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  • Question 1 - Which of the following body location is the appropriate site to apply pressure...

    Correct

    • Which of the following body location is the appropriate site to apply pressure when performing a carotid sinus massage?

      Your Answer: Thyroid cartilage

      Explanation:

      The common carotid artery runs through the neck and divides into internal and external carotid arteries on both sides near the upper thyroid cartilage. In emergency situations, carotid sinus massage is also used to diagnose or treat paroxysmal supraventricular tachycardia. During the procedure, to maximize access to the carotid artery, the patient is put in a supine position with the neck extended (i.e. elevating the chin away from the chest). The carotid sinus is normally positioned inferior to the angle of the jaw, near the arterial impulse, at the level of the thyroid cartilage. For 5 to 10 seconds, pressure is administered to one carotid sinus. Although pulsatile pressure applied in a vigorous circular motion may be more effective, continuous pressure is preferred since it is more reproducible. If the predicted reaction is not obtained, the operation is repeated on the opposite side after a one- to two-minute wait.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      61.8
      Seconds
  • Question 2 - In a patient with an ongoing seizure, after what time period should treatment...

    Incorrect

    • In a patient with an ongoing seizure, after what time period should treatment be commenced?

      Your Answer: 1 minute

      Correct Answer: 5 minutes

      Explanation:

      Immediate emergency care and treatment should be given to children, young people and adults who have prolonged or repeated convulsive seizures.Prolonged seizures last 5 minutes or more. Repeated seizures refer to 3 or more seizures in an hour.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      17.7
      Seconds
  • Question 3 - A tumour compresses the jugular foramen of a 50-year-old patient. Compression of several...

    Incorrect

    • A tumour compresses the jugular foramen of a 50-year-old patient. Compression of several nerves in the jugular foramen will result in which of the following complications?

      Your Answer: Inability to close the eye

      Correct Answer: Loss of gag reflex

      Explanation:

      The glossopharyngeal nerve, which is responsible for the afferent pathway of the gag reflex, the vagus nerve, which is responsible for the efferent pathway of the gag reflex, and the spinal accessory nerve all exit the skull through the jugular foramen. These nerves are most frequently affected if the jugular foramen is compressed. As a result, the patient’s gag reflex is impaired. The vestibulocochlear nerve is primarily responsible for hearing. The trigeminal nerve provides sensation in the face. The facial nerve innervates the muscles of face expression (including those responsible for closing the eye). Tongue motions are controlled mostly by the hypoglossal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      31.9
      Seconds
  • Question 4 - The following structures all lie anteriorly to the oesophagus EXCEPT for the: ...

    Correct

    • The following structures all lie anteriorly to the oesophagus EXCEPT for the:

      Your Answer: Thoracic duct

      Explanation:

      Posterior to the oesophagus, the thoracic duct is on the right side inferiorly but crosses to the left more superiorly (at T5).

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      53
      Seconds
  • Question 5 - A 45-year-old man had a painless superficial inguinal lymphadenopathy. It was later found...

    Correct

    • A 45-year-old man had a painless superficial inguinal lymphadenopathy. It was later found to be malignant. Which of the following parts of the body is most likely the origin of this cancerous lymph node?

      Your Answer: Anal canal

      Explanation:

      A cancer of the anal canal below the pectinate line would spread to the superficial inguinal lymph nodes. Anal cancer often spreads through lymphatic drainage to the internal iliac lymph nodes in lesions above the pectinate line and to the superficial inguinal lymph nodes in lesions below the pectinate line.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      66.1
      Seconds
  • Question 6 - A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part...

    Incorrect

    • A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part in a powerlifting competition, he felt a painful snap at the front of his shoulder and chest. There is also the presence of bruising and swelling over the left side of his chest. A ruptured pectoralis major muscle was suspected upon examining the injured area. Which of the following statements regarding the surface markings of the pectoralis major muscle is considered correct?

