14- Pre operative Fawzia MSQs Only Flashcards
1- A 37-year-old man presents with severe headache, photophobia arid neck stiffness. Karnig’s sign is positive and a midline lumbar puncture is performed immediately to determine if a cerebrospinal fluid (CSF) pathogen is involved. In performing this procedure, which is ‘he first of the following structures to be pierced by the lumbar puncture needle?
Interspinous ligament
in Order from skin to inward skin
supraspinus ligament
interspinus ligament
ligamentum flavum
2- 11. A 70-year-old woman from a nursing home presents to the! Emergency Department with abdominal pain and vomiting. On examination, she is dehydrated and her abdomen is distended. There is a 3 cm 4 cm swelling in her right groin which is non-tender, and there is no cough impulse. At operation, a femoral Hernia found. Which of the following lies medial to the neck of the hernia?
Lacunar ligament
3- 12. A 26-year-old man presents to the Emergency Department with extensive bleeding from his arm after sustaining a glass injury. On examination there is a 7 cm transverse laceration across the anterior aspect of his elbow. On exploring the cubital fossa you would expect the brachial artery to be:
lateral to the median nerve
4- 15. A 45-year-old mart presents with backache and leg pain due to a prolapsed lumbar Intervertebral disc. The pain, which is aggravated by coughing and sneezing, radiates to the lateral aspect of the foot. On examination, there is weakness of the plantar flexors of the foot, which nerve root is most likely to be involved?
S1
5- A 22-year-old man has been stabbed in the left fifth intercostal space at the edge of the sternum. Which structure is most likely to have been penetrated?
Right ventricle
6- 19. An 80-year-old man dislocates his shoulder it is reduced in the Emergency Department. At review three weeks later, he is unable to actively initiate abduction of his arm. Which muscle most likely damaged?
Supraspinatus
initiation up to 15 = supraspinatus
15-90 = deltoid
90 and above = trapezius + seratous anterior
7- 24. A 42-year-old multiparous woman is admitted to the Emergency Department due to pelvic discomfort. The duty gynecologist diagnoses uterine prolapse. Which anatomical structure gives significant direct support to the uterus?
Transverse perinea! Muscles
8- 29. Which one of me following muscles is an extensor of the hip?
Semitendinosus
9- 31. A 65-year-old man presents with haematuria and left loin pain. Computerised tomography demonstrates a left renal tumour. He undergoes a left radical nephrectomy. Where does the left renal artery lie?
Posterior to the left renal vein
remember it croses in front of the aorta and below SMA
10- 32. Within the posterior triangle, which nerve is at particular risk of damage during surgery?
Spinal accessory
11- 33. The right and left pulmonary arteries are derived from which of the following embryological aortic arches?
Sixth aortic arch
12- 35. During arch aortography, the vertebral artery would be seen to arise directly from which of the following?
Subclavian artery
13- 35. During arch aortography, the vertebral artery would be seen to arise directly from which of the following?
Subclavian artery
Subclavian artery is a little bit important, why ?
Because it Supplies :
Thyroid
Breast
Diaphragm
Brain stem
And upper limb
14- 37. A 3-year-old boy is admitted to hospital with severe vomiting. Radiographic examination reveals that he is suffering from annular pancreas. Which of these structures is constricted?
Second part of duodenum
16- 43. A surgeon makes a Pfannenstiel incision for access to the pelvic organs. He incises theabdominal wall down to and through the rectus sheath .- He retracts the rectus abdominis muscles laterally from the midline to expose the:
transversalis fascia
15- 39. A 36-year-old man presents with a two-month history of low back pain radiating to his left leg After clinical examination he is referred for an MRI scan. This shows a prolapsed intervertebral disc. The clinical signs are consistent with pressure on SI roots. Which combination of clinical signs is most likely?
Weak ankle plantarfiexion; altered sensation on the sole of the foot; loss of ankle jerk reflex.
The Trick here is to look for Ankle Reflex loss and sensory loss of s1 root = lateral foot & sole
17- 49. A 65-year-old man presents with vomiting and .weight loss. On examination he had 3 palpable epigastric mass. The transpyloric plane lies at which; vertebral level?
L1
L1 =
Pylorus
Neck of pancreaus
SMA
Gall bladder fundus
kidney hilum
2nd part of dudenum
dudenojujenal flexure
transverse colon
End of spinal cord
18- 51. In an emergency situation what is the most appropriate surgical method of obtaining an airway?
Piercing the cricothyroid membrane
cricothyrodotomy
21- 65. An 82-year-old man has complete occlusion of his inferior mesenteric artery on angiography but no symptoms or signs of colonic ischemia. Which of the following arteries is the most likely additional source of blood supply to the territory of the inferior mesenteric artery?
Middle colic
22- 69. A 35-year-old man is admitted to hospital with vomiting, nausea and severe headaches. An MRI scan reveals a tumour of the cerebellopontine angle. Which one of the following pairs of cranial nerves is most likely to be compressed by this tumour?
