Essential And Newest MCQ ANATOMY - EmergencyPedia

ANATOMYGeneral Questions1. Which is an example of hyaline cartilagea. intervertebral discsb. epiglottisc. articular surface of clavicled. epiphysese. knee menisciF – FibrocartilagenousF – Elastic fibrocartilagenousT – Hyaline cartilage but not the best answerT – Hyaline cartilageF - Fibrocartilagenous2. Hyaline cartilagea. forms glenoid labrumb. does not ossify with agec. relatively vasculard. forms epiphyseal growth platese. forms articular margins of acromioclavicular jointf. unable to be deformedg. regrows in new cartilage? – UnsureF – Does ossify with ageF – avascular so difficult to repairT – yes it does? – UnsureF – able to be deformedF – don’t think so3. An example of a synovial joint is p21 Moorea. intervertebral discb. sternomanubrial jointc. sacroiliac jointd. epiphysese. distal tibulofibular jointF – Fibrocartilagenous secondary cartilagenous jointF – Secondary cartilagenousT – Synovial joint BUT different from most because it has little movementF – Primary cartilaginous jointF – Syndesmosis/fibrous4. An example of a secondary cartilaginous joint p21Moorea. costochondral jointb. intervertebral discc. TMJd. lambdoid suture (head)e. proximal tibial epiphysis5. What type of joint is the 1st sternocostal joint p69 Moorea. Secondary cartilagenousb. Typical synovialc. Primary cartilagenousd. Fibrouse. Secondary synovial6. Which of the following movements are permitted at the jointsnamed p24 Moorea. Plane joint – gliding/sliding movementsb. Hinge joints- multiaxialc. Pivot joint – multi axiald. Saddle joint – multiaxiale. Condyloid joint – biaxialf. Ball and socket joint – biaxialF – Primary cartilaginous (usually temporary union)T – fibrocartilagenous secondary cartilaginous jointF – modified synovial joint p925 Moore’sF – fibrous jointF – primary cartilaginous jointNOTE: Secondary are strong slightly moveable(fibrocartilage –v- primary hyaline cartilage)F – manubriosternal joint, intervertebral discsF – sternocastal joints 2 to 7, costrovertebral joints synovial plane joints.Has joint cavity, articular cartilage and articular capsuleT – costochondral joints, xyphisternal joint, epiphysis and epiphyseal platesF – sutures of skull, radioulnar joints syndesmosis type of fibrous joint,dental joints gomphosisF – ? There are plane, hinge, pivot, saddle, condyloid, ball and socketT – usually uniaxial, gliding or sliding movements AC jointF – uniaxial, permit flexion and extension only elbowF – uniaxial, allows rotation only atlantoaxial jointF – biaxial, permits movements in two different planes first carpometacarpal jointT – biaxial, flexion and extension, abduction and adduction,and circumduction metacarpophalangeal jointF – multiaxial, movement on several axis hip joint1

ANATOMY7. Regarding muscle,a. epimysium covers muscle and collects fluidb. all skeletal muscle is a mix of red and white fibresc. white fibres are slow twitch and aerobicd. Motor unit supplies red and white muscle fibresF – Dense layer of collagen, surrounds skeletal muscle, continuous withtendonsT – best answerF – fast and anaerobic like white lightning!F – a motor unit supplies a motor fibre so you won’t have both types in one8. Regarding cardiac and skeletal muscle (repeat) p31NMa. both striatedb. multinucleatedc. gap junctionsTF - just skeletalF - just cardiac9. Regarding the deep fascia which is incorrecta. It is not present in the faceb. It forms the retinaculaec. It is anchored firmly to the periostiumd. It is well developed in the iliotibial tracte. It is not sensitivef. Can provide attachment for muscleg. Attaches to skin by thin fibrilsT – not present in faceT – it doesT – anchored to bone in some placesT – but unsureF – it is VERY sensitive and is supplied by the skinT – it canT – it does10. Panniculosus adiposusa. not well developed in manb. is a thin layer of musclec. is unlike fatd. contains nerves blood vessels and lymphF – well developed in manF – fat layerF – it is a fat layerT – it does11. Regarding bonea. Periostium covers the articulating surface of bonesb. Harversian canals are the smallest canals in bonec. Bone substance does not receive its nutrition fromthe periostiumd. Periostium is not sensitivee. nutrient artery supplies cortical bone predominantlyf. trabecular network in cancellous bone is capable ofconsiderable re-arrangement with regard to fibrerientationF – hyaline cartilage doesF – Haversian are the largest, canaliculi are smallerF – it does, and via nutrient arteriesF – it is very sensitiveF – but needs to be checkedT – this is how bone ensures good strength in the right direction2

