anatomy 18.04 Flashcards
At which level superior mesenteric artery branches from aorta?
L1
Which of the nerves listed below is directly responsible for the innervation of the lateral aspect of flexor digitorum profundus?
Ulnar nerve
Anterior interosseous nerve
Radial nerve
Median nerve
Posterior interosseous nerve
The anterior interosseous nerve is a branch of the median nerve and is responsible for innervation of the lateral aspect of the flexor digitorum profundus.
Which of the following statements relating to the knee joint is false?
It is the largest synovial joint in the body
When the knee is fully extended all ligaments (bar the anterolateral aspect of the posterior cruciate ligament) of the knee joint are taut
Rupture of the anterior cruciate ligament may result in haemarthrosis
The posterior aspect of the patella is extrasynovial
The joint is innervated by the femoral, sciatic and obturator nerves
The posterior aspect is intrasynovial and the knee itself comprises the largest synovial joint in the body. It may swell considerably following trauma such as ACL injury. Which may be extremely painful owing to rich innervation from femoral, sciatic and ( a smaller) contribution from the obturator nerve. During full extension all ligaments are taut and the knee is locked.
In a patient with an ectopic kidney where is the adrenal gland most likely to be located?
In the pelvis
On the contralateral side
In its usual position
Superior to the spleen
It will be absent
Because the kidney is present, rather than absent, the adrenal will usually develop and in the normal location.
An 18 year 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?
Pterygopalatine ganglion
Otic ganglion
Submandibular ganglion
Ciliary ganglion
None of the above
The parasympathetic fibres to the lacrimal apparatus transit via the pterygopalatine ganglion.
A 28 year old man is stabbed outside a nightclub in the upper arm. The median nerve is transected. Which of the following muscles will demonstrate impaired function as a result?
Palmaris brevis
Second and third interossei
Adductor pollicis
Abductor pollicis longus
Abductor pollicis brevis
Palmaris brevis - Ulnar nerve
Palmar interossei- Ulnar nerve
Adductor pollicis - Ulnar nerve
Abductor pollicis longus - Posterior interosseous nerve
Abductor pollicis brevis - Median nerve
T
he median nerve innervates all the short muscles of the thumb except the adductor and the deep head of the short flexor. Palmaris and the interossei are innervated by the ulnar nerve.
At which of the following levels does the inferior thyroid artery enter the thyroid gland?
C6
C2
C4
C3
C5
It enters the gland at C6.
What is the lymphatic drainage of the male spongy urethra?
External iliac nodes
Internal iliac nodes
Para aortic nodes
Deep inguinal nodes
Meso rectal nodes
The lymphatic drainage of the spongy urethra and the glans penis is to the deep inguinal nodes. The prostatic and membranous urethra drains to the internal iliac nodes.
Which of the muscles listed below is attached to the anterior aspect of the fibrous capsule that encases the elbow joint?
Pronator teres
Biceps
Brachialis
Triceps
Extensor carpi radialis longus
The brachialis inserts some of its fibres into the fibrous joint of the elbow capsule and when it contracts, it helps to flex the joint.
A 78 year old lady falls over in her nursing home and sustains a displaced intracapsular fracture of the femoral neck. A decision is made to perform a hemi arthroplasty through a lateral approach. Which of these vessels will be divided to facilitate access?
Saphenous vein
Superior gluteal artery
Superficial circumflex iliac artery
Profunda femoris artery
Transverse branch of the lateral circumflex artery
During the Hardinge style lateral approach the transverse branch of the lateral circumflex artery is divided to gain access. The vessels and its branches are illustrated below:
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?
Stratified squamous
Ciliated columnar
Non ciliated columnar
Non stratified squamous
None of the above
The external aspect of the tympanic membrane is lined by stratified squamous epithelium. This is significant clinically in the development of middle ear infections when this type of epithelium may migrate inside the middle ear.
During a neck dissection, a nerve is noted to pass posterior to the medial aspect of the first rib. Which of the nerves listed below is this most likely to be?
Medial cord of the brachial plexus
Long thoracic nerve
Nerve to subclavius
Medial pectoral nerve
Phrenic nerve
The key point is that the phrenic nerve runs posterior to the medial aspect of the first rib. Superiorly, it lies on the surface of scalenus anterior.
A 45 year old motor cyclist sustains a tibial fracture and is noted to have anaesthesia of the web space between his first and second toes. Which of the nerves listed below is most likely to be compromised?
