ANATOMY

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Anatomy Exam 2 (2018)

Which muscle of the forearm is colored in yellow?

Extensor digiti minimi
Extensor digitorum
Extensor carpi ulnaris
Extensor carpi radialis longus
Extensor carpi radialis brevis

Elite baseball pitchers can sometimes be forced out of a season due to a specific kind of radial nerve damage termed Posterior Interosseous Neuropathy (PIN). A sufferer from this would likely have diminished motor function for which muscle?
Extensor carpi radialis brevis
Supinator
Extensor indicis
Extensor carpi radialis longus
Extensor digitorum

A patient comes to your office , complaining of severe right elbow pain. Physical examination shows they have diminished function of their elbow extensors, but your examination rules out neurological damage. What is a likely diagnosis for this patient?
Golfer’s elbow
Nursemaid’s elbow
Tennis elbow
Medial epicondylitis
Saturday Night Syndrome

A patient with osteoarthritis walks into your office. Before your exam even starts you see her walking to the exam room and notice her hip dropping to one side. What nerve is injured?
Sciatic Nerve
Superior Gluteal Nerve
Inferior Gluteal Nerve
Anterior Rami branches of S1 and S2
Nerve to Quadratus femoris

An attending tries to embarrass you in front of a patient by asking you the best place to insert a needle when giving an intragluteal injection. But because you went to ARCOM, you can confidently say the needle should be placed:
Superomedial Quadrant to avoid the Sciatic Nerve
Suprerolateral Quadrant to avoid the Common Fibular Nerve
Superolateral Quadrant to avoid the Sciatic Nerve
Superomedial Quadrant to avoid the Common Fibular Nerve

A patient comes into your clinic complaining of dyspnea (difficulty breathing). You want to do some medical imaging to help your diagnosis so you decide to take an x-ray. You ask the patient to take a deep breath and then acquire the following image. What is the diagnosis?
The patient has fluid in the right lung preventing them from breathing correctly
The patient has damaged their right phrenic nerve, leading to partial paralysis of the diaphragm
The patient has inflammation of the liver causing the right lung to be compressed
The patient has a pneumothorax (collapsed lung)
No diagnosis, the patient is completely normal.

Your friend tells you that they are worried because their physician diagnosed them with a supernumerary rib located at L1. They ask you what symptoms they should be expecting from this condition. What do you tell them?
The rib will compress the lumbosacral plexus and most likely result in sciatica
The rib will compress the internal pudendal artery and lead to ischemia
Not to worry, an extra rib at L1 is usually asymptomatic
The rib will compress the subclavian artery, resulting in ischemia
The rib will compress the spinal nerve T12

Which of the following correctly describes the flow of blood from the aorta to the right anterior intercostal arteries?
Aorta → Right subclavian artery → Right internal thoracic artery → Anterior intercostal arteries
Aorta → Brachiocephalic trunk → Right Subclavian artery → Right superior thoracic artery → Anterior intercostal arteries
Aorta → Right subclavian artery → Right superior thoracic artery → Anterior intercostal arteries
Aorta → Brachiocephalic trunk → Right costocervical trunk → Right internal thoracic artery → Anterior intercostal arteries
Aorta → Brachiocephalic trunk → Right Subclavian artery → Right internal thoracic artery → Anterior intercostal arteries

A positive anterior drawer test is when the proximal head of a patient’s tibia can be pulled anteriorly on the femur, and the tibia moves anteriorly. Which structure must be damaged in order for the patient to elicit this movement?
Medial meniscus
Lateral meniscus
Fibular collateral ligament
Anterior cruciate ligament
Posterior cruciate ligament

The ankle is the most frequently injured major joint in the body. An ankle sprain is the most common type of ankle injury. A Pott Fracture-Dislocation occurs when the foot is forcibly ___________, resulting in both tibial and fibular fractures due to the strength of the ligaments attached to them.
Everted
Inverted
Plantarflexed
Dorsiflexed
Extended

You are doing clinical rotations when an 82 year old female patient comes into the emergency department complaining of severe right hip pain. You acquire the x-ray shown below. Due to the possibility of avascular necrosis, which of the following arteries are you most concerned about being damaged?
Acetabular branch of obturator artery
Lateral circumflex femoral
Medial circumflex femoral
Femoral artery
Internal pudendal artery

You are on rotations when an attending asks you to scrub in for an ACL repair surgery. In order to perform the surgery while also minimizing the loss of blood flow to the leg, the surgeon should ligate which of the following arteries?
Superior medial genicular
Popliteal artery just superior to the level of the ACL
Inferior lateral genicular
Inferior medial genicular
Middle genicular

Lindsey H., an uncoordinated OMS I student, is walking into lecture hall 2 for morning classes when she trips on the door frame and twists her ankle, forcing it to invert. Which of the following ligaments are you most concerned that Lindsey has probably torn?
Anterior talofibular
Anterior tibiotalar
Tibiocalcaneal
Calcaneofibular
Plantar calcaneonavicular (Spring ligament)

A spontaneously aborted fetus was found to have malformations in the development of the primordial heart and serous membranes of the pericardium and pleura. A defect is expected to have occurred in which of the following germ layers?
Endoderm
Surface Ectoderm
Paraxial Mesoderm
Lateral Mesoderm
Neural Crest Ectoderm

An embryo is visualized possessing midgut herniation, long upper limbs and webbed fingers. A crown to rump measurement of 20 mm is observed. What is the approximate age of the fetus?
Week 8, Day 54-55
Week 7, Day 49-51
Week 6, Day 44-46
Week 5, Day 41-43

Which of the following is NOT true regarding organogenesis?
The primordial heart comes from the lateral mesoderm
The epithelia of the bronchi come from the ectoderm
The lumbar vertebrae come from the paraxial mesoderm
The CNS comes from the ectoderm
Blood and lymphatic cells come from the lateral mesoderm

Lucas T. comes into your clinic complaining of a potential rotator cuff injury after an intense softball game. Since you went to ARCOM, you know that the Supraspinatus is the most frequently injured rotator cuff muscle. You decide to first do an ultrasound on the anterior lateral aspect of the patient’s shoulder to examine the supraspinatus muscle and acquire the following image. Which of the following correctly represents the Supraspinatus muscle?
A
B
C
D
E

The following ultrasound image was acquired from the anterior aspect of a patient’s shoulder. Which structure is represented by the outline in blue?
Transverse humeral ligament
The tendon of the long head of the Biceps brachii
Glenohumeral ligament
Acromioclavicular ligament
Trapezoid part of the Coracoclavicular ligament

You decide to practice surface anatomy with your good friend, Bobby G., who is conveniently shown below (he’s taken ladies!!). You are palpating along his sternal line when you come across a landmark located on the superior border of his manubrium. Since you have a strong knowledge of surface anatomy, you know that this landmark will align with which of the following vertebral bodies?
C7
T1
T2
T4
T9

Lab tests reveal that your patient has low levels of the colony-stimulating factor erythropoeitin (Epo). Which CBC result would be consistent with this finding?
Lower than normal red blood cells
Higher than normal red blood cells
Lower than normal T & B lymphocytes
Lower than normal granulocytes
Red blood cells, lymphocytes and granulocytes would all be lower than normal because Epo is a growth factor common to erythropoeisis, lymphopoeisis, and granulopoeisis

A patient comes into your office complaining of prolonged bleeding after they cut themselves while preparing dinner. You immediately consider that something must be wrong with their ability to clot/coagulate blood. If you are correct, what lab result would you most likely find?
Deficiency of Epo
Excess Epo
Deficiency of Tpo
Excess Tpo
Excess IL-6