ANATOMYNervous System1. With respect to dermatomal nerve supplyp87 Moore, p 539 and p696 NMa. the umbilicus is supplied by T12b. C7 supplies the index fingerc. anterior axial line divides C6 and C7d. T6 lies at level of the nipplee. heel skin is supplied by S2f. Great toe is L42. A dermatome pg87 Moorea. Is separated from a discontinuous dermatome by anaxial lineb. They do not overlap in the chestc. Is the area of skin and muscle supplied by a singlespinal nerved. They do not overlap at axial linesF – T10T – it doesF – they are contiguousF – T4T – also L5 according to my version of Moore’s, NOT NEW MOORE’sF – L5T – that is the definition of an axial lineF – They overlap in the chestF – pair of spinal nervesT – correct but not the best answer3. Diameter of a motor nerve fibre isa. 1-2 micrometereb. 10 millimetrec. 12-20 micrometresd. 5-7 millimetrese. 20-50 micrometersFFT – this is correctFF4. Regarding parasympathetic nervous systema. supply all viscerab. have connector cells in brainstem and sacrum? – not sureT - craniocaudal3

ANATOMYUpper Limb - Nerves1. Of the Brachial plexus what is INCORRECT?a. Divisions forming behind clavicle and entering anteriorTriangleb. Cords embrace 2nd part axillary arteryc. Cords enter axilla anterior to axillary artery.d. Branches of cords surround 3rd part of axillary arterye. Erbs palsy results in medially rotated arm with elbowflexionf. Ulnar nerve palsy (probably writing as C7/T1)gives interossei weakness and numbness over radialpart of handg. Injury proximal to trunks will not affectsupraspinatus/infraspinatush. Fall onto the shoulder damages C8/T1i. Pec major only muscle that can test all rootsj. suprascapular nerve is C5,6k. nerve to subclavius is C5, 6l. serratus anterior supplied by C6/7/8m. all branches originate from roots, divisions or cordsn. suprascapular nerve comes off the posterior cordo. dorsal scapular nerve comes off C5p. is contained in the anterior triangle of the neckq.r.s.t.u.there are 7 divisions of the trunksthe nerve to subclavius is the only trunkthe radial nerve is derived from C7,8,T1the axillary nerve is derived from the lateral chordthe roots lie between the scalene musclesF – Divisions have noithing to do with itT – named in relation to axillary arteryFT – p709-717F – c5-c6 deltoid, brachioradialis, brachialis and biceps(adducted shoulder, medrotated arm and extended elbow) p716F – gives ulna part of hand p759F – Suprascapular nerve comes off anterior division of superior trunk thereforeinjury proximal to trunks will knock them outFT – C5-T1TTF – C5,6,7F – The early ones come off early eg dorsal scap n comes off venral ramus ofC5FTF - the roots are in the posterior triangle of the neck and leave through thegap between anterior and middle scalene p708F- No 6F - No it is a branch coming off a trunkF - No it is C5-T1F- No it is from the posterior cordT - p 7082. Injury to the middle trunk of the brachial plexusa. will mean C8 sensation will be affectedb. will manifest in the medial chordc. will affect the long thoracic nerved. will affect the median nervee. all of the aboveF - NoF - WrongF - Wrong. It comes off the rootsTF3. In the upper limb, which is CORRECT? P682a. Upper arm recieves supply from T4b. upper arm and forearm supplied by C3,4,5,6,7,8,T1c. upper arm dermatomes are C4,5,8,T1d. elbow flexion is C7,8e. thumb dermatome is C8F - WrongF - Wrong not C3T -C4 is in neck. ? Could this be best answer?F - No. C5,6F - No, C64. Which myotome is incorrect:a. C5 shoulder adduction.F - Adduction is C6,75. Which movement of the arm does not involve C6a. Pronationb. Supinationc. shoulder adductiond. wrist flexione. wrist extensionT – C7 via pronator quadratus and pronator teresF – C6 supinator and biceps brachF – C6,7,8F – C6,7,8 (FCU FCR)F – C6,7,8 (ECRL and brevis and ECU)See 736, 737, 742, 793, 801, 806, 8074

