At which of the following ages does fetal movement first occur? A. 1 month B. 2 months C. 4 months D. 6 months E.

7 months

The correct answer is B. Neuromuscular development is sufficient to allow fetal movement in the eighth week of life. Other features of Week 8 include the first appearance of a thin skin, a head as large as the rest of the body, forward-looking eyes, appearance of digits on the hands and feet, appearance of testes and ovaries (but not distinguishable external genitalia), and a crownrump length of approximately 30 mm. By the end of the eighth week, nearly all adult structures have at least begun to develop, and the fetus "looks like a baby."

Most of the oocytes in the ovary of a prepubescent girl are in which meiotic stage? A. Anaphase of the second meiotic division B. Metaphase of the first meiotic division C. Metaphase of the second meiotic division D. Prophase of the first meiotic division E. Telophase of the first meiotic division

The correct answer is D. The first meiotic division is the "reduction" meiotic division, in which the diploid complement of DNA is reduced to a haploid complement. The bulk of oocytes in premenopausal women, girls, and babies are arrested at prophase of the first meiotic division. Postmenopausal women have very few viable oocytes. It is important to note that ovulation occurs before the oocyte is completely mature. The secondary oocyte leaving the follicle is in metaphase of the second meiotic division (choice C). The cell's metabolic operations have been discontinued and the oocyte drifts in a state of "suspended animation," awaiting the necessary stimulus for further development. If fertilization does not occur, the oocyte disintegrates without

completing meiosis.

An abrasion results in the total loss of epidermis over a large area of an arm, but one month later, the abrasion has healed, with regrowth of the epidermis. Which of the following mechanisms accounts for the restoration of the epidermis over the abraded area? A. Growth of epidermis from hair follicles and sweat glands in the dermis B. Migration of endothelial cells from newly grown capillaries C. Transformation of dermal fibroblasts into epidermal cells D. Transformation of macrophages into epidermal cells E. Transformation of melanocytes into epidermal cells

The correct answer is A. The dermis contains skin appendages (e.g., hair follicles), which contain epithelial stem cells. In the process of healing a large area where the epidermis has been lost but the dermis is intact, re-epithelialization occurs by growth of epidermal cells from the underlying skin appendages, as well as from the intact epidermis along the wound edges. Physiologically, the dermis lies beneath the epidermis. It has two major components, a superficial papillary layer and a deeper reticular layer. The papillary layer contains the capillaries and the sensory neurons, which supply the surface of the skin. The reticular layer consists of an interwoven meshwork of dense irregular connective tissue. None of the other cell types are known to directly contribute to the regeneration of epidermis over abraded skin.

Hirschsprung's disease indicates a developmental abnormality in which of the following embryonic tissues? A. Ectoderm B. Endoderm C. Neural crest D. Neural ectoderm

E. Splanchnic mesoderm

The correct answer is C. The baby has Hirschsprung's disease, which is due to an absence of ganglion cells in the wall of the colon. Neural crest cells contribute to the formation of many adult structures. Among these are all of the postganglionic neurons of the autonomic nervous system and the sensory neurons of the peripheral nervous system. Ectoderm (choice A) forms the epidermis of the skin and the parenchymal cells of glands associated with the skin such as the sweat glands, sebaceous glands, and mammary glands. Endoderm (choice B) forms the epithelial lining of the gut tube and the parenchymal cells of glands associated with the gut tube, such as the liver and pancreas. Neural ectoderm (choice D) forms the central nervous system, the somatic motor neurons of the peripheral nervous system, and the preganglionic neurons of the autonomic nervous system. Splanchnic mesoderm (choice E) forms the visceral peritoneum, visceral pleura, visceral pericardium, and the stroma and muscle of the wall of the gut, among other structures.

Injury at the lower border of a rib will most likely damage which structure? A. intercostal artery B. intercostal nerve C. intercostal vein D. internal intercostal muscle

The correct answer is B. The three structures in the intercostal space are, from superior to inferior, the intercostal vein, artery, and nerve. The proper site for insertion of an intercostal drain is superior to a rib, not directly at the level of the superior border but slightly higher to avoid the collateral branches of the nerve, artery, and vein. The nerve is the most inferior structure and thus most likely to be damaged by the drain (producing an anesthetic dermatome). In addition, the nerve is the least protected by the costal groove. The intercostal artery (choice A) is the middle structure and thus is not the most likely to be damaged.

Circulating stem cells (choice B) can repopulate damaged bone marrow (choice D). bone surfaces are covered by the periosteum. Which of the following is the source of the osteoblasts that formed this bone? A.The intercostal vein (choice C) is the most superior structure and is thus the least likely to be damaged. therefore. Circulating stem cells C. Occasionally. Following the healing of a tibial fracture. In addition. but deep deep tendon reflexes and Babinski's sign are absent. the more protected by the costal groove). Marrow E. Cancellous bone near the fracture B. neither the cancellous (choice A) nor the compact (choice C) bone near the fracture is the source of the bone-forming cells. In addition. new piece of viable bone near the joint (heterotopic ossification). a patient forms a small. Surprisingly. The source of bone-forming cells following a fracture is the damaged periosteum. many drains. The medial aspect of the cerebral hemispheres is most affected. will not even pass through a layer of internal intercostal muscle. The internal intercostal fibers (choice D) will tend to be separated by the drain. where they are covered by a layer of hyaline cartilage. when inserted. and is unable to move his right leg. The periosteum assists in the attachment of a bone to surrounding tissues and associated tendons and ligaments. some of these cells become "lost" and can form small pieces of inappropriately located bone that impair joint movement. Compact bone near the fracture D. from the neck of the rib to its angle. Except in joint cavities. Which artery is most likely involved? . A patient has a severe headache. There is no higher cortical function loss. the vein is the structure best protected by the costal groove (the further superior the structure. The periosteum is composed of an outer fibrous and inner cellular layer. which is interfering with joint mobility. Periosteum The correct answer is E. the internal intercostal muscle is membranous (internal intercostal membrane) posteriorly. but neither the bone marrow nor the circulating stem cells is the source of the bone-forming cells.

the trunk. paralysis of the right leg results from loss of blood flow to the portion of the left hemisphere supplied by the left anterior cerebral artery. left middle cerebral artery C. right posterior cerebral artery The correct answer is A. The posterior cerebral artery (choices C and E) supplies the occipital cortex. left posterior cerebral artery D. the left cerebral hemisphere controls the right side of the body. The medial aspect of the cerebral hemispheres is supplied by the anterior cerebral arteries. The right anterior cerebral artery (choice D) supplies blood to the medial aspect of the right cerebral hemisphere. and the proximal part of the lower extremities. dorsal mesogastrium C. dorsal mesoduodenum B. pleuropericardial membranes E. Because the corticospinal tracts cross over to the opposite side in the medulla oblongata.A. which controls the left leg. The middle cerebral artery (choice B) supplies the lateral convexity of the brain. As with the anterior cerebral artery territories. interruption of blood flow through this artery would probably produce visual deficits rather than paralysis. and the left hemisphere innervates the right body. The small portion of primary motor cortex located here sends fibers to spinal-cord segments innervating the lower limbs. An infant is born with an abnormally developed falciform ligament. Hence. the right hemisphere innervates the left body. These developmental anomalies are most likely due to abnormal development of the A. This patient has paralysis of the right leg. ventral mesentery . Primary motor cortices on the lateral aspects of the hemispheres send fibers to the brainstem (innervating the face) and to spinal-cord segments innervating the upper limbs. left anterior cerebral artery B. right anterior cerebral artery E. pericardioperitoneal canal D. The hepatogastric and hepatoduodenal ligaments are also malformed.

Bowman's capsule B. The simple squamous epithelium lining Bowman's capsule (choice A) is derived from mesoderm of the metanephric vesicle. Distal convoluted tubule C. The simple cuboidal epithelium lining the distal convoluted tubule (choice B) is derived from . and lesser omentum. Proximal convoluted tubule E. Ureter The correct answer is E.The correct answer is E. The ventral mesentery forms the falciform ligament. The dorsal mesoduodenum (choice A) is the mesentery of the developing duodenum. which later disappears so that the duodenum and pancreas lie retroperitoneally. the renal pelvis. and the major and minor calyces is derived from mesoderm of the ureteric bud. The transitional epithelium that lines the ureter. which is the mesentery of the stomach region. Which of the following structures is lined with epithelium derived from mesoderm of the ureteric bud? A. which can be divided into the hepatogastric and hepatoduodenal ligament. ligamentum teres. Both omental bursa and the greater omentum are derived from the dorsal mesogastrium (choice B). The pleuropericardial membranes (choice D) become the pericardium and contribute to the diaphragm. as is the cuboidal epithelium of the collecting tubules. The pericardioperitoneal canal (choice C) embryologically connects the thoracic and peritoneal canals. Loop of Henle D.

Choice B is incorrect because the preganglionic parasympathetic fibers that regulate these two salivary glands are carried by the chorda tympani (which joins with the lingual nerve) to the submandibular ganglion. Decreased salivation from the left submandibular and sublingual salivary glands C. The hypoglossal nerve is a pure motor nerve (general somatic efferent) to the intrinsic and most extrinsic muscles of the tongue. efferent limb). Choice E is incorrect because the taste fibers for the anterior two thirds of the tongue are carried via the chorda tympani to the facial nerve (CN VII) and hence to the brainstem. If the nerve is damaged. The gag reflex (choice A) is mediated by the glossopharyngeal nerve (CN IX.mesoderm of the metanephric vesicle. The simple squamous epithelium lining the loop of Henle (choice C) is derived from mesoderm of the metanephric vesicle. The muscles responsible for elevation of the pharynx (choice D) are innervated primarily by the vagus nerve (CN X). Inability to perceive sweet and salt taste sensation on the anterior part of the left side of the tongue The correct answer is C. Inability to elevate the pharynx on the left during swallowing E. Which of the following would most likely result from this injury? A. afferent limb) and the vagus nerve (CN X. Postganglionic fibers are then distributed to these glands. Decreased gag reflex on the left B. . denervation atrophy of the affected side will permit the intact musculature of the opposite side to operate unopposed. The proximal convoluted tubule (choice D) is lined with simple columnar epithelium derived from mesoderm of the metanephric vesicle. A patient's left hypoglossal nerve (CN XII) is injured during a carotid endarterectomy. thereby protruding the tongue to the side of the injury. Deviation of the tongue to the left on protrusion D.

