EMRCS ANATOMY 7 Flashcards
Which cranial nerve supplies the motor fibres of styloglossus?
Facial Trigeminal Vagus Hypoglossal Glossopharyngeal
Hypoglossal
The hypoglossal nerve supplies motor innervation to all extrinsic and intrinsic muscles of the tongue. The only possible exception to this is palatoglossus, which is jointly innervated by the vagus and accessory nerves.
What is the most inferior anterior aortic branch?
Median sacral artery Inferior mesenteric artery Lumbar artery Superior mesenteric artery Gonadal artery
Inferior mesenteric artery
The IMA leaves the front of the aorta usually about 3 to 4cm superior to its bifurcation. The median sacral is not an anterior branch.
Which of the following statements relating to the posterior cerebral artery is false?
It supplies the visual cortex It is closely related to the 3rd cranial nerve It is a branch of the basilar artery It is connected to the circle of Willis via the superior cerebellar artery When occluded may result in contralateral loss of field of vision
It is connected to the circle of Willis via the superior cerebellar artery
The posterior cerebral arteries are formed by the bifurcation of the basilar artery and is connected to the circle of Willis via the posterior communicating artery
An elderly man falls and lands on his hip. On examination, his hip is tender to palpation and x-rays are taken. There are concerns that he may have an intertrochanteric fracture. What is the normal angle between the femoral neck and the femoral shaft?
90o 105o 80o 130o 180o
130o
The normal angle in males between the femoral head and shaft is 130o. Changes to this angle may occur as a result of disease or pathology and should be investigated.
Females have an angle that is around 110-120o
A 22 year 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?
Tibialis anterior Peroneus longus Extensor hallucis longus Extensor digitorum longus Peroneus tertius
Peroneus longus
Peroneus longus is innervated by the superficial peroneal nerve (L4, L5, S1).
A 17 year old male presents to the clinic. He complains of difficulty using his left hand. It has been a persistent problem since he sustained a distal humerus fracture as a child. On examination, there is diminished sensation overlying the hypothenar eminence and medial one and half fingers. What is the most likely nerve lesion?
Anterior interosseous nerve Posterior interosseous nerve Ulnar nerve Median nerve Radial nerve
Ulnar nerve
This sensory deficit pattern is most consistent with ulnar nerve injury.
An 18 year old athlete attends orthopaedic clinic reporting pain and swelling over the medial aspect of the knee joint. The pain occurs when climbing the stairs, but is not present when walking on flat ground. Clinically there is pain over the medial, proximal tibia and the McMurray test is negative. What is the most likely cause of this patient’s symptoms?
Anterior cruciate ligament tear Prepatellar bursitis Medial meniscus injury Pes Anserinus Bursitis Fracture of tibia
Pes Anserinus Bursitis
Pes Anserinus Bursitis is common in sportsmen due to overuse injuries. The main sign is of pain in the medial proximal tibia. As the McMurray test is negative, medial meniscal injury is excluded.
Which of the following structures lies most posteriorly at the porta hepatis?
Cystic artery Common hepatic artery Left hepatic artery Portal vein Common bile duct
Portal vein
The portal vein is the most posterior structure at the porta hepatis.The common bile duct is a continuation of the common hepatic duct and is formed by the union of the common hepatic duct and the cystic duct.
A 76 year old man is undergoing an abdominal aortic aneurysm repair. The surgeons occlude the aorta with two clamps, the inferior clamp being placed at the point of aortic bifurcation. Which of the following vertebral bodies will lie posterior to the clamp at this level?
L1 T10 L4 L5 L2
L4
The aorta bifurcates at L4. An important landmark that is tested frequently.
Which of the following statements relating to the greater omentum is false?
It is less well developed in children under 5. It has no relationship to the lesser sac. It contains the gastroepiploic arteries. Has an attachment to the transverse colon. It may be a site of metastatic disease in ovarian cancer.
It has no relationship to the lesser sac.
It is connected with the lesser sac and the transverse colon. This plane is entered when performing a colonic resection. It is a common site of metastasis in many visceral malignancies.
