Loco Qs Flashcards

Question 1

Q

which out of skeletal, cardiac and smooth muscle has calmodulin?

skeletal
cardiac
smooth

Answer

A

which out of skeletal, cardiac and smooth muscle has calmodulin?

skeletal
cardiac
smooth

Question 2

Q

movements of the shoulder include a combination of movements from all but which of the following joints?

sternoclavicular joint
sternohumeral joint
glenohumeral joint
scapulothrocic joint
acromiclavicular joint

Answer

A

movements of the shoulder include a combination of movements from all but which of the following joints?

sternoclavicular joint
*- sternohumeral joint**
glenohumeral joint
scapulothrocic joint
acromiclavicular joint

Question 3

Q

What type of joint is A?

a) saddle
b) pivot
c) planar
d) hinge
e) condyloid

Answer

A

What type of joint is A?

saddle

Question 4

Q

which of the following is the A band?

A
B
C
D
E

Answer

A

which of the following is the A band?

A
B
C
D
E

Question 5

Q

the lateral rotators of the hip are innervated by which nerve supply?

L4, L5, S1
L5, S1, S2
S1, S2, S3
L3, L4, L5

Answer

A

the lateral rotators of the hip are innervated by which nerve supply?

L4, L5, S1
L5, S1, S2
S1, S2, S3
L3, L4, L5

Question 6

Q

what type of collagen do you find in ECM of bone tissue?

a) type I
b) type 2
c) type 3
d) type 4
e) type 5

Answer

A

what type of collagen do you find in ECM of bone tissue?

*a) type I**
b) type 2
c) type 3
d) type 4
e) type 5

Question 7

Q

A 24-year-old man gets into a gang fight and suffers a stab wound in the lower leg. After physical examination, his physician finds that he presents with a classic foot drop due to being unable to dorsiflex his foot. Which of the following nerves is injured in this case?

tibial nerve
genitofemoral nerve
common fibular nerve
obturator nerve
femoral nerve

Answer

A

A 24-year-old man gets into a gang fight and suffers a stab wound in the lower leg. After physical examination, his physician finds that he presents with a classic foot drop due to being unable to dorsiflex his foot. Which of the following nerves is injured in this case?

tibial nerve
genitofemoral nerve
common fibular nerve
obturator nerve
femoral nerve

Question 8

Q

Which one of the following structures separates the intervertebral disks from the spinal cord?

Anterior longitudinal liagment
Posterior longitudinal ligament
Supraspinous ligament
Inerspinous ligament
Ligamentum flavum

Answer

A

Which one of the following structures separates the intervertebral disks from the spinal cord?

Anterior longitudinal liagment
Posterior longitudinal ligament
Supraspinous ligament
Inerspinous ligament
Ligamentum flavum

Question 9

Q

What is the carpal tunnel? What is contained within it? (you’re looking for 10 items you might want to draw a simple diagram to help)

Answer

A

The carpal tunnel is created by a thick band of retinacula spanning between the carpal bones of the wrist, creating a tunnel. Passing through this tunnel are the tendons of

Flexor digitorum superficialis (4)
Flexor digitorum profundus (4)
Flexor pollicis longus (1)
And the Median nerve

Question 10

Q

A 10-year-old female presents to the GP with peri-oral blisters. A diagnosis of non-bullous impetigo is made. The GP is concerned about a risk of an intracranial infection spreading from the face, via the facial vein, to the cranial cavity. Through which venous structure is the facial vein connected which could lead to this spread?

Dual venous sinus
Cavernous sinus
Superficial temporal vein
Maxillary vein
External jugular vein

Answer

A

A 10-year-old female presents to the GP with peri-oral blisters. A diagnosis of non-bullous impetigo is made. The GP is concerned about a risk of an intracranial infection spreading from the face, via the facial vein, to the cranial cavity. Through which venous structure is the facial vein connected which could lead to this spread?

Dual venous sinus
Cavernous sinus
Superficial temporal vein
Maxillary vein
External jugular vein

Question 11

Q

What condition might also arise from interference of the lymphatic drainage?

Answer

A

Lymphedema

Question 12

Q

Which one of the following muscles inserts onto the lesser tuberostiy of the the humerus?

Subscapularis
Deltoid
Supraspinatus
Teres minor
Infraspinatus

Answer

A

Which one of the following muscles inserts onto the lesser tuberostiy of the the humerus?

Subscapularis
Deltoid
Supraspinatus
Teres minor
Infraspinatus

Question 13

Q

what do the arrows depcit?

sclerotic lesions of bone
periosteal reaction
lucent lesions of bone
osteopenia
osteonecrosis

Answer

A

what do the arrows depcit?

sclerotic lesions of bone
what do the arrows depcit?

sclerotic lesions of bone
periosteal reaction
lucent lesions of bone
osteopenia
osteonecrosislucent lesions of bone
osteopenia
osteonecrosis

Question 14

Q

Which nerve supplies sensation to the nail bed of the index finger?

Median
Radial
Ulnar
Musculocutaneous
Axillary

Answer

A

Which nerve supplies sensation to the nail bed of the index finger?

Median
Radial
Ulnar
Musculocutaneous
Axillary

Question 15

Q

which of the nerves from brachial plexus, if damaged, would result in a loss of shoulder abduction beyond 15 degrees?

Muscularcutaneous
*- axillary**
median
radial
ulnar nerve

Answer

A

which of the nerves from brachial plexus, if damaged, would result in a loss of shoulder abduction beyond 15 degrees?

Muscularcutaneous
*- axillary**
median
radial
ulnar nerve

Question 16

Q

which best describes the joint shown in the picture?

synchrondrosis
syndemosis
synostosis
symphysis
gomphosis
syndrondosis

Answer

A

which best describes the joint shown in the picture?

synchrondrosis
syndemosis
synostosis
symphysis
gomphosis
syndrondosis

Question 17

Q

what type of joint is the arrow pointing to?

a) Symphysis
b) Synostosis
c) Synchondrosis
d) Syndesmosis
e) Gomphosis

Answer

A

what type of joint is the arrow pointing to?

a) Symphysis
b) Synostosis
* *c) Synchondrosis: cartilaginous joints connected by hyaline cart**
d) Syndesmosis
e) Gomphosis

Question 18

Q

You are a medical student on placement practising your orthopaedic examinations. On observation of a patient’s knee, you notice that the centre of gravity lies medial to the knee joint and thus the knees bow outwards. What is the correct term for this?

Coxa valga
Genu valgus
Hallux varum
Coxa varum
Genu varum

Answer

A

You are a medical student on placement practising your orthopaedic examinations. On observation of a patient’s knee, you notice that the centre of gravity lies medial to the knee joint and thus the knees bow outwards. What is the correct term for this?

Coxa valga
Genu valgus
Hallux varum
Coxa varum
Genu varum

Question 19

Q

Which nerve is palpable around the head of the fibula?

deep fibular nerve
superificial fibular nerve
common fibular nerve
femoral nerve
tibial nerve

Answer

A

Which nerve is palpable around the head of the fibula?

deep fibular nerve
superificial fibular nerve
common fibular nerve
femoral nerve
tibial nerve

Question 20

Q

which part of pelvic bone do you sit on?

a) pubic tubercle
b) coccyx
c) ischial tuberosity
d) inferior pubic ramos
e) ischial spine

Answer

A

which part of pelvic bone do you sit on?

a) pubic tubercle
b) coccyx
* *c) ischial tuberosity**
d) inferior pubic ramos
e) ischial spine

Question 21

Q

which muscle of forearm does the arrow point to?

a) pronator teres
b) flexor carpi radialis
c) palmarus longus
d) flexor carpi ulnaris

Answer

A

which muscle of forearm does the arrow point to?

a) pronator teres
b) flexor carpi radialis
c) palmarus longus
d) flexor carpi ulnaris

Question 22

Q

which is more likely to break in humerus?

surgical neck
anatomical neck

Answer

A

which is more likely to break in humerus?

surgical neck
anatomical neck

Question 23

Q

which one of the following is not a lateral ligament of the ankle?

anterior talofibular ligament
posterior talofibular ligament
deltoid ligament
calcaneofibular ligament

Answer

A

which one of the following is not a lateral ligament of the ankle?

anterior talofibular ligament
posterior talofibular ligament
deltoid ligament
calcaneofibular ligament

Question 24

Q

A 43- year- old patient presents to his General practitioner complaining of fatigue and weight loss. He mentions he experiences pain around his right shoulder region and tingling sensations of his fourth and fifth fingers on his right hand. He is later diagnosed with an apical lung tumour, which presses on the C8-T1 nerve roots of the brachial plexus. Which nerve of the upper limb is primarily compromised?

Axillary nerve
Muscolskeletal nerve
Radial nerve
Ulnar nerve
Median nerve

Answer

A

A 43- year- old patient presents to his General practitioner complaining of fatigue and weight loss. He mentions he experiences pain around his right shoulder region and tingling sensations of his fourth and fifth fingers on his right hand. He is later diagnosed with an apical lung tumour, which presses on the C8-T1 nerve roots of the brachial plexus. Which nerve of the upper limb is primarily compromised?

Axillary nerve
Muscolskeletal nerve
Radial nerve
Ulnar nerve
Median nerve

Question 25

Q

A 12-year-old boy comes into the emergency room with pain in the wrist joint. He describes a dull ache that has persisted for three days. His wrist is mildly swollen. There is no bruising or misalignment. The doctor assesses active and passive movement: flexion, extension, abduction and adduction.

What type of synovial joint has been affected?

Ball and socket
condyloid
hinge
pivot
saddle

Answer

A

A 12-year-old boy comes into the emergency room with pain in the wrist joint. He describes a dull ache that has persisted for three days. His wrist is mildly swollen. There is no bruising or misalignment. The doctor assesses active and passive movement: flexion, extension, abduction and adduction.

What type of synovial joint has been affected?

Ball and socket
condyloid
hinge
pivot
saddle

Question 26

Q

name the two locations in bone where you can find osteoprogenitor cells [2]

Answer

A

name the two locations in bone where you can find osteoprogenitor cells [2]
periosteum
endosteum

Question 27

Q

A patient is noted to have impaired hip extension and lateral rotation. He has difficulty rising from a seat and can’t climb stairs is a stereotypical history for an injury to which nerve/structure?

Obturator nerve

Tibial nerve

Femoral nerve

Common peroneal nerve

Inferior gluteal nerve

Superior gluteal nerve

Answer

A

A patient is noted to have impaired hip extension and lateral rotation. He has difficulty rising from a seat and can’t climb stairs is a stereotypical history for an injury to which nerve/structure?