The suprascapular nerve (choice D) is a branch of the upper trunk of the brachial plexus. The patient is suffering from scalene triangle syndrome (thoracic outlet syndrome). If this nerve is cut. Vagus nerve The correct answer is A. the phrenic nerve is one of the nerves of the cervical plexus. and on the right side it recurs around the right subclavian artery. The vagus nerve (choice E) lies within the carotid sheath within the neck. The vagus nerve is not in contact with the anterior scalene muscle. transverse cervical. Anatomically. lesser occiptital. Incision of the anterior scalene muscle will relieve this compression. Phrenic nerve B. Suprascapular nerve E. The recurrent laryngeal nerve (choice B) is a branch of the vagus nerve. as well as the cervical nerves. It ascends to the larynx in the tracheoesophageal groove. Superior laryngeal nerve D. and greater auricular nerves. The suprascapular nerve innervates the supraspinatus and infraspinatus muscles.A patient with paresthesia of the medial side of the hand and forearm undergoes surgery to correct it. The lower trunk of the brachial plexus and the subclavian artery are being compressed between the anterior scalene muscle and the middle scalene muscle. It innervates the cricothyroid muscle of the larynx and the laryngeal mucosa above the vocal folds. . On the left side it recurs around the aortic arch. The superior laryngeal nerve is not in contact with the anterior scalene muscle. The phrenic nerve lies on the anterior surface of the anterior scalene muscle deep to the prevertebral fascia. This nerve distributes to the diaphragm other nerves of the cervical plexusm including the ansa cervicalis. The nerve innervates several laryngeal muscles and the laryngeal mucosa inferior to the vocal folds. Recurrent laryngeal nerve C. If the anterior scalene muscle is cut during this surgery. the diaphragm on that side of the body will be paralyzed. The carotid sheath is anterior to the prevertebral fascia. It is not in contact with the anterior scalene muscle. It arises from the upper trunk after the upper trunk has passed between the anterior and middle scalene muscles. supraclavical. The superior laryngeal nerve (choice C) is a branch of the vagus nerve that arises just after the vagus nerve passes through the jugular foramen. what nearby nerve must be avoided? A.

These are not in contact with this artery. Depression of the eye from the adducted position (choice C) is accomplished by the superior oblique muscle. The two most important hormones controlling Calcium metabolism are secreted from the: A. Loss of depression of the right eye from the adducted position D. including the medial rectus muscle. Thyroid and thymus glands C. Loss of visual field (choice E) results from lesions of the optic nerve or other elements of the visual pathway.Compression of a cranial nerve by a large aneurysm of the right superior cerebellar artery immediately distal to its origin from the basilar artery would cause which of the following clinical findings? A. This muscle is innervated by the trochlear nerve. Adenohypophysis and parathyroid glands . which is responsible for adduction of the eye. A superior cerebellar artery aneurysm would not compress this nerve. Sensation on the face (choice D) is mediated by the trigeminal nerve. which arises more caudally from the brainstem and is not in contact with this artery. This nerve arises from the anterolateral surface of the pons and is not in contact with this artery. The oculomotor nerve emerges from the interpeduncular fossa of the midbrain and then passes between the superior cerebellar artery and the posterior cerebral artery immediately lateral to the basilar artery. Loss of abduction of the right eye B. Aneurysm of any of these three arteries may compress the nerve. Loss of adduction of the right eye C. Abduction of the eye (choice A) is accomplished by the lateral rectus muscle. Loss of visual field of the right eye The correct answer is B. Parathyroid and thyroid glands B. The oculomotor nerve innervates a number of extraocular muscles in the orbit. which emerges from the dorsal surface of the midbrain and passes lateral to the cerebral peduncle before entering the cavernous sinus. This muscle is innervated by the abducens nerve. Loss of sensation on the right side of the face E.

or parathyroid hormone. The antagonist hormone. During a cranial nerve test. Which of the following muscles is paralyzed? A. the patient cannot elevate her right eye from the abducted position. Adrenal cortex and thyroid glands E.D. decreasing digestive absorption of calcium. The superior rectus muscle can elevate and adduct the eye from the neutral position. Right lateral rectus D. it is the only muscle that can depress the eye. Note that the term adenohypophysis in answer choice C refers to the anterior pituitary. Right inferior rectus C. The inferior oblique muscle (choice A) can elevate and abduct the eye from the neutral position. This term and neurohypophysis (posterior pituitary) are often used on NBDE. It reduces serum calcium by promoting calcium depositon in bones. it is the only muscle that can elevate the eye. Right superior rectus The correct answer is E.PTH. is secreted by parafollicular cells of the thyroid (follicular cells secrete thyroxin). it is the only muscle that can elevate the eye. From the abducted position. The superior oblique muscle (choice D) can depress and abduct the eye from the neutral . The lateral rectus muscle (choice C) can abduct the eye. is considered to be the most important hormone controlling calcium metabolism. Right superior oblique E. It increases serum calcium by increasing bone mineral resorption by osteoclasts. Right inferior oblique B. PTH is secreted by principal cells of the parathyroid. The inferior rectus muscle (choice B) can depress and adduct the eye from the neutral position. calcitonin. and decreasing calcium excretion by the kidney. From the abducted position. Parathyroid and adrenal glands The correct answer is A. and promoting calcium excretion. From the adducted position. increasing digestive absorption of calcium.

position. Digastric B. Which of the following arteries usually supplies these branches? A. Right gastric D. it is the only muscle that can depress the eye. Several arterial branches penetrate into the distal end of the lesser curvature of the stomach. Lateral pterygoid C. The right gastric artery supplies the distal lesser curvature. The right gastroepiploic artery (choice D) supplies the distal greater curvature. Short gastric The correct answer is C. Contraction of which of the following muscles contributes most to the backward movement of the lower jaw during the process of mastication? A. The short gastric artery (choice E) supplies the proximal greater curvature above the splenic artery. The left gastric artery (choice A) supplies the proximal lesser curvature. The left gastroepiploic artery (choice B) supplies the proximal greater curvature below the splenic artery. Medial pterygoid D. The arterial supply of the stomach is complex. From the adducted position. it therefore has a good potential to appear on the NBDE. Left gastroepiploic C. Temporalis . Right gastroepiploic E. Left gastric B. Mylohyoid E.

Inserting deeply into the cartilage D. Blending with the covering periosteum B. No deep attachments are usually made by fascia. The digastric (choice A) helps to depress (open) the lower jaw during chewing. Inserting deeply into the marrow The correct answer is A. which is usually found in marrow and is not the site for fascial attachment. The mylohyoid (choice D) helps to depress (open) the lower jaw during chewing. Fascial straps (retinacula) and fascial coverings of muscles or muscle groups characteristically attach to nearby bones by blending with the covering periosteum. or downward during chewing. forward movement. superficially via the periosteum. depression. It is innervated by the manibular branch of the trigeminal nerve. The backwardmovement step is accomplished by the posterior fibers of the temporalis muscle. Cancellous bone (choice B) is spongy bone. Inserting deeply into the diaphysis E. The temporalis originates along the temporal lines of the temporal bone and inserts into the coronoid process of the mandible. or diaphyses (choice D). Mastication is a complex process involving alternating elevation. Fascia attaches to bony shafts. Most fascia of the body that attach to bones attach by which of the following mechanisms? A. . Inserting deeply into the cancellous bone C. The medial pterygoid (choice C) helps to elevate (close) the lower jaw during chewing. The lateral pterygoid (choice B) helps to move the lower jaw forward. Fascia do not usually attach to cartilage (choice C). laterally.The correct answer is E. and backward movement of the lower jaw.

There are no abnormalities of the baby's palate. the right and left medial nasal prominences merge to form the philtrum of the upper lip. there is no pupillary response in either eye. Failure of the left lateral palatine process to fuse with the median palatine process B. In the formation of the upper lip.Fascia do not penetrate the bone to reach the marrow (choice E). However. Failure of a lateral palatine process to fuse with the median palatine process (choice A). The lateral maxillary prominence then merges with the merged medial nasal prominences. the right and left medial nasal prominences merge into a single prominence that forms the philtrum of the lip. Failure of the right palatine process to fuse with the left palatine process The correct answer is B. A newborn baby is noted to have a left unilateral cleft lip. results in a primary cleft palate. Failure of the primary palate to fuse with the secondary palate D. Failure of the right and left palatine processes to fuse (choice E) results in a secondary cleft palate. When a light is shined in her right eye. Failure of the right and left medial nasal prominences to merge E. Normally. the right and left palatine processes fuse together and fuse to the primary palate. Her extraocular movements are intact. What is the most likely location of her lesion? . Primary clefts of the palate are found anterior to the incisive foramen of the palate. Secondary cleft palates are found posterior to the incisive foramen. upon shining a light in her left eye. which is synonymous with a failure of the primary palate to fuse with the secondary palate (choice C). A patient experiences visual difficulties. This is a rare anomaly. Failure of this merger to occur results in a unilateral cleft lip. Which of the following developmental defects accounts for this occurrence? A. Normally. Primary cleft palates may occur along with cleft lips but are the result of a separate developmental defect. Failure of the right and left medial nasal prominences to merge (choice D) results in a median cleft lip. both ipsilateral and contralateral pupillary responses are apparent. Failure of the left maxillary prominence to unite with the left medial nasal prominence C.

because her right optic nerve is not functioning properly. and has a destination in the diencephalon via the optic chiasm. passes through the optic foramen of the sphenoid bone. right side E. The oculomotor nerve also mediates pupillary constriction (parasympathetic fibers). Anatomically. the light signal is not transmitted to the central nervous system (CNS). Right hyoglossus . right side C. left side B. Oculomotor nerve. Left hyoglossus C. Left genioglossus B. left side D.A. and innervates the ciliary muscle (allowing accommodation). left side The correct answer is D. Optic nerve. pupillary responses would be present in both eyes when shining a light in the right eye. When light is shined into her right eye. resulting in no pupillary response. Recall that the afferent limb of the pupillary light reflex is the optic nerve (CN II). As light is shined into her left eye. A patient with a lesion of the left optic nerve (choice C) would have no pupillary responses in either eye when shining a light in the left eye. eyelid opening (levator palpebrae). the optic nerve is a special sensory nerve that originates in the retina of the eye. the left optic nerve transmits the signal to the CNS. the efferent limb is the oculomotor nerve (CN III. parasympathetic fibers). Right genioglossus E. Optic nerve. Know your cranial nerves! This woman has a "Marcus-Gunn pupil" with a defect in the afferent pathway of the optic nerve (in this case. If the tongue deviates to the right side when protruded. which then sends an outbound signal through both the right and left oculomotor nerves to cause pupillary constriction in both eyes. the most likely cause is paralysis of which of the following muscles? A. Trochlear nerve. Left palatoglossus D. Oculomotor nerve. on the right side). The oculomotor nerve (choices A and B) innervates all extraocular muscles except the lateral rectus (innervated by the abducens nerve) and the superior oblique (innervated by the trochlear nerve choice E).

