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Question 1
Incorrect
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A 16-year old boy is brought to the emergency room after suffering a traffic accident. Upon examination, there is noted ipsilateral loss of proprioception and vibration, ipsilateral motor loss, and contralateral loss of pain and temperature sensation. A spinal cord injury is given as a diagnosis.
Which of the following is the most probable cause of this manifestation?Your Answer:
Correct Answer: Brown-Séquard syndrome
Explanation:Brown-Sequard Hemicord Syndrome consists of ipsilateral weakness (corticospinal tract) and loss of joint position and vibratory sense (posterior column), with contralateral loss of pain and temperature sense (spinothalamic tract) one or two levels below the lesion. Segmental signs, such as radicular pain, muscle atrophy, or loss of a deep tendon reflex, are unilateral. Partial forms are more common than the fully developed syndrome.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 2
Incorrect
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A 30 year old man presents to ED after a road traffic accident. Free intraperitoneal fluid is found on FAST (Focussed assessment for sonography in trauma) done in the supine position.
Which of these is most likely to be affected?
Your Answer:
Correct Answer: Hepatorenal recess
Explanation:Fluid accumulates most often in the hepatorenal pouch (of Morrison) in a supine patient. The hepatorenal pouch is located behind the liver and anterior to the right kidney and is the lowest space in the peritoneal cavity in the supine position.
Although the vesicouterine and rectouterine spaces are also potential spaces for fluid accumulation, fluid accumulation in them occur in the erect position.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 3
Incorrect
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A 29-year-old man has been complaining about his recent headaches. Detailed history was taken and a neurological examination was performed.
Which of the following cranial nerves is correctly paired with its lesion?Your Answer:
Correct Answer: The oculomotor nerve: the eye appears to look ‘down and out’
Explanation:The following are the lesions of the cranial nerves:
1. Olfactory nerve (I)
Reduced taste and smell, but not to ammonia which stimulates the pain fibres carried in the trigeminal nerve2. Optic nerve (II)
Manifested by visual field defects, pupillary abnormalities, optic neuritis, optic atrophy, papilledema3. Oculomotor nerve (III)
A fixed, dilated pupil which doesn’t accommodate, ptosis, complete internal ophthalmoplegia (masked by ptosis), unopposed lateral rectus causes outward deviation of the eye. If the ocular sympathetic fibres are also affected behind the orbit, the pupil will be fixed but not dilated.4. Trochlear nerve (IV)
Diplopia due to weakness of downward and inward eye movement. The most common cause of a pure vertical diplopia. The patient tends to compensate by tilting the head away from the affected side.5. Trigeminal nerve (V)
Reduced sensation or dysesthesia over the affected area. Weakness of jaw clenching and side-to-side movement. If there is a lower motor neuron (LMN) lesion, the jaw deviates to the weak side when the mouth is opened. There may be fasciculation of temporalis and masseter.6. Abducens nerve (VI)
Inability to look laterally. The eye is deviated medially because of unopposed action of the medial rectus muscle.7. Facial nerve (VII)
Facial weakness. In an LMN lesion the forehead is paralysed – the final common pathway to the muscles is destroyed; whereas the upper facial muscles are partially spared in an upper motor neurone (UMN) lesion because of alternative pathways in the brainstem. There appear to be different pathways for voluntary and emotional movement. CVAs usually weaken voluntary movement, often sparing involuntary movements (e.g., spontaneous smiling). The much rarer selective loss of emotional movement is called mimic paralysis and is usually due to a frontal or thalamic lesion.8. Vestibulocochlear nerve (VIII)
Unilateral sensorineural deafness, tinnitus. Slow-growing lesions seldom present with vestibular symptoms as compensation has time to occur.9. Glossopharyngeal nerve (IX)
Unilateral lesions do not cause any deficit because of bilateral corticobulbar connections. Bilateral lesions result in pseudobulbar palsy. These nerves are closely interlinked.10. Vagus nerve (X)
Palatal weakness can cause ‘nasal speech’ and nasal regurgitation of food. The palate moves asymmetrically when the patient says ‘ahh’. Recurrent nerve palsy results in hoarseness, loss of volume and ‘bovine cough’.11. Accessory nerve (XI)
Weakness and wasting of sternocleidomastoid and trapezius muscles12.Hypoglossal nerve (XII)
An LMN lesion produces wasting of the ipsilateral side of the tongue, with fasciculation; and on attempted protrusion the tongue deviates towards the affected side, but the tongue deviates away from the side of a central lesion. -
This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 4
Incorrect
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An 11-year-old boy was brought to the emergency room due to fever and pain in the ears. Upon physical examination, it was observed that the mastoid area is erythematous and there is a presence of a boggy, tender mass. A diagnosis of acute mastoiditis was made.