Obturator nerve

Tibial nerve

Femoral nerve

Common peroneal nerve

Inferior gluteal nerve

Superior gluteal nerve

Question 28

Q

which three nerves are involved in moving muscles of the hand?

musculocutaneous
median
ulnar
axillary
radial

Answer

A

which three nerves are involved in moving muscles of the hand?

musculocutaneous
median
ulnar
axillary
radial

Question 29

Q

A 38-year-old man has been suffering from mechanical back pain for several years. One morning he awakes from sleep and feels a sudden onset of pain in his back radiating down his left leg. Which one of the following events is most likely to account for his symptoms?

Prolapse of inner annulus fibrosus
Prolapse of outer annulus fibrosus
Prolaspe of nucleus pulpsosus
Rupture of the ligamentum flavum
None of the above

Answer

A

A 38-year-old man has been suffering from mechanical back pain for several years. One morning he awakes from sleep and feels a sudden onset of pain in his back radiating down his left leg. Which one of the following events is most likely to account for his symptoms?

Prolapse of inner annulus fibrosus
Prolapse of outer annulus fibrosus
Prolaspe of nucleus pulpsosus
Rupture of the ligamentum flavum
None of the above

Question 30

Q

which of the following is the only articulation between upper limb and axial skeleton?

sternoclavicular joint
acromiclavicular joint
glenohumeral joint
scapulothrocic joint

Answer

A

which of the following is the only articulation between upper limb and axial skeleton?

*- sternoclavicular joint**
acromiclavicular joint
glenohumeral joint
scapulothrocic joint

Question 31

Q

which dermatome do your legs lie on when sleeping?

S1
S2
S3
S4
S5

Answer

A

which dermatome do your legs lie on when sleeping?

S1
S2
S3
S4
S5

Question 32

Q

which type of cartilage is intensely eosinophilic (stained by eosin)?

elastic cartilage
fibrocartilage
hyaline cartilage

Answer

A

which type of cartilage is intensely eosinophilic (stained by eosin)?

elastic cartilage
*- fibrocartilage**
hyaline cartilage

Question 33

Q

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

Answer

A

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.

Question 34

Q

what type of joint is atalato-occipital joint?

hinge
plane
condyloid
saddle
pivot

Answer

A

what type of joint is atalato-occipital joint?

hinge
plane
condyloid
saddle
pivot

Question 35

Q

what is the nerve supply to the muscle labelled A?

medial pectoral nerve
musculocutaneous nerve
axillary nerve
accessory nerve
thoracodorsal nerve

Answer

A

what is the nerve supply to the muscle labelled A?

medial pectoral nerve
musculocutaneous nerve
axillary nerve
accessory nerve
thoracodorsal nerve

Question 36

Q

which muscle is the main muscle of forearm flexion?

pronator teres
flexor carpi radialis
pronator quadratus
flexor carip ulnaris
brachioradialis

Answer

A

which muscle is the main muscle of forearm flexion?

pronator teres
flexor carpi radialis
pronator quadratus
flexor carip ulnaris
brachioradialis

Question 37

Q

what is the zone within the epiphyseal growth plate shown on the right?

proliferation
resting
maturation
calcification
hypertrophy / degeneration

Answer

A

what is the zone within the epiphyseal growth plate shown on the right?

proliferation
resting
maturation
calcification
hypertrophy / degeneration

Question 38

Q

which of the following best describes botulinis toxins effect on Ach-Receptor?

agonist
antagonist
depolarisng blocker
release inhibitor
synthesis inhibitor

Answer

A

which of the following best describes botulinis toxins effect on Ach-Receptor?

agonist
antagonist
depolarisng blocker
*- release inhibitor**
synthesis inhibitor

Question 39

Q

why can you get an estimate of bone marrow by undertaking a bone biopsy? [1]

Answer

A

why can you get an estimate of bone marrow by undertaking a bone biopsy? [1]
as we age, get a transition from red bone marrow –> yellow bone marrow (adipocytes)

Question 40

Q

which out of skeletal, cardiac and smooth muscle is multinucleate?

skeletal
cardiac
smooth

Answer

A

which out of skeletal, cardiac and smooth muscle is multinucleate?

skeletal
cardiac
smooth

Question 41

Q

During pronation and supination, movements of which of the following bones are occurring?

Rotation of the ulna and radius on the humerus
Rotation of the ulna on the radius
Rotation of the radius on the ulna
Rotation of the carpals on the distal radius and ulna
Rotation of the humerus on the scapula

Answer

A

During pronation and supination, movements of which of the following bones are occurring?

Rotation of the ulna and radius on the humerus
Rotation of the ulna on the radius
Rotation of the radius on the ulna
Rotation of the carpals on the distal radius and ulna
Rotation of the humerus on the scapula

The radius is the bone which moves during pronation and supination of the arm

Question 42

Q

A 77-year-old man with symptoms of intermittent claudication is due to have his ankle brachial pressure indices measured. The dorsalis pedis artery is impalpable. Which one of the following tendinous structures lies medial to it, that may facilitate its identification?

Extensor digitorum longus tendon
Peroneus tertius tendon
Extensor hallucis longus tendonn
Extensor digitorum brevis tendon
Flexor digitorum longus tendon

Answer

A

A 77-year-old man with symptoms of intermittent claudication is due to have his ankle brachial pressure indices measured. The dorsalis pedis artery is impalpable. Which one of the following tendinous structures lies medial to it, that may facilitate its identification?

Extensor digitorum longus tendon
Peroneus tertius tendon
Extensor hallucis longus tendonn
Extensor digitorum brevis tendon
Flexor digitorum longus tendon

Question 43

Q

Which one of the following anatomical structures lies within the spiral groove of the humerus?

Median nerve
Radial nerve
Tendon of triceps
Musculocuteanous nerve
Axillary nerve

Answer

A

Which one of the following anatomical structures lies within the spiral groove of the humerus?

Median nerve
Radial nerve
Tendon of triceps
Musculocuteanous nerve
Axillary nerve

Question 44

Q

You see a 17-year-old male in the emergency department who had a fall onto out-stretched hands and now has an x-ray proven fracture of a bone in his forearm. Which of the following bones is most likely affected by this fracture given the mechanism of injury?

Olecranon of the ulna
Styloid process of the ulna
Distal shaft of the radius
Styloid process of the radius
Lunate

Answer

A

You see a 17-year-old male in the emergency department who had a fall onto out-stretched hands and now has an x-ray proven fracture of a bone in his forearm. Which of the following bones is most likely affected by this fracture given the mechanism of injury?

Olecranon of the ulna
Styloid process of the ulna
Distal shaft of the radius
Styloid process of the radius
Lunate

Question 45

Q

An injury to the spinal accessory nerve will affect which of the following movements?

Lateral rotation of the arm
Adduction of the arm at the glenohumeral joint
Protraction of the scapula
Upward rotation of the scapula
Depression of the scapula

Answer

A

An injury to the spinal accessory nerve will affect which of the following movements?

Lateral rotation of the arm
Adduction of the arm at the glenohumeral joint
Protraction of the scapula
Upward rotation of the scapula
Depression of the scapula

The spinal accessory nerve innervates trapezius. The entire muscle will retract the scapula. However, its upper and lower fibres act together to upwardly rotate it.

Question 46

Q

A 39-year-old patient with motor neurone disease develops weakness in a muscle innervated by a cranial nerve.

Which of the following muscles is most likely affected?

Levator scapulae muscle
Middle scalene muscle
Sternohyoid muscle
sternothoid muscle
trapezius

Answer

A

A 39-year-old patient with motor neurone disease develops weakness in a muscle innervated by a cranial nerve.

Which of the following muscles is most likely affected?

Levator scapulae muscle
Middle scalene muscle
Sternohyoid muscle
sternothoid muscle
trapezius - Spinal accessory nerve (CN XI) supplies the trapezius

Question 47

Q

An 85-year-old man presents to the hospital after tripping and falling onto an outstretched left hand. He now complains of pain in his left arm. An x-ray is performed which shows a surgical neck fracture of the left humerus.

Damage to what nerve is most associated with this injury?

Axillary nerve
Median nerve
Musculocuteaneous nerve
Radial nerve
Ulnar nerve

Answer

A

An 85-year-old man presents to the hospital after tripping and falling onto an outstretched left hand. He now complains of pain in his left arm. An x-ray is performed which shows a surgical neck fracture of the left humerus.

Damage to what nerve is most associated with this injury?

Axillary nerve
Median nerve
Musculocuteaneous nerve
Radial nerve
Ulnar nerve

Question 48

Q

the brachial plexus arrises from which nerves?

a) C5, C6, C7, C8 & T1
b) C4, C5, C6, C7 & T1
c) C5, C6, C7, C8 & T2
d) C4, C5, C6, C7 & T2
e) C4, C5, C6, C7 & C8

Answer

A

the brachial plexus arrises from which nerves?

*a) C5, C6, C7, C8 & T1**
b) C4, C5, C6, C7 & T1
c) C5, C6, C7, C8 & T2
d) C4, C5, C6, C7 & T2
e) C4, C5, C6, C7 & C8

Question 49

Q

What level do you find the iliac crest?

L1
L2
L3
L4
L5

Answer

A

What level do you find the iliac crest?

L1
L2
L3
L4
L5

Question 50

Q

which of the following best describes tubocurarine on Ach receptor?

agonist
antagonist
depolarisng blocker
release inhibitor
synthesis inhibitor

Answer

A

which of the following best describes tubocurarine on Ach receptor?

agonist
*- antagonist**
depolarisng blocker
release inhibitor
synthesis inhibitor

Question 51

Q

On exploring the cubital fossa you would expect the brachial artery to be:

Anterior to the median nerve
Superficial to the bicipital aponeurosis
Medial to the median nerve
Lateral to the biceps tendon
Lateral to the median nerve

Answer

A

On exploring the cubital fossa you would expect the brachial artery to be:

Anterior to the median nerve
Superficial to the bicipital aponeurosis
Medial to the median nerve
Lateral to the biceps tendon
Lateral to the median nerve

Question 52

Q

bicep brachii, brachialis and coracobrachialis are innervated by:

a) C6, C7, C8
b) C5, C6, C7
c) C8, T1
d) C5, C6, C7, C8
e) C5, C6, C7, C8, T1

Answer

A

bicep brachii, brachialis and coracobrachialis are innervated by:

a) C6, C7, C8
* *b) C5, C6, C7 - musculocutaneous nerve**
c) C8, T1
d) C5, C6, C7, C8
e) C5, C6, C7, C8, T1

Question 53

Q

Which nerve follows the medial border of the biceps femoris muscle (musculus biceps femoris)?

deep fibular nerve
superificial fibular nerve
common fibular nerve
femoral nerve
tibial nerve

Answer

A

Which nerve follows the medial border of the biceps femoris muscle (musculus biceps femoris)?

deep fibular nerve
superificial fibular nerve
common fibular nerve
femoral nerve
tibial nerve

Question 54

Q

During a game of rugby, a player is tackled and sustains a twisting injury to his knee. He is found to have a soft tissue knee injury. Which structure originates from the medial surface of the lateral femoral condyle and inserts onto the anterior intercondylar area of the tibial plateau?

