1ST BM Flashcards by SALI BABY

The following part or branch of the brachial plexus receives contributions from the C8 spinal nerve: *
A. Lateral cord
B. Lateral pectoral nerve
C. Posterior cord
D. Nerve to the rhomboid muscles
E. Suprascapular nerve

C. Posterior cord

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The following part or branch of the brachial plexus has a terminal branch that supplies the skin on the medial side of the arm. *
A. Musculocutaneous nerve
B. Lateral cord
C. Thoracodorsal nerve
D. Medial cord
E. Upper subscapular nerve

D. Medial cord

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The following part of the brachial plexus is formed from the anterior divisions of two trunks. *
A. Lateral cord
B. Posterior cord
C. Median nerve
D. Medial cord
E. Lower trunk

B. Posterior cord

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The following part of the brachial plexus has branches that supply the extensor muscles of the arm. *
A. Lateral cord
B. Medial cord
C. Posterior cord
D. Thoracodorsal nerve
E. Lateral and medial cords

C. Posterior cord

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During its course in the upper limb, the axillary nerve lies _______________. *
A. in front of the lateral epicondyle of the humerus.
B. against the spiral groove of the humerus.
C. medial to the brachial artery in the cubital fossa.
D. against the surgical neck of the humerus.
E. behind the medial epicondyle of the humerus.

D. against the surgical neck of the humerus.

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During its course in the upper limb, the ulnar nerve lies __________. *
A. Behind the medial epicondyle of the humerus.
B. In front of the lateral epicondyle of the humerus.
C. Behind the flexor retinaculum of the wrist.
D. Against the spiral groove of the humerus.
E. Medial to the brachial artery in the cubital fossa.

A. Behind the medial epicondyle of the humerus

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During its course in the upper limb, the median nerve lies __________. *
A. Anterior to the flexor retinaculum of the wrist.
B. In front of the lateral epicondyle of the humerus.
C. Against the spiral groove of the humerus.
D. Against the surgical neck of the humerus.
E. Medial to the brachial artery in the cubital fossa.

E. Medial to the brachial artery in the cubital fossa

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During its course in the upper limb the radial nerve lies __________. *
A. Against the spiral groove of the humerus.
B. In front of the medial epicondyle of the humerus.
C. Behind the flexor retinaculum of the wrist.
D. Medial to the brachial artery in the cubital fossa.
E. Against the surgical neck of the humerus.

A. Against the spiral groove of the humerus.

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The extensor carpi radialis brevis muscle is innervated by the \_\_\_\_\_\_\_\_\_\_. *
A. Radial nerve.
B. Ulnar nerve.
C. Superficial radial nerve.
D. Deep branch of the radial nerve.
E. Deep branch of the ulnar nerve.

D. Deep branch of the radial nerve.

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The dorsal interossei muscles are innervated by the __________. *
A. Deep branch of the radial nerve.
B. Deep branch of the ulnar nerve.
C. Musculocutaneous nerve.
D. Superficial branch of the ulnar nerve.
E. Median nerve.

B. Deep branch of the ulnar nerve.

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The extensor indicis muscle is innervated by the \_\_\_\_\_\_\_\_\_\_. *
A. Radial nerve.
B. Ulnar nerve.
C. Median nerve.
D. Deep branch of the radial nerve.
E. Deep branch of the ulnar nerve.

D. Deep branch of the radial nerve.

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The extensor carpi ulnaris muscle is innervated by the \_\_\_\_\_\_\_\_\_\_. *
A. Median nerve.
B. Deep branch of the ulnar nerve.
C. Ulnar nerve.
D. Radial nerve.
E. Deep branch of the radial nerve.

E. Deep branch of the radial nerve.

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The extensor carpi radialis longus muscle is innervated by the \_\_\_\_\_\_\_\_\_\_. *
A. Deep branch of the ulnar nerve.
B. Ulnar nerve.
C. Radial nerve.
D. Median nerve.
E. Anterior interosseous nerve.

C. Radial nerve.

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A 20 -year-old male receives a deep stab wound around the superior angle of the scapula near the medial border, which injures both the spinal accessory nerves and dorsal scapular. Such an injury could result in paralysis or weakness of which of the following muscles? *
A. Trapezius and serratus posterior superior
B. Rhomboid minor and latissimus dorsi
C. Trapezius and Rhomboid major
D. Levator scapulae and erector spinae

C. Trapezius and Rhomboid major

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12.	A 2-year-old female presents to her paediatrician with rather new onset of bowel and bladder dysfunction and loss of the lower limb function. Her mother had not taken enough folic acid (to the point of a deficiency) during her pregnancy. On examination, the child has protrusion of the spinal cord and meninges and is diagnosed with which of the following conditions? *
A. Spina bifida occulta
B. Meningocele
C. Meningomyelocele
D. Myeloschisis