Which of the following parts of the temporal bone is most likely involved?Your Answer:
Correct Answer: Petrous part
Explanation:Mastoiditis is the inflammation of a portion of the temporal bone referred to as the mastoid air cells. The mastoid air cells are epithelium lined bone septations that are continuous with the middle ear cavity.
The temporal bone is composed of four parts: the mastoid process, the petrous pyramid, the squamous, and tympanic portions. The mastoid process and the petrous pyramid are the portions of particular interest because of the prevalence of suppurations within these parts of the temporal bone.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 5
Incorrect
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A 25-year-old footballer develops pain and stiffness in his thigh. A diagnosis of iliopsoas syndrome is made.
Iliacus is innervated by which of the following nerves? Select ONE answer only.Your Answer:
Correct Answer: Femoral nerve
Explanation:Iliacus is innervated by the femoral nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 6
Incorrect
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A 34-year-old man presented to the emergency room after being involved in a road traffic accident. Upon observation and examination, it was noted that he was hypotensive and has muffled heart sounds. It was suspected that he has pericardial effusion, so an emergency pericardiocentesis was to be performed.
In performing pericardiocentesis for suspected pericardial effusion, which of the following anatomical sites are at risk of being punctured?Your Answer:
Correct Answer: 1 cm below the left xiphocostal angle
Explanation:Pericardiocentesis is a procedure done to remove fluid build-up in the sac around the heart known as the pericardium. The pericardium can be tapped from almost any reasonable location on the chest wall. However, for the usual blind pericardiocentesis, the subxiphoid approach is preferred. Ideally, 2-D echocardiography is used to guide needle insertion and the subsequent path of the needle/catheter.
In the subxiphoid approach, the needle is inserted 1 cm inferior to the left xiphocostal angle with an angle of 30 degrees from the patient’s chest with a direction towards the left mid-clavicle.
The fingers may sense a distinct give when the needle penetrates the parietal pericardium. Successful removal of fluid confirms the needle’s position.
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This question is part of the following fields:
- Abdomen And Pelvis
- Anatomy
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Question 7
Incorrect
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A 25-year old male is brought to the emergency room after a traffic accident. Upon examination, there was tenderness and erythema on the right acromioclavicular joint, with notable step deformity. On radiographic imaging, there is a superior elevation of the clavicle, a twice than normal coracoclavicular distance, and absence of fracture.
Which of the following structure/s is/are likely to have ruptured?Your Answer:
Correct Answer: Acromioclavicular ligament, coracoclavicular ligament and joint capsule
Explanation:Acromioclavicular joint injuries account for more than forty percent of all shoulder injuries. Mild injuries are not associated with any significant morbidity, but severe injuries can lead to significant loss of strength and function of the shoulder. Acromioclavicular injuries may be associated with a fractured clavicle, impingement syndromes, and more rarely neurovascular insults.