If the left genioglossus muscle were paralyzed (choice A). which also gives rise to the middle ear cavity and the inner epithelial lining of the tympanic membrane. Stylohyoid muscle E. The hyoglossus muscles (choices B and E) are innervated by the hypoglossal nerves. the tongue would deviate toward the left on protrusion because of the unopposed action of the right genioglossus muscle. These muscles are not active during protrusion of the tongue.The correct answer is D. the stapedius. Which of the following is a derivative of the second pharyngeal arch? A. The genioglossus muscle is innervated by the hypoglossal nerve. Their function is to pull the tongue back (retract) and upward toward the palate. which also gives rise to the outer epithelial lining of the tympanic membrane. the left genioglossus muscle pulls the tongue forward and to the right. External auditory meatus C. When the right genioglossus muscle is paralyzed. The external auditory meatus (choice B is derived from the first pharyngeal cleft. The palatoglossus muscle (choice C) are innervated by the vagus nerves rather than the hypoglossal nerves. The function of these muscles is to retract the tongue. Eustachian tube B. which also gives rise to the muscles of facial expression. Palatine tonsil D. Tensor tympani The correct answer is D. The Eustachian tubes (choice A) are derived from the first pharyngeal pouch. the posterior belly of the digastric muscle. The stylohyoid is derived from the second pharyngeal arch. The left genioglossus muscle is innervated by the left hypoglossal nerve. . The function of the genioglossus muscle is to pull the tongue forward (protrude) and toward the opposite side. Reichert's cartilage. and the facial nerve.

First pharyngeal arch → muscles of mastication → trigeminal nerve Second pharyngeal arch → muscles of facial expression → facial nerve Damage to the parasagittal region and falx cerebri will most likely result in which of the following neurologic deficits? A. Furthermore. .The palatine tonsil (choice C) is derived from the epithelial lining of the second pharyngeal pouch. near the midline. the mylohyoideus. Taste (choice A) is supplied by cranial nerves VII. Altered taste B. and the maxillary and mandibular divisions of the trigeminal nerve. Facial sensation (choice C) is supplied by cranial nerve V. and X. Loss of facial sensation D. The tensor tympani (choice E) is derived from the first pharyngeal arch. A meningioma of the parasagittal region and the falx cerebri would be located at the top of the brain. the nuclei of which are in the brainstem. which also gives rise to the muscles of mastication. Ptosis E. the tensor veli palantini. These nerves arise from the brainstem. Unilateral deafness The correct answer is B. Its interior portions attach anteriorly to the crista galli and posteriorly to the internal occipital crest. the maxillary and mandibular bones. In this position. The falx cerebri is a fold of dura mater that projects between the cerebral hemispheres in the longitudinal tissues. it could compress the sensory or motor cortex supplying the lower extremities. Note that knowing the embryology of these structures helps you remember the innervation of the muscles of the face. IX. the anterior belly of the digastric muscle. the area of the sensory cortex that subserves the face is on the lateral aspect of the cortex and would not be affected by a tumor in the parasagittal region. Leg paralysis C.

and it does not undergo opacification injury. nonkeratinized. They are successfully treated at present with lens extraction and implantation of prosthetic lenses. however. The retina (choice E) consists of multiple layers of neural cells. Cataracts may occur as a consequence of diabetes mellitus. which arises from the brainstem. Squamous metaplasia is a reparative process. Aqueous humor B. long-term steroids. It is not known whether senile cataracts represent disease or normal opacification with age. it does not undergo opacification. keratinized. which arises from the brainstem. traumatic. and 3) lens opacities may be invisible or grossly visible. squamous cells. As such. Aqueous humor (choice A) is continually replaced due to active secretion by the ciliary body. The optic nerve (choice D) is not transparent. infective. Optic nerve E. In which of the following structures are the opacifications located with cataract formation? A. It may. 2) no pain or redness is seen. The retina is transparent but is not the site of cataract formation. usually due to friction injury to the cornea or a vitamin A deficiency. Retina The correct answer is C. Unilateral deafness (choice E) suggests damage to cranial nerve VIII. it is in constant flux. . or congenital infections. The diagnostic characteristics for cataracts are as follows: 1) blurred vision that is progressive over months to years. squamous cells are replaced by opaque. or metabolic insults. Lens D. in which the transparent. Cornea C. Cataracts are lens opacifications.Ptosis (choice D) can be caused by a deficit in cranial nerve III. Corneal opacification (choice B) is generally a consequence of squamous metaplasia. atrophy due to ischemic.

Deltoid B. A good way to remember what passes through the superior oribital fissure is that everything that innervates the eye. the ophthalmic nerve (V1). the trochlear nerve (CN IV).A sharp instrument passing through the superior orbital fissure would most likely sever which of the following structures? A. The maxillary nerve (V2. The mandibular nerve (V3. choice B) passes through the internal auditory meatus. choice C) passes through the foramen ovale. passes through this fissure. Which of the following muscles would be most likely be paralyzed? A. The facial nerve (CN VII. choice D) passes through the foramen rotundum. Middle meningeal artery The correct answer is A. Facial nerve C. Mandibular nerve D. other than the optic nerve. and the abducens nerve (CN VI). Maxillary nerve E. Flexor carpi ulnaris C. Flexor pollicis brevis E. Palmaris longus . A knife wound to the neck damages the posterior cord of the brachial plexus. The middle meningeal artery (choice E) passes through the foramen spinosum. Flexor digitorum superficialis D. Abducens nerve B. This incudes the oculomotor nerve(CN III).

and can occur in tumors or when an egg is fertilized by two sperm. the embryo will have 47 chromosomes (trisomy) or 45 chromosomes (monosomy). During the process of meiosis. The deltoid originates from the clavicle and scapula. The flexor digitorum superficialis (choice C). Uniploidy The correct answer is C. and the palmaris longus (choice E) are supplied by the median nerve.The correct answer is A. An unbalanced translocation (choice D) occurs when non-homologous chromosomes exchange genetic material with a net loss or gain of critical genetic material. The posterior cord supplies the axillary and radial nerves. When a gamete with the normal 23 chromosomes combines at fertilization with a gamete with 22 or 24 chromosomes. The process described is nondisjunction. Triploidy (choice B) is the term used when a cell has 69 chromosomes (3N or 3 sets). This muscle is responsible for abduction of the arm. which will cause one daughter cell to have 24 chromosomes. Balanced translocation (choice A) occurs when non-homologous chromosomes exchange genetic material in such a way that no critical genetic material is lost. the flexor pollicis brevis (choice D). Trisomy D. specifically the axillary nerve. The flexor carpi ulnaris (choice B) is supplied by the ulnar nerve. Meiosis is cell division that produces gametes with half of the normal somatic chromosome complement. This failure would be most likely to produce which of the following conditions if fertilization occurs and an embryo later develops? A. a single homologous chromosome pair fails to separate during the first meiotic division. . only the deltoid is supplied by one of these two nerves. Unbalanced translocation E. Nondisjunction can occur in either the first or second meiotic division. Balanced translocation B. Of the muscles listed. Triploidy C. It inserts into the deltoid tuberosity of the humerus. while the other will have 22 chromosomes.

Veins of the face communicate with the superior ophthalmic vein. Cavernous sinus B. passes through the superior orbital fissure to enter the orbit. Straight sinus The correct answer is A. Superior petrosal sinus E. The anterior continuation of the cavernous sinus. Because of the absence of valves in emissary veins. and VI. Sigmoid sinus D. The sigmoid sinus passes through the jugular foramen and drains into the internal jugular vein. The sigmoid sinus (choice C) is the anterior continuation of the transverse sinus in the middle cranial fossa. which may lead to an infected cavernous sinus thrombosis. The superior ophthalmic vein directly communicates with which of the following dural venous sinuses? A. and the internal carotid artery. seen normally in sperm and eggs. The superior petrosal sinus (choice D) is at the apex of the petrous portion of the temporal bone and is a posterior continuation of the cavernous sinus. The straight sinus (choice E) is at the intersection of the falx cerebri and the falx cerebelli in the posterior cranial fossa. V1. the superior ophthalmic vein. The occipital sinus (choice B) is at the base of the falx cerebelli in the posterior cranial fossa. Occipital sinus C. Cutaneous infections may be carried into the cavernous sinus and result in a cavernous sinus infection.Uniploidy (choice E) is the state of having 23 chromosomes. venous flow may occur in either direction. The cavernous sinus is lateral to the pituitary gland and contains portions of cranial nerves III. V2. . IV. The superior petrosal sinus connects the cavernous sinus with the sigmoid sinus. The straight sinus connects the inferior sagittal sinus with the confluence of sinuses. It drains into the confluence of sinuses.