      Your Answer:

      Correct Answer: It inserts into the lateral lip of the bicipital groove of the humerus

      Explanation:

      The pectoralis major is the superior most and largest muscle of the anterior chest wall. It is a thick, fan-shaped muscle that lies underneath the breast tissue and forms the anterior wall of the axilla.Its origin lies anterior surface of the medial half of the clavicle, the anterior surface of the sternum, the first 7 costal cartilages, the sternal end of the sixth rib, and the aponeurosis of the external oblique of the anterior abdominal wall.The insertion of the pectoralis major is at the lateral lip of the intertubercular sulcus of the humerus. There are 2 heads of the pectoralis major, the clavicular and the sternocostal, which reference their area of origin. The function of the pectoralis major is 3-fold and dependent on which heads of muscles are involved:- Flexion, adduction and medial rotation of the arm at the glenohumeral joint- Clavicular head causes flexion of the extended arm- Sternoclavicular head causes extension of the flexed armArterial supply of the pectoralis major, the pectoral artery, arises from the second branch of the axillary artery, the thoracoacromial trunk.The 2 heads of the pectoralis major have different nervous supplies. The clavicular head derives its nerve supply from the lateral pectoral nerve. The medial pectoral nerve innervates the sternocostal head. The lateral pectoral nerve arises directly from the lateral cord of the brachial plexus, and the medial pectoral nerve arises from the medial cord.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 7 - A 76-year-old man presents with complaints of double vision. Upon physical examination, it...

    Incorrect

    • A 76-year-old man presents with complaints of double vision. Upon physical examination, it was observed that he exhibits left-sided hemiplegia and left-sided loss of joint position sense, vibratory sense and discriminatory touch. In addition, he has the inability to abduct his right eye and is holding his head towards the right side. A CT scan was ordered and showed that he has suffered a right-sided stroke. Branches of which of the following arteries are most likely implicated in the case?

      Your Answer:

      Correct Answer: Basilar artery

      Explanation:

      Inferior medial pontine syndrome, also known as Foville syndrome, is one of the brainstem stroke syndromes which occurs when there is infarction of the medial inferior aspect of the pons due to occlusion of the paramedian branches of the basilar artery.It is characterized by ipsilateral sixth nerve palsy, facial palsy, contralateral hemiparesis, contralateral loss of proprioception and vibration, ipsilateral ataxia, ipsilateral facial weakness, and lateral gaze paralysis and diplopia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 8 - Which of the following statement is correct with regards to the female urethra?...

    Incorrect

    • Which of the following statement is correct with regards to the female urethra?

      Your Answer:

      Correct Answer: The urethra opens in the vestibule that lies between the labia minora.

      Explanation:

      The urethra in women is short (about 4 cm long), and begins at the base of the bladder. Its course runs inferiorly through the urogenital diaphragm, then into the perineum. It then opens in the vestibule which lies between the labia minora. The inferior aspect of the urethra is bound to the anterior surface of the vagina. The urethral opening is anterior to the vaginal opening in the vestibule. As the urethra passes through the pelvic floor, it is surrounded by the external urethral sphincter.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 9 - A 23-year-old student presents with a fever and sore throat. Upon physical examination,...

    Incorrect

    • A 23-year-old student presents with a fever and sore throat. Upon physical examination, it was observed that he had bilaterally enlarged tonsils that are covered in large amounts of exudate. A diagnosis of tonsillitis was made. The lymph from the tonsils will drain to which of the following nodes?

      Your Answer:

      Correct Answer: Deep cervical lymph nodes

      Explanation:

      The tonsils are collections of lymphatic tissue located within the pharynx. They collectively form a ringed arrangement, known as Waldeyer’s ring: pharyngeal tonsil, 2 tubal tonsils, 2 palatine tonsils, and the lingual tonsil. Lymphatic fluid from the lingual tonsil drains into the jugulodigastric and deep cervical lymph nodes.Lymphatic fluid from the pharyngeal tonsil drains into the retropharyngeal nodes (which empty into the deep cervical chain), and directly into deep cervical nodes within the parapharyngeal space.The retropharyngeal and the deep cervical lymph nodes drain the tubal tonsils.The palatine tonsils drain to the jugulodigastric node, a node of the deep cervical lymph nodes, located inferior to the angle of the mandible.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 10 - Which of the following statements is false regarding the biceps brachii muscle? ...

    Incorrect

    • Which of the following statements is false regarding the biceps brachii muscle?

      Your Answer:

      Correct Answer: It pronates the radioulnar joint in the forearm

      Explanation:

      The biceps brachii muscle is one of the chief muscles of the arm. The origin at the scapula and the insertion into the radius of the biceps brachii means it can act on both the shoulder joint and the elbow joint, which is why this muscle participates in a few movements of the arm. It derives its name from its two heads which merge in one unique distal body, defining the unusual structure of the muscle.The biceps brachii muscle is supplied by the musculocutaneous nerve (C5-C6), a branch of the brachial plexus.Arterial supply to the biceps brachii muscle varies considerably, coming from up to eight vessels originating from the brachial artery in the middle third of the arm.In the shoulder joint both muscle heads partially enforce opposite movements. The long head pulls the arm away from the trunk (abduction) and turns it inwards (inward rotation) whereas the short head pulls the arm back towards the trunk (adduction). When both heads contract simultaneously it leads to an arm bend (flexion). In the elbow joint the muscle bends the forearm (flexion) and rotates it outwards (supination). The supination is most powerful in a flexed elbow. In addition to the movement functions, the biceps has the important task to support the humeral head within the shoulder joint. Its antagonist is the triceps brachii in the posterior compartment of the arm.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 11 - An injury to which nerve affects innervation to the adductor portion of the...

