get better (partial obstruction).
– Swelling of the gland, also usually intermittent, often suddenly appearing or increasing before mealtimes, and then slowly going down (partial obstruction).
– Tenderness of the involved gland.
– Palpable hard lump, if the stone is located near the end of the duct. If the stone is near the submandibular duct orifice, the lump may be felt under the tongue.
– Lack of saliva coming from the duct (total obstruction).
– Erythema (redness) of the floor of the mouth (infection).
– Pus discharging from the duct (infection).
– Cervical lymphadenitis (infection).
– Bad Breath.
– Rarely, when stones form in the minor salivary glands, there is usually only slight local swelling in the form of a small nodule and tenderness. -
This question is part of the following fields:
- Generic Surgical Topics
- Head And Neck Surgery
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Question 12
Incorrect
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A 41 year old lawyer presents with diarrhoea and bleeding from the rectum which has been occurring for the past 16 days. She has also noticed that she has had incontinence at night. What is her most likely diagnosis?
Your Answer:
Correct Answer: Inflammatory bowel disease
Explanation:Answer: Inflammatory bowel disease
Inflammatory bowel disease (IBD) is an idiopathic disease caused by a dysregulated immune response to host intestinal microflora. The two major types of inflammatory bowel disease are ulcerative colitis (UC), which is limited to the colonic mucosa, and Crohn disease (CD), which can affect any segment of the gastrointestinal tract from the mouth to the anus, involves skip lesions, and is transmural. There is a genetic predisposition for IBD, and patients with this condition are more prone to the development of malignancy.
Generally, the manifestations of IBD depend on the area of the intestinal tract involved. The symptoms, however, are not specific for this disease. They are as follows:
Abdominal cramping
Irregular bowel habits, passage of mucus without blood or pus
Weight loss
Fever, sweats
Malaise, fatigue
Arthralgias
Growth retardation and delayed or failed sexual maturation in children
Extraintestinal manifestations (10-20%): Arthritis, uveitis, or liver disease
Grossly bloody stools, occasionally with tenesmus: Typical of UC, less common in CD
Perianal disease (e.g., fistulas, abscesses): Fifty percent of patients with CD
The World Gastroenterology Organization (WGO) indicates the following symptoms may be associated with inflammatory damage in the digestive tract [1] :
Diarrhoea: mucus or blood may be present in the stool; can occur at night; incontinence may occur
Constipation: this may be the primary symptom in ulcerative colitis, when the disease is limited to the rectum; obstipation may occur and may proceed to bowel obstruction
Bowel movement abnormalities: pain or rectal bleeding may be present, as well as severe urgency and tenesmus
Abdominal cramping and pain: commonly present in the right lower quadrant in Crohn disease; occur peri umbilically or in the left lower quadrant in moderate to severe ulcerative colitis
Nausea and vomiting: occurs more often in Crohn disease than in ulcerative colitis
The nocturnal diarrhoea and incontinence are important symptoms in diagnosis IBD.
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This question is part of the following fields:
- Colorectal Surgery
- Generic Surgical Topics
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Question 13
Incorrect
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A 3 year old boy is awaiting surgery for a ruptured appendix and the nurse wants to give him an infusion of intravenous fluid whilst waiting for theatre. Given that his electrolytes are normal, which of the following infusion fluid would be appropriate?
Your Answer:
Correct Answer: 0.9% Saline solution
Explanation:Indications for IV fluids include:
– Resuscitation and circulatory support
– Replacing on-going fluid losses
– Maintenance fluids for children for whom oral fluids are not appropriate
– Correction of electrolyte disturbancesAccording to the NICE guidelines, if children and young people need IV fluid resuscitation, use glucose‑free crystalloids that contain sodium in the range 131–154 mmol/litre, with a bolus of 20 ml/kg over less than 10 minutes. Take into account pre‑existing conditions (for example, cardiac disease or kidney disease), as smaller fluid volumes may be needed.
All the others are contraindicated according to the guidelines as they are either made of glucose or are colloids.
Gelofusine is a 4% w/v solution of succinylated gelatine (also known as modified fluid gelatine) used as an intravenous colloid, and behaves much like blood filled with albumins.
Dextrose solution is a mixture of dextrose (glucose) and water. It is used to treat low blood sugar or water loss without electrolyte loss. Intravenous sugar solutions are in the crystalloid family of medications. They come in a number of strengths including 5%, 10%, and 50% dextrose.
