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  • Question 1 - Given a patient with dislocation of the patella, which muscle is the most...

    Correct

    • Given a patient with dislocation of the patella, which muscle is the most important to address during rehabilitation to prevent recurrent dislocation?

      Your Answer: Vastus medialis

      Explanation:

      Patellar dislocation is a disabling musculoskeletal disorder which predominantly affects younger people who are engaged in multidirectional physically active pursuits. Conservative (non-operative) treatment is the treatment of choice for FTPD (first time patellar dislocation). Quadriceps strengthening exercises are considered one of the principal management aims for people following FTPD. A United Kingdom (UK) survey of physiotherapy practice has shown that quadriceps strengthening and specific-vastus medialis obliquus (VMO) or distal vastus medialis (VM) muscle strengthening or recruitment exercises were two of the most frequently used interventions for this population. Specific VM exercises are favoured in some quarters based on the assumption that the VM has an important role in preventing excessive lateral patellar translation.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      5.3
      Seconds
  • Question 2 - A 77 year old lady presents to ED with her left leg shortened...

    Correct

    • A 77 year old lady presents to ED with her left leg shortened and externally rotated following slipping and falling on a wet bathroom floor. There is an intracapsular fracture of the neck of femur seen on imaging studies. She is at risk of avascular necrosis of the head of femur. This is caused by lack of blood supply from which of these arteries?

      Your Answer: Medial circumflex artery

      Explanation:

      The primary blood supply to the head of the femur is from branches of the medial femoral circumflex artery. The superior and inferior gluteal arteries supply the hip joint but not the head of femur.The lateral circumflex artery anastomoses with the medial femoral circumflex artery and assists in supplying the head of femur. The obturator artery is an important source of blood supply in children up to about 8 years. It gives rise to the artery of the head of femur which runs in the ligamentum teres and is insufficient to supply the head of femur in adults.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      9.9
      Seconds
  • Question 3 - The following statements are not true of the flexor digiti minimi brevis, except?...

    Incorrect

    • The following statements are not true of the flexor digiti minimi brevis, except?

      Your Answer: It receives its blood supply from the deep palmar arch

      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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      19
      Seconds
  • Question 4 - Which of the following is NOT a typical feature of an abducens nerve...

    Correct

    • Which of the following is NOT a typical feature of an abducens nerve palsy:

      Your Answer: Inability to look up

      Explanation:

      CN VI 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.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      21.6
      Seconds
  • Question 5 - A 24-year-old waiter cuts his hand on a dropped plate that smashed and...

    Correct

    • A 24-year-old waiter cuts his hand on a dropped plate that smashed and damages the nerve that innervates opponens digiti minimi.The opponens digiti minimi muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer: The deep branch of the ulnar nerve

      Explanation:

      Opponens digiti minimi is a triangular-shaped muscle in the hand that forms part of the hypothenar eminence. It originates from the hook of the hamate bone and the flexor retinaculum and inserts into the medial border of the 5thmetacarpal.Opponens digiti minimi is innervated by the deep branch of the ulnar nerve and receives its blood supply from the ulnar artery.Opponens digiti minimi draws the fifth metacarpal bone anteriorly and rotates it, bringing the fifth digiti into opposition with the thumb.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      32
      Seconds
  • Question 6 - Where on the body is the radial artery pulsation best palpated? ...

    Incorrect

    • Where on the body is the radial artery pulsation best palpated?

      Your Answer: At the wrist just medial to the flexor carpi radialis tendon

      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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      13.6
      Seconds
  • Question 7 - A 53-year-old man arrives at the emergency department complaining of visual impairment in...

    Correct

    • A 53-year-old man arrives at the emergency department complaining of visual impairment in his right eye. On examination, you notice that neither his right nor left pupil constricts when you shine a light in his right eye. When you flash a light in his left eye, the pupils of both his left and right eyes constrict. Which of the following nerves is the most likely to be affected:

      Your Answer: Optic nerve

      Explanation:

      In full optic nerve palsy, the afferent pupillary light reflex is lost. Because the afferent optic nerve does not sense light flashed in the afflicted eye, the ipsilateral direct and contralateral consensual reflexes are gone. However, the contralateral direct and ipsilateral consensual reflexes are intact because the efferent oculomotor nerve is normal.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      70.1
      Seconds
  • Question 8 - Which of the following is NOT a typical side effect of opioid analgesics:...

