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Medex Surgery MCQ > Anatomy > Flashcards

Anatomy Flashcards

1
Q

A 19 years old female is admitted with suspected meningitis. The HO is due to perform a lumbar puncture. What is the most likely first encoutered when needle is inserted?

a. Ligamentum flavum
b. Denticulate ligament
c. Dural sheath
d. Pia Mater
e. Supraspinous ligament

A

e. Supraspinous ligament`

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2
Q

A 34 years old male is being examined in the pre-operative assessment clinic. A murmur is identified in the 5th intercostal space just next to left side of the sternum. From where is it most likely to to have originated?

a. Mitral valve
b. Aortic valve
c. Pulmonary valve
d. Right ventricular aneurysm
e. Tricuspid valve

A

e. Tricuspid valve

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3
Q

What is the correct embryological origin of stapes?

a. First pharyngeal arch
b. Second pharyngeal arch
c. Third pharyngeal arch
d. Fourth pharyngeal arch
e. Fifth pharyngea

A

b. Second pharyngeal arch

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4
Q

Which muscle initiates the abduction of the shoulder?

a. Infraspinatus
b. Latissimus dorsi
c. Supraspinatus
d. Deltoid
e. Teres major

A

c. Supraspinatus

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4
Q

What is the the most important structure involved in supporting uterus?

a. Round ligament
b. Broad ligament
c. Uterosacral ligament
d. Cardinal ligament
e. Central perineal tendon

A

e. Central perineal tendon

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5
Q

A 22 years old man suffers a compound fracture of the tibia. During attempted surgical repair the deep peroneal nerve is divided. Which of the following muscles will not be affected as a result?

a. Tibialis anterior
b. Peroneus longus
c. Extensor hallucis longus
d. Extensor digitorum longus
e. Peroneus tertius

A

b. Peroneus longus

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6
Q

A 56 years old man in undergoing a superficial parotidectomy for a pleomorphic adenoma. During the dissection of the parotid, which of the following structures will be encountered lying most superficially?

a. Facial nerve
b. External carotid artery
c. Occipital artery
d. Maxillary artery
e. Retromandibular vein

A

a. Facial nerve

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7
Q

A 43 years old man is stabbed outside of a nightclub. He suffers a transection of his median nerve just as it leaves the brachial plexus. Which of the following features is least likely to ensue?

a. Ulnar deviation of the wrist
b. Complete loss of wrist flexion
c. Loss of pronation
d. Loss of flexion at the thumb joint
e. Inability to oppose the thumb

A

b. Complete loss of wrist flexion

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8
Q

A 78 years old man is due to undergo an endarterectomy of the internal carotid artery. Which of the following nervous structures are most at risk during the dissection?

a. Recurrent laryngeal nerve
b. Sympathetic chain
c. Hypoglossal nerve
d. Phrenic nerve
e. Lingual nerve

A

c. Hypoglossal nerve

other nerves include:
- Greater auricular nerve
- Superior laryngeal nerve

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9
Q

Which of the following structures is not transmitted by the jugular foramen?

a. Hypoglossal nerve
b. Accessory nerve
c. Internal jugular nerve
d. Inferior petrosal sinus
e. Vagus nerve

A

a. Hypoglossal nerve

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10
Q

Which of the following fascial structures encases the apex of the lungs?

a. Waldeyers fascia
b. Sibsons fascia
c. Pretracheal fascia
d. Clavipectoral fascia
e. None of the above

A

b. Sibsons fascia

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11
Q

With regards to the jugular vein, which of the following statements is untrue?

a. It lies within the carotid sheath
b. It is the continuation of the sigmoid sinus
c. The terminal part of the thoracic duct crosses anterior to it to insert into the right subclavian vein
d. The hypoglossal nerve is closely related to it as it passes near the atlas
e. The vagus nerve is closely related to it within the carotid sheath

A

c. The terminal part of the thoracic duct crosses anterior to it to insert into the subclavian vein

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12
Q

A 28 years old man requires a urethral catheter to be inserted prior to undergoing a splenectomy. Where is the first site of resistance to be encountered on inserting the catheter?