0.45% saline/ 5% glucose solution also contains glucose hence it is contraindicated. -
This question is part of the following fields:
- Generic Surgical Topics
- Paediatric Surgery
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Question 14
Incorrect
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Which of the following muscles is solely contained in the anterior triangle of the neck and divides the anterior triangle into three smaller triangles?
Your Answer:
Correct Answer: Digastric
Explanation:The digastric muscle is a small muscle located under the jaw. It lies below the body of the mandible, and extends, in a curved form, from the mastoid process to the symphysis menti. The digastric divides the anterior triangle of the neck into three smaller triangles:
– The submaxillary triangle, bounded above by the lower border of the body of the mandible and a line drawn from its angle to the sternocleidomastoid, below by the posterior belly of the digastric and the stylohyoid and in front by the anterior belly of the digastric
– The carotid triangle, bounded above by the posterior belly of the digastric and stylohyoid, behind by the sternocleidomastoid and below by the omohyoid
– The suprahyoid or submental triangle, bounded laterally by the anterior belly of the digastric, medially by the midline of the neck from the hyoid bone to the symphysis menti and inferiorly by the body of the hyoid bone. -
This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 15
Incorrect
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An old man fell and fractured a carpal bone articulating with the pisiform bone. Which bone was most likely fractured?
Your Answer:
Correct Answer: Triquetral
Explanation:The pisiform bone has an oval facet for articulation with the triquetral bone. The pisiform bone is a sesamoid bone, and is anterior to the other carpal bones.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 16
Incorrect
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If your EEG shows waves with a frequency range of 8-12 Hz, the waves most likely to be seen are:
Your Answer:
Correct Answer: Alpha
Explanation:Electroencephalography (EEG) is the neurophysiological measurement of the electrical activity of the brain. It is done by placing electrodes on the scalp or subdurally. In reality, the electrical currents are not measured, but rather the voltage differences between different parts of the brain. Four major types of EEG activity are recognized, which are alpha, beta, delta and theta.
Alpha waves, also known as Berger’s waves ranges in frequency from 8-12 Hz. Best detected with eyes closed, alpha waves are characteristic of a relaxed, alert state of consciousness. An alpha-like normal variant called mu is sometimes seen over the motor cortex (central scalp) and attenuates with movement or, rather, with the intention to move. -
This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 17
Incorrect
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Raised alkaline phosphatase and positive antimicrobial antibody indicates which of the following conditions presenting with pruritus?
Your Answer:
Correct Answer: Primary biliary cirrhosis
Explanation:An autoimmune disease, primary biliary cirrhosis results in destruction of intrahepatic bile ducts. This leads to cholestasis, cirrhosis and eventually, hepatic failure. Symptoms includes fatigue, pruritus and steatorrhea. Increased IgM levels, along with antimitochondrial antibodies are seen in the serum. Liver biopsy is diagnostic, and also aids in staging of disease.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 18
Incorrect
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A surgeon trainee is assisting in an operation to ligate the ductus arteriosus. The consultant supervising explains that caution is required when placing a clamp on the ductus to avoid injury to an important structure immediately dorsal to it. To which structure is the consultant referring?
Your Answer:
Correct Answer: Left recurrent laryngeal nerve
Explanation:The left recurrent laryngeal nerve branches off the vagus and wraps around the aorta, posterior to the ductus arteriosus/ligamentum arteriosum from whence it courses superiorly to innervate the laryngeal muscles.
Accessory Hemiazygous vein is on the left side of the body draining the posterolateral chest wall and emptying blood into the azygos vein.
The left internal thoracic artery is branch of the left subclavian artery supplying blood to the anterior wall of the thorax.
Left phrenic nerve is lateral to the vagus nerve.
Thoracic duct: is behind the oesophagus, coursing between the aorta and the azygos vein in the posterior chest.
Right recurrent laryngeal nerve: loops around the right subclavian artery and is not in danger in this procedure. -
This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 19
Incorrect
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A 45-year-old female will undergo a diagnostic laparoscopy. Which of the agents listed below should be used for inducing pneumoperitoneum?
Your Answer:
Correct Answer: Carbon dioxide
Explanation:Laparoscopic surgery involves insufflation of a gas (usually carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum. This causes an increase in intra-abdominal pressure (IAP). Carbon dioxide is insufflated into the peritoneal cavity at a rate of 4–6 litre min−1 to a pressure of 10–20 mm Hg. The pneumoperitoneum is maintained by a constant gas flow of 200–400 ml min−1.
