MCEM MCQ Anatomy 1. Mandible Injuries (a) The angle of the mandible is the most common area to be fractured.
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
-n which the talus is driven into the calcaneus. r a twistin injury. (c) "er $0% of calcaneal fracture !atients suffer associated injuries of the s!ine* !el"is or hi!.
Tru e
Fals e
(d) Internuclear o!thalmo!legia occurs hen there is failure of adduction of one eye and nystagmus in the o!!osite eye.
Tru e
Fals e
(e) +uadrice!s tendon ru!ture is most common is indi"iduals under ,0 years of age /uadriceps tendon rupture is most common is individuals over 0' years of ae after sudden contraction of the #uadriceps muscle.
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
23% of the time. (b) Marfans syndrome increases the likelihood of mandibular dislocation Marfans syndrome increases the likelihood of mandibular dislocation dislocation as does Ehlers Danlos syndrome. (c) Most dislocations ( >70% ) are traumatic Most dislocations occur spontaneously when the jaw is open wide. (d) ith dislocation !atients are unable to close their mouths com!letely and ha"e difficulty s!eaking. With dislocation patients are unable to close their mouths completely and have difficulty speakin. (e) #lain radiogra!hs are usually unhel!ful in dislocation of the mandible. !lain radioraphs of the mandible" includin bilateral obli#ue views" virtually always show the affected condyle lyin anterior to the articular eminence $. The folloing are true& (a) 'alcaneal fracture is the most commonly fractured tarsal bone. $alcaneus injuries represent 2% of all fractures seen in adults. he os calcis is the most fre#uently fractured tarsal bone" accountin for more than &'% of tarsal fractures. $alcaneus fractures are most commonly commonly seen in youn men( )cott *icklebur" MD" $alcaneus +ractures, www.emedicine.com (b) The mechanism of injury of calcaneal fracture is aial loading.
-. The ubcla"ian /rtery& (a) n the left the ubcla"ian artery arises directly from the aorta but on the right it is a branch of the brachioce!halic trunk n the left the )ubclavian artery arises directly from the aorta but on the riht it is a branch of the brachiocephalic trunk (b) ehind and abo"e the subcla"ian artery are the roots of the brachial !leus. 1ehind and above the subclavian artery are the roots of the brachial pleus. (c) /t the outer border of the third rib the subcla"ian artery changes it1s name to the aillary artery. t the outer border of the first rib the subclavian subclavian artery chanes it4s name to the the aillary artery. (d) The internal thoracic artery is a branch of the subcla"ian artery. he internal thoracic artery is a branch of the subclavian artery. (e) The scalenus anterior se!arates the subcal"ian "ein in front from the subcla"ian artery behind. he scalenus anterior separates the subcalvian subcalvian vein in front from the subclavian artery behind
MCEM MCQ Anatomy ,. 'hest drain insertion& (a) 2ormal !osition is beteen the ,th and 3th I' s!aces. he normal position is between the 0th and 5th -$ spaces. (b) eteen the anterior and mid4aillary line 1etween the anterior and mid6aillary line. (c) The !oint at hich the anterior aillary fold meets the chest all is a useful guide. he point at which the anterior aillary fold meets the chest wall is a useful uide. (d) If the chest drain initially yields 5000ml of blood* or subse6uently drains >$00mlhr there should be urgent referral to a cardiothoracic surgeon. -f the chest drain initially yields 7'''ml of blood" or subse#uently drains 82''ml9hr there should be urent referral to a cardiothoracic sureon for possible thoracotomy. (e) 8ateral chest all to the a!ices is a reflection of tube length for drainage of a !neumothora. :ateral chest wall to the apices is a reflection of tube lenth for drainae of a pneumothora. 3. 9egional /naeasthesia (a) The radial ner"e !ro"ides sensation to the lateral to thirds of the dorsum of the hand he radial nerve provides sensation to the lateral two thirds of the dorsum of the hand (b) 5% lignocaine has a concentration of 5mgml 7% linocaine has a concentration of 7'm9ml (c) The median ner"e is anaesthetised by injecting local beteen the fleor car!i radialis and the !almaris longus. he median nerve is anaesthetised by injectin local between the fleor carpi radialis and the palmaris lonus. (d) The median !ro"ides sensation to the lateral to thirds of the !alm of the hand* !almar surfaces of the lateral three and one half digits* and their fingerti!s !rovides sensation to the lateral two thirds of the palm of the hand" palmar surfaces of the lateral three and one half diits" and their finertips (e) /t the rist the ulnar ner"e is blocked by injecting local anaesthetic beteen the ulnar artery and the fleor car!i ulnaris. t the wrist the ulnar nerve is blocked by by injectin local anaesthetic between between the ulnar artery and the fleor carpi ulnaris. :. 9u!tured /chilles ( calcaneal ) tendon (a) #ain has a gradual onset hile running or jum!ing. !ain has a sudden onset while runnin or jumpin. (b) The ru!ture usually occurs about 5 cm abo"e the tendon insertion. he rupture usually occurs about 5 cm above the tendon insertion. (c) #ain may be !ercei"ed as a kick.
(d) It is im!ossible to alk after an achilles tendon ru!ture. -t is still possible to walk after an achilles tendon rupture" thouh with a limp. (e) It is im!ossible to !lantar fle the foot after an achilles tendon ru!ture. deree of plantar fleion is still still possible.-t is impossible to raise raise the heel from the floor when the foot is on the round. ap may be felt in the tendon course course ;particularly within 20 hours of the the injury<.
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
MCEM MCQ Anatomy ,. 'hest drain insertion& (a) 2ormal !osition is beteen the ,th and 3th I' s!aces. he normal position is between the 0th and 5th -$ spaces. (b) eteen the anterior and mid4aillary line 1etween the anterior and mid6aillary line. (c) The !oint at hich the anterior aillary fold meets the chest all is a useful guide. he point at which the anterior aillary fold meets the chest wall is a useful uide. (d) If the chest drain initially yields 5000ml of blood* or subse6uently drains >$00mlhr there should be urgent referral to a cardiothoracic surgeon. -f the chest drain initially yields 7'''ml of blood" or subse#uently drains 82''ml9hr there should be urent referral to a cardiothoracic sureon for possible thoracotomy. (e) 8ateral chest all to the a!ices is a reflection of tube length for drainage of a !neumothora. :ateral chest wall to the apices is a reflection of tube lenth for drainae of a pneumothora. 3. 9egional /naeasthesia (a) The radial ner"e !ro"ides sensation to the lateral to thirds of the dorsum of the hand he radial nerve provides sensation to the lateral two thirds of the dorsum of the hand (b) 5% lignocaine has a concentration of 5mgml 7% linocaine has a concentration of 7'm9ml (c) The median ner"e is anaesthetised by injecting local beteen the fleor car!i radialis and the !almaris longus. he median nerve is anaesthetised by injectin local between the fleor carpi radialis and the palmaris lonus. (d) The median !ro"ides sensation to the lateral to thirds of the !alm of the hand* !almar surfaces of the lateral three and one half digits* and their fingerti!s !rovides sensation to the lateral two thirds of the palm of the hand" palmar surfaces of the lateral three and one half diits" and their finertips (e) /t the rist the ulnar ner"e is blocked by injecting local anaesthetic beteen the ulnar artery and the fleor car!i ulnaris. t the wrist the ulnar nerve is blocked by by injectin local anaesthetic between between the ulnar artery and the fleor carpi ulnaris. :. 9u!tured /chilles ( calcaneal ) tendon (a) #ain has a gradual onset hile running or jum!ing. !ain has a sudden onset while runnin or jumpin. (b) The ru!ture usually occurs about 5 cm abo"e the tendon insertion. he rupture usually occurs about 5 cm above the tendon insertion. (c) #ain may be !ercei"ed as a kick.
(d) It is im!ossible to alk after an achilles tendon ru!ture. -t is still possible to walk after an achilles tendon rupture" thouh with a limp. (e) It is im!ossible to !lantar fle the foot after an achilles tendon ru!ture. deree of plantar fleion is still still possible.-t is impossible to raise raise the heel from the floor when the foot is on the round. ap may be felt in the tendon course course ;particularly within 20 hours of the the injury<.
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
MCEM MCQ Anatomy n eamination the patient cannot stand on tip6toe. =. #rimary motor and sensory cortices (a) Motor;!recentral gyrus
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
(d) omatosensory;!ostcentral gyrus
Tru e
Fals e
(e)
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru
Fals
+rontal lobe (b) /uditory;u!erior tem!oral lobe >eschl(s yrus (c) lfactory;fontal lobe
-n the occipital corte =. The rachial #leus& (a) ehind the cla"icle each trunk di"ides into the anterior and !osterior cords. 1ehind the clavicle each trunk divides into the anterior and posterior division (b) The !osterior di"isions of the u!!er and middle trunk make u! the lateral cord. he anterior divisions of the upper and middle trunk make up the lateral cord. (c) The roots of the brachial !leus emerge into the !osterior triangle in front of the scalenus anterior and the scalenus medius. he roots of the brachial pleus emere into the posterior trianle between the scalenus anterior and the scalenus medius. (d) The root of the "entral ramus of T5 makes the middle trunk of the brachial !leus he root of the ventral ramus of $= makes the middle trunk of the brachial pleus (e) The brachial !leus is se6uentially di"ided into the roots* the trunks * the di"isions* and the cords. he brachial pleus is se#uentially divided into the roots" the trunks " the divisions" and the cords. . The folloing are true regarding the "ertebral column& (a) There are se"en cer"ical "ertebrae There are se"en cer"ical "ertebrae. "ertebrae. (b) There are 5$ thoracic "ertebrae. There are 5$ thoracic thoracic "ertebrae. (c) There are fi"e lumbar "ertebrae There are fi"e lumbar "ertebrae. (d) There are three sacral "ertebrae. There are fi"e sacral "ertebrae "ertebrae fused to form the sacrum sacrum (e) There are three coccygeal "ertebrae. There are four coccygeal coccygeal "ertebrae hich are usually fused. 7'. 2eck Trauma (a) #enetrating neck trauma rarely causes multi!le i njuries. Multiple injuries are sustained 00 to 52% of the time with penetratin neck trauma. (b) trangulation may cause the formation of !etechiae in the subconjuncti"ae.
MCEM MCQ Anatomy
(c) trangulation may cause the formation of !etechiae belo the le"el of injury. )tranulation may cause the formation of petechiae above the level of injury. (d) Major "essel injury may simulate an acute stroke.
(e)
e
e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
?ascular injury is most common with penetratin trauma. 77. The 77. The $nd 'ranial 2er"e& (a) 2ormal "isual acuity is !resent hen the line on the snellen chart marked : can be read from : metres aay. *ormal visual acuity is present when the line on the snellen chart marked & can be read from & metres away. (b) Migraine is a cause of sudden blindness in both eyes Miraine is a cause of sudden blindness in one eye. (c) The fibres from the o!tic chiasm concerned ith "ision tra"el in the o!tic tract to the medial geniculate body. he fibres from the optic chiasm concerned with vision travel in the optic tract to the lateral eniculate body. (d) ?ibres from the o!tic radiation !ass through the anterior !art of the internal ca!sule and finish in the "isual corte in the occi!ital lobe. +ibres from the optic radiation pass throuh the posterior part of the internal capsule and finish in the visual corte in the occipital lobe. (e) ?ibres ser"ing the loer 6uadrants course through the !arietal lobe hile fibres ser"ing the u!!er 6uadrants tra"erse the tem!oral lobe. +ibres servin the lower #uadrants course throuh the parietal lobe while fibres servin the upper #uadrants traverse the temporal lobe. 5$. @oints (a) #atellofemoral dislocation is the commonest large joint dislocation. @lenohumeral dislocation is the commonest lare joint dislocation. (b) Alenohumeral dislocation is the second commonest large joint dislocation !atellofemoral dislocation dislocation is the second commonest lare joint dislocation. (c) Blbo dislocations are the third largest large joint dislocation in the body. Elbow dislocations are the third larest lare joint dislocation in the body. (d) The majority of elbo dislocations are !osterior. he majority of elbow dislocations are posterior. (e) The most common mechanism of injury during elbo dislocation is direct trauma to the olecranon hen a !erson falls on a fleed elbo. he most common mechanism of injury for an elbow dislocation is fall on an outstretched hand ; +)> < 73. /ortic Cissection (a) The "ast majority of !atients ha"e !hysical signs suggesti"e of dissection. he presence of pulse deficits or focal neuroloical deficits increases the likelihood likelihood of an acute thoracic aortic dissection in the appropriate clinical settin. $onversely" a completely normal chest radioraph result or the absence of pain of sudden onset lowers the likelihood. verall" however" the clinical eamination is insufficiently sensitive to rule out aortic dissection iven the hih morbidity of missed dianosis.Alompass M. Does this patient have have an acute thoracic dissectionB CM 2''2, 2= 22&2B=2.