The AC joint is a diarthrodial joint defined by the lateral process of the clavicle articulating with the acromion process as it projects anteriorly off the scapula. The joint is primarily stabilized by the acromioclavicular ligament, which is composed of an anterior, posterior, inferior, and superior component. Of note, the superior portion of the AC ligament is the most important component for the stability of the AC joint. Supporting structures include two coracoclavicular ligaments (trapezoid and conoid ligaments), which provide vertical stability, as well as the coracoacromial ligament.
Patients with an AC joint injury typically present with anterosuperior shoulder pain and will describe a mechanism of injury of blunt trauma to the abducted shoulder or landing on an outstretched arm, suggestive of this type of injury. They may describe pain radiating to the neck or shoulder, which is often worse with movement or when they try to sleep on the affected shoulder. On examination, the clinician may observe swelling, bruising, or a deformity of the AC joint, depending on the degree of injury. The patient will be tender at that location. They may have a restriction in the active and passive range of motion secondary to pain. Piano key sign may be seen, with an elevation of the clavicle that rebounds after inferior compression.
Standard X-rays are adequate to make a diagnosis of acromioclavicular joint injury and should be used to evaluate for other causes of traumatic shoulder pain.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 8
Incorrect
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Carbamazepine is indicated for all of the following EXCEPT for:
Your Answer:
Correct Answer: Myoclonic seizures
Explanation:Carbamazepine is a drug of choice for simple and complex focal seizures and is a first-line treatment option for generalised tonic-clonic seizures. It is also used in trigeminal neuralgia and diabetic neuropathy. Carbamazepine may exacerbate tonic, atonic, myoclonic and absence seizures and is therefore not recommended if these seizures are present.
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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 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 10
Incorrect
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Where on the body is the radial artery pulsation best palpated?
Your Answer:
Correct Answer: At the wrist just lateral to the flexor carpi radialis tendon
Explanation:The radial artery lies lateral to the large tendon of the flexor carpi radialis muscle and anterior to the pronator quadratus at the distal end of the radius. The flexor carpi radialis muscle is used as a landmark in locating the pulse.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 11
Incorrect
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The following statements are not true of the flexor digiti minimi brevis, except?
Your Answer:
Correct Answer: It is situated on the radial border of abductor digiti minimi
Explanation:Flexor digiti minimi brevis muscle is located on the ulnar side of the palm, lying on the radial border of the abductor digiti minimi. Together with the abductor digiti minimi and opponens digiti minimi muscles, it forms the hypothenar eminence. The muscle is situated inferior and lateral to adductor digiti minimi muscle and superior and medial to opponens digiti minimi muscle. The proximal parts of flexor digiti minimi brevis and abductor digiti minimi muscles form a gap through which deep branches of the ulnar artery and ulnar nerve pass.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 12
Incorrect
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Which of the following would you NOT expect from a deep fibular nerve palsy:
Your Answer:
Correct Answer: Loss of sensation over heel
Explanation:Damage to the deep fibular nerve results in loss of dorsiflexion of the ankle, with resultant foot drop with high-stepping gait, loss of toe extension, weakness of foot inversion and loss of sensation over the webspace between the 1st and 2nd toes.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 13
Incorrect
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A 36-year-old man who works in a farm presents with a deep laceration over the palm of his hand. A median nerve block was performed at his wrist to facilitate wound exploration and closure.
Which of the following statements regarding median nerve blocks at the wrist is considered correct?Your Answer:
Correct Answer: The needle should be inserted approximately 2.5 cm proximal to flexor retinaculum
Explanation:A median nerve block is a simple, safe, and effective method of obtaining anaesthesia to the palmar aspect of the thumb, index finger, middle finger, radial portion of the palm and ring finger. The median nerve lies deep to the flexor retinaculum and about one centimetre under the skin of the volar wrist.
The palmaris longus tendon lies superficial to the retinaculum and is absent in up to 20% of patients.
The median nerve is located slightly lateral (radial) to the palmaris longus tendon and medial (ulnar) to the flexor carpi radialis tendon.The procedure is as follows:
– Check sensation and motor function of the median nerve. Wear gloves and use appropriate barrier precautions.
