A phlebotomist attempts to draw venous blood from a vein in a patient’s cubital fossa. The punctured vessel squirts blood with every heartbeat. What structure did the phlebotomist damage?
Superficial ulnar artery
Deep brachial artery
Posterior interosseus artery
Median cubital vein
A 32-year-old male carpenter presents to your office complaining of a weakness with abduction of the arm. The weakness is most pronounced between 30-90 degrees. Injury to which nerve results in this presentation?
A 45-year-old female sustains a bone fracture depicted in the attached image. Which nerve is most likely to be damaged as a result of the fracture?
Dorsal scapular nerve
Lateral cutaneous nerve of the arm
Recurrent branch of the median nerve
What muscle has its distal attachment at the area indicated by the arrow?
Extensor carpi ulnaris
Fourth dorsal interosseus
A 6-year-old falls from a swing and onto her elbow. Immediately following the fall, her mother notices a gross deformity at the elbow. A fracture through the supracondylar region of the humerus (just proximal to elbow) is identified on x-ray and a manipulation is performed to restore alignment of the bone. Immediately following the re-alignment of the humeral fracture no radial or ulnar pulse is palpable. Which structure is most likely trapped in the fracture?
A neurological exam reveals signs of multiple sclerosis in a patient. The patient is referred to a radiologist, who uses MRI to search for lesions in the cervical spinal cord. Which of the following image planes would most likely reveal the lesions?
A coronal plane through the eyes
A horizontal plane through the tip of the nose
A parasagittal plane through the left eye
A transverse plane through the ears
The median sagittal plane
Bifid spinous processes and foramina transversarii are characteristic of which type of vertebrae?
A driver sustains a whiplash injury in an accident with another vehicle. His physician explains that, as his head jolted backwards, the joints of his neck were hyperextended. This movement most likely caused strain in which of the following ligaments?
Anterior longitudinal ligament
Posterior longitudinal ligament
A pediatrician examines a 6-month-old female infant. The parents report that the baby crawls frequently, but that she has not tried standing or walking, even with the assistance of furniture. In which region of the vertebral column would the pediatrician most likely find a lordosis?
An accident victim presents to the emergency department supine on a stretcher, with both arms folded across his chest. In this position, his wrist lies ____ to his elbow.
Damage to the cardiopulmonary splanchnic nerves would most likely affect which of the following types of axons?
post ganglionic parasympathetic
To control excessive sweating of the armpits and palms, a surgeon performs a trans-thoracic sympathectomy to selectively destroy cell bodies of neurons that innervate sweat glands. These cells are located in the:
Dorsal root ganglion
Dorsal horn of spinal cord
Cardiopulmonary splanchnic nerve
The celom spaces for the guts and the lungs are formed by the:
Epaxial somite cells
Lateral plate mesoderm
Hypaxial somite cells
Which of the following is a location where ectoderm contacts endoderm without mesoderm in between?
In the adult, the notochord differentiates into the:
Bony vertebral bodies
Nuclei pulposi of the intervetebral discs
Transverse vertebral processes and ribs
Which joint has the widest range of motion for the following actions: flexion, circumduction, adduction, rotation?
Humero-radial part of the elbow
A 12-year-old boy is riding his bicycle and stops a fall by landing on his hands and knees. His right wrist is in pain and X-ray reveals a hairline fracture at the distal end of his radius. You express concern to his parents that injury to the epiphysis could result in abnormal or terminated growth there, which would result in which of the following:
The right radius would become shorter than the left radius
The affected radius would become thicker than normal
The head of the radius may not rotate on the capitulum of the humerus
The interosseus membrane would not form
A displacement of the ulnar artery
Axons from which spinal cord segment(s) is/are found in the axillary nerve of an anatomically normal brachial plexus?
C5, C6, C7, C7, and T1
C7, C8, T1
A 23-year-old male is brought to the emergency department with a stab wound penetrating the anterior surface of his right arm 2 inches distal to the glenohumeral joint. Based on the size, depth and location of the wound, you are concerned that nerve damage has occurred. If permanent nerve damage has occurred, which of the following muscles has most likely lost function?
medial head of triceps brachii
A 10-year-old boy crashes in a bicycle race. He complains of severe pain when moving his left shoulder and arm. Radiography reveals a fracture of the greater tubercle of the humerus. He demonstrates significant weakness when laterally rotating and abducting his arm. Which muscle may be impaired as a direct result of the fracture?