C. Meningomyelocele

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12.	This term refers to the collection of spinal nerves at the inferior end of vertebral canal: *
A. Conus medullaris
B. Cauda equina
C. Plexus
D. Filum terminale

B. Cauda equina

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This structure identifies a vertebra to be cervical: *
A. Intervertebral foramen
B. Transverse foramen
C. Vertebral foramen
D. Articular process

B. Transverse foramen

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10.	The suboccipital triangle contains this important structure: *
A. Vagus nerve
B. Vertebral artery
C. Rectus capitis posterior major
D. Sympathetic ganglion

B. Vertebral artery

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A patient who complains of low back pain which radiates to the buttock, posterior thigh, leg and foot most likely has impingement of this/these spinal nerve(s): *
A. S5, Co1
B. L4, L5, S1
C. S2, S3, S4
D. L1, L2, L3

B. L4, L5, S1

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The innermost meningeal layer that is adherent to the brain and spinal cord is the: *
A. Arachnoid
B. Choroid plexus
C. Dura
D. Pia

D. Pia

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A 27-year-old woman is brought to the emergency department awake and alert after sustaining multiple gunshot wound to her neck and back. On work up revealed revealed injury in the intervertebral foramina between the second and third cervical vertebrae and between the fourth and fifth thoracic vertebrae. Which of the following spinal nerves may be damaged? *
A. Fourth cervical and fourth thoracic nerves
B. Fifth cervical and fifth thoracic nerves
C. Fourth cervical and fifth thoracic nerves
D. Third cervical and fourth thoracic nerves

D. Third cervical and fourth thoracic nerves

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A 30-year-old man suffers a stab wound that penetrated into his suboccipital triangle, injuring the suboccipital nerve between the vertebral artery and the posterior arch of the atlas. Which of the following muscles would be unaffected by such a lesion? *
A. Rectus capitis posterior major
B. Splenius capitis
C. Obliquus capitis superior
D. Obliquus capitis inferior

B. Splenius capitis

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This structure passes through and is protected by the transverse foramen: *
A. Vagus nerve
B. Spinal cord
C. Vertebral vessel
D. Spinal nerve

C. Vertebral vessel

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Which back muscle is innervated by the dorsal scapular nerve: *
A. Trapezius
B. Levator scapulae
C. Latissimus dorsi
D. Serratus posterior

B. Levator scapulae

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``` MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s. The vertebral arch of a typical vertebra is composed of: * A. Body B. Laminae C. Processes D. Pedicles ```

A. Body

``` A clinically palpable apical group lymph node is a * A. Level II lymph nodes B. Level III lymph nodes C. Level I lymph nodes D. Level IV lymph nodes ```

B. Level III lymph node

``` A clinically positive posterior group lymph node is a * A. Level II lymph nodes B. Level III lymph nodes C. Level I lymph nodes D. Level IV lymph nodes ```

C. Level I lymph nodes

12. A 50 year-old woman was diagnosed with invasive ductal carcinoma (breast cancer). During axillary dissection, the surgeon was able to palpate enlarged group of nodes behind both pectoralis minor and pectoralis major muscle * A. Rotter’s and Central group lymph nodes B. Central and Rotter’s group lymph nodes C. Lateral and Rotter’s group lymph nodes D. Rotter’s groupand Scapular lymph nodes

B. Central and Rotter’s group lymph nodes

``` A clinically positive central group lymph node is a * Level II lymph nodes Level III lymph nodes Level I lymph nodes Level IV lymph nodes ```

Level II lymph nodes

``` A clinically positive interpectoral group lymph node is a * Level II lymph nodes Level III lymph nodes Level I lymph nodes Level IV lymph nodes ```

Level II lymph nodes

Which of the following nodes receives the majority of the breast tissue lymph * Posterior intercostal nodes Parasternal nodes Infraclavicular nodes Axillary nodes

Axillary nodes

The medial mammary artery(ies) is/are a direct branch(es) of * A. Thoracoacromial artery B. 2nd,3rd and 4th perforating branches of internal thoracic artery C. Posterior intercostal arteries D. Axillary artery

C. Posterior intercostal arteries

The lymphatics from upper part of mammary gland may directly drain into : * The parasternal lymph nodes. Subdiaphragmatic lymph nodes. Apical group of axillary lymph nodes. Pectoral group of axillary lymph nodes.

Apical group of axillary lymph nodes.

