Anatomical Sciences Flashcards
1
Q
Which of the following structures carry lymph into the node’s subcapsular
sinus, through the cortical sinus and into the superficial cortex and paracortex?
- efferent lymphatic vessels
- afferent lymphatic vessels
- both afferent and efferent lymphatic vessels
- neither afferent or efferent lymphatic vessels
A
• afferent lymphatic vessels
enter on convex surface, into subcapsulary sinus –> through cortical into superficial cortex and paracortex
cleansed/presented from cortical to medulla
Filtered: leaves through efferent.
Thoracic duct: both lower + ULQ. Right lymphatic duct: URQ
Paracortex - T cells; cortex - follicles.
Hilum: blood vessels enter, efferent lymph exit
2
Q
Which of the following vessels are characterized by the presence of valves? • arterioles only • capillaries only • sinusoids only • veins only •lymphatics only •lymphatics and capillaries •lymphatics and veins
A
• lymphatics and veins
3
Q
T cells are produced in the \_\_\_ .and mature in the \_\_ . •liver, thymus • bone marrow, liver • bone marrow, thymus •lymph nodes, thymus
A
• bone marrow, thymus
DiGeorge: no thymus and parathyroids
4
Q
Posterior 1/3 of the tongue drains into: • facial nodes • occipital nodes • submandibular nodes • deep cervical nodes • submental nodes • jugulodigastric nodes
A
• deep cervical nodes; along internal jugular vein
- drain salivary, thyroid, posterior 1/3 of tongue
tonsils, nose, pharynx, larynx –> jugular lymph trunk - submandibular: maxillary and mandibular teeth except mandibular incisors
- submental: tip of tongue, mandib incisors –> into submandibular and deep cervical
5
Q
When antigen recognition occurs by a lymphocyte, B cells are activated and migrate to which area oft he lymph node? • inner medullary region • medullary cords • medullary sinuses • germinal centers
A
• germinal centers
medullary cords: B + plasma
paracortex: T
germinal centers: B when activated, go to mature
6
Q
The lymph from the lower extremities drains into the:
•left internal jugular vein
• left subclavian vein
• junction of the left internal jugular and subclavian veins
• superior vena cava
• junction of the right internal jugular and subclavian veins
A
• junction of the left internal jugular and subclavian veins
btw mammary drain into axillary
7
Q
Which of the following is NOT a function of the spleen?
• removal of old or defective blood cells from blood
• forming crypts that trap bacteria
• storage of blood platelets
• storage of iron
A
• forming crypts that trap bacteria
clearing old erythrocytes: reticuloendothelial
only efferent lymphatics (like thymus)
8
Q
Which of the following tonsil(s) is/are covered by nonkeratinized stratified squamous epithelium? Select all that apply. •lingual tonsils only • pharyngeal tonsil only • palatine tonsils only • pharyngeal and palatine tonsils •lingual and palatine tonsils • all of the above
A
• lingual and palatine tonsils
pharyng tonsils (adenoids) - columnar pseudostratified, no crypts palatine - nonkeratinized stratified squamous; crypts but no sinuses lingual - single crypt, nonkeratinized strat squam; dorsal tongue
9
Q
In which of the following locations would one most likely find yellow bone marrow in an adult? • diaphysis offemur • epiphysis of humerus • ribs • cranial bones • vertebrae
A
• diaphysis of femur
yellow marrow in dyaphyses; red: skull, vertebrae, thoracic cage, heads of long bones
at birth, all marrow is red (till like 7)
10
Q
Which of the following cells are agranulocytes? Select all that apply. • basophils • eosinophils • lymphocytes • monocytes • neutrophils
A
- lymphocytes
- monocytes
Never Let Monkeys Eat Bananas
11
Q
Which of the following statements is NOT true regarding erythrocytes? They: • are biconcave in shape • have an average lifespan of 30 days • rely completely on anaerobic metabolism • have no nucleus • have no mitochondria • are disposed of by the spleen
A
• have an average lifespan of 30 days
completely anaerobic
12
Q
The formed elements of blood include all of the following EXCEPT one. Which one is the EXCEPTION? • plasma • red blood cells • platelets • white blood cells
A
• plasma
13
Q
Regarding the difference between plasma and serum, which of the following
statements is true?
• serum is yellow; plasma has no color
• serum contains antibodies; plasma does not
• plasma contains clotting proteins; serum does not
• plasma contains hemoglobin; serum does not
A
• plasma contains clotting proteins; serum does not
14
Q
Platelets are best described as: • megakaryocytes • cytoplasmic fragments • agranulocytes • immature leukocytes • lymphoid cells
A
• cytoplasmic fragments
TXA2 prothrombotic; PGI2 vasodil and reduce plt aggregation
15
Q
Which of the following is CORRECT regarding the articular cartilages? Select all that apply. • they are covered by disks • most of them are covered by hyaline cartilage • they are covered by perichondrium • they are covered by periosteum • they are vascular ANATOMIC SCIENCES 15 copyright Cl 20 13-2014 Dental Decks
A
• most of them are covered by hyaline cartilage
TMJ has fibroctlg
16
Q
Which of the following joints is/are a synarthrosis? Select all that apply. • temporomandibular joint • skull sutures • synovial joints • condyloid joints
A
• skull sutures
synarthrosis - immoveable (b/w flat)
amphiartrosis - pubic symphysis
diarthrodial - fully moving
17
Q
The spheno-occipital joint and epiphyseal cartilage plates are classified as which of the following joints? • sutures • symphyses • synchondrosis • syndesmoses
A
• synchondrosis
spheno-occipital jt and ctlg plates - synchondroses
syndesmoses: tibiofibular distal, tympanostapedial
18
Q
The paramedics arrive at the scene of a minor motor vehicle collision. One driver claims to have experienced whiplash and is having trouble shaking her head in a “NO” motion. She is fine with nodding her head in a “YES” manner.
Which of the following joints allows maximum rotational movement of the head about its vertical axis (saying “NO”)?
• intervertebral joint
• atlantoaxial joint
• atlanta-occipital joint
• costovertebral joint
A
• atlantoaxial joint
atlantooccipital YES
atlantoaxial NO
19
Q
When someone is rotating the forearm with the palm turning outward, this motion is termed as: • abduction • adduction • flexion • extension • pronation • supination
A
• supination
20
Q
The ureter connects which of the following parts of the kidney to the urinary bladder? • renal papi lla • renal columns • renal calyx • renal pelvis
A
• renal pelvis
pelvis connects calyx to ureters;
bladder transitional epithelium
21
Q
Name the following structures of the nephron in the order they are encountered
from blood to urine.
(1) distal convoluted tubule (2) bowman’s capsule (3) collecting duct (4) glomerulus
(5) loop of Henle (6) proximal convoluted tubule
A
• 4,2,6,5, 1,3
22
Q
Which of the following persists as the definitive (permanent) kidney? • pronephos • metanephros • mesonephros • none of the above ANATOMIC SCIENCES 22 copyright Cl 20 13-2014 Dental Decks
A
• metanephros
23
Q
A 26-year-old female has been previously diagnosed with McCune-Albright
syndrome. There is bony fibrous dysplasia of the anterior cranial base leading
to the encasement and narrowing of the optic canal. Although her vision is
normal, there is concern that there will be compression of the optic nerve
and which of the following other structure(s)?
• ophthalmic nerve (CN Vl)
• cranial nerves Il l, IV, and VI
• ophthalmic artery
• ophthalmic veins
A
• ophthalmic artery
The optic canal is located posteriorly in the lesser wing of the sphenoid. It communicates with the middle cranial fossa. It transmits t he optic nerve and the ophthalmic
artery.
cribiform - olfactory
hypoglossal (in occipital) - hypoglossal
carotid (in temporal) - internal carotid artery
lacrimal canal - tear duct
inferior orbital fissure:
infraorb and zygomatic branches of V2, infraorb a
superior orbtal fissure: III, IV, VI; lacrimal, frontal of V1; ophth vein, sympath
optic canal: II + opth a
stylomastoid: VII
24
Q
A 62-year-old female visits the family physician with complaints of right-sided
hearing loss, ringing in the right ear (tinnitus), numbness over the right half
of her face, and dizziness. The physician diagnoses her with an acoustic
schwannoma that is occluding her right internal acoustic meatus. The internal
acoustic meatus pierces the posterior surface of the petrous part of the temporal
bone. The internal acoustic meatus transmits which two structures?
