EMRCS ANATOMY 6 Flashcards
Which of the following types of epithelium lines the lumenal surface of the normal oesophagus?
Non keratinised stratified squamous epithelium Ciliated columnar epithelium Keratinised stratified squamous epithelium Non ciliated columnar epithelium None of the above
Non keratinised stratified squamous epithelium
The oesphagus is lined by non keratinised stratified squamous epithelium. Changes to glandular type epithelium occur as part of metaplastic processes in reflux.
Which of the following structures is not directly related to the right adrenal gland?
Diaphragm posteriorly Kidney inferiorly Right renal vein Inferior vena cava Hepato-renal pouch
Right renal vein
The right renal vein is very short and lies more inferiorly.
Which of the following aortic branches leaves the aorta approximately 1cm below the coeliac axis?
Renal artery Inferior mesenteric artery Superior mesenteric artery Lumbar artery Gonadal artery
Superior mesenteric artery
The SMA leaves the aorta approximately 1cm below the coeliac axis. This is usually a level of L1. It is crossed anteriorly by the splenic vein and the body of the pancreas. It runs downwards and forwards anterior to the uncinate process.
Through which of the structures listed below does the axillary nerve pass?
Quadrangular space Triangular space Subclavicular space Sub pectoral space Intercostal space
Quadrangular space
Axillary nerve passes through the quadrangular space
With respect to the basilic vein, which statement is false?
Its deep anatomical location makes it unsuitable for use as an arteriovenous access site in fistula surgery It originates from the dorsal venous network on the hand It travels up the medial aspect of the forearm Halfway between the shoulder and the elbow it lies deep to muscle It is joined by the brachial vein to form the axillary vein
Its deep anatomical location makes it unsuitable for use as an arteriovenous access site in fistula surgery
It is used in arteriovenous fistula surgery during a procedure known as a basilic vein transposition.
Mobilisation of the left lobe of the liver will facilitate surgical access to which of the following?
Abdominal oesophagus Duodenum Right colic flexure Right kidney Pylorus of stomach
Abdominal oesophagus
The fundus of the stomach is a posterior relation. The pylorus lies more inferolaterally. During a total gastrectomy division of the ligaments holding the left lobe of the liver will facilitate access to the proximal stomach and abdominal oesophagus. This manoeuvre is seldom beneficial during a distal gastrectomy.
The following statements relating to the ankle joint are true except?
Three groups of ligaments provide mechanical stability The sural nerve lies medial to the Achilles tendon at its point of insertion Eversion of the foot occurs at the sub talar joint The flexor hallucis longus tendon is the most posterior structure at the medial malleolus The saphenous nerve crosses the ankle joint.
The sural nerve lies medial to the Achilles tendon at its point of insertion
The sural nerve lies behind the distal fibula. Inversion and eversion are sub talar movements. The structures passing behind the medial malleolus from anterior to posterior include: tibialis posterior, flexor digitorum longus, posterior tibia vein, posterior tibial artery, nerve, flexor hallucis longus.
The oesophagus is constricted at the following levels apart from:
Cricoid cartilage Arch of the aorta Lower oesophageal sphincter Left main stem bronchus Diaphragmatic hiatus
Lower oesophageal sphincter
The oesophagus is not constricted at the level of the lower oesophageal sphincter.
A 19 year old man is playing rugby when he suddenly notices a severe pain at the posterolateral aspect of his right thigh. Which of the following muscle groups is most likely to have been injured?
Semimembranosus Semitendinosus Long head of biceps femoris Gastrocnemius Soleus
Long head of biceps femoris
The biceps femoris is the laterally located hamstring muscle. The semitendinosus and semimembranosus are located medially. Rupture of gastrocnemius and soleus may occur but is less common.
Which of the following is a branch of the third part of the axillary artery?
