ANATOMY 2010 Medboard

ANATOMYPhysician’s Licensure ExaminationMay 28, 2010; 8:00am 12:00nn

1. A patient with an isolated occulomor nerve paralysis would present with the following findings on the affected side

A) constricted pupils C) weakness of eyelid closureB) eyelid deviated laterally D) all of the above

2. Reproductive adaptations noted in the female true pelvis include the following EXCEPT

A) greater pubic angle C) longer pelvic cavityB) wider sacrosciatic notches D) cylindrical pelvic cavity

3.A high velocity bullet penetrates the posterior aspect of the shoulder and severely injures the origin of the posterior cord of the brachial plexus. Each of the following nerves might possible be affected EXCEPT the

A) upper subscapular C) thoracodorsalB) radial D) medial pectoral

4.During the proliferative phase of the menstrual cycle, one can observe thatA) the endometrium thickens largely because of edemaB) glycogen disappears in the basal cytoplasm of the glandular epitheliumC) there is a two to threefold increase in the thickness of the endometriumD) the endometrial glands become quite tortuous

5. Bile formed by hepatic cells is first secreted into theA) bile canaliculi C) space of DisseB) bile ducts D) hepatic duct

6. A patient with an isolated injury to the mandibular division of the trigeminal nerve would present withA A) atrophy of the temporalis muscle on the affected side

B) flattened nasaolabial fold on the affected sideB C) numbness of the cheek on the affected side

D)A and C only

7. The landmark structure noted during the dissection of the gluteal areaA) gluteus medius C) quadratus femorisB) piriformis D) obturator externus

8.Semen is composed of products produced by all of the following EXCEPT theA) seminiferous tubules C) bulbourethral glandsB) seminal vesicles D) rete testis

9. True ribs includeA) 5th B) 7th C) 8th D) A and B

10. A patient was noted to have atrophy of the temporalis and masseter muscles on one side of the face. His corneal reflex on the affected side was normal and he had no sensory deficit in the cheek area. This patient most probably has a lesion involving the

A) mandibular division of CN VB) maxillary division of CN VC) ophthalmic division of CN VD) terminal branches of CN VII

1


11. The primary hip flexor is theA) sartorius B) rectus femoris C) iliopsoas D) pectineus

12. The following secretions are correctly attached with their cells of origin in every pair EXCEPT

A) glucagon pancreatic alpha cellsB) intrinsic factor parietal cells of the stomachC) insulin pancreatic beta cellsD) hydrochloric acid chief cells of the stomach

13. A patient presented with complete paralysis of one side of the face with intact lacrimation and taste sensation (anterior 2/3 of tongue) The cranial nerve involved in this case most probably has a tension at the level of the

A) internal auditory meatus C) sytlomastoid foramenB) geniculate ganglion D) external auditory meatus

14. This structure is highly vulnerable in surgical manipulation of the ductus arteriosusA) esophagus C) left vagus nerveB) left bronchus D) left recurrent laryngeal nerve

15. The three types of granulocytes usually can be distinguished best under the light microscope on the basis of

A) nuclear morphology and cell sizeB) nuclear morphology onlyC) cell size onlyD) staining reaction of cytoplasmic granules

16. The liver is anatomically divided into right and left unequal halves along the fissure of the

A) ligamentum venosum C) falciform ligamentB) inferior vena cava D) porta hepatic

17. Both skeletal and smooth muscle can be found in the muscularis externa of the A) stomach C) colonB) duodenum D) esophagus

18. This structure is highly vulnerable in cancerous growth in R pulmonary hilum and posterior mediastinum

A) trachea C) vagus nerveB) superior intercostal vein D) pulmonary ligament

19. During erection of the penis, the volume of the blood occupying the spaces of the cavernous sinuses is increased by

A) contraction of the musculature of the dorsal artery of the penisB) relaxation of the musculature of the dorsal artery of the penisC) contraction of the musculature of the helicine arteriesD) relaxation of the musculature of the helicine arteries

20.The granules found in the cells of the adrenal medulla consist ofA) hydrocortisone C) epinephrine