A preschooler complains of pain in her right elbow. She says it began to hurt when her father picked her up by the arm. She is afraid to use her arm and she holds it with the elbow flexed and forearm pronated. Upon examination you notice a prominent bulge on the lateral side of her elbow. What is the most likely cause of the bulge?
Dislocation of the radial head
Dislocation of the glenohumeral joint
Dislocation of the ulna
Fracture of the medial epicondyle
Separation of the acromioclavicular arety
A 20-year-old female fell from the parallel bars during a gymnastics competition. A neurological examination reveals that she has a lesion of the lateral cord of the brachial plexus. Which of the following muscles is weakened as a result of this injury?
Which of the following structures of the dura mater can be found between the cerebrum and cerebellum?
Superior sagittal sinus
A pituitary tumor has grown to the point where it is affecting a nearby cranial nerve. Which of the following cranial nerves is closest to the pituitary and would be most likely affected in some way?
Spinal accessory nerve
Which of the following bones contributes to the inner surface of the cranial fossa?
What cranial nerve provides visceral efferent innervation to the lacrimal gland?
Which of the following muscles is innervated by the external laryngeal nerve?
Which of the following muscles is a longitudinal muscle of the pharynx?
Inferior pharyngeal constrictor
Superior pharyngeal constrictor
Middle pharyngeal constrictor
After the removal of a brain tumor from the inferior surface of the frontal lobes, it appears that the damage done to the walls of the cribriform plate has resulted in lesions to nerves passing between their foramina. The nerve most likely to have been injured is part of what cranial nerve?
Optic nerve (CN II)
Olfactory nerve (CN I)
Facial nerve (CN VII)
Glossopharyngeal nerve (CN IX)
Trigeminal nerve (CN V)
A woman’s husband comments that she snores, and when you ask her to close her mouth and breathe she has trouble. You squint your eye, and ask her to copy your action, but she cannot. You suspect that she lacks control over the orbicularis oculi muscles. A portion of what cranial nerve is most likely dysfunctional?
Vagus nerve (CN X)
Hypoglossal nerve (CN XII)
A patient recovering from a virally induced Bell’s palsy presents with an unusual circumstance in which he sheds tears when he is eating, known as “crocodile tears syndrome”. The improperly healed nerve connections he has experienced have resulted in parasympathetics that normally go to ____________ to be redirected to _______________.
Lacrimal glands; salivary glands
Sweat glands; salivary glands
Salivary glands; lacrimal glands
Lacrimal glands; sweat glands
Sweat glands; lacrimal glands
A 19-year-old college student presents to the emergency department with lacerations to his face around his cheeks after being hit by a car. You proceed to suture the laceration which requires repair of arterial damage. After recovery, he complains of uneven blushing of his cheeks. A lesion to which of thefollowing nerve structures is most likely the cause of these symptoms?
External carotid plexus
Internal carotid plexus
Nerve of the pterygoid canal
A patient with a history of chewing tobacco presents with complaints of trouble swallowing. After examination, it is clear that he has trouble constricting his pharynx during swallowing. What cranial nerve is responsible for constricting the pharynx and is resulting in this man’s dysphagia?
A patient presents with an extreme case of herpes zoster virus infection that has spread to the trigeminal ganglion. It appears that one of its external manifestations is that a group of vesicles has erupted in the cornea, causing corneal ulcerations. Which of the following nerves is directly involved in this corneal ulceration?
After a surgical procedure that removed a tumor from the parotid gland, a patient presents with difficulty moving his eyebrows and wrinkling the skin of his forehead. Which nerve most likely has been affected by the surgery?
Cervical branch of facial nerve
Temporal branch of facial nerve
A cyclist that was the victim of a hit and run is brought unconscious into the emergency department. To evaluate for elevated intracranial pressure, you inspect his eyes with an ophthalmoscope and note signs of papilledema. Which nerve is directly visualized on this examination?
A college student at a concert is enthusiastically dancing and shaking his head when he suddenly feels extremely dizzy and drops to the floor. He has not had any alcohol or drugs, nor has he been injured by another person. After getting up, he explains that he was shaking his head and the symptoms happened suddenly. What organ’s dysfunction is most likely responsible for this?