How many lactiferous ducts drain into nipple of the mature female breast * 25-30 35-40 15-20 5-10

15-20

``` The mammary glands are modified versions of which type of gland? * sebaceous gland lymph gland sweat gland tonsillar tissue endocrine gland ```

sweat gland

``` Which of the following does NOT supply the breast with blood? * lateral thoracic artery thoracoacromial artery posterior intercostals arteries internal thoracic artery costoclavicular artery ```

costoclavicular artery

``` The high death rate associated with breast cancer is related to which of the following? * nerve supply blood supply venous drainage complex lymphatic drainage ```

complex lymphatic drainage

The retromammary space is located between which of the following structures? * skin and the areola pectoralis major and minor breast and deep pectoral fascia suspensory ligament and the skin lactiferous sinus and the nipple

breast and deep pectoral fascia

``` After a vehicular accident, a back muscle that forms the boundaries of the triangle of auscultation and the lumbar triangle receives no blood. Which of the following muscles might be ischemic? * Rhomboid minor Latissimus dorsi Trapezius Splenius capitis ```

Latissimus dorsi

``` The intervertebral foramina is formed by this/these structure(s) when the vertebrae articulate: * Lamina Vertebral foramen Pedicle Vertebral notches ```

Vertebral notches

Low back pain due to spinal nerve impingement is most commonly caused by: * Intervertebral disc protrusion/herniation Abnormal curvature of the vertebral column Fracture of the vertebral arch New growth

Intervertebral disc protrusion/herniation

A 38-year-old woman with a long history of shoulder pain is admitted to a hospital for surgery. Which of the following muscles becomes ischemic soon after ligation of the superficial or ascending branch of the transverse cervical artery? * Latissimus dorsi Multifidus Trapezius Rhomboid major

Trapezius

``` The 7th cervical vertebra is differentiated from the other cervical vertebrae by its: * Oval body Large vertebral arch Large, triangular vertebral foramen Non-bifid spinous process ```

Non-bifid spinous process

The thoracic vertebrae are differentiated from the other vertebrae by this characteristic feature: * Large body Triangular vertebral foramen Long spinous process Presence of costal facets

Presence of costal facets

``` One of the following is part of the Suboccipital group of back muscles: * Spinalis Multifidus Interspinales Rectus capitis ```

Rectus capitis

What statement is true regarding the Trapezius muscle: * Flat triangular muscle that begins in the lower portion of the back Originates from the spinous processes of T7 to L5 Innervated by vagus nerve (CN X) Inserts into the clavicle and scapula

Inserts into the clavicle and scapula

``` A vehicular accident patient who manifests numbness from foot to the level of groin most likely has injury to what segment of the spinal cord: * L4 T12 L2 T10 ```

T12

If a head trauma patient has a cranial CT scan finding of subdural hematoma, this means that intracranial bleeding occurs into the space between: * Outermost layer and the middle layer of the brain meninx Middle layer and innermost layer of the brain meninx Brain tissue and innermost layer of the brain meninx Cranial bone and outermost layer of the brain meninx

Outermost layer and the middle layer of the brain meninx

This statement is correct about the intermediate group of back muscles: * Innervated by the posterior (dorsal) rami of the thoracic nerves Fibers of the muscles pass parallel to the vertebral column Group acts as a whole to elevate the ribs thus aiding in inspiration Consists of two serratus posterior muscles

Consists of two serratus posterior muscles

``` MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s. This/these are is/are the process(es) of a typical vertebra: * Spinous Transverse Articular Pedicle ```

Spinous Transverse Articular

``` A 30-year-old worker with history of fall has a lesion of the dorsal scapular nerve, making him unable to adduct his scapula. Which of the following muscles is most likely paralyzed? * Multifidus Rotator longus Rhomboid major Semispinalis capitis ```

Rhomboid major

``` This back muscle originates from the spinous processes of upper thoracic vertebrae and inserts to the medial border of scapula: * Serratus Latissimus dorsi Rhomboid Trapezius ```

Rhomboid

This description is typical for a lumbar vertebra: * Slender long spinous process Short transverse processes Large vertebral body Wide costal facets

Large vertebral body

``` MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s This/these are is/are the process(es) of a typical vertebra: * Spinous Pedicle Articular Transverse ```

Spinous Articular Transverse

``` MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s Movement(s) by the vertebral column include(s): * Flexion Extension Rotation Circumduction ```

Flexion Extension Rotation Circumduction

21. MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s This/these statement(s) is/are true regarding sacrum: * Absence of vertebral canal Made up of 5 fused vertebrae Normally concave Spinous processes fused to form median sacral crest

Made up of 5 fused vertebrae Normally concave Spinous processes fused to form median sacral crest

``` 20. MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s. The main action(s) of the Rotatores muscle on the spine is/are: * Stabilization Lateral flexion Rotation to opposite side Extension ```

Stabilization Rotation to opposite side Extension

``` MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s. Erector spinae group of back muscles includes: * Semispinalis Longissimus Rotatores Iliocostalis ```

Longissimus

18. MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s. Which of the following statement(s) is/are true regarding the Splenius muscle: * Originates from the lower half of the ligamentum nuchae and spinous processes of C8 to T6 Innervated by the anterior rami of the middle and lower cervical nerves Together (the left and the right) they extend the neck Inserts into the mastoid process of the temporal bone and transverse processes of the upper cervical vertebrae

Originates from the lower half of the ligamentum nuchae and spinous processes of C8 to T6 Together (the left and the right) they extend the neck Inserts into the mastoid process of the temporal bone and transverse processes of the upper cervical vertebrae