Facial and vestibulocochlear
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cerebral 2 (1,2 )
midbrain 2 (3,4)
pons 4 ( 5,6,7,8 )
medulla 4 ( 9,10,11,12 )
23- 70. After resection of d rectal tumour a patient experiences erectile dysfunction. Which of the following nerves is most likely to have been damaged in surgery?
Pelvic splanchnic nerves
Nervi ergintis
24- 72. A 22-year-old man arrives to the Emergency Department with sudden breath less ness due to a large pneumothorax. A chest drain is inserted into the fifth left intercostal space in 5th mid-axillary line. There is haemorrhape into the drainage bottle. Which of the following structures is the most likely cause of this acute haemorrhage?
Intercostal artery
25- 76. In order to expose the right axillary artery, a transverse skin incision is typically made below the clavicle from a point just lateral to the sternal end of the clavicle to the deltopectoral groove. Which of the following structures would be encountered in the dissection down to the vessel?
Thoraco-acromial artery
26- 77. A 4-year-old boy presents to the Emergency Department with a two-day history of headache vomiting and drowsiness. A CT scan reveals dilatation of both his lateral ventricles and his third cerebral ventricle. His fourth ventricle was of normal size. It is suspected that he has an obstruction to his cerebrospinal fluid flow. At which of the following sites is the obstruction most likely to be?
Cerebral aqueduct (of Sylvius)
27- 80. A 56-year-old man with chronic emphysema is on the high dependency unit (HDU), ten days after anterior resection. He has developed acute shortness of breath’ and hypotension): Which of the following landmarks would be the most appropriate to use to obtain a femoral arterial blood gas sample?
A point midway between the anterior superior iliac-spine and the’ pubic symphysis
28- 81. A 70-year-old man complains of persistent numbness since.an inguinal hernia repair one year previously. The numbness affects the top of the scrotum, root of penis, and a small area below the medial part of the inguinal ligament. Which nerve is likely to have been damaged?
llioinguinal nerve
29- 82. A 12-year-old girl has a diastolic murmur. It is maximally audible in the second left intercostal space. Pathology of which structure is the most likely cause?
Pulmonary valve
30- 87. A 60-year-old man undergoes cystectomy for a bladder carcinoma. During surgery, the ureters are identified. On which region of the bladder do the ureters pierce the bladder wall?
Posterior surface
A very famous Recall Anatomy Question yet does come with many answsers
if you found Base in the options choose it
if not go for posterior like here
31- 88. A year-old patient in the intensive care unit has a tracheostomy performed via the second, third and fourth tracheal rings. Which intervening structure is most likely to require transection?
Thyroid isthmus
32- 89. A 23-year old man is assaulted and sustains a stabbing injury to the left groin. The wound- is cleaned and a simple dressing applied; Six months later the patient returns with pulsatile swelling at the site of the injury. The most probable lesion present is:
False aneurysm of the femoral artery
33- 91. A 16-year-old boy is hit on the left side of the face by a ball. There are no broken bones but the boy complains of numbness of the face below the eye. Which nerve has most likely been compromised?
infra-orbital nerve
34- 94. After receiving an intermascular Injection in the buttock, a 25 year-old man complains of inability to evert his foot Which nerve is most likely to have been injured?
Common peroneal (fibular) component of sciatic
Evertion of the foot is specifically the lateral compartment action ( Pernoneus Longus & brevis ) via superficial peroneal nerve
35- 98. A 36-year-old man falls on his outstretched right hand. Examination reveals tenderness in the anatomical snuff box. Which one of the following tendons form a boundary of the anatomical snuff box?
Extensor pollicis longus
…………………….
Forms medial boundry of the snuff box
36- 122. A 55-year-old man presents with back ache. Neurological examination reveals lack of extension of the left great toe .; Which of the following spinal cord segments are likely to be involved?
L4, L5 & S1
37- 103. A 34-year-old man is seen in the Emergency Department with a fibular fracture following football match. On examination he is noted to have loss of foot eversion. Which area of skin should be examined to confirm. loss of the cutaneous distribution of the affected-nerve?
Cross the dorsal surface of the foot
it’s the anterior part which you can see with your eye
when you look at it
yes it’s not the sole :)
38- 110. A 10-year-old child presents with progressive facial weakness and a squint. On examination there is a lower motor neuron facial weakness and failure of abduction of one eye. An MRI scan shows a small, intrinsic mass lesion within the central nervous system. Where is this most likely to be located?
The pons
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Cerebrum 2
mid brain 2
pons 4
medulla 4
39- 116. A 50-year-old man complains of recent onset diplopia. On examination he is unable to lookinwards and downwards with his right eye; The most likely diagnosis is a lesion of the?
trochlear nerve
40- 127. A 66-year-old woman with known tumour of her spine has started to retain urine and is experiencing decreased anal and rectal tone. The tumour is pressing directly on the conus medullaris. At which one of the following vertebral levels is the tumour most likely to be located?