    Correct

    • Which of the following is NOT a typical side effect of opioid analgesics:

      Your Answer: Diarrhoea

      Explanation:

      All opioids have the potential to cause:Gastrointestinal effects – Nausea, vomiting, constipation, difficulty with micturition (urinary retention), biliary spasmCentral nervous system effects – Sedation, euphoria, respiratory depression, miosisCardiovascular effects – Peripheral vasodilation, postural hypotensionDependence and tolerance

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      42.1
      Seconds
  • Question 9 - Which of the following statements accurately describes the flexor digitorum superficialis muscle? ...

    Incorrect

    • Which of the following statements accurately describes the flexor digitorum superficialis muscle?

      Your Answer: It assists with pronation of the forearm at the elbow

      Correct Answer: It flexes the middle phalanges of the medial four fingers at the proximal interphalangeal joints

      Explanation:

      Flexor digitorum superficialis is the largest muscle of the anterior compartment of the forearm. It belongs to the superficial flexors of the forearm, together with pronator teres, flexor carpi radialis, flexor carpi ulnaris and palmaris longus. Some sources alternatively classify this muscle as an independent middle/intermediate layer of the anterior forearm, found between the superficial and deep groups.Flexor digitorum superficialis is innervated by muscular branches of the median nerve, derived from roots C8 and T1 that arises from the medial and lateral cords of the brachial plexus. The skin that overlies the muscle is supplied by roots C6-8 and T1.The primary arterial blood supply to the flexor digitorum superficialis is derived from the ulnar artery and its anterior recurrent branch. In addition to branches of the ulnar artery, the anterior and lateral surfaces of the muscle are supplied by branches of the radial artery; and its posterior surface also receives branches from the median artery.The main function of flexor digitorum superficialis is flexion of the digits 2-5 at the proximal interphalangeal and metacarpophalangeal joints. Unlike the flexor digitorum profundus, flexor digitorum superficialis has independent muscle slips for all four digits. This allows it to flex the digits individually at their proximal interphalangeal joints. In addition, flexor digitorum superficialis aids the aids flexion of the wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      22.9
      Seconds
  • Question 10 - A 69-year-old man presents with a painful groin swelling on the right side....

    Correct

    • A 69-year-old man presents with a painful groin swelling on the right side. The suspected diagnosis is an inguinal hernia.Which of the following examination features make it more likely to be an indirect inguinal hernia?

      Your Answer: It can be controlled by pressure over the deep inguinal ring

      Explanation:

      The reduced indirect inguinal hernia can be controlled by pressure over the internal ring; a direct inguinal hernia cannot.An indirect inguinal hernia can be reduced superiorly then superolaterally, while a direct inguinal hernia can be reduced superiorly then posteriorly.An indirect inguinal hernia takes time to reach full size, but a direct inguinal hernia appears immediately upon standing.Indirect inguinal hernias are seen as elliptical swelling, while direct inguinal hernias appear as symmetric, circular swelling.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      21.7
      Seconds
  • Question 11 - A 45-year old man presented to the emergency room with complains of chest...

    Correct

    • A 45-year old man presented to the emergency room with complains of chest pain and breathlessness. Upon history taking and examination, it was discovered that he had a right-sided spontaneous pneumothorax and had a failed attempt at pleural aspiration. The pneumothorax is still considerable in size, but he remains breathless. A Seldinger chest drain was inserted but it started to drain frank blood shortly after. Which of the following complications is most likely to have occurred?

      Your Answer: Intercostal artery laceration

      Explanation:

      Injury to the intercostal artery (ICA) is an infrequent but potentially life-threatening complication of all pleural interventions. Traditional anatomy teaching describes the ICA as lying in the intercostal groove, protected by the flange of the rib. This is the rationale behind the recommendation to insert needles just above the superior border of the rib. Current recommendations for chest drain insertion suggest that drains should be inserted in the ‘safe triangle’ in order to avoid the heart and the mediastinum and be above the level of the diaphragm. The safe triangle is formed anteriorly by the lateral border of the pectoralis major, laterally by the lateral border of the latissimus dorsi, inferiorly by the line of the fifth intercostal space and superiorly by the base of the axilla. Imaging guidance also aids in the safety of the procedure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      16.2
      Seconds
  • Question 12 - A 22 year old professional athlete sustains an inversion injury to her left...

    Correct

    • A 22 year old professional athlete sustains an inversion injury to her left ankle during the 800m. Which of the following ligaments is most likely injured:

      Your Answer: Anterior talofibular ligament

      Explanation:

      Inversion injuries at the ankle in plantarflexion (such as when wearing high heels) are common, and typically result in damage to the lateral collateral ligament of the ankle, made up of the anterior talofibular, the calcaneofibular and the posterior talofibular ligaments. The anterior talofibular and the calcaneofibular ligaments are most commonly injured, and the posterior talofibular ligament rarely. The spring ligament supports the head of the talus, the deltoid ligament supports the medial aspect of the ankle joint, and the long and short plantar ligaments are involved in maintaining the lateral longitudinal arch of the foot.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      12.8
      Seconds
  • Question 13 - You suspect that your patient with polycystic kidney disease has developed a berry...