``` The muscle that will compensate in part for the paralysis of the supinator muscle is the __________. * A. Extensor carpi ulnaris muscle. B. Brachialis muscle. C. Triceps brachii muscle. D. Biceps brachii muscle. E. Anconeus muscle. ```

D. Biceps brachii muscle.

``` A shoulder separation that involves the lateral end of the clavicle sliding onto the superior aspect of the acromion would most likely result from damage to the __________. * A. Costoclavicular ligament. B. Sternoclavicular ligament. C. Coracoclavicular ligament. D. Glenohumeral ligament. E. Coracoacromial ligament. ```

C. Coracoclavicular ligament.

The synovial sheath of the flexor pollicis longus muscle forms the __________. * A. Thenar space. B. Radial bursa of the wrist. C. Midpalmar space. D. Ulnar bursa of the wrist. E. Digital synovial sheath for the index finger.

B. Radial bursa of the wrist.

To test for trapezius muscle paralysis, you would ask the patient to __________. * A. Flex the arm fully. B. Adduct the arm against resistance. C. Push against the wall with both hands. D. Shrug the shoulder. E. Abduct the arm fully.

D. Shrug the shoulder.

The lymph from the medial quadrants of the breast drains mainly into the __________. * A. Posterior axillary (subscapular) nodes. B. Internal thoracic nodes. C. Anterior axillary (pectoral) nodes. D. Lateral axillary (brachial) nodes. E. Infraclavicular (deltopectoral) nodes.

B. Internal thoracic nodes.

``` Cutting the dorsal scapular nerve would most likely results in paralysis of the __________. * A. Supraspinatus muscle. B. Deltoid muscle. C. Rhomboid major muscle. D. Trapezius muscle. E. Infraspinatus muscle. ```

C. Rhomboid major muscle.

. After injury to a nerve at the wrist, the thumb is laterally rotated and adducted. The hand looks flattened and apelike. The nerve that has been damaged is the __________. * A. Anterior interosseous nerve. B. Ulnar nerve. C. Deep branch of the radial nerve. D. Median nerve. E. Superficial branch of the radial nerve.

D. Median nerve.

``` The dermatome present over the lateral side of the wrist is __________. * A. C8. B. C6. C. T1. D. T2. E. C5. ```

B. C6.

The following statements concerning the blood vessels of the upper limb are correct except which? * A. The pulsation of the radial artery is felt anterior to the distal third of the radius between the tendons of the brachioradialis and the flexor carpi radialis. B. The axillary vein is formed by the union of the venae comitantes of the brachial artery and the basilic vein. C. The cephalic vein arises on the palm of the hand. D. The axillary sheath surrounds the axillary vessels and the brachial plexus. E. The cephalic vein drains into the axillary vein.

C. The cephalic vein arises on the palm of the hand.

``` At the wrist, the flexor retinaculum is attached to the following bones EXCEPT which? * A. The hook of the hamate B. The ridge on the greater multangular C. The pisiform bone D. The tubercle of the navicular E. The triquetral bone ```

E. The triquetral bone

. The following statements concerning the shoulder joint are correct except which? * A. The inferior part of the capsule is the weakest. B. The subacromial bursa communicates with the joint cavity. C. The strength of the joint depends largely on the tone of the surrounding muscles. D. Dislocation of the shoulder joint is common. E. The axillary artery lies in front of the shoulder joint.

B. The subacromial bursa communicates with the joint cavity.

The following statements concerning the lymphatic drainage of the upper limb are correct except which? * A. Lymph from an infected nail bed of the little finger drains into the supratrochlear lymph node. B. Lymph from infected cut of the index finger drains into the infraclavicular nodes. C. Lymph from an infected graze over the medial side of the elbow joint drains into the anterior (pectoral) group of axillary nodes. D. Lymph from the upper lateral quadrant of the breast drains into the anterior (pectoral) group of axillary nodes. E. Lymph from a boil on the back over the inferior angle of the scapula drains into the posterior (subscapular) nodes.

C. Lymph from an infected graze over the medial side of the elbow joint drains into the anterior (pectoral) group of axillary nodes.