Carbon dioxide is the most frequently used gas for insufflation of the abdomen as it is colourless, non-toxic, non-flammable and has the greatest margin of safety in the event of a venous embolus (highly soluble). It is absorbed readily from the peritoneum, causing an increase in PaCO2. This has direct, as well as indirect (by raising catecholamine levels), effects on the cardiovascular system. Thus, tachycardia, increased cardiac contractility and reduction in the diastolic filling can result in decreased myocardial oxygen supply to demand ratio and greater risk of myocardial ischaemia.
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This question is part of the following fields:
- Principles Of Surgery-in-General
- Surgical Technique And Technology
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Question 20
Incorrect
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A 64 year old woman with metastatic breast cancer presents with bone pain. Radiological reports show a metastatic lytic lesion in her femoral shaft. The lesion occupies 75 percent of the bone diameter. Which of the following would be the most appropriate step in the management of this patient?
Your Answer:
Correct Answer: Fixation with intramedullary nail
Explanation:The role of surgery for bone metastasis can be divided into (i) prophylactic fixation to prevent impending pathological fractures, (ii) stabilization of a pathological fractures, (iii) segmental resection of tumours, and (iv) arthroplasty for replacing joints that have been destroyed by a tumour. To this end, orthopaedic surgeons have a vast array of surgical devices and implants in their surgical armamentarium at their disposal. These include plates and screws, intramedullary fixation devices, and tumour endoprostheses.
Even with surgical fixation only 30% of pathological fractures unite. -
This question is part of the following fields:
- Oncology
- Principles Of Surgery-in-General
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Question 21
Incorrect
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Fine-needle aspiration is a type of biopsy procedure. When performing a fine-needle aspiration of the lungs, which is the most common complication of the procedure?
Your Answer:
Correct Answer: Pneumothorax
Explanation:Pneumothorax is the most common complication of a fine-needle aspiration procedure. Various factors, such as lesion size, have been associated with increased risk of pneumothorax .
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 22
Incorrect
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Infection to all of the following will lead to enlargement of the superficial inguinal lymph nodes, except for:
Your Answer:
Correct Answer: Ampulla of the rectum
Explanation:The superficial inguinal lymph nodes form a chain immediately below the inguinal ligament. They receive lymphatic supply from the skin of the penis, scrotum, perineum, buttock and abdominal wall below the level of the umbilicus.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 23
Incorrect
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A 43 year old construction worker is rushed to the A&E department after complaining of chest pain after an episode of severe vomiting. He was found to be in shock. What would be his diagnosis?
Your Answer:
Correct Answer: Boerhaave’s syndrome
Explanation:Boerhaave syndrome refers to an oesophageal rupture secondary to forceful vomiting and retching. They are often associated with the clinical triad (Mackler’s triad) of vomiting, chest pain and subcutaneous emphysema. Other symptoms include epigastric pain, back pain, dyspnoea and shock. This condition was universally fatal before the age of surgery.
Ideal management for Boerhaave syndrome involves a combination of both conservative and surgical interventions.
Mainstays of therapy include the following:
– Intravenous volume resuscitation
– Administration of broad-spectrum antibiotics
– Prompt endoscopic and/or surgical intervention -
This question is part of the following fields:
- Generic Surgical Topics
- Upper Gastrointestinal Surgery
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Question 24
Incorrect
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A 27-year-old ski instructor who falls off a ski lift and sustains a spiral fracture of the midshaft of the tibia. Attempts to achieve a satisfactory position in plaster have failed. Overlying tissues are healthy. What is the most appropriate course of action?
Your Answer:
Correct Answer: Intramedullary nail
Explanation:Initially, all tibial shaft fractures should be stabilized with a long posterior splint with the knee in 10-15° of flexion and the ankle flexed at 90°
Closed fractures with minimal displacement or stable reduction may be treated nonoperatively with a long leg cast, but cast application should be delayed for 3-5 days to allow early swelling to diminish. The cast should extend from the midthigh to the metatarsal heads, with the ankle at 90° of flexion and the knee extended. The cast increases tibial stability and can decrease pain and swelling.
Despite proper casting techniques and adequate follow-up, not all nonoperatively treated tibial shaft fractures heal successfully.
Operative fixation is required when fractures are unstable. Surgical options include plating, external fixation, intramedullary nailing, and, in some cases, amputation.
Intramedullary nailing with locking screws (see the image below) has become the treatment of choice for most tibial shaft fractures. The prevalence of non-union and malunion is greatly decreased in comparison with the other methods of fixation. Patients are also able to return to low-impact activities much sooner than they can with the other treatments. -
This question is part of the following fields:
- Generic Surgical Topics
- Orthopaedics
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Question 25
Incorrect
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Which one of the following muscles is innervated by the facial nerve?