MCEM MCQ Anatomy (b) udden onset chest !ain is !resent in % of cases )udden onset chest pain is present in about 5% of cases.Alompass M. Does this patient have an acute thoracic dissectionB CM 2''2, 2= 22&2B=2. (c) C4Cimers are usually not raised on acute thoracic dissection D6Dimer assay is usually raised in acute thoracic dissection (d) Most chest D 9ayEs do not sho an abnormality
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru
Fals
Most chest F Gay(s do show abnormalities. mon the most common abnormalities are widened mediastinum and an abnormal contour of the aorta. 70. "arian 'ysts (a) /re !resent in about :% of asym!tomatic !ost meno!ausal omen
(b) May !resent ith urinary retention houh normally symptomless (c) 'an be most accurately diagnosed by trans abdominal ultrasound as malignant ?ainal ultrasound is much more accurate predictin benin nature in up to H&% of cases (d) /fter the meno!ause are best managed by a ait and see !olicy his is reasonable in pre menopausal women (e) tandard surgical treatment is to remo"e all cysts o"er 3cm in diameter 1ecause there is a 75% risk of malinancy 75. The folloing are true of the sensory su!!ly to the hand (a) The radial ner"e su!!lies sensation to the dorsal surface of the hand in the region of the little finger. he radial nerve supplies sensation to the dorsal surface of the hand in the reion of the thumb.he radial nerve is composed of fibers from $&" $= and $ (b) The median ner"e is the only sensory su!!ly to the anterior surface of the ring finger. he sensory supply of the medial half of the anterior surface of the rin finer is from the ulnar nerve. he sensory supply of the lateral half of the anterior surface of the rin finer is from the medial nerve. (c) The ulnar ner"e su!!lies !art sensation to the !osterior surface of the ring finger. he ulnar nerve supplies part sensation to the posterior surface of the rin finer. (d) ensation to the dorsal ti! of the inde finger is su!!lied by the radial ner"e. )ensation to the dorsal tip of the inde finer is supplied by the median nerve. (e) The radial ner"e has no anterior hand sensory fibres. n the anterior surface the median nerve supplies the lateral 3 792 diits while the ulnar nerve supplies the medial 7 792 diits. he radial nerve supplies sensory fibres to the anterior surface of the thumb. n the dorsal surface the radial nerve supplies most of the dorso6lateral hand but not distal to the !-! joints of the inde"middle and rin finers which are supplied by the median nerve. he medial 7 792 diits are supplied by the ulnar nerve on the dorsal surface. 5:. 9egional /naesthesia (a) The total "olume of the anaesthetic agent should not eceed = m8 for a digital ner"e block. he total volume of the anaesthetic aent should not eceed 0 m: for a diital nerve block. (b) The sural ner"e is blocked beteen the lateral malleolus and the /chilles
MCEM MCQ Anatomy tendon. he sural nerve is blocked between the lateral malleolus and the chilles tendon (c) The sural ner"e lies just anterior to the short sa!henous "ein. he sural nerve lies just anterior to the short saphenous vein. (d) The sa!henous ner"e is blocked beteen the lateral malleolus and the anterior tibial tendon. he saphenous nerve is blocked between the medial malleolus and the anterior tibial tendon. (e) The !osterior tibial ner"e is blocked by injecting the local anaesthetic beteen the !osterior tibial artery and lateral malleolus. he posterior tibial nerve is blocked by injectin the local anaesthetic between the posterior tibial artery and achilles tendon at the level of the medial malleolus. 57. ?inger injuries& (a) The mallet finger deformity is !roduced by a"ulsion of the fleor tendon from its insertion. Etensor tendonI (b) If a fracture of the distal !halan effects more than 5- rd of the the joints articular surface the joint may become unstable. -f a fracture of the distal phalan effects more than 793 rd of the the joints articular surface the joint may become unstable. (c) Fy!eretension of the finger at the base of the metacar!o!halangeal joint may result in a trans"erse fracture at the base of the !roimal !halan. >yperetension of the finer at the base of the metacarpophalaneal joint may result in a transverse fracture at the base of the proimal phalan. (d) ?racture of the metacar!al neck ith "olar dis!lacement of the head is commonest in the ,th metacar!al. $ommonest in the 5th metacarpal" a boers fracture. (e) / alter4Farris ty!e II e!i!hyseal fracture of the base of the little finger !roimal !halan is commonly from an abduction injury. )alter6>arris type -- epiphyseal fracture of the base of the little finer proimal phalan is commonly from an abduction injury. 5=. Fand Injuries (a) / boers fracture is the most common metacar!al fracture +racture of the 0th or 5th metacarpal neck (b) 'rush injuries to the hand are not at risk of com!artment syndrome $rush injuries to the hand are at risk of compartment syndrome. (c) Treatment of non4dis!laced middle !halan fractures includes a gutter s!lint in the !osition of function and referral reatment of non6displaced middle phalan fractures includes a utter splint in the position of function and referral (d) Treatment of non4dis!laced !roimal !halan fractures includes a gutter s!lint in the !osition of function and referral reatment of non6displaced proimal phalan fractures includes a utter splint in the position of function and referral (e) If more than one third of the articular surface of the distal !halan is in"ol"ed in a fracture internal fiation is recommended -f more than one third of the articular surface of the distal phalan is involved in a fracture internal fiation is recommended 5. Tra!eGium ?racture (a) 9esults in !ainful ring finger mo"ements rapeJium fracture results in painful thumb movements. (b) Tenderness is !resent at the base of the hy!othenar eminence enderness is present at the base of the thenar eminence
e
e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
MCEM MCQ Anatomy Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
(c) The second of cambells lines runs along the inferior orbital margins
Tru e
Fals e
(d) / teardro! sign is associated ith an orbital margin fracture
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
(b) reath sounds should be checked for at the anterior chest all bilaterally.
Tru e
Fals e
(c) reath sounds are normally louder on the right side of the chest all.
Tru
Fals
(c) Treatment consists of an abo"e elbo backslab and ortho!aedic referral. reatment consists of a thumb spica splint and orthopaedic referral. (d) #atients usually com!lain of a !ainful and eak !inch.
(e) Tra!eGial fractures usually result from a direct blo to the dorsum of the hand or from a fall on a radially de"iated closed fist rapeJial fractures usually result from a direct blow to the dorsum of the hand or from a fall on a radially deviated closed fist. !atients usually complain of a painful and weak pinch. n clinical eamination" point tenderness is present on direct palpation of the trapeJium. $0. Testis* e!ididymis and s!ermatic cord& (a) / hydrocele occurs hen there is atery fluid beteen the !arietal and "isceral layers of the tunica "aginalis ( a serous sac of !eritoneal origin ) hydrocele occurs when there is watery fluid between the parietal and visceral layers of the tunica vainalis ; a serous sac of peritoneal oriin < (b) The testicular artery is a direct branch of the abdominal aorta hich arises just abo"e the renal arteries and descends in the s!ermatic cord to the !osterior as!ect of the testes. he testicular artery is a direct branch of the abdominal aorta which arises just below the renal arteries and descends in the spermatic cord to the posterior aspect of the testes. (c) The ductus deferens ascends on the lateral side of the e!ididymis. he ductus deferens ascends on the medial side of the epididymis. (d) The e!ididymis is on the !osterior as!ect of the testes and is - m in length. he epididymis is on the posterior aspect of the testes and is & m in lenth. (e) The head of the e!ididymis lies on the u!!er !ole of the testis here it is joined by the efferent ducts. he head of the epididymis lies on the upper pole of the testis where it is joined by the efferent ducts. $5. Maillofacial 9adiogra!hs (a) hould be assessed by tracing cambells lines here are 5 of them.he first runs from the Jyomaticofrontal suture above the orbital marins and across the labella. (b) The first of cambells lines runs from the Gygomaticofrontal suture abo"e the orbital margins and across the glabella.
feature of a downward blow out fracture (e) oft tissue selling is a direct sign of maillary fracture )oft tissue swellin is an indirect sin" as are opacification of the maillary sinus. $$. #ro!er tracheal tube !lacement& /uscultation (a) reath sounds should be checked for at the lateral chest all bilaterally.
MCEM MCQ Anatomy e
e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
(b) raising intra abdominal !ressure to assist in micturition
Tru e
Fals e
(c) hel!s in eight lifting
Tru e
Fals e
(d) /ssists in return of blood to the right side of the heart
Tru e
Fals e
(e) /ssists in initiation of mo"ement
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
(d) Aastric bubbling noises are heard o"er the e!igastrium. his may indicate the tube is not in the trachea. (e) 'hest e!ansion is often greater on the right hand side. $hest epansion should be e#ual. $-. The !hrenic ner"e is in"ol"ed in (a) !ulling the dia!hragm don on ins!iration
he diaphram moves down on inspiration to increase the vertical diameter of the thora. -ncreasin intra abdominal pressure will aid in micturition" parturition and defecation. 1y takin a deep breath and holdin it you can fi the diaphram to raise intra abdominal pressure to such an etent that it prevents vertebral column fleion. 1y raisin intraabdominal pressure and lowerin intrathoracic pressure the venous return to the riht side of the heart is encouraed. $,. The ?emoral Triangle& (a) The femoral "ein is medial to the femoral ner"e. he femoral vein is medial to the femoral nerve. (b) The femoral canal is on the lateral side of the femoral artery in the femoral triangle. he femoral canal is on the medial side of the femoral artery in the femoral trianle. (c) The femoral artery is a continuation of the eternal iliac artery and lies miday beteen the anterior su!erior iliac s!ine and the !ubic tubercle. he femoral artery is a continuation of the eternal iliac artery and lies midway between the anterior superior iliac spine and the pubic symphysis. (d) In the femoral triangle the femoral "ein is on the lateral as!ect of the femoral artery. -n the femoral trianle the femoral artery is related laterally to the femoral nerve and medially to the femoral vein and femoral canal. (e) The femoral ner"e is medial to the femoral artery in the femoral canal. he femoral nerve is lateral to the femoral artery in the femoral canal. $3. Alenohumeral dislocation (a) /nterior dislocations usually occur ith ecessi"e eternal rotation ith the arm in abduction. (b) 9ecurrent anterior shoulder dislocation becomes increasingly fre6uent ith age. Gecurrent anterior dislocation is indirectly related to ae. '% of those below 2' years and 7'% of those over 0' years. (c) /bout 50% of !eo!le ith anterior dislocations ill also ha"e com!ression fractures of the u!!er as!ect of the humeral head.
MCEM MCQ Anatomy bout &'% of people with anterior dislocations will also have compression fractures of the upper aspect of the humeral head" this results in a flattened sement referred to as a hatchet deformity; >ills6)achs < (d) ?ractures of the greater tuberosity of the humerus occur in 53% of !eo!le ith anterior dislocation. lso anterior dislocation is associated with fractures of the anterior rim of the lenoid fossa. (e) #osterior dislocations are ty!ically associated ith anteromedial fracture of the humeral head. Kp to half of posterior dislocations are not reconised in the initial ! film. $:. /ortic Cissection (a) $-rds of tears occur in the descending aorta 293 rds of tears occur in the ascendin aorta. 795 th occur in descendin. (b) Mortality is highest at $4- days. Mortality is hihest in the first few hours. (c) If the right coronary ostium is in"ol"ed the B'A may gi"e an inferior infarct !attern. -f the riht coronary ostium is involved the E$@ may ive an inferior infarct pattern. (d) Is associated ith cocaine use* !regnancy and hy!ertension. ther associations include marfan(s" trauma" and coarctation. (e) Medical thera!y is indicated for uncom!licated dissection of descending aorta.
