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Clinical cases for Quiz 1

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Anatomy- Clinical cases for Quiz 1- PMU

Question 1 of 18

1

A patient complains of pain on the lower left side of her back. A radiograph confirms a hernia passing posterolaterally immediately superior to the iliac crest. This hernia passes through the

Select one of the following:

  • Lumbar triangle

  • Triangle of auscultation

  • Inguinal triangle

  • Triangle of Calot

  • Greater sciatic foramen

Explanation

Question 2 of 18

1

Fill the blank space to complete the text.

During a triathalon biking accident, a rider fell and landed with the handle bar of her bike forced upward into her right axilla. Subsequently while swimming in another triathalon event she found that her right arm tired so badly during the swimming portion that she could barely finish the event. During examination it was found that movements involving adduction, medial rotation and extension of her arm were particularly weak and affected her swimming stroke. The nerve injured was the

Explanation

Question 3 of 18

1

Fill the blank space to complete the text.

After a penetrating wound in the area of the posterior axillary fold a patient had weakness in extension and adduction of the arm. Which muscle is likely involved?

Explanation

Question 4 of 18

1

Fill the blank space to complete the text.

While wandering around in the dark in an unfamiliar home, a visitor accidentally walks into a plate glass door. The door shatters and a shard of glass severs the posterolateral aspect of the woman's neck. Examination reveals that the she is unable to elevate the tip of her shoulder on the injured side. The nerve injured the

Explanation

Question 5 of 18

1

Fill the blank space to complete the text.

A person receives a laceration along the anterior border of the trapezius muscle in the neck and subsequently the point of his shoulder (scapula) sags and he has some difficulty fully abducting his arm. What nerve appears to have been severed? The

Explanation

Question 6 of 18

1

A 33-year-old woman underwent partial thyroidectomy for hyperthyroidism in which the thyroid failed to take radioactive iodine. She is noted to have some hoarseness of voice 1 month later. Which of the following is the more likely explanation?

Select one of the following:

  • Endotracheal tube trauma to the vocal cords

  • Injury to the cricoid cartilage

  • Injury to the thyroid cartilage

  • Injury to the recurrent laryngeal nerve

Explanation

Question 7 of 18

1

A 15-year-old boy is eating a fish dinner and inadvertently has a bone ”caught in his throat." He complains of significant pain above the vocal cords. Which of the following nerves is responsible for carrying the sensation for this pain?

Select one of the following:

  • Superior laryngeal nerve

  • Recurrent laryngeal nerve

  • Spinal accessory nerve

  • Hypoglossal nerve

Explanation

Question 8 of 18

1

A 25-year-old woman underwent surgery for a thyroid nodule. Two months later, she complains of dryness of skin and muscle spasms.
Which of the following is the most likely explanation?

Select one of the following:

  • Low serum magnesium

  • Low serum calcium

  • Low serum potassium

  • Low serum sodium

  • Low serum glucose

Explanation

Question 9 of 18

1

A 54-year-old woman has undergone partial thyroid resection due to a nontender cold nodule that likely represents cancer. One week after surgery, she complains of twitching of the right arm and "spasms" of both hands. Which of the following is the most likely explanation?

Select one of the following:

  • Anxiety after surgery

  • Effects of anesthesia

  • Parathyroid glands removed

  • Vagal nerve injury

Explanation

Question 10 of 18

1

A 2-year-old girl is diagnosed with torticollis involving the right (sternocleidomastoid m.) SCM.
Which of the following describes the most likely anatomical change?

Select one of the following:

  • Head flexed forward in the midline

  • Head rotated to the right

  • Head rotated to the left

  • Head extended in the midline plane

Explanation

Question 11 of 18

1

A 24-year-old football player receives a blow to the left skull, and the team physician finds weakness of the left SCM. Which of the following associated findings is most likely to be seen in this patient?

Select one of the following:

  • Weakness of the masseter muscle

  • Decreased sensation of the ipsilateral face

  • Decreased tearing from the ipsilateral eye

  • Weakness of the trapezius muscle

Explanation

Question 12 of 18

1

A clinician is palpating the anterior neck of a patient who has been involved in a motor vehicle accident and notes the laryngeal prominence.
Which of the following describes the anatomical structure that corresponds to this prominence?

Select one of the following:

  • Thyroid cartilage

  • Cricoid cartilage

  • Hyoid bone

  • First tracheal ring

Explanation

Question 13 of 18

1

A 45-year-old woman is undergoing thyroid surgery for suspected thyroid cancer. The surgeon has taken a midline approach and encounters significant bleeding below the isthmus of the thyroid gland. Which of the following is the likely cause of the bleeding?

Select one of the following:

  • Penetration into the trachea

  • Superior thyroid artery

  • Inferior thyroid artery

  • Thyroid ima artery

  • Inferior laryngeal artery

Explanation

Question 14 of 18

1

An emergency cricothyroidotomy is thought to be warranted due to airway collapse and severe laryngoedema. Which of the following is the most accurate description of the location of the cricothyroid membrane?

Select one of the following:

  • Immediately superior to the thyroid cartilage

  • Immediately inferior to the thyroid cartilage

  • lmmediately inferior to the cricoid cartilage

  • Just deep to the isthmus of the thyroid gland

  • Immediately inferior to the hyoid bone

Explanation

Question 15 of 18

1

Following thyroid surgery, it was noted that a patient frequently aspirated fluid into her lungs. Upon examination it was determined that the area of the piriform recess above the vocal fold of the larynx was numb. What nerve may have been injured?

Select one of the following:

  • External branch of the superior pharyngeal

  • Hypoglossal

  • Internal branch of the superior laryngeal

  • Lingual

  • Recurrent laryngeal

Explanation

Question 16 of 18

1

Fill the blank space to complete the text.

In the process of doing an axillary lymph node dissection in a 50 year-old patient, the surgery resident cleans the space between the pectoralis major and minor muscles, in an attempt to remove all of the lateral pectoral lymph nodes. Upon recovery it is noted that the patient‘s lower pectoralis major is paralyzed. The nerve most likely injured is the

Explanation

Question 17 of 18

1

Fill the blank space to complete the text.

Postoperative examination revealed that the medial border and inferior angle of the left scapula became unusually prominent (projected posteriorly) when the arm was carried forward in the sagittal plane, especially if the patient pushed with outstretched arm against heavy resistance (e.g., a wall). What muscle must have been denervated during the axillary dissection?

Explanation

Question 18 of 18

1

The prognosis in breast cancer is poorer as more proximal lymph nodes are found to have cancerous cells in them.
Spread of cancer to which of the following axillary nodes would indicate the worst prognosis?

Select one of the following:

  • apical

  • central

  • lateral

  • pectoral

  • subscapular

Explanation

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