A 48 year old man with newly diagnosed hypertension is found to have a phaeochromocytoma of the left adrenal gland and is due to undergo a laparoscopic left adrenalectomy. Which of the following structures is not directly related to the left adrenal gland?
Crus of the diaphragm Lesser curvature of the stomach Kidney Pancreas Splenic artery
Lesser curvature of the stomach
The left adrenal gland is slightly larger than the right. It is crescent in shape and its concavity is adapted to the medial border of the upper part of the left kidney. The upper area is covered by peritoneum of the omental bursa which separates it from the cardia of the stomach
Which of the following nerves innervates the long head of the biceps femoris muscle?
Inferior gluteal nerve Tibial division of sciatic nerve Superior gluteal nerve Common peroneal division of sciatic nerve Obturator nerve
Tibial division of sciatic nerve
The short head of biceps femoris, which may occasionally be absent, is innervated by the common peroneal component of the sciatic nerve. The long head is innervated by the tibial division of the sciatic nerve.
A 40 year old woman had the anterior lobe of the pituitary removed because of a tumour. Without postoperative supplements, which of the following could occur?
Failure to produce adequate amounts of thyroxine Failure to produce parathyroid hormone in response to hypocalcaemia Failure to secrete catecholamine in response to stress Failure to secrete insulin in hyperglycemia Inability to concentrate urine in response to water deprivation
Failure to produce adequate amounts of thyroxine
Its an anterior pituitary lesion and that is the reason thyroxine secretion is affected. ADH is released by the posterior pituitary.
A 72 year old male with end stage critical ischaemia is undergoing an axillo-femoral bypass. What structure is not closely related to the axillary artery?
Posterior cord of the brachial plexus Scalenus anterior muscle Pectoralis minor muscle Axillary vein Lateral cord of the brachial plexus
Scalenus anterior muscle
The axillary artery is the continuation of the subclavian artery. It is surrounded by the cords of the brachial plexus (from which they are named). The axillary vein runs alongside the axillary artery throughout its length.
A 28 year old man is shot in the right chest and develops a right haemothorax necessitating a thoracotomy. The surgeons decide to place a vascular clamp across the hilum of the right lung. Which of the following structures will lie most anteriorly at this point?
Thoracic duct Phrenic nerve Vagus nerve Pulmonary artery Pulmonary vein
Phrenic nerve
The phrenic nerve lies anteriorly at the root of the right lung.
An 18 year old boy is undergoing an appendicectomy for appendicitis. At which of the following locations is the appendix most likely to be found?
Pre ileal Pelvic Retrocaecal Post ileal None of the above
Retrocaecal
Most appendixes lie in the retrocaecal position. If a retrocaecal appendix is difficult to remove then mobilisation of the right colon significantly improves access.
A 56 year old man is undergoing a pancreatectomy for carcinoma. During resection of the gland which of the following structures will the surgeon not encounter posterior to the pancreas itself?
Left crus of the diaphragm Superior mesenteric vein Common bile duct Portal vein Gastroduodenal artery
Gastroduodenal artery
The gastroduodenal artery divides into the gastro-epiploic and pancreaticoduodenal arteries at the superior aspect of the pancreas.
Which of the following bones is related to the cuboid’s distal articular surface?
All metatarsals 5th metatarsal Calcaneum Medial cuneiform 3rd metatarsal
5th metatarsal
The cuboid is located at the lateral aspect of the foot between the calcaneus posteriorly and the 4th and 5th metatarsals distally.
From which structure is the central tendon of the diaphragm derived?
Septum transversum Pleuroperitoneal folds Diaphragmatic crura Dorsal mesocardium Oropharyngeal membrane
Septum transversum
The septum transversum is a thick ridge of mesodermal tissue in the developing embryo that separates the thoracic and abdominal cavities and forms the central tendon of the diaphragm
Where does Stensens duct primarily open?
Immediately lateral to the foramen caecum Floor of mouth Opposite the second molar tooth Opposite the fifth molar tooth Into the post nasal space
Opposite the second molar tooth
Stensens duct conveys secretions from the parotid gland and these enter the oral cavity at the level of the second molar tooth.