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru
Fals
nd medical therapy may be considered for old stable dissections ; 82 weeks <" and isolated arch dissections. $7. 'entral
MCEM MCQ Anatomy he sternum runs from 5 to (e) The u!!er border of the li"er is usually at T:
e
e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
he upper border of the liver is usually at & $. im!le ankle strain(ith damage to a fe fibres of a ligament only) (a) light selling )liht swellin may develop almost immediately after injury. (b) ruising 1ruisin is associated with more severe injuries. (c) @oint instability -t would re#uire major damae to cause joint instability. (d) Ciscomfort o"er the ligament Discomfort over the liament is often found with mild strains. (e) Cramatic !ain relief ith cold com!resses. )liht swellin develops immediately but settles to a lare etent within a few hours.1ruisin occurs with a true or severe sprain. -t would re#uire major damae to produce joint instability. $old compresses may help reduce the swellin. -0. The folloing are true& (a) Fi! etension is !erformed by the femoral ner"e. -nfeior luteal performs hip etension. (b) The femoral ner"e is com!osed of 85 and 8$ ner"e roots. he femoral nerve is composed of :2":3 and :0. (c) The inferior gluteal ner"e is com!osed of 83*5*$ ner"e roots. he inferior luteal nerve is composed of :5")7")2 nerve roots. (d) Fi! etension is !erformed by the gluteus maimus muscle. -nferior luteal nerve" :5")7")2 nerve roots. (e) Fi! abduction is !erformed by gluteus medius and minimus. )uperior luteal nerve. -5. ith regard to neck trauma the folloing are true& (a) #enetrating injuries to the neck Gone 5 etends from the cla"icle to the cricoid cartilage. Lone 7 etends from the clavicles to the cricoid cartilae (b) #enetrating injuries to the neck Gone $ etends from the cricoid cartilage to the hyoid bone. With reard to penetratin injuries to the neck Jone 2 etends from the cricoid cartilae to the anle of the mandible. (c) #enetrating injuries to the neck Gone - etends from the hyoid bone to the base of the skull. With reard to penetratin injuries to the neck Jone 3 etends from the anle of the mandible to the skull base. (d) reach of the !latysma is an indication for emergency surgical e!loration. reach of the !latysma * e"idence of "ascular injury *e"idence of surgical em!hysema and haemodynamic instability due to major bleeding from a neck ound are indications for emergency surgical e!loration. -$. Myocardial 'ontusion
MCEM MCQ Anatomy Tru e
Fals e
Tru e
Fals e
(c) n B'A may be re!resented by dysrhythmiaEs
Tru e
Fals e
(d) n Trans Thoracic to dimensional echo may be re!resented by focal or regional all motion abnormalities
Tru e
Fals e
(e) Cysrhythmias should be managed conser"ati"ely
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
(c) The trice!s is inner"ated by the radial ner"e
Tru e
Fals e
(d) The su!inator refle is inner"ated by the radial ner"e
Tru e
Fals e
(e) The knee jerk tests knee fleion
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
(a) Is usually caused by blunt trauma to the chest Especially with fractures to sternum or anterior r ibs (b) n B'A may be re!resented by bundle branch block !attern
Manae as usual. --. Tendon 9eflees (a) The bice!s are inner"ated by the radial ner"e Musculocutaneous" $56& (b) The bice!s refle main ner"e roots are '34:
Etension9/uadriceps9:360 -,. The sca!hoid bone (a) The sca!hoid only articulates ith the radius* lunate* ca!itate* and tra!eGoid. he scaphoid articulates with the radius" lunate" capitate" trapeJoid" and trapeJium (b) / small !ortion of the surface is co"ered by hyaline cartilage *early the entire surface is covered by hyaline cartilae (c)
MCEM MCQ Anatomy radial artery" which divides into 260 branches before enterin the waist of the scaphoid alon the dorsal ride. he branches course volar and proimal within the bone" supplyin ='65% of the scaphoid. he volar scaphoid branch also enters the bone as several perforators in the reion of the tubercle, these supply the distal 2'%63'% of the bone -3. Aastrointestinal leeding& (a) /bout ,0% of duodenal bleeds ill re4bleed ithin $, 4,= hours. bout 7'% of duodenal bleeds will re6bleed within 20 60 hours. (b) / Mallory eiss tear occurs in the distal oeso!hagus due to a tear in the mucosa usually from re!eated "omiting* but may also occur secondary to sneeGing Mallory weiss tear occurs in the distal oesophaus due to a tear in the mucosa usually from repeated vomitin" but may also occur secondary to sneeJin (c) In loer AI bleeding* not from haemorrhoids* the most common aetiologies are adenomatous !oly!s. -n lower @- bleedin" not from haemorrhoids" the most common aetioloies are diverticular disease and aniodysplasia. (d) /ngiodys!lasia is more common in !atients ith aortic regurgitation. niodysplasia is more common in patients with aortic stenosis. (e) #HC causes about -0% of all u!!er AI bleeds.
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
!KD causes about &'% of all upper @- bleeds -:. ttaa /nkle 9ules&Indication for D 9ay (a) #osterior edge of lateral malleolus bone tenderness. !osterior ede of lateral malleolus bone tenderness is an indication for F Gay. (b) Ti! of lateral malleolus bone tenderness. ip of lateral malleolus bone tenderness is an indication for F Gay (c) #osterior edge of medial malleolus bone tenderness. !osterior ede of medial malleolus bone tenderness is an indication for F Gay. (d) Ti! of medial malleolus bone tenderness. ip of medial malleolus bone tenderness is an indication for F Gay. (e) ase of the 3th metacar!al. 1ase of the 5th metatarsal tenderness is an indication for F Gay. http99www.bmj.com9ci9content9full932&9=3&907=+7 -7. The folloing are true ith regard to loer "ertebral le"els& (a) The bifurcation of the aorta occurs at the "ertebral le"el of 8, he bifurcation of the aorta occurs at the vertebral level of :0 (b) The sacral dim!les are at the "ertebral le"els of $ he sacral dimples are at the vertebral levels of )2 (c) The !osterior su!erior iliac s!ine is at the "ertebral le"el of 5 he posterior superior iliac spine is at the vertebral level of )2 (d) The dural sac ends at the "ertebral le"el of 5 he dural sac ends at the vertebral level of )2 (e) The rectum starts at the "ertebral le"el of he rectum starts at the vertebral level of )3 -=. Bye Bmergencies
MCEM MCQ Anatomy (a) Fer!es im!le )? classically causes a dendritic epithelial defect. reatment is with topical anti6 virals. (b) Fer!es oster !thalmicus fre6uently in"ol"es a concurrent iritis >erpes Loster pthalmicus is shinles in the distribution of the trieminal nerve" ocular involvement and fre#uently involves a concurrent iritis. (c) Fy!hema is not associated ith rebleeding. Gebleedin can occur about 365 days followin the initial injury. (d) #eri4orbital cellulitis is associated ith !ainful eye mo"ements.
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
rbital cellulitis is but peri6orbital cellulitis is not. -. The !inal 'ord& (a) There are $ !airs of s!inal ner"es. here are 37 pairs of spinal nerves. (b) There are = !airs of cer"ical ner"es. here are pairs of cervical nerves. (c) There are 55 !airs of thoracic ner"es. here are 72 pairs of thoracic nerves. (d) There are , !airs of sacral ner"es. here are 5 pairs of sacral nerves. (e) There are , !airs of coccygeal ner"es. here is usually 7 pair of coccyeal nerves. he spinal cord ives rise to 37 pairs of spinal nerves cervical" 72 thoracic" 5 lumbar" 5 sacral" and 7 coccyeal ,0. Tract Cysfunction (a) 'orticos!inal tract injury is characterised by contralateral motor deficits -psilateral.$orticospinal tract injury is characterised by ipsilateral motor deficits. (b) !inothalamic tract injury is characterised by i!silateral !ain and tem!erature sensation loss $ontralateral.)pinothalamic tract injury is characterised by contralateral pain and temperature sensation loss. (c) #osterior 'olumn injury is characterised by i!silateral !ro!rioce!tion loss !osterior $olumn injury is characterised by ipsilateral proprioception loss (d) 'er"ical !ine injury may !resent ith hy!otension and bradycardia This is neurogenic shock due to loss of sym!athetic tone. (e) 'er"ical s!ine injuries may !resent ith !ain abo"e but not belo the cla"icle $ervical spine injuries may present with pain above but not below the clavicle ,5. /natomical considerations& (a) The origin of the coeliac ais is at T= he oriin of the coeliac ais is at 72 (b) 8- is crossed by the trans!yloric !lane of addison ( half ay beteen the su!rasternal notch and the sym!hysis !ubis.) :7 is crossed by the transpyloric plane of addison ; half way between the suprasternal notch and the symphysis pubis.<
MCEM MCQ Anatomy Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
(b) 'arotid artery aneursym
Tru e
Fals e
(c) #osterior 'ommunicating /rtery /neursym
Tru e
Fals e
(d) 2aso!haryngeal tumor s!read
Tru e
Fals e
(e) egeners Aranulomatosis
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru
Fals
(c) The "agi !ierce the dia!hragm at T= along ith the oeso!hagus he vai pierce the diaphram at 7' alon with the oesophaus (d) The aortic o!ening in the dia!hragm is anterior to the median arcuate ligament and transmits the aGygous and hemiaGygous "eins he aortic openin in the diaphram is posterior to the median arcuate liament and transmits the aJyous and hemiaJyous veins (e) The aortic o!ening transmits the thoracic duct. he aortic openin transmits the thoracic duct. ,$. 'arotid inus yndrome may be caused by (a) Trauma
r any other cause of infection such as sinusitis or tuberculosis ,-. The folloing is true ith regard to ru!ture of the bice!s tendon& (a) It most often affects $0 to ,0 year old men. Gupture of the biceps most commonly affects 0' to &' year olds. (b) May cause a !o!!ing sound during some acti"ity. r a sudden pain with a snappin sensation. (c) houlder aching may be orse at night. r painful durin repetitive or overhead movements (d) May cause a "isible mass beteen the shoulder and the elbo. -f not visible may well be palpable. (e) The treatment of choice is surgical re!air. f debatable value" but may be helpful in youn athletic types. ,,. 'la"icle fractures (a) /ccount for 5 in $0 adult fractures
(b) /re usually caused by a direct blo to the cla"icle hey are usually caused by a fall onto the lateral clavicle. (c) 2on dis!laced fractures are almost alays seen on /# "ies. *on displaced fractures may be difficult to see on ! views and may need 2' deree ; Lanca < views or 05 deree cephalic tilt. (d) 8ateral 5- rd of the cla"icle are the most common site for fracture. Middle 793 rd are the most common site for fracture and represents '% of fractured clavicles.; llman classification < (e) 2on dis!laced lateral 5-rd cla"icular fractures should be treated
MCEM MCQ Anatomy e
e
Tru e
Fals e
(b) 'lass II shock usually do not ha"e any mental aniety
Tru e
Fals e
(c) 'lass III !atients usually ha"e some aniety
Tru e
Fals e
(d) 'lass I< !atients are usually alert and not confused
Tru e
Fals e
(e) 'lass II !atients are usually confused
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
conser"ati"ely. Displaced lateral 793rd fractures usually re#uire operative intervention because they have a hih rate of non6union. *on displaced medial 793rd fractures are treated conservatively while displaced re#uire orthopaedic referral. www.aafp.or9afp92''0777597H0=.html ,3. Faemorrhagic shock (a) 'lass I !atients usually do not ha"e any mental aniety
$lass -6sliht aniety" $lass --6more aniety" $lass ---6 anious and sometimes confused" class -?" confused and letharic ,:. /!!reciation of the gross anatomy of the testis& (a) The ductus deferens ascends on the medial side of the e!ididymis. he ductus deferens ascends on the medial side of the epididymis. (b) The e!ididymis is on the !osterior as!ect of the testes and is : m in length. he epididymis is on the posterior aspect of the testes and is & m in lenth. (c) The head of the e!ididymis lies on the loer !ole of the testis here it is joined by the efferent ducts. he head of the epididymis lies on the upper pole of the testis where it is joined by the efferent ducts. (d) / hydrocele occurs hen there is atery fluid beteen the !arietal and "isceral layers of the tunica albuginea. hydrocele occurs when there is watery fluid between the parietal and visceral layers of the tunica vainalis ; a serous sac of peritoneal oriin < (e) The testicular artery is a direct branch of the abdominal aorta hich arises just belo the renal arteries and descends in the s!ermatic cord to the !osterior as!ect of the testes. he testicular artery is a direct branch of the abdominal aorta which arises just below the renal arteries and descends in the spermatic cord to the posterior aspect of the testes. ,7. Traumatic rain Injury (a) The majority of cases of e!idural haematoma ha"e a loss of consciousness folloed by a lucid inter"al folloed by neurological decline. minority" approimately 2'%" of cases have this classical description. (b) =0% of cases of e!idural haematoma ha"e a skull fracture that lacerates meningeal arteries. '% of cases of epidural haematoma have a skull fracture that lacerates menineal arteries. (c) / fied and dilated !u!il because of a e!idural haematoma is an early sign. fied and dilated pupil because of a epidural haematoma is a late sin. (d) 'ontralateral hemi!aresis in e!idural haematoma is an early sign.