    Incorrect

    • You suspect that your patient with polycystic kidney disease has developed a berry aneurysm as a complication of his disease. The patient complains of a sudden, severe headache. You are guessing subarachnoid haemorrhage secondary to a ruptured berry aneurysm as the cause of his severe headaches. What is the most likely location of his aneurysm?

      Your Answer: Posterior communicating artery

      Correct Answer: Anterior communicating artery

      Explanation:

      One of the complications that polycystic kidney disease may cause is the development of a brain aneurysm. A berry aneurysm is the most common type of brain aneurysm. The Circle of Willis, where the major blood vessels meet at the base of the brain, is where it usually appears. The most common junctions of the Circle of Willis where an aneurysm may occur include the anterior communicating artery (35%), internal carotid artery (30%), the posterior communicating artery and the middle cerebral artery (22%), and finally, the posterior circulation sites, most commonly the basilar artery tip.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      11.3
      Seconds
  • Question 14 - A suspicious growth on the posterior tongue of a 40-year-old man was discovered...

    Correct

    • A suspicious growth on the posterior tongue of a 40-year-old man was discovered by his dentist and was immediately referred for possible oral cancer. The lymph from the posterior tongue will drain to which of the following nodes?

      Your Answer: Deep cervical nodes

      Explanation:

      Lymph from the medial anterior two thirds of the tongue travels to the deep cervical lymph nodes.Lymph from the lateral anterior tongue goes to the submandibular nodes.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      12.5
      Seconds
  • Question 15 - A 63-year-old man presents with severe abdominal pain and vomiting of blood. An...

    Correct

    • A 63-year-old man presents with severe abdominal pain and vomiting of blood. An endoscopy was performed and a peptic ulcer was found to have eroded into an artery nearby.Which of the following most likely describes the location of the ulcer?

      Your Answer: The posterior duodenum

      Explanation:

      The most common cause of upper gastrointestinal bleeding is peptic ulcer disease, particularly gastric and duodenal ulcers. Duodenal ulcers are most commonly associated with bleeding compared with gastric ulcers. Posterior duodenal ulcers are considered to be the most likely to cause severe bleeding because of its proximity to the branches of the gastroduodenal artery (GDA).

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      5.5
      Seconds
  • Question 16 - You are reviewing a patient complaining of loss of vision. Previous images shows...

    Incorrect

    • You are reviewing a patient complaining of loss of vision. Previous images shows a lesion at the optic chiasm. What type of visual field defect are you most likely to see in a lesion at the optic chiasm:

      Your Answer: Homonymous hemianopia with macular sparing

      Correct Answer: Bitemporal hemianopia

      Explanation:

      A lesion at the optic chiasm will result in a bitemporal hemianopia.A lesion of the optic nerve will result in ipsilateral monocular visual loss.A lesion of the optic tract will result in a contralateral homonymous hemianopia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      14.8
      Seconds
  • Question 17 - A lesion to which part of the optic radiation will result in contralateral...

    Incorrect

    • A lesion to which part of the optic radiation will result in contralateral homonymous inferior quadrantanopia?

      Your Answer: Right occipital lobe

      Correct Answer: Right parietal lobe

      Explanation:

      A visual loss in the lower left quadrant in both visual fields is an indication of an inferior homonymous. This is due to a lesion of the superior fibres of the optic radiation in the parietal lobe on the contralateral side of the visual pathway.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      105.5
      Seconds
  • Question 18 - Which coronary artery is mostly likely affected if an ECG shows a tombstone...

    Incorrect

    • Which coronary artery is mostly likely affected if an ECG shows a tombstone pattern in leads V2, V3 and V4?

      Your Answer: Right coronary artery

      Correct Answer: Left anterior descending artery

      Explanation:

      Tombstoning ST elevation myocardial infarction can be described as a STEMI characterized by tombstoning ST-segment elevation. This myocardial infarction is associated with extensive myocardial damage, reduced left ventricle function, serious hospital complications and poor prognosis. Tombstoning ECG pattern is a notion beyond morphological difference and is associated with more serious clinical results.Studies have shown that tombstoning is more commonly found in anterior than non-anterior STEMI, thus, higher rates of left anterior descending artery disease are observed in patients with tombstoning pattern.The following ECG leads determine the location and vessels involved in myocardial infarction:ECG Leads Location Vessel involvedV1-V2 Septal wall Left anterior descendingV3-V4 Anterior wall Left anterior descendingV5-V6 Lateral wall Left circumflex arteryII, III, aVF Inferior wall Right coronary artery (80%) or Left circumflex artery (20%)I, aVL High lateral wall Left circumflex arteryV1, V4R Right ventricle Right coronary arteryV7-V9 Posterior wall Right coronary artery

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      6.2
      Seconds
  • Question 19 - Which of the following is most likely to cause a homonymous hemianopia: ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      7
      Seconds
  • Question 20 - A patient who has a nerve injury has sparing of the upper half...