a. Bulbar urethra
b. Membranous urethra
c. Internal sphincter
d. Prostatic urethra
e. Bladder neck

A

b. Membranous urethra

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13
Q

A 23 years old man undergoes an orchidectomy. The right testicular vein is ligated; into which structure does it drain?

a. Right renal vein
b. Inferior vena cava
c. Common iliac vein
d. Internal iliac vein
e. External iliac vein

A

b. Inferior vena cava

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14
Q

A 24 years old man falls and sustain a fracture through his scaphoid bone. From which of the following areas does the scaphoid derive the majority of its blood supply?

a. From its proximal medial border
b. From its proximal lateral border
c. From its proximal posterior surface
d. From the proximal end
e. From the distal end

A

e. From the distal end

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15
Q

A 21 years old man has an inguinal hernia and is undergoing a surgical repair. As the surgeons approach the inguinal canal they expose the superficial inguinal ring. Which of the following forms the lateral edge of this structure?

a. Inferior epigastry artery
b. Conjoint tendon
c. Rectus abdominis muscle
d. External oblique aponeuresis
e. Transversalis fascia

A

d. External oblique aponeuresis

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16
Q

Which of the following cranial venous sinuses is unpaired?

a. Transverse sinus
b. Superior sagittal sinus
c. Carvenous sinus
d. Sigmoid sinus
e. Inferior petronus sinus

A

b. Superior sagittal sinus

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17
Q

Which of the following laryngeal tumours will not typically metastasise to the cervical lymph nodes?

a. Glottic
b. Supraglottic
c. Subglottic
d. Transglottic
e. Aryepiglottic fold

A

a. Glottic

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18
Q

Which of the following forms the medial wall of the femoral canal?

a. Pectineal ligament
b. Adductor longus
c. Sartorius
d. Lacunar ligament
e. Inguinal ligament

A

d. Lacunar ligament

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19
Q

A 67 years old man is undergoing a transurethral resection of a bladder tumour using diathermy. Suddenly during the procedure the patients leg begins to twitch. Stimulation of which of the following nerves is the most likely cause?

a. Femoral
b. Pudendal
c. Sciatic
d. Obturator
e. Gluteal

A

d. Obturator

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20
Q

A 5 years old boy is playing with some small bearings. Unfortunately he inhales one. To which of the following lung regions is the ball most likely to settle?

a. Right lower lobe
b. Left main bronchus
c. Right upper lobe
d. Left lower lobe
e. None of the above

A

a. Right lower lobe

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21
Q

A patient presents with superior vena caval obstruction. How many collateral circulations exists as alternative pathways of venous return?

a. None
b. One
c. Two
d. Three
e. Four

A

e. Four

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22
Q

An 18 years old man is cutting some plants when a small piece of vegetable matter enters his eye. His eye becomes watery. Which of the following is responsible for relaying parasympathetic neuronal signals to the lacrimal apparatus?

a. Pterygopalatine ganglion
b. Otic ganglion
c. Submandibular ganglion
d. Ciliary ganglion
e. None of the above

A

a. Pterygopalatine ganglion

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23
Q

Which of the nerves listed below is responsible for the innervation of the lateral aspect of flexor digitorum profundus?

a. Ulnar nerve
b. Anterior interosseous nerve
c. Radial nerve
d. Median nerve
e. Posterior interosseous nerve

A

b. Anterior interosseous nerve

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24
Q

A 45 years old lady is undergoing a Whipple procedure for carcinoma of the pancreatic head. The bile duct is transected. Which of the following vessels is mainly responsible for the blood supply to the bile duct?

a. Cystic artery
b. Hepatic artery
c. Portal vein
d. Left gastric artery
e. None of the above

A

b. Hepatic artery

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25
Q

A 43 years old lady is undergoing total thyroidectomy for an extremely large goitre. The surgeons decide that the access may be improved by division of the infra hyoid strap muscles. At which of the following sites should they be divided?