MCEM MCQ Anatomy $ontralateral hemiparesis in epidural haematoma is a late sin. (e) / common mechanism for subdural haematoma is an acceleration4 deceleration injury common mechanism for subdural haematoma is an acceleration6 deceleration injury. ,=.
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
With increasin ae the porportion of fibrocartilae to water increases. ,. Testes* B!ididymis and !ermatic 'ord& (a) The cremasteric fascia containing the cremasteric muscle is deri"ed from the rectus abdominis muscle. he cremasteric fascia containin the cremasteric muscle is derived from the internal obli#ue muscle (b) The eternal s!ermatic fascia is deri"ed from the a!oneurosis of the trans"ersalis fascia. he eternal spermatic fascia is derived from the aponeurosis of the eternal obli#ue muscle (c) The round ligament terminates in the fibrofatty tissue of the labium majus. he round liament terminates in the fibrofatty tissue of the labium majus. (d) The dee! inguinal ring transmits the genital branch of the genitofemoral ner"e. he deep inuinal rin transmits the enital branch of the enitofemoral nerve. (e) The internal s!ermatic fascia is deri"ed from the internal obli6ue. he internal spermatic fascia is derived from the transversalis fascia 30. Intracranial bleeding (a) Btra dural haematoma is often due to bleeding from the anterior branch of the middle meningeal artery after a tem!oral bone fracture he classical history of this haematoma is one of an intial loss of consciousness followed by a subse#uent lucid period follwed by neuroloical deterioration. (b) /n acute rise in intracranial !ressure may manifest as a falling !ulse rate. $ushins response is characterised by bradycardia and hypertension. (c) /n acute rise in intracranial !ressure may manifest as a rising blood !ressure. $ushins response is characterised by bradycardia and hypertension. (d) /mnesia for e"ents >53min before the head injury is an indication for 'T rain can. mnesia for events 83'min before the head injury is an indication for $ 1rain )can. (e) /n acute rise in intracranial !ressure may manifest as a central res!iratory de!ression. n acute rise in intracranial pressure may manifest as a central respiratory
MCEM MCQ Anatomy depression. $ushins response occurs with bradycardia and hypertension 35. /bdominal structures corres!onding to "ertebral le"els& (a) The renal arteries originate at the "etebral le"el of 85$.
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
(b) olid organs such as li"er resist ca"itation more than softer tissues such as lung
Tru e
Fals e
(c) Figh "elocity injuries usually ha"e less bacterial contamination
Tru e
Fals e
(d) /bdominal gunshot ounds in"ariably re6uire la!arotomy.
Tru e
Fals e
(e) 'ranial gunshot ounds in"ariably re6uire "entilation.
Tru e
Fals e
Tru e
Fals e
(b) The !osterior half of the ear is su!!lied by branch of the trigeminal ner"e.
Tru e
Fals e
(c) The !osterior !art of the ear is su!!lied by $ ner"e branches deri"ed from the cer"ical !leus.
Tru e
Fals e
(d) The "agus ner"e has no role in the iner"ation of the ear.
Tru e
Fals e
(e) The "agus ner"e su!!lies the eternal auditory canal.
Tru e
Fals e
Tru e
Fals e
he renal arteries oriinate at the vetebral level of :792. (b) The s!inal cord ends in adults at the le"el of 85$. he spinal cord ends in adults at the level of :792. (c) The aGygous and hemiaGygous "eins are formed at 8, "ertebral le"el. he aJyous and hemiaJyous veins are formed at :2 vertebral level (d) The ligament of treitG is at the le"el of the u!!er border of the 8, "ertebra. he liament of treitJ is at the level of the upper border of the :2 vertebra. (e) The umbilicus is at the "ertebral le"el of 8-,. he umbilicus is at the vertebral level of :390. 3$. Aunshot ounds& (a) Tem!orary ca"itation is caused by a sonic shock a"e in high "elocity injuries.
3-. ith regard to inner"ation of the ear (a) The anterior half of the ear is su!!lied by the auriculotem!oral ner"e hich is a branch of the mandibular !ortion of the trigeminal ner"e.
he anterior half of the ear is supplied by the auriculotemporal nerve which is a branch of the mandibular portion of the trieminal nerve.he posterior part of the ear is supplied by 2 nerve branches derived from the cervical pleus.he vaus nerve supplies the eternal auditory canal.he position for an ear block is where the ear lobe attaches to the head. 3,. Blbo Cislocation (a) n lateral D 9ay the radius and the ulna are most commonly dis!laced !osteriorly. n lateral F Gay the radius and the ulna are most commonly displaced posteriorly.
MCEM MCQ Anatomy (b) The most fre6uent neurological injury is to the median ner"e. he most fre#uent neuroloical injury is to the ulnar nerve. (c) n clinical eam the olecranon !rocess is commonly not !rominent. n clinical eam the olecranon process is commonly prominent. (d) n clinical eam the elbo is commonly fleed at 0 degrees. n clinical eam the elbow is commonly fleed at 05 derees and the olecranon is prominent. (e)
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
Tru e
Fals e
he most common artery involved is the brachial artery. 55. tructure ?unction and Mechanics of the
MCEM MCQ Anatomy 1. Maxillofacial radiographs
(a) Orthopantomogram view can be used to assess the frontal bones False ?OP is used to assess the mandible (b) !ubmentovertical pro"ection is used to assess the #$gomatic arch %rue ? (c) Occiptomental views are used to assess the maxilla %rue ?Occiptomental views are used to assess the maxilla& orbital floors and #$gomatic arches (d) Occipitomental views are used to assess the orbital floors %rue ?Occiptomental views are used to assess the maxilla& orbital floors and #$gomatic arches (e) Occipitomental views are used to assess the #$gomatic arches %rue ?Occiptomental views are used to assess the maxilla& orbital floors and #$gomatic arches
'. !urface natom$
(a) %he phar$nx becomes the oesophagus at *+ %rue ?%he phar$nx becomes the oesophagus at *+ (b) *, is the first clearl$ palpable spinous process. %rue ?*, is the first clearl$ palpable spinous process. (c) %he superior border of the scapula is at %- False ?%he superior border of the scapula is at %' (d) %he suprasternal notch is at the level of %'- %rue ?%he suprasternal notch is at the level of %'(e) %he end of the obli/ue fissure of the lung is at the spine of %- %rue ?%he end of the obli/ue fissure of the lung is at the spine of %-. !urface natom$ of the nterior Forearm
(a) %he brachial arter$ divides into the radial and ulnar arteries "ust below the line of the elbow "oint. %rue ?%he brachial arter$ divides into the radial and ulnar arteries "ust below the line of the elbow "oint. (b) %he radial arter$ lies in a groove between the flexor carpi radialis and the anterior border of the radius. %rue ?%he radial arter$ lies in a groove between the flexor carpi radialis and the anterior border of the radius. %he radial arter$ lies in a groove between the flexor carpi radialis and the anterior border of the radius. (c) %he radial arter$ can be palpated on the lateral side of the trape#ium in the anatomical snuff box. False ?%he radial arter$ can be palpated on the lateral side of the scaphoid in the anatomical snuff box. (d) 0n the area of the wrist and hand the ulnar arter$ is covered b$ the palmer aponeurosis. %rue ?0n the area of the wrist and hand the ulnar arter$ is covered b$ the palmer aponeurosis. (e) %he pulsations of the ulnar arter$ are recognised lateral to the pisiform bone. %rue ?%he pulsations of the ulnar arter$ are recognised lateral to the pisiform bone
MCEM MCQ Anatomy . 2adial 3ead Fractures
(a) 2adial head fractures are the most common fractures of the elbow %rue ?2adial head fractures are the most common fractures of the elbow (b) %he radial head articulates with the trochlea False ?%he radial head articulates with the capitellum. (c) %he radial head serves as a stabiliser against forces awa$ from the midline. %rue ?%he radial head serves as a stabiliser against valgus stress. (d) 2adial head fractures are usuall$ the result of a fall on an outstretched hand causing the radial head to be driven into the trochlea. False ?2adial head fractures are usuall$ the result of a fall on an outstretched hand causing the radial head to be driven into the capitellum. (e) re associated with medial epicond$le avulsion fractures. %rue ?%his is secondar$ to valgus stress. 4. natomical *onsiderations of the thoracic vertebrae
(a) %he start of the arch of the aorta is at %%4 %rue ?%he start of the arch of the aorta is at %%4 (b) %he sternum runs from %4 to %5 %rue ?%he sternum runs from %4 to %5 (c) %he upper border of the liver is usuall$ at %6 False ?%he upper border of the liver is usuall$ at %+ (d) %he inferior angle of the scapula is at %- False ?%he inferior angle of the scapula is at %, (e) %he 07* goes through the diaphragm at %5 %rue ?%he 07* goes through the diaphragm at %5 ( along with the right phrenic nerve ) +. the ulnar nerve is interrupted at the wrist the following muscles are not innervated.
(a) Palmaris brevis . %rue ?Palmaris brevis is innervated b$ the superficial terminal branch of the ulnar nerve in the hand. (b) Opponens pollicis False ?Opponens pollicis is innervated b$ the median nerve. (c) Flexor pollicis brevis False ?Flexor pollicis brevis is innervated b$ the median nerve. (d) bductor pollicis brevis False ?bductor pollicis brevis is innervated b$ the median nerve. (e) Flexor carpi ulnaris False ?Flexor carpi ulnaris is innervated b$ a branch of the ulnar nerve in the forearm.
MCEM MCQ Anatomy ,. 8euroanatom$
(a) %he fibers of the p$ramids cross in the pons. False ?%he fibers of the p$ramids cross in the medulla.%he crossing event is called the decussation of the p$ramids (b) %he cerebral peduncles largel$ contain motor fibers. %rue ?%he cerebral peduncles largel$ contain motor fibers. (c) Motor and somatosensor$ information travel through the anterior limb of the internal capsule. False ?Motor and somatosensor$ information travel through the posterior limb of the internal capsule. (d) 0n the motor cortex the lateral side of the g$rus controls the hands and face. %rue ?0n the motor cortex& the bod$ is mapped out across the extent of the g$rus. *ontrol of the feet lies near the midline at the top of the g$rus& whereas the lateral side of the g$rus controls the hands and face. 5. %he following headaches usuall$ have associated focal abnormal neurolog$
(a) Migraine False ?Possible but not usual (b) *a channel bloc9er associated headache False ? (c) 8itrates associated headache False ? (d) *O poisoning headache False ? (e) %emporal rteritis False ?
Other headaches without associated neurolog$ include tension& and analgesic 6. :uring initial management of a multipl$ in"ured patient
(a) !hoc9 management is the first priorit$. False ? (b) *ervical spine control is usuall$ necessar$. %rue ?*ervical spine control is usuall$ necessar$. (c) ;xternal haemorrhage should be ignored. False ? (d) Pulse oximetr$ is usuall$ unhelpful. False ?%he results of pulse oximetr$ should be interpreted with particular caution in the presence of abnormal haemoglobins(the pulse oximetr$ reading represents a summation of ox$hemoglobin and carbox$hemoglobin and in cases of carbon monoxide poisoning or in chronic& heav$ smo9ers& a falsel$ reassuring pulse oximetr$ reading ma$ mas9 arterial desaturation)& nail polish& deepl$ pigmented s9in& h$poperfusion& anemia& venous congestion& or when certain vital d$es (such as meth$lene blue& indoc$anine green& fluorescein& indigo carmine& and isosulfan blue) are used for clinical purposes. (e) 0schaemic limbs demand immediate attention. False ?