    Incorrect

    • An injury to which nerve affects innervation to the adductor portion of the adductor magnus?

      Your Answer:

      Correct Answer: Posterior branch of the obturator nerve

      Explanation:

      The nerves that supply the adductor magnus muscle have an embryologic origin from the anterior divisions of the lumbosacral plexus and include the obturator nerve, posterior division (L2-4), and the tibial portion of the sciatic nerve (L4). It is innervated by the posterior division of the obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 12 - A 26-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.Which...

    Incorrect

    • A 26-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.Which of the following is NOT an action of the gluteus maximus muscle? Select ONE answer only.

      Your Answer:

      Correct Answer: Hip abduction

      Explanation:

      Gluteus maximus is the main extensor muscle of the hip and assists with lateral rotation of the thigh at the hip joint. It also acts as a hip adductor, steadies the thigh, and assists in raising the trunk from a flexed position.Gluteus maximus is innervated by the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 13 - Regarding the intervertebral disc, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the intervertebral disc, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: In L4 - L5 disc herniation, the L5 spinal nerve root is the most commonly affected.

      Explanation:

      A posterolateral herniation of the disc at the L4 – L5 level would be most likely to damage the fifth lumbar nerve root, not the fourth lumbar nerve root, due to more oblique descending of the fifth lumbar nerve root within the subarachnoid space.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 14 - 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:

      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
      0
      Seconds
  • Question 15 - Contraction of the diaphragm results in which of the following effects: ...

    Incorrect

    • Contraction of the diaphragm results in which of the following effects:

      Your Answer:

      Correct Answer: Increased vertical dimension of the thorax

      Explanation:

      Contraction of the diaphragm (as in inspiration) results in flattening (depression) of the diaphragm with an increase in vertical dimension of the thorax. This results in decreased intrathoracic pressure and increased intra-abdominal pressure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 16 - A 36-year-old man presented to the emergency room with a two-week history of...

    Incorrect

    • A 36-year-old man presented to the emergency room with a two-week history of shortness of breath, fevers, and malaise. A chest X-ray was ordered and the results confirmed the diagnosis of a right middle lobe pneumonia. Which of the following structures of the heart lies closest to the consolidation?

      Your Answer:

      Correct Answer: Right atrium

      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 ventricleThe silhouette sign of Felson is with respect to the right middle lobe. The right heart border should have a distinct appearance due to the right atrium abutting aerated right middle lobe. The consolidation in the right middle lobe has resulted in loss of this silhouette.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 17 - Which of the following muscles are primarily involved in passive inspiration: ...

    Incorrect

    • Which of the following muscles are primarily involved in passive inspiration:

      Your Answer:

      Correct Answer: Diaphragm and external intercostal muscles

      Explanation:

      Passive inspiration is produced by contraction of the diaphragm (depressing the diaphragm) and the external intercostal muscles (elevating the ribs). In inspiration, elevation of the sternal ends of the ribs (‘pump handle’ movement), elevation of the lateral shafts of the ribs (‘bucket handle’ movement) and depression of the diaphragm result in expansion of the thorax in an anteroposterior, transverse and vertical direction respectively. This results in an increased intrathoracic volume and decreased intrathoracic pressure and thus air is drawn into the lungs.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 18 - A foot drop is a sign of damage to which of the following...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 19 - Injury to which nerve can lead to weakness or paralysis of the brachialis...

    Incorrect

    • Injury to which nerve can lead to weakness or paralysis of the brachialis muscle?

      Your Answer:

      Correct Answer: The musculocutaneous nerve

      Explanation:

      The brachialis muscle is a prime flexor of the forearm at the elbow joint. It is fusiform in shape and located in the anterior (flexor) compartment of the arm, deep to the biceps brachii. The brachialis is a broad muscle, with its broadest part located in the middle rather than at either of its extremities. It is sometimes divided into two parts, and may fuse with the fibres of the biceps brachii, coracobrachialis, or pronator teres muscles. It also functions to form part of the floor of the cubital fossa.The brachialis is primarily supplied by the musculocutaneous nerve (C5, C6). In addition, a small lateral portion of the muscle is innervated by the radial nerve (C7).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 20 - If a lesion is observed in Broca's area, which function is expected to...

