Loco Qs Flashcards

Question

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 1

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 2

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

Answer 3

_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 4

which three nerves are involved in moving muscles of the hand? musculocutaneous **median** **ulnar** axillary **radial**

Answer 5

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 6

which of the following is the only articulation between upper limb and axial skeleton? * *- sternoclavicular joint** - acromiclavicular joint - glenohumeral joint - scapulothrocic joint

Answer 7

which dermatome do your legs lie on when sleeping? S1 **S2** S3 S4 S5

Answer 8

which type of cartilage is intensely eosinophilic (stained by eosin)? - elastic cartilage * *- fibrocartilage** - hyaline cartilage

Answer 9

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.**

Answer 10

what type of joint is atalato-occipital joint? hinge plane **condyloid** saddle pivot

Answer 11

what is the nerve supply to the muscle labelled A? medial pectoral nerve musculocutaneous nerve axillary nerve **accessory nerve** thoracodorsal nerve

Answer 12

which muscle is the main muscle of forearm flexion? pronator teres flexor carpi radialis **pronator quadratus** flexor carip ulnaris brachioradialis

Answer 13

what is the zone within the epiphyseal growth plate shown on the right? proliferation resting maturation calcification **hypertrophy / degeneration**

Answer 14

which of the following best describes botulinis toxins effect on Ach-Receptor? - agonist - antagonist - depolarisng blocker * *- release inhibitor** - synthesis inhibitor

Answer 15

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)**

Answer 16

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

Answer 17

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**

Answer 18

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 19

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 20

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 21

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.**

Answer 22

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**

Answer 23

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 24

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 25

What level do you find the iliac crest? L1 L2 L3 **L4** L5

Answer 26

which of the following best describes tubocurarine on Ach receptor? - agonist * *- antagonist** - depolarisng blocker - release inhibitor - synthesis inhibitor

Answer 27

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 28

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

Answer 29

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 30

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 31

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 32

Which structure secretes the synovial fluid into the synovial joint? articular capsule articular cartilage **synovial membrane** articular disc

Answer 33

damage to which nerve would cause you to see B ? - posterior tibial nerve - anterior tibial nerve - superficial peroneal nerve * *- common peroneal nerve**

Answer 34

which nerve has been affected here? a) Musculocutaneous b) Axillary c) Median d) Radial * *e) Ulnar**

Answer 35

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 36

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 37

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 38

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 39

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 40

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 41

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 42

which of the following has heart shaped vertebral body? - cervical * *- thoracic** - lumbral - sacral - coccyx

Answer 43

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 44

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 45

Which type of synovial joint can move around three axes? - saddle - hinge - ellipsoid - planar * *- ball & socket**

Answer 46

What is the cell indicated by the arrow? 1. chondroblast 2. chondrocyte 3. osteoblast **4. osteoclast** 5. osteocyte 6. osteoprogenitor

Answer 47

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 48

carpo-metacarpal

Answer 49

what type of joint is the radiocarpal? a) hinge b) pivot c) planar d) saddle * *e) condyloid**

Answer 50

what movements does carpo-metacarpal permit? flexion extension abduction **opposition** adduction

Answer 51

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 52

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 53

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 54

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

Answer 55

which of the following best describes joint A? **synchrondrosis** syndemosis synostosis symphysis gomphosis syndrondosis

Answer 56

_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 57

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 58

what type of joint is atalato-occipital joint? hinge plane **condyloid** saddle ball and socket

Answer 59

Which one of the following represents the root values of the sciatic nerve? **L4-S3** L1-L4 L3-S1 S1-S4 L5-S1

Answer 60

which type of imaging is used as a guide to therpeautic interventions? - x-ray - MRI - CT scan - PET scan * *- ultrasound**

Answer 61

_Which nerve supplies brachioradialis?_ **Radial nerve** Median nerve Ulnar nerve Long thoracic nerve Musculocutaneous nerve

Answer 62

which nerve do you test by asking a patient to abduct and adduct their fingers? musculocutaneous median **ulnar** axillary radial

Answer 63

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 64

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 65

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 66

**Greater tuberosity**

Answer 67

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 68

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 69

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 70

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 71

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 72

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 73

_Which nerve supplies extensor carpi radialis longus?_ Ulnar nerve Musculocutaneous nerve Median nerve Long thoracic nerve **Radial nerve**

Answer 74

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 75

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 76

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 77

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

Answer 78

which of the following are sources of the axillary nerve? - C8-T1 - C7-T1 * *- C5-C6** - C5-C7 - C5-T1