a. In their upper half
b. In their lower half
c. In the middle
d. At the origin from the hyoid
e. At the point of their insertion

A

a. In their upper half

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26
Q

A 7 years old boy presents with right iliac fossa pain and there is a clinical suspicion that appendicitis is present. From which of the following embryological structures is the appendix derived?

a. Vitello-intestine duct
b. Uranchus
c. Foregut
d. Hindgut
e. Midgut

A

e. Midgut

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27
Q

A 22 years old women has recently undergone a surgical excision of the submandibular gland. She presents to the follow up clinic with a complaint of tongue weakness on the ipsilateral side to her surgery. Which nerve has been damaged?

a. Hypoglossal nerve
b. Lingual nerve
c. Inferior alveolar nerve
d. Facial nerve
e. Lesser petrosal nerve

A

a. Hypoglossal nerve

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28
Q

You decide to take an arterial blood gas from the femoral artery. Where should the needle be inserted to gain the sample?

a. Mid point of the inguinal ligament
b. Mid inguinal point
c. 2cm inferomedially to the pubic tubercle
d. 2cm superomedially to the pubic tubercle
e. 3cm inferolaterally to the deep inguinal ring

A

b. Mid inguinal point

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29
Q

A 67 years old man undergoes a carotid endarterectomy and seems to recover well following surgery. When he is reviewed on the ward post operatively he complains that his voice is hoarse. What is the most likely cause?

a. Damage to the accessory nerve
b. Damage to the cervical plexus
c. Damage to the glossopharyngeal nerve
d. Damage to the hypoglossal nerve
e. Damage to the vagus

A

e. Damage to the vagus

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30
Q

A 25 years old man has an inguinal hernia, which of the following structures must be divided (at open surgery) to gain access to the inguinal canal?

a. Transversalis fascia
b. External oblique aponeuresis
c. Conjoint tendon
d. Rectus abdominis
e. Inferior epigastric artery

A

b. External oblique aponeuresis

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31
Q

A 34 years old man is shot in the postero-inferior aspect of his thigh. Which of the following lies at the most lateral aspect of the popliteal fossa?

a. Popliteal artery
b. Popliteal vein
c. Common peroneal nerve
d. Tibial nerve
e. Small saphenous vein

A

c. Common peroneal nerve

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32
Q

A 67 years old man has an abdominal aortic aneurysm which displaces the left renal vein. Which branch of the aorta is most likely to affected at this level?

a. Inferior mesentric artery
b. Superior mesentric artery
c. Coeliac axis
d. Testicular artery
e. None of the above

A

b. Superior mesentric artery

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33
Q

A 12 year old boy undergoes surgery for the recurrent mastoid infections. Post operatively he complains of an altered taste sensation. Which of the following nerves has been injured?

a. Glossopharyngeal
b. Greater petrosal
c. Olfactory
d. Trigeminal
e. Chorda tympani

A

e. Chorda tympani

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34
Q

The first root of the brachial plexus commonly arises at which of the following levels?

a. C6
b. C5
c. C3
d. C2
e. C8

A

b. C5

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35
Q

What is the anatomical level of transpyloric plane?

a. T11
b. T12
c. L1
d. L4
e. T10

A

c. L1

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36
Q

A 35 years old man falls and sustains a fracture to the middle third of his clavicle. Which vessels is at the greatest risk of injury?

a. Subclavian vein
b. Subclavian artery
c. External carotid artery
d. Internal carotid artery
e. Vertebral artery

A

a. Subclavian vein

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37
Q

A 53 years old man with end stage mitral valve stenosis is undergoing a mitral valve replacement. The heart is opened and the musculi pectinati are identified. Where are these structures located?

a. Right ventricle
b. Left ventricle
c. Right atrium
d. Pulmonary valve
e. Aortic valve

A

c. Right atrium

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38
Q

A 33 year old man sustains an injury to his forearm and wrist. When examined in clinic he is unable to adduct his thumb. What is the most likely underlying nerve lesion?

a. Radial nerve
b. Superficial branch of the ulnar nerve
c. Median nerve
d. Posterior interosseous nerve
e. Deep branch of the ulnar nerve