A 17-year-old female regains consciousness after surviving an automobile accident. You examine her and observe ptosis of the right eyelid, and she is not able to voluntarily lift that eyelid. When you manually raise the eyelid, she complains of double vision. You note that the eye is depressed and abducted, and the patient is not able to appreciably move her eye from this position. What structure is most likely affected?
Oculomotor nerve proximal to division
Only the superior division of the oculomotor nerve
Only the inferior division of the oculomotor nerve
If you tilt your head to your right side, which muscle facilitates extorsion of the left eye while at the same time preventing depression of the left eye?
A 23-year-old male is hospitalized and undergoing treatment to resolve a clot and infection in the cavernous sinus. You are evaluating the patient and discover he is unable to abduct his right eye. What structure is most likely affected?
Lateral rectus muscle
Superior oblique muscle
Medial rectus muscle
Which of the following muscles is innervated by the facial nerve (CN VII)?
Anterior belly of digastric
The infraorbital nerve passes through which bone?
Which of the following is typically a branch of the thyrocervical trunk?
Supreme intercostal artery
Internal thoracic artery
Ascending cervical artery
Deep cervical artery
Which of the following structures represents the involuted (obliterated; closed-off) umbilical vein, running in the free inferior margin of the falciform ligament from the umbilicus up to the liver?
Medial umbilical ligament
Median umbilical ligament
Lateral umbilical fold
Which of the following arteries is typically a direct branch of the posterior division of the internal iliac artery?
Superior gluteal artery
Inferior epigastric artery
Superior vesical artery
The levator ani musculature takes origin in part from a fibrous band called the:
A mosquito lands on the forehead of a male professor and bites him 1 cm above the medial end of the eyebrow. The pain of this bite and subsequent itch are sensed via which nerve?
Greater occipital nerve
The lesser and greater peritoneal sacs connect to one another via the:
Omental foramen (of Winslow)
Left colic gutter
A pathologist is presented with a section of diseased bowel that was resected in the operating room earlier that morning. The documentation does not indicate where the specimen was taken; however, the pathologist notices the presence of encroaching mesenteric fat, multiple arterial arcades, short vasa recta, and a relatively smooth internal mucosa with a few widely-spaced circular folds. The specimen most likely came from the:
Within the kidney, two or three major calyces come together to drain urine into the:
A patient with a severe sinus infection exhibits signs of the infection spreading to the eye. Which of the following is the more likely path along which the infection spread?
A patient presents with a laceration to the neck that reaches the external surface of the sternocleidomastoid muscle, but no deeper. There is a moderately sized vessel that was severed and is bleeding. What is this vessel?
External jugular vein
Internal jugular vein
Anterior jugular vein
Transverse cervical nerve
Common carotid artery
Which of these structures is secondarily retroperitoneal?
Which labeled structure is the esophagus? (Please see attachment)
Which of the following is a characteristic of the peritoneum?
Pain from the para-umbilical parietal peritoneum is referred to the shoulder
Parietal peritoneum is insensitive to pressure, pain, and laceration
The peritoneal cavity is completely closed in females
The peritoneal cavity is completely closed in males
Visceral peritoneum is sensitive to heat, cold, and laceration
A 23-year-old man with no history of abdominal trauma has received a stab wound to the abdomen two centimeters to the left of the umbilicus. The knife penetrated approximately eight centimeters into the peritoneal cavity and was directly anteroposteriorly oriented. The blade missed all of the major arteries, but punctured the underlying structures. Which of the following best describes the nature of the injury with respect to the underlying abdominal structures? (Please see attachment)
Structures receiving blood from the celiac trunk will be affected
Structures receiving blood from the inferior mesenteric artery will be affected
The knife punctured the ileum just medial to the ascending colon
The knife punctures the cecum lateral to the ileo-cecal junction
The third and fourth parts of the duodenum were punctured
A 30-year-old female arrives at the hospital following an automobile accident. You discover that the palate and upper teeth are moving separate from the rest of the face. The zygomatic arches and nose are not moving with the palate. Where is the posterior end of the fracture most likely to be?
Pterygoid plates of sphenoid
Superior orbital fissure
A 52-year-old male patient has a persistent infection of the skin on the right upper lip that has not resolved with antibiotics. Now you discover that the infection has spread to the cavernous sinus, but not the pterygoid plexus of the infratemporal fossa. Which of the following is the most likely route by which the infection spread to the cavernous sinus?