Medial meniscus
Posterior cruciate ligament
Lateral collateral ligament
Anterior cruciate ligament
Popliteus

Answer

A

During a game of rugby, a player is tackled and sustains a twisting injury to his knee. He is found to have a soft tissue knee injury. Which structure originates from the medial surface of the lateral femoral condyle and inserts onto the anterior intercondylar area of the tibial plateau?

Medial meniscus
Posterior cruciate ligament
Lateral collateral ligament
Anterior cruciate ligament
Popliteus

Question 55

Q

which of the following muscles is innervated by the accessory nerve (CNXI)?

a) trapezius
b) latissimus dorsi
c) teres major
d) pectoralis major
e) pectoralis minor

Answer

A

which of the following muscles is innervated by the accessory nerve (CNXI)?

*a) trapezius**
b) latissimus dorsi
c) teres major
d) pectoralis major
e) pectoralis minor

Question 56

Q

Which structure secretes the synovial fluid into the synovial joint?

articular capsule
articular cartilage
synovial membrane
articular disc

Answer

A

Which structure secretes the synovial fluid into the synovial joint?

articular capsule
articular cartilage
synovial membrane
articular disc

Question 57

Q

damage to which nerve would cause you to see B ?

posterior tibial nerve
anterior tibial nerve
superficial peroneal nerve
common peroneal nerve

Answer

A

damage to which nerve would cause you to see B ?

posterior tibial nerve
anterior tibial nerve
superficial peroneal nerve
*- common peroneal nerve**

Question 58

Q

which nerve has been affected here?

a) Musculocutaneous
b) Axillary
c) Median
d) Radial
e) Ulnar

Answer

A

which nerve has been affected here?

a) Musculocutaneous
b) Axillary
c) Median
d) Radial
* *e) Ulnar**

Question 59

Q

Following 6 weeks in a plaster cast on his left leg, David, a 22-year-old male, attends clinic for its removal.

It it noted that his left foot appears plantar flexed, foot drop.

Which nerve is usually affected causing foot drop?

Common peroneal nerve
Superificial peroneal nerve
Femoral nerve
Tibial nerve
Obturaror nerve

Answer

A

Following 6 weeks in a plaster cast on his left leg, David, a 22-year-old male, attends clinic for its removal.

It it noted that his left foot appears plantar flexed, foot drop.

Which nerve is usually affected causing foot drop?

Common peroneal nerve
Superificial peroneal nerve
Femoral nerve
Tibial nerve
Obturaror nerve

Question 60

Q

A 72-year-old woman presents to the hospital with paralysis of the hamstring muscles, and weakness of most muscles of the lower leg and foot following a hip replacement surgery. Which nerve is most likely damaged during the surgery?

sciatic nerve
pudendal nerve
genitofemoral nerve
saphenous nerve
obturator nerve

Answer

A

A 72-year-old woman presents to the hospital with paralysis of the hamstring muscles, and weakness of most muscles of the lower leg and foot following a hip replacement surgery. Which nerve is most likely damaged during the surgery?

sciatic nerve
pudendal nerve
genitofemoral nerve
saphenous nerve
obturator nerve

Question 61

Q

During a physical examination, it turns out that a patient is not able to stand on his tiptoe - which nerve lesion is most likely in the background?

common fibular nerve
femoral nerve
superficial fibular nerve
genitofemoral nerve
tibial nerve

Answer

A

During a physical examination, it turns out that a patient is not able to stand on his tiptoe - which nerve lesion is most likely in the background?

common fibular nerve
femoral nerve
superficial fibular nerve
genitofemoral nerve
tibial nerve

Question 62

Q

A 35-year-old man falls and sustains a fracture to the medial third of his clavicle. Which vessel is at greatest risk of injury?

Subclavian vein
Subclavian artery
External carotid artery
Internal carotid artery
Vertebral artery

Answer

A

A 35-year-old man falls and sustains a fracture to the medial third of his clavicle. Which vessel is at greatest risk of injury?

Subclavian vein
Subclavian artery
External carotid artery
Internal carotid artery
Vertebral artery

Question 63

Q

The foramen marking the termination of the adductor canal is located in which of the following?

Adductor longus
Adductor magnus
Adductor brevis
Sartorius
Semimebranosus

Answer

A

The foramen marking the termination of the adductor canal is located in which of the following?

Adductor longus
Adductor magnus
Adductor brevis
Sartorius
Semimebranosus

Question 64

Q

which of the anterior muscles of the forearm does not originate from shoulder joint?

a) bicep brachii
b) brachialis
c) coracobrachialis
d) tricep brachii

Answer

A

which of the anterior muscles of the forearm does not originate from shoulder joint?

a) bicep brachii
b) brachialis: : mid shaft of humerus to elbow
* *c)** coracobrachialis
d) tricep brachii

Answer 65

A

A student is seen in the emergency department on Sunday morning following a night out with some friends. He woke up having fallen asleep with his arm over the back of a park bench and he is diagnosed with a radial nerve injury. Which of the following muscles is likely to be weak on examination due to this injury?

Opponens pollicis
Extensor carpi ulnaris
Flexor capri ulnaris
Flexor digitorum superficialis
Dorsal interossei

Answer 66

A

which of the following has heart shaped vertebral body?

cervical
*- thoracic**
lumbral
sacral
coccyx

Answer 67

A

Measuring Margot, you also find that she has indeed lost 6cm in height compared to her previous measurement 5 years ago. Where has the height been lost? (Select all that apply)

Facet joint space

Vertebral body

Intervertebral disc space

It is an illusion due to the kyphosis

As can be seen on the imaging, a wedge fracture causes substantial loss of height of the vertebral body. Often, more than one vertebral level will be fractured, so the effect is additive. In addition, as we age, we lose height in the intervertebral disc space as the intervertebral disc is exposed to sustained compression.

The posterior elements of the vertebrae are not typically affected by the wedge fracture.

The kyphosis and loss of height are both caused by the same underlying pathology, but even if it were possible to restore the normal curvature of the back, the loss of height would still be apparent.

Answer 68

A

Which one of the following structures does not pass anterior to the lateral malleolus?

Anterior tibial artery
Extensor digitorum longus
Tibialis longus
Peroneus brevis
Peroneus tertius

Answer 69

A

Which type of synovial joint can move around three axes?

saddle
hinge
ellipsoid
planar
*- ball & socket**

Answer 70

A

What is the cell indicated by the arrow?

chondroblast
chondrocyte
osteoblast
4. osteoclast
osteocyte
6. osteoprogenitor

Answer 71

A

Which upper limb muscles cause the pinching of the shoulder blades toward each other?

a) teres minor
* *b) middle trapezius**
c) superior trapezius
* *d) rhomboids**
e) lower trapezius

Answer 72

A

carpo-metacarpal

Answer 73

A

what type of joint is the radiocarpal?

a) hinge
b) pivot
c) planar
d) saddle
* *e) condyloid**

Answer 74

A

what movements does carpo-metacarpal permit?

flexion
extension
abduction
opposition
adduction

Answer 75

A

Which one of the following structures separates the ulnar artery from the median nerve?

Brachioradialis
Pronator teres- It lies deep to pronator teres and this separates it from the median nerve.
Tendon of biceps brachii
Flexor carpi ulnaris
Brachialis

Answer 76

A

which of the following is the main blood supply to the head of femur?

obturator artery
medial femoral circumflex artery
lateral femoral circumflex artery
*- retinacular artery**

Answer 77

A

which of the nerves from brachial plexus, if damaged, would result in a loss of extension of the wrist?

Muscularcutaneous
axillary
median
*- radial**
ulnar nerve

Answer 78

A

what structural characterisitc of woven bone makes it softer than non-woven bone? [1]
collagen fibres are not arranged in lamellar (layers)

Answer 79

A

which of the following best describes joint A?

synchrondrosis
syndemosis
synostosis
symphysis
gomphosis
syndrondosis

Answer 80

A

A patient loses the ability to plantarflex and invert his foot is a stereotypical history for an injury to which nerve/structure?

Femoral nerve

Inferior gluteal nerve

Tibial nerve

Superior gluteal nerve

Obturator nerve

Lateral cutaneous nerve of the thigh

Answer 81

A

which is the the largest muscle of the anterior compartment of the forearm?

a) flexor digitorum profundus?
* *b) flexor digitorium superficialis**
c) flexor carpi radialis
d) pronator teres
e) flexor capri ulnaris

Answer 82

A

what type of joint is atalato-occipital joint?

hinge
plane
condyloid
saddle
ball and socket

Answer 83

A

Which one of the following represents the root values of the sciatic nerve?

L4-S3
L1-L4
L3-S1
S1-S4
L5-S1

Answer 84

A

which type of imaging is used as a guide to therpeautic interventions?

x-ray
MRI
CT scan
PET scan
*- ultrasound**

Answer 85

A

Which nerve supplies brachioradialis?

Radial nerve

Median nerve

Ulnar nerve

Long thoracic nerve

Musculocutaneous nerve

Answer 86

A

which nerve do you test by asking a patient to abduct and adduct their fingers?

musculocutaneous
median
ulnar
axillary
radial

Answer 87

A

A 32-year-old man is stabbed in the neck and the inferior trunk of his brachial plexus is injured. Which of the modalities listed below is least likely to be affected?

Initiaing abduction of the shoulder
Abduction of the fingera
Flexion of the little finger
Sensation on the palmar aspect of little finger
Gripping a screwdriver

Answer 88

A

A junior doctor sees two patients with ulnar nerve palsy in quick succession. The first patient has an injury of the wrist and presented with a severe ‘claw-like’ deformity of the hand. The second patient has an injury at the elbow and has a similar, but less severe deformity. Why is the presentation paradoxically less severe at the more proximal site of injury?