Answer 79

Which one of the following muscles does not adduct the shoulder? Teres major Pectoralis major Coracobrachialis **Supraspinatous - abducts** Latissimus dorsi

Answer 80

which joint initiates shoulder elevation? [1] **glenohumeral** which one assists after the first 30 degrees? [1] **sternothoracic**

Answer 81

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 82

overproduction of bone

Answer 83

what type of jont does the arrow point to? symphysis syndesmosis **synostosis** synchondrosis gomphosis

Answer 84

which nerve is vulnerable to mid-humeral shaft fracture? - Muscularcutaneous - axillary - median **- radial** - ulnar nerve

Answer 85

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 86

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 87

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 88

which of the following bones undergoes intramembranous ossification? a) tibia b) sternum c) manubrium * *d) vomer** e) maxilla

Answer 89

Which of the structures listed below articulates with the head of the radius superiorly? **Captiluum** Ulna Medial epicondyle Trochlea Lateral epicondyle

Answer 90

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 ## Footnote **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 91

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 92

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 93

Which nerve derives from L4-S3? Femoral nerve Vagus nerve lateral femoral cutaneous nerve saphenous nerve **sciatic nerve**

Answer 94

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 95

which of the following best describes this joint? **synchrondrosis** syndemosis synostosis symphysis gomphosis syndrondosis

Answer 96

What is the tissue indicated by the arrow? it comes from a developing skull 1. Bone 2. Bone marrow 3. Elastic cartilage 4. Fibrocartilage **5. Fibrocollagenous tissue** 6. Hyaline cartilage

Answer 97

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

Answer 98

_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 99

Which of the following inserts onto the lesser trochanter? Psoas minor **Psoas major** Sartorius Obturaror externus Gemellus

Answer 100

what structure is preventing damage to the spinal cord? - ligamentum flavum - dens * *- transverse ligament**

Answer 101

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 102

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 103

_Which nerve supplies adductor pollicis?_ Long thoracic nerve Radial nerve **Ulnar nerve** Median nerve Musculocutaneous nerve

Answer 104

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

Answer 105

what type of joint is A? symphysis **syndesmosis** synostosis synchondrosis gomphosis

Answer 106

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 107

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 108

_Which nerve supplies abductor pollis brevis?_ Musculocutaneous nerve **Median nerve** Radial nerve Ulnar nerve Long thoracic nerve

Answer 109

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 110

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

Answer 111

_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 112

## Footnote _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 113

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 114

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 115

A = secondary ossification centre

Answer 116

mid-humeral shaft fracture is a risk of damaging which nerve? musculocutaneous median ulnar axillary **radial**

Answer 117

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 118

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 119

which nerve has being tested here? a) Musculocutaneous b) Axillary c) Median * *d) Radial** e) Ulnar

Answer 120

carpo-metacarpal joint [1]

Answer 121

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 122

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 123

2 breaks nerves: * *axillary (red)** * *radial (yellow)**

Answer 124

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 125

none of the _intrinsic muscles_ _of the hand_ are innervated by which nerves? **musculocutaneous** median ulnar **axillary** **radial**

Answer 126

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 127

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

Answer 128

which artery is commonly used to gain access to abdominal aorta? - descending aorta * *- femoral artery** - hepatic artery proper - common iliac artery

Answer 129

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 130

bicep brachii attaches distally to: a) humerus **b) radius** c) ulnar d) coracoid process e) scapular

Answer 131

_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 132

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 133

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 134

which of the following is the M line? A B **C** D E

Answer 135

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 136

_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 137

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 138

_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 139

Mnemonic for radial nerve muscles: BEST B rachioradialis E xtensors S upinator T riceps

Answer 140

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 141

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 142

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 143

Which muscle initiates abduction of the shoulder? Infraspinatus Latissimus dorsi **Supraspinatus** Deltoid Teres major

Answer 144

**subscapularis**

Answer 145

_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 146

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 147

which of the following best describes carbachol on Ach receptor? * *- agonist** - antagonist - depolarisng blocker - release inhibitor - synthesis inhibitor

Answer 148

which best describes the arrow? sclerotic lesions of bone periosteal reaction **lucent lesions of bone: dark areas in bone** osteopenia osteonecrosis

Answer 149

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 150

**anterior iliofemoral ligament -** makes anterior side more stable than posterior

Answer 151

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 152

Which types of synovial joints allow movement around two axes? [2] * *- saddle** - hinge * *- ellipsoid** - planar - pivot