A patient comes into your clinic with defective red bone marrow and hematopoietic stem cells. You realize this condition can lead to Pancytopenia. What do you suspect this patient to have?
Aplastic Anemia
Polycythemia
Sickle-cell Disease
Malaria
Pernicious Anemia

A CBC reveals depressed levels of monocytes, what would be the most effective course of treatment to boost the number of monocytes? Administration of:
IL3
SCF
Tpo
M-CSF
GM-CSF

A patient presents to your clinic complaining of numbness on the posterior side of the leg after being struck in the region during a football game. The patient is still capable of plantar flexion and dorsiflexion. What nerve that is most likely damaged?
Sciatic Nerve
Inferior Gluteal Nerve
Superior Gluteal Nerve
Sural Nerve
Tibial Nerve

A patient presents with bruising on the posterior thigh/gluteal region and severe pain upon extension of the hip. You take an x-ray and acquire the image shown below. Which of the following best describes the injury exhibited by the patient?
A hamstring strain which caused a subsequent avulsion fracture of the ischial tuberosity
A quadriceps strain which caused a subsequent avulsion fracture of the ischial tuberosity
A gluteal strain which caused a subsequent avulsion fracture of the ischial tuberosity
A hamstring strain which caused a subsequent avulsion fracture of the ischial spine
A gluteal strain which caused a subsequent avulsion fracture of the gluteal tuberosity

Which of the following is NOT a border of the popliteal fossa?
Semitendinosus
Biceps Femoris
Medial Head of Gastrocnemius
Lateral head of gastrocnemius and plantaris
Adductor magnus

Chris F. is enjoying his Saturday afternoon lounging by the pool at the Residents. Unfortunately, he got a little over zealous and accidentally slipped getting into the pool. He hit the posterior side of his thigh on the concrete edge which subsequently damaged the common fibular portion of his sciatic nerve. Which of the following muscles would no longer be functional?
Long head of Biceps brachii
Short head of Biceps brachii
Semimembranosus
Semitendinosus
Piriformis

A patient comes into the clinic complaining of pain along the medial aspect of their calf, foot, and ankle. Upon examination of their posterior knee you notice a large pulsating mass and suspect an aneurysm of the popliteal artery. Which of the following nerves is mostly likely being affected by this condition?
Common fibular nerve
Sural nerve
Saphenous nerve
Superficial fibular nerve
Tibial nerve

Eosinophilia is a condition in which the eosinophil count in the peripheral blood exceeds the normal range. Which of the following infections would most likely result in eosinophilia?
Malaria
Influenza A
Dengue
Hookworm infection
Bacterial meningitis

The picture below shows a:
Lymphocyte
Eosinophil
Monocyte
Basophil
Neutrophil

You are on a surgical rotation when a resident asks you to run a CBC on a patient that has had a relatively recent lung transplant. Which of the following would indicate that the patient is at an increased risk for rejection of the donor tissue?
Elevated monocyte count
Elevated Basophil count
Elected Eosinophil count
Elevated Neutrophil count
Elected Lymphocyte count

A patient comes into your clinic complaining of chronic fatigue. You decide to take a blood sample and see the following image under your microscope. What’s the diagnosis, doc?
Bacterial infection
Sickle cell anemia
Babesiosis
Porphyria
M-GSH deficiency

Which of the following is NOT true regarding the spleen?

A splenectomy would leave patients at a higher risk of infection due to low monocyte count
Spleen develops during the hepatosplenothymic phase of fetal development during weeks 4-8
Severe blood loss can be mitigated by limited production of RBCs within the spleen
The spleen develops from the intermediate mesoderm
The spleen is responsible for recycling iron within the body

Which of the following correctly identifies the following structures in the correct order?

Aortic bulb, left ventricle, right atrium, superior vena cava, main pulmonary artery
Aortic bulb, right ventricle, right atrium, superior vena cava, main pulmonary artery
Main pulmonary artery, left ventricle, right atrium, superior vena cava, aortic bulb
Aortic bulb, left ventricle, left atrium, superior vena cava, main pulmonary artery
Aortic bulb, right ventricle, left atrium, inferior vena cava, main pulmonary artery

A 78-year old patient presents with an advanced cancer in the posterior mediastinum. The surgeons are in a dilemma as to how to manage the condition. Which of the following structures is most likely damaged?

Arch of the aorta
Arch of the azygos vein
Brachiocephalic veins
Hemiazygos vein
Trachea

While dissecting the posterior mediastinum, you find a structure on the anterior surface of the vertebral bodies between the thoracic aorta and the azygos being, running superiorly and inferiorly. What was the most likely structure found.

Accessory hemiazygos vein
Esophagus
Hemiazygos vein
Thoracic duct
Trachea

The presence of a retrosternal goiter is an indication for which of the following mediastinal lesions?

Thymus
Thyroid
Thoracic aorta
Terrible lymphoma
Trachea
Teratoma and germ cell tumors

A 24 y/o male was in a car accident and was unfortunately pronounced dead on scene. Autopsy reveals a compression fracture damaging spinal nerves C3, C4, & C5. Which of the following nerves were most likely responsible for the cause of death?

Phrenic nerve
Vagus nerve
Recurrent laryngeal nerves
Lower intercostal nerves
Sphlantic nerves

The following picture shows a CT image at the level of the superior mediastinum. Which of the following correctly labels #4?

Left subclavian artery
Left common carotid artery
Brachiocephalic trunk
Trachea
Right subclavian artery

Ebstein’s anomaly, a rare congenital defect, which may lead to enlargement of the heart or even heart failure. Which of the following defects would cause this disorder?

Displacement of the tricuspid valve toward the apex of the heart
Displacement of the mitral valve toward the apex of the heart
Incomplete fusion of the foramen ovale during fetal development
Enlargement of the left ventricle
Weakening of papillary muscles that control blood flow through the heart

Where is the ideal location to auscultate the mitral valve?

Right 5th intercostal space, 7-9 cm from the midline
Left 3rd intercostal space, 5-7 cm from the midline
Left 5th intercostal space, 7-9 cm from the midline
8th intercostal space, at the midline
Right 3rd intercostal space, 5-7 cm from the midline

The interventricular sulcus demarcates the boundary between the left and right ventricles. Which vessels can be found together along the posterior interventricular sulcus?

Posterior interventricular artery and the great cardiac vein
Anterior interventricular vein and the circumflex coronary artery
Great cardiac vein and the right marginal artery
Middle cardiac vein and the right marginal artery
Posterior interventricular artery and the middle cardiac vein

The below image shows a pathological slide taken from the epididymis. Which of the following best describes the structure that the arrow is pointing to?

Cilia
Stereocilia
Microvilli
Microcilia
None of the above

Pacemaker cells are specialized cardiomyocytes that create electrical impulses (action potentials) within the heart. These pacemaker cells are connected to neighboring contractile cells, which enable them to locally depolarize adjacent cells. What structure is responsible for this communication between pacemaker cells and the nearby contractile cells?

Zonula adherens
Macula adherens
Gap Junctions
Zonula occludens
Desmosomes

Primary cilitary dyskinesia, also called immotile ciliary syndrome, is a rare, autosomal recessive genetic disorderthat causes defects in the action of cilia. Which of the following is a NOT a consequence of this disease?