Retained innervation of flexor digitorum profundus muscle
Retained innervation of the flexor digitorum superficialis mucle
Denervation of flexor digitorum superficialis muscle
Denervation of flexor digitorum profundus muscle
Less severe injury of ulnar nerve due to protection from surrounding muscles

Answer 89

A

A patient presents with weakness of ankle dorsiflexion and reduced sensation in the lateral aspect of the forefoot - which nerve is most likely injured?

deep fibular nerve
superificial fibular nerve
common fibular nerve
femoral nerve
tibial nerve

Answer 90

A

Greater tuberosity

Answer 91

A

You are in the emergency department and a patient has just come in after falling off his motorcycle onto an outstretched hand. On examination of his hand, there is significant pain in the anatomical snuffbox. The medial border of this region is formed by the tendon of a muscle that attaches to the distal phalanx of the thumb and causes extension of the metacarpophalangeal joint and interphalangeal joints.

What is the name of this muscle and which nerve is it innervated by?

Abductor pollicis longus - radial nerve
Extensor pollicis brevis - median nerve
Extensor pollicis brevis - radial nerve
Extensor pollicis longus - median nerve
Extensor pollicis longus - radial nerve

Answer 92

A

Which muscle is responsible for causing flexion of the interphalangeal joint of the thumb?

Flexor pollicis longus
Flexor pollicis brevis
Flexor digitorum superficialis
Flexor digitorum profundus
Adductor pollicis

Answer 93

A

Which of the following structures is generally at the highest risk of damage with a surgical neck fracture if the humerus?

Axillary nerve
Axillary artery
Radial nerve
Brachial artery
Musculocutaneous nerve

Answer 94

A

Which one of the following nerves is responsible for the motor innervation of the sternocleidomastoid muscle?

Ansa cervicalis
Accessory nerve
Hypoglossal nerve
Facial nerve
Vagus nerve

Answer 95

A

A histopathologist receives several specimens from various muscle tissues. A distinguishing feature that can identify the type of muscle is the presence of nuclei. Which of the following muscle types only has/have one nucleus located centrally along the muscle fibre?

Skeletal and smooth muscle
Cardiac and smooth muscle
Cardia and skeletal muscle
Smooth, cardiac and skeletal muscle
Skeletal muscle

Answer 96

A

An elderly man has a cervical disc prolapse in his spine which causes an injury to the spinal cord where the disc pressed against it.

Based on the anatomy of the spinal cord; which of the following cell groups and their associated function is most likely to be affected at the level of injury?

Dorsal horn cells & motor defect
Dorsal horn cells & sensory defect
Intermediate horn cells and an autonomic defect
Ventral horn cells & motor defect
Ventral horn cells & sensory defect

Answer 97

A

Which nerve supplies extensor carpi radialis longus?

Ulnar nerve

Musculocutaneous nerve

Median nerve

Long thoracic nerve

Radial nerve

Answer 98

A

A 30-year-old male presents with weakness in his wrist and his fingers. His hand appears ‘clawed’ with wasting of the lumbrical muscles and hypothenar eminence noted. There is numbness over his ring and little finger. He reports having fractured his arm six weeks ago when he fell from his skateboard but adhered to keeping it immobilised in a cast as advised.

What injury is likely to have caused this patient’s presentation?

Distal radius fracture
Lateral epicondyle fracture
Medial epicondyle fracture
Scaphoid fracture
Shaft of the humerus fracture

Answer 99

A

Latissimus dorsi acts on the upper limb to bring about extension, and medial rotation. However is the upper limbs are in a fixed position (for example above the head holding onto a rail) latissimus dorsi pulls the trunk towards the upper limb (a pull up). It is an important climbing muscle.

Serratus anterior protracts and rotates the scapula, and at rest holds the scapula flat to the back. Weakness in this muscle can therefore cause winging of the scapula.*
Abduction of the shoulder requires rotation of the scapula, so a weakness in this muscle will result in weaker abduction.*

Answer 100

A

John, a 78-year-old male, presents to the emergency department following a low impact fall. He complains of pain in his left leg.

An X-ray is organised which demonstrates an intracapsular neck of femur fracture on the left leg. Therefore, John is listed for a hemiarthroplasty, to prevent avascular necrosis of the femoral head.

Which vessel is the main blood supply to the femoral head and at most risk of injury in John’s specific fracture?

Peforating branches of the profunda femoris artery
Lateral femoral circumflex artery
Medial femoral circumflex artery
Anterior branch of the obturator artery
Posterior branch of the obturator artery

Answer 101

A

which out of skeletal, cardiac and smooth muscle has troponin? [2]

skeletal
cardiac
smooth

Answer 102

A

which of the following are sources of the axillary nerve?

C8-T1
C7-T1
*- C5-C6**
C5-C7
C5-T1

Answer 103

A

Which one of the following muscles does not adduct the shoulder?

Teres major
Pectoralis major
Coracobrachialis
Supraspinatous - abducts
Latissimus dorsi

Answer 104

A

which joint initiates shoulder elevation? [1]
glenohumeral

which one assists after the first 30 degrees? [1]
sternothoracic

Answer 105

A

A 23-year-old man presents with delayed diagnosis of appendicitis. The appendix is retrocaecal and has perforated causing a psoas abscess. Into which structure does the psoas major muscle insert?

Greater trochanter of the femur
Linea aspera of the femur
Lesser trochanter of the femur
Iliac crest
none of the above

Answer 106

A

overproduction of bone

Answer 107

A

what type of jont does the arrow point to?

symphysis
syndesmosis
synostosis
synchondrosis
gomphosis

Answer 108

A

which nerve is vulnerable to mid-humeral shaft fracture?

- Muscularcutaneous
- axillary
- median
- radial
- ulnar nerve

Answer 109

A

A 22 years old male comes to his GP and complains that he is unable to bend his left elbow. On examination, the GP notices that flexion of his left elbow and supination of his forearm has greatly weakened.

Which of the following nerves is most likely to be injured?

Radial nerve
Median nerve
Musculocutaneous nerve - Bicep brachii is the main muscle responsible for elbow flexion and forearm supination. Elbow flexion is also assisted by brachialis.
Ulnar nerve
Axillary nerve

Answer 110

A

which type of imaging is used to look at blood flow in arteries and veins?

- x-ray
- MRI
- CT scan
- PET scan
- ultrasound - doppler ultrasound

Answer 111

A

A doctor is reviewing a 24 years old male who presented to the emergency department with wrist drop and weak extension of his left elbow. The doctor concludes that radial nerve has been damaged which innervates the tricep brachii.

Where does this muscle insert?

Head of the humerus
Greater tuburcle
Coracoid process
Coronoid process of the ulna
Olecranon process of the ulna

Answer 112

A

which of the following bones undergoes intramembranous ossification?

a) tibia
b) sternum
c) manubrium
* *d) vomer**
e) maxilla

Answer 113

A

Which of the structures listed below articulates with the head of the radius superiorly?

Captiluum
Ulna
Medial epicondyle
Trochlea
Lateral epicondyle

Answer 114

A

A young man presents with a right-sided winged scapula following an injury during a rugby game. His doctor explains that one of his nerves has been damaged. Which nerve is this?

Musculocutaneous nerve
Accessory nerve
Axillary nerve
Long thoracic nerve
Thoracodorsal nerve

Winged scapula occurs due to paralysis of the serratus anterior, which is innervated by the long thoracic nerve. This nerve has superficial course along the ribs, which makes rib injuries a common cause of this disorder.

Answer 115

A

An obese 40-year-old woman attends the Emergency Department with acute onset lower back pain. During the neurological examination you note reduced knee jerk reflex on the left compared with the right. At what spinal level does this correspond to?

L1,L2
S3-S4
S1-S2
L3-L4
L4-L5

Answer 116

A

A patient sustains damage to the median nerve during a carpal tunnel release. Which of the following muscles will be affected?

Abductor digiti minimi
Abductor pollicis brevis
Adducot pollicis
Palmaris brevis
Flexor digiti minimi brevis

Answer 117

A

Which nerve derives from L4-S3?

Femoral nerve
Vagus nerve
lateral femoral cutaneous nerve
saphenous nerve
sciatic nerve

Answer 118

A

Where does the tendon of the coracobrachialis originate?

Acromion
Greater tubercle of humerus
Supraglenoid tubercle of the scapula
Coracoid process
Infraglenoid tubercle of the scapula

Answer 119

A

which of the following best describes this joint?

synchrondrosis
syndemosis
synostosis
symphysis
gomphosis
syndrondosis

Answer 120

A

What is the tissue indicated by the arrow? it comes from a developing skull

Bone
Bone marrow
Elastic cartilage
Fibrocartilage
5. Fibrocollagenous tissue
6. Hyaline cartilage

Answer 121

A

what substance is secreted by osteocytes to indicate bone health? [1]

sclerostin

Answer 122

A

A woman develops a winged scapula following a mastectomy is a stereotypical history for an injury to which nerve/structure?

Long thoracic nerve

Radial nerve

Ulnar nerve

Lower trunk of the brachial plexus (C8, T1)

Median nerve

Axillary nerve

Answer 123

A

Which of the following inserts onto the lesser trochanter?

Psoas minor
Psoas major
Sartorius
Obturaror externus
Gemellus

Answer 124

A

what structure is preventing damage to the spinal cord?

ligamentum flavum
dens
*- transverse ligament**

Answer 125

A

What structures are found in this region of the hand? (select all that apply)

Ulnar artery
Musculocutaenous nerve
scaphoid bone
radial artery
pisiform bone

Answer 126

A

Which one of the following forms the floor of the anatomical snuffbox?

Radial artery
Cephalic vein
Extensor pollicis brevis
Scaphoid bone
Cutaneous branch of radial nerve

Answer 127

A

Which nerve supplies adductor pollicis?

Long thoracic nerve

Radial nerve

Ulnar nerve

Median nerve

Musculocutaneous nerve

Answer 128

A

what type of collagen is found in hyaline cartilage? [1]
type 2 collagen

Answer 129

A

what type of joint is A?

symphysis
syndesmosis
synostosis
synchondrosis
gomphosis

Answer 130

A

A 28-year-old man is stabbed outside a nightclub in the upper arm. The median nerve is transected. Which one of the following muscles will demonstrate impaired function as a result?

Palmris brevis
Second & third interossei
Adductor pollicis
Abdcutor pollicis longus
Abdcutor pollicis brevis

Answer 131

A

A 30-year-old gentleman presents to the Emergency Department with pain in his right hand after falling onto an outstretched hand in a football game that same day. You perform a full hand examination and find that the pain is localised to the anatomical snuffbox, so you order an x-ray to investigate a suspected scaphoid bone fracture.

What structure, passing through the anatomical snuffbox, is most likely to be damaged in this injury?