The following structures pass superficial to the flexor retinaculum at the wrist except which? * A. Palmar cutaneous branch of the median nerve B. Ulnar nerve C. Flexor pollicis longus tendon D. Ulnar artery E. Palmar cutaneous branch of the ulnar nerve

C. Flexor pollicis longus tendon

Collateral circulation around the shoulder joint would involve the following except which? * A. The subscapular artery B. The superficial cervical artery C. The suprascapular artery D. The anterior circumflex humeral artery E. The lateral thoracic artery

E. The lateral thoracic artery

``` The proximal row of carpal bones includes all the following carpal bones except which? * A. The pisiform B. The capitate C. The lunate D. The triquetral E. The scaphoid ```

B. The capitate

Regarding a “winged scapula,” the following facts are correct except which? * A. The spinal part of the accessory nerve is damaged. B. The inferior angle of the scapula projects backward. C. The serratus anterior muscle may be wasted. D. The long thoracic nerve is damaged. E. The scapula can no longer be pulled anteriorly around the chest wall (as in thrusting the upper limb anteriorly when reaching).

A. The spinal part of the accessory nerve is damaged.

The following statements concerning the rotator cuff are correct except which? * A. It adds stability to the shoulder joint. B. It is formed by the tendons of the short muscles around the shoulder joint. C. The muscle tendons are fused to the capsule of the shoulder joint. D. Degeneration or tearing of the cuff will cause severe pain in the shoulder region. E. All the muscle tendons associated with the cuff are innervated by the suprascapular nerve.

E. All the muscle tendons associated with the cuff are innervated by the suprascapular nerve.

``` Which of the following pass through the quadrangular space? * A. Circumflex scapular artery B. Nerve to the lateral head of triceps C. Radial nerve D. Profunda artery E. Post humeral circumflex vessels ```

E. Post humeral circumflex vessels

. Which of the following is true about the Flexor Carpi Radialis? * A. Supplied by radial nerve. Median nerve B. Pierces flexor retinaculum C. Pronator wroing D. ???? Synergist with finger flexors E. Inserts to thumb 2nd and 3rd metacarpal

D. ???? Synergist with finger flexors

``` The contents of the posterior fascial compartment of the upper arm: * A. Radial nerve B. Profunda brachii artery C. The three heads of biceps muscle D. A and B are correct E. B and C are correct ```

D. A and B are correct

``` The muscles of the anterior compartment of the arm: * A. Long head of triceps B. Coracobrachialis C. Brachioradialis D. Brachialis E. Estensor digitorum superficialis ```

E. Estensor digitorum superficialis

A 30-year-old plasterer was finishing a difficult ceiling in a remodeled kitchen. He was standing on top of a stepladder with his right arm above his head. As he used his right hand to move the trowel, loaded with plaster, across the ceiling, he suddenly felt an acute spasm of pain over the tip of the right shoulder. At physical examination of the patient in the emergency department, it was found that the pain in the right shoulder recurred in the middle range of abduction and that there was extreme tenderness over the greater tuberosity of the humerus. What is the most likely structural damage in this patient? * A. Fracture of the upper end of the humerus B. Tearing of the deltoid muscle C. Fracture of the acromion D. Lesion of the rotator cuff E. Tearing of the trapezius muscle

D. Lesion of the rotator cuff

The position adopted by the right arm in this patient can be explained by paralysis of which of the following groups of muscles? * A. Supraspinatus, deltoid, biceps brachii, greater part of brachialis, infraspinatus, and teres minor B. Latissimus dorsi, triceps, anconeus, brachioradialis, and supinator C. Flexor digitorum superficialis, flexor pollicis longus, flexor carpi radialis longus, and flexor carpi ulnaris D. Extensor carpi ulnaris, supinator, extensor indicis, and extensor digiti minimi E. Pectoralis major, abductor pollicis longus, extensor pollicis brevis, and extensor pollicis longus

A. Supraspinatus, deltoid, biceps brachii, greater part of brachialis, infraspinatus, and teres minor

A 17-year-old girl was thrown from her horse while attempting a difficult jump. She landed on her right shoulder and the right side of her head. It was noticed after a week of hospitalization that she kept her right arm medially rotated and close to her side with the forearm pronated. At physical examination, an area of anesthesia was found along the lateral side of the upper part of the arm. Which of the following was damaged during the accident? * A. The lower trunk of the brachial plexus B. The axillary nerve C. The radial nerve D. The middle trunk of the brachial plexus E. The C5 and C6 roots of the brachial plexus

E. The C5 and C6 roots of the brachial plexus

A 19-year-old girl was seen in the emergency department and found to have a knife wound to the front of her left wrist. A careful examination revealed that two superficial tendons on either side of the median nerve had been severed. Which of the following tendons were likely to have been cut? * A. The flexor pollicis longus and the pronator quadratus tendons B. The flexor carpi ulnaris and the flexor digitorum profundus tendons C. The flexor digitorum superficialis and the flexor carpi radialis tendons D. The brachioradialis and the pronator teres tendons E. The abductor pollicis longus and the extensor pollicis brevis tendons