    Incorrect

    • A patient who has a nerve injury has sparing of the upper half of the orbicularis oculi muscle but not the lower half. Which branch of the facial nerve supplies the lower half of the orbicularis oculi?

      Your Answer: Temporal branch

      Correct Answer: Zygomatic branch

      Explanation:

      The facial nerve divides into five terminal branches once in the parotid gland. 1. The temporal branch innervates muscles in the temple, forehead and supraorbital areas.2. The zygomatic branch innervates muscles in the infraorbital area, the lateral nasal area and the upper lip.3. The buccal branch innervates muscles in the cheek, the upper lip and the corner of the mouth. 4. The marginal mandibular branch innervates muscles of the lower lip and chin. 5. The cervical branch innervates the platysma muscle.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      17.1
      Seconds
  • Question 21 - You are examining the lower limbs of a 54 year old man who...

    Incorrect

    • 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: Obturator nerve

      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).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      10.2
      Seconds
  • Question 22 - A 4-year old boy is taken to the emergency room after a sudden...

    Correct

    • A 4-year old boy is taken to the emergency room after a sudden onset of coughing and wheezing. Further investigation reveals that he was drawing quietly in his room, when suddenly, he became anxious and started coughing. The parents also noted that the eraser on top of the pencil was missing.A plain radiographic chest imaging is conducted, and confirmed foreign body aspiration.Which of the following areas in the tracheobronchial tree is the most probable location of the aspirated eraser?

      Your Answer: Right main bronchus

      Explanation:

      In foreign body aspiration, the foreign body is more likely to enter the right main bronchus because it is shorter, wider and more vertical than the left main bronchus. In a patient who is standing or sitting, the foreign body tends to become lodged in the posterobasal segment of the inferior lobe of the right lung.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      41.4
      Seconds
  • Question 23 - A 70-year old male is taken to the Emergency Room after suffering a...

    Correct

    • A 70-year old male is taken to the Emergency Room after suffering a traumatic fall while showering. Upon physical examination, the attending physician noted a hyperextended neck, 1/5 muscle strength in both upper extremities, 4/5 muscle strength in both lower extremities, and variable loss in sensation. The patient is placed in the wards for monitoring. For the next 24 hours, anuria is noted.Which of the following spinal cord injuries is the most likely diagnosis?

      Your Answer: Central cord syndrome

      Explanation:

      Central cord syndrome is the most common type of incomplete cord injury and almost always occurs due to a traumatic injury. It results in motor deficits that are worse in the upper extremities as compared to the lower extremities. It may also cause bladder dysfunction (retention) and variable sensory deficits below the level of injury.The majority of these patients will be older and present with symptoms after a fall with hyperextension of their neck. On examination, patients will have more significant strength impairments in the upper extremities (especially the hands) compared to the lower extremities. Patients often complain of sensory deficits below the level of injury, but this is variable. Pain and temperature sensations are typically affected, but the sensation of light touch can also be impaired. The most common sensory deficits are in a cape-like distribution across their upper back and down their posterior upper extremities. They will often have neck pain at the site of spinal cord impingement.Bladder dysfunction (most commonly urinary retention) and priapism can also be signs of upper motor neuron dysfunction. The sacral sensation is usually preserved, but the clinician should assess the rectal tone to evaluate the severity of the compression.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      56.8
      Seconds
  • Question 24 - A patient is sent in by her GP with suspected ectopic pregnancy. Tubal...

    Correct

    • A patient is sent in by her GP with suspected ectopic pregnancy. Tubal ectopic pregnancies occur most commonly in which part of the uterine tube:

      Your Answer: Ampulla

      Explanation:

      Ectopic pregnancy most commonly occurs in the ampulla (70% of cases).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      4.8
      Seconds
  • Question 25 - A 7-year old boy is referred to the Paediatrics Department due to slurred...

    Correct

    • A 7-year old boy is referred to the Paediatrics Department due to slurred speech. Upon further examination, the attending physician noted the presence of dysdiadochokinesia, intention tremors, and nystagmus. An MRI is taken, which revealed a brain tumour.Which of the following options is the most probable diagnosis given the clinical features of the patient?

