Anatomy Exam 2 (2018) Published on August 30, 2020 by ehudspeth 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!