The median nerve
The deep branch of the radial nerve
the basilic nerve
the radial artery
the extensor pollicis longus muscle

Answer 132

A

Which nerve supplies abductor pollis brevis?

Musculocutaneous nerve

Median nerve

Radial nerve

Ulnar nerve

Long thoracic nerve

Answer 133

A

A 62-year-old man presents to the Emergency Department with right-sided facial drooping and slurred speech.

You suspect this patient has had a stroke and perform a cranial nerves examination. His hypoglossal nerve has been affected.

What symptom would you expect to see in this patient?

Loss of taste (anterior 2/3 tongue)
Loss of taste (posterior 1/3 tongue)
Paralysis of mastrication muscles
Tongue devation to the left
Uvula deviation to the right

Answer 134

A

Acceptable responses: olecrannon of the ulna, olecrannon, Ulnar olecrannon

Answer 135

A

A patient develops foot drop following a fibular neck fracture is a stereotypical history for an injury to which nerve/structure?

Femoral nerve

Inferior gluteal nerve

Tibial nerve

Common peroneal nerve

Obturator nerve

Superior gluteal nerve

Answer 136

A

A patient develops loss of knee extension and sensory loss to the anterior and medial aspect of the thigh following a stab injury is a stereotypical history for an injury to which nerve/structure?

Femoral nerve

Common peroneal nerve

Lateral cutaneous nerve of the thigh

Tibial nerve

Superior gluteal nerve

Obturator nerve

Answer 137

A

A sprinter attends the emergency department with severe leg pain. He had forgotten to warm up and ran a 100m sprint race. Towards the end of the race he experienced pain in the posterior aspect of his thigh. The pain worsens, localising to the lateral aspect of the knee. The sprinter is unable to flex the knee. What structure has been injured?

Anterior cruciate ligament
Posterior cruciate ligament
Semimebranosus tendon
Semitendinosus tendon
Biceps femoris tendon

The biceps femoris is commonly injured in sports that require explosive bending of the knee as seen in sprinting, especially if the athlete has not warmed up first. Avulsion most commonly occurs where the long head attaches to the ischial tuberosity. Injuries to biceps femoris are more common than to the other hamstrings.

Answer 138

A

During a block dissection of the groin, the sartorius muscle is identified. What is the nerve supply to this muscle?

Obturator nerve
Posterior division of the femoral nerve
Anterior division of the femoral nerve
Sciatic nerve
Genitofemoral nerve

Answer 139

A

A = secondary ossification centre

Answer 140

A

mid-humeral shaft fracture is a risk of damaging which nerve?

musculocutaneous
median
ulnar
axillary
radial

Answer 141

A

which of the following bones does not undergo intramembranous ossification?

a) frontal
b) clavicle
c) parietal
* *d) zygomatic**
e) nasal

all others are flat bones of skull (clavicle also undergos this)

Answer 142

A

A 24-year-old female is rushed to the emergency department after sustaining an injury during training. She is a competitive powerlifter and her training involves rapid, explosive movements with heavy weights.

On examination, weakness of knee flexion, and some localised knee swelling is noted. The emergency doctor is concerned about the detachment of the biceps femoris from the site of insertion and requests an orthopaedic review.

Which of the following is the site of insertion of the long and short head of biceps femoris?

Medial surface of proximal tibia
Tibial tuberosity
Head of the fibula
Medial tibial condyle
Lesser trochanter

Answer 143

A

which nerve has being tested here?

a) Musculocutaneous
b) Axillary
c) Median
* *d) Radial**
e) Ulnar

Answer 144

A

carpo-metacarpal joint [1]

Answer 145

A

The following statements regarding the rectus abdominis muscle are true except:

It runs from the symphysis pubis to the xiphoid process
Its nerve supply is from the ventral rami of the lower 6 thoracic nerves
It has collateral supply from both superior and inferior epigastric vessels
It lies in a muscular aponeurosis throughout its length
It has a number of tendinous intersections that penetrate through the anterior layer of the muscle

Answer 146

A

Where does the tendon of the long head of biceps brachii originate?

Acromion
Greater tubercle of humerus
Supraglenoid tubercle of the scapula
Coracoid process
Infraglenoid tubercle of the scapula

Answer 147

A

2 breaks

nerves:

*axillary (red)**
*radial (yellow)**

Answer 148

A

Which of the following nerves has five nerve roots?

Obturator nerve
inferior gluteal nerve
sciatic nerve: L4, L5, S1, S2, and S3
superior gluteal nerve
femoral nerve

Answer 149

A

none of the intrinsic muscles of the hand are innervated by which nerves?

musculocutaneous
median
ulnar
axillary
radial

Answer 150

A

A 25-year-old man is stabbed in the upper arm. The brachial artery is lacerated at the level of the proximal humerus, and is being repaired. A nerve lying immediately lateral to the brachial artery is also lacerated. Which one of the following is the nerve most likely to be?

Ulnar nerve
Median nerve
Radial nerve
Intercostobrachial nerve
Axillary nerve

Answer 151

A

which out of skeletal, cardiac and smooth muscle has z disks? [2]

skeletal
cardiac
smooth

Answer 152

A

which artery is commonly used to gain access to abdominal aorta?

descending aorta
*- femoral artery**
hepatic artery proper
common iliac artery

Answer 153

A

A 37-year-old man attends his general practitioner with reduced mobility of his right hip. He reports a chronic history of mid and lower back pain from working in a lumberyard. He is noted on examination to have reduced flexion and external rotation of the hip, he reports to have noted some weakness and reduced range of movement at the gym when performing single-leg squats on the affected side but does not notice when performing ordinary, two-legged squats.

What is the likely lower limb structure affected, causing in this patient’s presentation?

Femoroacetabular ligament
Lateral cutaneous nerve of thigh
Medial meniscus
Psoas muscle-The iliopsoas group is the main flexor of the hip
Trochanter bursa

Answer 154

A

bicep brachii attaches distally to:

a) humerus
b) radius
c) ulnar
d) coracoid process
e) scapular

Answer 155

A

during periods of low Ca2+ serum, what does release of parathyroid hormone cause to occur at the kidney?

a) increases Ca2+ excretion in urine, increases P04 excretion in urine; increases Ca2+ reabsorbtion & increases P04 reabsobtion
b) decreases Ca2+ excretion in urine, increases P04 excretion in urine; increases Ca2+ reabsorbtion & increases P04 reabsobtion

c) decreases Ca2+ excretion in urine, increases P04 excretion in urine; increases Ca2+ reabsorbtion & decreases P04 reabsobtion

d) decreases Ca2+ excretion in urine, increases P04 excretion in urine; decreases Ca2+ reabsorbtion & increases P04 reabsobtion
e) decreases Ca2+ excretion in urine, increases P04 excretion in urine; decreases Ca2+ reabsorbtion & increases P04 reabsobtion

Answer 156

A

which substance inactivates osteoclasts to maintain Ca2+ levels at an appropriate level?

a) PTH
b) sclerostin
c) 1,25-dihydroxyvitamin D
* *d) calcitonin**
e) RANK

Answer 157

A

which of the following tightens the interaction between vesicle and presynaptic membrane complexes at the presynaptic membrane, causing them to merge?

syntaxin
SNAP25
synaptobrevin
*- synaptotagmin**

Answer 158

A

which of the following is the M line?

A
B
C
D
E

Answer 159

A

Andy, a 22-year-old male, presents to the emergency department following a fall on an outstretched hand during a rugby match. He complains of pain in his right shoulder.

The emergency doctor proceeds to check the neurovascular status and then orders an x-ray which shows a surgical neck fracture of the right humerus.

Considering the nerve most likely to be affected by this fracture, which muscles are likely to have reduced movement?

Teres minor and trapezius
Teres minor and deltoid - surgical neck fractures damage the axillary nerve. supplies these two muscles
Teres major and deltoid
Teres major, trapezius and deltoid
Teres minor, trapezius and deloid

Answer 160

A

A patient cannot adduct his thigh following an anterior hip dislocation is a stereotypical history for an injury to which nerve/structure?

Tibial nerve

Common peroneal nerve

Lateral cutaneous nerve of the thigh

Obturator nerve

Femoral nerve

Superior gluteal nerve

Answer 161

A

Quick rhyme to remember the nerve roots:

S1,2: tie my shoe - ankle reflex.

L3,4: kick the door - knee reflex.

C5,6: pick up sticks - biceps reflex.

C7,8: lay them straight - triceps reflex.

Answer 162

A

A boy presents with arm problems after falling from a tree, during which he caught a branch to save himself. On examination he has a claw hand with a hyperextended wrist is a stereotypical history for an injury to which nerve/structure?

Long thoracic nerve

Axillary nerve

Upper trunk of the brachial plexus (C5,C6)

Median nerve

Lower trunk of the brachial plexus (C8, T1)

Radial nerve

Answer 163

A

Mnemonic for radial nerve muscles: BEST

B rachioradialis
E xtensors
S upinator
T riceps

Answer 164

A

which is the muscle that is major flexor of the hip joint?

a) sartoruis
b) rectus femoris
* *c) iloapsoas**
d) vastus medialis
e) quad major

Answer 165

A

A 78-year-old man presents with symptoms consistent with intermittent claudication. To assess the severity of his disease you decide to measure his ankle brachial pressure index. To do this you will identify the dorsalis pedis artery. Which one of the following statements relating to this vessel is false?

It originates from the peroneal artery - its a continuation of anterior tibial artery
It is crossed by the tendon of extensory hallucis brevis
Two veins are usually closely related to it
It passes under the inferior extensor retinaculum
The tendon of extensoru hallucis longus lies medial to it

Answer 166

A

Adam, a 17-year-old male, attends his follow up shoulder clinic appointment following a traumatic motorbike injury.

Mr Singh, the orthopaedic surgeon, carries out a shoulder examination and notes winging of the left scapula.

Which muscle is affected?

Trapezius
Deltoid
Levator scapulae
Rhomboid major
Serratus anterior

Answer 167

A

Which muscle initiates abduction of the shoulder?

Infraspinatus
Latissimus dorsi
Supraspinatus
Deltoid
Teres major

Answer 168

A

subscapularis

Answer 169

A

Which one of the following actions is directly caused by cortisol?

Stimulates release of insulin-like growth factors

Increases gluconeogenesis

Increases secretion of melanocyte-stimulating hormone (MSH) and corticotrophin-releasing hormone (CRH)

Increases proximal tubule Na+/H+ activity

Stimulates thirst

Decreases osteoclastic activity

Answer 170

A

An Afro-Caribbean patient presents to her GP complaining of fatigue, bone pain and hair loss. The GP arranges some blood tests, finds that the patient has hypocalcaemia and prescribes vitamin D supplements. After a few weeks the patient feels much better and her calcium levels have returned to normal.