• trigeminal nerve (CN V) and facial nerve (CN VII)
• facial nerve (CN VII) and vestibulocochlear nerve (CN VIII)
• vestibulocochlear nerve (CN VIII) and vagus nerve (CN X)
• trigeminal nerve (CN V) and vagus nerve (CN X)
A
• facial nerve (CN VII) and vestibulocochlear nerve (CN VIII)
internal acoustic meatus
25
Which of the following foramina appears as a small round radiolucent area
on the mandibular premolar and can be confused with a periapical abscess if
not recognized correctly?
• mandibular foramen
• incisive foramen
• mental foramen
• foramen ovale
• mental foramen
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Through which ofthe following foramina does the largest ofthe three (paired)
arteries that supplies the meninges pass?
• foramen magnum
• jugular foramen
• foramen rotundum
• foramen ovale
• foramen spinosum
• foramen lace rum
```
• foramen spinosum-the artery i s the middle meningeal artery which i s the largest
of the three (paired) arteries which supply the meninges, the others being the
anterior meningeal artery and the posterior meningeal artery
rotundum V2
oval V1
spinosum MMA (all three in sphenoid)
incisive: nasopalatine n. + sphenopalatine a.
between occipital and temporal - jugular: IX, X, XI
XI enters via foramen magnum and exits via jugular
vertebral arteries in foramen magnum
27
The cranial nerves that supply motor innervations to the muscles that move
the eyeball all enter the orbit through a foramen that is between the:
·lesser wing of sphenoid and fronta l bone
·lesser wing of sphenoid and ethmoid bone
• greater and lesser wings of sphenoid bone
•lesser wing of sphenoid, frontal and ethmoid bones
• greater and lesser wings of sphenoid bone
contains III, IV, VI;
ophth vein; sympathetics
petrotympanic fissure: chorda tympani
lacerum - between sphen/occip/temp -- n. of pterygoid
28
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Which of the following terms means air in the chest?
• hemothorax
• pyothorax
• pneumothorax
• pulmothorax
• pulmonary inflation
```
• pneumothorax
29
```
where trachea splits into primary
bronchi is the:
• carina
•lingula
• mediastinum
• bronchial tree
```
• carina
T4-5, level of sternal angle)
30
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Which of the following components of the respiratory system does NOT have
cilia?
• tertiary bronchioles
• primary bronchioles
• alveolar ducts
• respiratory bronchioles
• terminal bronchioles
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alveolar ducts
conducting zone - up to terminal bronchioles; dead zone, no O2 exchange
respiratory zone - respiratory brinchioles, alveolar ducts, alveoli
no ctlg, no glands in bronchioles
still some cilia in respiratory bronchioles
no cilia in alveolar ducts (actual gas exchange)
31
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Which of the following vessels supply blood to the bronchi?
• pulmonary arteries
• pulmonary veins
• subclavian arteries
• none of the above
```
bronchial
root of lung^ primary bronchus, pulm a. and vv. vagus passes behind root
32
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Which of the following is NOT a part of the lower respiratory tract?
•laryngopharynx
• trachea
• primary bronchus
• alveolar duct
```
laryngopharynx
upper respiratory tract - up to larynx; lower - trachea and onward
inferior mediastinum: anterior, middle (= pericardium), posterior
33
All of the paranasal sinuses drain into one of the three meatuses (superior,
middle, and inferior) EXCEPT one. Which one is the EXCEPTION?
• maxillary sinus
• frontal sinus
• ethmoidal sinus
• sphenoidal sinus
sphenoidal drains into sphenoethmoidal recess;
maxillary --> middle meatus
ethmoidal and frontal via meatuses
olfactory epithelium prominent in upper medial portion
34
While ascending to 30,000 feet, the passengers on a commercial flight experience
the sensation of their ears "popping:' The swallowing or yawning that
triggers this equalizes the pressure of the middle ear with the surrounding
atmosphere via the eustachian (auditory) tube. The pharyngeal opening for
this tube, along with the salpingopharyngeal fold, pharyngeal recess, and
pharyngeal tonsils (adenoids) are all located in the:
•laryngopharynx
• oropharynx
• nasopharynx
• none of the above
nasopharynx
aufitory tube openings, pharyng tonsils; up to soft palate and uvula
respiratory epithelium
oropharynx: from soft palate to hyoid: lingual + palatine tonsils
laryngopharynx: from hyoid to esophagus
35
A women in Ethiopia who has a human papillomavirus infection, starts to
grow warts on her larynx and respiratory tract. In order to allow her to breathe
an emergency airway maybe established by opening into the trachea:
• through the thyrohyoid membrane
• between the thyroid and cricoid cartilage
• between thyroid cartilages
• above the level of thyroid cartilage
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between thyroid and cricoid
| median cricothyroid ligament
36
Which of the following describes the function of the surfactant?
• increases the surface area of the alveoli
• reduces the attractive forces of 0 2 molecules and increases surface tension
• reduces the cohesive force of H20 molecules and lowers surface tension
• increases the cohesive force of ai r molecules and raises surface tension
• none of the above
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reduces cohesive water, lowers surface tension
cells of respiratory mucosa: clara cells (GAGs); type I pneumocytes (simple squamous, 95%, gas exchange); type II (granular cuboidal, make surfactant); alveolar macrophages
37
The external carotid artery terminates within the parotid gland, just behind
the neck of the mandible, where the external carotid artery gives off two final
branches. Which of the following is one of those terminal branches?
• superior thyroid artery
• superficial temporal artery
• posterior auricular artery
• occipital artery
• facial artery
• middle meningeal artery
• anterior ethmoidal artery
superficial temporl and maxillary are two terminal branches of external carotid
Some Anatomists Like Fornication, Others Prefer Sado Maso
superior thyroid (-->)
ascending pharyngeal ()
Facial (-->)
Occipital ()
terminates behind neck of mandible in parotid gland;
begins at upper border of thyroid ctlg
38
```
The Circle of Willis is formed by all of the following arteries EXCEPT one. Which
one is the EXCEPTION?
• anterior communicating artery
• posterior communicating artery
• anterior cerebral artery
• superior cerebellar artery
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superior cerebellar artery - branch of basilar; arises before posterior cerebral, does not partake in circle of Willis; two vertebrals combine into basilar
internal carotid --> anterior and middle cerebral; basilar --> posterior cerebral. ant + post communicating branches;
right common carotid arises from brachiocephalix; left from aortic arch
39
In carotid s inus syncope, the carotid sinus is overly sensitive to manual stimulation
and can lead to loss of consciousness. Given this, which of the following
statements is true?
• it is stimulated by changes in blood pressure
• it functions as a chemoreceptor
• it is innervated by the facia l nerve
• it is located at the terminal end of the external carotid artery
• it communicates freely with the cavernous sinus
stimulated by blood pressure
carotid sinus - dilation of internal carotid near its origin from common carotid. baroreceptors (blood pressure). innerv by IX
```
carotid body - at bifurcation of common carotid; chemoreceptors
aortic body (chemo, baro) - aortic arch, X.
```
baroreflex in response to increased BP --> decreases HR
decreased BP --> increases HR
40
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Which of the following branches of the internal carotid artery is most frequently
implicated in a stroke?
• ophthalmic artery
• anteri or choroidal artery
• middle cerebral artery
• anteri or cerebral artery
I refer to card 38-1 for illustration)
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middle cerebral a. - largest branch of internal carotid, most often occluded in stroke
intracranial berry aneurysms - in Willis
41
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The sinusoids are most likely found in all of the following organs EXCEPT one.
Which one is the EXCEPTION?
• spleen
• bone marrow
• cartilage
• parathyroid glands
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```
cartilage
sinusoid: blood vessel with discontinuous endothelium
liver, lymphoid, endocrine, hematopoietic
walls partly made of phagocytic cells; involved in phagocytosis and AB formation
42
```
The most prominent functional component in the tunica media of large
arteries is the:
• skeletal muscle cells
• elastic f ibers
• smooth muscle cells
• collagen
```
elastic fibers
in small aa. - smooth mm cells
tunics: intima (endothelium + BM; all vessels, atherosclerosis - plaque b/w endothelium and BM)
media - regulates BP, thicker in aa.
adventitia - elastic + cllagen + vasa vasorum; thicker in vv.
43
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The tunica media and adventitia are absent in which blood vessel type?