Beta cells of pancreas C. Adrenal medulla . but not the fingertips. it is essential to anesthetize a branch of this nerve (possibly a proper digital branch) to eliminate pain sensation around the nail bed of the index finger. The ulnar nerve (choice E) supplies the palmar and dorsal surfaces of the medial hand. the lateral half of flexor digitorum profundus. biceps. the physician would most likely anesthetize a branch of the A. and the distal dorsal surface of the index and middle fingers (including the nail beds). The median nerve supplies the surface of the lateral palm. and most of the brachialis muscle. quadratus and p. Therefore. including the palmar and dorsal surfaces of the fourth and fifth digits. radial nerve E. Adrenal cortex D. The anterior interosseous nerve supplies the flexor pollicis longus. musculocutaneous nerve D. The radial nerve (choice D) supplies skin on the radial side of the dorsal surface of the hand. teres). Neither the anterior interosseus (choice A) nor the musculocutaneous (choice C) nerves supplies the hand. Alpha cells of pancreas B. then becomes the lateral cutaneous nerve of the forearm. The median nerve of the branchial plexus distributes to the flexor muscles on the forearm (flexor carpi radialis and palmaris longus). the palmar surface of the first three digits. prior to performing surgery in this area. the pronators (p. Which glandular area secretes hormones which are products of tyrosine metabolism? A. ulnar nerve The correct answer is B. and pronator quadratus. The musculocutaneous nerve supplies the coracobrachialis. anterior interosseus nerve B. and skin over the lateral surface of the hand. median nerve C.In preparation for a procedure to remove the fingernail on an index finger. digital flexors.

g. the gut tube is connected to the yolk sac by a narrow connection known as the yolk stalk. also a steroid hormone. Umbilical herniation The correct answer is D. the midgut normally herniates into the umbilical cord and then subsequently retracts into the abdominal cavity. Failure of peritoneal fusion D. Both are peptide hormones. this connection degenerates. while beta cells secrete insulin. mobile cecum). a condition known as gastroschisis. Incomplete fusion of the lateral body folds E. Failure of the intestinal loop to retract from the umbilical cord (choice A) results in omphalocele. The pathway of production of these compunds is a s follows: tyrosine to DOPA to dopamine to norepinephrine to epinephrine. Incomplete fusion results in a defect that allows abdominal viscera to protrude from the abdominal cavity. During the fourth week of development. Failure of the intestinal loop to retract from the umbilical cord B. Normally..The products of the adrenal medulla are epinephrine (adrenalin) and norepinephrine (noradrenalin). Failure of the yolk stalk to degenerate (choice B) results in an ileal (Meckel's) diverticulum or a vitelline fistula or cyst. Testes The correct answer is D. Failure of this peritoneal fusion (choice C) will result in certain organs that are normally immobile being mobile (e. Which of the following is the likely cause of this defect? A. both steroid hormones. . the lateral body folds move ventrally and fuse in the midline to form the anterior body wall. Failure of the yolk stalk to degenerate C.E. During development. The hormone secreted by alpha cells of the pancreas is glucagon. certain peritoneal organs fuse with the posterior abdominal wall to become secondarily retroperitoneal. The adrenal cortex secretes a variety of hormones including cortisol and aldosterone. A newborn infant has some of its abdominal viscera protruding through a defect in the abdominal wall. The testes secrete testosterone. During development. In the early embryo.

anhidrosis (lack of sweating). The cervical sympathetic chain (choice A) contains preganglionic sympathetic nerve fibers. A lesion of these nerves may result in Horner's syndrome. Trigeminal nerve The correct answer is C. Such protrusions are covered by subcutaneous fascia and skin. . arising from the upper thoracic spinal cord. The oculomotor nerve also contains preganglionic parasympathetic fibers that synapse. which ascend to the cervical sympathetic ganglia. The facial nerve (choice B) innervates the muscles of facial expression. on postganglionic parasympathetic nerve fibers that innervate the sphincter pupillae muscle. which includes a ptosis and miosis (pupillary constriction) and. distinguishing them from gastroschisis. Facial nerve C. Cervical sympathetic chain B. A lesion of this structure will cause Horner's syndrome. inferior. A lesion of the oculomotor nerve may therefore result in both drooping of the eyelid (ptosis) and dilation of the pupil (mydriasis). often. A lesion of this nerve may therefore result in the inability to close the eye. in the ciliary ganglion. The oculomotor nerve innervates the levator palpebrae superioris. Oculomotor nerve D. as well as the superior. If a patient has a drooping right eyelid and a dilated right pupil. A lesion of this nerve may interfere with the corneal blink reflex. This nerve also innervates the inferior oblique muscles. which constricts the pupil. including the orbicularis oculi muscle. Superior cervical ganglion E. The trigeminal nerve (choice E) provides sensory innervation to much of the head. and medial rectus muscles.Umbilical herniation (choice E) results from abdominal viscera protruding through a weakness in the abdominal wall after development. which of the following neural structures is most likely affected? A. The superior cervical ganglion (choice D) contains the cell bodies of postganglionic sympathetic nerves that innervate structures in the head. which elevates the eyelid.

it has already innervated most of the rib. putamen . claustrum D. Sixth intercostal space immediately above the seventh rib just lateral to the angle of the rib The correct answer is B. Use of an anesthetic at this point would not be effective. After passing through the intervertebral foramen between the seventh and eighth thoracic vertebrae. Thus. Use of a local anesthetic at this point will anesthetize the rib. Seventh intercostal space immediately below the seventh rib just medial to the angle of the rib D. By the time the intercostal nerve has reached the midclavicular line (choice A). hippocampus E. amygdala B. it is not along the lower border of the rib. The seventh intercostal nerve (the anterior ramus of the seventh thoracic spinal nerve) innervates the seventh rib. While the intercostal nerve is in the intercostal space medial to the angle of the rib (choice C). Sixth intercostal space immediately above the seventh rib in the midclavicular line B.An injection to anesthetize pain from a fracture of the seventh rib should be gien in what area? A. The intercostal nerve does not lie along the upper border of the rib (choices D and E). caudate nucleus C. Seventh intercostal space immediately below the seventh rib in the midclavicular line Seventh intercostal space immediately below the seventh rib just lateral to the angle of the rib C. The nucleus that lies immediately medial (and deep) to the uncus is the A. injection at these sites would not be effective. E. it occupies a position along the lower border of the rib. After passing the angle of the rib. the nerve lies in the seventh intercostal space. in the costal groove.

The first posteriorly located branch is the one leading to the apical aspect of (either) lower lobe. which is the medial protrusion of the parahippocampal gyrus. Anterior segment of the right upper lobe B. the fluid flows into the trachea and then into either of the (typically the right) main bronchi. The caudate nucleus (choice B) is a deep nuclear structure that lies lateral to the lateral ventricles.The correct answer is A. The amygdala is a collection of nuclei that lies directly beneath the uncus. All other segments of the bronchial tree and their corresponding portions of lung are more . Inferior lingular segment of the left upper lobe D. is an external structure seen on the ventral surface of the temporal lobe. In a supine or nearly supine patient. The uncus. In contrast. The hippocampus (choice D) is a nuclear structure that lies in the interior of the parahippocampal gyrus. The lateral and posterior segments of the lower lobes are also supplied by posteriorly branching segmental bronchi. the posterior aspects of the upper lobes are somewhat protected by an initial anteriorly directed bifurcation before their segmental bronchi arise. The claustrum (choice C) is a thin and elongated nucleus that lies just medial to the insular cortex. Lateral segment of the right middle lobe E. Superior lingular segment of the left upper lobe The correct answer is B. Aspiration pneumonia is a common complication observed in nursing home patients. The putamen (choice E) is a nuclear structure that resides lateral to the caudate and medial to the claustrum. The most probable site of the pneumonia can be anticipated by knowing the anatomy of the bronchial tree because the aspirated fluid usually flows downhill. A nursing home patient who aspirates while lying on his back would be most likely to develop pneumonia involving which of the following sites? A. Apical segment of the right lower lobe C.

anterior.

The hormone most responsible for regulating sodium balance is secreted from: A. Zona glomerulosa of the adrenal cortex B. Zona reticularis of the adrenal medulla C. Zona fasiculata of the adrenal medulla D. Zona fasiculata of the adrenal cortex E. Zona glomerulosa of the adrenal medulla

The correct answer is choice A.Firstly, the hormone involved is aldosterone, which acts to increase sodium resorption in the kidney. Note that aldosterone (a mineralcorticoid) and the glucocorticoids (cortisol, cortisone) are produced by the adrenal cortex, not medulla. The medulla, with a different developmental origin and cell type, produces catecholamines such as epinephrine and norepinephrine. The cortex, which is outside the medulla, is in three regions. On the outside is the Zona Glomerulosa, source of the mineralcorticoids. Inside of that is the Zona Fasiculata, which together with the innermost layer of the cortex, the Zona Reticularis, produce glucocortoids. Remember that interior to the Zona Reticularis, you will find the adrenal medulla. Also note that as a memory aid, the cortex layers from the outside in are G-F-R, like the GFR of the kidney.

During embryological development, hematopoiesis occurs in different organs at different times. Which of the following are the correct organs, in the correct sequence, at which hematopoiesis occurs embryologically? A. Amnion, yolk sac, placenta, bone marrow B. Placenta, liver and spleen, yolk sac, bone marrow C. Placenta, spleen and lymphatic organs, bone marrow D. Yolk sac, bone marrow, liver and spleen E. Yolk sac, liver, spleen and lymphatic organs, bone marrow

The correct answer is E. By the third week of development, hematopoiesis begins in the blood islands of the yolk sac. Beginning at 1 month of age and continuing until 7 months of age, blood elements are also formed in the liver. Hematopoiesis occurs in the spleen and lymphatic organs between 2 and 4 months, and in the bone marrow after 4 months.