What is the major mechanism through which the patient’s serum calcium increased?

An increase in calcium absorbtion from the gut
A decrease in phosphate absorption from the gut
Increased Ca sequestration into bone
Increasing parathyroid secretion
Increased Ca reabsoprtion by the kidneys

Answer 171

A

which of the following best describes carbachol on Ach receptor?

*- agonist**
antagonist
depolarisng blocker
release inhibitor
synthesis inhibitor

Answer 172

A

which best describes the arrow?

sclerotic lesions of bone
periosteal reaction
lucent lesions of bone: dark areas in bone
osteopenia
osteonecrosis

Answer 173

A

what type of joint is the radio-carpal joint?

a) saddle
b) planar
* *c) condyloid**
d) hinge
e) pivot

permits extension and flexion and ulnar and radial devaitation (side to side)

Answer 174

A

anterior iliofemoral ligament - makes anterior side more stable than posterior

Answer 175

A

A patient attending the neurology outpatient clinic is found to have a motor deficit. The neurologist detects flaccid weakness, decreased reflexes and muscle fasciculations.

Where is the lesion?

Motor cortex
Internal capsule
Midbrain
Medulla
Peripheral nerve

Reduced tone (flaccid) weakness, decreased reflex responses and muscle fasciculations are all features of a lower motor neurone lesion. The lower motor neurones begin in the anterior horn of the spinal cord and synapse at the neuromuscular junction.

Answer 176

A

Which types of synovial joints allow movement around two axes? [2]

*- saddle**
hinge
*- ellipsoid**
planar
pivot

Answer 177

A

A 3rd-year medical student is asked to insert a cannula in the cubital fossa of the patient.

Which of the following structure is found at the cubital fossa?

Ulnar nerve
Femoral nerve
Femoral artery
Tricep tendon
Median nerve

Answer 178

A

which of the following is the I band?

A
B
C
D
E

Answer 179

A

which dermatome covers the big toe?

L4
L5
S1
S2
S3

Answer 180

A

A 40-year-old woman is experiencing persisting muscle weakness in her legs and arms for the last 3 months. After being referred to hospital, she consents to a muscle biopsy from her right quadriceps. The samples are sent to histopathology for review. In which of the following muscle type(s) would you expect to see sarcomeres when viewed under a microscope?

Skeletal and smooth muscle
Cardiac and smooth muscle
Smooth muscle
Skeletal and cardiac muscle
Skeletal, smooth and cardiac muscle

Answer 181

A

A 56-year-old patient is brought into the emergency department via ambulance after a road traffic collision. His hip appears to be in flexion, abduction, and external rotation. He has a pelvic x-ray which shows the right femoral head appearing larger than the left femoral head and the right femoral head appearing medial to the acetabulum. There is no fracture noted and no overlying skin lesions to the site. Closed reduction is performed with traction when the patient is adequately sedated. He is reviewed several hours later by the physiotherapy team and it is noted that he is unable to adduct his thigh.

Which is the most likely nerve that has been damaged?

Femoral nerve
Inferior gluteal nerve
Lateral femoral cut. nerve
Obturator nerve
Superior gluteal nerve

Answer 182

A

which nerve would you be likely to hit if you did IM in D?

*- sciatic nerve**
posterior tibial nerve
anterior tibial nerve
superficial peroneal nerve
common peroneal nerve

Answer 183

A

A 52-year-old man walks into the doctor’s office and the doctor immediately notices how the man places the lateral foot edge first in each step of the affected leg. Which of the following nerves is most likely damaged?

tibial nerve
saphenous nerve
common fibular nerve
superficial fibular nerve
deep fibular nerve

Answer 184

A

Acceptable responses: nucleus pulposus, nucleus pulposis

Answer 185

A

which type of imagine is best for seeing bone fractures?

x-ray
MRI
*- CT scan**
PET scan
ultrasound

Answer 186

A

Abduction of the thumb, and opposition of the thumb.

Answer 187

A

What does the arrow indicate in this developing foot?

Bone
Epithelium
Fibrocollagenous tissue
Hyaline cartilage
Nutrient artery

Answer 188

A

which vertebral levels are iliac crest?

L1
L2
L3
L4
L5

Answer 189

A

A 23-year-old figure skater is rushed into the hospital after stumbling and falling on her lower leg during practice. An X-ray of her leg reveals a proximal fibular fracture. Which nerve may most likely be damaged in this scenario?

Femoral nerve
sciatic nerve
common fibular nerve
tibial nerve
obturator nerve

Answer 190

A

endochondral ossification is characterised by the production of which type of collagen?

a) type I
* *b) type 2**
c) type 3
d) type 4
e) type 5

occurs via the production of hyaline cartliage - which is type 2

Answer 191

A

A young man presents with a left-sided winged scapula following a fight in a pub. On examination he is found to have difficulty performing a certain movement with his left arm. Which movement is this most likely to be?

Extension
Flexion
Abduction
Adduction
Supination and pronation

Winged scapula is due to paralysis of serratus anterior, which is involved in arm abduction. Therefore, any answer suggesting otherwise is incorrect.

Answer 192

A

where do you find the cell body of the motor unit of the NMJ? [1]

dorsal root ganglion
ventral horn of the spinal cord
laterlal horn of the spinal cord
dorsal root of the spinal cord

Answer 193

A

B: corocoid process
C: glenoid fossa
E: acromion
F: biciptial groove (inbetween the tubercles) for long head of bicep tendon

Answer 194

A

which ligament supports C1-C2 joint?

anterior longitudinal ligament
posterior longitudinal ligament
ligamentum flavum
interspinous ligament

Answer 195

A

which, out of skeletal, cardiac and smooth muscle has more T tubules ?

skeletal
cardiac
smooth

Answer 196

A

A 42-year-old woman presents to her GP complaining of pain in her left hand. She says that she has been experiencing intermittent pins and needles around her left thumb and index fingers on the palm of her hand. The pain has been going on for around 2 months and she has noticed that it is worse during the night, and sometimes keeps her awake.

What nerve is likely to be causing her symptoms?

Axillary nerve
Median nerve
Musculocutaenous nerve
Radial nerve
ulnar nerve

Answer 197

A

what type of joint is highlighted?

pivot: annular ligament = creates pivot joint !!
saddle
condyloid
hinge
ball and socket

Answer 198

A

the hip joint is most stable in which position?

a) flexion
b) extension
c) adduction
d) adduction
e) internal rotation

Answer 199

A

which ligament is damaged here?

*- posterior cruciate ligament**
anterior cruciate ligament
medial collateral ligament
lateral collateral ligament

Answer 200

A

which rotator muscle is most likely to have a tear occur ?

a) teres minor
b) supraspinatous
c) infraspinatous
* *d) subscapularis**
e) serratus anterior

Answer 201

A

Which one of the following fingers is not a point of attachment for the palmar interossei?

Middle finger
Little finger
Ring finger
Index finger
None of the above

The middle finger has no attachment of the palmar interosseous.

Answer 202

A

what type of joint is DIP?

a) saddle
b) ball and socket
c) planar
* *d) hinge**
e) condyloid

Answer 203

A

which out of skeletal, cardiac and smooth muscle has two muscle layers?

skeletal
cardiac
smooth - circ and long

Answer 204

A

Which upper limb muscle cause the gliding of the shoulders downward (depression)?

a) teres minor
b) middle trapezius
c) superior trapezius
d) rhomboids
e) lower trapezius

Answer 205

A

At what level does the sciatic nerve usually bifurcate into the tibial and common peroneal nerves?

Superior aspect of the popliteal fossa
Inferior aspect of the popliteal fossa
Inferior border of the gluteus maximus
Inferior border of the piriformis muscle
In the pelvis

Answer 206

A

A patient has had a muscle biopsy carried out due to progressive muscle weakness. In his clinic appointment, he is shown a histological specimen and the doctor points to the sarcomere. Which of the following describes what the doctor was pointing to?

The interface between actin & myosin filaments
An artefactual finding
A band on myofibre
The I band
The region between two Z-lines on the myofibril

Answer 207

A

what type of joint is A?

a) saddle
b) ball and socket
* *c) planar**
d) hinge
e) condyloid

Answer 208

A

in the thenar eminence, the flexor pollicis brevis & oppenens pollicis , abductor pollicis brevis are all innervated by the median nerve. Which nerve is the adductor policis innervated by?

musculocutaneous
median
ulnar
axillary
radial

Answer 209

A

fracture to the head of the fibula can cause damage to which nerve?

sciatic nerve
posterior tibial nerve
anterior tibial nerve
superficial peroneal nerve
*- common peroneal nerve**

wraps around the neck of the fibula - vulnerable to fracture !

Answer 210

A

which ligament stops abrupt flexion & extends from the lamina above to lamina below of adjacent vertebra

anterior longitudinal ligament
posterior longitudinal ligament
*- ligamentum flavum**
interspinous ligament

Answer 211

A

which nerve has being tested here?

a) Musculocutaneous
b) Axillary
c) Median
d) Radial
* *e) Ulnar**

Answer 212

A

A 67-year-old man is undergoing a transurethral resection of a bladder tumour using diathermy. Suddenly during the procedure the patient’s thigh begins to twitch. Stimulation of which of the following nerves is the most likely cause?

Femoral
Pudendal
Sciatic
Obturator: The obturator nerve is most closely related to the bladder (see below)

Gluteal

Answer 213

A

A 26-year-old woman was recently involved in a car accident. She now presents with paralysis of the deep posterior muscles of the lower leg. Which of the following nerves was most likely injured in the accident?

tibial nerve
saphenous nerve
common fibular nerve
superficial fibular nerve
deep fibular nerve

Answer 214

A

A = Radial nerve
B = Ulnar nerve & Median

Answer 215

A

femur has moved backwards!

popliteal artery
sciatic nerve
common peroneal vein

cruciate ligaments
collateral ligaments

menisci

Answer 216

A

which is the primary muscle of scapular protraction?

a) teres minor
b) subscapularis
* *c) serratus anterior**
d) rhomboids
e) pec major

Answer 217

A

Which one of the following muscles does not attach to the radius

Pronater quadratus
Biceps
Brachioradialis
Supinator
Brachialis

Answer 218

A

which nerve is likely to be affected by herniated disc?

sciatic nerve
femoral nerve
vagus nerve
common peroneal nerve

Answer 219

A

which is the first muscle to initatie abduction?

supraspinatus muscle
infraspinatus muscle
teres minor
subscapularis muscle
deltoid muscle

conducts first 10 degrees of abduction !