C. The flexor digitorum superficialis and the flexor carpi radialis tendons

``` On examination of a 53-year-old woman, it was found that she could abduct her left shoulder to only a 15° position. She told her physician that 10 years ago she had fallen on ice outside her front door and had dislocated her left shoulder joint. It was noted that the head of the humerus was in its norm al position relative to the scapula on the left side. Her left shoulder when compared with the right shoulder, however, showed flattening and had lost most of the normal curvature. Which of the following muscles was likely to have been paralyzed by the dislocation of the shoulder joint 10 years ago? * A. The rhomboid minor B. The deltoid C. The supraspinatus D. The teres minor E. The subscapularis ```

B. The deltoid

``` A 14-year-old boy fell off a wall and fractured his right humerus at mid-shaft. The wrist joint immediately assumed a flexed position that the patient was unable to correct. Extension and supination of the forearm was weakened but not abolished, and skin sensation over the lateral side of the dorsum of the hand was diminished. Which damaged peripheral nerve could account for these symptoms and signs? * A. The ulnar nerve B. The median nerve C. The radial nerve D. The axillary nerve E. The musculocutaneous nerve ```

C. The radial nerve

Diminished sweating and increased warmth and vasodilation of the skin vessels over the hypothenar eminence as well as the ring and the little fingers could result from the following except which? * A. A lesion of the posterior cord of the brachial plexus. B. Ulnar nerve damage behind the medial epicondyle of the humerus. C. A lesion of the medial cord of the brachial plexus. D. A lesion of the eighth cervical nerve. E. Ulnar nerve damage over the front of the wrist.

A. A lesion of the posterior cord of the brachial plexus.

During an automobile accident, a patient fractured the neck of her right radius and damaged a closely related nerve. At physical examination, the patient exhibited the following except which? * A. Weakness in extending the terminal phalanx of the thumb. B. A loss of skin sensation on the lateral part of the dorsum of the hand. C. An inability to extend the metacarpophalangeal joint of the index finger. D. A normal ability to adduct the thumb at the carpometacarpal joint. E. Normal skin sensation down the medial border of the hand.

B. A loss of skin sensation on the lateral part of the dorsum of the hand.

The following statements regarding the sympathetic innervation of the upper limb are correct except which? * A. There are preganglionic nerve fibers originating in spinal cord segments T2 to 8. B. It causes vasoconstriction of the arteries and veins of the skin. C. There are preganglionic nerve fibers synapsing in the middle cervical, the inferior cervical, and the first thoracic ganglia. D. Many of the postganglionic fibers are distributed within the branches of the brachial plexus. E. The sympathetic nerves do not innervate the sweat glands.

E. The sympathetic nerves do not innervate the sweat glands.

Which statement most appropriately describes the female breast? * It overlies the 3rd to 8th ribs. It consists of 2–3 lobules. It has suspensory ligaments, which tether the dermis to the fascia of the chest wall. The retro-mammary space lies deep to pectoralis major. The areolar glands are responsible for lactation.