Answer 153

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 154

which of the following is the I band? A B C D **E**

Answer 155

which dermatome covers the big toe? L4 **L5** S1 S2 S3

Answer 156

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 157

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 158

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 159

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 160

*Acceptable responses*: nucleus pulposus, nucleus pulposis

Answer 161

which type of imagine is best for seeing bone fractures? - x-ray - MRI * *- CT scan** - PET scan - ultrasound

Answer 162

*Abduction of the thumb, and opposition of the thumb.*

Answer 163

What does the arrow indicate in this developing foot? **Bone** Epithelium Fibrocollagenous tissue Hyaline cartilage Nutrient artery

Answer 164

which vertebral levels are iliac crest? L1 L2 L3 **L4** L5

Answer 165

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 166

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 167

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 168

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 169

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

Answer 170

which ligament supports C1-C2 joint? - anterior longitudinal ligament - posterior longitudinal ligament - ligamentum flavum - interspinous ligament

Answer 171

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

Answer 172

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 173

what type of joint is highlighted? **pivot: annular ligament = creates pivot joint !!** saddle condyloid hinge ball and socket

Answer 174

the hip joint is most stable in which position? a) flexion **b) extension** c) adduction d) adduction e) internal rotation

Answer 175

which ligament is damaged here? * *- posterior cruciate ligament** - anterior cruciate ligament - medial collateral ligament - lateral collateral ligament

Answer 176

which rotator muscle is most likely to have a tear occur ? a) teres minor b) supraspinatous c) infraspinatous * *d) subscapularis** e) serratus anterior

Answer 177

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 178

what type of joint is DIP? a) saddle b) ball and socket c) planar * *d) hinge** e) condyloid

Answer 179

which out of skeletal, cardiac and smooth muscle has two muscle layers? skeletal cardiac **smooth - circ and long**

Answer 180

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 181

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 182

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 183

what type of joint is A? a) saddle b) ball and socket * *c) planar** d) hinge e) condyloid

Answer 184

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 185

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** ## Footnote **wraps around the neck of the fibula - vulnerable to fracture !**

Answer 186

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 187

which nerve has being tested here? a) Musculocutaneous b) Axillary c) Median d) Radial * *e) Ulnar**