A woman suffers a fracture of the left tenth and eleventh ribs. Which of the following organs is most likely to have been injured by these fractured ribs? A. Descending colon B. Jejunum C. Left adrenal gland D. Left kidney E. Spleen

The correct answer is E. The spleen is a soft, friable organ with a thin capsule and is subject to injury upon trauma to the left side of the abdomen. It is located in the upper left quadrant of the abdomen, deep to the left ninth, tenth, and eleventh ribs. It is the most commonly injured organ in the abdomen. The adult spleen contains the largest number of lymphoid tissues in the human body. The descending colon (choice A) lies in a retroperitoneal position on the left side of the posterior abdominal wall. The descending colon begins at the splenic flexure immediately inferior to the spleen. The jejunum (choice B) is a peritoneal structure suspended by a long mesentery. It is located primarily in the upper left quadrant of the abdomen. Its long mesentery allows the jejunum to be highly mobile and thus is not likely to be injured by trauma to the body wall. The left adrenal gland (choice C) is a retroperitoneal structure that lies near the upper pole of the left kidney. It is embedded within fat and is thus well protected from injury. The left kidney (choice D) is a retroperitoneal structure that is well protected by fat.

The tongue will move in which direction when protuded with surgical damage to the right hypoglossal nerve? A. Downward B. Upward C. Directly forward

D. To the right E. To the left

The correct answer is D. There are two ways to answer this question. The formula method is that a tongue with muscle or nerve injury will protrude toward the side of injury, in this case the right side. This is similar to the case of the mandible protruding toward the side of injury when a lateral pterygoid is injured.The logical method is to imagine intrinsic muscles and extrinsic protruders of the tongue on the right side not receiving stimulation from innervation. In this case, only the left side protruders will operate. The tongue will protrude only on the left side, with the immobile right side acting as a stationary pivot while the tongue moves from left to right (toward the injured side).

You are asked to hold your upper arm against your lateral chest wall, with the palm upward. You then rotate the hand so that the palm faces downward, without bending the wrist. This motion is known as: A. abduction of the forearm B. adduction of the forearm C. flexion of the forearm D. pronation of the forearm E. supination of the forearm

The correct answer is D. When the forearm is rotated from anatomic position (palms facing forward, thumbs out) so that the palm faces posteriorly, the forearm is said to be pronated. Abduction (choice A) raises the arm to a horizontal position away from the body; adduction

. circumvallate papillae D. They are small. aphthous ulcers B. or red mouth lesions. They are intermediate in size between filiform and circumvallate papillae. making this condition unlikely. Candidal colonies (choice B) appear in thrush. into anatomic position) is referred to as supination (choice E). filiform papillae E. Fungiform papillae (choice E) are mushroom-shaped structures scattered among the filiform papillae. white. These are large circular structures surrounded by moat-like depressions. These are most likely A. They do not contain taste buds. The lateral surfaces of these papillae contain taste buds. There are also small serous-only salivary glands in these papillae.(choice B) is the reverse. fungiform papillae The correct answer is C. Rotation of the forearm so that the palm faces forward (i. which occurs more commonly in the immunocompromised host or in those taking antibacterial drugs. They frequently contain taste buds. in front of the plane of the body. candidal colonies C. You are told that the patient is healthy and not taking medications. Filiform papillae (choice D) are the most numerous papillae of the tongue.e. elongated cones that create the tongue's rough texture. Aphthous ulcers (choice A) are small.. The large bumps at the back of his tongue are circumvallate papillae. Flexion (choice C) brings the arm or forearm forward. An otherwise healthy student taking no medications is concerned because he has noticed several painless uniform "large bumps" at the back of his tongue.

Attempts to straighten out a flexed thigh cause great pain in a patient with appendicitis. Medial umbilical ligament C. Gracilis E. Cloaca B. It is later subdivided into urogenital and anal areas. Biceps femoris C. The urachus is a fibrous remnant that extends from the umbilicus to the urinary bladder. The cloaca (choice A) is the primitive. Psoas major The correct answer is E. Ureter E. Adductor magnus B. This produces clinically a "positive psoas sign." in which attempts to straighten the patient's flexed (to relieve pain) hip produce sometimes marked exacerbation of the pain. None of the other muscles listed pass near the appendix. endoderm-lined region that receives the terminal portion of the hindgut. Urachus D. It is also known as the median umbilical ligament of the anterior abdominal wall. Which of the following structures does the fetal allantoic duct become in the adult? A. The medial umbilical ligament (choice B) is a paired structure located deep to the peritoneum of . Urethra The correct answer is C. Acute appendicitis can cause either infection or a sympathetic inflammation of the psoas. This is due to the position of the appendix near which muscle? A. The path of the psoas major lies in the retroperitoneum and comes close to the appendix. Gluteus maximus D.

Bulbus cordis B. The coronary sinus and the oblique vein of the left atrium also derive from the sinus venosus. Microscopic examination of a PAS-stained histological section of a Graafian follicle demonstrates a bright reddish-pink. The truncus arteriosus (choice E) gives rise to the proximal part of the aorta and the proximal part of the pulmonary artery. Primitive ventricle D. The smooth part of the right atrium (the sinus venarum) is derived from the sinus venosus. The smooth part of the right atrium derives from which of the following embryonic structures? A. Sinus venosus E. The ureter (choice D) is the muscular tube that conveys urine from the kidney to the urinary bladder. Which of the following terms most accurately describes this ring? . The urethra (choice E) is the passageway that carries urine from the bladder to the perineum. The primitive atrium (choice B) gives rise to the trabeculated part of the right and left atria. acellular ring around the ovum. Primitive atrium C. The bulbus cordis (choice A) gives rise to the smooth part of the right ventricle (conus arteriosus) and the smooth part of the left ventricle (aortic vestibule). It is formed by the obliterated umbilical artery. Truncus arteriosus The correct answer is D. The primitive ventricle (choice C) gives rise to the trabeculated part of the right and left ventricles.the anterior abdominal wall.

Binding of the sperm cell membrane to the zona pellucida triggers the acrosome reaction. Corona radiata B. The theca interna (choice D) and externa (choice C) are formed from the connective tissue surrounding the follicle. during which acrosomal enzymes are released that digest the zona pellucida. which surrounds the ovum. Transverse cervical nerve The correct answer is D. Theca interna E. Greater occipital nerve D. Great auricular nerve C. The ring described is the zona pellucida.A. Spinal accessory nerve E. allowing the spermatozoon to contact and fuse with the ovum cell membrane. Theca externa D. The microvilli are surrounded by a layer of glycoproteins. The follicular cells immediately outside the zona pellucida form the corona radiata (choice A). The patient also cannot shrug his right shoulder. a patient can no longer raise his right arm above the horizontal position. The larger cumulus oophorus (choice B) is the hill of follicular cells that surrounds the ovum. Cumulus oophorus C. Axillary nerve B. microvilli from the surrounding granulosa cells intermingle with cells of the primary oocyte. The zona pellucida is rich in polysaccharides and glycoproteins and consequently stains brightly pink or red with PAS stain. Which of the following nerves was injured? A. Anatomically. and the entire region is called the zona pellucida. Zona pellucida The correct answer is E. Following a surgical procedure on the right side of the neck. The spinal accessory nerve crosses the posterior triangle of the neck . as layers of granulosa cells develop around the primary oocyte.

No muscles are innervated by these nerves. is likely to reach the brain by which of the following routes? A. which provide cutaneous innervation to the skin of the neck. External carotid artery C. The superior sagittal sinus (choice D) is located in the falx cerebri and drains venous blood from . This question requires knowledge of pathophysiology with a basic understanding of anatomy. a destructive fungal infection of the sinuses. Also. which is responsible for upward rotation and elevation of the scapula. It provides cutaneous innervation to the skin of the back of the head. Superior sagittal sinus E. abduction and flexion of the arm above the horizontal plane is not possible. No muscles are innervated by this nerve. Without the ability to upwardly rotate the scapula.immediately deep to the investing fascia of the neck. It is a branch of the brachial plexus. Internal carotid artery D. The greater occipital nerve (choice C) is the dorsal ramus of the second cervical spinal nerve. and it leaves the axilla to innervate the deltoid and teres minor muscles. Superior vena cava The correct answer is A. The route from the face to the brain is not arterial (choices B and C). This nerve innervates the trapezius muscle. shrugging of the shoulder is impaired with paralysis of the trapezius muscle. Cavernous sinus B. Zygomycosis. both of which are potentially fatal. A lesion of this nerve in the posterior triangle leads to paralysis of the trapezius. The axillary nerve (choice A) does not pass through the neck. The cavernous sinuses are located on either side of the body of the sphenoid bone and become a potential route of infection because they receive blood both from the face (via the ophthalmic veins and sphenoparietal sinus) and from some of the cerebral veins. The great auricular nerve (choice B) and transverse cervical nerve (choice E) are branches of the cervical plexus. The spread of infection into the cavernous sinus can produce either central nervous system (CNS) infection or cavernous sinus thrombosis.

contraction of this muscle tends to stretch and adduct the vocal ligament. Its contraction causes adduction of the vocal ligament. Its contraction causes slackening of the vocal ligament. The thyroarytenoid muscle (choice D) is innervated by the recurrent laryngeal nerve and is attached to the thyroid cartilage and the arytenoid cartilage. Lateral cricoarytenoid C. Its contraction causes abduction of the vocal ligament. Zygomycosis does not reach the brain by way of the superior sagittal sinus. The cricothyroid is innervated by the external laryngeal nerve. The posterior cricoarytenoid muscle (choice C) is innervated by the recurrent laryngeal nerve and is attached to the cricoid cartilage and the arytenoid cartilage. It attaches to either the thyroid cartilage and the vocal ligament. It is innervated by the recurrent laryngeal nerve. which innervates all of the intrinsic laryngeal muscles. The vocalis muscle (choice E) is the most medial part of the thyroarytenoid muscle.the brain to other dural sinuses. except for the cricothyroid muscle. Cricothyroid B. Which of the following muscles would retain its innervation subsequent to this injury? A. from which it eventually drains into the jugular vein. The recurrent laryngeal nerve is a branch of the vagus nerve. A surgeon inadvertently sections the recurrent laryngeal nerve during a procedure. Thyroarytenoid E. . Posterior cricoarytenoid D. The lateral cricoarytenoid muscle (choice B) is innervated by the recurrent laryngeal nerve and is attached to the cricoid cartilage and the arytenoid cartilage. Vocalis The correct answer is A. The superior vena cava (choice E) drains blood from the upper part of the body into the heart. Its contraction causes tension on segments of the vocal ligament. or the arytenoid cartilage and the vocal ligament. The cricothyroid is attached to the cricoid cartilage and the thyroid cartilage.