Inferior ophthalmic vein
Inferior petrosal sinus
An MRI shows a white mass located inferior to the bladder and superior to the corpus spongiosum. This is most likely a tumor in the:
Cervical region of the uterus
The male equivalent of the uterine artery is the artery to the:
Bulb of the vestibule
To the obturator canal from the external iliac
Superior margin of the bladder
Which of the following is derived from the embryonic mesonephric system of ducts?
Neck of the bladder
A semen analysis is performed on a patient. The amount of semen appears to be normal but very few spermatozoa are seen. The problem resides with the:
Blood in the 10th posterior intercostal vein on the left side typically drains directly into the:
Accessory hemiazygous vein
Internal thoracic vein
Superior intercostal vein
The thickened lateral portion of the fascia lata, along with tendinous fibers from the gluteus maximus and tensor fascia latae muscles, is called the:
Fibular collateral ligament
The fibrous capsule of the testis is formed by the:
Cavity of the tunica vaginalis
Parietal layer of the tunica vaginalis
Which of the following shows a correct pairing of an anterior abdominal wall layer with its homologous layer in the scrotum or spermatic cord?
Transversalis fascia - internal spermatic fascia
External abdominal oblique - tunica dartos
Camper's fascia - cremaster muscle
Scarpa's fascia - external spermatic fascia
Transversus abdominus - tunica vaginalis
The ligamentum arteriosum is the remnant of a fetal vessel that once connected the aortic arch with the:
Left brachiocephalic vein
Left pulmonary artery
The superior vena cava is formed by the confluence of the:
Left & right brachiocephalic veins
Subclavian vein & internal jugular vein
Left & right common iliac veins
Cephalic & axillary veins
Azygos & hemiazygos veins
An incomplete fibrocartilage ring that slightly deepens the tibial plateau at the knee joint is called a:
The sural nerve runs in the superficial fascia of the posterior leg (i.e. the calf), adjacent to which blood vessel?
Small saphenous vein
Great saphenous vein
Dorsalis pedis artery
Anterior tibial artery
Extension of the hip joint, as in climbing stairs or rising from a seated position, is accomplished by which of the following muscles?
Short head of biceps femoris
Tensor fascia latae
Which of the following is a direct branch of the popliteal artery?
Superior medial genicular artery
Medial femoral circumflex artery
Profunda femoris artery
The deep niche where parietal pleura reflects from the ribs onto the diaphragm is called the:
The diaphragm receives motor innervation derived from which spinal nerve branches?
C3 - C5 ventral rami
T1 - T5 ventral rami
C1 - C3 dorsal rami
C1 - C3 ventral rami
C5 - T1 ventral rami
Rheumatic disease has left the tricuspid valve of an 82-year-old woman incompetent with an abnormal backflow of blood between what two cardiac structures?
Ascending aorta & conus arteriosus
Conus arteriosus & right ventricle
Left atrium & right atrium
Left ventricle & left atrium
Right ventricle & right atrium
A 68-year-old man suffering from acute myocardial ischemia reports pain in the cutaneous tissue of the medial side of his upper left arm. If this particular pain is cardiac induced, which of the following spinal nerves is most likely conveying the associated afferent nerve fibers from the sympathetic trunk to the spinal cord?
A 24-year-old active male presents to the emergency department with a recent onset of a swollen knee. He injured his knee while playing soccer. He cannot bear weight on his leg; his knee is painful and warm to the touch. You suspect that he has blood and a torn ligament in his knee. Which of the following results would you expect to see on a synovial fluid aspiration of his knee?