A

e. Deep branch of the ulnar nerve

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39
Q

A 34 years old lady suffers from hyperparathyroidism. The right inferior parathyroid is identified as having an adenoma and is scheduled for resection. From which of the following embryological structures is it derived?

a. Second pharyngeal pouch
b. Third pharyngeal pouch
c. Fourth pharyngeal pouch
e. First pharyngeal pouch
e. None of the above

A

b. Third pharyngeal pouch

40
Q

Which of the following structures separates the subclavian artery and vein?

a. Digastric muscle
b. Prevertebral fascia
c. Anterior scalene muscle
d. Middle scalene muscle
e. Omohyoid

A

c. Anterior scalene muscle

41
Q

A 33 years old man was stabbed in the right chest and undergoes a thoracotomy. The right lung is mobilised and the pulmonary ligament inspected. Which of the following structures does not lie within the pulmonary ligament of the right lung?

a. Pulmonary artery
b. Azygous vein
c. Pulmonary vein
d. Bronchus
e. None of the above

A

b. Azygous vein

42
Q

A 56 years old man requires long term parenteral nutrition and the decision made to insert a PICC line for long term venous access. This is inserted into the basilic vein at the region of the elbow. As the catheter is advanced, into which venous structure is the tip of the catheter most likely to pass from the basilic vein?

a. Subclavian vein
b. Axillary vein
c. Posterior circumflex humeral vein
d. Cephalic vein
e. Superior vena cava

A

b. Axillary vein

43
Q

A 23 year old man is involved in a fight outside a nightclub and sustains a laceration to his right arm. On examination he has lost extension of the fingers in his right hand. What nerve most likely to be injured?

a. Ulnar nerve
b. Musculocutaneous nerve
c. Radial nerve
d. Median nerve
e. Axillary nerve
f. Intercostobrachial nerve

A

c. Radial nerve

44
Q

A 40 years old lady trips and falls through a glass door and sustains a severe laceration to his left arm. Amongst her injuries it is noticed that she has lost the ability to adduct the fingers of her left hand. What nerve most likely to be injured?

a. Ulnar nerve
b. Musculocutaneous nerve
c. Radial nerve
d. Median nerve
e. Axillary nerve
f. Intercostobrachial nerve

A

a. Ulnar nerve

45
Q

A 28 years old rugby player injures his right humerus and on examination is noted to have a minor sensory deficit overlying the point of deltoid insertion into the humerus. What nerve most likely to be injured?

a. Ulnar nerve
b. Musculocutaneous nerve
c. Radial nerve
d. Median nerve
e. Axillary nerve
f. Intercostobrachial nerve

A

e. Axillary nerve

46
Q

A 53 years old man is undergoing a radical gastrectomy for carcinoma of the stomach. Which of the following structures will need to be divided to gain access to the coeliac axis?

a. Lesser omentum
b. Greater omentum
c. Falciform ligament
d. Median arcuate ligament
e. Gastrosplenic ligament

A

a. Lesser omentum

47
Q

A 76 years old man complains of symptoms of claudication. The decision is made to measure his ankle brachial pressure index. The signal from dorsalis pedis artery is auscultated with a hand held doppler device. This vessel is the continuation of which of the following?

a. Posterior tibial artery
b. Anterior tibial artery
c. Peroneal artery
d. Popliteal artery
e. None of the above

A

b. Anterior tibial artery

48
Q

A 67 years old man is due to undergo a revisional total hip replacement using a posterior approach. After dividing gluteus maximus in the line of its fibres there is brisk arterial bleeding. Which of the following vessels is likely to be responsible?

a. Profunda femoris artery
b. External iliac artery
c. Internal iliac artery
d. Obturator artery
e. Inferior gluteal artery

A

e. Inferior gluteal artery

49
Q

A 17 years old lady presents with right iliac fossa pain and diagnosed a having acute appendicitis. You take her to theatre to a perform a laparoscopic appendicectomy. During the procedure the scrub nurse distracts you and you inadvertantly avulse the appendicular artery. The ensuing haemorrhage is likely to be supplied directly from which vessel?