MCEM MCQ Anatomy 1<. *hest drain insertion is usuall$ indicated in patients with the following conditions
(a) Mediastinal traversing wounds. %rue ? (b) Flail chest. %rue ?Flail chest occurs when three or more ad"acent ribs are each fractured in two places& creating one floating segment comprised of several rib sections and the soft tissues between them. %his unstable section of chest wall exhibits paradoxical motion (ie& it moves in the opposite direction of the unin"ured& normal= functioning chest wall) with breathing& and is associated with significant morbidit$ from pulmonar$ contusion. bnormal motion can be difficult to detect ma9ing the diagnosis difficult. 0nitial management of flail chest consists of ox$gen and close monitoring for earl$ signs of respirator$ compromise& ideall$ using both pulse oximetr$ and capnograph$ in addition to clinical observation. >se of noninvasive positive airwa$ pressure b$ mas9 ma$ obviate the need for endotracheal intubation in alert patients. Patients with severe in"uries& respirator$ distress& or progressivel$ worsening respirator$ function re/uire endotracheal intubation and mechanical ventilator$ support. (c) Open pneumothorax. %rue ? (d) 2uptured diaphragm. False ? (e) !urgical emph$sema. False ? 11. Ma"or %rauma
(a) Pelvic fractures in children are rare and clinicall$ apparent& ma9ing the routine screening pelvic 2a$ obsolete. %rue ? (b) 3$pertonic saline is beneficial in h$potensive patients with head in"ur$. False ? (c) !teroids are beneficial in patients with head in"ur$ and *! @14 False ?httpwww.thelancet.com"ournalslancetarticleP00!<1<+,-+<1,155'abstract. (d) Patients intubated without the need for anaesthetic drugs had a survival rate of about 'A False ? (e) post traumatic head in"ur$ sei#ure is an indication to re/uest a *% brain scan immediatel$ according to the 80*; guidelines. %rue ?httpwww.nice.org.u9nicemediapdf*4+Buic92eduide.pdf
One 8ew Cealand stud$ of -, children who had a pelvic 2a$ found onl$ 1 fracture and this fracture was clinicall$ apparent. %he authors recommend not 2a$ing. 0n the *2!3 trial steroids in patients with head in"ur$ showed more harm than good. httpwww.thelancet.com"ournalslancetarticleP00!<1<+,-+<1,155'abstract
MCEM MCQ Anatomy 1'. 2egarding fracture classifications
(a) %he 8eer classification refers to distal radial fractures. False %he 8eer classification refers to proximal humeral fractures. (b) %he Fr$9man classification refers to proximal humeral fractures. False %he Fr$9man classification refers to distal radial fractures. (c) %he !chat#9er classification refers to tibial plateau fractures. %rue %he !chat#9er classification refers to tibial plateau fractures. (d) %$pe 00 is the most common t$pe of !alter=3arris fracture presentations. %rue %$pe 00 is the most common t$pe of !alter=3arris fracture presentations.
1-. %he glossophar$ngeal nerve (*8 0)
(a) rises in the pons. False ?%he glossophar$ngeal nerve is mainl$ sensor$. 0t arises in the medulla. (b) Deaves the s9ull through the "ugular foramen %rue ?%he glossophar$ngeal nerve leaves the s9ull through the "ugular foramen along with the vagus and accessor$ nerve. (c) 0s the efferent pathwa$ of the gag reflex False ?!ensor$ fibers provide sensation to the tonsillar fossa and phar$nx ( the afferent pathwa$ of the gag reflex) and taste to the posterior '- rdEs of the tongue. (d) !upplies taste fibers to the anterior two=thirds of the tongue False ?!ensor$ fibers provide sensation to the tonsillar fossa and phar$nx ( the afferent pathwa$ of the gag reflex ) and the taste to the posterior '- rdEs of the tongue. (e) !upplies the st$lophar$ngeal muscle. %rue ?Motor fibers suppl$ the st$lophar$ngeus muscle& autonomic fibers suppl$ the parotid gland& and a sensor$ branch supplie the carotid sinus. 1. %he following statements are true
(a) %he median nerve supplies the interossei of the hand False ?>lnar (b) %he radial nerve supplies the abductor pollicis brevis False ?%he radial nerve does not suppl$ an$ of the intrinsic muscles of the hand (c) %he ulnar nerve supplies sensation to the one and a half ulnar digits %rue ? (d) %he extensor muscles of the forearm are supplied b$ the radial nerve %rue ? (e) %he biceps muscle is supplied b$ the musculocutaneous nerve %rue ?
MCEM MCQ Anatomy 14. %he following are true in relation to common root compression s$ndromes produced b$ lumbar disc disease
(a) n !1 root lesion will produce wea9ness of plantar flexion of the an9le and toes. %rue ?n !1 root lesion will produce wea9ness of plantar flexion of the an9le and toes. (b) n !1 root lesion will cause loss of the 9nee "er9 reflex. False ?n !1 root lesion will cause loss of the an9le "er9 reflex. (c) n D root lesion will cause sensor$ loss at the anteromedial shin. %rue ?n D root lesion will cause sensor$ loss at the anteromedial shin. (d) n D4 root lesion will cause sensor$ loss over the sole of the foot. False ?n D4 root lesion will cause sensor$ loss over the dorsum of the foot and anterolateral shin while an !1 root lesion will cause sensor$ loss over the sole of the foot. 1+. %he ;ar
(a) %he cochlea contains the auditor$ sensor$ receptors. %rue ?%he cochlea contains the auditor$ sensor$ receptors and the vestibular lab$rinth contains the balance receptors (b) %he vestibular lab$rinth contains the balance receptors. %rue ?%he cochlea contains the auditor$ sensor$ receptors and the vestibular lab$rinth contains the balance receptors (c) lood suppl$ to the inner ear is from the internal carotid arter$. False ?lood suppl$ to the inner ear is from the vertebrobasilar s$stem. (d) %he anterior vestibular arter$ to the cochlea False ?%he anterior vestibular arter$ provides the blood suppl$ to the anterior and hori#ontal semicircular canals but not to the cochlea (e) %he anterior vestibular arter$ provides the blood suppl$ to the anterior and hori#ontal semicircular canals. %rue ?%he anterior vestibular arter$ provides the blood suppl$ to the anterior and hori#ontal semicircular canals but not to the cochlea 1,. *olles Fracture
(a) 0s a fracture of the radius within 1 cm of the wrist. False ?*olles fracture is a fracture of the radius within '.4 cm of the wrist. (b) %he distal fragment is displaced anteriorl$. False ?%he distal fragment is displaced posteriorl$ and with radial displacement. (c) %he angulation of the distal radius normall$ has a 4 degree forward tilt on the poximal carpal bones as seen on the lateral 2a$ ( i.e in peole without a fracture ) %rue ?%he angulation of the distal radius normall$ has a 4 degree forward tilt on the poximal carpal bones as seen on the lateral 2a$ ( i.e in peole without a fracture ) (d) *olles fracture is associated with flexor pollicis longus rupture in the wee9s following in"ur$. False ?*olles fracture is associated with extensor pollicis longus tendon rupture in the wee9s following the in"ur$. (e) *olles fracture usuall$ follows a fall onto a flexed wrist False ?*olles fracture usuall$ follows a fall onto an outstretched hand. !mithEs fracture usuall$ follows a fall onto a flexed wrist.
MCEM MCQ Anatomy 15. 2adiograph 0nterpretation
(a) %he right heart border is formed b$ the outer border of the right ventricle. False ?%he right heart border is formed b$ the outer border of the right atrium. (b) %he left heart border is formed b$ the outer border of the left ventricle. %rue ?%he left heart border is formed b$ the outer boder of the left ventricle. (c) %he left margin of the right ventricle lies about a thumbs breath in from the left heart border. %rue ?%he left margin of the right ventricle lies about a thumbs breath in from the left heart border and on the surface of the heart this is mar9ed b$ the left anterior descending arter$. (d) 7alve calcification is best seen on the P view. False ?7alve calcification is best seen on the lateral view as on the P view valve calcification cannot be visualised over the spine. (e) large pulmonar$ arter$ will cause hilar enlargement. %rue ? large pulmonar$ arter$ will cause hilar enlargement as will l$mphadenopath$.
16. %he facial nerve
(a) %he nerve emerges on the anterior surface of the brain between the pons and the medulla and it enters the internal acoustic meatus with the vestibulocochlear nerve. %rue ?%he nerve emerges on the anterior surface of the brain between the pons and the medulla and it enters the internal acoustic meatus with the vestibulocochlear nerve. (b) %he greater petrosal nerve arises from the nerve at the geniculate ganglion. %rue ?%he greater petrosal nerve contains taste fibers from the palate. 0t also contains preganglionic paras$mpathetic fibres that s$napse in the pter$gopalatine ganglion. %he postganglionic fibers are secretomotor to the lacrimal gland and the glands of the nose and palate. (c) Passes through the posterior fossa. %rue ? (d) On reaching the medial wall of the middle ear the nerve swells to form the sensor$ geniculate ganglion. %rue ? (e) ;merges from the temporal bone through the st$lo=mastoid foramen. %rue ?
%he facial nerve arises in the medulla and emerges between the pons and medulla. 0t then passes through the posterior fossa and runs through the middle ear before emerging from the st$lo=mastoid foramen and running through the parotid. '<. %he Forearm (a) %he radial arter$ can be palpated on the medial side of the scaphoid in the anatomical snuff box. False ?%he radial arter$ can be palpated on the lateral side of the scaphoid in the anatomical snuff box. (b) %he pulsations of the ulnar arter$ are recognised lateral to the lunate bone. False ?%he pulsations of the ulnar arter$ are recognised lateral to the pisiform bone (c) %he radial arter$ lies in a groove between the flexor digitorum profundus and the anterior border of the radius. False ?%he radial arter$ lies in a groove between the flexor carpi radialis and the anterior border of the radius. (d) 0n the area of the wrist and hand the ulnar arter$ is covered b$ the palmer aponeurosis. %rue
MCEM MCQ Anatomy ?0n the area of the wrist and hand the ulnar arter$ is covered b$ the palmer aponeurosis. (e) %he brachial arter$ divides into the radial and ulnar arteries "ust below the distal third of the humerus. False ?%he brachial arter$ divides into the radial and ulnar arteries "ust below the line of the elbow "oint.
'1. Gith regard to innervation of the scalp
(a) %he frontal part of the scalp is innervated b$ branches of the opthalmic part of the trigeminal nerve. %rue
(b) %he frontal part of the scalp is innervated b$ the supraorbital and supratrochlear nerves. %rue
(c) %he posterior part of the scalp is innervated b$ branches of the first division of the trigeminal nerve False
(d) %he posterior part of the scalp is innervated b$ branches of the cervical plexus. %rue
(e) %he cervical plexus pla$s a role in innervation of the posterior and lateral scalp. %rue
%he frontal part of the scalp is innervated b$ the supraorbital and supratrochlear nerves which are branches of the first division of the trigeminal nerve.%he posterior part of the scalp is innervated b$ branches of the cervical plexus& more specificall$ the greater and lesser occipital nerves. %he cervical plexus innervates the lateral scalp through the lesser occipital nerve. ''. Muscles of the hand
(a) Flexor pollicis brevis flexes the M*P "oint of the thumb. %rue
(b) Flexor pollicis brevis is innervated b$ median nerve %rue %his is usuall$ the case however ma$ also be innervated b$ the deep branch of the ulnar nerve (c) Flexor pollicis longus flexes proximal phalanx of thumb False Flexor pollicis longus flexes distal phalanx of thumb (d) ;xtensor pollicis longus extends the 0P and M*P "oints of the thumb %rue ? (e) ;xtensor pollicis brevis forms anterior border of the anatomical snuff box. %rue ;xtensor pollicis brevis forms anterior border of the anatomical snuff box and the posterior border of the snuffbox is the tendon of the extensor pollicis longus. '-. Penetrating in"uries of the diaphragm
(a) %he arching domes of the diaphragm highest point is the level of the +th rib False
(b) 0f a penetrating in"ur$ is "ust below the level of the nipples one should not be suspicious of a penetrating in"ur$ to the diaphragm False
MCEM MCQ Anatomy (c) %he left dome of the diaphragm is higher than the right dome in normal people. False
(d) %he right dome of the diaphragm is higher than the left dome in normal people. %rue
(e) %he right dome of the diaphragm is more li9el$ to suffer a penetrating in"ur$. False
%he arching domes of the diaphragm can reach the level of the 4th rib.0f a penetrating in"ur$ is "ust below the level of the nipples one should be suspicious of a penetrating in"ur$ to the diaphragm '. Occlusion of the anterior cerebral arter$ causes
(a) Paral$sis of the opposite leg %rue ? (b) Perseveration %rue ? (c) >rinar$ incontinence %rue ? (d) rasp reflex in the opposite hand %rue ? (e) Gernic9es(receptivefluent) d$sphasia False ? '4. 0n the alert patient with evidence of blunt abdominal trauma
(a) Peritoneal lavage is helpful if the patient is stable. %rue ?1<<&<<< 2*mm- or 4<< G*mm- is considered a positive peritoneal lavage and reflects intra= abdominal bleeding. (b) Peritoneal lavage is indicated if the patient is unstable. False ?%he patient is li9el$ to need a laparotom$ if there has been abdominal trauma and heshe is haemod$namicall$ unstable. (c) Gith F!% scanning free fluid visible in the abdomen implies at least 4<
MCEM MCQ Anatomy '+. Ottawa an9le rules %he following re/uire 2a$
(a) %enderness at the base of the 4th metatarsal. %rue ? (b) one tenderness along the distal + cm of the posterior edge of the tibia or tip of the medial malleolus %rue ? (c) one tenderness along the distal + cm of the posterior edge of the fibula or tip of the lateral malleolus %rue ? (d) one tenderness at the navicular bone (for foot in"uries). %rue ? (e) Pregnanc$ is an exclusion criteria. %rue ?long with children and those with diminished abilit$ to follow the test.
