Anatomy III Midterm Review Flashcards
All of the following can be palpated or percussed except: A. frontal sinuses, B. maxillary sinuses, C. mastoid process, D. sphenoid sinuses
Sphenoid sinuses
While performing a complete PE on a 20 y/o, you palpate a small nttp nodular midline mass that is located superior to the thyroid gland. Dx?
Thyroglossal duct cyst
Atrophy of the gastrocnemius and soleus muscles is associated w/ herniation of which IV discs?
L5-S1
All can be visually observed when mouth is closed except:
A. oral candidiasis,
B. uvular deviation d/t injury to CN X,
C. pharyngeal tonsillar hypertrophy,
D. geographic tongue assoc w/ psoriasis
Pharyngeal tonsillar hypertrophy
26 y/o male construction worker is brought to the ED after traumatic accident where a steel beam dropped onto the top of his head. Which of the following fractures is most likely caused by his injury? A. Type I fx of C2 vertebra B. Burst fx of C1 vertebra C. Compression fx of C7 vertebra D. Pedicle fx of C3 vertebra
Burst fx of C1 vertebra
20 y/o female restrained driver sustained an apparent cervical spine hyperextension injury after a rear-end collision while at a stop light. Rad exam reveals several cervical vertebral body fractures and rupture of adjacent vertebral ligament. What ligament most likely ruptured during this hyperextension injury?
Anterior longitudinal ligament
35 y/o police officer shot in back and develops Brown-Séquard syndrome (hemisection of spinal cord) @ level of T5 on right. What neuro findings would you expect on PE?
Impaired proprioception and vibration sensation on the right
26 y/o male presents to PCP w/ painful rash that worsened over last 2 days. PE reveals vesicular rash that is restricted to a band spanning from the spine around the right flank anteriorly to abruptly stop at the midline umbilicus. Dx w/ shingles. Which nerve is most likely involved?
T10
Which of the following conditions is characterized clinically by combined UMN and LMN symptoms? A. Subacute combined degneration B. ALS C. Polymyelitis D. Vit B12 deficiency
ALS
Bone marking of groove defined as?
Elongated depression or furrow
All are actions of SNS except: A. Tachycardia B. Ejaculation C. Inhibition of urination D. Bronchial smooth muscle contraction
Bronchial smooth muscle contraction
CN XI can be found in which triangle of the neck?
Posterior cervical
Dural venous confluence of sinuses is the meeting place for all of the following except: A. Superior sagittal sinus B. Straight sinus C. Frontal sinus D. Occipital sinus
Frontal sinus
During a LP, all are traversed by the spinal needle except: A. Supraspinous ligament B. Ligamentum flavum C. Interspinous ligament D. Posterior longitudinal ligament
Posterior longitudinal ligament
Which of the following can result from acute otitis media? A. Mastoiditis B. Meningitis C. Facial nerve paralysis D. All over the above
All of the above
All are possible complications of osteoporosis except: A. Vertebral compression fractures B. Kyphosis C. Distal radius fracture D. Osteoid osteoma of the femur
Osteoid osteoma of the femur
Of all the meningeal spaces, which is a "real" space (i.e. not a space that becomes a space pathologically) A. Epidural space B. Subdural space C. Subarachnoid space D. All are "real" spaces
Subarachnoid space
26 y/o male undergoes surgical resection of a papillary carcinoma of the thyroid. Post-op, he is noted to have hoarseness of the voice. What nerve was most likely injured during surgery?
Recurrent laryngeal nerve
What are the primary curvatures of the vertebral column in an adult?
Thoracic and sacral kyphoses
The basal ganglia include?
Caudate + putamen, subthalamic nucleus, substantia nigra
A homonymous hemianopsia can be caused by a lesion in which of the following parts of the vision pathway? A. Left optic nerve B. Right optic tract C. Left lateral geniculate body D. Center of the optic chiasm
Right optic tract
Loss of sensation at the level of the nipples reflects damage to what nerve?
T4
Syringomyelia is characterized by a syrinx (pathological tubular cavity) which expands around the central canal and damages the anterior white commissure. What clinical finding would you expect?