2


B) glucocorticoids D) mineralocorticoids

21. The deep perineal space in the male contains each of the following EXCEPTA) membranous urethra C) bulbourethral glandsB) prostate gland D) sphincter urethrae muscle

22. Loss of extension of the knee would result from damage to theA) femoral nerve C) tibial and common fibularB) tibial nerve D) obturator nerve

23. Which of the following epithelia can usually be found in the normal female reproductive system?

A) stratified squamous and simple columnarB) transitional and stratified squamousC) simple columnar and transitionalD) simple columnar and pseudostratified

24. By inserting the finger into the rectum, the following can be readily felt and examinedA) enlarged seminal vesicles C) A and BB) prostate gland D) none of the above

25. The ventral rami of the brachial plexus are seen at theA) posterior cervical triangle C) submandibular triangleB) carotid triangle D) muscular triangle

26. The function of the interstitial endocrine cells of the testis is toA) form acrosomeB) secrete testosteroneC) support the germinal epitheliumD) supply nutrients to the sex cells

27. The vermiform appendix is best located by following theA) anterior cecal arteryB) descending branch of the right colic arteryC) ileum to the ileocolic junctureD) teniae coli of the ascending colon

28. From which of the following sites is primary cancer most likely to metastasize to the lung by venous spread?

A) ileum C) kidneyB) appendix D) transverse colon

29. Simple cuboidal epithelium is usually found inA) parietal layer of Bowman’s capsuleB) descending limb of the loop of HenleC) rete testisD) single layer on the free surface of the ovary

30. The roof of the adductor canal is formed by theA) rectus femoris C) adductor longusB) vastus medialis D) sartorius

31. Trauma to the sternocostal surface of the heart would more likely damage the

3


A) right atrium C) left ventricleB) right ventricle D) left atrium

32. Interruption of blod flow in the internal iliac artery would affect blood flow to each of the following EXCEPT the

A) medial thigh musclesB) ductus deferensC) lower abdominal wall and rectus abdominis muscleD) rectum

33. A child suspected of aspirating a small button is seen in the ER. While there is no complain of pain, there is frequent coughing. Physical examination showed absence of breath sounds. Aspirated small objects tend to lodge in the right inferior lobar bronchus for all the following reasons EXCEPT

A) left main stem ( primary) bronchus is more horizontalB) right inferior lobar bronchus nearly continues the direction of the tracheaC) right lung has no middle lobeD) right main stem(primary) bronchus is of greater diameter than the left

34. This structure separates the perineum from the pelvic cavityA) ischiorectal fossa C) pelvic diaphragmB) urogenital diaphragm D) urogenital triangle

35. Drug detoxification occurs in theA) Golgi apparatus C) rough endoplasmic reticulumB) smooth endoplasmic reticulum D) lysosomes

36. The ligament that prevents C1 vertebrae from translating against C2 isA) alar ligament C) transverse ligamentB) tentorial ligament D) posterior longitudinal ligament

37. The scala vestibuli of the inner ear communicates with the scala tympani via theA) modiolus C) cecum cupulareB) helicotrema D) aqueduct

38. The Haversian canals of bone tissueA) contain chondrocytesB) are lined by cement linesC) form the central structure of a Haversian systemD)run perpendicular to the long axis of the bone

39. The hepatic portal vein is correctly described by each of the following EXCEPTA) it drains most of the venous blood from the gastrointestinal tractB) it forms by the confluence of the superior mesenteric and splenic veinsC) it is located in the hepatoduodenal ligamentA) it forms posterior to the head of the pancreas

40. The internal spermatic fascia is derived from theA) external oblique aponeurosisB) peritoneumC) transversus abdominis aponeurosisD) transversalis fascia

41. The vagus nerve enters the abdominal cavity through the

4


A) aortic hiatus C) sternocostal hiatusB) esophageal hiatus D) vena caval aperture

42. The part of the uterine tube which is removed during fimbriectomy A) cornua C) ampullaB) isthmus D) infundibulum

43. Pressure developing deep to the flexor retinaculum would affect each of the following EXCEPT the

A) median nerveB) ulnar nerveC) tendons of the flexor digitorum superficialis muscleD) tendons of the flexor pollicis longus muscle