Dextrocardia
Reduced ability to absorb nutrients in the jejunum
No mucus removal from lungs
Infertility
Impaired development of skull sinuses

Your friend from class seems to be experiencing some medical school syndrome and tells you that they have diagnosed themself with pleural mesothelioma. In order to put their mind at ease, you remind them that mesothelioma is a fairly rare cancer and that they would probably had to have been exposed to which of the following carcinogens?

Asbestos
Tobacco
Chlordane
Arsenic
Tell them that they may be entitled to financial compensation

This is the most common form of gestational trophoblastic disease. It is characterized by trophoblastic hyperplasia, villous edema, and the absence of embryo. This is the result of fertilization of an empty oocyte by a single sperm with duplication of paternal material. What is this referred to as?

Vasculogenesis
Teratogenesis
Hydatidiform mole
Hypervitaminosis A
Hypovitaminosis A

Sclerotome differentiate to form bones, cartilage, and tendon. From which mesodermal layer do sclerotomes arise?

Paraxial mesoderm
Intermediate mesoderm
Lateral plate mesoderm
Axial mesoderm
Medial plate mesoderm

A woman, approximately 2 weeks pregnant, who had just missed her menstrual period was concerned that a glass of wine she had consumed the week before may have harmed her embryo. What would you tell your patient about Fetal Alcohol Syndrome, a neurodevelopmental disorder caused by environmental teratogens?

Death of the embryo may occur due to consumption of alcohol during the first week of pregnancy, the period of maximal sensitivity to abnormal development.
The central nervous system will begin to develop in the third embryonic week, therefore, the embryo was not in a critical developmental phase at the time of consumption.
From weeks 3-8 of development, the embryo is least susceptible to external teratogens, so the embryo is not at risk for Fetal Alcohol Syndrome.
Beginning the ninth week of development, the embryo is most susceptible to external teratogens, so the embryo is not at risk for Fetal Alcohol Syndrome.

Despite the recommendation of everyone ever, Angel S. is back doing crossfit. She trips doing box jumps and lands on her right abducted palmar hand. She is experiencing pain on the lateral side of her wrist, especially during radial deviation (abduction) and extension. She goes to the Emergency Department and they take x-ray shown below. Which of the following bones is fractured?

Lunate
Scaphoid
Triquetrum
Hamate
Trapezoid

A student falls on the steps outside of ARCOM and catches themselves, fracturing their scaphoid bone. Which artery is most likely to be damaged with this injury?

Ulnar artery
Common interosseous artery
Deep palmar arterial arch
Princeps pollicis artery
Radial artery

A patient presents in your clinic with carpal tunnel syndrome complaining of difficulty performing delicate hand movements. Which intrinsic hand muscles would she exhibit weakness?

Abductor pollicis brevis and dorsal interossei
The lumbrical muscles
The lateral two lumbricals and opponens pollicis
Palmar interossei and abductor pollicis brevis
Flexor digiti minimi brevis & Abductor digiti minimi

A man comes into your clinic after having his hand closed in a car door. After a series of neurological tests, the patient displays Froment’s sign, unable to hold a sheet of paper between his thumb and first finger. Froment’s sign displays damage to which nerve?

Ulnar nerve
Median nerve
Radial nerve
Musculocutaneous nerve
Anterior interosseous nerve

Which of the following is NOT a border of the femoral triangle?

inguinal ligament
Sartorius
tensor fascia latae
adductor longus
none of the above

While jogging down a poorly lit road, Ricky slipped on a wet spot and managed to severely tear his pectineus. Which actions will he now have difficulty performing?

flexion and medial rotation of the thigh
abduction and medial rotation of the leg
adduction and flexion of the thigh
abduction and extension of the leg
abduction and extension of the thigh

After he fell off a roller coaster, Johnny broke every bone and tore nearly every nerve in his body. However, his femoral nerve remained unscathed and Johnny made a full recovery. Which muscle was still functional after the miraculous landing?

Vastus medialis
Piriformis
Quadratus femoris
Semitendinosus
Obturator externus

What disease is most likely indicated by this image?

Hurler’s syndrome
Ehlers-Danlos syndrome
Marfan syndrome
Scleroderma
Osteogenesis imperfecta

Which of the following is NOT an associated symptom of Scleroderma?

Skin containing calcium deposits
Laxity of skin
Acid reflux
Blood vessel spasms
Red marks on skin from dilation of capillaries

All of the following are potential symptoms of Marfan syndrome EXCEPT:

Eye trouble (myopia and astigmatism)
Cardiac valve instability
Scoliosis
Short stature
Unusual flexibility of hand joints

Connective tissue principally arises from which of the following?

Parenchyme
Mesenchyme
Telenchyme
Ectoderm
Endoderm

Connective tissue principally arises from which of the following?
Mesenchyme
Umbilical cord
Spleen
Dermis
Tendon

Seth B. finally gained the courage to go back to the electric cowboy after his last encounter with the assailant who brutally stabbed him in the parking lot. Unfortunately, as Seth is walking through the parking lot this time he trips over the curb. In the process of doing this he damages the vessel and nerve lying lateral to his tibialis anterior muscle. Which nerve and artery are most likely damaged?
Anterior tibial artery and Deep fibular nerve
Posterior tibial artery and superficial fibular nerve
Tibial artery and common fibular nerve
Saphenous artery and common fibular nerve
Tibialis anterior and superficial fibular nerve

Damage to the superficial fibular nerve would lead to which of the following?
Inability to invert foot
Inability to evert foot
Reduced dorsiflexion
Inability to flex the knee
Inability to extend the knee

Which of the following correctly describes the order in which blood would flow from the aorta to the dorsalis pedis artery?
Aorta → Common Iliac artery → Internal iliac artery → Femoral artery → Popliteal artery → Anterior Tibial artery → Dorsalis pedis artery
Aorta → Common Iliac artery → External iliac artery → Femoral artery → Popliteal artery → Posterior Tibial artery → Dorsalis pedis artery
Aorta → Common Iliac artery → External iliac artery → Femoral artery → Popliteal artery → Anterior Tibial artery → Dorsalis pedis artery
Aorta → Common Iliac artery → Internal iliac artery → Saphenous artery → Popliteal artery → Anterior Tibial artery → Dorsalis pedis artery
Aorta → Common Iliac artery → External iliac artery → Profunda femoris artery → Popliteal artery → Anterior Tibial artery → Dorsalis pedis artery

Tube thoracostomy is the insertion of a tube (chest tube) into the pleural cavity to drain air, blood, bile, pus, or other fluids. The tube is usually inserted in the fourth or fifth intercostal space in the mid-to-anterior axillary line. Which of the following layers of pleura must the chest tube penetrate in order to perform this procedure?
Mediastinal parietal pleura
Diaphragmatic parietal pleura
Costal parietal pleura
Visceral pleura
C & D

Thoracentesis is a procedure in which a needle is inserted into the pleural space between the lungs and the chest wall. This procedure is done to remove excess fluid from the pleural space to help you breathe easier. Which of the following describes the most appropriate location of needle insertion when performing this procedure at the midclavicular line?
The lower portion of the 6th intercostal space
The upper portion of the 6th intercostal space
The lower portion of the 7th intercostal space
The upper portion of the 7th intercostal space
The lower portion of the 8th intercostal space

Which of the following nodes would have to be present for a patient to be diagnosed with hilar lymphadenopathy?
Tracheal
Tracheobronchial
Bronchopulmonary
Pulmonary
Brachiomediastinal

Damage to the medial plantar nerve would lead to an inability to use all of the following muscles, EXCEPT:
Flexor hallucis brevis
Flexor digitorum brevis
Abductor hallucis
1st pedal lumbrical
Adductor hallucis

A patient comes into your clinic experiencing pain in their feet, which are notably flat. When performing a physical exam, you ask them to stand on the balls of their feet. When they do this their rearfoot remains neutral instead of inverting slightly as expected. What would be your recommendation for this patient?
Nothing can be done, they have Ehlers danlos syndrome
You recommend for them to do “heel raises” to strengthen their tibialis posterior muscle
You recommend surgery to correct the deformation in the long plantar ligament
You prescribe Tylenol 3 and let them go about their business
You recommend surgery to correct their calcaneal tendon deformation

After a long night of stomping on the floor of their second-story Residents apartment, an OMS1 student complains of sudden increased swelling and pain of the foot. After a trip to the doctor, they received the above x-ray. What is the best diagnosis for their condition?