Superficial peroneal nerve
Deep peroneal nerve
Sural nerve
Long saphenous nerve
Tibial nerve
The deep peroneal nerve lies in the anterior muscular compartment of the lower leg and can be compromised by compartment syndrome affecting this area. It provides cutaneous sensation to the first web space. The superficial peroneal nerve provides more lateral cutaneous innervation.
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?
Taste sensation from anterior two thirds of the tongue
Closing the ipsilateral eyelid
Raising the ipsilateral side of the lip
Ipsilateral corneal reflex
Buccinator muscle
The chorda tympani branches inside the facial canal and will therefore be unaffected by this most unfortunate event! The corneal reflex is mediated by the opthalmic branch of the trigeminal nerve sensing the stimulus on the cornea, lid or conjunctiva; the facial nerve initiates the motor response of the reflex.
Which of the following is true in relation to the sartorius muscle?
Innervated by the deep branch of the femoral nerve
Inserts at the fibula
It is the shortest muscle in the body
Forms the Pes anserinus with Gracilis and semitendinosus muscle
Causes extension of the knee
It is innervated by the superficial branch of the femoral nerve. It is a component of the pes anserinus.
Which cranial nerve provides general sensation to the anterior two thirds of the tongue?
Facial
Trigeminal
Hypoglossal
Vagus
Glossopharyngeal
Taste to the anterior two thirds of the tongue is supplied by the facial nerve, the trigeminal supplies general sensation, this is mediated by the mandibular branch of the trigeminal nerve (via the lingual nerve).
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?
Superior gluteal nerve
Obturator nerve
Sciatic nerve
Femoral nerve
Inferior gluteal nerve
Damage to the superior gluteal nerve will result in a Trendelenburg gait.
Which of the following bones is related to the cuboid’s distal articular surface?
All metatarsals
5th metatarsal
Calcaneum
Medial cuneiform
3rd metatarsal
The cuboid is located at the lateral aspect of the foot between the calcaneus posteriorly and the 4th and 5th metatarsals distally.
A 24 year old man falls and sustains a fracture through his scaphoid bone. From which of the following areas does the scaphoid derive the majority of its blood supply?
From its proximal medial border
From its proximal lateral border
From its proximal posterior surface
Superficial palmar arch vessels
Dorsal carpal branch vessels
The dorsal carpal branch vessels supply 80% of the scaphoid via retrograde flow. There is a minor supply from the superficial palmar arch vessels that supplies the distal 20% of the scaphoid.
A 53 year old lady is recovering following a difficult mastectomy and axillary nodal clearance for carcinoma of the breast. She complains of shoulder pain and on examination has obvious winging of the scapula. Loss of innervation to which of the following is the most likely underlying cause?
Latissimus dorsi
Serratus anterior
Pectoralis minor
Pectoralis major
Rhomboids
Winging of the scapula is most commonly the result of long thoracic nerve injury or dysfunction. Iatrogenic damage during the course of the difficult axillary dissection is the most likely cause in this scenario. Damage to the rhomboids may produce winging of the scapula but would be rare in the scenario given.
A 72 year old man with carcinoma of the lung is undergoing a left pneumonectomy. The left main bronchus is divided. Which of the following thoracic vertebrae lies posterior to this structure?
T3
T7
T6
T10
T1
The left main bronchus lies at T6. Topographical anatomy of the thorax is important as it helps surgeons to predict the likely structures to be injured in trauma scenarios (so popular with examiners)
Which of the following nerves conveys sensory information from the laryngeal mucosa?
Glossopharyngeal
Laryngeal branches of the vagus
Ansa cervicalis
Laryngeal branches of the trigeminal
None of the above
The laryngeal branches of the vagus supply sensory information from the larynx.
What is the nerve supply to the muscle indicated by an X on the prosection below?
CN XI
CN IX
Median pectoral nerve
Lateral pectoral nerve
Suprascapular nerve
Be careful not to confuse CN IX with CN XI
The muscle indicated is trapezius and it is innervated by the accessory nerve (CN XI)
Which of the following nerves is responsible for the motor innervation of the sternocleidomastoid muscle?
Ansa cervicalis
Accessory nerve
Hypoglossal nerve
Facial nerve
Vagus nerve
The motor supply to the sternocleidomastoid is from the accessory nerve. The ansa cervicalis supplies sensory information from the muscle.