• arteries
• arterioles
• capillaries
• venules
• veins
```
capillaries: simple layer of endothelium, no media or adventitia
velocity slowest, resistance most
flow proportional to radius^4
44
```
The hepatic veins that drain the liver empty into the:
• hepatic sinusoids
• azygous vein
• inferi or vena cava
• inferi or vena cava and azygous veins
• portal vein
```
IVC
portal triad = hepatic a., portal v., bile duct
aorta --> hepatic a. --> interlobular branches;
hepatic portal v. --> interlobular branches
-------> sinusoids, central vv., hepati vv., IVC
45
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The greatest drop in blood pressure is seen at the transition from:
• arterioles to capillaries
• arteries to arterioles
• capillaries to venules
• venules to veins
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arteries --> arterioles
arteries - mainly transport
arterioles (very muscular wall) - mainly BP
capillaries - diffusion
veins -- transport
46
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All of the following vessels supply blood to the tonsils EXCEPT one. Which
one is the EXCEPTION?
• ascending pharyngeal artery
• tonsil lar branch of facial artery
• superior labial artery
• dorsal lingual artery
I refer to card 37 A-1 for illustration I
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superior labial artery
facial artery portions:
cervical (tonsillar, asc palatine, submental)
and facial (inf labial, sup labial, lat nasal, angular (to medial eye))
palatine tonsil supply: dorsal lingual, asc palatine, tonsillar, asc pharyngeal, lesser palatine
47
```
Which of the following arteries is found between the hyoglossus and
genioglossus muscles?
• inferi or alveolar artery
• posterior superior alveolar artery
•lingual artery
• infraorbital artery
• facial artery
```
lingual runs between hyoglossus and genioglossus; loop crossed by hypoglossal n.
branches: suprahyoid, dorsal lingual, sublingual, deep lingual
```
inf alv v, a, n along with lingual n.
pterygomandibular space (between medial pterygoid and ramus)
```
48
```
If the palatal mucosa opposite to the maxillary first molar was lacerated and
bleeding occurred, which of the following arteries is most likely to be
involved?
• greater palatine artery
• descending palatine artery
• nasopalatine artery
•lesser palatine artery
• middle superior alveolar artery
• posterior superi or alveolar artery
```
greater palatine
end of maxillary a. - sphenopalatine (nasal cavity) --> later nasopalatine branch through incisive foramen (supplies anterior palate up to canine)
49
Examination of a patient with an ulcerative carcinoma of the posterior third
of the tongue revealed bleeding from the lesion and difficulty swallowing
(dysphagia). The bleeding was seen to be arterial; which of the following
arteries was involved?
• deep lingual artery
• dorsal lingual artery
• tonsillar artery
• sublingual artery
dorsal lingual - posterior superficial tongue
branches of lingual a: dorsal lingual (base + body of tongue)
suprahyoid - muscles
sublingual: floor, siblingual salivaries + mylohyoid
deep lingual - apex of tongue
Motor of tongue: XII (except palatoglossus - vagus)
Sensory: V3 lingual - anterior 2/3
IX - posterior 1/3
X (inf. laryng) - epiglottis
Taste: VII (chorda), IX
tonsillar a. - branch of facial
lingual + facial - common trunk off external carotid
50
During a boxing match a boxer got a blow on the lateral side of the skull,
immediately he fell unconscious for several seconds. He was asymptomatic
for the first 24 hours then he developed symptoms of elevated intracranial
pressure (headache, nausea and vomiting). Which of the following arteries is
most likely involved?
• inferior alveolar artery
• middle meningeal artery
• infraorbital artery
• deep temporal artery
• middle cerebral artery
middle meningeal - branch of maxillary
infratemporal fossa - where branches off
foramen spinosum to dura mater and calvaria
runs beneath pterion (super thin)
51
Which arteries supply the greater curvature of the stomach?
• right gastric, left gastri c and short gastri c arteri es
• right and left gastroepiploic arteries
• right gastric, left gastroepiploic and short gastri c arteries
• right gastroepiploic, left gastroepiploic and short gastric arteries
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right and left gastroepiploics and short gastrics (these - to fundus and upper; branches of splenic)
lesser curvature: right gastric inferiorly, left gastric superiorly
All - branches of celiac (off abdominal aorta, ~T12 just below diaphragm)
supplies foregut
branches:
- splenic (pancreatic, l. gastroepiploic, short gastric)
- left gastric (short, top of stomach + esophag branches)
- common hepatic (gastroduodenal [right gastroepiploic, superior pancreaticoduodenal], right gastric, hepatic proper [left hepatic, right hepatic, cystic])
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The internal thoracic artery ends in the sixth intercostal space by dividing
into the:
• anterior and posterior intercostal arteries
• subclavian and inferior epigastric arteries
• superi or epigastri c and musculophrenic arteri es
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superior epigastric (runs in rectum sheath to meet with inferior from external iliac; meet around umbilicus) and musculophrenic (runs around to back) - branches of internal thoracic in 6th intercostal space
internal thoracic - branch of subclavian (VITCD)
runs on pleura behind ctlges, lateral to sternum
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hypoglossal - bone and what runs
occipital bone, hypoglossal nerve
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carotid - bone and what runs
temporal bone, internal carotid a.
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inferior orbital fissure
infraorbital and zygomatic branches of infraorbital a
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superior orbital fissure
between greater and lesser wings of sphenoid
III, IV, VI
lacrimal, fromtal of V,
ophthalmic vein, sympaths
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optic canal
II and ophth artery
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stylomastoid
VII
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internal acoustic meatus
VII + VIII
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rotundum
V2
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ovale
V1
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spinosum
MMA
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incisive
nasopalatine n and sphenopalatine a
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jugular
IX, X, XI
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petrotympanic fissure
chorda tympani
66
lacerum
between sphen/occip/temp, n. of pterygoid
67
At what level does the abdominal aorta bifurcate into the common iliac
arteries and also gives rise to the middle sacral artery?
• T1O
• T12
·T2
•L4
• L5
L4
aortic opening of diaphragm - T12
runs retroperitoneal
splits into common iliacs and unpaired median sacral at L4
very elastic in tunica media
ascending aorta gives off right and left coronaries
arch gives off brachiocephalic, l common carotid and l subclavian
descending: T4-T12
abdominal T12-L4
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The blood supply of the mucosa of the nasal septum is derived mainly from
the:
• facial artery
• maxillary artery
• inferi or alveolar artery
• internal carotid artery
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maxillary a (--> sphenopalatine)
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lateral wall of pterygopalatine fossa
laterally - pterygomaxillary fissure to infratemporal fossa
Pterygomaxillary Fissure
The pterygomaxillary fissure connects the infratemporal fossa with the pterygopalatine fossa (see figure 1). It transmits two neurovascular structures:
Posterior superior alveolar nerve – a branch of the maxillary nerve. It exits through the fissure into the infratemporal fossa, where it goes on to supply the maxillary molars.
Terminal part of the maxillary artery – enters the pterygopalatine fossa via the fissure.
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medial wall of pterygopalatine fossa
Sphenopalatine Foramen
This foramen is the only opening in the medial boundary. It connects the pterygopalatine fossa to the nasal cavity – specifically the superior meatus.
It is formed by the sphenopalatine notch at the superior aspect of the perpendicular plate of the palatine bone and the body of the sphenoid.
The sphenopalatine foramen transmits the sphenopalatine artery and vein, as well as the nasopalatine nerve (a large branch of the pterygopalatine ganglion – CNV2).
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superior wall of pterygopalatine fossa
Foramen Rotundum
The foramen rotundum connects the pterygopalatine fossa to the middle cranial fossa. It is one of three openings in the posterior boundary of the pterygopalatine fossa. It conducts a single structure, the maxillary nerve.
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anterior wall of pterygopalatine fossa
Inferior Orbital Fissure
The inferior orbital fissure forms the superior boundary of the pterygopalatine fossa and communicates with the orbit. It is a space between the sphenoid and maxilla bones.
The zygomatic branch of the maxillary nerve and the infraorbital artery and vein pass through the inferior orbital fissure.