L1/L2
46- 13. A 65-year-old man has a history of transient ischemic attacks. He is due to undergo carotid endarterectomy. Which one of the following is true of the internal carotid artery?
A. Begins at the level of the sixth cervical vertebra
B. Divides into the anterior, middle and posterior cerebral arteries
C. Gives off the ophthalmic artery(Right)
D. Is accompanied within the skull by preganglionic sympathetic nerves
E. Passes through the foramen ovale
………………………………………………………………
Ophthalmic artery :
Begins at C3 when CCA bifurcates enters through carotid canal in forumen lacerum ends in the circle of willis separated from external carotid by styloid process
Branches :
1. Ophthalmic artery
2. Ant & Middle cerebral arteries
3. Posterior communicating & Anterior Choroid arteries
42- 134. A 4-year-old boy, is brought to the Emergency Department with a painful right elbow. His father stales that he was swinging his son by his arms when the pain came on suddenly An X-ray shows that the radial head is displaced from its usual position. What is the ligament (of the proximal radio-ulnar joint) that holds the radial head in place?
Annular ligament
44- 5. A 32-years old man presents with a painful torticollis there is no past medical history and his only complaint is that he has been feeling rather tired over the last 4 nights. On examination, he has large rubbery mass in the lateral aspect of his neck as well as a few smaller masses along his internal jugular vein. You correctly assume that the muscular neck spasm and the large mass are connected. The most likely cause of his torticollis is due to pressure on?
Spinal accessory nerve
nerve supply of Trapezius & Sternomastoid
48- 16. A 55-year-old man presents with acute back pain following a severe road traffic accident. Neurological examination reveals lack of sensation of the umbilicus and below. What is the spinal level of the neurological deficit likely to be?
T10
47- 15. A 26-year-oJd man presents to the Emergency Department after sustaining a glass cut to his arm. On examination there is a 10 cm longitudinal laceration on the anterior aspect of his upper arm. He has symptoms suggestive of ulnar nerve injury.
On exploring the upper part of the arm we would expect the ulnar nerve to be:
medial to the brachial artery
49- 19. A 60-year»old man presents to the-Emergency Department with epistaxis. The source of the bleeding is identified as Little’s area and resolves with direct cautery. Which vessel is most likely responsible for the bleeding?
Sphenopalatine artery
Kiesselbach’s area, or Kiesselbach’s triangle.
The arteries are: 4
Anterior ethmoidal artery (branch of the ophthalmic artery)
Sphenopalatine artery (terminal branch of the maxillary artery)
Greater palatine artery (from the maxillary artery)
Septal branch of the superior labial artery (from the facial artery)
51- 22, A 26-year-old man is having a stereotactic frame fitted to his skull prior to radiosurgery on a cerebral arteriovenous malformation. Four pins secure the frame tightly through the scalp to the outer table of the skull, two anteriorly, two posteriorly. On insertion of one of the-posterior pins, arterial haemorrhage is encountered. Which artery is most likely to have been punctured?
The occipital artery
53- 28. A 45-year-old man presented with backache and leg pain due to -prolapsed lumbar . intervertebral’ disc. The pain, which is aggravated by coughing and sneezing; radiates to the dorsum of the foot On examination there is weakness, of the dorsiflexion of the foot. Which nerve root is most likely to be involved?
L5
52- 24. A 2 day old baby presents with increasing respiratory distress. He was born at term By normal vaginal delivery. On examination he has cyanosis of the lower limbs and marked respiratory in drawing of the chest His femoral pulses ate absent bilaterally and he has been anuric for the last 2 hours. Pulse rate is 140 beats/minute, regular, and his blood pressure is 60/30 mmhg in both upper limbs. What is the most likely diagnosis?
Interrupted aortic arch
Tetralogy of Fallot (TOF) is a congenital heart defect with four components:
1) large ventricular septal defect (VSD), which is a hole between the two ventricles or pumping chambers in the heart;
2) pulmonary stenosis, which is narrowing beneath or in the blood vessel leading to the lungs;
3) overriding of the aorta, in which the aorta lies directly above the ventricular septal defect; and
4) as a result of these events, the right ventricle becomes thickened or hypertrophied.
56- 32. A 19-year-old woman presents to the Emergency .Department profoundly hypovolemic having fallen from a horse. A postero-anterior (PA) chest radiograph shows a fracture to the medial third of the left clavicle. Which of the following vessels was-most likely damaged?
Left subclavian artery
54- 29. A 75-year-old woman, who has a carcinoma of the upper rectum, undergoes anterior resection. The arterial blood supply of the upper rectum arises from which of the following?
Inferior mesenteric artery
The rectum receives arterial supply through three main arteries: Superior rectal artery - terminal continuation of the inferior mesenteric artery. Middle rectal artery - branch of the internal iliac artery. Inferior rectal artery - branch of the internal pudendal artery.