=ra$s are onl$ re/uired if there is bon$ pain in the malleolar or midfoot area& and an$ one of the following one tenderness along the distal + cm of the posterior edge of the tibia or tip of the medial malleolus one tenderness along the distal + cm of the posterior edge of the fibula or tip of the lateral malleolus one tenderness at the base of the fifth metatarsal (for foot in"uries). one tenderness at the navicular bone (for foot in"uries). n inabilit$ to bear weight both immediatel$ and in the emergenc$ department for four steps. *ertain groups are excluded& in particular children (under the age of 15)& pregnant women& and those with diminished abilit$ to follow the test (for example due to head in"ur$ or intoxication). ',. Mandibular Fractures
(a) >suall$ occur on one side of the mandible onl$ False ? (b) %he most common area of fracture is the angle of the mandible %rue (c) Ma$ present with bon$ crepitus %rue (d) Ma$ present with malocclusion %rue (e) Ma$ present with limited 2OM %rue '5. %he following are true
(a) iceps is innervated b$ musculocutaneous %rue ? (b) rachioradialis is innervated b$ musculocutaneous False ?$ radial nerve (c) ;lbow flexion is initiated b$ nerve roots *4 and *+ %rue ? (d) %riceps are innervated b$ *, %rue ? (e) Finger flexion is mediated b$ the radial nerve False ?Median and ulnar
MCEM MCQ Anatomy '6. %he 3and
(a) %he median nerve enters the hand through the carpal tunnel& deep to the flexor retinaculum& between the tendons of the flexor digitorum superficialis and the flexor carpi radialis. %rue ?%he median nerve enters the hand through the carpal tunnel& deep to the flexor retinaculum& between the tendons of the flexor digitorum superficialis and the flexor carpi radialis. (b) %o anaesthetise the median nerve local anaesthetic is in"ected between the tendonEs of the flexpr carpi radialis and palmaris longus. %rue ?%o anaesthetise the median nerve local anaesthetic is in"ected between the tendonEs of the flexpr carpi radialis and palmaris longus. (c) t the wrist the ulnar nerve is bloc9ed b$ in"ecting local anaesthetic between the palmaris longus and the flexor carpi ulnaris False ?t the wrist the ulnar nerve is bloc9ed b$ in"ecting local anaesthetic between the ulnar arter$ and the flexor carpi ulnaris. (d) %he ulnar nerve supplies cutaneuos sensation to the volar surface of the middle finger. False ?%he ulnar nerve supplies cutaneuos sensation to the volar surface of the little finger and the medial half of the ring finger. (e) bout 4 mlEs of 'A lignocaine is re/uired to anaesthetise the ulnar nerve. False ? -<. Deft common carotid arter$
(a) Dies postero=laterall$ to the left vagus nerve in the nec9. False %he left common carotid arter$ lies antero=medial to the left vagus nerve in the nec9 (b) Dies anteriorl$ to the prevertebral fascia in the nec9. %rue %he left common carotid arter$ lies anteriorl$ to the prevertebral fascia in the nec9. (c) ives off the left inferior th$roid arter$. False %he left th$roid arter$ is a branch of the left th$rocervical trun9 of subclavian (d) 0s a direct branch from the aortic arch. %rue %he left common carotid arter$ is a direct branch from the aortic arch. -1. 3aemorrhagic !hoc9
(a) Pulse @1<< is consistent with class 0 shoc9 %rue ? (b) Pulse 1<<=1'< is consistent with class 00 shoc9 %rue ? (c) Pulse 1'<=1< is consistent with class 000 shoc9 %rue ? (d) Pulse H1< is consistent with class 07 shoc9 %rue ? (e) Pulse 1'<=1< is consistent with class 07 shoc9 False ?
%D! classification. @1<< class 0& @1'< class 00& @1< class 000& H1< class 07
MCEM MCQ Anatomy -'. %he Dumbar Plexus
(a) %he femoral nerve originates from the lumbar plexus from D'& D- and D. %rue ?%he femoral nerve originates from the lumbar plexus from D'& D- and D. (b) %he obturator nerve originates from D1 and D' and supplies the adductor muscles of the thigh. False ?%he obturator nerve originates from D'& D- and D and supplies the adductor muscles of the thigh. (c) %he femoral nerve supplies the s9in on the posterior aspect of the leg and foot. False ?%he femoral nerve supplies the s9in on the medial side of the leg and foot. (d) %he ilioh$pogastric nerve supplies the cremaster muscle. False ?%he genitofemoral nerve supplies the cremaster muscle. (e) %he femoral nerve supplies the s9in on the medial surface of the thigh onl$. False ?%he femoral nerve supplies the s9in on the anterior surface of the thigh.%he obturator nerve innervates the adductors of the thigh and the s9in on the medial surface of the thigh.
--. Dower vertebral levels
(a) %he dural sac ends at the vertebral level of !- False ?%he dural sac ends at the vertebral level of !' (b) %he rectum starts at the vertebral level of !1 False ?%he rectum starts at the vertebral level of !(c) %he bifurcation of the aorta occurs at the vertebral level of D4 False ?%he bifurcation of the aorta occurs at the vertebral level of D (d) %he sacral dimples are at the vertebral levels of !1 False ?%he sacral dimples are at the vertebral levels of !' (e) %he posterior superior iliac spine is at the vertebral level of !' %rue ?%he posterior superior iliac spine is at the vertebral level of !' -. *ompartment s$ndrome
(a) %he pain is characteristicall$ mild. False ? (b) %he pain is characteristicall$ well localised. False ? (c) Palpation of the affected compartment will exacerbate the pain. %rue ?Palpation of the affected compartment will exacerbate the pain. (d) Passive stretching of muscles in the affected compartment will exacerbate the pain. %rue ?Passive stretching of muscles in the affected compartment will exacerbate the pain. (e) Paraesthesia is a feature before pain. False ?
%he pain is severe and poorl$ localised.Palpation of the affected compartment will exacerbate the pain.Passive stretching of muscles in the affected compartment will exacerbate the pain.Paraesthesia is a feature after pain.
MCEM MCQ Anatomy -4. D$mphatic drainage of the thoracic wall.
(a) %he s9in drains to the axillar$ l$mph nodes. %rue
(b) %he intercostal spaces drain to the internal thoracic nodes. %rue
(c) %he posterior spaces drain to the posterior intercostal nodes. %rue
(d) %he posterior intercostal spaces drain to the para aortic nodes %rue
(e) %he s9in on the posterior surface drains to the para=aortic nodes False
%he s9in drains to the axillar$ l$mph nodes.%he intercostal spaces drain forwards to the internal thoracic nodes and bac9wards to the posterior intercostal nodes and the para aortic nodes. -+. *haracteristic features of repetitive strain in"ur$
(a) Pain felt deep in the wrist. %rue ?Pain felt deep in the wrist radiating to forearm and shoulder is a characteristic feature of repetitive strain in"ur$. (b) Mar9ed oedema of fingers and hand. False ?!ub"ective feeling of swelling but nothing to find on examination. (c) !$mptoms worse at night False ?Gorsen with wor9 and improve with rest. Pain initiall$ clears at night but can become constant. (d) 2aised ;!2. False ?8o clinical signs. 2a$ and bloods are normal. (e) ood response to 8!0:s. False ?8ot of great help. -,. %he rachial Plexus
(a) %he dorsal scapular nerve is a branch of *,. False ?%he dorsal scapular nerve is a branch of *4. (b) %he medial cord supplies the extensor structures on the posterior aspect of the limb. False ?%he posterior cord supplies the extensor structures on the posterior aspect of the limb. (c) %he anterior division of the lower trun9 forms the medial cord. %rue ?%he anterior division of the lower trun9 forms the medial cord. (d) %he posterior cord ma$ contain neurons from all the spinal nerves contributing to the brachial plexus %rue ?%he posterior cord ma$ contain neurons from all the spinal nerves contributing to the brachial plexus. (e) 0n the axilla the posterior divisions unite to form the lateral cord False ?0n the axilla the posterior divisions unite to form the posterior cord
MCEM MCQ Anatomy -5. %he 7ertebral *olumn
(a) Dateral flexion of the bod$ is restricted b$ the thoracic section of the vertebral column. %rue ?Dateral flexion of the bod$ is restricted b$ the thoracic section of the vertebral column because of the ribs. (b) 2otation ( twisting of the bod$ ) of the bod$ is least extensive in the lumbar region. %rue ?2otation of the bod$ is least extensive in the lumbar region. (c) Flexion and extension of the vertebral column is extensive in the cervical and thoracic regions but limited b$ the lumbar region. False ?Flexion and extension of the vertebral column is extensive in the cervical and lumbar regions but limited b$ the thoracic region. (d) %he cervical vertebrae normall$ have a posterior convexit$ while the thoracic region has a posterior concavit$. False ?%he cervical vertebrae normall$ have a posterior concavit$ while the thoracic region has a posterior convexit$. (e) %here is normall$ , cervical vertebrae& 1' thoracic vertebrae& 4 lumbar vertebrae& and 4 sacral vertebrae& and cocc$geal vertebrae. %rue ?%here is normall$ , cervical vertebrae& 1' thoracic vertebrae& 4 lumbar vertebrae& and 4 sacral vertebrae& and cocc$geal vertebrae.
-6. %he thorcic spine
(a) 3as an increased amount of flexibilit$ afforded b$ itEs articulation with the rib cage. False ?%he rib cage ma9es the thoracic spine more inflexible and more rigid. (b) %he thorcic spine is the most commonl$ in"ured part of the spine. False ?%he thoracic spine is among the least fre/uentl$ in"ured parts of the spine. (c) %he spinal canal is wider than that found in the cervical spine. False ?%he spinal canal is narrower in the thoracic spine than that found in the cervical or lumbar spine. (d) Ghen spinal cord in"ur$ does occur the$ are mostl$ neurologicall$ complete. %rue ?ecause of the high ratio of spinal cord to spinal canal in the thoracic spine when spinal cord in"ur$ does occur it is usuall$ complete. (e) %he thoracolumbar "unction (%11=D') is considered a transitional #one between the fixed thoracic and mobile lumbar regions %rue ?%he thoracolumbar "unction (%11=D') is considered a transitional #one between the fixed thoracic and mobile lumbar regions <. %he following muscles and nerve root suppl$ are correctl$ paired
(a) :eltoid*4 %rue ?*4 is the nerve root for shoulder abduction b$ the deltoid muscle. (b) Grist ;xtensors*+ %rue ?*+ is the nerve root for wrist extension. (c) *,;lbow ;xtension %rue ?*, is the nerve root for elbow extension. (d) %1bductor :igiti Minimi %rue ?%1 is the nerve root for little finger abduction b$ abductor digiti minimi.