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contents of pterygpalatine fossa
max a, max n, pterygopalatine ganglion
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```
The distal portion of the duodenum receives arterial supply from the inferior
pancreaticoduodenal artery which branches from the:
• celiac trunk
• gastroduodenal artery
• superior mesenteric artery
• inferi or mesenteric artery
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SMA (inferior pancreaticoduodenal)
proximal part, before ampulla and opening of bile duct - superior pancreaticoduodenal, off of gastroduodenal off common hepatic off celiac
up to distal third of transverse colon - SMA
jej and ileum branches are on left side of SMA
rectum: superior rectalis off IMA
middle - internal iliac
inferior - internal pudendal
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All of the following are direct branches of the subclavian artery EXCEPT one.
Which one is the EXCEPTION?
• internal t horacic artery
• thyrocervical artery
• inferi or thyroid artery
• dorsal scapular
```
inferior thyrod is branh of thyrocervical
Vertebral
Internal Thoracic
Thyrocervical (--> inferior thyroid, suprascapular, transverse ervical)
Costocervical
Dorsal scapular
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All of the following statements concerning the common carotid arteries are
true EXCEPT one. Which one is the EXCEPTION?
• the common carotid arteri es are the same in length
• the common carotid arteri es differ in their mode of origin
• the right common carotid artery is a branch of the brachiocephalic trunk
• the left common carotid artery is a branch of the aortic arch
[refer to card 38 A-1, 49-1 for illustration)
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not same length
right off brachiocephalic. left self off arch
common carotid in sheath with internal jugular and vagus
level of larynx - splits into internal and external
internal --> ophthalmic (in optic canal with II) + anterior and middle cerebral (-->into Willis)
external: some anatomists like fornication, others prefer sado maso
77
```
What is the major arterial origin supplying the mandibular anterior teeth?
• mandibular artery
• facial artery
• vertebral artery
• maxillary a
```
maxillary artery:
branches: anterior (from infraorbital, after orbital fissure), middle (same) and posterior superior alveolar (before pterygopalatine fossa) + inferior alveolar (for all mandibular teeth)
inf alv also gives mental and incisive
Parts and branches of maxillary:
1st - mandibular (posterior to lateral pterygoid, horizontal, deep to neck of condyle)
-- deep auricular, anterior tympanic, MMA, inferior alveolar
2nd (pterygoid) - adjacent to lateral pterygoid, medial to temporal
--> masseteric, deep temporal, pterygoid branches, buccal
3rd (pterygopalatine) - distal (anterior) to pterygoid, between heads of lateral pterygoid through pterygomaxillary fissure into pterygopalatine fossa
-- posterior superior alveolar, infraorbital, a of pterygoid canal, pharygeal, descending palatine (splits into greater and lesser), sphenopalatine - walls and septum of nose
78
arteries
Which of the following statements is TRUE regarding the left and right renal
arteries?
• they both arise from the abdominal aorta below the superior mesenteric artery
• the left renal artery is longer that the right renal artery
• the right renal artery is somewhat higher than the left renal artery
• the right renal artery arises below the superior mesenteric artery, while the left one
arises below the inferior mesenteric artery
ANATOMIC SCIENCES
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ental Oe
both arise from abdominal below SMA
right is longer (passes behind IVC), left a bit higher
urinary bladder supplied by internal iliacs
79
```
The subscapular artery which supplies the subscapularis muscle branches off
the:
• subclavian artery
• 1st part of axillary artery
• 2nd part of axillary artery
• 3rd part of axillary artery
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```
3rd of axillary
Sixties - superior thoracic
Teens - thoracoacromial
Like - Lateral thoracic
Sex - Subscapular
And - anterior humeral
Pot - posterior humeral
Subclavian is same vessel but before 1st rib (VIT (IST) CD)
80
Which of the following statements is CORRECT regarding vertebral arteries?
• inside the skull, the two vertebral arteri es join up to form the basilar artery
• they arise from thyrocervical trunk
• they enter the skull through carotid canal
• they pass through the t ransverse foramina of all 7 cervical vertebrae
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branch off subclavian, pass through C6-C1 and foramen magnum, combine into basilar
verterbrals - posterior inferior cerebellar
basilar - anterior inferior cerebellar + superior cerebellar
81
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Which ofthe following structures provides attachment to falx cerebri?
• cribriform plate
• crista galli
•lesser wing of sphenoid
• greater wing of sphenoid
• corpus callosum
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```
crista galli
lateral masses of ethmoid = sinuses + orbital plate (medial wall of orbit)
82
The hypophyseal fossa is located in a depression in the body of the sphenoid
bone; it houses which of the following structures?
• hypothalamus
• pituitary
• cerebellum
• hippocampus
• corpus cal losum
pituitary sits in sella
greater wings of sphenoid - lateral wall of orbit, roof of infratemporal fossa
foramen rotundum - V2
ovale - V3
spinosum - MMA
lesser wings - roof of orbit and superior orbital fissure
optic canal - CN II + ophth artery
pterygoid process with medial and lateral plates
lateral - for both pterygoids
medial has hamulus for tensor veli palatini
83
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Flat bones of the skull, maxilla, major parts of the mandible and clavicles are
formed by:
• endochondral ossification
• subchondral ossification
• intramembranous ossification
• primary ossification
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```
intramembranous ossification
84
During distalization of molars in bodily orthodontic movement, the alveolar
bone distal to the tooth must resorb, and the alveolar bone mesial to the
tooth must appositionally grow. In orthodontic movement, the alveolar
bone is being remodeled. This remodeling is a function of:
• osteocl asts and osteoblasts
• chondroblasts and osteoblasts
• osteoblasts and osteocytes
• chondrocytes and osteocytes
osteoblasts and clasts
85
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All are functions of the skeletal system EXCEPT one. Which one is the EXCEPTION?
• lymph filtration
• mineral storage
• support
• protection
• body movement
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```
lymh filtration
86
```
At the temporomandibular joint (TMJ), hinge movements occur between
the:
• condyle and articular eminence
• art icular disc and articular eminence
• condyle and articular disc
• art icular disc and articular cavity
• condyle and articular cavity
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```
hinge in lower (initiates movement, between condyle and disc), glide in upper (gliding after hinge, between disc and eminence)
chorda tympani - petrotympanic fissure
87
A patient comes into the orthodontist's office as referred to by his general
dentist. The orthodontist notes the patient's tongue thrusts and notes that
early treatment could prevent skeletal problems. Soft tissue development is
thought to encourage mandibular growth:
• upward and forward
• upward and backward
• downward and forward
• downward and backward
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down and forward
88
```
Which of the following structures does NOT form a portion of the lateral wall
of the nasal cavity?
• maxilla
• palatine bone
• conchae
• vomer
• ethmoid
```
vomer
89
```
A tubercle is:
• a small, rounded process
• a prominent elevated ridge or border of a bone
• a large, rounded, roughened process
• a sharp, slender, projecting process
ANATOMIC SCIENCES
bone
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```
small rounded process
prominent elevated ridge - crest
large rounded roughened - tuberosity
sharp slender projecting - spine
90
```
The shaft of a long bone is capped on the end by spongy bone that is surrounded
by compact bone. This is called the:
• periosteum
• diaphysis
• endosteum
• epiphysis
```
epiphysis
91
```
The hypophyseal fossa which houses the pituitary gland is located within
which of the following cranial fossae?
• anteri or cranial fossa
• middle cranial fossa
• posterior cranial
```
middle cranial fossa
border between anterior (smallest) and middle - lesser wing
between middle and posterior (largest) - petrous part
posterior contains cerebellum medulla pons
92
Treacher Collins syndrome is a rare genetic disorder that presents with many
craniofacial deformities. One of the characteristic traits is downward slanting
eyes, which is caused by underdevelopment of the bone that forms the
substance of the cheek. Which bone is this that anchors many of the muscles
of mastication and facial expression?
• ethmoid bone
• zygomatic bone
• occipital bone
• sphenoid bone
zygomatic
93
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Which of the following can be defined as a tube-like passage running
through a bone?
• fovea
• meatus
• fossa
• fissure
```
meatus
94
```
The ganglion that supplies the mucous membrane of the mouth and nose
with parasympathetic fibers is located in which of the following fossae?
• pterygopalatine fossa
• infratemporal fossa
• temporal fossa
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```
pterygopalatine
| pterygopalatine ganglion with parasymps for mouth and nose mucosa
95
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The pterygopalatine fossa communicate laterally with infratemporal fossa
though which of the following?
• sphenopalatine foramen
• foramen rotundum
• foramen lacerum
• pterygomaxillary fissu re
• inferi or orbital fissu re
```
pterygomaxillary fissure
96
```
Which ofthe following receives the opening ofthe nasolacrimal duct?