Compression of the facial nerve within the facial canal may result in facial palsy (Bell's palsy). and he complains that saliva drips from his mouth while he is chewing. The buccinator muscle. The palatopharyngeus. Because the muscles on one side of the face are paralyzed. Ciliated columnar epithelium . Which of the following cell types was most likely observed in the involved areas? A. a patient has swelling of the left facial nerve within the facial canal. The palatoglossus (choice C) and palatopharyngeus (choice D) muscles are innervated by the vagus nerve. These muscles of mastication function to elevate the mandible. The patient's face appears asymmetrical.As a result of a viral infection. Temporalis The correct answer is A. forms the palatoglossal fold (anterior pillar of the fauces). which is located within the cheek and is innervated by the facial nerve. The masseter and temporalis muscles (choices B and E) are innervated by the mandibular division of the trigeminal nerve. The palatoglossus. as occurs during swallowing. Biopsy demonstrates epithelial metaplasia. Palatoglossus D. immediately anterior to the palatine tonsil. This muscle functions to draw the tongue and soft palate closer together. Masseter C. forms the palatopharyngeal fold (posterior pillar of the fauces). which is immediately posterior to the palatine tonsil. the face appears asymmetrical. It inserts into the fibers of the obicularis oris. with its mucosal covering. Buccinator B. Paralysis of which of the following muscles accounts for these symptoms? A. Palatopharyngeus E. This muscle causes elevation of the pharynx. Paralysis of this muscle can result in food and saliva accumulating between the teeth and the cheek. as occurs during swallowing. The buccinator originates from the alveolar processes of the maxilla and mandible. with its mucosal covering. functions to hold food against the teeth while it is being chewed.

The inferior pancreaticoduodenal artery is a branch of the superior mesenteric artery. peritoneal lining. in which the normally nonkeratinizing squamous epithelium (choice E) of the esophagus undergoes metaplasia to gastric or intestinal-like epithelium composed of nonciliated columnar epithelial cells. itself a branch of the celiac trunk. This is due to anastomoses between which vessels? A. Nonkeratinizing squamous epithelium The correct answer is D. in addition to being the normal epithelium of the esophagus. Despite blockage of the celiac trunk. Occlusion of the celiac trunk would allow blood from the superior mesenteric artery to . Superior pancreaticoduodenal artery and inferior pancreaticoduodenal artery The correct answer is E. which is a branch of the common hepatic artery. Cuboidal epithelium (choice B) is found in the kidney. Keratinizing squamous epithelium D. The superior pancreaticoduodenal artery is a branch of the gastroduodenal artery. Ciliated columnar epithelium (choice A) is found in the respiratory tract. Barrett's esophagus typically develops in the setting of chronic gastroesophageal reflux and significantly increases the risk of later development of adenocarcinoma of the distal esophagus. Nonciliated columnar epithelium E. Left gastroepiploic artery and right gastroepiploic artery C. Left gastroepiploic artery and right gastroepiploic artery B. and pleural lining. Proper hepatic artery and gastroduodenal artery D. The medical condition is Barrett's esophagus. Nonkeratinizing squamous epithelium (choice E). and vagina. Keratinizing squamous epithelium (choice C) is found in skin. nose.B. Right colic artery and middle colic artery E. the organs receiving their blood supply from the trunk continue to operate normally. Cuboidal epithelium C. is found in mouth.

The left gastroepiploic artery is a branch of the splenic artery. The hair cells are embedded in the tectorial membrane. Reissner's membrane D. The proper hepatic and gastroduodenal arteries (choice C) are branches of the common hepatic artery. These cells rest on the basilar membrane (choice A). Basilar membrane B. which separates the scala tympani (choice D) from the scala media. The receptors of the cochlear duct provide us with a sense of hearing that allows us to detect the quietest whisper and yet remain functional in a crowded. The left gastric and right gastric arteries (choice A) both receive their blood from the celiac trunk. Scala vestibuli The correct answer is B. The left and right gastroepiploic arteries (choice B) both receive their blood supply from the celiac trunk. which is a branch of the common hepatic artery (a branch of the celiac trunk). The tectorial membrane that lies on the hair cells does not form a boundary between the different scala. which is a branch of the celiac trunk. Damage to which of the following structures might produce hair cell loss? A.reach the branches of the celiac trunk via the connections between the superior and inferior pancreaticoduodenal arteries. The organ of Corti contains hair cells from the cochlear branch of the vestibulocochlear nerve (CN VIII). The left gastric artery is a direct branch of the celiac trunk. which is a branch of the common hepatic artery (a branch of the celiac trunk). The right gastric artery is usually a branch of the proper hepatic artery. which is a branch of the celiac trunk. The right colic and middle colic arteries (choice D) are both branches of the superior mesenteric artery. which consists of pressure waves conducted through air or water. noisy environment. Organ of Corti C. which generates action potentials. the membrane separating the scala media from . Hearing is the detection of sound. and movement of the basilar membrane below the cells causes the hairs to bend. The right gastroepiploic artery is a branch of the gastroduodenal artery. Scala tympani E.

Aorta B. The alar plate forms the dorsal (posterior) part of the spinal cord and becomes the sensory or afferent portion of the cord. During development. Iliac arteries E. The spinal cord arises from the caudal end of the neural tube. separated by a longitudinal groove called the sulcus limitans (choice E). Which of the following locations in the embryo later forms the dorsal horn of the spinal cord? A. Schwann cells. an alar and a basal plate is formed. chromaffin cells of the adrenal medulla. and odontoblasts.the scala vestibuli (choice E) is Reissner's (vestibular) membrane (choice C). or efferent. pseudounipolar cells of spinal and cranial nerve ganglia. The brain forms from the rostral end of the neural tube (choice D). Ductus arteriosus D. Rostral end of neural tube E. The basal plate (choiceB) is the ventral (anterior) part of the cord and becomes the motor. leptomeningeal cells. portion of the spinal cord and therefore would contain anterior horn cells. Carotid arteries C. Neural crest D. Pulmonary arteries . Sulcus limitans The correct answer is A. The neural crest (choice C) develops into multipolar ganglion cells of autonomic ganglia. From which of the following fetal vessels do the umbilical arteries arise? A. Alar plate B. melanocytes. Basal plate C.

As these arteries travel along the inner surface. This mass is most likely a cyst that developed from which of the following embryonic structures? A. slightly above the larynx is mobile and elevates upon protrusion of the tongue. The thyroglossal duct develops as an evagination of the floor of the pharynx in the region where the tongue develops. The second pharyngeal cleft (choice C) normally does not remain patent. as seen in this patient. which is seen on the lateral side of the neck along the anterior . If part of this pouch does remain patent. the terminal segment of the abdominal aorta divides to form the right and left common iliac arteries. Second pharyngeal cleft D.The correct answer is D. where each divides to form the internal iliac artery and external iliac artery. This pouch normally remains patent. This cleft normally remains patent. Second pharyngeal pouch E. The distal end of this duct normally forms the thyroid gland. The paired umbilical arteries arise from the iliac arteries. The adult foramen cecum of the tongue marks the site of this evagination. The first pharyngeal pouch (choice B) forms the middle ear cavity and the auditory tube. First pharyngeal pouch C. First pharyngeal cleft B. Near the level of vertebra L4. The single umbilical vein takes the newly oxygenated fetal blood from the placenta to the liver and then to the inferior vena cava via the ductus venosus. The first pharyngeal cleft (choice A) forms the external ear canal. they descend behind the cecum and sigmoid colon. Failure of a part of the duct to degenerate may lead to a thyroglossal duct cyst or a median cervical cyst. It is typically covered over by the overgrowth of the second pharyngeal arch. A mass in the anterior midline of the neck. These arteries carry blood to the pelvis and lower limbs. They supply unoxygenated fetal blood to the placenta. the proximal part of the duct normally degenerates. it may form a lateral cervical cyst. Thyroglossal duct The correct answer is E.

involuntary muscle. Esophagus D. An ulcer damages an artery supplying the area of the greater curvature of the stomach. Which artery is involved? A. Which of the following sites contains striated muscle that is not under voluntary control? A. cardiac muscle is also considered striated. Ingrowth of mesoderm cells results in the formation of the palatine tonsil. specialized pacemaker cells establish a regular rate of contraction. Right gastroepiploic . Left gastric B. Striated (skeletal) muscle not under voluntary control is an unusual feature of the upper and middle thirds of the esophagus. As a side note.border of the sternocleidomastoid muscle. Left gastroepiploic C. The pharyngeal mucosa in this area arises from the endoderm of the pouch. Gallbladder E. The second pharyngeal pouch (choice D) forms the tonsillar fossa of the pharynx. Colon C. Because these pacemaker cells regulate the heart and the central nervous system does not. cardiac muscle cells do not rely on nerve activity to start a contraction. the lower third contains only smooth muscle. Instead. Right gastric D. Stomach The correct answer is C. The middle third of the esophagus contains roughly half striated and half smooth muscle. Bladder B. All the other structures listed in the answer choices contain smooth muscle.

which has a nucleus in the medulla and is necessary for the gag reflex. Glossopharyngeal (IX) C. Cranial nerve IX is the glossopharyngeal nerve. off the splenic artery. The afferent of this reflex arc consists of the . it is unlikely that this artery would be directly damaged by ulceration of the stomach near the pyloric sphincter. The gag reflex is elicited by touching either side of the posterior pharynx with a tongue blade. supplies the left half of the lesser curvature of the stomach. producing bilateral elevation of the palate and bilateral contraction of the pharyngeal muscles. Short gastric The correct answer is D. The right gastroepiploic artery. Vestibulocochlear (VIII) The correct answer is B. supplies the left half of the greater curvature of the stomach. supplies the right half of the lesser curvature of the stomach. off the proper hepatic artery. These findings suggest involvement of the nucleus of which of the following cranial nerves? A. Although it anastomoses with the right gastroepiploic artery.E. off the splenic artery (occasionally the left gastroepiploic). The short gastric artery (choice E). The left gastroepiploic artery (choice B). supplies the right half of the greater curvature of the stomach and could be directly affected by ulceration of the greater curvature of the stomach at a site this close (4 cm) to the pyloric sphincter. off the gastroduodenal artery. Spinal accessory (XI) E. The right gastric artery (choice C). An elderly patient has had multiple small strokes lending to an absence of the gag reflex. supplies the fundus of the stomach. which is the most distant from the pylorus. off the celiac trunk. Hypoglossal (XII) D. The left gastric artery (choice A). actually one of several (4 to 5) short gastric arteries. Facial (VII) B.