a. Inferior mesentric artery
b. Superior mesentric artery
c. Ileo-colic artery
d. Internal iliac artery
e. None of the above

A

c. Ileo-colic artery

50
Q

A 63 years old man who smokes heavily presents with dyspepsia. He is tested and found to be positive for Helicobacter pylori infection. One evening he has an episode of haematemesis and collapses. What is the most likely vessel to be responsible?

a. Portal vein
b. Short gastric arteries
c. Superior mesentric arteries
d. Gastroduodenal artery
e. None of the above

A

d. Gastroduodenal artery

51
Q

Which of the following nerves is responsible for the cremasteric reflex?

a. Lateral femoral cutaneous nerve
b. Femoral nerve
c. Obturator nerve
d. Genitofemoral nerve
e. None of the above

A

d. Genitofemoral nerve

52
Q

Which of the following structures is not located within the mediastinum?

a. Thymus
b. Heart
c. Great vessels
d. Arch of azygous vein
e. Vertebral bodies

A

e. Vertebral bodies

53
Q

A 22 years old man is stabbed in the chest at the level of junction between the sternum and manubrium. Which structure is at greatest risk?

a. Left atrium
b. Oesophagus
c. Thyroid gland
d. Inferior vena cava
e. Aortic arch

A

e. Aortic arch

54
Q

Which of the following nerves passes through the greater and lesser sciatic foramina?

a. Pudendal nerve
b. Sciatic nerve
c. Superior gluteal nerve
d. Inferior gluteal nerve
e. Posterior cutaneous nerve of the thigh

A

a. Pudendal nerve

55
Q

A cervical rib is due to which of the following?

a. Hyperplasia of the annulus fibrosus
b. Proliferation of the nucleus pulposus
c. Fusion of the transverse processes of the 6th and 7th cervical vertebrae
d. An accessory cervical vertebra
e. Elongation of the transverse processes of the 7th cervical vertebra

A

e. Elongation of the transverse processes of the 7th cervical vertebra

56
Q

Which of the structures listed below is not a content of the carotid sheath?

a. Internal jugular vein
b. Internal carotid artery
c. Vagus nerve
d. Recurrent laryngeal nerve
e. Common carotid artery

A

d. Recurrent laryngeal nerve

57
Q

A 73 years old lady is admitted with brisk rectal bleeding. Despite attempts a resuscitation the bleeding proceeds to cause haemodynamic compromise. An upper GI endoscopy is normal. A mesentry angiogram is performed and contrast blush is seen in the region of the sigmoid colon. The radiologist decides to embolise the vessel supplying this area. At what spinal level does it leave the aorta?

a. L2
b. L1
c. L4
d. L3
e. T10

A

d. L3

58
Q

A 23 years old lady with troublesome axillary hyperhidrosis is undergoing a thorascopic sympathectomy to treat the condition. Which of the following structures will need to be divided to access the symphathetic trunk?

a. Intercostal vein
b. Intercostal artery
c. Parietal pleura
d. Visceral pleura
e. None of the above

A

c. Parietal pleura

59
Q

In which space is a lumbar puncture performed?

a. Subdural space
b. Epidural space
c. Subarachnoid space
d. Extradural space
e. Intraventricular space

A

c. Subarachnoid space

60
Q

A 21 years old man is stabbed in the antecubital fossa. A decision is made to surgically explore the wound. At operation, the surgeon dissects down onto the brachial artery. A nerve is identified medially, which nerve is it likely to be?

a. Radial
b. Recurrent branch of median
c. Anterior interosseous
d. Ulnar
e. Median

A

e. Median

61
Q

A 65 years old man with long standing atrial fibrillation develops an embolus to the lower leg. The decision is made to perform an embolectomy, utilising a trans popliteal approach. After incising the deep fascia, which of the following structures will the surgeon encounter first on exploring the central region of the popliteal fossa?