A. Ipsilateral loss of pain sensation and DTR
B. Contralateral loss of proprioception
C. Bilateral loss of pain and temperature sensation
D. Flaccid paralysis
Bilateral loss of pain and temperature sensation
After a car crash, 26 y/o man presents w/ HA + midback px. Rad exam reveals trauma to thoracic spine and bleeding from anterior and posterior internal vertebral venous plexuses. Where is the blood most likely accumulating? A. Epidural space B. Lumbar triangle C. Subarachnoid space D. Subdural space
Epidural space
Which of the following back muscles can be visualized when the upper extremities are elevated? A. Rhomboid + teres major B. Trapezius C. Latissimus dorsi D. All of the above
All of the above
The hangman fracture refers to?
Fracture of the pars interarticularis of C2 d/t abrupt hyperextension
With swallowing, all of the following visibly rise and then fall to their resting positions except: A. Thyroid cartilage B. Cricoid cartilage C, Thyroid gland D. Hyoid bone
Hyoid bone
CSF drains from the 4th ventricle into?
The central canal
In determining the correct level of entry of a spinal needle for an LP, palpating the superior iliac crests and following the interconnecting supracristal plane will most readily guide you to which structure?
L4 vertebral body
64 y/o man w/ hx of HTN + DMT2 is brought into ED w/ sudden onset of right-sided hemiplegia, conjugate eye deviation toward the left, and a difficulty initiating speech. Infarction of what vessel most likely caused his current clinical situation?
Upper division of left middle cerebral artery
64 y/o male w/ hx of HTN + DMT2 is brought into ED w/ sudden onset of right-sided hemiplegia, conjugate eye deviation toward the left, and a difficulty initiating speech. Based on symptoms, what region is most likely involved?
Broca’s area
22 y/o woman brought into ED after MVA. Restrained driver of car going 50 mph that crashed into rear of another car. Driver-side airbag did not deploy. Her head jerked forward, impacting the steering wheel, and then jerked backward, impacting the headrest. She remained conscious during the entire event. She c/o runny nose and states she cannot smell anything properly. Which of the following is the most likely cause of her current sx? A. Fx of temporal bone B. Basilar skull fx C. Fx of cribiform plate D. Epidural hematoma
Fx of cribiform plate
22 y/o woman brought into ED after MVA. Restrained driver of car going 50 mph that crashed into rear of another car. Driver-side airbag did not deploy. Her head jerked forward, impacting the steering wheel, and then jerked backward, impacting the headrest. She remained conscious during the entire event. She c/o runny nose and states she cannot smell anything properly. What is the explanation for the runny nose?
CSF leak
24 y/o man brought to ED after being attacked outside bar. Says some person came up to him and hit him on the left side of his head w/ a baseball bat. Police happened to pass by and interrupt the attack. One officer thought he had a mild concussion but still recommended he go to the ED. PE revealed contusion over left temporal bone. He was completely conscious + had appropriate mentation. He was discharged w/ analgesics and advised to return if he felt worse. His roommate came home the next day and found the pt face down on the floor non-responsive. Most likely diagnosis?
A. Subdural hematoma causing uncal herniation
B. SAH causing herniation through foramen magnum
C. ICH of the medulla oblongata
D. Epidural hematoma from the middle meningeal artery which continued bleeding
Epidural hematoma from the middle meningeal artery which continued bleeding
Decussation of the pyramids of the medulla involves which of the following? A. Descending corticospinal fibers B. Ascending spinothalamic fibers C. Descending cerebellospinal fibers D. Ascending dorsal column fibers
Descending corticospinal fibers
Damage to the right oculomotor nerve (CN III) would result in which of the following:
A. Upward and inward mvt of R eye d/t unopposed action of the right medial rectus and inferior oblique muscles
B. Constriction of the right pupil d/t increased tone of the constrictor pupillae muscle
C. Downward and outward mvt of the right eye d/t unopposed action of the right superior oblique and lateral rectus muscles
D. Ptosis of the right eyelid d/t inhibition of the orbicularis oris muscles
Downward and outward mvt of the right eye d/t unopposed action of the right superior oblique and lateral rectus muscles
42 y/o obese woman presents to the ED c/o severe headache “worst of my life!” Began 1 hr ago and has been unrelenting despite taking acetaminophen and ibuprofen. Admits to smoking crystal meth earlier in the day. Afebrile + BP of 180/100 w/ pulse of 100bp. She is exhibiting some neck and back px as well, but no chest pain. CT scan demonstrates a SAH in the right sylvian fissure. What is a possible dreaded complication of her condition?
Cerebral ischemia secondary to vasospasm