      Your Answer: Astrocytoma of cerebellum

      Explanation:

      Pilocytic astrocytoma (PCA), previously known as cystic cerebellar astrocytoma or juvenile pilocytic astrocytoma, was first described in 1931 by Harvey Cushing, based on a case series of cerebellar astrocytomas; though he never used these terms but rather described a spongioblastoma. They are low-grade, and usually well-circumscribed tumours, which tend to occur in young patients. By the World Health Organization (WHO) classification of central nervous system tumours, they are considered grade I gliomas and have a good prognosis.PCA most commonly occurs in the cerebellum but can also occur in the optic pathway, hypothalamus, and brainstem. They can also occur in the cerebral hemispheres, although this tends to be the case in young adults. Presentation and treatment vary for PCA in other locations. Glial cells include astrocytes, oligodendrocytes, ependymal cells, and microglia. Astrocytic tumours arise from astrocytes and are the most common tumour of glial origin. The WHO 2016 categorized these tumours as either diffuse gliomas or other astrocytic tumours. Diffuse gliomas include grade II and III diffuse astrocytomas, grade IV glioblastoma, and diffuse gliomas of childhood. The other astrocytic tumours group include PCA, pleomorphic xanthoastrocytoma, subependymal giant cell astrocytoma, and anaplastic pleomorphic xanthoastrocytoma.PCA can present with symptoms secondary to the posterior fossa mass effect. This may include obstructive hydrocephalus, with resultant headache, nausea and vomiting, and papilledema. If hydrocephalus occurs before the fusion of the cranial sutures (<18-months-of-age), then an increase in head circumference will likely occur. Lesions of the cerebellar hemisphere result in peripheral ataxia, dysmetria, intention tremor, nystagmus, and dysarthria. In contrast, lesions of the vermis cause a broad-based gait, truncal ataxia, and titubation. Posterior fossa lesions can also cause cranial nerve palsies. Diplopia may occur due to abducens palsy from the stretching of the nerve. They may also have blurred vision due to papilledema. Seizures are rare with posterior fossa lesions.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      16
      Seconds
  • Question 26 - A 54 year old patient presents with vertigo, ipsilateral hemiataxia, dysarthria, ptosis and...

    Incorrect

    • 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: Anterior cerebral artery

      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.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      19
      Seconds
  • Question 27 - Superficial fibular nerve palsy results in which of the following clinical features: ...

    Incorrect

    • Superficial fibular nerve palsy results in which of the following clinical features:

      Your Answer: Loss of eversion and weakness of dorsiflexion of the foot

      Correct Answer: Loss of eversion of the foot

      Explanation:

      Damage to the superficial fibular nerve results in loss of eversion of the foot and loss of sensation over the lower anterolateral leg and the dorsum of the foot.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      17.8
      Seconds
  • Question 28 - A 30-year old male is brought to the emergency room after a terrible...

    Incorrect

    • A 30-year old male is brought to the emergency room after a terrible fall during a photoshoot. The patient reported falling on his right forearm. There is evident swelling and tenderness on the affected area, with notable weakness of the flexor pollicis longus muscle. Radiographic imaging showed a fracture on the midshaft of the right radius.Which of the following nerves is most likely injured in the case above?

      Your Answer: The radial nerve

      Correct Answer: The anterior interosseous nerve

      Explanation:

      Flexor pollicis longus receives nervous supply from the anterior interosseous branch of median nerve, derived from spinal roots C7 and C8.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      60.1
      Seconds
  • Question 29 - Which of the following muscles is most responsible for thigh extension at the...

    Incorrect

    • Which of the following muscles is most responsible for thigh extension at the hip joint?

      Your Answer: Quadriceps femoris, gluteus medius and gluteus minimus

      Correct Answer: Hamstrings and gluteus maximus

      Explanation:

      For hip extension, the gluteus maximus and hamstring muscles work together. To compensate for gluteus maximus weakness, the hamstring frequently acts as the primary hip extensor.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      22
      Seconds
  • Question 30 - A patient suffers from an injury to his hip and thigh. As a...

    Incorrect

    • A patient suffers from an injury to his hip and thigh. As a consequence of his injury, the nerve that was damaged innervates the obturator externus muscle.In which of the following nerves is the obturator externus muscle innervated by?

      Your Answer: The anterior division of the femoral nerve

      Correct Answer: Posterior branch of the obturator nerve

      Explanation:

      The obturator externus is innervated by the posterior branch of the obturator nerve, L2-L4.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      163.3
      Seconds
  • Question 31 - Regarding the lacrimal apparatus, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the lacrimal apparatus, which of the following statements is CORRECT:

      Your Answer: The lacrimal gland is located in the inferomedial region of the orbit.