• superi or meatus
• middle meatus: ethmoidal bulla
• middle meatus: Hiatus of semilunaris
• sphenoethmoidal recess
• inferior meatus
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```
inferior meatus
superior receives posterior ethomidal sinuses
middle had ethmoidal bulla
anterior ethmoidal and frontal sinuses drain into infundibulum which in turn drains into hiatus semilunaris
maxillary drains into hiatus semilunaris
sphenoidal sinus - into sphenoethomidal recess
97
A prosthodontist designs his maxillary removable complete and partial
dentures to engage the hamular notch behind the maxillary tuberosities.
The hamulus is a small slender hook, which accommodates the action of the
tensor veli palatini. The hamulus is a component of which bone?
• lateral pterygoid plate of sphenoid bone
• medial pterygoid plate of sphenoid bone
• maxilla
• hori zontal plate of palatine bone
• perpendicular plate of palatine bone
medial pterygoid plate of sphenoid
| tensor veli palatini: motor from V3, sensory from V2
98
A young patient arrives in the physician's office with unexplained, persistent
symptoms. The patient has had bloody nasal discharge and painful oral
lesions. A chest x-ray reveals "coin lesions" and labs reveal kidney failure.
Ultimately, the isolation of the AN CAs - lgG antibodies - yield a diagnosis of
Wegener's granulomatosis. The dentist who referred this patient to the
physician made a note of the necrotizing oral lesion that had perforated the
hard palate into the nasal cavity. The roof of the oral cavity is formed by the:
• ethmoid and palatine bones
• maxilla and nasal bones
• maxilla and palatine bones
• nasal and vomer bones
maxilla and palatine
hard palate: anterior 2/3 = palatine processes of maxilla
posterior - horizontal plate of palatine
99
```
Most precisely, osteocytes are located in which of the following spaces?
• canaliculi
• lacunae
· lamellae
• trabeculae
```
lacunae
haversian canal surrounded by lamellae
100
Which of the following is the largest bone of the pelvis?
·ilium
• ischium
• pubis
ilium
meet at acetabulum: superior - ilium
posteroinferior - ischium
anteromedial - pubis
inguinal ligament from pubic tubercle to ASIS
sciatic n - largest in body
101
The trachea divides into left and right main bronchi at the level of?
• the upper part of sternum
• the mid part of the body of the sternum
• just above the xiphoid process
• junction of manubrium and body of sternum
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junction of manubrium and sternum = sternal angle, ~2nd intercostal space
T4-5
also there: 2nd cartilage, beginning of arch
rib 1 is attached to manubrium
2-7 to body of sternum
8-10 = false ribs, to ctlg of above
11-12 float
costal groove: VAN below rib, nerve least covered
7 - 12 - 5 + sacrum (5) + coccyx
102
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Which of the following bones articulates with the capitulum of the humerus?
• radius
• acromion
• ulna
• scapula
• clavicle
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radius
trochlea with ulna (its olecranon)
wrist: radius is lateral
coronoid fossa on anterior of humerus
clavicle - manubrium and acromion
103
```
Which of the following bones forms the major part of the lateral wall of the
orbit?
• frontal bone
• zygomatic bone
• maxillary bone
• sphenoid
```
zygomatic
walls of orbit:
superior = frontal (+ lesser wing of sphenoid сзади)
medial = ethmoid + contributions from frontal, lacrimal and sphenoid
inferior = maxilla, zygomatic, palatine
lateral = zygomatic + greater wing
104
superior wall of orbit
frontal + lesser wing of sphenoid
105
lateral wall of orbit
zygomatic + greater wing of sphenoid
106
medial wall of orbit
ethmoid + contributions from lacrimal, frontal and sphenoid
107
inferior wall of orbit
maxilla, palatine, zygomatic
108
Kartagener syndrome is a hereditary syndrome; it's characterized by recurrent
upper and lower respiratory tract infections. Dysfunction of which
organelle is responsible for this syndrome?
• centriole
·flagellum
• vacuole
•cilium
cilium
Kartagener is respiratory ciliary dysfx
cilia = 9+2 arrangement
centriole is triplets
109
cilia arrangement
9+2
110
centriole arrangement
triplets
111
```
The inactive X chromosome in a female cell is called the ____ which is
an example of ___ _
• pineal body, euchromatin
•lateral body, heterochromatin
• golgi body, euchromatin
• barr body, heterochromatin
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```
Barr body, heterochromatin *inactive condensed DNA)
112
```
In which cellular component are glycoproteins assembled for extracellular
use?
• the Golgi apparatus
• the endoplasmic reticulum
• the nucl eus
• the nucleolus
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Golgi
fx of Golgi: modify proteins and lipids
storage and packaging
glycoproteins assembled for extracellular use
O-glycosylation
trans - to membrane
cis - to nucleus
rough ER continuous with perinuclear space
COPII targets for fusion with Golgi
113
cis side of Golgi
nucleus
114
trans side of Golgi
to memrane
115
targets from ER to fuse with Golgi
COPII
116
Which of the following is the distinctive array of microtubules in the core of
cilia and flagella composed of a central pair surrounded by a sheath of nine
doublet microtubules (characteristic "9 + 2" pattern)?
• centriole
• axoneme
• tubulin
• malleolus
axoneme
core of cilia and flagella (9+2)
made from MTs
dynein arms - enables to beat + radial spoke
nexin - inter-doublet linkage
centrioles - mitotic spindle
117
inter-doublet linkage in cilia/flagellae
nexin
118
core of cilia and flagella
axoneme, made out of MTs
119
```
Which ofthe following organelles have double membranes?
Select all that apply.
• mitochondria
• golgi apparatus
• peroxisomes
• centriole
• nucleus
• nucleolus
```
m/ch + nucleus
120
```
All of the following are considered as specialized types of macrophages
EXCEPT one, which one is the EXCEPTION?
• kupffer cells
• microglial cells
• osteoclasts
• langerhans cells
• plasma
```
plasma cells
Kupffer - m/ph in liver (sinusoids)
langerhans - APC in skin
alpha-pancreatic - glucagon, beta - insulin
Leydig - testosteron
Sertoli - testicular fluid
121
testosteron cells + what do and where
Leydig, interstitial, in CT around tubules
122
testicular fluid cells + what do and where
Sertoli, line seminiferous tubules, responsive to FSH
| secrete hormones, ABPs etc
123
Which cell lines the lumen of the seminiferous tubules and secretes hormones,
androgen binding proteins (ABPs) and other proteins that facilitate
spermatogenesis?
• interstitial cells of Leydig
• principal cells
• sertoli cells
• clara cells
Sertoli - line seminiferous tubules, secrete hormones, ABPs etc.
sensitive to FSH
Leydig - in vascular CT around tubules, secrete testosteron
btw clara cells make GAGs in respiratory epithelium
124
clara cells
respiratory, make GAGs
125
```
Protein synthesis occurs in all of the following phases EXCEPT one. Which
one is the EXCEPTION?
• G1 phase
• S phase
• G2 phase
• M phase
```
M phase
cell growth and protein production stop
G1 - S (DNA synthesis), G2
126
The plasma membrane (cell membrane):
• surrounds the cell wall and serves to protect t he cell from changes in osmotic pressure
• is a polysaccharide-containing structure that functions in attachment to solid surfaces,
preventing desiccation, and protection
• is a non-permeable membrane enclosing t he cell wall
• is a dynamic, selectively permeable membrane enclosing t he cytoplasm
dynamic, selectively permeable, encloses c/pl
m/ch and nucleus - double-membraned
m/ch contains cyclic DNA
peripheral proteins can be removed with detergent
for integrated proteins, need to disrupt membrane
127
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What type of cell in the dental papilla adjacent to the inner enamel epithelium
differentiates into odontoblasts?
• stellate reticular cell
• mesenchymal cell
• ameloblast
• follicular cel
```
mesenchymal
NC --> spinal and autonomic ganglia, Schwann, pigment, chromaffin, teeth
128
On the playground at recess, a young girl is stung by a bee and immediately
breaks out in hives and starts gasping for air. The teacher grabs an epinephrine
autoinjector from the first aid kit and is able to save the girl. What cells,
when bound by lgE, are responsible for this anaphylactic reaction?