    Incorrect

    • If a lesion is observed in Broca's area, which function is expected to become affected?

      Your Answer:

      Correct Answer: Formation of words

      Explanation:

      The primary functions of the Broca area are both language production and comprehension. While the exact role in the production is still unclear, many believe that it directly impacts the motor movements to allow for speech. Although originally thought to only aid in speech production, lesions in the area can rarely be related to impairments in the comprehension of language. Different regions of the Broca area specialize in various aspects of comprehension. The anterior portion helps with semantics, or word meaning, while the posterior is associated with phonology, or how words sound. The Broca area is also necessary for language repetition, gesture production, sentence grammar and fluidity, and the interpretation of others’ actions.Broca’s aphasia is a non-fluent aphasia in which the output of spontaneous speech is markedly diminished and there is a loss of normal grammatical structure. Specifically, small linking words, conjunctions, such as and, or, and but, and the use of prepositions are lost. Patients may exhibit interjectional speech where there is a long latency, and the words that are expressed are produced as if under pressure. The ability to repeat phrases is also impaired in patients with Broca’s aphasia. Despite these impairments, the words that are produced are often intelligible and contextually correct. In pure Broca’s aphasia, comprehension is intact.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 21 - Your consultant requests that you do a lumbar puncture on a patient who...

    Incorrect

    • Your consultant requests that you do a lumbar puncture on a patient who is suspected of having meningitis. This patient, a 15-year-old female, presented to the emergency department with a fever, headache, and neck stiffness. Where should you aspirate a sample of CSF?

      Your Answer:

      Correct Answer: Subarachnoid space

      Explanation:

      A lumbar puncture, also known as a spinal tap, is a procedure that involves inserting a needle into the lower back’s lumbar region. A needle is inserted into the space between the arachnoid mater and the pia mater, also known as the subarachnoid space, to remove a sample of cerebrospinal fluid.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 22 - Which of the following is NOT a typical cerebellar sign: ...

    Incorrect

    • Which of the following is NOT a typical cerebellar sign:

      Your Answer:

      Correct Answer: Hypertonia

      Explanation:

      Hypotonia means decreased muscle tone. It can be a condition on its own, called benign congenital hypotonia, or it can be indicative of another problem where there is progressive loss of muscle tone, such as muscular dystrophy or cerebral palsy. It is usually detected during infancy. Hypotonia is characteristic of cerebellar dysfunction.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 23 - A 60-year-old man with trauma to his cervical spine suffers from damage to...

    Incorrect

    • A 60-year-old man with trauma to his cervical spine suffers from damage to the ansa cervicalis, resulting to paresis of his infrahyoid muscles.All of the following are considered infrahyoid muscles, except:

      Your Answer:

      Correct Answer: Mylohyoid

      Explanation:

      Infrahyoid muscles are also known as “strap muscles” which connect the hyoid, sternum, clavicle and scapula. They are located below the hyoid bone on the anterolateral surface of the thyroid gland and are involved in movements of the hyoid bone and thyroid cartilage during vocalization, swallowing and mastication. They are composed of four paired muscles, organized into two layers.Superficial layer consists of the sternohyoid and omohyoidDeep layer consists of the sternothyroid and thyrohyoid.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 24 - Which of the following is an adverse effect of carbamazepine: ...

    Incorrect

    • Which of the following is an adverse effect of carbamazepine:

      Your Answer:

      Correct Answer: Aplastic anaemia

      Explanation:

      Common adverse effects include nausea and vomiting, sedation, dizziness, headache, blurred vision and ataxia. These adverse effects are dose related and are most common at the start of treatment.Other adverse effects include:Allergic skin reactions (and rarely, more serious dermatological conditions)Hyponatraemia (avoid concomitant use with diuretics)Leucopenia, thrombocytopenia and other blood disorders including aplastic anaemiaHepatic impairment

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds
  • Question 25 - In adults, the conus medullaris of the spinal cord lies at which of...

    Incorrect

    • In adults, the conus medullaris of the spinal cord lies at which of the following vertebral levels:

      Your Answer:

      Correct Answer: L1/L2

      Explanation:

      At birth, the conus medullaris lies at L3. By the age of 21, it sits at L1/L2.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 26 - A 70-year-old woman presents with right-sided loss of pain and temperature sense on...