It has suspensory ligaments, which tether the dermis to the fascia of the chest wall.

``` A 55 year-old woman is found on examination to have a 3 cm breast mass with palpable axillary lymph nodes. During surgery, the surgeon is able to harvest nodes located superiorly at the inferior edge of the axillary vein and medially at the medial border of the subscapularis muscle and laterally at the lateral border of the latissimus dorsi muscle. Which group of axillary lymph node is best described above? * Rotter’s group Central group Axillary vein group Scapular group ```

Axillary vein group

MODIFIED MULTIPLE CHOICE.check the box/es of your correct answer/s. The statement is correct regarding external mammary nodes * Location of the group of nodes ,superiorly at inferior edge of axillary vein, medially at lateral border of pectoralis minor muscle and laterally at medial border of subscapularis Belongs to level I group of nodes Located laterally at border of latissimus dorsi muscle,superiorly at inferior edge of axillary vein and medially at medial border of subscapularis muscle Located at the clavipectoral fascia

Location of the group of nodes ,superiorly at inferior edge of axillary vein, medially at lateral border of pectoralis minor muscle and laterally at medial border of subscapularis Belongs to level I group of nodes

1. Which of these statements are true considering the vasculature and lymphatic drainage of the breast? * Venous drainage is predominantly to the internal mammary vein. Lymphatic drainage is divided evenly between the axillary and internal mammary nodes. The superficial lymphatics of each breast remain separate in healthy people. All the axillary lymphatics drain through the apical axillary nodes.

All the axillary lymphatics drain through the apical axillary nodes.

1. Which of the following statement(s) is/ are true regarding the female breast? * The base of the adult female breast consistently overlies the 2nd to 6th ribs, from the sternal edge to the midaxillary line. The upper outer quadrant extends towards the axilla as the “axillary tail”. The breast consists of 15–20 lobules of glandulartissue, all individually drained by a corresponding lactiferous duct, which empty at the nipple via the lactiferous sinus. The retro-mammary space is located between the posterior capsule of the breast and the fascia over pectoralis major. This space is commonly exploited in the placement of implants. The areolar glands of Montgomery are modified sebaceous glands located beneath the areola and are responsible for lubricating the area. These glands may enlarge or become infected, especially during pregnancy

The base of the adult female breast consistently overlies the 2nd to 6th ribs, from the sternal edge to the midaxillary line. The upper outer quadrant extends towards the axilla as the “axillary tail”. The breast consists of 15–20 lobules of glandulartissue, all individually drained by a corresponding lactiferous duct, which empty at the nipple via the lactiferous sinus. The retro-mammary space is located between the posterior capsule of the breast and the fascia over pectoralis major. This space is commonly exploited in the placement of implants. The areolar glands of Montgomery are modified sebaceous glands located beneath the areola and are responsible for lubricating the area. These glands may enlarge or become infected, especially during pregnancy

Which of these statement(s) is/are true considering the vasculature and lymphatic drainage of the breast? * The main supply is via the lateral thoracic and thoracoacromial branches of the axillary artery. The internal mammary (internal thoracic) artery supplies a significant part of the medial aspect via perforating branches. The posterior intercostal arteries also make a minor contribution. Venous drainage follows the arterial supply of the breast and is primarily to the axillary vein. Approximately 75% of drainage is to the axillary lymph nodes, primarily to the anterior group. The majority of the remaining drainage, especially of the medial part, is to the internal mammary nodes. The superficial lymphatics have connections with the opposite breast and anterior abdominal wall. If the normal drainage channels become obstructed by malignant disease, metastatic spread may, therefore, occur to the contralateral breast or axillary nodes.

The main supply is via the lateral thoracic and thoracoacromial branches of the axillary artery. The internal mammary (internal thoracic) artery supplies a significant part of the medial aspect via perforating branches. The posterior intercostal arteries also make a minor contribution. Venous drainage follows the arterial supply of the breast and is primarily to the axillary vein. Approximately 75% of drainage is to the axillary lymph nodes, primarily to the anterior group. The majority of the remaining drainage, especially of the medial part, is to the internal mammary nodes. The superficial lymphatics have connections with the opposite breast and anterior abdominal wall. If the normal drainage channels become obstructed by malignant disease, metastatic spread may, therefore, occur to the contralateral breast or axillary nodes.

1. Which of the following statement(s) is/are true? * Dimpling of the skin occurs as a result of glandular fibrosis and shortening of Cooper ligaments Lymph node metastasis first occur in Level II and III of the axilla up to 20% of the time Skin edema of breast cancer is only a result of direct skin invasion by tumor none of the above

Dimpling of the skin occurs as a result of glandular fibrosis and shortening of Cooper ligaments

Which is correct regarding the mammary gland? * It has 15-20 lobules. Lateral border of the breast is between lateral margin of latissimus dorsi and lateral margin of pectoralis major It has 4-8 lactiferous ducts. Its most lymph drains into the parasternal lymph nodes.

Lateral border of the breast is between lateral margin of latissimus dorsi and lateral margin of pectoralis major

The intervertebral foramen is where this structure passes through: * Spinal cord Spinal nerve Vertebral artery Parasympathetic neuronal fibers

Spinal nerve

A 52-year-old man is brought to the emergency department after a multiple car accident. Which of the following conditions is produced by a force that drives the trunk forward while the head lags behind in a rear-end automobile collision? * Hangman fracture Jefferson fracture Whiplash injury Herniated disk

Whiplash injury

``` For the above case, A surgical resident who performs lumbar tap to get sample of CSF for examination will most likely insert the spinal needle between which 2 vertebrae: * L4 and L5 T11 and T12 L1 and L2 S1 and S2 ```

L4 and L5

A 17-year-old male was admitted complaining of headache, fever, chills, and stiff neck with his history fall 10 days prior. On examination, necrotic wound with depressed skull fracture. A Cranial CT scan revealed open depressed fracture right parietal area with cerebral abscess formation. He was diagnosed with meningitis and needs a lumbar puncture or spinal tap. Cerebrospinal fluid (CSF) is normally withdrawn from which of the following spaces? * Subdural space Space between the spinal cord and the pia mater Subarachnoid space Space between the arachnoid and dura maters

Subarachnoid space

This structure of a vertebra provides attachment to the ligamentum flava: * Pedicle Body Lamina Transverse process

Lamina

A 32-year-old construction worker is taken to the emergency department after having fallen off a roof 4 hours earlier and complains of headache, backache, and weakness. A magnetic resonance imaging (Radiologic examination) would reveal blood in which of the following spaces if the internal vertebral venous plexus was ruptured? * Space deep to the pia mater Space between the arachnoid and dura maters Space between the vertebral canal and the dura mater Subarachnoid space