Endothelial cells B.ipsilateral glossopharyngeal nerve. Laryngeal cartilages are derived from neural crest. It originates from the posterior 1/3 of the tongue. are derived from visceral mesoderm. you should remember to test for its function. Its destination includes sensory nuclei of the medulla oblongata. The glossopharyngeal nerve is a mixed sensory and motor nerve to the head and neck. The larynx also contains three pairs of smaller hyaline cartilages: the arytenoid. Laryngeal cartilage D. The larynx is composed of three cartilages that form the "body of the larynx": the thyroid cartilage. Cranial nerve VIII (choice E) is the vestibulocochlear nerve. supplies the efferent limb. Type I pneumocytes The correct answer is C. Which of the following respiratory system components is derived from neural crest? A. Tracheal glands E. while the vagus nerve. but it does not supply the oropharynx. Cranial nerve XII (choice C) is the hypoglossal nerve. and cuneiform cartilages. Epithelium of primary bronchi C. which supplies motor function to the face. and carotid arteries of the neck. The endothelial cells (choice A). Cranial nerve XI (choice D) is the spinal accessory nerve. corniculate. as a loss of gag reflex can lead to the patient's death secondary to an aspiration pneumonia. Although the glossopharyngeal nerve may seem to be one of the less important cranial nerves. pharynx. which supplies the trapezius and sternocleidomastoid. responsible for hearing and equilibrium. and the epiglottis. . which supplies the intrinsic and most extrinsic muscles of the tongue. It is not involved in the gag reflex. bilaterally. in the simple squamous epithelium that lines the pulmonary capillaries. Cranial nerve VII (choice A) is the facial nerve. palate. the cricoid cartilage. as well as the pharyngeal muscles involved in swallowing.

The epithelial lining of primary bronchi (choice B) is derived from endoderm. These are the only muscles not formed from mesoderm. Somites (choice C) give rise to the inferior muscles of the neck. muscles of facial expression (arch 2). as well as additional small muscles. The somitomeres are specialized masses of mesoderm found in the head region that give rise to the muscles of the head. Type I pneumocytes (choice E) are derived from endoderm. The optic cup ectoderm (choice B) gives rise to the muscles of the iris (sphincter and dilator pupillae). Tracheal glands (choice D) and epithelium both derive from endoderm. 2. 3. Optic cup ectoderm C. The branchial arches (choice A) give rise to muscles of mastication (arch 1). Branchial arches B. Somitomeres E. Somites D. Splanchnic mesoderm The correct answer is D. The extraocular muscles are derived from somitomeres 1. Which of the following nerves is most likely to be affected by this tumor? . The extraocular muscles are derived from which of the following structures? A. and muscles of the pharynx and larynx (arches 3-6). and 5. Splanchnic mesoderm (choice E) gives rise to smooth muscle of the viscera and the heart muscle. A CT scan reveals a small tumor at the cerebellopontine angle of the brain.

Which of the following additional symptoms would likely also be present? A.A. Inability to shrug the shoulder The correct answer B. The facial nerve innervates the muscles of facial expression. Glossopharyngeal nerve C. Hyperacusis C. It passes through the internal acoustic canal of the temporal bone to reach the stylomastoid foramen. Inability to feel the face E. The glossopharyngeal and vagus nerves (choices B and E) emerge from the brain stem at the postolivary sulcus. A patient is unable to close her right eye. Facial nerve B. The trigeminal nerve (choice D) emerges from the brain stem at the anterolateral surface of the pons. Inability to chew D. Trigeminal nerve E. The . The optic nerve (choice C) exits from the optic chiasm on the ventral surface of the diencephalon. Physical examination reveals weakness of the right orbicularis oculi. These are the two nerves that will be initially affected by a tumor in this region. Optic nerve D. This is caudal to the cerebellopontine angle. The facial nerve and the vestibulocochlear nerves emerge from the brain stem at the cerebellopontine angle. Vagus nerve The correct answer is A. This is rostral and ventral to the cerebellopontine angle. The entire anatomy of the facial nerve is as follows: the facial nerve originates from the taste receptors on the anterior 2/3 of the tongue (sensory) and from nuclei of the pons (motor). This is rostral to the cerebellopontine angle. Blurred vision B.

An inability to chew (choice C) would probably be the result of a lesion of the trigeminal nerve (CN V). additional findings would be hyperacusis (increased sensitivity to sound because of stapedius muscle paralysis). Middle cerebral artery C. Middle meningeal artery D. This patient would also lose her corneal reflex on that side because of an inability to blink and would have ipsilateral paralysis of the muscles of facial expression distal to the lesion. inferior rectus. which leads to an inability to close the ipsilateral eye because of damaged motor fibers to the orbicularis oculi. which innervate the extraocular muscles. Which of the following blood vessels was most likely torn? A. and medial and lateral pterygoid muscles). and inferior oblique muscles. lack of taste sensation in the anterior two-thirds of the tongue. Superficial temporal artery E. masseter. If the lesion affected the facial nerve more proximally. and disturbed lacrimation and salivation. An inability to feel the face (choice D) would also be the result of a CN V lesion. Superior cerebral vein . CN VI innervates the lateral rectus and CN IV innervates the superior oblique. A patient received a severe blow to the lateral side of the head. Motor fibers of CN V innervate the muscles of mastication (temporalis. and a lesion of these fibers may cause the jaw to deviate to the side of the weak muscles. abducens (CN VI). The submandibular and sublingual salivary glands are innervated via the submandiublar ganglion. This patient has a lesion of the facial nerve (VII). CN III innervates the medial rectus. or trochlear (CN IV) nerves. A lesion of the accessory nerve (CN XI) would cause paralysis of the trapezius muscle. Anterior cerebral artery B. Blurred vision (choice A) could occur with lesions of the oculomotor (CN III). resulting in an epidural hematoma. superior rectus. which results in a sagging of the shoulder and a weakness in attempting to shrug the shoulder (choice E).visceral motor portion innervates the lacrimal gland and nasal mucous glands via the sphenopalatine ganglion. This lesion could result in the ipsilateral loss of general sensation of the face and also of the mucous membranes of the oral and nasal cavities.

you should also consider the possibility that this is actually which of the following? A. Articular cartilage (choice A) is radiolucent. The epiphyseal plate of the bone contains cartilage that is radiolucent. the distal end of the ulna. The superficial temporal artery (choice D) is a branch of the external carotid artery and is external to the skull. A tear of these veins results in blood entering the potential space between the dura and arachnoid (subdural space). Secondary ossification center The correct answer is B. but occurs at the very tip of the long bones. This may be easily mistaken for a fracture by the inexperienced. causing an epidural hematoma. Before diagnosing a fracture. causing a subdural hematoma. Epiphyseal plate C. The plate in a bone that is not yet fully ossified can produce a "line" crossing the bone near the end. the epiphyseal plate separates the epiphysis from the diaphysis. The middle meningeal artery is in the interior of the lateral portion of the cranial cavity. Articular cartilage B. The superior cerebral veins (choice E) drain the cerebral hemisphere and enter the superior sagittal sinus. The anterior cerebral artery and middle cerebral artery (choices A and B) lie on the surface of the brain. The x-ray of a child's arm after a fall appears to show a fracture near. Anatomically. A tear of either of these arteries would result in blood entering the subarachnoid space (subarachnoid hemorrhage). and the middle cerebral arteries supply the lateral surface of the cerebral hemispheres. A tear of this artery results in blood entering the potential space between the outer dural layer and the skull (epidural space). embedded in the periosteal (outer) layer of the dura.The correct answer is C. Perichondrium D. . This artery supplies the skin and other tissue of the temple region. Perichondrium (choice C) is usually difficult to see on x-ray. The anterior cerebral arteries supply the medial surface of the cerebral hemispheres. Primary ossification center E. but not at.

Mesonephros E. The mesonephros (choice D) functions as an interim kidney in the embryo. and the spleen. Endoderm C. and the neural crest. the epithelial lining of the gastrointestinal and respiratory tracts. The mesoderm gives rise to the adrenal cortex. serous membranes lining body cavities. Which of the following embryonic structures gives rise to the adrenal cortex? A. epidermis and its appendages. mammary glands. bone. The ectoderm (choice A) gives rise to the central nervous system. it also gives rise to connective tissue. pancreas. melanocytes. pituitary gland. blood and lymph vessels. urinary bladder. kidneys. gonads. urethra. cartilage. The major structural component of the sperm flagellum is the: A. In addition.Primary (choice D) and secondary (choice E) ossification centers are radiopaque. leptomeninges. muscle. thyroid and parathyroid glands. autonomic ganglia. microtubule B. and the adrenal medulla. Ectoderm B. thymus. The neural crest cells (choice E) give rise to cells of the spinal and cranial nerves. Neural crest cells The correct answer is C. tooth enamel. liver. connective tissue and bone of branchial arch origin. and auditory tube. Mesoderm D. The endoderm (choice B) gives rise to the parenchyma of the tonsils. peripheral nervous system. microfilament .