    Incorrect

    • A 70-year-old woman presents with right-sided loss of pain and temperature sense on the body as well as left-sided loss of pain and temperature sense on the face. She also has complaints of vertigo, nausea, and tinnitus. Further examination of her cranial nerves suggest the presence of Horner's Syndrome. An MRI and CT scan was ordered and results showed that she is suffering from a left-sided stroke. Branches of which of the following arteries are most likely implicated in the case?

      Your Answer:

      Correct Answer: Posterior inferior cerebellar artery

      Explanation:

      Wallenberg syndrome is also known as lateral medullary syndrome and posterior inferior cerebellar artery syndrome. It is the most common posterior circulation ischemic stroke syndrome. The primary pathology of Wallenberg syndrome is occlusion of the posterior inferior cerebellar artery (PICA) or one of its branches.It is characterized by vertigo with nystagmus, nausea and vomiting, and sometimes hiccups, dysphonia, dysarthria, and dysphagia often present with ipsilateral loss of gag reflex, ipsilateral ataxia with a tendency to fall to the ipsilateral side, pain and numbness with impaired facial sensation on the face, impaired taste sensation, and impaired pain and temperature sensation in the arms and legs.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 27 - Regarding CSF (cerebrospinal fluid) production, approximately how much is produced per day? ...

    Incorrect

    • Regarding CSF (cerebrospinal fluid) production, approximately how much is produced per day?

      Your Answer:

      Correct Answer: 500 ml

      Explanation:

      CSF fills the ventricular system, a series of interconnected spaces within the brain, and the subarachnoid space directly surrounding the brain. The intraventricular CSF reflects the composition of the brain’s extracellular space via free exchange across the ependyma, and the brain “floats” in the subarachnoid CSF to minimize the effect of external mechanical forces. The volume of CSF within the cerebral ventricles is approximately 30 mL, and that in the subarachnoid space is about 125 mL. Because about 0.35 mL of CSF is produced each minute, CSF is turned over more than three times daily. Approximately 500 mL of CSF is produced per day, at a rate of about 25 mL per hour.CSF is a filtrate of capillary blood formed largely by the choroid plexuses, which comprise pia mater, invaginating capillaries, and ependymal cells specialized for transport. The choroid plexuses are located in the lateral, third, and fourth ventricles. The lateral ventricles are situated within the two cerebral hemispheres. They each connect with the third ventricle through one of the interventricular foramina (of Monro). The third ventricle lies in the midline between the diencephalon on the two sides. The cerebral aqueduct (of Sylvius) traverses the midbrain and connects the third ventricle with the fourth ventricle. The fourth ventricle is a space defined by the pons and medulla below and the cerebellum above. The central canal of the spinal cord continues caudally from the fourth ventricle, although in adult humans the canal is not fully patent and continues to close with age.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 28 - A 22 year old male has been stabbed and is brought to the...

    Incorrect

    • A 22 year old male has been stabbed and is brought to the ED with a stab wound to his upper limb. On examination, the patient is unable to flex the distal interphalangeal joints of the ring and little finger. However, the proximal interphalangeal joint is intact. The most likely affected nerve is which of the following, and at which level is this occurring?

      Your Answer:

      Correct Answer: Ulnar nerve at elbow

      Explanation:

      The medial half of the flexor digitorum profundus is innervated by the ulnar nerve. Paralysis of this muscle results in loss of flexion at the distal interphalangeal joint of the ring and little finger. Flexion at the proximal interphalangeal joint is preserved as this is a function of the flexor digitorum superficialis which is innervated by the median nerve. The ulnar nerve is not correct as ulnar nerve injury at the wrist would not affect the long flexors, and the injury must have been more proximal.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 29 - Which of the following clinical features is NOT typical of a facial nerve...

    Incorrect

    • Which of the following clinical features is NOT typical of a facial nerve palsy:

      Your Answer:

      Correct Answer: Inability to raise the eyelid

      Explanation:

      Facial nerve palsy can result in inability to close the eye due to paralysis of the orbicularis oculi muscle. Elevation of the eyelid in eye opening is a function of the levator palpebrae superioris muscle and the superior tarsal muscle, innervated by the oculomotor nerve and the sympathetic chain respectively.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      0
      Seconds
  • Question 30 - A 25-year old male is brought to the emergency room after a traffic...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (3/4) 75%
Head And Neck (1/1) 100%
Central Nervous System (0/1) 0%
Pharmacology (0/1) 0%
Cranial Nerve Lesions (0/1) 0%
Thorax (1/1) 100%
Abdomen (1/1) 100%
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