• mast cells
• macrophages
• platelets
• kupffer cells
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mast cells:
| heparin, histamin, bradykinin, IgE, serotonin, SES-A, lysosomal enzymes
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```
A chromosome is maximally condensed chromatin wrapped around a protein
base of primarily:
• hydroxyapatite
• hyaluronan
• histones
• haploid
```
histones
human: 23x2 choromosomes
histones - very basic (+)
Arg, Lys, His - beads for DNA
130
AAs in histones
very basic (+)
arginine, lysine, histidine
131
```
Plasma cells are immediate derivations of which cell type?
• CDS+ T cell
• CD4+ T cell
• B lymphocyte
• neutrophil
• eosinophil
```
B
132
```
Which ofthe following is a specialized macrophage located in the liver?
• fibroblasts
• hepatocyte
• kupffer cell
• erythrocyte
```
kupffer - in sinusoids
133
```
Which of the following is the site of synthesis of rRNA and is NOT bound by a
membrane?
• endoplasmic reticulum
• ribosomes
• golgi apparatus
• nucleolus
• plasma membrane
```
nucleolus
inside nucleus, not membrane bound, rRNA synthesis
smooth ER - steroid, detox, Ca storage
rough: proteins for extracellular --> then to Golgi (COPII)
nucleus - 2 membranes, very basophilic bc lots of RER (nucleic acids like basic dyes)
m/ch and lysosomes - acidophilic
134
which ER stores Ca
smooth
135
which ER make steroids
smooth
136
what color m/ch
eosinophilic
137
what color lysosomes
eosinophilic
138
```
In which phase of mitosis do the chromosomes condense and become visible,
the nuclear membrane breaks down, and the mitotic spindle apparatus
forms at opposite poles of the cell?
• interphase
• prophase
• metaphase
• anaphase
• telophase
```
prophase - condense and become visible, membarne breaks, spindle apparatus at poles
metaphase - align, MT spindle
anaphase - separate and move
telophase - arrive at poles, cytokinesis --> 2 daughter cells
139
order of phases in mitosis
pro (condense begin), meta, ana, telo
140
All of the following statements regarding differences between meiosis and
mitosis are FALSE EXCEPT one. Which one is the EXCEPTION?
• both require one division to complete the process
• crossing over occurs in mitosis, it does not occur in meiosis
• meiosis occurs in germ cells only
• in mitosis the daughter cells have half the number of chromosomes as the parent
cell (2n ton), while in meiosis the daughter cells have the same number of chromosomes
as the parent cells (2n to 2n)
• in meiosis the daughter cells have the same genetic information as the parent cell,
while in mitosis the daughter cells are genetically different from the parent cell
meiosis in germ cells only
synapsis of bivalents, crossing over, chiasmata - meiosis
141
```
Almost all human body cells have mitochondria EXCEPT one, which one is the
EXCEPTION?
• fibroblasts
• RBCs
• osteobl asts
• osteoclasts
```
RBCs - purely anaerobic glycolysis
142
```
The main distinguishing feature of the jejunum is the presence of prominent:
• brunner's glands
• rugae
• peyer's patches
• teniae coli
• plicae circulares
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plicae circulares = valves of Kerckring
duodenum - Brunner's glands in submucosa (alkaline)
jejunum - plicae circulares, fewer arcades, longer branches
ileum - Peyer's patches, B12 (cobalamin), more arcades, shorter branches
B12: pernicious, gastric parietal intrinsic factor needed for absorption
143
Brunner's glands
alkaline in duodenum
144
Peyer's patches
ileum
145
more arcades shorter branches
ileum
146
less arcades longer branches
jejunum
147
B12 absorption
intrinsic factor by gastric parietal cells
pernicious anemia
ileum
148
A patient comes to the emergency room presenting with jaundice and
intense pain in the upper abdominal and between the shoulder blades. The
physician suspects choledocholithiasis that is caused by cholesterol stones
formed in which organ that stores and concentrates the bile.
• appendix
• gallbladder
·liver
• pancreas
• spleen
gallbladder
Oddi's sphincter + hepatopancreatic ampulla
cholecystokinin - stimulates gallbladder contraction, made by duodenum
149
what stimulates gallbladder contraction
CKK, made by duodenum
150
name of sphincter in gallbladder
Oddi
151
what makes CCK
duodenum, stimulates gallbladder contraction
152
The smooth muscle coat of the large intestine consists of three bands called
taeniae coli.
The walls of the large intestine have more villi than the small intestine.
• both statements are t rue
• both statements are false
• the f irst statement is t rue, the second is false
• the f irst statement is fa lse, the second is t rue
first true, second false
large intestine - many glands, taeniae coli (not continuous smooth mm)
anal region - longitudinal folds
153
```
Name the glands found in the submucosa of the duodenum that secrete an
alkaline mucus to protect the walls of the mucosa.
• peyer's patches
• glands of Kerckring
• hertwig's glands
• brunner's glands
• crypts of Lieberkuhn
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brunner's glands
duodenum is retroperitoneal except first 2cm
duodenal papila
superior pancreaticoduodenal - off gastroduodenal
inferior - off SMA
sympath: splanchnic, parasymp: vagus
crypts of Lieberkuhn = paneth cells
154
crypts of lieberkuhn
paneth
155
retroperitoneal organs
```
S = Suprarenal (adrenal) glands
A = Aorta/Inferior Vena Cava
D = Duodenum (second and third segments)*
```
```
P = Pancreas* except tail
U = Ureters
C = Colon (ascending and descending only)*
K = Kidneys
E = Esophagus
R = Rectum
```
156
secondarily retroperitoneal organs
For secondarily retroperitoneal remember ‘Pussy Cat Dolls“:
P = Pancreas except tail
C = Colon (only ascending and descending)
D = Duodenum (only parts 2-4)
157
```
At which level does the esophagus pierce the diaphragm?
·C6
• TS
• TlO
• T12
```
T10
I Ate 10 Eggs At 12
IVC 8, Esophagus 10, Aorta 12
esophagus starts at C6
pierces into stomach at T10 (esophag hiatus)
GERD, Barrett (metaplasia) --> adenocarcinoma
parasymp vagus, motor - recurrent laryngeal
158
motor innerv of esophagus
recurrent laryngeal
159
```
The lateral surface of the stomach is called the:
•lesser curvature
• greater curvature
•lesser omentum
• greater omentum
ANATOMIC SCIENCES
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```
greater curvature
mm layers: outer long, middle circular, inner oblique
r + l gastric - lesser curvature
l + r gastroomental - greater curvature
parietal (oxyntic) - fundus and body, HCl + intrinsic factor
chief - fundus and body - pepsinogen
G - throughout - gastrin
160
```
Which ofthe following vessels does NOT supply blood to the liver?
• hepatic veins
• hepatic portal vein
• common hepatic artery
• celiac trunk
```
hepatic veins
hepatic triad = hepatic a + portal v + bile duct
falciform + triangular + coronary ligaments
joined to stomach by lesser omentum and duodenum by hepatoduodenal ligament
kupffer in siusoids
161
One significant difference between the jejunum and the ileum is that the ileum
characteristically contains more of which feature below?
• plicae circulares
• brunner's glands
• taeniae coli
• peyer's patches
• vil li
peyer's patches
jejunum: more plicae, more villi
absorbs carbs and proteins
ileum: more peyer, absorbs bile salts and B12
more goblet cells that secrete mucus
162
```
Peristalsis for what organ is controlled by taeniae coli?
• esophagus
• stomach
• large intestine
• small intes
```
large intestine
Hirschprung - no myenteric plexus - --> decreased motility
major fx of large intestine - absorption of water
163
Which cells, located in the crypts of Lieberkiihn, secrete an antibacterial
enzyme that maintains the gastrointestinal barrier?
• paneth cells
• enteroendocrine cells
• sertoli cells
• absorptive
paneth
mostly in ileum
lysozyme for antibacterial
brush border = goblet cells (mucus, ileum)
absorptive (simple columnar)
enteroendocrine (secretin, cholecystokinin, abundant in duodenum)
164
```
Which ofthe following cells are responsible for secreting glucagon?
• alpha cell s
• beta cells
• delta cells
• gamma cell s
```
alpha
beta is insulin, delta is somatostatin, gamma - polypeptides
endocrine islands
165
which pancreas cells make somatostatin
delta
166
which pancreatic cells make polypeptides
gamma
167
what do delta pancreatic cells make
somatostatin
168
what do gamma pancreatic cells make
polypeptides
169
```
Which of the following provides parasympathetic stimulation to the sigmoid
colon?