– Locate the flexor carpi radialis and palmaris longus tendons, which become prominent when the patient flexes the wrist against resistance. The palmaris longus tendon is usually the more prominent of the two tendons.
– Needle-entry site: The needle will be inserted adjacent to the radial (lateral) border of the palmaris longus tendon just proximal to the proximal wrist crease. If the palmaris longus tendon is absent, the needle-entry site is about 1 cm ulnar to the flexor carpi radialis tendon.
– Cleanse the site with antiseptic solution. Place a skin wheal of anaesthetic, if one is being used, at the needle-entry site.
– Insert the needle perpendicularly through the skin and advance it slowly until a slight pop is felt as the needle penetrates the flexor retinaculum. When paraesthesia in the distribution of the median nerve confirms proper needle placement, withdraw the needle 1 to 2 mm.
– Aspirate to exclude intravascular placement and then slowly (i.e., over 30 to 60 seconds) inject about 3 mL of anaesthetic. If the patient does not feel paraesthesia, redirect the needle in an ulnar direction, under the palmaris longus tendon. If paraesthesia is still not felt, slowly inject 3 to 5 mL of anaesthetic in the proximity of the nerve 1 cm deep to the tendon.
– Allow about 5 to 10 minutes for the anaesthetic to take effect. -
This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 14
Incorrect
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Which of the following is NOT a typical side effect of opioid analgesics:
Your Answer:
Correct Answer: Diarrhoea
Explanation:All opioids have the potential to cause:
Gastrointestinal effects – Nausea, vomiting, constipation, difficulty with micturition (urinary retention), biliary spasm
Central nervous system effects – Sedation, euphoria, respiratory depression, miosis
Cardiovascular effects – Peripheral vasodilation, postural hypotension
Dependence and tolerance -
This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 15
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 16
Incorrect
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A 55 year old man presents to ED complaining of leg weakness. Your colleague has examined the patient and suspects femoral nerve palsy. Which of the following clinical features would you LEAST expect to see on examination of this patient:
Your Answer:
Correct Answer: Weakness of hip extension
Explanation:Damage to the femoral nerve results in weakness of hip flexion and knee extension and loss of sensation over the anterior thigh and the anteromedial knee, medial leg and medial foot.
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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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A patient suffers an injury to his thigh that damages the nerve that innervates pectineus.
Which of the following nerves has been damaged in this case? Select ONE answer only.Your Answer:
Correct Answer: Femoral nerve
Explanation:Pectineus is innervated by the femoral nerve. It may also receive a branch from the obturator nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 18
Incorrect
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Needle thoracentesis in a patient with tension pneumothorax is performed at which anatomical landmark?
Your Answer:
Correct Answer: 2nd intercostal space mid-clavicular line
Explanation:Pleural aspiration describes a procedure whereby pleural fluid or air may be aspirated via a system inserted temporarily into the pleural space. This may be for diagnostic purposes (usually removing 20–50 ml fluid) or therapeutic to relieve symptoms. In the literature it is varyingly called thoracocentesis, thoracentesis or pleural aspiration.
In determining the correct patient position and site of insertion, it is important for the operator to be aware of the normal anatomy of the thorax and the pathology of the patient. Patient position is dependent on the operator preference and the site of the pathology. In the case of a posterior lying locule, this may be specific to the image-guided spot where fluid is most likely to be obtained. In most circumstances, however, the site of insertion of the needle is either in the triangle of safety or the second intercostal space in the midclavicular line. The patient may therefore either sit upright leaning forward with arms elevated but resting on a table or bed, thereby exposing the axilla, or lying on a bed in a position.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 19
Incorrect
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Which of the following muscles acts as an extensor of the shoulder joint?
Your Answer:
Correct Answer: Teres major
Explanation:The glenohumeral joint possesses the capability of allowing an extreme range of motion in multiple planes.