Answer 220

A

which of the following nerves causses foot drop when injured?

obturator nerve
saphenous nerve
femoral nerve
tibial nerve
common fibular nerve

Answer 221

A

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 a posterior surgical approach the surgeons encounter a tough ligamentous structure lying anterior to the spinous processes. This structure is most likely to be the

Transverse spinal ligament
Supraspinal ligament
Anterior longitudinal ligament
Ligamentum flavum
Posterior longitudinal ligament

Answer 222

A

how long does it take for osteoblasts mineralise the unminerilased matrix? [1]

7-10 days

Answer 223

A

An 82-year-old man is being treated by physiotherapy in the community, following a long period of immobilisation due to depression. He is having particular difficulty abducting his hip.

What muscle contributes most to this movement?

Gluteus maximus
Gluteus medius
Hamstrings
Ilipsoas
Quadratus femoris

Answer 224

A

A = synchondrosis (hyaline cart)
B = symphysis
C = synovial planar joint

Answer 225

A

excessive lordosis is caused by increased curvature in which thoracic region?

cervical
thoracic
*- lumbral L4L**
sacral
coccyx

Answer 226

A

what is the tissue indicated by the arrow?

compact bone
fibrocartilage
fibrocolllagenous tissue
hyaline cartilage
trabecular bone

Answer 227

A

which out of skeletal, cardiac and smooth muscle has no regeneration?

skeletal
cardiac
smooth

Answer 228

A

below are the muscles of the thenar eminence. they are all innervated by the median nerve apart from ?

flexor pollicis brevis
oppenens pollicis
*- adductor pollicis: ulnar nerve**
abductor pollicis brevis

Answer 229

A

which of the following best describes Ach on Ach receptor?

*- agonist**
antagonist
depolarisng blocker
release inhibitor
synthesis inhibitor

Answer 230

A

A 60-year-old keen hill walker experiences pain in her leg when walking uphill and climbing stairs. Which of the following muscles is responsible for hip extension?

Gluteus minimus
Gluteus medius
Gluteus maximus
Rectus femoris
Tensor fascia latae

Answer 231

A

A - hinge joint: dorsi flexion & plantar flexion
B - MCP: ellipsiod: flex / ext. add / abd

Answer 232

A

L type calcium channels [2]
heart
vascular smooth muscle

N type calcium channels [1]
pre-synaptic terminals

Answer 233

A

Inhibits inflammatory and immune responses:

Somatostatin

Secretin

Glucagon

Antidiuretic hormone

CCK

Cortisol

Answer 234

A

a postive trendelenburg test is likely to occur from damage to which nerve?

superior gluteal nerve
inferior gluteal nerve
femoral nerve
common peroneal nerve
superficial peroneal nerve

Answer 235

A

which is the most superficial out of the following

a) bicep brachii
b) brachialis
c) coracobrachialis

Answer 236

A

which muscle do the lumbricals arise from?

*- flexor digitorum profundus**
brachialis
flexor digitorum superficialis
palmaris longus
flexor carpi ulnaris

Answer 237

A

Which nerve does the saphenous nerve arise from?

obturator nerve
tibial nerve
femoral nerve
sciatic nerve
genitofemoral nerve

Answer 238

A

Which nerve supplies extensor pollicis longus muscle?

Ulnar nerve

Long thoracic nerve

Radial nerve

Median nerve

Musculocutaneous nerve

Answer 239

A

palsy of which nerve means is difficult / unable to conduct a power grip due to an unstable base from extensors not working?

musculocutaneous
median
ulnar
axillary
radial

Answer 240

A

Ellie, a 5-year-old girl, falls on to an outstretched hand sustaining a supracondylar fracture. The doctors are concerned she may have damaged some contents of the cubital fossa.

Radial nerve, biceps tendon, brachial artery, median nerve - ‘Really Need Beer To Be At My Nicest’
Radial nerve, biceps tendon, brachial artery, ulnar nerve
Median nerve, biceps tendon, brachial artery, radial nerve
Ulnar nerve, biceps tendon, brachial artery, radial nerve
Radial nerve, biceps tendon, brachial artery, median nerve

Answer 241

A

John, a 67-year-old male, presents to the emergency department following a stroke. He has reduced sensation and movement in his left upper and lower limbs.

The emergency department doctor carries out a full upper and lower limb neurological exam on John. One of the many signs he notes is hyperreflexia of the ankle reflex on the left.

What are the nerve roots of this reflex?

L1, L2
L2, L3, L4
S1, S2, S3
S1, S2
S2, S3

Answer 242

A

A 25-year-old male is involved in an accident at work where he is cut with a loose piece of glass. The glass cuts his skin and damages the tendons of one of the muscles in his hand. As a result of the injury he is unable to flex the distal interphalangeal joint of his middle finger. He is still able to flex the proximal interphalangeal joint (PIP) and the metacarpophalangeal (MCP) joint of the same digit. All other fingers are unaffected.

Which muscle was most likely affected?

Flexor pollicis longus
Flexor carpi ulnaris
Flexor digitorum superficialis
Flexor digitorum profundus
Adductor pollicis

Answer 243

A

which of the following is the Z line?

A
B
C
D
E

Answer 244

A

A patient develops a ‘claw’ hand following a medial epicondyle fracture is a stereotypical history for an injury to which nerve/structure?

Ulnar nerve

Axillary nerve

Long thoracic nerve

Lower trunk of the brachial plexus (C8, T1)

Upper trunk of the brachial plexus (C5,C6)

Radial nerve

Answer 245

A

Which nerve supplies biceps brachii?

Radial nerve

Musculocutaneous nerve

Median nerve

Ulnar nerve

Long thoracic nerve

Answer 246

A

what type of joint is between radius and annular ligament of the ulna??

a) saddle
b) pivot
c) planar
d) hinge
e) condyloid

Answer 247

A

Injury to which nerve of the leg can most likely lead to atrophy of the lateral calf?

Femoral nerve
Tibila nerve
lateral femoral cutaneous nerve
superficial fibular nerve
deep fibular nerve

Answer 248

A

which is the thickest and strongest tendon in the body?

Supraspinatus tendons
Flexor carpi radialis tendons
Sartorius tendons
Flexor digitorum longus tendons
*- Calcaenous tendon**

Answer 249

A

where does the aorta bifuricate into common iliac artery?

L1
L2
L3
*- L4**
L5

Answer 250

A

Following an axillary node clearing surgery your patient shows the following sign.

Using your knowledge of upper limb anatomy which actions would you expect to be weakened? (select all that apply)

Scapula retraction
Scapula rotation
Scapula protrusion
Scapula elevation

The sign shown here is scapular winging. This is usually as a result of a weakened serratus anterior muscle. Serratus anterior is innervated by the long thoracic nerve, found running along the medial aspect of the axilla.

Serratus anterior is responsible for scapula protraction and rotation. It also hold the scapula flat against the back.

Answer 251

A

which is the primary muscle of returning the arms downward from the overhead position?

a) teres minor
b) subscapularis
c) serratus anterior
* *d) rhomboids**
e) pec major

Answer 252

A

which type of cartilage is found in invertebral discs?

elastic cartilage
*- fibrocartilage**
hyaline cartilage

Answer 253

A

Retraction of which of the following structures will improve access to the femoral artery in the groin?

Quadriceps
Adductor longus
Adductor magnus
Pectineus
Sartorius

Answer 254

A

You see a 30-year-old weight lifter in primary care complaining of a painful right arm. He describes a ‘pop’ during his last workout. On examination you notice a large swelling in the proximal arm and are unable to palpate the distal insertion of biceps brachii. Which of the following movements is likely to be affected?

Pronation
Supination: Major function of Biceps Brachii is supination as well as elbow flexion
Wrist flexion
Elbow extension
Shoulder abduction

Answer 255

A

which nerve has had an injury in this photo?

musculocutaneous
median
ulnar
axillary
radial

Answer 256

A

A 23-year-old man is undergoing a hernia repair and the mesh is to be sutured to the inguinal ligament. From which of the following does the inguinal ligament arise?

Transversus abdominis fascia
Internal oblique
Rectus sheath
Rectus abdominis muscle
External oblique aponeurosis

Answer 257

A

which muscle in the upper limb initiates the first 10 / 15 degrees of abduction

a) teres minor
* *b) supraspinatous**
c) infraspinatous
c) subscapularis
e) pec major

Answer 258

A

Which upper limb muscle cause the gliding of the shoulders upward toward the ears (elevation)?

*a) levator scapulae**
b) middle trapezius
*c) superior trapezius**
d) rhomboids
e) lower trapezius

Answer 259

A

During a hip examination, John, a 68-year-old male, is found to have a positive trendelenburg’s sign. When he stands on only his left leg, his right pelvis drops.

What muscles are affected in John?

Right gluteus medius and gluteus minimus
Right gluteus medius and medius
Right gluteus maximus
Left gluteus medius and gluteus minimus
Left gluteus maximus and medius

When a person with paralysis of the superior gluteal nerve is asked to stand on one leg, the pelvis on the unsupported side descends, indicating that the gluteus medius on the affected side is weak or non functional ( a positive Trendelenburg test).

When the right superior gluteal nerve is damaged, there is lack of innervation to the right gluteus minimus and gluteus medius muscles and when the patient stands on their right leg there is lack of stability and the left pelvis drops.

Answer 260

A

which of the nerves from brachial plexus is likely to be damaged by dislocated shoulder?

Muscularcutaneous
*- axillary**
median
radial
ulnar nerve

axillary nerve is under

Answer 261

A

At which anatomical location can the posterior tibial pulse be found?

Inferior posteriorly to the medial malleolus
Superior posteriorly to the medial malleolus
Superior anterioly to the medial malleolus
Inferiorly posterioly to the lateral malleolus
Superior posterioly to the lateral malleolus

Answer 262

A

What tissue is indicated by the blue arrow?

endomysium
endosteum
perichondrium
perimysium
* *5. periosteum**

Answer 263

A

Swelling of the tendons can compress the median nerve, leading to a median nerve palsy

Answer 264

A

Which one of the following actions is directly caused by calcitonin?

Decreases renal reabsorption of phosphate

Up-regulates alpha-1 receptors on arterioles

Stimulates release of insulin-like growth factors

Increases plasma calcium

Decreases osteoclastic activity

Increases gastric motility

Answer 265

A

which muscles of leg cause foot inversion? [2]
tibialis posterior - deep posterior compatment
tibialis anterior - anterior comparment

Answer 266

A

this patient has shingles predominately in which dermatome?