MCEM MCQ Anatomy 1. 3ip Fractures
(a) ;xtracapsular fractures are more li9el$ to compromise blood suppl$ to the femoral head than intracapsular fractures. False ? (b) 0solated femoral head fractures are most commonl$ associated with hip dislocations. %rue ? (c) 8on displaced nec9 fractures are treated with pin fixation. %rue ? (d) :isplaced fractures are treated with open reduction or prosthesis placement. %rue ? (e) Overall mortalit$ for intertrochanteric hip fractures is 4
3ip fracture incidence doubles for each decade after 4<. 3ip fracture incidence is - to times higher in women than in men. %he affected leg in a hip fracture is classicall$ shortened and externall$ rotated. 0ntracapsular hip fractures involve the femoral head and femoral nec9. ;xtracapsular hip fractures ma$ be intertrochanteric or subtrochanteric. 0ntracapsular fractures are more li9el$ to compromise blood suppl$ to the femoral head than extracapsular fractures. 0solated femoral head fractures are most commonl$ associated with hip dislocations. 8on displaced nec9 fractures are treated with pin fixation. :isplaced fractures are treated with open reduction or prosthesis placement. 0ntertrochanteric fractures are classed as stable or unstable. stable fractures are those which the medial cortices of the femoral nec9 and the femoral fragment abut. Overall mortalit$ for intertrochanteric hip fractures is 1< to -
'. *lassification of shoc9
(a) *lass 0 shoc9 is when blood loss is @1
*lass 0 I @14A& *lass 00 I @-
MCEM MCQ Anatomy -. 80*; uideline !election of dults for *% rain
(a) *! @ 1- when first assessed in ;: *% brain should be re/uested immediatel$ according to the 80*; guidelines after head in"ur$. %rue ?*! @ 1- when first assessed in ;: *% brain should be re/uested immediatel$ (b) 0f *! @ 14 when assessed ' hours after presentation in ;: *% brain should be re/uested. %rue ?0f *! @ 14 when assessed ' hours after presentation in ;: *% brain should be re/uested. (c) suspected s9ull fracture is not an indication to re/uest a *% rain scan. False ? suspected s9ull fracture is an indication to re/uest a *% rain scan. (d) EPandaE e$es are not an indication to re/uest a *% rain scan False ?EPandaE e$es is an indication to re/uest a *% brain scan as this is evidence of a fracture at the s9ull base. (e) collection of blood in the middle ear space is not an indication to re/uest a *% rain scan. False ?3aemot$mpanum is an indication to re/uest a *% rain scan as this is evidence of a fracture at the s9ull base. . Openings in the diaphragm
(a) %he aortic opening lies anterior to the bod$ of %1< False %he aortic opening lies anterior to the bod$ of %1'.%he aortic opening transmits the aorta&the thoracic duct and the a#$gous vein (b) %he aortic opening transmits the aorta&the thoracic duct& the a#$gous vein& and the vagus nerve. False %he aortic opening transmits the aorta&the thoracic duct and the a#$gous vein. %he oesophageal opening transmits the vagi. (c) %he esophageal opening is at the level of %1' False %he esophageal opening is at the level of %1<. (d) %he esophageal opening transmits the phrenic nerve False %he esophageal opening transmits the vagi at %1<. %he right phrenic nerve penetrates the diaphragm with the 07* while the left phrenic nerve penetrates on itEs own. (e) %he caval opening transmits the inferior vena cava at the level of %5 %rue %he caval opening transmits the inferior vena cava at the level of %5.
%he aortic opening lies anterior to the bod$ of %1'.%he aortic opening transmits the aorta&the thoracic duct and the a#$gous vein.%he esophageal opening transmits the vagus nerve 4. Gith regard to the nervous s$stem
(a) :orsal columns carr$ proprioception and vibration sense %rue :orsal columns ( Posterior *olumns ) carr$ proprioception and vibration sense and decussate in the brainstem. (b) %he dorsal columns decussate in the medulla %rue %he dorsal columns decussate in the medulla (c) %he sensor$ cortex is in the parietal lobe %rue %he sensor$ cortex is in the parietal lobe (d) %he spinothalamic tract decussates at the level of the brainstem. False %he spinothalamic tract is a sensor$ pathwa$ originating in the spinal cord that transmits information about pain& temperature& itch and crude touch to the thalamus. %he pathwa$ decussates at the level of the spinal
MCEM MCQ Anatomy cord& rather than in the brainstem. %he posterior column=medial lemniscus pathwa$ and corticospinal tract decussate in the brainstem. (e) %he muscles of mastication are innervated b$ the facial nerve False %he muscles of mastication are innervated b$ the trigeminal nerve ( *8 7 )More specificall$& the$ are innervated b$ the mandibular branch& or 7-
%he dorsal columns carr$ proprioception and vibration sense. From the leg the$ ascend in gracilis fasicles and from the arm the$ ascend as the cuneatus fasiciles.0n the caudal medulla the$ s$napse and decussate in the internal arcuate fibres.%he$ then ascend to the ventroposterolateral(7PD) nucleas of the thalamus and from there to the sensor$ cortex of the parietal lobe. +. %he sternal angle lies at the level
(a) %he sternal angle lies at the level of the second intercostal space. False %he sternal angle lies at the level of the second costal cartilage. (b) %he sternal angle lies at the level of the intervertebral disc between the 4th and +th thoracic vertebrae False %he sternal angle lies at the level of the intervertebral disc between the th and 4th thoracic vertebrae. (c) %he sternal angle lies at the level of the "unction of the ascending aorta and the aortic arch but not at the "unction between the descending aorta and the aortic arch. False %he sternal angle lies at the level of the "unction of the ascending aorta and the aortic arch ( and also the "unction between the aortic arch and the descending aorta ) (d) %he sternal angle lies at the level of the "unction between the superior and inferior mediastinum. %rue %he sternal angle lies at the level of the "unction between the superior and inferior mediastinum. (e) %he sternal angle lies at the level of the bifurcation of the trachea. %rue %he sternal angle lies at the level of the bifurcation of the trachea.
%he sternal angle lies at the level of the second costal cartilage.s well as the above it lies at the "unction of the superior and inferior mediastinum. ,. bnormal J7P
(a) iant EvE waves are seen in tricuspid regurgitation. %rue ?iant EvE waves are seen in tricuspid regurgitation. (b) 8o EaE waves are seen in Fib. %rue ?8o EaE waves are seen in Fib. (c) 0nspirator$ filling is normal. False ?KussmaulEs sign is seen in pericardial constriction& tamponade and severe asthma. (d) 2enal Failure ma$ cause an abnormal J7P. %rue ?Pericarditis or fluid overload. (e) *annon waves are seen in ventricular tach$cardia. %rue ?*annon waves are seen in ventricular tach$cardia and complete heart bloc9. 5. *ervical !pond$losis
(a) Ghen severe most commonl$ effects *4*+ %rue
MCEM MCQ Anatomy (b) *ausing pain in the nec9 re/uires nec9 immobilisation False
(c) Ma$ produce s$mptoms of vertebrobasilar insufficienc$. %rue
(d) M$elopath$ is best treated with manipulation. False
(e) 2adiculopath$ rarel$ recovers completel$. False
*ervical !pond$losis =Ghen severe most commonl$ effects *4*+ as this is where bending the nec9 is greatest. Most episodes settle without treatment.:isc protrusion ma$ narrow the vertebral arteries and cause vertebrobasilar insufficienc$.Manipulation is contraindicated in m$elopath$. 6. %he following are causes of spinal cord compression
(a) !pond$losis. %rue ? (b) D$mphoma. %rue ? (c) bscess. %rue ? (d) !$ringom$elia. %rue ? (e) 3aematom$elia. %rue ?
!$ringom$elia and 3aematom$elia are causes of intramedullar$ spinal cord compression. Other causes include trauma& prolapsed disc& and tumors. 4<. 7eins of the >pper Dimb
(a) ll veins in the upper limb possess valves. %rue ?ll veins in the upper limb possess valves. (b) %he cephalic vein originates from the medial side of the venous networ9 on the dorsum of the hand. False ?%he cephalic vein originates from the postero=lateral aspect of the venous networ9 on the dorsum of the hand. (c) %he cephalic vein passes upwards along the lateral border of the forearm anterior to the head of the radius %rue ?%he cephalic vein passes upwards along the lateral border of the forearm anterior to the head of the radius (d) 0n the upper arm the cephalic vein ascends on the lateral aspect of the biceps brachii to the groove between the deltoid and pectoralis ma"or %rue ?0n the upper arm the cephalic vein ascends on the lateral aspect of the biceps brachii to the groove between the deltoid and pectoralis ma"or (e) %he basilic vein begins on the medial side of the venous networ9 on the dorsum of the hand. %rue ?%he basilic vein begins on the medial side of the venous networ9 on the dorsum of the hand.
MCEM MCQ Anatomy 41. Pelvis 2a$s
(a) %he urethra and bladder lie close to the pubic s$mph$sis are damaged b$ a ma"orit$ of traumatic in"uries to this area. False ?%he urethra and bladder lie close to the pubic s$mph$sis and are sometimes damaged b$ trauma to this area (0n 14 th of cases) (b) For the pubic bones to separate b$ over '.4 cm one or both of the ligaments have to be torn. %rue ?For the pubic bones to separate b$ over '.4 cm one or both of the ligaments have to be torn. (c) 0t is onl$ possible to obtain the correct diagnosis in 4
(a) Patella %rue ?%he patella is often subluxeddislocated in ehler=danlos s$ndrome (b) !houlder Joint %rue ?%he shoulder "oint is often subluxeddislocated in ehler=danlos s$ndrome. (c) %he temporomandibular "oint %rue ?%he temporomandibular "oint is often subluxeddislocated in ehler=danlos s$ndrome. (d) %he subtalar "oint %rue ?%he subtalar "oint is often subluxeddislocated in ehler=danlos s$ndrome.
;hlers=danlos s$ndrome comprises "oint h$permobilit$& s9in h$perextensibilit$&scar d$strophica and excessive bleeding. 4-. :iagnostic Peritoneal lavage is positive when
(a) 2*Es H1&<<< cellsmm- False ?2*Es H1<<&<<< cellsmm(b) G*Es H1<< cellsmm- False ?H4<< cellsmm(c) Food Particles %rue ? (d) ile %rue ? (e) Faeces %rue ?
lso 4ml gross blood& or exit of lavage fluid via chest tube or bladder catheter
MCEM MCQ Anatomy 4. rachioradialis
(a) Flexes arm at the elbow. %rue ?rachioradialis flexes the arm at the elbow. (b) !upinates the forearm. False !upination of the forearm is the action of the biceps brachii. (c) rings forearm into midprone position. %rue ?rachioradialis brings the forearm into the midprone position. (d) rachioradialis is innervated b$ ulnar nerve. False rachioradialis is innervated b$ the radial nerve. (e) Overlies ulnar arter$. False ?rachioradialis overlies the radial arter$. 44. %he Optic 8erve
(a) bitemporal hemianopia ma$ be caused b$ a pituitar$ tumor or a sella meningioma. %rue ? bitemporal hemianopia ma$ be caused b$ a pituitar$ tumor or a sella meningioma (b) homon$mous hemianopia is caused b$ a lesion of the optic tract to the occipital cortex. %rue ? homon$mous hemianopia is caused b$ a lesion of the optic tract to the occipital cortex. (c) n incomplete lesion of the optic tract is associated with a central scotomata. False ?n incomplete lesion of the optic tract is associated with macular ( central ) vision sparing (d) n upper /uadrant homon$mous hemianopia is associated with a parietal lobe lesion. False ? lower /uadrant homon$mous hemianopia is associated with a parietal lobe lesion. (e) lower /uadrant homon$mous hemianopia is associated with a temporal lobe lesion. False ?n upper /uadrant homon$mous hemianopia is associated with a temporal lobe lesion.