An unfused epiphyseal plate
A goriloid fracture
Jones fracture
Onychocryptosis
Pott fracture

A patient comes into your clinic with a severe ingrown toenail, which is shown below. Which of the following is the proper diagnosis of this condition?
Tinea unguium
Tinea pedis
Onychocryptosis
Verruca plantaris
Diabetic foot lesions/ulcers

Which of the following is NOT true regarding intrinsic muscles of the foot?
The plantar interossei are unipennate
The plantar interossei are responsible for adduction of the toes
The dorsal interossei are responsible for abduction of the toes
The lumbricals are responsible for flexion of the metatarsal phalangeal joints and extension of the interphalangeal joints of the toe
The midline of the foot is through the 3rd toe

You are practicing surface anatomy on your good friend Mitsu B. You are palpating the surface just below her patellar tendon on the anterior aspect of her proximal leg. Which of the following bony landmarks should you be able to feel?
Fibular head
Medial condyle of the tibia
Lateral condyle of the tibia
Patella
Tibial tuberosity

Which of the following correctly labels the numbered structures in order?
Tibia, Medial meniscus, fibula
Femur, Lateral meniscus, Tibia
Femur, medial meniscus, Tibia
Tibia, Lateral meniscus, fibula
Fibula, Anterior Cruciate Ligament, Tibia

Which of the following correctly identifies the structure outlined in red?
Femur
Patella
Suprapatellar fat pad
Quadriceps tendon
Medial Collateral Ligamanet

Cardiac tamponade is a serious medical condition in which blood or fluids fill the pericardial cavity. This places extreme pressure on your heart. In these cases, pericardiocentesis must be performed to relieve the pressure. Which of the following is the correct location for where pericardiocentesis must be performed?
5th intercostal space right to the sternum
7th intercostal space left to the sternum
7th intercostal space right to the sternum
5th intercostal space left to the sternum
2nd intercostal space left to the sternum

You are on rotations when an attending asks you if you would like to scrub in for surgery involved coronary artery bypass grafting. While in surgery, you ask the surgeon where the transverse pericardial sinus is located. But instead of telling you, the surgeon decides to showing you by slipping his index finger through the sinus. Which of the following best represents where the surgeon’s index finger is located?
Posterior to the aorta/pulmonary trunk and anterior to the superior vena cava
Posterior to the aorta, pulmonary trunk, and superior vena cava
Anterior to aorta, pulmonary trunk, and superior vena cava
Anterior to the aorta/pulmonary trunk and posterior to the superior vena cava
Posterior to the superior vena cava/aorta, anterior to the pulmonary trunk

Which of the following correctly lists the layers associated with the heart from most superficial to most deep?
Fibrous pericardium → parietal pericardium → Endocardium → Myocardium → Epicardium
Fibrous pericardium → parietal pericardium → Epicardium → Myocardium → Endocardium
Parietal pericardium → Fibrous pericardium → Epicardium → Myocardium → Endocardium
Parietal pericardium → Fibrous pericardium → Endocardium → Myocardium → Epicardium
Myocardium → Fibrous pericardium → parietal pericardium → Epicardium → Endocardium

A patient presents to the clinic with a painful fever blister on his right toe. The doctor explains that if this continued, it would produce a protective thickening or hardening of the outer epithelium layers known as a callus. The doctor explains to the shadowing resident that this blister arose from one of the epidermal layers, which is a deep, single layer of cells that separates the dermis from the epidermis. Which of the following best describes this layer of cells?
Stratum corneum
Stratum basale
Stratum granulosum
Stratum spinosum
Stratum lucidum

The 5 layers of the epidermis consist of stratified squamous keratinized epithelium consisting of keratinocytes as well as many other cells. Some of the cells give rise to skin color, others are necessary for light touch, and some serve in immune function. These cells that assist in immunity are known as antigen presenting cells, and are made in the bone marrow, and then travel to the epidermis. They leave the epidermis and bind, process, and present antigens to T lymphocytes in the lymph nodes. Which of the following is most likely the cell type being described?
Merkel cells
Melanocytes
B cells
Langerhans cells
Keratinocytes

The integumentary system is very essential in preventing water loss from the body, which would cause severe dehydration. One of the epidermal layers of the skin, the stratum granulosum, consists of 2 types of specific granules, each with a very important role. Which of the following is a lipid-rich structure located in the stratum granulosum that makes the epidermis impermeable to water, thus preventing dehydration?
Tonofibrils
Keratohyaline
Lamellar granules
Dermal papillae
Filaggrin

What is the most appropriate diagnosis for someone with a congenital tyrosinase defect resulting in hypopigmentation of the skin?
Hyperhidrosis
Albinism
Vitiligo
Lentino senilis
Ephelides

Identify the structure indicated by the crudely drawn arrow.
Sebaceous Gland
Eccrine Gland
Merkel Disc
Arrector Pili Muscle
Internal Root Sheath

After a long white coat weekend filled with family fun and studying, ARCOM students arrive at school Monday morning to find that their beloved coffee maker has been stolen! The security staff suspect an inside job as all of the cameras in the atrium were conveniently sabotaged. Which of the following anatomical features would be most helpful in allowing the security staff to narrow down a list of suspects:
Tonofibrils
Dermatoglyphs
Extensor Retinaculum
Ephelis
Lamellar Granules

A patient comes to your office with a bladder infection. While performing your routine examination you notice that the patient is unable to sense coarse touch, pressure, and vibrations. You believe that this may be indicative of a defect in their:
Meissner corpuscles
Pacinian corpuscles
Krause end bulbs
Ruffini corpuscles
Merkel cells

Your patient who came in following a myocardial infarction has been scheduled for a triple coronary bypass surgery. Which three coronary arteries are being surgically altered in this procedure?
Anterior interventricular branch, posterior interventricular branch, circumflex branch
Circumflex branch, right coronary artery, left coronary artery
Anterior interventricular branch, circumflex branch, right coronary artery
Posterior interventricular branch, marginal artery, left coronary artery
Anterior interventricular branch, left coronary artery, right coronary artery

Your patient comes in with chest pain and there is cause that it may be a heart attack. What vein runs alongside the artery that is most likely to be occluded?
Posterior cardiac vein
Left marginal cardiac vein
Middle cardiac vein
Left posterior ventricular cardiac vein
Great cardiac vein

A baby was born with a congenital defect in which its foramen ovale was still open after birth. What defect would this be characterized as?
Atrioventricular defect
Ventricular septal defect
Sinu-atrial defect
Atrial septal defect
Right marginal defect

Which of the following is NOT true regarding the various cells within bone?
Parathyroid hormone stimulates bone reabsorption via direct activation of osteoclasts
Calcitonin inhibits osteoclast activity, decreasing blood calcium levels
Osteoclasts can contain up to 50 nuclei
Osteoblasts become osteocytes when they become entrapped in lacunae
The development of osteoclasts and osteoblasts are inseparably linked