S1
S2
S3
S4
S5

Answer 267

A

during periods of low serum Ca2+, the synthesis of 1,25 dihydroxyvitamin D at the liver causes what to occur?

*a) increase absorbtion of Ca2+ at the gut**
b) inactivation of sclerostin
c) increased excretion of Ca2+ at the gut
d) increased Ca2+ absorbtion at kidney
e) increases activity of osteoclasts

Answer 268

A

Which one of the following nerves provides innervation to the short head of biceps femoris?

Superior gluteal nerve
Inferior gluteal nerve
Pudendal nerve
Tibial branches of sciatic nerve
Common peroneal branch of sciatic nerve

Answer 269

A

what type of joint is carp-metacarpal?

a) condyloid
b) hinge
c) ball & socket
* *d) saddle**
e) pivot

Answer 270

A

David, a 22-year-old male, attends clinic for removal of a 6-week plaster cast of his lower limb, it it noted that his left foot appears plantar flexed, foot drop.

The doctor checks sensation in his lower limb and feet and notes it is reduced in area innervated by the deep fibular nerve.

Which area of the lower limb or foot would be affected in David?

Medial aspect of the leg
Lateral foot
Dorsum of the foot
Webspace between first and second toes
Sole of the foot

Answer 271

A

In respect of skeletal muscle contraction, thin filaments that transmit the forces generated by myosin to the ends of the muscle:

Sarcomere

T-tubule

Actin

M-line

Tropomyosin

Titin

Answer 272

A

ask them do a power grip - uses wrist extensors which requires radial nerves: would be weak

also charactersied by wrist drop

Answer 273

A

which rotator cuff muscle is locted anteriorly?

a) teres minor
b) supraspinatous
c) infraspinatous
c) subscapularis

Answer 274

A

Acceptable responses: tibial, tibial nerve

Answer 275

A

which joint in the body is the most mobile?

a) knee
b) hip
c) MCP
d) elbow
* *e) shoulder**

Answer 276

A

Where is the site of insertion of three of the rotator cuff muscles?

Acromion
Greater tubercle of humerus
Supraglenoid tubercle of the scapula
Coracoid process
Infraglenoid tubercle of the scapula

Answer 277

A

You are a doctor, reviewing a 24 years old male who presented to the emergency department with an injury to his triceps muscle resulting in loss of extension of his left elbow.

Where does the long head of this muscle originate from?

Head of the humerus
Supraglenoid tubercle of the scapula
Infraglenoid tubercle of the scapula
Coracoid process
Greater tubercle

Answer 278

A

which best describes the joint shown in the picture?

synchrondrosis
syndemosis
synostosis
symphysis
gomphosis
syndrondosis

Answer 279

A

Following a humeral fracture this patient has their peripheral nerves tested.

They have been asked to flex their knuckles (metacarpophalyngeal joints) and extend their fingers (interphalageal joints).

Based on the image below which nerves can you conclude are intact?

Ulnar nerve
Median nerve
Axillary nerve
Radial nerve

The lumbricles are responsible for this unusal action, flexion at the MCPs and extension at the IPs. There are 4 lumbricles, the lateral 2 are innervated by the median nerve and the medial 2 are innervated by the ulnar nerve.

So based on this position of the hand we can conclude that the median and ulnar nerves are intact. (there are many other tests for these nerves which are used more commonly).

Answer 280

A

which rotator cuff muscle attaches to the lesser tubercle??

a) teres minor
b) supraspinatous
c) infraspinatous
* *d) subscapularis**
e) serratus anterior

Answer 281

A

A 19-year-old male presents to his physician after hurting himself while attempting to perform ‘hammer curls’, an exercise that involves flexion of the elbow joint in pronation. He complains of elbow pain.

On examination, weakness of elbow flexion is noted, and on palpation of his elbow, there is local tenderness. The physician suspects an underlying injury to the nerve supply of the brachialis.

Which one of the following correctly describe the nerves that innervate the brachialis muscle?

Musculocuteanous and radial nerve
Musculocuteanous and median nerve
Radial nerve and median nerve
Radial nerve and ulnar nerve
Median nerve and ulnar nerve

Answer 282

A

Where does the tendon of the short head of biceps brachii originate?

Acromion
Greater tubercle of humerus
Supraglenoid tubercle of the scapula
Coracoid process
Infraglenoid tubercle of the scapula

Answer 283

A

which nerve has being tested here?

a) Musculocutaneous
b) Axillary
* *c) Median**
d) Radial
e) Ulnar

Answer 284

A

J. Developing bone: The tissue at the arrow is…

Compact bone
Dense irregular fibrocollagenous tissue
3. Hyaline cartilage (calcified)
Hyaline cartilage (normal)
5. Trabecular bone

Answer 285

A

which is the longest nerve in the body?

a) femoral nerve
b) median nerve
c) ulnar nerve
* *d) sciatic nerve**

Answer 286

A

A patient is found to have a positive Trendelenburg sign is a stereotypical history for an injury to which nerve/structure?

Inferior gluteal nerve

Superior gluteal nerve

Common peroneal nerve

Lateral cutaneous nerve of the thigh

Obturator nerve

Tibial nerve

Answer 287

A

which of the following best describes this joint?

synchrondrosis
syndemosis
synostosis
symphysis : made from fibrocart
gomphosis
syndrondosis

Answer 288

A

Weakness in flexion, adduction and internal rotation.

Answer 289

A

Where does the long head of the biceps brachii orginate? [1]
Supraglenoid tubercle

Answer 290

A

which of the following is the H band?

A
B
C
D
E

Answer 291

A

Spinal accessory nerve (CN XI) with the trapezius muscle paralysed.*
Cranial nerves do not all have motor and sensory fibres, the spinal accessory nerve is purely motor, so there is only a motor loss.*

Answer 292

A

Which one of the following nerves provides innervation to the short head of biceps femoris?

Superior gluteal nerve
Inferior gluteal nerve
Pudendal nerve
Tibial branches of sciatic nerve
Common peroneal branch of sciatic nerve

Answer 293

A

What are the two main muscular branches of the sciatic nerve (nervus ischiadicus)?

tibial nerve
genitofemoral nerve
common fibular nerve
obturator nerve
femoral nerve

Answer 294

A

A 91-year-old lady presents to the emergency department following a fall. She is found to have a neck of femur fracture and a total hip replacement is performed. As part of her post-op care, she is prescribed vitamin D for her bones.

How would you expect this to affect the ions in her blood?

Increased plasma calcium
Increased plasma phosphate
Increased plasma calcium and phosphate
Increased potassium
Redeced Calcium

Answer 295

A

what is the structure in the centre of the field?

canaliculus
diaphysis
epiphyseal plate
osteon
osteoid
periosteum

Answer 296

A

which nerve, when hit, is commonly caused the funny bone?

muscularcutaneous
axillary
median
radial
*- ulnar nerve**

Answer 297

A

excessive kyphosis is caused by increased curvature in which thoracic region?

cervical
thoracic
lumbral
sacral
coccyx

Answer 298

A

A patient presents to the clinic following a surgical procedure. She complains that she is unable to shrug her shoulder. What is the most likely underlying nerve injury?

Acecessory nerve: trapezuis !
Cervical plexus
Ansa cervicalis
Long thoracic nerve
Axillary nerve

Answer 299

A

the fracture is in which of the following?

L1
L2
L3
L4
L5

The vertebral body of L3 does not appear as uniform as its neighbours - it is smaller and irregular. We can identify it as L3 by counting the levels up from the sacrum.

This type of fracture is known as a wedge fracture, and in the absence of trauma in an older person, may be one of the first signs of osteoporosis. Osteoporosis primarily affects trabecular bone, which makes up the majority of the vertebral body hence, the body becomes weaker, bows in the middle, and forces are directed to the periphery. Continued force on a weak vertebral body may cause it to crush.

Answer 300

A

A 19-year-old man presents to the GP with loss of sensation laterally to his left forearm following a weight-lifting session. On examination, the biceps reflex in his left arm is diminished.

Which nerve roots are most likely affected?

C1, C2
C3, C4
C5, C6
C7, C8
T1, T2

Answer 301

A

teres minor
infraspinatous

Answer 302

A

which muscle causes flexion of the DIP?

*a) flexor digitorum profundus**
b) flexor digitorium superficialis
c) flexor carpi radialis
d) pronator teres
e) flexor capri ulnaris

Answer 303

A

on the anterior side of the scapula, which is present?

a) suprascapular fossa
* *b) subscapularis fossa**
c) infrascapular fossa
d) acrominion

Answer 304

A

Which type of synovial joint does the first carpometacarpal joint (articulatio carpometacarpalis pollicis) belong to?

*- saddle**
hinge
ellipsoid
planar
pivot

Answer 305

A

what type of joint is MCP?

a) saddle
b) pivot
c) planar
d) hinge
e) condyloid

Answer 306

A

What is the sensory distribution of this nerve

It does not have a sensory branch
Medial aspect of the thigh
plantar surface of the foot
dorsum of the foot

The nerve wrapping around the fibular neck is the common peroneal nerve. The common peroneal nerve splits into the superficial and deep peroneal branches. These branches provide motor supply to the lateral and anterior compartments respectively.

They also have a sensory component which is distributed across the skin on the lateral aspect of the leg and the dorsum of the foot.

Answer 307

A

which nerve is most likely to be affected by a herniated disc?

common peroneal
tibial nerve
*- sciatic nerve**
femoral nerve
vagus nerve

Answer 308

A

Which nerve would you find in the region highlighted in yellow on the image below?

Ulnar nerve
Median nerve
Axillary nerve
Radial nerve

Answer 309

A

Which of the muscles below does not cause lateral rotation of the hip?

Obturator internus
Quadrartus femoris
Gemellus inferior
Piriformis
Pectineus

Answer 310

A

Alice, a 54-year-old female, is recovering on the orthopaedic ward following internal fixation of a tibia fracture. She suddenly complains of increasing pain in her lower limb.

With the recent history and the cast on her leg, the ward doctor suspects compartment syndrome. He removes the cast and the intracompartmental pressure in the anterior compartment is greater than 30mmHg (critical).

Considering the fascial compartment affected, what nerve is most likely to be at risk without emergency management?

Deep peroneal nerve
Superficial peroneal nerve
Tibial nerve
Lateral cutaneous nerve
Medial cutaneous nerve

Answer 311

A

what do the arrows depcit?

sclerotic lesions of bone
periosteal reaction
lucent lesions of bone
osteopenia
osteonecrosis