Flexion – Defined as bringing the upper limb anterior in the sagittal plane. The usual range of motion is 180 degrees. The main flexors of the shoulder are the anterior deltoid, coracobrachialis, and pectoralis major. Biceps brachii also weakly assists in this action.
Extension—Defined as bringing the upper limb posterior in a sagittal plane. The normal range of motion is 45 to 60 degrees. The main extensors of the shoulder are the posterior deltoid, latissimus dorsi, and teres major.
Internal rotation—Defined as rotation toward the midline along a vertical axis. The normal range of motion is 70 to 90 degrees. The internal rotation muscles are the subscapularis, pectoralis major, latissimus dorsi, teres major, and the anterior aspect of the deltoid.
External rotation – Defined as rotation away from the midline along a vertical axis. The normal range of motion is 90 degrees. Primarily infraspinatus and teres minor are responsible for the motion.
Adduction – Defined as bringing the upper limb towards the midline in the coronal plane. Pectoralis major, latissimus dorsi, and teres major are the muscles primarily responsible for shoulder adduction.
Abduction – Defined as bringing the upper limb away from the midline in the coronal plane. The normal range of motion is 150 degrees. Due to the ability to differentiate several pathologies by the range of motion of the glenohumeral joint in this plane of motion, it is essential to understand how different muscles contribute to this action.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 20
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 21
Incorrect
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A 54 year old patient presents with vertigo, ipsilateral hemiataxia, dysarthria, ptosis and miosis.
Which of these blood vessels has most likely been occluded?
Your Answer:
Correct Answer: Posterior inferior cerebellar artery
Explanation:Posterior inferior cerebellar artery (PICA) occlusion is characterised by vertigo, ipsilateral hemiataxia, dysarthria, ptosis and miosis. PICA occlusion causes infarction of the posterior inferior cerebellum, inferior cerebellar vermis and lateral medulla.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 22
Incorrect
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A 70-year-old man has a resting tremor, rigidity, bradykinesia, and a shuffling gait. Parkinson's disease is caused by one of the following mechanisms:
Your Answer:
Correct Answer: Loss of dopaminergic neurons in the substantia nigra
Explanation:Parkinson’s disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed but not halted, by treatment. The 2 major neuropathologic findings in Parkinson’s disease are loss of pigmented dopaminergic neurons of the substantia nigra pars compacta and the presence of Lewy bodies and Lewy neurites. See the images below.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 23
Incorrect
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Which of these is NOT a lithium side effect:
Your Answer:
Correct Answer: Peptic ulcer disease
Explanation:Adverse Effects of lithium Include
Leucocytosis (most patients)
Polyuria/polydipsia (30-50%)
Dry mouth (20-50%)
Hand tremor (45% initially, 10% after 1 year of treatment)
Confusion (40%)
Decreased memory (40%)
Headache (40%)
Muscle weakness (30% initially, 1% after 1 year of treatment)
Electrocardiographic (ECG) changes (20-30%)
Nausea, vomiting, diarrhoea (10-30% initially, 1-10% after 1-2 years of treatment)
Hyperreflexia (15%)
Muscle twitch (15%)
Vertigo (15%)
Extrapyramidal symptoms, goitre (5%)
Hypothyroidism (1-4%)
Acne (1%)
Hair thinning (1%) -
This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 24
Incorrect
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Which of the following is most likely affected in De Quervain's tenosynovitis?
Your Answer:
Correct Answer: Extensor pollicis brevis
Explanation:De Quervain tenosynovitis is named after the Swiss surgeon, Fritz de Quervain, who first described it in 1895. It is a condition which involves tendon entrapment affecting the first dorsal compartment of the wrist. With this condition thickening of the tendon sheaths around the abductor pollicis longus and extensor pollicis brevis develops where the tendons pass in through the fibro-osseous tunnel located along the radial styloid at the distal wrist. Pain is exacerbated by thumb movement and radial and ulnar deviation of the wrist.