      Correct Answer: Lacrimal fluid is drained from the eyeball through the lacrimal punctum.

      Explanation:

      Lacrimal fluid is drained from the eyeball through the lacrimal punctum.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      100
      Seconds
  • Question 32 - A 18 year old student presents to ED with a headache, fever and...

    Incorrect

    • A 18 year old student presents to ED with a headache, fever and photophobia. You suspect meningitis and agree to observe your junior performing a lumbar puncture. What is the highest safest vertebral level to perform lumbar puncture in adults:

      Your Answer: L4/L5

      Correct Answer: L3/L4

      Explanation:

      In adults, the spinal cord typically ends between L1/L2 whereas the subarachnoid space extends to approximately the lower border of vertebra S2. Lumbar puncture is performed in the intervertebral space L4/L5 or L3/L4.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      7.1
      Seconds
  • Question 33 - CSF is reabsorbed from subarachnoid space via which of the following structures: ...

    Incorrect

    • CSF is reabsorbed from subarachnoid space via which of the following structures:

      Your Answer: Cerebral aqueduct

      Correct Answer: Arachnoid granulations

      Explanation:

      From the subarachnoid cisterns in the subarachnoid space, CSF is reabsorbed via arachnoid granulations which protrude into the dura mater, into the dural venous sinuses and from here back into the circulation.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      22.1
      Seconds
  • Question 34 - All these structures make up the portal triad EXCEPT? ...

    Incorrect

    • All these structures make up the portal triad EXCEPT?

      Your Answer: Vagal parasympathetic nerve fibres

      Correct Answer: Branches of the hepatic vein

      Explanation:

      The portal triad, is made up of a portal arteriole (a branch of the hepatic artery), a portal venule (a branch of the hepatic portal vein) and a bile duct. Also contained within the portal triad are lymphatic vessels and vagal parasympathetic nerve fibres.Branches of the hepatic vein is not part of the portal triad

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      83.7
      Seconds
  • Question 35 - A 16-year old boy is brought to the emergency room after suffering a...

    Incorrect

    • 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: Central cord syndrome

      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.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      24.5
      Seconds
  • Question 36 - A 44 year old woman is brought to ED having fallen down the...

    Incorrect

    • A 44 year old woman is brought to ED having fallen down the stairs and injured her right arm. On examination she is unable to abduct her arm normally, and has weakness of lateral rotation. She has sensory loss over the lateral aspect of her upper arm. Which of the following injuries is most likely to produce this pattern of injury:

      Your Answer: Fracture of the glenoid fossa

      Correct Answer: Surgical neck of humerus fracture

      Explanation:

      Damage to the axillary nerve will result in loss of abduction past about 15 degrees and weakness of lateral rotation due to paralysis of the deltoid and teres minor and loss of sensation over the regimental badge area on the upper lateral arm. The axillary nerve is most likely injured in fracture of the surgical neck of the humerus due to its course where it winds around this region together with the posterior humeral circumflex vessels.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      24.8
      Seconds
  • Question 37 - Which of the following best describes the popliteal artery's course? ...

    Incorrect

    • Which of the following best describes the popliteal artery's course?

      Your Answer: Terminates as the posterior tibial and the fibular artery

      Correct Answer: After exiting the popliteal fossa terminates at the lower border of the popliteus muscle

      Explanation:

      The popliteal artery divides into the anterior and posterior tibial arteries at the lower border of the popliteus after exiting the popliteal fossa between the gastrocnemius and popliteus muscles.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      633.7
      Seconds
  • Question 38 - A patient suffers a lower limb fracture that causes damage to the nerve...

    Incorrect

    • 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: Deep peroneal nerve

      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.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      11.4
      Seconds
  • Question 39 - Which anatomical structure is divided following an emergency department anterolateral thoracotomy? ...

    Incorrect

    • Which anatomical structure is divided following an emergency department anterolateral thoracotomy?

      Your Answer: Teres minor

      Correct Answer: Latissimus dorsi

      Explanation:

      Thoracotomy describes an incision made in the chest wall to access the contents of the thoracic cavity. Thoracotomies typically can be divided into two categories; anterolateral thoracotomies and posterolateral thoracotomies. These can be further subdivided into supra-mammary and infra-mammary and, of course, further divided into the right or left chest. Each type of incision has its utility given certain circumstances.A scalpel is used to sharply divide the skin along the inframammary crease overlying the fifth rib. Electrocautery is then used to divide the pectoralis major muscle and serratus anterior muscle. Visualization of the proper operative field can be achieved with the division and retraction of the latissimus dorsi. Either the fourth or fifth intercostal space is then entered after the division of intercostal muscles above the rib to ensure the preservation of the neurovascular bundle. Once the patient is properly secured to the operating table, the ipsilateral arm is raised and positioned anteriorly and cephalad to rest above the head. The incision is started along the inframammary crease and extended posterolaterally below the tip of the scapula. It is then extended superiorly between the spine and the edge of the scapula, a short distance. The trapezius muscle and the subcutaneous tissues are divided with electrocautery. The serratus anterior and latissimus dorsi muscles are identified and can be retracted. The intercostal muscles are then divided along the superior border of the ribs, and the thoracic cavity is accessed.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      574.5
      Seconds
  • Question 40 - A 38-year-old taxi driver sustained blunt force trauma to his anterior chest from...

    Correct

    • 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: 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

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      17.8
      Seconds
  • Question 41 - A patient complains of headache and visual loss. CT scan demonstrates a lesion...

    Incorrect

    • A patient complains of headache and visual loss. CT scan demonstrates a lesion of the temporal lobe. What type of visual field defect would you most expect to see in this patient:

      Your Answer: Contralateral homonymous inferior quadrantanopia

      Correct Answer: Contralateral homonymous superior quadrantanopia

      Explanation:

      Axons from the lateral geniculate nucleus (LGN) carry visual information, via the upper and lower optic radiations, to the visual cortex in the occipital lobe:The upper optic radiation carries fibres from the superior retinal quadrants (corresponding to the inferior visual field quadrants) and travels through the parietal lobe to reach the visual cortex. The lower optic radiation carries fibres from the inferior retinal quadrants (corresponding to the superior visual field quadrants) and travels through the temporal lobe to reach the visual cortex of the occipital lobe.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      18.5
      Seconds
  • Question 42 - Regarding an avulsion fracture, a sudden contraction of which muscle may lead to...

    Correct

    • Regarding an avulsion fracture, a sudden contraction of which muscle may lead to fracture of the head of the fibula?

      Your Answer: Biceps femoris

      Explanation:

      Avulsion fractures of the fibular head are rare and are so-called the arcuate signal. The “arcuate signal” is used to describe an avulsed bone fragment related to the insertion site of the tendon of the biceps femoris associated with the arcuate complex, which consists of the fabellofibular, popliteofibular, and arcuate ligaments. Such lesions are typically observed in direct trauma to the knee with excessive varus and internal rotation forces or indirect trauma with the same direction of the force.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      10.9
      Seconds
  • Question 43 - A 29 year old woman is unable to invert her foot after sustaining...

    Incorrect

    • A 29 year old woman is unable to invert her foot after sustaining an injury to her leg playing water-polo. Which of the following nerves are most likely damaged:

      Your Answer: Deep and superficial fibular nerve

      Correct Answer: Tibial and deep fibular nerve

      Explanation:

      Inversion of the foot is primarily produced by the tibialis anterior and the tibialis posterior muscles, innervated by the deep fibular nerve and the tibial nerve respectively.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      163.7
      Seconds
  • Question 44 - A 22-year-old student presents with severe headache accompanied with nausea and vomiting. Upon...

    Correct

    • A 22-year-old student presents with severe headache accompanied with nausea and vomiting. Upon observation and examination, it was noted that he is febrile and Kernig's sign is positive. A diagnosis of meningitis was suspected and a lumbar puncture was to be performed.Which of the following statements regarding meningitis is true?

      Your Answer: The dura mater is the outermost layer

      Explanation:

      Meningitis is defined as the inflammation of the meninges due to an infection caused by a bacteria or a virus. Symptoms usually include stiffness of the neck, headache, and fever. There are 3 meningeal layers that surround the spinal cord and they are the dura mater, arachnoid matter, and pia mater. The dura mater is the outermost and thickest layer out of all the 3 layers. The arachnoid atter is the middle layer, and is very thin.The third and deepest meningeal layer is the pia mater that is bound tightly to the surface of the spinal cord.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      13.1
      Seconds
  • Question 45 - A patient diagnosed with cranial nerve palsy exhibits asymmetrical movement of the palate,...

    Correct

    • A patient diagnosed with cranial nerve palsy exhibits asymmetrical movement of the palate, nasal regurgitation of food, and nasal quality to the voice. Which of the following cranial nerves is most likely responsible for the aforementioned features?

      Your Answer: Vagus nerve

      Explanation:

      The vagus nerve, ‘the wanderer’, contains motor fibres (to the palate and vocal cords), sensory components (posterior and floor of external acoustic meatus) and visceral afferent and efferent fibres. 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’.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      106.5
      Seconds
  • Question 46 - A patient presents complaining of visual loss. On examination you note a contralateral...