4+. %horacic vertebrae
(a) %he top of the arch of the aorta is at the level of %- %rue ?%he top of the arch of the aorta is at the level of %- (b) %he manubrium sterni encompasses levels %- and % %rue ?%he manubrium sterni encompasses levels %- and % (c) %he a#$gous vein enters the !7* at %+ False ?%he a#$gous vein enters the !7* at % (d) %he angle of louis is at the level of %4 %rue ?%he angle of louis is at the level of %4 (e) %he bifurcation of the trachea is at the level of %%4 %rue ?%he bifurcation of the trachea is at the level of %%4
MCEM MCQ Anatomy 4,. Gound ;valuation
(a) :iffuse bleeding most often occurs from the subdermal plexus and superficial veins %rue ? :iffuse bleeding most often occurs from the subdermal plexus and superficial veins (b) Povidone=iodine based s9in disinfectant suppress bacterial growth on intact s9in. %rue ? (c) Povidone=iodine based s9in disinfectant should be used in the wound itslf to suppress bacterial growth. False ?Povidone=iodine based s9in disinfectant should not be used in the wound itself as it ma$ impair host defences and promote bacteria growth. (d) *hlorhexidine based s9in disinfectant should be used in the wound itslf to suppress bacterial growth. False ?*hlorhexidine based s9in disinfectant should not be used in the wound itself as it ma$ impair host defences and promote bacteria growth. (e) 0n well perfused tissues (e.g.& scalp) wounds closed without prior hair removal heal with an increase in infection. False ?0n well perfused tissues (e.g.& scalp) wounds closed without prior hair removal heal with no apparent increase in infection 45. %he circle of willis is supplied b$
(a) ;xternal carotid arteries False ?%he circle of willis is supplied b$ the internal carotid. (b) asilar arteries %rue ?%he basilar arter$ gives off the pontine& lab$rinthine& superior and anterior inferior cerebellar arteries. (c) >nion of vertebral arteries %rue ? (d) rachial rter$ False ? (e) xillar$ arter$ False ? 46. *entral 7ein *annulation *omplications include
(a) rterial laceration. %rue fter failure of placement& this is the commonest complication of central line insertion. (b) %ension pneumothorax. %rue (c) 3aemothorax is increased with 0J7 cannulation when compared to the subclavian route. False (d) *ardiac %amponade. %rue ?*an be caused if the tip of the line lies below the pericardial reflection and it perforates the vessel wall. 0tEs least li9el$ to happen via the internal "ugular vein (e) ir ;mbolism. %rue
Other complications during placement can be nerve in"ur$. fter placement local infection or venous thrombosis can be possible complications.
MCEM MCQ Anatomy +<. 3and 0nfections
(a) %he hand position of function for splinting includes the M*P "oint being at 4< to 6< degrees flexion. %rue ? (b) Midpalmer space infection occurs from spread of a flexor tenos$novitis or from a penetrating wound to the palm causing infection in the radial or ulnar bursa of the hand. %rue ? (c) Paron$chia is an infection of the lateral nail fold. %rue ? (d) Flexor tenos$novitis is suggested b$ tenderness over the flexor tendon sheath. %rue ? (e) *losed fist in"ur$ ( human bite wound above the M*P "oint resulting from punching an individual ) be be explored& irrigated and allowed to heal b$ secondar$ intention. %rue ? +1. ;$e %rauma
(a) h$phema is not a reflection on the degree of trauma sustained. False ? h$phema suggests significant ocular trauma. (b) 2estricted upward ga#e suggests a blow out fracture with entrapment of the inferior rectus. %rue ?2estricted upward ga#e suggests a blow out fracture with entrapment of the inferior rectus. (c) ruptured globe is implied b$ a flat anterior chamber. %rue ? ruptured globe is implied b$ a flat anterior chamber. (d) %he sensation of the inferior orbital nerve is tested below the e$e and on the ipsilateral side of the nose. %rue ?%he sensation of the inferior orbital nerve is tested below the e$e and on the ipsilateral side of the nose. (e) %he pupil can be constricted or dilated after sustaining trauma. %rue ?%he pupil can be constricted or dilated after sustaining trauma.
lowout fractures are the most common orbital fractures. %hese in"uries occur when a blunt ob"ect stri9es the globe& resulting in expansion of orbital contents and subse/uent rupture through the bon$ floor. Patients ma$ have enophthalmos& or sun9en globe& when a large section is ruptured. 0nfraorbital anesthesia is a more common finding and develops when the infraorbital nerve is contused b$ the initial trauma or when compressed b$ bon$ fragments. nesthesia of the maxillar$ teeth and upper lip is more reliable than numbness over the chee9. :iplopia& particularl$ on upward ga#e that usuall$ indicates inferior rectus muscle entrapment& is another important clinical finding. step=off deformit$ ma$ be palpated over the intraorbital rim. !ubcutaneous emph$sema is pathognomonic for fracture into a sinus or nasal antrum. +'. n ulnar nerve lesion ma$ be represented as follows
(a) 3$perextension at the M*P "oint of the little and ring fingers accompanied b$ flexion of the interphalangeal "oints. %rue ?%his is claw=li9e hand pattern.3$perextension at the M*P "oint of the little and ring fingers accompanied b$ flexion of the interphalangeal "oints. (b) *lawing of the hand is more pronounced with a more proximal lesion. False ?*lawing of the hand is more pronounced with a lesion at the wrist as a lesion at or above the elbow causes loss of flexor digitorum profundus and less flexion at the 0P "oints.
MCEM MCQ Anatomy (c) Froments sign tests thumb adduction. %rue ?%he patient is as9ed to grasp a piece of paper between the thumb and the lateral aspect of the index finger. (d) %he ulnar nerve supplies the sensor$ component to the medial half of the ring finger. %rue ?%he ulnar nerve supplies the sensor$ component to the medial half of the ring finger. +-. %he following are true
(a) Knee flexion is performed b$ the /uadriceps. False ?Knee flexion is performed b$ the hamstringsL (b) %he hamstrings are innervated b$ the obturator nerve. False ?%he hamstrings are innervated b$ the sciatic nerve. (c) %he sciatic nerve innervates the /uadriceps. False ?%he femoral nerve(D'-) innervates the /uadriceps. (d) %he obturator nerve is composed of fibers from D'&D- and D. %rue ?%he obturator nerve is composed of fibers from D'&D- and D. (e) %he sciatic nerve is responsible for an9le dorsiflexion %rue ?%he common peroneal nerve is an extension of the sciatic nerve.
Knee flexion is performed b$ the hamstrings which are innervated b$ the sciatic nerve(!1). %he sciatic nerve is responsible for an9le dorsiflexion via the common peroneal nerve. %he obturator nerve is composed of fibers from D'&D- and D. +. >reters
(a) ;ach ureter measures approximatel$ 1reteric stones fre/uentl$ arrest where the renal pelvis "oins the ureter. %rue ?>reteric stones fre/uentl$ arrest where the renal pelvis "oins the ureter& where the ureter is 9in9ed as it passes the pelvic brim and where the ureter pierces the bladder wall. (d) re supplied in the inferior end b$ the renal arteries. False ?%he upper end is supplied b$ the renal arteries& the middle is supplied b$ the testicular or the ovarian arter$ and the inferior end is supplied b$ the superior vesical arter$. (e) D$mph drainage is to the lateral aortic and iliac nodes. %rue ?D$mph drainage is to the lateral aortic and iliac nodes. +4. Dumbar Plexus
(a) %he lumbar plexus is formed b$ the anterior rami of the upper four lumbar nerves. %rue ?%he lumbar plexus is formed b$ the anterior rami of the upper four lumbar nerves. (b) 0t is situated within the psoas muscle %rue ?0t is situated within the psoas muscle (c) %he femoral nerve originates from the lumbar plexus from D1 and D'. False ?%he femoral nerve originates from the lumbar plexus from D'& D- and D
MCEM MCQ Anatomy (d) %he obturator nerve originates from D1 and D'. False ?%he obturator nerve originates from D'& D- and D (e) %he obturator nerve innervates the adductors of the thigh and the s9in on the medial surface of the thigh. %rue ?%he obturator nerve innervates the adductors of the thigh and the s9in on the medial surface of the thigh. ++. %he following are correct
(a) %he oesophageal opening in the diaphragm is at the level of %5 False ?%he oesophageal opening in the diaphragm is at the level of %1< (b) ranches of the right gastric vessels go through the diaphragm at %1< False ?ranches of the left gastric vessels go through the diaphragm at %1< (c) %he left phrenic nerve pierces the diaphragm lateral to the central tendon at the level of %+ False ?%he left phrenic nerve pierces the diaphragm lateral to the central tendon at the level of %5 (d) %he right phrenic nerve pierces the diaphragm with the 07* at %+ False ?%he right phrenic nerve pierces the diaphragm with the 07* at %5 (e) %he sternoxiphisternal "oint is at the level of %56 %rue ?%he sternoxiphisternal "oint is at the level of %56 +,. %he rachial Plexus
(a) %he ulnar nerve is largel$ made up from *+ and *, fibres. False ?%he ulnar nerve is largel$ made up from *5 and %1 fibres. (b) %he axillar$ nerve is given off b$ the posterior cord. %rue ?%he axillar$ nerve is given off b$ the posterior cord. (c) %he musculocutaneous nerve is made up from *4 & *+ & and *, %rue ?%he musculocutaneous nerve is made up from *4 & *+ & and *, (d) %he medial cord and the lateral cord form the median nerve %rue ?%he medial cord and the lateral cord form the median nerve (e) %he dorsal scapular nerve ( *4 ) supplies the serratus anterior muscle. False ?%he dorsal scapular nerve ( *4 ) supplies the rhomboid muscles. !erratus nterior is supplied b$ the long thoracic nerve. +5. %he following are true in relation to common root compression s$ndromes produced b$ lumbar disc prolapse
(a) n D4 root lesion will cause pain from the buttoc9 to the lateral aspect of the leg and on the dorsum of the foot. %rue ?n D4 root lesion will cause pain from the buttoc9 to the lateral aspect of the leg and on the dorsum of the foot. (b) n D root lesion will cause pain from the lateral aspect of the thigh to the medial side of the calf. %rue ?n D root lesion will cause pain from the lateral aspect of the thigh to the medial side of the calf. (c) n !1 root lesion will cause sensor$ loss on the sole of the foot and the posterior calf. %rue ?n !1 root lesion will cause sensor$ loss on the sole of the foot and the posterior calf. (d) n D4 root lesion will cause sensor$ loss on the dorsum of the foot and anterolateral aspect of the leg. %rue ?n D4 root lesion will cause sensor$ loss on the dorsum of the foot and anterolateral aspect of the leg.
MCEM MCQ Anatomy +6. %he rachial Plexus
(a) 0n the axilla the posterior divisions unite to form the posterior cord %rue ?0n the axilla the posterior divisions unite to form the posterior cord (b) %he lateral cord supplies the extensor structures on the posterior aspect of the limb. False ?%he posterior cord supplies the extensor structures on the posterior aspect of the limb. (c) %he posterior division of the lower trun9 forms the medial cord. False ?%he anterior division of the lower trun9 forms the medial cord. (d) %he posterior cord ma$ contain neurons from all the spinal nerves contributing to the brachial plexus %rue ?%he posterior cord ma$ contain neurons from all the spinal nerves contributing to the brachial plexus (e) %he dorsal scapular nerve is a branch of *4. %rue ?%he dorsal scapular nerve is a branch of *4 ,<. Fissure 0n no
(a) *ause painless rectal bleeding False ?0s a common casue of painful rectal bleeding (b) 0n most cases occur in the midline anteriorl$ False ?0n most cases occur in the midline posteriorl$. (c) :iscomfort is constant between bowel motions. False ?:iscomfort resolves between bowel motions. (d) re associated with sentinel pileEs %rue ?s a result of h$pertrophied papillae. (e) PatientEs should increase dietar$ bran %rue ? ,1. Dumbar Puncture
(a) %he plane of the iliac crest runs through D1=D'. False ?%he plane of the iliac crest runs through D-=D. (b) %he spinal cord in the adult ends at the level of D1='. %rue ?%he spinal cord in the adult ends at the level of D1='. (c) Ghen performing a lumbar puncture the EgiveE is felt when passing through the interspinous ligament. False ?%he EgiveE is felt when passing through the ligamentum flavum. (d) %he opening pressure is usuall$ @1< cm of *!F. False ?%he opening pressure is usuall$ ,=15cm of *!F. (e) %he *!F protein content is usuall$ <.14 to <.4gD. %rue ?Other important values include G** @4. For ever$ 1<<< 2*Es& subtract 1 G* and <.<14 protein.
3eadache& which occurs in 1< to -