44. A patient enters the emergency room not being able to raise his foot. The nerve that is suspected to be damaged is the

A) tibial C) obturatorB) common fibular D) medial plantar

45. Sinusoids are correctly described by each of the following EXCEPTA) they have a irregular tortuous lumenB) they are lined by endothelial cells

C) they have a dense connective tissue wallD) they have no phagocytic elements

46. The opening into the lesser sac is through theA) foramen of Bochdalek C) foramen of MorgagniB) foramen of Winslow D) foramen transversarium

47.Damage to the obturator nerve on the lateral wall of the pelvis would affect the function of each of the following muscles EXCEPT the

A) sartorius C) adductor longusB) gracilis D) pectineus

48. When removing the right lung, the surgeon has to be careful to protect which of the following structures passing posterior to the root of the lung?

A) hemiazygos vein C) right phrenic nerveB) right vagus nerve D) thoracic aorta

49. Which muscle is responsible for expelling the last drops of urine in the maleA) sphincter urethrae C) sphincter vesicaeB) bulbocavernosi D) ischiocavernosi

50. At the hepatoduodenal ligament, the structure that occupies a medial location is theA) common bile duct C) inferior vena cavaB) portal vein D) hepatic artery

5

ANATOMYPhysician’s Licensure ExaminationMay 28, 2010; 8:00am 12:00nn51. The thoracic duct enters the venous circulation at the junction of

A) superior vena cava and right atriumB) left subclavian and left internal jugular veinC) left and right brachiocephalic veinD) right subclacian and right internal jugular vein

52. The axillary artery may be ligated at this point without compromising the blood supply to the upper extremity

A) proximal to the thyrocervical trunkB) distal to the subscapular arteryC) between the thyrocervical trunk and subscapular arteryD) none of the above

53. Separates the submandibular triangle from the carotid triangleA) posterior belly of digastric C) sternohyoidB) omohyoid D) hyoid bone

54. An occlusion of the superior mesenteric artery would result in necrosis of each of the following EXCEPT the

A) ascending colon C) ileumB) rectum D) cecum

55. Occupies the tracheoesophageal grooveA) vagus nerve C) recurrent laryngeal nerveB) sympathetic trunk D) phrenic nerve

56. A woman’s inability to supinate the forearm could result from an injury to which of the following pair of nerves

A) axillary and radial C) radial and musculocutaneousB) median and ulnar D) suprascapular and axillary

57. Following tonsillectomy, a patient noted loss of general sensation and taste from the posterior one third of the tongue. It could be assumed that the injured nerve was a branch of the

A) glossopharyngeal nerve C) lingual nerveB) facial nerve D) hypoglossal nerve

58. The median cubital vein is a communication between theA) cephalic and basilic C) cephalic and axillaryB) basilic and axillary D) axillary and subclavian

59. Fenestrated capillaries haveA) extremely attenuated areas of endothelium with poresB) thickened areas with poresC) diaphragm that have the same thickness as unit membranesD) pores that are evenly spaced over the entire surface of the endothelium

60. A severe blow to the side of the head could fracture which one of the following bones in the roof of the orbit?

A) palatine C) frontal

6


B) maxilla D) zygomatic

61. Occupies a medial location within the carotid sheathA) internal jugular vein C) vagus nerveB) ansa cervicalis D) common carotid artery

62. Each of the following characterizes the levator ani muscles EXCEPTA) it forms the principal part of the pelvic diaphragmB) it separates the floor of the pelvis from the ischioanal fossaC) it arises from the inner surface of the superior ramus of the pubisD) it separates the superficial and deep inguinal spaces

63. A basketball player who trips and falls, landing on his outstretched hand will most likely fractures which carpal bone?