A patient presents to your office with a painful swelling of the femur. After taking his history you find he has Paget Disease. You remember to Ms. Heather’s lectures regarding such symptoms and associated disease. What should you do next?
Obtain an MRI to confirm/deny the possibility of Osteoblastoma
Obtain a bone sample to confirm/deny the possibility of Osteoblastoma
Obtain a CT to confirm/deny the possibility of Osteosarcoma
Obtain an MRI to confirm/deny the possibility of Osteosarcoma
Obtain a blood sample to confirm/deny the possibility of Osteosarcoma

You hear some of your friends talking about the best wrestlers of all time. One of them states that Andre the Giant was a “natural Hulk.” You smirk and politely state that the reason he looked the way he did was not because he was a real live hulk, but rather:
Rheumatoid Arthritis in the jaw
Osteoblastoma pressing on his spinal cord
Heterotrophic Ossification of his entire skeleton
Acromegaly, a tumor on his anterior pituitary gland
No, he was a real live hulk

The following photomicrographs shows the three various types of cartilage. Which of the following correctly labels the locations (in order) of the tissue from which these histological samples could have come from?
Epiglottis, Trachea, annulus fibrosus
Primary bronchus, epiglottis, nucleus pulposus
Pinna of ear, pubic symphysis, annulus fibrosus
Pinna of ear, pubic symphysis, nucleus pulposus
Trachea, Epiglottis, annulus fibrosus

A patient comes into your clinic who had been previously diagnosed with osteoarthritis. In order to grade the severity of their condition, you decide to take a cartilage biopsy from the patients interphalangeal joints. Upon histological examination, you notice a discontinuity of the surface and loss of small portion of the superficial matrix. The slide that you are viewing is shown below. What stage of osteoarthritis is this patient in?
Stage 1
Stage 2
Stage 3
Stage 4
Stage 5

Which of the following is NOT true regarding the cartilage matrix?
Aggrecan serves to resist compression in the cartilage matrix
The main glycosaminoglycans in the cartilage matrix include chondroitin, keratin sulfate, and hyaluronic acid
Glycosaminoglycans are extremely hydrophobic
Aggrecan is the most common proteoglycan found in cartilage
The main glycoprotein in the cartilage matrix is chondronectin

Which of the following correctly identifies the cell specified in the following pictomicrograph?
Osteocyte
Osteoblast
Chondrocyte
Chondroblast
Osteoclast

Time is Up!
Take the 2019 test
Anatomy Exam 2 (2019)

A patient comes in saying they can’t feel their hand. Due to a language barrier, they cannot articulate where their hand is numb. Upon physical examination, you note that they are able to grasp a paper between their first and second distal phalange but not between their third and fourth phalange. Which nerve are you concerned with?
Median Nerve
Radial Nerve
Ulnar Nerve
Recurrent branch of the medial nerve
Deep branch of the ulnar nerve

An inability to feel the skin on the dorsal surface of the base of the thumb would result from which of the following?
Damage to the deep ulnar nerve
Damage to the radial nerve
Damage to the recurrent branch of the median nerve
Damage to the median nerve
Damage to the ulnar nerve

During the first day of anatomy dissection, Dr. Throckmorton cut the tip of his finger requiring stitches. Which of the following explains why it bled like the dickens?
There are lots of recurrent arteries in the hand
He nicked his superficial palmar arch
He nicked his deep palmar arch
The capillary beds have more blood in them
There are more proprioceptors in the fingertips

An inability to abduct the thumb would result from which of the following?
Damage to the deep ulnar nerve
Damage to the superficial branch of the radial nerve
Damage to the recurrent branch of the median nerve
Damage to the median nerve
Damage to the ulnar nerve

Which of the following is a cause of clubbed nails?
COPD
Leprosy
Cystic fibrosis
Kidney failure
Type II diabetes

A T1 weighted MRI shows the following issue. Which of the following actions would they not be able to do?
Extend their pinky
Adduct their wrist
Extend their index finger
Supinate their wrist
Extend their thumb

A patient presents to the ED after a game of intramural flag football and is unable to extend their DIP joint on their right 2nd finger. During their physical exam you also notice that they have blood visible beneath their nailbed. Which of the following injuries did they most likely sustain?
Extensor tendon rupture
Avulsion injury of the distal manual phalanx
Avulsion injury of the distal pedal phalanx
Dislocation
Sesamoid formation

While performing a physical exam on your patient you notice what appears to be a bruise under the patient’s nail. The patient doesn’t remember any trauma that occurred to the phalange. You decide to trephinate it. It bleeds, but does not clear. This is most likely which of the following?
Indication of subungual hematoma
Indication of subungual melanoma
Indication of kidney problems
Indication of liver disease
Indication of heavy metal poisoning

Delilah just found out she’s pregnant. She has struggled with migraines since college and was put on Depakote, a valproic acid derivative. Her doctor tells her that she can no longer take this medication. Which of the following is an explanation as to why?
It affects the closing of the primitive streak resulting in a sacrococcygeal teratoma
It causes the notochord to pinch off into three pieces essentially resulting in three non-functional spinal cords
It could cause anencephaly from the neural tube not closing completely
It could cause the fetus to not form an axial skeleton
It could cause the fetus to form two extra arm buds in place of their leg buds

Janis went into her OBGYN after getting a positive pregnancy test. Her hCG levels were elevated but a transvaginal ultrasound did not show an embryo. Upon further examination, a hydatidiform mole was discovered. How did this happen?
The female pronucleus did not participate in development
The male pronucleus did not participate in development
More than one sperm got through the zona pellucida
She has miscarried after the embryo was attached to the uterine lining
The embryo did not form enough primary chorionic villi so it did not receive the proper nutrients for development

Which of the following happens during week two of human development?
Neural tube formation
Gastrulation
Hypoblast forms
Amniotic cavity forms
Fertilization

You and a classmate know that the bladder arises from the mesodermal layer of the embryo but are arguing over which division it comes from. Which of the following is the correct origin of the bladder?
Paraxial mesoderm
Intermediate mesoderm
Mesodermal cells of the parietal layer (lateral plate)
Mesodermal cells of the visceral layer (lateral plate)
Cardiogenic mesoderm

Patients with Cystic Fibrosis (CF) often produce an increase in respiratory mucous due to a genetic disorder and increased chloride ion pumping into the extracellular fluid. An increase in this respiratory mucous makes it difficult for which of the following structures to function properly?
Microvilli
Stereocilia
Cilia
Flagella
All of the above

Medications work by being able to get into the bloodstream, however many of these drugs would be lethal if they were to cross the blood-brain barrier. Which of the following junctions makes it so that these drugs cannot affect the integrity of the brain?
Adherent junctions
Desmosome
Hemidesmosomes
Tight junctions
Gap Junctions

Rachel comes in to your office saying that almost everything she is eating is either giving her diarrhea or making her constipated. She has lost almost 15 pounds this month without trying. A blood test confirms that she has celiac disease. Why would changing her diet help to alleviate her symptoms?
The cilia in her digestive tract are unable to move the types of food that she is consuming causing damage, so changing her diet would help with repairing the cilia
The microvilli were unable to absorb the foods that she was consuming, but after a week of a changed diet she should have new microvilli that has replaced the non-functioning microvilli.
The microvilli in her digestive tract are unable to move the types of food that she is consuming causing damage, so changing her diet would help with repairing the microvilli
The cilia were unable to absorb the foods that she was consuming, but after a week of a changed diet she should have new microvilli that has replaced the non-functioning cilia