a. Popliteal vein
b. Common peroneal nerve
c. Popliteal artery
d. Tibial nerve
e. None of the above

A

d. Tibial nerve

62
Q

A 43 years old man is undergoing a right hemicolectomy and the ileo-colic artery is ligated. From which of the following vessels it is derived?

a. Inferior mesenteric artery
b. Superior mesenteric artery
c. Coeliac axis
d. Aorta
e. None of the above

A

b. Superior mesenteric artery

63
Q

A 53 years old man is undergoing a distal pancreatectomy for trauma. Which of the following vessels is responsible for the arterial supply to the tail of the pancreas?

a. Splenic artery
b. Pancreaticoduodenal artery
c. Gastric artery
d. Hepatic artery
e. Superior mesentric artery

A

a. Splenic artery

64
Q

A 43 years old lady presents with varicose veins and undergoes a saphenofemoral disconnection, long saphenous vein stripping to the ankle and isolated hook phlebectomies. Post operatively she notices an area of numbness superior to her ankle. What is the most likely cause of this?

a. Sural nerve injury
b. Femoral nerve injury
c. Saphenous nerve injury
d. Common peroneal nerve injury
e. Superficial peroneal nerve injury

A

c. Saphenous nerve injury

65
Q

A man sustain laceration between the base of the little finger and wrist. Several weeks after the injury there is loss of thumb adduction power. Which nerve is most likely to have been injured?

a. Superficial ulnar nerve
b. Deep ulnar nerve
c. Median nerve
d. Radial nerve
e. Recurrent branch of median nerve

A

b. Deep ulnar nerve

66
Q

What is the course of the median nerve relative to the brachial artery in the upper arm?

a. Medial to anterior to lateral
b. Lateral to posterior to medial
c. Medial to posterior to lateral
d. Medial to anterior to medial
e. Lateral to anterior to medial

A

e. Lateral to anterior to medial

67
Q

Which of the following is not the content of the cavernous sinus?

a. Oculomotor nerve
b. Internal carotid artery
c. Opthalmic artery
d. Abducens nerve
e. Optic nerve

A

e. Optic nerve

Content of cavernous sinus
Occulomotor nerve
Trochlear nerve
Opthalmic nerve
Maxillary nerve
Carotid artery
Abducent nerve
T

68
Q

Surgical occlusion of which of these structures, will results in the greatest reduction in hepatic blood flow?

a. Portal vein
b. Common hepatic artery
c. Right hepatic artery
d. Coeliac axis
e. Left hepatic artery

A

a. Portal vein

69
Q

A 43 year old man is due to undergo an excision of the sub mandibular gland. Which of the following incisions is the most appropriate for this procedure?

A. A transversely orientated incision 4cm below the mandible
B. A transversely orientated incision immediately inferior to the mandible
C. A vertical incision 3 cm anterior to the angle of the mandible and extending inferiorly
D. A transversely orientated incision 2cm above the mandible
E. A transversely orientated incision 12cm below the mandible

A

A. A transversely orientated incision 4cm below the mandible

70
Q

A 5 year old boy presents with recurrent headaches. As part of his assessment he undergoes an MRI scan of his brain. This demonstrates enlargement of the lateral and third ventricles. Where is the most likely site of obstruction?

A. Foramen of Luschka
B. Foramen of Magendie
C. Foramen of Munro
D. Aqueduct of Sylvius
E. None of the above

A

D. Aqueduct of Sylvius

71
Q

A 23 year old man presents with appendicitis. A decision is made to perform an appendicectomy. The operation commences with a 5cm incision centered on McBurneys point. Which of the following structures will be encountered first during the dissection?

A. External oblique aponeurosis
B. Internal oblique muscle
C. Transversalis fascia
D. Rectus sheath
E. Peritoneum

A

A. External oblique aponeurosis

72
Q

A 23 year old man is undergoing an inguinal hernia repair. The surgeons mobilise the spermatic cord and place it in a hernia ring. A small slender nerve is identified superior to the cord. Which nerve is it most likely to be?