Your Answer:
Correct Answer: Buccinator
Explanation:Buccinator is a muscle of facial expression and is therefore innervated by the facial nerve. The lateral pterygoid, masseter, anterior belly of digastric and temporalis are all muscles of mastication and therefore innervated by the mandibular division of the trigeminal nerve.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 26
Incorrect
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A 54 year old man with end stage renal failure is undergoing a live donor renal transplant. The surgeon decides to implant the kidney in the left iliac fossa via a Rutherford Morrison incision. To which vessels should the transplanted kidney be anastomosed?
Your Answer:
Correct Answer: External iliac artery and vein
Explanation:For this procedure:
Following the preparation of the patient, a Rutherford-Morison incision was made at the right or left iliac fossa to access to the iliac vessels. Heparin (2500-4000 IU bolus) was given intravenously prior to the clamping of the iliac vessels. The renal artery was first anastomosed in an end-to-side fashion to the external iliac artery. The corner sutures (6/0 Prolene) were placed while the kidney allograft was first placed at the medial side of the incision. The lateral side of the renal artery was anastomosed by continuous suture using the 6/0 Prolene suture. The kidney allograft was then flipped to the lateral side and the medial side of the renal artery was anastomosed to the external iliac artery. The anastomosis was checked by placing a small vascular bulldog to the renal artery and the vascular clamp was released over the external iliac artery.Following the renal artery anastomosis, the renal vein was anastomosed in an end-to-side fashion to the external iliac vein. Two corner sutures (5/0 Prolene) were placed first, then the lateral side of renal vein anastomosis was performed with continuous sutures from inside the lumen, and then a medial side anastomosis was performed by continuous sutures from the outside of the lumen (Figure (Figure2).2). Similarly, the anastomosis was checked by placing a vascular clamp over the renal vein and then releasing the vascular clamp on the external iliac vein.
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This question is part of the following fields:
- Generic Surgical Topics
- Organ Transplantation
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Question 27
Incorrect
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What is the linea aspera:
Your Answer:
Correct Answer: Serves as an attachment for adductors of the thigh
Explanation:The linea aspera is a prominent longitudinal ridge or crest on the middle third of the femur. It has a medial and a lateral lip and a narrow, rough, intermediate line. The vastus medialis arises from the medial lip of the linea aspera and has superior and inferior prolongations. The vastus lateralis takes origin from the lateral lip . The adductor magnus is inserted into the linea aspera. Two muscles are attached between the vastus lateralis and the adductor magnus: the gluteus maximus is inserted above and the short head of the biceps femoris arises below. Four muscles are inserted between the adductor magnus and the vastus medialis: the iliacus and pectineus superiorly, and the adductor brevis and adductor longus inferiorly.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 28
Incorrect
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During strenuous exercise, what else occurs besides tachycardia?
Your Answer:
Correct Answer: Increased stroke volume
Explanation:During strenuous exercise there is an increase in:
– Heart rate, stroke volume and therefore cardiac output. (CO = HR x SV)
– Respiratory rate (hyperventilation) which will lead to a reduction in Paco2.
– Oxygen demand of skeletal muscle, therefore leading to a reduction in mixed venous blood oxygen concentration.
Renal blood flow is autoregulated, so renal blood flow is preserved and will tend to remain the same. Mean arterial blood pressure is a function of cardiac output and total peripheral resistance and will increase with exercise, mainly as a result of the increase in cardiac output that occurs. -
This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 29
Incorrect
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The gastrosplenic ligament also known as the gastrolienal ligament is the structure that connects the greater curvature of the stomach to the hilum of the spleen. Which of the following arteries would most likely be injured if a surgeon accidentally tore this ligament?
Your Answer:
Correct Answer: Short gastric
Explanation:The short gastric arteries arise from the end of the splenic arteries and form five to seven branches. The short gastric arteries inside the gastrosplenic ligament from the left to the right, supply the greater curvature of the stomach. The hepatic artery proper runs inside the hepatoduodenal ligament. The right gastric artery and the left gastric artery are contained in the hepatogastric ligament. The caudal pancreatic artery branches off from the splenic artery and supplies the tail of the pancreas. The middle colic artery supplies the transverse colon. The splenic artery does not travel in the gastrosplenic ligament and so it would not be damaged by a tear to this ligament.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 30
Incorrect
SESSION STATS - PERFORMANCE PER SPECIALTY