Pemphigus foliaceus is a dyshessive skin disorder caused by an autoimmune disease in which IgG autoantibodies from patients recognize desmogleins (Dsg), which are cadherin-type cell–cell adhesion molecules found in which of the following junctions?
Zonula adherens
Macula adherens
Hemidesmosome
Tight junction
Gap junctions

Which of the following is the least stable joint?
Glenohumeral joint
Sternoclavicular joint
Acromioclavicular joint
Humeroradial joint
Proximal radioulnar joint

While cheering, Kali is dropped from a stunt landing directly on her shoulder, which of the following is the MOST LIKELY injury?
Tear of her glenohumeral ligament
Tear of her coracohumeral ligament
Fracture of her humeral diaphysis
Tear of her transverse humeral ligament
Dislocation of her shoulder

A 12 year old male patient presents to the emergency department after following an ATV accident. Imaging confirms avulsion of the medial epicondyle of the humerus. The patient complains of paresthesia in the fifth digit and the medial half of the fourth digit. Which action of the thumb is most likely weakened or absent in this patient?
Adduction
Abduction
Extension
Flexion
None of the above

A patient presents to your clinic after a recent wrist injury and you notice they are able to hyper-abduct their wrist. What structures are likely to be involved in this injury?
Posterior radiocarpal and anterior joint capsule
Radial collateral and lateral part of joint capsule
Bony apposition between styloid process of radius and scaphoid
Bony apposition between radius and carpal bones
Anterior radiocarpal and anterior part of joint capsule

Which of the following is NOT a function of the Sartoris?
Flexion at the hip
Lateral Rotation of the Thigh
Extension at the knee
Medial Rotation of the Leg
Flexion at the knee

Edna was carrying in her groceries when she slipped and fell on the ice hitting the posterolateral aspect of her hip and buttocks. She is unable to rotate her toes inward with her leg straight from a standing position. Which of the following muscles is likely injured?
Tensor Fasciae Latae
Gluteus maximus
Piriformis
Pectinius
Obturator externus

Which of the quadriceps muscles has a primary function other than extension at the knee joint?
Vastus Lateralis
Vastus Medialis
Vastus Intermedius
Articularis Genu
Rectus Femoris

Which of the following is NOT a component of the Femoral Triangle?
Sartorius
Iliopsoas
Inguinal Ligament
Gracilis
Adductor Longus

Chloe suffers from chronic kidney infections usually brought about from UTIs. She usually gets Doribax, an IM-injected antibiotic, at the first sign of a UTI to prevent it from becoming a kidney infection. While at the doctor’s office, a new nurse is training and begins to prep the lower lateral quadrant of her left buttcheck when her trainer stops her. Why shouldn’t the shot be injected there?
There isn’t enough subcutaneous fat in this region so it would cause unnecessary pain
This region is highly vascular and would cause bleeding
This drug should be given IV and not IM
This region has large nerves passing through that could be punctured causing nerve damage
There is too much subcutaneous fat in this area and it would not be well-absorbed.

Vivian is an avid rock-climber. While rappelling down, her cable was too loose causing her to rappel down very quickly. On her rapid dissent, she was punctured in her right gluteal region with a very sharp stick which went into the thickest part of her right glute about two inches. While in the ER, she is asked to stand on her left leg and her right hip veers up. Which of the following nerves did Vivian injure?
Sciatic
Superior gluteal
Nerve to quadratus femoris
Nerve to obturator internus
Inferior gluteal

A patient comes into the ER and has reportedly injured his pudendal nerve. Your attending tells you that he is concerned for the injury but also other possible injuries in the roots in the Sacral Plexus. What roots might be of concern?
L5-S3
L4-S4
L4-S5
L2-S2
S1-S4

Respectively, which of the following muscle-nerve pairs is INCORRECT?
Gluteus Maximus, Inferior Gluteal Nerve
Gluteus Medius, Superior Gluteal Nerve
Gluteus Minimus, Superior Gluteal Nerve
Inferior Gemelli, Nerve to Obturator internus
Superior Gemelli, Nerve to Obturator internus

Which of the following nerves is sensory only?
Sciatic
Common Fibular
Tibial
Sural
All of the above are mixed (sensory and motor) nerves

Which of the following muscles makes up a part of the floor for the popliteal fossa?
Semitendinosus
Biceps Femoris
Plantaris
Gastrocnemius
Soleus

A blockage is discovered in the popliteal artery just after it has passed through the adductor hiatus. Which of the following blood vessels will receive blood and then be able to bypass the blockage to allow blood flow inferior to the knee?
Superior medial genicular artery
Middle genicular artery
Inferior lateral genicular artery
Anterior tibial recurrent artery
Descending genicular artery

A soccer player comes into the ED with pain in her posterior thigh after injuring herself in a game earlier that night. When looking at the patients MRI T2 scan you notice a large white area where she is feeling pain. What does the large white area represent?
Hematoma
Edema
Muscle Strain
Ischial tuberosity avulsion
Tumor

The lining of the bronchi allows for the exchange of oxygen across the membrane through the function of epithelial cells. Which of the following is the origin of this layer?
Endoderm
Paraxial mesoderm
Intermediate mesoderm
Surface ectoderm
Lateral mesoderm

A mother brings her baby to the clinic that you are working at. You take note of the fact that the baby displays thin lip, flat nose bridge, and a short nose. Following your observations, if the baby has fetal alcohol syndrome, what is the time period during which it was most likely exposed to ethanol?
The entire first trimester
Weeks 1-2
Weeks 3-8
Weeks 8-12
Ethanol would not have an impact on embryonic development

Cleft lip is a common craniofacial defect in which the roof of the mouth and the lip does not fully fuse. Although it is easily identifiable appearance-wise it generally is asymptomatic. Which layer of the trilaminar disc is affected by this defect?
Endoderm
Head mesoderm
Lateral mesoderm
Neuroectoderm
Intermediate mesoderm

Defective enamel development can be the result of an inherited condition called amelogenesis imperfecta, or congenital enamel hypoplasia, which is estimated to affect about 1 in 14,000 people in the United States. This condition can also cause unusually small teeth and a variety of dental problems. Which layer of the trilaminar disc is affected by this defect?
Endoderm
Head mesoderm
Lateral mesoderm
Neuroectoderm
Intermediate mesoderm

A patient presents to the ED in severe distress after a ruptured aortic aneurysm. While rushing the patient to the OR you notice they are quite tall with very slender limbs and unusually long fingers. After looking at the patient’s chart, you’re not surprised to find out they have which of the following conditions?
Hurler’s Syndrome
Kniest Dysplasia
Alport Syndrome
Marfan Syndrome
Ehlers-Danlos Syndrome

Studies have found that pericyte loss in adults and aging brain can lead to neurodegeneration and neuroinflammation. Which of the following explain the cellular basis of this?
They are involved in the formation of the blood-brain barrier
They are involved at the neuromuscular junctions
They are involved in moving nutrients to the brain
They are involved in blood circulation to the brain
They are involved in the process of AChE degeneration

An unlabelled slide appears as above. Given that this is connective tissue, what is its most likely function?
Support
Resistance to stress in one direction
Resistance to stress in multiple directions
Flexible support
Providing oxygen and nutrients

Which of the following is derived from antigen-stimulated b-lymphocytes, primary producers of circulating antibodies and has a clock face nucleus?
Plasma cells
Fibroblasts
Pericytes
Mast cells
Basophils