A. Iliohypogastric nerve
B. Pudendal nerve
C. Femoral branch of the genitofemoral nerve
D. Ilioinguinal nerve
E. Obturator nerve

A

D. Ilioinguinal nerve

73
Q

A 34 year old man undergoes excision of a sarcoma from the right buttock. During the procedure the sciatic nerve is sacrificed. Which of the following will not occur as a result of this process?

A. Loss of extension at the knee joint
B. Foot drop
C. Inability to extend extensor hallucis longus
D. Loss of sensation to the posterior aspect of the thigh
E. Loss of sensation to the posterior aspect of the lower leg

A

A. Loss of extension at the knee joint

74
Q

Where does the spinal cord terminate in neonates?

A. L1
B. L2
C. L3
D. L4
E. L5

A

C. L3

75
Q

A 45 year old man is undergoing a low anterior resection for a carcinoma of the rectum. Which of the following fascial structures will need to be divided to mobilise the mesorectum from the sacrum and coccyx?

A. Denonvilliers fascia
B. Colles fascia
C. Sibsons fascia
D. Waldeyers fascia
E. None of the above

A

D. Waldeyers fascia

76
Q

A 10 year old child has a grommet inserted for a glue ear. What type of epithelium is present on the external aspect of the tympanic membrane?

A. Stratified squamous B. Ciliated columnar
C. Non ciliated columnar
D. Non stratified squamous
E. None of the above

A

A. Stratified squamous

77
Q

A 73 year old lady is admitted with acute mesenteric ischaemia. A CT angiogram is performed and a stenotic lesion is noted at the origin of the superior mesenteric artery. At which of the following levels does this branch from the aorta?

A. L1
B. L2
C. L3
D. L4
E. L5

A

A. L1

78
Q

Which of the following structures does not pass through the foramen ovale?

A. Lesser petrosal nerve
B. Accessory meningeal artery
C. Maxillary nerve
D. Emissary veins
E. Otic ganglion

A

C. Maxillary nerve

79
Q

A 72 year old man is undergoing an open abdominal aortic aneurysm repair. The aneurysm is located in a juxtarenal location and surgical access to the neck of aneurysm is difficult. Which of the following structures may be divided to improve access?

A. Cisterna chyli
B. Transverse colon
C. Left renal vein
D. Superior mesenteric artery
E. Coeliac axis

A

C. Left renal vein

80
Q

An occlusion of the anterior cerebral artery may compromise the blood supply to the following structures except:

A. Medial inferior surface of the frontal lobe
B. Corpus callosum
C. Medial surface of the frontal lobe
D. Olfactory bulb
E. Brocas area

A

E. Brocas area

81
Q

Parasympathetic fibres innervating the parotid gland originate from which of the following?

A. Submandibular ganglion B. Otic ganglion
C. Ciliary ganglion
D. Pterygopalatine ganglion
E. None of the above

A

B. Otic ganglion

82
Q

Following an oesophagogastrectomy the surgeons will anastomose the oesophageal remnant to the stomach, which of the following is not part of the layers that comprise the oesophageal wall?

A. Serosa
B. Adventitia
C. Muscularis propria
D. Submucosa
E. Mucosa

A

A. Serosa

83
Q

Which of the following structures suspends the spinal cord in the dural sheath?

A. Filum terminale
B. Conus medullaris
C. Ligamentum flavum
D. Denticulate ligaments
E. Anterior longitudinal ligament

A

D. Denticulate ligaments

84
Q

Where is the ‘safe triangle’ for chest drain insertion located?

A. 4th intercostal space, mid axillary line
B. 5th intercostal space, mid axillary line
C. 4th intercostal space, mid scapular line
D. 5th intercostal space, mid scapular line
E. 4th intercostal space, mid clavicular line

A

B. 5th intercostal space, mid axillary line

85
Q

Your consultant decides to perform an open inguinal hernia repair under local anaesthesia. Which of the following dermatomal levels will require blockade?

A. T10
B. T12
C. T11
D. S1
E. S2

A

B. T12

86
Q

A 53 year old man presents with an inguinal hernia. Which of the following surface landmarks may be used to identify the location of the deep inguinal ring?