A) trapezium C) scaphoidB) capitate D) hamate

64. Lymphatic nodules are found in each of the following EXCEPTA) lymph nodes C) tonsilsB) thymus D) walls of urinary tract

65. A spleen may be ruptured in traumatic injuries to the chest if these ribs are fractured and displaced

A) 5th, 6th, 7th level of the posterior axillary lineB) 7th, 8th , 9th level of the midaxillary lineC) 9th, 10th, 11th level of the left posterior axillary lineD) 10th, 11th, 12 anteriorly

66. A diastolic murmur coming from a stenosed mitral valve in patient with RHD is best heard or auscultated at the

A) 5th ICS left midclavicular lineB) 4th ICS left parasternal border

C) 2nd ICS left parasternal borderD)4th ICS right parasternal border

67. Surgically, it is important to locate which one of the following structures located immediately posterior to the second part of the duodenum

A) transverse colon C) hilum of right kidneyB) left lobe of the liver D) gallbladder

68. Podocytes are associated with which of the following parts of the urinary systemA) distal convoluted tubule C) major calyces

B) thick limb of loop of Henle D) visceral layer of Bowmans capsule

69. A baby sustained a lower brachial plexus injury due to traumatic childbirth (forceful pulling on the arm). The following is/are true statements regarding this type of injury

A) results in loss of abduction, flexion and lateral rotation of the shoulderB) results in clawhand deformity C) leads to sensory deficit in the lateral aspect of the upper extremity

7


D) all of the above

70. Which of the following layers in the wall of a medium sized artery contains smooth muscle

A) internal elastic membrane C) tunica adventitiaB) external elastic membrane D) tunica media

71. A lesion of the lingual nerve immediately after it receives the chorda tympani nerve could result in each of the following EXCEPT

A) loss of sublingual gland secretionB) sensory loss from lower teethC) loss of taste from anterior two thirds of the tongueD) loss of submandibular gland secretion

72. The superior vena cava could be damaged by a stab wound deep to theA) right first costal cartilage C) right sternoclavicular jointB) right fourth costal cartilage D) left second costal cartilage

73. All of the following statements concerning the uterus are correct EXCEPTA) the broad ligament reflects from the posterior surface of the uterus to the

rectum to form the rectouterine pouchB) the round ligament connects the uterus to the ovaryC) the broad ligament extends from the anterior surface of the uterus onto the

bladder forming the vesicouterine pouchD) the uterine tubes enter the uterus in the superior border of the broad ligament

74. A 58yearold man presented with a year history of chest pain. The attacks were increasing in frequency and were only relieved by rest. Cardiac catheterization revealed an area of occlusion of the circumflex branch of the left coronary artery. The damage to the heart would probably involve the

A) left atrium and left ventricle C) right and left ventriclesB) right atrium and left ventricle D) apex of the heart

75. A severe infection that obstructs the middle meatus would affect drainage from each of the following sinus EXCEPT the

A) maxillary sinus C) nasolacrimal ductB) frontal sinus D) anterior ethmoid air cells

76. Plicae circulares is most abundant in what part of the gastrointestinal tractA) duodenum C) ileumB) jejunum D) large intestine

77. A woman on her 3rd trimester of pregnancy developed paresthesia of the hands. She has difficulty in doing her crossstitch hobby. Her most likely problem affects the

A) median nerve C) radial nerveB) ulnar nerve D) axillary nerve

78.A 9yearold boy fell hitting his elbow. Physical examination showed weakness in wrist flexion and loss of adduction. Loss of sensation was noted on the medial side of his hand. What nerve was most probably injured

8


A) musculocutaneous C) radialB) ulnar D) median

79. Carcinoma of the _____part of the pancreas usually shows itself first by painless progression jaundice with enlargement and distention of the gall bladder

A) head C) bodyB) neck D) tail

80. Sperms found in these structures are capable of fertilizing ovaA) seminiferous tubules C) ductuli efferentesB) rete testis D) epididymis

81. A myocardial infarction that damages the heart muscle in the anterior two thirds of the interventricular septum would result primarily from occlusion of the

A) posteiror interventricular arteryB) marginal branch of the right coronary arteryC) marginal branch of the left coronary arteryD) anterior interventricular artery