• vagus nerve
• phrenic nerve
• Tl-l2
• S2-S4
```
S2-S4
foregut: celiac trunk
hepatic portal system (l gastric and splenic vv)
celiac nodes,
thoracic nn in celiac plexus for symps, vagus for parasymps
midgut: SMA
hepatic portal (SMV)
superior mesenteric nodes
thoracic nn in SM plexus for symps, vagus for parasymps
```
hindgut - starts at last 1/3 of transverse colon all the way to rectum
IMA
hepatic portal (IMV)
superior and inferior mesenteric nodes
inferior mesenteric plexus for symps,
S2-S4 for parasymps
```
170
supply of rectum:
rectum: superior rectalis off IMA
middle - internal iliac
inferior - internal pudendal
171
```
Which of the following triangles is bounded by the sternocleidomastoid, the
posterior belly of digastric and the superior belly of omohyoid muscle?
• submental triangle
• digastric triangle
• carotid triangle
• muscular triangle
• occipital triangle
• subclavian triangle
```
carotid
Anterior triangle: submental is madible, anterior digastric and hyoid bone (floor is mylohyoid)
carotid triangle is superior omohyoid, SCM and posterior digastric
contains bifurcation of carotid, internal jugular, vagus, hypoglossal
digaastric trinagle is anterior and posterior digastric + mandible, contains submandibular gland
muscular triangle boundariessuperior omo, midline and SCM
Posterior triangle:
occipital (SCM/trap/omo) - accessory n.
subclavian (SCM/trap, clavicle)
172
submental triangle boundaries
submental is madible, anterior digastric and hyoid bone (floor is mylohyoid)
173
carotid triangle boundaries
carotid triangle is superior omohyoid, SCM and posterior digastric, contains bifurcation of carotid, internal jugular, vagus, hypoglossal
174
muscular triangle boundaries
muscular triangle boundariessuperior omo, midline and SCM
175
digastric triangle boundaries
digaastric trinagle is anterior and posterior digastric + mandible, contains submandibular gland
176
what makes posterior triangle of neck
Posterior triangle:
occipital (SCM/trap/omo) - accessory n.
subclavian (SCM/trap, clavicle)
177
```
Which of the following muscles assists in opening the pharyngeal orifice of
the auditory tube during swallowing?
• stylopharyngeus
• palatopharyngeus
• salpingopharyngeus
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salpingopharyngeus
all these are longitudinal mm of pharynx
stylo - IX
salpingo and palato - vagus
178
stylopharyngeal supply
IX
179
salpingopharyng supply
vagus
180
palatopharyng supply
vagus
181
```
Which ofthe following contains thick myosin filaments ONLY?
• H zone
• I band
• A band
• all of the above
```
H band
```
A bands don't change
H - only myosin
Z - middle of I
I is everything that's not A
A has both thick and thin
```
actin - mostly I, extend to A
now draw picture
182
```
The is the most superficially located and strongest muscle of mastication?
• temporalis
• medial pterygoid
• lateral pterygoid
• masseter
```
masseter
lingual n. runs on lateral surface of medial pterygoid
temporalis m helps medial pterygoid and masseter elevate and close
both lats - protrusion
one - lateral deviation to opposite side
all mastication mm - V3 (+ tensor tympani and tensor veli palatini)
183
what do lateral pterygoids do
protrude
184
motor fx of V3
all mastication + tensor veli palatinin + tensor tympani
185
```
The anterior and posterior pillars of the fauces enclose which area of lymphoid
tissue?
• lingual tonsils
• pharyngeal tonsils
• palatine tonsils
• peyer's patches
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palatine tonsils
fauces - passage from mouth to pharynx
```
anterior = palatoglossal fold with muscle
posterior = palatopharyngeal fold with muscle
```
186
```
Which of the following muscles are innervated by the axillary nerve?
Select all that apply.
• pectoralis major
• pectoralis minor
• teres major
• teres minor
• deltoid
• latissimus dorsi
```
deltoid and teres minor
now draw brachial plexus
187
innervation of pec major
med and lat pec
188
innervation of pec minor
med pec
189
innervation of teres major
upper and lower subscap
190
innervation of teres minor
axillary
191
innervation of deltoid
axillary
192
innervation of latissimus dorsi
thoracodorsal (=middle subscap)
193
```
All the following muscles are innervated by the same nerve that innervates
the muscles of mastication EXCEPT one, which one is the exception?
• mylohyoid
• tensor tympani
• tensor vel i palatini
• anteri or belly of digastric
• posterior belly of digastric
[refer to card 119 A-1 for illustration )
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posterior belly of digastric - facial n.
all mm of mastication + 2 tensors - V3 and maxillary artery
develop from first pharyngeal arch
194
```
All the muscles of the tongue are innervated by the hypoglossal nerve
EXCEPT one. Which one is the exception?
• hyoglossus
• styloglossus
• palatoglossus
• genioglossus
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palatoglossus - vagus
all other mm of tongue (intrinsic and extrinsic) - hypoglossal
btw as a reminder
stylopharyngeal IX
salpingopharyngeal and palatopharyngeal - X
195
```
Most of the muscles that act on the shoulder girdle and upper limb joints are
supplied by branches of the brachial plexus. Which of the following is NOT?
• levator scapulae
• rhomboid major
• rhomboid minor
• trapezius
• serratus anterior
• pectoralis minor
• subclavius
```
trap - accessory n. XI
runs in occipital trinagle of posterior neck (SCM trap omo)
serratus anterior pulls scapula down and forward - LTN
trap:upper elevates scapula, middle pulls medially, lower pulls medially so that glenoid faces up and forward
196
innervation of serratus anterior
LTN
197
what does serratus anterior do
pull scapula down and forward
198
levator scapulae + rhomboids
dorscal scapular n. (off C5)
| raise medial border of scapula
199
A 16-year-old girl who is just about to have her junior prom comes crying
into the physician's office, but is lacrimating only from her right eye. The left
half of her face is also paralyzed. An oral exam reveals trauma to her buccal
mucosa where her teeth have bitten her cheek. Which muscle is responsible
for keeping mucous membranes out of the plane of occlusion and food out
ofthe buccal vestibule?
• medial pterygoid
• lateral pterygoid
• buccinator
• masseter
• temporalis
buccinator
damage to facial n. - Bell's palsy
parotid duct travels over masseter and penetrates buccinator,
opens near 2nd maxillary molar
200
```
All of the following muscles are responsible for elevating the mandible
EXCEPT one. Which one is the exception?
• masseter
• medial pterygoid
• mylohyoid
• temporalis
```
mylohyoid - floor of mouth, suprahyoid depressor actually
mylohyoid
geniohyoid (on top of mylo)
digastric
201
```
The action of which of the following muscles would be affected if the hamulus
was fractured?
• uvular
• palatopharyngeus
• tensor vel i palatini
• palatoglossus
•levator veli palatini
```
tensor veli palatini loops over hamulus
all mm of soft palate - X, except tensor veli - V3
202
```
Which of the following travels with the esophagus through the esophageal
opening in the diaphragm?
• aorta
• thoracic duct
• azygos vein
• vagus nerve
• right phrenic nerve
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vagus + esophagus T10
phrenic runs between pericardium and pleura and innervates diaphragm
diaphragm is higher on right
203
```
Which costal muscle can typically cross more than one intercostal space?
• external intercostal
• internal intercostal
• innermost intercostals
• subcostal
• transverse thoracic
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subcostal
external hand in pocket elevates
internal and innermost vice versa
subcostal elevates
transverse thoracic ffrom sternum to ctlges depresses
main m of respiration is diaphragm
204
Name the molecule that lies along the surface ofF-actin and physically covers
myosin binding sites during the resting state.
• G-actin
· tropomyosin
• troponin
• light meromyosin
• heavy meromyosin
tropomyosin
G-actin globules assebled into F-actin fiber
light meromyosin is backbone with lateral heavy meromyosins which interact with actin
when troponin binds Ca, it pulls tropomyosin off binding site and lets myosin
205
```
The right and left rectus abdominis muscles are entirely independent, being
separated by a connective structure called the:
• pyramidalis
• gubernaculum
• linea alba
• il iopectineal arch
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linea alba
spermatic cord or round ligament of uterus runs below internal oblique --> cremaster
back wall of abdominal:
psoas major and minor and quadratus lumborum (lumbar plexus)
iliacus (femoral n.)