ANATOMY5. Which is a branch of medial corda. Medial pectoral nerveb. Lateral pectoral nervec. Dorsal scapulad. Axillary nervee. Lower subscapularT – C8, TiF – lateral cord c5-c7F – ventral ramus c5F – terminal branch posterior cord c5,6F – anterior branch of posterior cord P711 moores6. Which one of the following statements regarding the dorsalscapular nerve (nerve to the rhomboids) is correctPg 695, 708 to 711 (good table 710)a. it is a branch of C6 from the cervical plexusF - C5 ventral ramus with common contribution from C4b. it passes through scalenus mediusTc. it usually gives a branch to serratus anteriorF - no branches mentionedd. it does not supply levator scapulaeF - occasionally supplies levator scapulaee. it is at risk of injury as it runs superficial to the rhomboids F - enters deep surface of rhomboids7. something medial nerve injury affectsa. all of arm flexors8. If the median nerve is injured at the level of the wrist, whichof these actions CANNOT be performed? Pg 739 Moorea. oppose thumb to little fingerb. flex tip of thumb9. Injury to wrist with impairment of Abduction of thumb,what other lesion is probable p833NMa. Inability to flex DIP joint index fingerb. Inability to flex DIP joint index fingerc. Inability to oppose thumb to little finger10. Which of the following findings makes the diagnosis ofcarpal tunnel syndrome UNLIKELY?a. wasted thenar musclesb. loss of sensation over the thenar eminence11. Regarding the radial nerve p710, 713, 714 p794NMa. it runs with profunda brachii in the radial grooveb. it contains fibres from C 5,6,7,8 onlyc. it has no cutaneous branches in the upper armd. it occupies the whole length of the radial groovee.f.g.h.i.j.Runs with profunda brachii in the radial groovegives off the posterior interosseus in the spiral groovecontains only fibres of C 5,6,7occupies the entire length of the radial groovepasses through the quadrilangular spaceit gives off the posterior interosseous nervein the radial grooveT – as belowT - flexor Pollicus Longus supplied by ant interosseous nerve from mediananterior interosseous nerve supplies pronator quadratus, flexor pollicislongus and FDP non-ulna portion. It is a branch of the MEDIAN n in thdistal part of the cubital fossa)F - The innervation to FDP, FDS is Median nerve (ulna nerve to median part ofFDP) BUT it is ABOVE the wrist (and lumbricals 2,3,4 interossei with still beworking from ulna n)FT - AbdPB and OP are both supplies by Median nerveFT - Correct answer because palmar cutaneous branch comes off before thecarpal tunnelT - pg 83 LastsF - T1 as well) Moore 713F – supplies skin of post aspect of arm-posterior cutaneous nerve of arm- andforearm Moore 713F – lies for most part behind medial head of triceps separating it from bone.Only at lateral edge of humerus is nerve in contact with periosteum of lower endof radial groove) pg 83 LastsTF - No. comes off laterF - No gives C5-T1?F - No. I think it comes through triangular spaceF - No. It gives off PIN at level of lateral epicondyle of the humerus5