A. Mid point of the inguinal ligament
B. The mid inguinal point
C. The pubic tubercle
D. The medial edge of external oblique
E. 2cm supero medially to the femoral artery

A

A. Mid point of the inguinal ligament

87
Q

A 44 year old man is undergoing a parotidectomy and the surgeon is carefully preserving the facial nerve. Unfortunately his trainee then proceeds to divide it. Which of the following will not be affected as a result?

A. Taste sensation from anterior two thirds of the tongue
B. Closing the ipsilateral eyelid
C. Raising the ipsilateral side of the lip
D. Ipsilateral corneal reflex
E. None of the above

A

A. Taste sensation from anterior two thirds of the tongue

88
Q

A 45 year old lady develops severe back pain and on examination is found to have clinical evidence of an L5/ S1 radiculopathy. Her symptoms deteriorate and eventually a laminectomy is performed. During the surgical approach the surgeons encounter a tough ligamentous structure lying anterior to the spinous processes. This structure is most likely to be the:

A. Transverse spinal ligament
B. Supraspinal ligament
C. Anterior longitudinal ligament
D. Ligamentum flavum
E. Posterior longitudinal ligament

A

D. Ligamentum flavum

89
Q

Which of the following does not pass through the superior orbital fissure?

A. Inferior opthalmic vein
B. Abducens nerve
C. Opthalmic artery
D. Trochlear nerve
E. Superior opthalmic vein

A

C. Opthalmic artery

90
Q

An 18 year old man undergoes a tonsillectomy for attacks of recurrent acute tonsillitis. Whilst in recovery he develops a post operative haemorrhage. Which of the following vessels is the most likely culprit?

A. Facial vein
B. External palatine vein
C. External carotid artery D. Internal jugular vein
E. None of the above

A

B. External palatine vein

91
Q

A patient is found to have an ischaemic left colon. Which artery arising from the aorta at around the level of L3 is most likely to account for this situation?

A. Superior mesenteric artery
B. Inferior mesenteric artery
C. Superior rectal artery
D. Ileocolic artery
E. Middle colic artery

A

B. Inferior mesenteric artery

92
Q

At which level does the aorta perforate the diaphragm?

A. T10
B. T9
C. T8
D. T11
E. T12

A

E. T12

93
Q

A 24 year old lady is stabbed in the buttock. Following the injury the wound is sutured in the emergency department. Eight weeks later she attends the clinic, as she walks into the clinic room she has a waddling gait and difficulty with thigh abduction. On examination she has buttock muscle wasting. Which nerve has been injured?

A. Superior gluteal nerve
B. Obturator nerve
C. Sciatic nerve
D. Femoral nerve
E. Inferior gluteal nerve

A

A. Superior gluteal nerve

94
Q

At which level is the hilum of the left kidney located?

A. L1
B. L2
C. T12
D. T11
E. L3

A

A. L1

95
Q

During a radical neck dissection, division of which of the following fascial layers will expose the ansa cervicalis?

A. Pretracheal fascia
B. Carotid sheath
C. Prevertebral fascia
D. Investing layer of fascia E. Sibsons fascia

A

A. Pretracheal fascia

96
Q

A 73 year old lady presents with symptoms of faecal incontinence. On examination she has weak anal sphincter muscles. What are the main nerve root values of the nerves supplying the external anal sphincter?

A. S2,3
B. L5, S1
C. S4,5
D. S5
E. S2,3,4

A

E. S2,3,4

97
Q

A 22 year old falls over and lands on a shard of glass. It penetrates the palmar aspect of his hand, immediately lateral to the pisiform bone. Which of the following structures is most likely to be injured?

A. Palmar cutaneous branch of the median nerve
B. Lateral tendons of flexor digitorum superficialis
C. Ulnar artery
D. Flexor carpi radialis tendons
E. Lateral tendons of flexor digitorum profundus

A

C. Ulnar artery

Medex Surgery MCQ (5 decks)

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