    Correct

    • A patient presents complaining of visual loss. On examination you note a contralateral homonymous hemianopia. Where is the most likely site of the lesion:

      Your Answer: Optic tract

      Explanation:

      At the optic chiasm, fibres from the medial (nasal) half of each retina crossover, forming the right and left optic tracts.The left optic tract contains fibres from the left lateral (temporal) retina and the right medial retina.The right optic tract contains fibres from the right lateral retina and the left medial retina.Each optic tract travels to its corresponding cerebral hemisphere to reach its lateral geniculate nucleus (LGN) located in the thalamus where the fibres synapse.A lesion of the optic tract will cause a contralateral homonymous hemianopia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      8
      Seconds
  • Question 47 - A 45-year-old obese patient goes to the emergency department with a fever and...

    Correct

    • A 45-year-old obese patient goes to the emergency department with a fever and significant right upper quadrant pain. The pain radiates to her right shoulder tip.  Murphy's sign is positive and acute cholecystitis is diagnosed. The pain referred to the shoulder tip is caused by one of the following nerves:

      Your Answer: Phrenic nerve

      Explanation:

      Gallbladder inflammation can cause pain in the right upper quadrant and right shoulder, which is caused by irritation of the diaphragmatic peritoneum. Pain from areas supplied by the phrenic nerve is often referred to other somatic regions served by spinal nerves C3-C5.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      6.6
      Seconds
  • Question 48 - After a work-related accident, a 33-year old male is taken to the emergency...

    Correct

    • After a work-related accident, a 33-year old male is taken to the emergency room with difficulty in adduction and flexion of his left arm at the glenohumeral joint. The attending physician is suspects involvement of the coracobrachialis muscle.The nerve injured in the case above is?

      Your Answer: The musculocutaneous nerve

      Explanation:

      The coracobrachialis muscle is innervated by the musculocutaneous nerve (C5-C7) a branch of the lateral cord of the brachial plexus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      146.3
      Seconds
  • Question 49 - A man presents to the emergency department with a hand laceration that has...

    Correct

    • A man presents to the emergency department with a hand laceration that has damaged the opponens digiti minimi muscle.All of the following statements regarding the opponens digiti minimi muscle is considered correct, except:

      Your Answer: It is innervated by the superficial branch of the ulnar nerve

      Explanation:

      Opponens digiti minimi (ODM) is an intrinsic muscle of the hand. It’s a triangular muscle that extends between the hamate bone (carpal bone) and the 5th metacarpal bone. It forms the hypothenar muscle group together with the abductor digiti minimi and flexor digiti minimi brevis, based on the medial side of the palm (hypothenar eminence). These muscles act together in moving the little finger. The opponens digiti minimi is responsible for flexion, lateral rotation and opposition of the little finger.Its origin is the hook of hamate and flexor retinaculum. It inserts into the medial border of 5th metacarpal bone. It is innervated by the deep branch of the ulnar nerve, which stems from the brachial plexus (C8, T1 spinal nerves).Its blood supply is by the deep palmar branch of ulnar artery and deep palmar arch, which is the terminal branch of the radial artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      798.9
      Seconds
  • Question 50 - In which part of the gastrointestinal tract is Meckel's diverticulum commonly located? ...

    Correct

    • In which part of the gastrointestinal tract is Meckel's diverticulum commonly located?

      Your Answer: Ileum

      Explanation:

      Meckel’s diverticulum is the most prevalent congenital anomaly of the gastrointestinal tract, affecting approximately 2% of the general population. Meckel’s diverticulum are designated true diverticula because their walls contain all the layers found in normal small intestine. Their location varies among individual patients, but they are usually found in the ileum within 100 cm of the ileocecal valve.Approximately 60% of Meckel’s diverticulum contain heterotopic mucosa, of which over 60% consist of gastric mucosa. Pancreatic acini are the next most common; others include Brunner’s glands, pancreatic islets, colonic mucosa, endometriosis, and hepatobiliary tissues.A useful, although crude, mnemonic describing Meckel’s diverticulum is the “rule of twos”: 2% prevalence, 2:1 male predominance, location 2 feet proximal to the ileocecal valve in adults, and half of those who are symptomatic are under 2 years of age.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      4.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (23/49) 47%
Lower Limb (4/11) 36%
Upper Limb (3/8) 38%
Cranial Nerve Lesions (2/3) 67%
Central Nervous System (6/14) 43%
Pharmacology (1/1) 100%
Abdomen And Pelvis (3/3) 100%
Thorax (3/5) 60%
Head And Neck (1/3) 33%
Abdomen (2/3) 67%
Passmed