206
```
All of the following structures are located between the superior and middle
pharyngeal constrictors EXCEPT one. Which one is the EXCEPTION?
• stylopharyngeus muscle
• glossopharyngeal nerve
• stylohyoid ligament
• recurrent laryngeal nerve
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recurrent laryngeal nerve
all constrictors innervated by pharyng plexus
above superior constrictor: auditory tube, levator palatini, ascending palatine a.
between superior and middle: stylopharyng m, glossopharyng n. and stylohyoid ligament
between middle and inferior: internal branch of superior laryngeal n. and superior laryngeal artery
below inferior constrictor: recurrent laryngeal nerve and inferior laryngeal artery
207
what runs between superior and middle pharyn constrictors
stylohyoid ligament
glossopharyngeal nerve
stylopharyng muscle
208
what runs between middle and inferior pharyng constrictor
internal branch of superior laryngeal nerve and superior laryngeal artery
209
below inferior constrictor runs
recurrent laryngeal and inferior laryngeal artery
210
```
The connective tissue layer surrounding each individual muscle fiber is
called the:
• perimysium
• epimysium
• endomysium
• sarcolemma
```
endomysium
211
At a picnic, the kids all decide to hang upside down on the monkey bars. One
daring kid decides that he will try to eat a grape while hanging upside down
and finds that he has no trouble doing this. Peristalsis and other similar
movements are produced by which type of muscle tissue?
• smooth muscle tissue
• striated muscle tissue
• skeletal muscle t issue
• cardiac muscle tissue
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smooth
212
A surgeon performing a thyroidectomy accidentally transects a nerve. The
patient then presents with hoarseness and difficulty breathing. There is a
loss of sensation below the vocal folds and loss of motor innervation to all of
the intrinsic muscles of the larynx except the cricothyroid muscle. Which
nerve was transected during the surgery?
• recurrent laryngeal nerve
• internal branch of superior laryngeal nerve
• external branch of superior laryngeal nerve
• accessory nerve
• glossopharyngeal nerve
common damage is recurrent laryngeal nerve
innervates all intrinsic muscles of larynx except cricothyroid
cricothyroid is by external branch of superior laryngeal
sensation above vocal folds - internal branch of superior laryngeal
below - recurrent laryngeal
213
innervation of cricothyroid
external branch of superior laryngeal nerve
internal branch of it runs between middle and inferior constrictors
cricothyroid extends vocal folds
214
sensation above vocal folds and where it runs
internal branch of superior laryngeal nerve, passes between middle and inferior constrictors
215
The axilla, or armpit, is a localized region of the body between the upper
humerus and thorax. It provides a passageway for the large, important
arteries, nerves, veins, and lymphatics that ensure that the upper limb
functions properly. The muscle that forms the bulk of the anterior axillary
fold is the:
• latissimus dorsi
• pectoralis major
• subscapulari s
• teres minor
• teres major
pec major
```
anterior fold - pecs
posterior fold - lat dorsi + teres major
lat wall humerus
posterior wall - subscapularis, teres major, lat dorsi
anterior wall - pecs + subclavian
```
216
posterior fold/wall of axilla
lat dorsi, teres major/subscapularis
217
```
All the infrahyoid muscles are innervated by the ansa cervicalis (Cl -3)
EXCEPT one. Which one is the EXCEPTION?
• sternohyoid
• sternothyroid
• thyrohyoid
• omohyoid
```
all ansa except thyrohyoid which is C1 via hypoglossal
suprahyoids:
digastric: posterior facial, anterior V3
mylohyoid V3
geniohyoid hypoglossal
stylohyoid facial
SCM C2+3
218
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Which of the following is NOT a characteristic of cardiac muscle?
• multinuclear
• intercalated discs
• gap junctions
• desmosomes
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multinuclear
219
A nervous dental student is performing the inferior alveolar nerve block for
the first time. His injection passes the ramus, but he thinks deposition of the
anesthetic will work. His patient complains that he can't "move his face" on
the side ofthe injection. Which gland did the dental student penetrate?
• sublingual gland
• submandibular gland
• parotid gland
• von Ebner's glands
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parotid
220
```
Biceps brachii is the major ____ of elbow joint, and ____ ofthe forearm.
• f lexor, pronator
• f lexor, supinator
• extensor, pronator
• extensor, supinator
• pronator, supinator
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flexor, supinator
triceps (radial n.) - extensor
brachialis starts at middle of humerus to coronoid of ulna,
musculocutaneous n.
flexor of elbow
coracobrachialis sameeeeee
biceps brachii two heads: longer at supraglenoid, shorter at coracoid; musculocutaneous, flexor + supinator
221
Which of the following muscles originates from the medial surface of the
lateral pterygoid plate?
• superficial head of the medial pterygoid
• deep head of the medial pterygoid
•lower head of the lateral pterygoid
• upper head of the lateral pterygoid
I refer to card 119 A-1 for illustration I
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deep head of medial pterygoid
its supf from maxilla
lower head of lateral from lat pteryg plate to neck of condyle; upper from greater sphenoid wing into TMJ
temporalis from temp fossa to coronoid
anterior and superior fibers elevate, posterior retract mandible
222
attachments of lateral pterygoid
upper: greater sphenoid --> TMJ
lower: plate --> neck of condyle
223
attachments and fx of temporalis
to coronoid
| superior and anterior fibers elevate, posterior fibers retract mandible
224
A patient comes to the emergency room after boxing practice. He was hit
with an uppercut and heard a crack in his jaw joint. ACT scan shows a condylar
fracture with damage to the articular disc. When the patient attempts
protrusion, the mandible markedly deviates to the left. Which muscle is
unable to contract?
• left lateral pterygoid
• right lateral pterygoid
•left medial pterygoid
• right medial pterygoid
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left lateral pterygoid
225
A 46-year-old woman comes into the dentist's office for a cleaning. He
notices that her tongue is slightly swollen, fiery red, and smooth. Her diet
history indicates that she has had a loss of appetite for quite some time and
that she has been feeling fatigued. A call to her physician indicates a history
of iron deficiency anemia and associated glossitis. In glossitis, the smooth
nature is caused by a lack of which papillae that are the most numerous and
cover the anterior two-thirds of the tongue?
• foliate
• circumvallate
• fungiform
• filiform
filiform
Plummer-Vinson: postmenopausal: dysphagia (eaophag webs), glossitis, iron deficiency
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Which ofthe following muscles cells does NOT contain troponin?
• skeletal muscl e cell
• cardiac muscl e cell
• smooth muscle cell
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smooth
poor sarcoplasmic tericulum
calmodulin binds Ca
227
Skeletal muscle possesses a well developed sarcoplasmic reticulum. This
along with T tubules and terminal cisternae function in the release and
reuptake of:
• sodium
• phosphate
• calcium
• glucose
Ca
number of mm fibers does not increase
troponin + Ca in skel and cardiac
calmodulin + Ca in smooth
228
```
Which ofthe following muscles elevates and abducts the eyeball?
• medial rectus
• lateral rectus
• superior rectus
• inferi or rectus
• superior oblique
• inferi or oblique
```
inferior oblique
IO + IR - adduct and laterally rotate
SO + SR - abduct and medially rotate
LR6, SO4
all - ophthalmic artery
229
Internal Oblique does what
elevate, laterally rotate and adduct
230
Superior Oblique does what
depress, abduct, medially rotate
231
Superior Rectus does what
elevate, medially rotate, abduct
232
All mm of pharynx supplied by except which is
IX + X except stylopharyng which is IX
233
All mm of larynx supplied by except which is
recurrent laryngeal except cricothyroid which is external branch of superior laryngeal nerve
234
all mm of tongue supplied by except which is
hypoglossal except palatoglossal which is X
235
all soft palate supplied by except which is
IX+X except tensor veli which is V3
236
all infrahyoid supplied by except which is
ansa (C1-C3) (btw CSM is C2+3) except thryohyoid which is C1 via hypoglossal
237
where does glossopharyngeal pass?
between superior and middle pharyng constrictors
238
what attaches actin in smooth mm cells?
dense bodies
239
which mm sense extracellular Ca
smooth and cardiac
240
which mm have gap jxns
cardiac (also intercalated) and smooth
241
mode of stimulation in cardiac
all or none