Space between the vertebral canal and the dura mater

A 50 -year-old worker complaining of lower back pain and numbness of the left lower extremity seek consult to her orthopaedic surgeon. She is diagnosed with herniated disk. Her magnetic resonance imaging (MRI) scan reveals that the posterolateral protrusion of the intervertebral disk between L4 and L5 vertebrae would most likely affect nerve roots of which of the following spinal nerves? * Third lumbar nerve Fourth lumbar nerve Fifth lumbar nerve First sacral nerve

Fifth lumbar nerve

A 58-year-old man is a restrained passenger in a high-speed motor vehicle collision; he is brought to the emergency department. Cervical x-ray (open-mouth and anteroposterolateral view) noted with multiple fractures of the transverse processes of the cervical and upper thoracic vertebrae. Which of the following muscles might be affected? * Levator scapulae Rhomboid major Serratus posterior superior Rectus capitis posterior major

Levator scapulae

When cerebrospinal fluid (CSF) is withdrawn by lumbar puncture for further examination, which of the following structures is most likely penetrated by the needle? * Pia mater Ligamentum flavum Filum terminale externum Posterior longitudinal ligament

Ligamentum flavum

A 44-year-old woman comes to her physician and complains of headache and backache. On examination, she is found to have fluid accumulated in the spinal epidural space because of damage to blood vessels or meninges. Which of the following structures is most likely ruptured? * Internal vertebral venous plexus Vertebral artery Vertebral vein External vertebral venous plexus

Internal vertebral venous plexus

These are bony pillars that attach the vertebral arch to the vertebral body: * Articular process Pedicles Transverse process Laminae

Pedicles

``` Injury to the dorsal scapular nerve will result to shifting of the scapula to what direction: * Medial Cephalad Lateral Caudad ```

Lateral

``` An 80-year-old female has an abnormally increased curvature of the thoracic vertebral column. Which of the following conditions is the most likely diagnosis? * Lordosis Scoliosis Kyphosis Meningocele ```

Kyphosis

Which of the following is true regarding the deep fascia of the back: * Separates the deep back muscles from the superficial and intermediate back muscles Attaches medially to the bodies of thoracic vertebrae Consists of single layer of thick connective tissue Attaches inferiorly to the sacrum

Separates the deep back muscles from the superficial and intermediate back muscles

MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s. Which is/are true statement(s) regarding the blood supply of the spinal cord: * Anterior and posterior veins drain directly into the vena cava Posterior spinal arteries originate from vertebral artery Anterior spinal artery is a direct branch of basilar artery Segmental arteries arise from arteries outside the vertebral column

Posterior spinal arteries originate from vertebral artery Segmental arteries arise from arteries outside the vertebral column

MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s. This/these statement(s) is/are true regarding the white matter of the spinal cord: * Surrounds the central canal Divided into 3 columns: dorsal, lateral and ventral Contains the interneurons, cell bodies of motor neurons Composed of myelinated bundles of nerve fibers

Divided into 3 columns: dorsal, lateral and ventral Composed of myelinated bundles of nerve fibers

MODIFIED MULTIPLE CHOICE: check the box/es of your correct answer/s. The cerebrospinal fluid is located in the following cavity(ies)/space(s) of brain and spinal cord: * Subdural space Subarachnoid space Central canal Ventricles

Subarachnoid space Central canal Ventricles

The quadrangular space in the region of the shoulder transmits the following structures except which? * A. The axillary nerve B. The posterior circumflex humeral artery C. The lymphatic vessels D. The radial nerve E. The posterior circumflex humeral vein

D. The radial nerve

The following statements concerning the lateral cord of the brachial plexus are true except which? * A. It contains sympathetic nerve fibers B. It has a branch that supplies the pectoralis major muscle C. It has a branch that supplies the skin on the lateral side of the forearm D. It has a branch that supplies the skin on the lateral side of the upper arm E. It lies lateral to the second part of the axillary artery

D. It has a branch that supplies the skin on the lateral side of the upper arm

An examination of a patient with carpal tunnel syndrome may reveal all the following symptoms and signs except which? * A. Atrophy of the muscles of the thenar eminence B. Weakness in opposition of the thumb C. Loss of skin sensation on the medial part of the palm D. Loss of skin sensation on the anterior surface of the index finger E. Normal skin sensation on the anterior surface of the little finger

C. Loss of skin sensation on the medial part of the palm

The following movements are expected to be normal after a complete section of the medial cord of the brachial plexus except which? * A. Extension of the wrist B. Flexion of the elbow C. Abduction of the shoulder joint D. Metacarpophalangeal flexion and interphalangeal extension of the medial four fingers E. Metacarpophalangeal flexion and interphalangeal extension of the thumb

D. Metacarpophalangeal flexion and interphalangeal extension of the medial four fingers