Superior thoracic Lateral thoracic Dorsal scapular Thoracoacromial Posterior circumflex humeral
Posterior circumflex humeral
The other branches include:
Subscapular
Anterior circumflex humeral
The dorsal scapular artery arises from the third part of the subclavian artery in most cases
Which of the following structures separates the intervertebral disks from the spinal cord?
Anterior longitudinal ligament Posterior longitudinal ligament Supraspinous ligament Interspinous ligament Ligamentum flavum
Posterior longitudinal ligament
The posterior longitudinal ligament overlies the posterior aspect of the vertebral bodies. It also overlies the posterior aspect of the intervertebral disks
At what level does the aorta bifurcate into the left and right common iliac arteries?
L1 L2 L3 L4 L5
L4
The aorta typically bifurcates at L4.
A 23 year old man is due to undergo a mitral valve repair for mitral regurgitation. Which of the following is a feature of the mitral valve?
Its closure is marked by the first heart sound It has two anterior cusps The chordae tendinae attach to the anterior cusps only The chordae tendinae anchor the valve directly to the wall of the left ventricle It is best auscultated in the left third interspace
Its closure is marked by the first heart sound
The mitral valve is best auscultated over the cardiac apex, where its closure marks the first heart sound. It has only two cusps. These are attached to chordae tendinae which themselves are linked to the wall of the ventricle by the papillary muscles.
A 23 year old lady with sialolithiasis of the submandibular gland is undergoing excision of the gland. Which of the following nerves is at risk as the duct is mobilised?
Lingual nerve Buccal nerve Facial nerve Glossopharyngeal Vagus
Lingual nerve
The lingual nerve wraps around Whartons duct. The lingual nerve provides sensory supply to the anterior 2/3 of the tongue
Which of the following is true in connection with the phrenic nerves?
They both lie anterior to the hilum of the lungs They are derived from spinal roots C 2,3,4 They pierce the diaphragm at the level of T7 They consist of motor fibres only None of the above
They both lie anterior to the hilum of the lungs
They both lie anterior to the hilum of the lung. The phrenic nerves have both motor and sensory functions. For this reason sub diaphragmatic pathology may cause referred pain to the shoulder.
A 32 year old man presents with an inguinal hernia and undergoes an open surgical repair. The surgeons decide to place a mesh on the posterior wall of the inguinal canal to complete the repair, which of the following structures will lie posterior to the mesh?
Transversalis fascia External oblique Rectus abdominis Obturator nerve None of the above
Transversalis fascia
This is actually quite a straightforward question. It is simply asking for the structure that forms the posterior wall of the inguinal canal. This is composed of the transversalis fascia, the conjoint tendon and more laterally the deep inguinal ring.
A 22 year old man is involved in a fight and is stabbed in the posterior aspect of his right leg. The knife passes into the popliteal fossa. He sustains an injury to his tibial nerve. Which muscle is least likely to be compromised as a result?
Tibialis posterior Flexor hallucis longus Flexor digitorum brevis Soleus Peroneus tertius
Peroneus tertius
Peroneus tertius is innervated by the deep peroneal nerve.
Which of the following overlies the outer muscular layer of the intrathoracic oesophagus?
Serosa Meissners plexus Auerbach's plexus Loose connective tissue None of the above
Loose connective tissue
The oesophagus has no serosal covering and hence holds sutures poorly. The Auerbach’s and Meissner’s nerve plexuses lie in between the longitudinal and circular muscle layers and submucosally. The sub mucosal location of the Meissner’s nerve plexus facilitates its sensory role.
Which nerve lies medially on the thyroid gland, in the groove between the oesophagus and trachea?
Vagus nerve External laryngeal nerve Recurrent laryngeal nerve Ansa cervicalis Phrenic nerve
Recurrent laryngeal nerve
The recurrent laryngeal nerve may be injured at this site during ligation of the inferior thyroid artery.
At which of the following spinal levels does the oesophagus pass through the diaphragm into the abdominal cavity?
L2 L1 T10 T5 T12
T10
The oesophagus passes into the abdomen at T10.