82. The horizontal fissure of the right lung separates theA) superior and middle lobe C) inferior and middle lobeB) superior and inferior lobe D) superior lobe from cardiac notch

83. In Dupuytren’s contracture, the flexion of the MCP joints is actually due toA) compression of the median nerve at the wrist, leading to atrophy of the muscles of oppositionB) inflammation of the synovium of the long flexor tendons, leading to scarringC) atrophy of the lumbrical muscles due to disuseD. fibrosis of the digital slips of the palmar aponeurosis

84. It would be difficult for a gallbladder infection to easily reach which one of the following viscera

A) liver C) cystic ductB) third part of the duodenum D) transverse colon

85. After leaving the trabecular sinuses of a lymph node, lymph passes directly into theA) afferent lymphatic vessels C) subscapular sinusesB) efferent lymphatic vessels D) medullary sinuses

86. A vertical incision through the midline of the anterior abdominal wall will traverse the

A) rectus abdominis C) internal obliqueB) external oblique D) linea alba

87. The contents of an indirect inguinal hernia enters the inguinal canal ______ to the inferior epigastric artery

A) lateral C) inferiorB) medial D) none of the above

88. A penetrating knife wound to the posterior shoulder in the quadrangular space would damage the axillary nerve and the

A) anterior circumflex humeral artery C) subscapular artery

9


B) posterior circumflex humeral artery D) superior thoracic artery

89.A tumor involving the fifth to twelfth thoracic vertebrae could affect each of the following structures in the posterior mediastinum EXCEPT the

A) thoracic duct C) azygos veinB) phrenic nerve D) descending aorta

90. Damage to the anatomic snuffbox might be expected to injure theA) ulnar nerve C) ulnar arteryB) capitate bone D) radial artery

91. The cerebral arterial circle (circle of Willis) is formed by branches of the internal carotid artery and the

A) external carotid artery C) basilar arteryB) vertebral artery D) middle meningeal artery

92. AS a result of an injury to the ulnar nerve in the arm, all of the following changes in the hand will be noted EXCEPT

A) sensory loss on the little finger and one half of the ring fingerB) the thumb is strongly adductedC) loss of flexion of the distal interphalangeal joints of the fourth and fifth digitsD) marked wasting in the hypothenar eminence

For questions 9395A 63 year old woman shows a fine, pillrolling tremor in both upper extremities, with tremors at rest. There is an overall poverty of movements. The patient’s gait is shuffling and motor performance is delayed.

93. The most likely diagnosis isA) Wilson’s disease C) Benedikt’s syndromeB) Parkinson’s disease D) Liverbrain disease

94. Dysfunction of this structure is implicated in the above diseaseA) substantia gelatinosa C) substantia nigraB) red nucleus D) cerebellum

95. Treatment involves administration ofA) dopamine C) acetylcholineB) Ldihydroxyphenylalanine D) serotonin

96. The powerful extension of the thigh required when one is standing from a sitting position is the function of the

A) gluteus maximus C) psoas majorB) iliacus muscle D) piriformis

97. Ejaculatory fluid is composed of products produced by all of the following EXCEPT the

A) seminiferous tubules C) bulbourethral glandsB) seminal vesicles D) rete testis

10


98. Respiratory distress syndrome occurs most commonly becauseA) too few mature alveoli have developedB) surfactant production is insufficientC) the lungs are partially filled with amniotic fluidD) type I alveolar epithelial cells produce a greatly thickened basement

membrane

For question 99100

A 55yearold woman complained of numbness in the legs, which spread to involve her hands. There were sudden sharp pains, variable in location, but usually localized to one or the other leg. On examination, her pupils were of unequal size. ArgyllRobertson pupils and Romberg’s sign were present. Although the patient’s strength was normal she was areflexic in all limbs.

99. The most likely diagnosis isA) Brown Sequard syndrome C) multiple sclerosisB) tabes dorsalis D) meningiona

100. Above findings is the result ofB) degeneration of posterior columnsA) upper motor neuron damageB) cerebellar diseaseC) degeneration of basal ganglia

11

Documents

ANATOMY 2010 Medboard