A patient present after a motorcycle accident in which they injured their medial malleolus and the contents of the tarsal tunnel. Which of the following actions would this patient have reduced capability?
Dorsiflexion
Plantarflexion
Eversion of the Foot
Adduction of the 1st Toe
Extension of DIP and PIP joints

A patient presents with the inability to dorsiflex their foot. Which of the following nerves is most likely damaged?
Tibial
Anterior Tibial
Common Fibular
Deep Fibular
Superficial Fibular

Which of the following plantarflexion muscles is LEAST important in that action?
Gastrocnemius
Soleus
Plantaris
Tibialis Posterior
Flexor Digitorum Longus

A Jones Fracture of the tuberosity of the 5th metatarsal would likely damage the tendon of which muscle?
Tibialis Anterior
Tibialis Posterior
Extensor Digitorum Brevis
Fibularis Longus
Fibularis Brevis

Which of the following is true for both the hand and the foot?
Centered around the 3rd ray axis
TMT joints/CMC joints will dorsiflex/extend
Dorsal Interossei are bipennate
8 tarsal/carpal bones
Each digit has 3 phalanges

Which of the following is innervated by the lateral plantar nerve?
Flexor Digitorum Brevis
Adductor Hallucis
Abductor Hallucis
Extensor Digitorum Brevis
First Lumbrical

Bethany was doing a fouetté turn when she lost her balance and fell onto the outside of her foot. She thought she had just twisted her ankle or sprained her foot, but after a week of it hurting decided to go to the clinic. Her doctor tells her that she has a Jones fracture. This means that she fractured which of the following?
Calcaneus
Cuboid
Fifth metatarsal tuberosity
Fifth distal pedal phalange
Fifth intermediate pedal phalange

After a pick up game of basketball over the weekend, Robert believes he has sprained his ankle. He is unable to rotate his foot in or out. Which type of sprain does he likely have?
Tibiotalar
Subtalar
Calcaneocuboid
Naviculocuneiform
Talonavicular

An unlabeled tissue sample slide was found as seen above. Where in the body could this have come from?
Dorsum of hand
Fingernail
Bladder
Plantar surface of foot
Cornea

Mutations in the gene OCA2 cause an autosomal recessive disorder that affects tyrosinase. Which of the following would you expect a patient with this mutation to present with?
Excessive pigmentation
Lack of melanocytes
Increased risk of blindness
Decreased risk of melanoma
Severe skin flaking

As we age, type I collagen in which layer of skin begins to break down causing skin to lose its elasticity and become wrinkled?
Papillary layer of dermis
Reticular layer of dermis
Stratum spinosum of epidermis
Stratum corneum of epidermis
Stratum granulosum of epidermis

Ta mako is a traditional Maori tattooing practice in which deep cuts are incised and then a chisel is dipped into pigment and tapped into cuts. This process leaves the tattoos with textured grooves instead of smooth skin seen in traditional tattooing. In which layer does this pigment reside?
Subcutaneous
Papillary dermis
Reticular dermis
Stratum basale
Stratum spinosum

Morphea is a form of localized scleroderma where waxy patches of varying sizes appear on the skin with thickened skin below. The skin in these areas are not able to feel a bug land on them. Which of the following mechanoreceptors is affected in morphea?
Meissner Corpuscles
Pacinian Corpuscles
Krause end bulbs
Ruffini Corpuscles
Lamellated Corpuscles

Which of the following is a difference between eccrine and apocrine sweat glands?
Eccrine are found in the armpits and genitalia whereas apocrine is found all over the body
Eccrine are simple cuboidal whereas apocrine are stratified cuboidal
Eccrine receive cholinergic fibers whereas apocrine are innervated by adrenergic nerve fibers.
Eccrine open onto the skin surface whereas apocrine open into a lumen within the body
Eccrine sweat glands utilize holocrine secretion whereas apocrine sweat glands utilize apocrine secretion

Epidermolysis bullosa is a disease that causes hemidesmosomes to break down causing formation of blisters and sloughing of skin. Which of the following stains would allow pathologists to see the hemidesmosomes?
Hematoxylin/Eosin
Toluidine Blue
Periodic Acid Schiff
Osmium tetroxide
Masson’s Trichrome

Heavily glycosylated proteins would be expected to be released from which of the following?
Holocrine Glands
Apocrine Glands
Mucosal Merocrine Glands
Serous Merocrine Glands
Sweat Glands

A 13 year old boy in the 95th percentile for weight presents to your clinic limping and complaining of pain in his groin. Which of the following would you expect to see on his x-ray?
Avascular necrosis of the femoral head
Traumatic hip dislocation
Slipped Capital Femoral Epiphysis
Fracture of the pubis
Leg-Cath-Perth disease

Legg-Calvé-Perthes disease (LCPD) is avascular necrosis of the femoral head resulting from compromise of the blood supply to this area. Which of the following arteries would be affected?
Obturator Artery
Lateral circumflex femoral artery
Medial circumflex femoral artery
Profunda femoral artery
Inferior gluteal artery

Female sports players frequently laterally dislocate the patella. Which of the following is an explanation of why?
The lateral groove is smaller than the medial groove so it is more likely to dislocate that direction
Female hips are wider offset so they are more susceptible to a lateral dislocation
Female patellas are much less tightly associated with the femur and tibia than their male counterparts
The grooves of female patellas are not as large so they are more likely to dislocate in either direction than male patellas
Male patellas have an extra lip on the groove that help to keep them in place than female patellas.

While performing an anterior drawer test on one of your patients you note that excessive movement is present. On that same patient you observe that there is a normal amount of “give” in the posterior drawer test. Which of the following ligaments might you expect to be damaged?
ACL
PCL
Medial Meniscus
Lateral Meniscus
Medial Collateral Ligament

Which of the following could have caused the abnormality in the image below?
Splenomegaly
Paralysis of the left phrenic nerve
Paralysis of the right phrenic nerve
Paralysis of both phrenic nerves
Pericardial effusion

When attempting to do a thoracentesis in the 8th intercostal space, where will you anesthetize?
Only the 8th intercostal space
The 8th and the 9th intercostal space
Only the 9th intercostal space
The phrenic nerve/diaphragm interaction
All 12 intercostal spaces

Which of the following rib abnormalities would be the most problematic?
Absence of the 12th
Absence of the 11th
Cervical Rib
Lumbar Rib
None of the above would cause any problem

The first rib is atypical in that it can be described as the broad and sharpest of the 12 ribs. It also is noted to have grooves for both which of the following?
First Intercostal Nerve & First Intercostal Artery
First Subcostal Muscles & First Innermost Intercostal Muscles
Subclavian Vein & Subclavian Artery
Manubrium & Costoclavicular Cartilage
Intercostal Vasculature & Collateral Vasculature

Donald has bacterial bronchitis. This has caused an excess of non-serous fluid to build up in his lungs causing him tightness in his chest and a persistent productive cough. Which of the following categories can bronchitis be classified as?
Hemothorax
Hydrothorax
Pyothorax
Chylothorax
Pneumothorax

Which of the following is an example of a parasympathetic function of the pulmonary plexus?
Increasing airflow
Decreasing blood flow to lungs
Coughing when there is an irritation
Sensing stretch to prevent overfilling of lungs
Increased oral secretions

After running a marathon, Mary was in tripod position heavily breathing. Which of the following is ensuring that she is not rupturing a lung by overfilling it?
Vagus Nerve
Cough Reflex
Chemoreception
Hering Breuer Reflex
Nociception

Which of the following would cause hilar lymphadenopathy?
Breast cancer
Tuberculosis
Punctured lung
Hemothorax
Pneumothorax

Walter is in the ER with chest pain from a possible myocardial infarction and claims that he has shooting pains down his left arm. Which of the following explain this?
The electrical impulses of the heart are firing rapidly causing pain to shoot along the pathway taken from the left ventricle which goes down the left arm
The vagus nerve in the superior mediastinum is sending signals to the abdominal viscera which is causing a viscerosomatic pain as it passes the dermatome of the left arm
The phrenic nerves in the middle mediastinum is sending signals to the diaphragm which is causing a viscerosomatic pain as it passes the dermatome of the left arm
The splanchnic nerves in the posterior mediastinum is sending signals to the abdomen which is causing a viscerosomatic pain as it passes the dermatome of the left arm
The electrical impulses are causing the vessels of the arm to constrict and blood pressure to increase. This causes pain as the blood rushes through the now narrower blood vessels.