Transparent, clear, WBC < 200, PMN < 25%
Cloudy, yellow, WBC > 50000, PMN > 50%
Transparent, yellow, WBC < 200-2000, PMN < 25%
Cloudy, yellow, WBC > 200-50000, PMN > 50%
Red, opaque, RBC and WBC variable
In a patient with an antalgic gait, he will compensate by:
Diminishing the percentage of time spent in stance phase
Externally rotate his knee during stance phase
Exaggerate the amount of knee and hip flexion in swing phase
Initiate stance phase on his toes
Engage a Trendelenberg gait pattern
During the act of running:
Stance phase is increased in time
Swing phase is shortened in time
There is no period of toe-off
Vertical displacement of the body is diminished as compared to walking
There is no double stance phase
In addition to lubrication and chondrocyte nutrition, normal synovium functions to:
Aid in fracture healing
Provide collage precursors for bone growth
Maintain the non-adherent tissue surface
Provide an attachment site for muscles
Support the blood vessels that enter the articular cartilage
When you read an x-ray, the appearance "color" of any tissue type is most directly related to:
Position of subject in proximity to xray generator
Density of tissue in terms of chemical composition
Angle at which image is taken
Proximity of subject to film or digital receiver
Movement of the subject
In the attached frontal projection radiograph of the chest, there is a region surrounded by the red dotted line. This represents a pulmonary infiltrate located in:
Left upper lobe
Right lower lobe
Left lower lobe
Right middle lobe
A 35-year-old male arrives at your office complaining of nausea and pain in his right lower quadrant. You discover a bulge in the right lower quadrant that is tender and enlarges when the patient coughs. The structure that most likely fills the bulge is a portion of the:
You will conduct abdominal surgery on a male patient who has a history of hernias, a weak anterior abdominal wall, and difficulty healing abdominal incisions. You do not want to weaken his muscles any further. You want to make the incision in a well-vascularized area where the muscle fibers of the layers of the anterior abdominal wall are most closely aligned. Where should you make your incision?
Junction of the inguinal, flank, and pubic regions
Junction of flank, hypocondrium, and umbilical regions
Epigastric region, midway between anterior and 10th rib and xiphisternum
Intersection of median plane and division between umbilical and pubic regions
Intersection of median plane and division between umbilical and epigastric regions
Remembering that some layers of the anterior abdominal wall continue onto the spermatic cord and/or scrotum but have a different name there; which of the following layers of the anterior abdominal wall does not continue into the spermatic cord and/or scrotum, regardless of whether the individual is an embryo, fetus, or adult?
Internal oblique muscle
External oblique muscle
Transversus abdominis muscle
A 19-year-old receives a crippling blow to the left knee during a football game. Examination reveals abnormal anterior displacement of the tibia on the femur. Your diagnosis includes damage to which ligament?
A patient presents with pain in the back of her knee. An arteriogram reveals a blood clot in the popliteal artery at its proximal end. Which blood vessel can still allow blood to reach the foot?
Lateral circumflex femoral artery
Superior medial genicular vein
Which of the following prevents back flow of blood from the pulmonary trunk?
The structure that receives both the great cardiac vein and the small cardiac vein is called the:
Middle cardiac vein
Left pulmonary vein
Superior vena cava
Inferior vena cava
Salivary glands found in the roof of the mouth receive parasympathetic innervation that originally synapsed in which ganglion?
Superior cervical ganglion
A toddler that tends to push small objects up his nose presents to your office with a nosebleed. You find that he pushed a toothpick up under his inferior nasal concha. What opening lies nearby that may be affected?
Opening to the frontal sinus
Opening to the anterior ethmoid air cell
Opening to the nasolacrimal canal
Opening to the maxillary sinus
Opening to the posterior ethmoid air cell
Which of the following glands secretes its contents through a single hole on either side that opens near the frenulum at the base of the tongue?
A patient presents with acute blockage of the submandibular duct resulting in inflammation that compresses the lingual nerve nearby, in the floor of the oral cavity. What functional modality may be interfered with if the lingual nerve is affected?
Taste to the anterior 2/3 of the tongue
Salivary production from the parotid gland
Taste to the posterior 1/3 of the tongue
Motor innervation to intrinsic tongue muscles
Motor innervation to extrinsic tongue muscles
When a patient of yours attempts to stick out his tongue, it deviates to the right side every time. You suspect that his right hypoglossal nerve is injured. The unopposed protrusion from the left side is mediated by which muscle?
Which of the following muscles forms the floor of the oral cavity?
Which of the following structures is derived from an endochondral ossification?
Which of the following structures is derived from a pharyngeal cartilage ossification?
Upper part of occipital bone
Upper part of temporal bone
Which of the following structures is derived from a placode?
Inner ear cavity
A patient has problems with hearing due to malformation of the malleus bone in the ear. This is the result of a problem with the development of which of the following?
Pharyngeal arch one
Pharyngeal arch four
Pharyngeal arch two
Cranial nerve eight
Cranial nerve seven