The estimated prevalence of de Quervain tenosynovitis is about 0.5% in men and 1.3% in women with peak prevalence among those in their forties and fifties. It may be seen more commonly in individuals with a history of medial or lateral epicondylitis. Bilateral involvement is often reported in new mothers or child care providers in whom spontaneous resolution typically occurs once lifting of the child is less frequent.
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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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You are examining the lower limbs of a 54 year old man who presented after falling from a ladder at home. During your neurological assessment you note a weakness of hip flexion. Which of the following nerves is the most important for flexion of the thigh at the hip joint:
Your Answer:
Correct Answer: Femoral nerve
Explanation:Flexion of the thigh at the hip joint is produced by the sartorius, psoas major, iliacus and pectineus muscles, assisted by the rectus femoris muscle, all innervated by the femoral nerve (except for the psoas major, innervated by the anterior rami of L1 – 3).
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 26
Incorrect
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A 55-year-old woman was complaining of headaches. On examination, the patient is found to have weakness on the left side of her body and her eyes are deviated towards the right hand side. These are signs of damage to which of the following areas?
Your Answer:
Correct Answer: Frontal lobe
Explanation:Some potential symptoms of frontal lobe damage can include loss of movement, either partial or complete, on the opposite side of the body.
In the patient’s case, it is a result of motor cortex damage on the right side since her left side of the body is affected. The conjugate eye deviation symptom towards the side of the lesion is a result of damage to the frontal eye field.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 27
Incorrect
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A foot drop is a sign of damage to which of the following nerves?
Your Answer:
Correct Answer: Deep fibular nerve
Explanation:The deep fibular nerve was previously referred to as the anterior tibial nerve.
It starts at the common fibular nerve bifurcation, between the fibula and the proximal part of the fibularis longus. Damage to this nerve can cause foot drop or loss of dorsiflexion since this nerve controls the anterior leg muscles.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 28
Incorrect
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A 36-year-old man presented to the emergency room after an incident of slipping and falling onto his back and left hip. Upon physical examination, it was noted that he has pain on hip extension, but normal hip abduction.
Which of the following muscles was most likely injured in this case?Your Answer:
Correct Answer: Gluteus maximus
Explanation:The primary hip extensors are the gluteus maximus and the hamstrings such as the long head of the biceps femoris, the semitendinosus, and the semimembranosus. The extensor head of the adductor magnus is also considered a primary hip extensor.
The hip abductor muscle group is located on the lateral thigh. The primary hip abductor muscles include the gluteus medius, gluteus minimus, and tensor fasciae latae.
The secondary hip abductors include the piriformis, sartorius, and superior fibres of the gluteus maximus. -
This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 29
Incorrect
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A 40-year-old woman presents with retrosternal central chest pain that she has been complaining about for the past two days. Upon deep inspiration and while lying flat, the pain worsens but relieved by sitting forwards. The pain radiates to both of her shoulders. The result of her ECG shows widespread concave ST-elevation and PR depression. A diagnosis of pericarditis is suspected.
Which of the following nerves is responsible for the pattern of her pain?Your Answer:
Correct Answer: Phrenic nerve
Explanation:Pericarditis is inflammation of the pericardial sac and is the most common pathologic process involving the pericardium. Frequently, pericardial inflammation can be accompanied by increased fluid accumulation within the pericardial sac forming a pericardial effusion, which may be serous, hemorrhagic or purulent depending on aetiology.
The classic presentation is with chest pain that is central, severe, pleuritic (worse on deep inspiration) and positional (improved by sitting up and leaning forward). The pain may also be radiating and may involve the ridges of the trapezius muscle if the phrenic nerve is inflamed as it traverses the pericardium.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 30
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:
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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SESSION STATS - PERFORMANCE PER SPECIALTY