A problem in the maturation of the pleuropericardial membrane is a defect that is not compatible with life. This is because the pleuropericardial membrane…
Becomes the fibrous pericardium and without it, the heart would not stay in place
Becomes the serous pericardium and without it, the heart would rub against the cavity wall
Is involved in the formation of the divisions of the heart and without it, the heart would not be able to compartmentalize
It is involved in the separation of heart from lungs and without it, neither one would be functioning
It is involved in responsible for drainage of fluids around the heart and without it they would accumulate and have nowhere to go.

While performing a pericardiocentesis in your very first clinical rotation the attending ask you what an alternative approach would be to the procedure, rather than entering “through the 5th or 6th intercostal space, proximal to the sternum”. You respond by telling him which of the following?
Enter at the infrasternal angle and pass the needle inferoposteriorly
Enter the needle at the suprasternal notch and pass the needle superoposteriorly
Enter the needle from the intervertebral space of T1-T2 passing the needle inferoanteriorly
Enter at the infrasternal angle and pass the needle superoposteriorly
There is no alternative approach

Which of the following structures would you expect to find in the anterior mediastinum?
Esophagus
Trachea
Thymus Remnants
All of the above

Samuel presents to your clinic with a runny nose, sore throat, and cough. After running basic blood test you note that his eosinophil count is extremely elevated. What type of infection should be of primary concern?
Bacterial
Viral
Parasitic
Fungal
Prion

While on your pathology rotation you are asked to observe a particular leukocyte that is noted to lack granules. Which of the following cells could you potentially be viewing?
Monocyte
Neutrophil
Eosinophil
Basophil
Lymphocyte

What type of granulocyte is known as the “first responders” concerning infection sites and is expected to dye “neutral pink” when exposed to H&E staining?
Monocyte
Neutrophil
Eosinophil
Basophil
Lymphocyte

A patient comes to your office after being exposed to poison ivy. Which of the following progenitor cells would you expect to be in excess in your patient?
Megakaryocyte
Erythrocyte
Myeloblast
Natural killer cell
Plasma cell

Natalie has megaloblastic anemia due to her vegan lifestyle and lack of red meat over the past five years. Which of the following would you expect her to be elevated due to it not being utilized?
Thrombopoetin
Erythropoietin
Tumor Necrosis factor-alpha
FMS-tyrosine kinase-like ligand 3
Transforming growth factor

While playing with your new kitten, Dwight, he scratched you out of the blue for no reason, as kittens often do. Your hand starts bleeding. Which of the following parts of the body would you expect to ramp up its thrombopoietin production in response?
Stromal cells of bone marrow
Endothelial cells of bone marrow
Helper-T cells
Hepatic cells
Macrophages

As an embryo develops it goes through the following phases of fetal hemopoiesis:

Hepatosplenothymic

Medullolymphatic

Pre-hepatic

Medullary

Which of the following has the phases in the correct chronological order?
4, 3, 2, 1
3, 1, 2, 4
3, 2, 1 ,4
3, 1, 4, 2
4, 1, 2, 3

In which structure would you find deoxygenated blood from the entire body?
Superior vena cava
Inferior vena cava
Coronary sinus
Azygous vein
Sinus of venarum

After an acute myocardial infarction some patients will develop a murmur that they didn’t previously have. Which of the following is a potential reason as to why this is?
The myocardial infarction caused papillary muscle dysfunction
The blood now pumps through the heart at a slower rate
The myocardial infarction created a hole in the interventricular septum
The dead tissue of the heart slows down the blood through the valves
The valves have become paralyzed and remain open.

A baby is born with patent fossa ovalis meaning that their fossa ovalis did not fully fuse. What problems would you expect this child to have if left untreated?
They would not be able to efficiently pump blood throughout their body
They would not be able to efficiently pump blood to their lungs
They would not be able to perfuse their tissues efficiently
They would have a mitral murmur
They would have a tricuspid murmur

In which layer of the heart is the conduction system?
Epicardium
Myocardium
Endocardium
Subendothelial connective tissue
Subcardium

The circumflex artery has an almost complete occlusion. Which of the following anastomoses ensures that the left atrium is still receiving adequate blood flow?
Posterior Interventricular artery
Anterior Interventricular artery
Right coronary artery
Left marginal artery
Right marginal artery

After running from a vicious chiwawa, which of the following is triggering your SA node to decrease your heart rate back to normal?
Vagus nerve
Neurons from the lateral horn of T1-T4
Preganglionic sympathetic fibers
Left recurrent laryngeal nerve
Cardiac plexus

In the event of observing a bull charge towards you in a closed-off alleyway, you notice your heart rate has started to increase. Which of the following would you expect to be involved in signaling for this physiological event?
The Vagus nerve
The Accessory Nerve
Preganglionic sympathetic fibers
The Phrenic Nerve
The Pelvic Splanchnic

Which of the following is the most anterior?
Brachiocephalic trunk
Left common carotid artery
Left subclavian artery
Left brachiocephalic vein
Thymus

Which of the following is true regarding the thymus?
It increases hormonal secretion at puberty
It is located posterior to the great arteries of the heart
It is located in the pericardium
It is bilobar
It is the place of maturation for B-cells

Chris is a patient of yours that has recently suffered from an aneurysm is his ascending aorta. Which of the following anatomical factors makes it more likely for a patient to have such an event?
Serous pericardium covers the entire heart
Fibrous pericardium reinforcement is only found on the surfaces of the heart
Fibrous pericardium reinforcement doesn’t begin until the start of the aortic arch
The endothelial lining of the distal ascending aorta sustains a great deal of thrust during each phase of diastole

While obtaining a history from a new patient of yours, you ask about any prior medical history. They state that they had an aortic coarctation 1 year earlier. What would be the most probable location of such pathology?
At the start of the ascending aorta
As the descending aorta bifurcates
The likelihood of coarctation remains constant throughout the entire aorta
The aortic root
At the site of the ligamentum arteriosum
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Anatomicomedical Terminology and Overview of Bodily Systems
Extrinsic Back Muscles
Vertebral Column
Intrinsic Back Muscles and Suboccipital Region
Medical Imaging Techniques
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Spinal Canal Contents
Introduction to Ultrasonography
Shoulder Region
Pectoral Region and Superficial Structures of the Upper Limb
Intro to Human Development and Part of Week 1
Cytoplasm
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Arm and Cubital Fossa
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Palmar Hand
Posterior Forearm and Dorsum of Hand
Week 3 of Human Development
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Upper Limb Joints
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Weeks 4-8 of Human Development
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