Answer 188

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 189

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 190

``` A = Radial nerve B = Ulnar nerve & Median ```

Answer 191

**femur has moved backwards!** popliteal artery sciatic nerve common peroneal vein cruciate ligaments collateral ligaments menisci

Answer 192

which is the primary muscle of scapular protraction? a) teres minor b) subscapularis * *c) serratus anterior** d) rhomboids e) pec major

Answer 193

Which one of the following muscles does not attach to the radius Pronater quadratus Biceps Brachioradialis Supinator **Brachialis**

Answer 194

which nerve is likely to be affected by herniated disc? **sciatic nerve** femoral nerve vagus nerve common peroneal nerve

Answer 195

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 196

which of the following nerves causses foot drop when injured? obturator nerve saphenous nerve femoral nerve tibial nerve **common fibular nerve**

Answer 197

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 198

how long does it take for osteoblasts mineralise the unminerilased matrix? [1] **7-10 days**

Answer 199

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 200

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

Answer 201

excessive lordosis is caused by increased curvature in which thoracic region? - cervical - thoracic * *- lumbral L4L** - sacral - coccyx

Answer 202

what is the tissue indicated by the arrow? compact bone fibrocartilage fibrocolllagenous tissue hyaline cartilage **trabecular bone**

Answer 203

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

Answer 204

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 205

which of the following best describes Ach on Ach receptor? * *- agonist** - antagonist - depolarisng blocker - release inhibitor - synthesis inhibitor

Answer 206

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 207

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

Answer 208

L type calcium channels [2] **heart vascular smooth muscle** N type calcium channels [1] **pre-synaptic terminals**

Answer 209

_Inhibits inflammatory and immune responses:_ Somatostatin Secretin Glucagon Antidiuretic hormone CCK **Cortisol**

Answer 210

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 211

which is the most superficial out of the following **a) bicep brachii** b) brachialis c) coracobrachialis

Answer 212

which muscle do the lumbricals arise from? * *- flexor digitorum profundus** - brachialis - flexor digitorum superficialis - palmaris longus - flexor carpi ulnaris

Answer 213

Which nerve does the saphenous nerve arise from? obturator nerve tibial nerve **femoral nerve** sciatic nerve genitofemoral nerve

Answer 214

_Which nerve supplies extensor pollicis longus muscle?_ Ulnar nerve Long thoracic nerve **Radial nerve** Median nerve Musculocutaneous nerve

Answer 215

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 216

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 217

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 218

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 219

which of the following is the Z line? **A** B **C** D E

Answer 220

_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 221

_Which nerve supplies biceps brachii?_ Radial nerve **Musculocutaneous nerve** Median nerve Ulnar nerve Long thoracic nerve

Answer 222

what type of joint is between radius and annular ligament of the ulna?? a) saddle b) **pivot** c) planar d) hinge e) condyloid

Answer 223

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 224

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 225

where does the aorta bifuricate into common iliac artery? - L1 - L2 - L3 * *- L4** - L5

Answer 226

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 227

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 228

which type of cartilage is found in invertebral discs? - elastic cartilage * *- fibrocartilage** - hyaline cartilage

Answer 229

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 230

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 231

which nerve has had an injury in this photo? musculocutaneous **median** ulnar axillary radial

Answer 232

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 233

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 234

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 235

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).** ## Footnote **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 236

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 237

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 238

What tissue is indicated by the blue arrow? 1. endomysium 2. endosteum 3. perichondrium 4. perimysium * *5. periosteum**

Answer 239

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

Answer 240

_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 241

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

Answer 242

this patient has shingles predominately in which dermatome? S1 S2 **S3** S4 S5

Answer 243

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 244

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 245

what type of joint is carp-metacarpal? a) condyloid b) hinge c) ball & socket * *d) saddle** e) pivot

Answer 246

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 247

_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 248

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

Answer 249

which rotator cuff muscle is locted anteriorly? a) teres minor b) supraspinatous c) infraspinatous **c) subscapularis**

Answer 250

*Acceptable responses:* tibial, tibial nerve

Answer 251

which joint in the body is the most mobile? a) knee b) hip c) MCP d) elbow * *e) shoulder**

Answer 252

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 253

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 254

which best describes the joint shown in the picture? synchrondrosis **syndemosis** synostosis symphysis gomphosis syndrondosis

Answer 255

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 256

which rotator cuff muscle attaches to the lesser tubercle?? a) teres minor b) supraspinatous c) infraspinatous * *d) subscapularis** e) serratus anterior

Answer 257

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 258

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 259

which nerve has being tested here? a) Musculocutaneous b) Axillary * *c) Median** d) Radial e) Ulnar

Answer 260

J. Developing bone: The tissue at the arrow is… 1. Compact bone 2. Dense irregular fibrocollagenous tissue **3. Hyaline cartilage (calcified)** 4. Hyaline cartilage (normal) 5. Trabecular bone

Answer 261

which is the longest nerve in the body? a) femoral nerve b) median nerve c) ulnar nerve * *d) sciatic nerve**

Answer 262

_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 263

which of the following best describes this joint? synchrondrosis syndemosis synostosis **symphysis : made from fibrocart** gomphosis syndrondosis

Answer 264

*Weakness in flexion, adduction and internal rotation.*

Answer 265

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

Answer 266

which of the following is the H band? A B C **D** E

Answer 267

* 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 268

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

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 270

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 271

what is the structure in the centre of the field? canaliculus diaphysis epiphyseal plate **osteon** osteoid periosteum

Answer 272

which nerve, when hit, is commonly caused the funny bone? - muscularcutaneous - axillary - median - radial * *- ulnar nerve**

Answer 273

excessive kyphosis is caused by increased curvature in which thoracic region? - cervical - **thoracic** - lumbral - sacral - coccyx

Answer 274

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 275

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 276

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 277

teres minor infraspinatous

Answer 278

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 279

on the anterior side of the scapula, which is present? a) suprascapular fossa * *b) subscapularis fossa** c) infrascapular fossa d) acrominion

Answer 280

Which type of synovial joint does the first carpometacarpal joint (articulatio carpometacarpalis pollicis) belong to? * *- saddle** - hinge - ellipsoid - planar - pivot

Answer 281

what type of joint is MCP? a) saddle b) pivot c) planar d) hinge e) **condyloid**

Answer 282

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 283

which nerve is most likely to be affected by a herniated disc? - common peroneal - tibial nerve * *- sciatic nerve** - femoral nerve - vagus nerve

Answer 284

Which nerve would you find in the region highlighted in yellow on the image below? Ulnar nerve **Median nerve** Axillary nerve Radial nerve

Answer 285

Which of the muscles below does not cause lateral rotation of the hip? Obturator internus Quadrartus femoris Gemellus inferior Piriformis **Pectineus**

Answer 286

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 287

what do the arrows depcit? **sclerotic lesions of bone** periosteal reaction lucent lesions of bone osteopenia osteonecrosis