Left ventricle C. This is a basic histological question of a type found commonly on NBDE. at the level of vertebrum C6. The 9 single fibers form a circular ring in cross section around the 2 doubled fibers in the center. From this point. Pulmonary trunk D. Right atrium E. Left atrium B. The other significant fact is that all eucaryotic flagella and cilia have this same structure (for example. One of the significant facts about the fibers is that they are composed of microtubules. Right ventricle The correct answer is A. passes inferiorly along the dorsal wall of the mediastinum. The left ventricle is not related to the esophagus. The left ventricle (choice B) forms most of the left border of the heart and most of the diaphragmatic surface of the heart. The sperm cell flagellum is notable for a “9+2” arrangement of fibers formed from microtubules. The left atrium forms most of the posterior wall of the heart. the diaphragmatic hiatus. Note that procaryotic (bacterial) flagellea do NOT share this structure. made up of tubulin. it descends toward the thoracic cavity posterior to the trachea. ciliary body The correct answer is choice A. Enlargement of the left atrium may compress the esophagus and cause dysphagia. The pulmonary trunk (choice C) emerges from the right ventricle on the anterior surface of the . Anatomically. and enters the abdominopelvic cavity through an opening in the diaphragm. cilia form the tracheal lining).C. which asks about basic cellular organelles and structures. mysosin filament E. In cases of dysphagia where the esophagus is compressed. the esophagus begins posterior to the cricoid cartilage. The esophagus passes immediately posterior to the heart. which structure would be most likely to cause the compression? A. actin filament D.

The right atrium (choice D) forms the right border of the heart. predominantly mucous cells.heart. Superficial temporal artery . The pulmonary trunk is not related to the esophagus. The right ventricle (choice E) forms most of the anterior wall of the heart and a small portion of the diaphragmatic surface of the heart. Maxillary artery C. As you proceed from the midline laterally. Esophageal mucosa B. The primary arterial supply to the nasal mucosa is a direct branch of which of the following arteries? A. Salivary glands can contain predominantly serous cells. acini in the sublingual gland are almost pure mucous cells. The sublingual salivary glands are located beneath the mucous membrane of the floor of the mouth. It is not related to the esophagus. or both in their acini. whereas acini in the submandibular gland (choice E) contain a mixture of serous and mucous cells. Facial artery B. Acini in the parotid gland (choice C) are mostly pure serous cells. Oral mucosa C. The esophageal mucosa (choice A) and the oral mucosa (choice B) are squamous epithelia that do not form acini. Numerous sublingual ducts open along either side of the lingual frenulum. Submandibular gland The correct answer is D. Parotid gland D. It is not related to the esophagus. Which of the following tissues normally has the highest percentage of mucus-secreting cells? A. Sublingual gland E.

The major source of blood supply to the nasal mucosa is the sphenopalatine artery. VII D. The transverse facial artery (choice E) is a branch of the superficial temporal artery. which is the terminal branch of the maxillary artery. X The correct answer is B. V2 B. The superior labial artery provides blood supply to the upper lip. It provides blood supply to the parotid gland. The facial artery (choice A) is a direct branch of the external carotid artery. The other terminal branch is the maxillary artery. It has a septal branch that provides some of the blood supply to the anterior portion of the septal mucosa of the nasal cavity. The superior labial artery (choice D) is a branch of the facial artery. and the skin of the lateral face. this is not the major blood supply to the nasal cavity. V3 C. Superior labial artery E. The superficial temporal artery (choice C) is a terminal branch of the external carotid artery. IX E. Which of the following cranial nerves carries the pain sensation from the tip of tongue? A. It provides most of the blood supply to the superficial face. This question is essentially asking "which of the following nerves innervates the tip of the tongue?" The innervation of the tongue is complex. The superficial temporal artery provides blood supply to the temporal region and the lateral portion of the scalp. the parotid duct. However.D. Transverse facial artery The correct answer is B. The sphenopalatine artery enters the nasal cavity from the pterygopalatine fossa by passing through the sphenopalatine foramen in the lateral wall of the nasal cavity. The mandibular division of the trigeminal nerve (V3) carries general somatic sensation from the anterior two- .

The maxillary division (V2. the thyroid gland curves across the anterior surface of the trachea just below the thyroid cartilage that forms the majority of the anterior surface of the larynx. the isthmus. This finding is related to the embryonic origin of the thyroid near which of the following structures? A. First pharyngeal pouch B. as well as the lower eyelid. choice C) carries taste from the anterior two-thirds of the tongue. the thyroid descends in front of the pharynx. for obvious reasons!) Anatomically. Usually. Second pharyngeal arch E. The thyroid gland originates as a mass of endodermal tissue near the foramen cecum. . choice D) carries sensation and taste from the posterior onethird of the tongue. The glossopharyngeal nerve (IX. and lips. A biopsy's pathology report comes back with a diagnosis of normal thyroid tissue. The facial nerve (VII. (In rare cases. During development. Uncommonly. choice E) carries sensation from the lower pharynx. and upper lip. the thyroglossal duct disappears. as well as the palate. which is near the tuberculum impar (which becomes the central part of the tongue). upper gingiva. Nasolacrimal duct D. The mandibular branch is also a sensory nerve for the lower gingiva. choice A) carries somatic sensation from the palate. including at the back of the tongue. and a portion of the pharynx. teeth. as well as innervating the lacrimal gland and the submandibular and sublingual salivary glands. The two lobes of the thyroid gland are united by a slender connection. all of the thyroid tissue remains at this site.thirds of the tongue. forming a mass that should not be excised. maintaining a connection to the tongue via the thyroglossal duct. cheek. residual ectopic thyroid tissue can be left anywhere along the path. A mass is noted at the back of a young man's tongue. The vagus nerve (X. Foramen cecum C. Third pharyngeal pouch The correct answer is B. nose.

The pharyngeal mucosa (choice C) receives its sensory innervation from the glossopharyngeal nerve. If the nerve that accompanies the superior laryngeal artery is damaged. . In this region. This nerve provides sensory innervation to the laryngeal mucosa above the vocal folds.The first pharyngeal pouch (choice A) develops into the middle ear and eustachian tube. The nasolacrimal ducts (choice C) connect the eyes to the oropharynx. The lateral cricoarytenoid muscle (choice E) receives its motor innervation from the recurrent laryngeal nerve. The superior laryngeal artery is a branch of the superior thyroid artery. The third pharyngeal pouch (choice E) develops into the thymus and inferior parathyroid glands. which of the following functional losses will ensue? A. it is accompanied by the internal branch of the superior laryngeal nerve. Paralysis of the cricothyroid muscle E. Loss of sensation in the laryngeal mucosa above the vocal folds B. The laryngeal mucosa below the vocal folds (choice B) receives its sensory innervation from the recurrent laryngeal nerve. The second pharyngeal arch (choice D) develops into many muscles of the face and the styloid process of the temporal bone. It enters the larynx by passing through the cricothyroid membrane. Paralysis of the lateral cricoarytenoid muscle The correct answer is A. Loss of sensation in the pharyngeal mucosa D. The cricothyroid muscle (choice D) receives its motor innervation from the external branch of the superior laryngeal nerve. Loss of sensation in the laryngeal mucosa below the vocal folds C.

. thus depriving the embryo of oxygenated blood. The part that remains forms the valve of the foramen ovale. septum primum to fuse with the endocardial cushions D. After birth. Failure of the ostium secundum to form would result in embryonic death because there would be no pathway for blood to pass from the right atrium to the left atrium when the ostium primum closes. complete fusion never occurs (probe patency). The ostium primum does not form within the septum primum (choice A). This achieves functional closure of the foramen ovale. The gap that exists between the two atria during this period is the ostium primum. ostium primum to form within the septum primum B. septum primum to fuse with the septum secundum E. The septum secundum normally does not fuse with the endocardial cushions (choice E). The ostium secundum normally forms within the septum primum (choice B) before the ostium primum closes by fusion of the septum primum with the endocardial cushions. The septum primum (first interatrial septum) develops by growing from the cranial end of the embryonic atrium toward the endocardial cushions. however. the ostium primum gets smaller until it is closed when the septum primum completes its growth and completely fuses with the endocardial cushions. the ostium primum is the space within the developing atrium not yet occupied by the septum primum. Fusion does not normally occur at this time. That is. Failure of the septum primum to fuse completely with the endocardial cushions leaves a persistent ostium primum. known as a primum-type atrial septal defect. As the septum primum continues its growth. The ostium primum is the communication between the two atria that exists during the formation of the septum primum. This part of the septum primum normally does not fuse with the septum secundum (choice D) during prenatal life. the valve of the foramen ovale is pushed against the septum secundum as a result of the increased pressure in the left atrium. ostium secundum to form within the septum primum C. In some people. septum secundum to fuse with the endocardial cushions The correct answer is C. Most of the septum primum normally disappears.An atrial septal defect results from failure of the A. it usually occurs later in life in most people.

but bilateral damage (which surprisingly can also be missed if it develops slowly) may lead to occasional bizarre errors in odor identification. The olfactory nerves are technically the neurons on the mucosal side of the cribriform plate that send processes through the plate to synapse in the olfactory bulb. From which of the following locations in the female genital tract was the biopsy obtained? A. Fallopian tube D. The insula (choice A) is thought to contain the primary gustatory (taste) cortex. Cervix B. Vagina . Postcentral gyrus D. Insula B. The axons likely compressed by this mass project to which of the following structures? A. A biopsy specimen demonstrates a ciliated columnar epithelium. Ovary E. Pyriform cortex The correct answer is E. The precentral gyrus (choice D) contains the primary motor cortex. Unilateral damage is often not noticed by the patient. Precentral gyrus E. severe infection. which in turn sends axons to the pyriform cortex (the primary olfactory cortex). Endometrium C.A CT scan of the head demonstrates a mass in the olfactory groove area. The nucleus ambiguus (choice B) provides the special visceral efferent fibers carried by the glossopharyngeal and vagus nerves. Nucleus ambiguus C. The postcentral gyrus (choice C) contains the primary sensory cortex. The olfactory nerves can be damaged by head injury. and tumors (such as meningiomas) that may compress the olfactory bulbs.

the beating of the cilia helps move the egg into the uterus. The superior gluteal nerve from roots L4-S1 is responsible for hip abduction. If you see a patient on the NBDE with "foot drop.The correct answer is C. The cervix (choice A) and vagina (choice E) are lined by squamous epithelium. The hip adduction machine would provide resistance to the medial aspects of the thighs. Each uterine tube is a hollow. obturator nerve D. superior gluteal nerve The correct answer is E. A person sits with his legs together and then opens his legs against lateral resistance." think of damage to the deep peroneal nerve. The obturator nerve (choice C) is responsible for hip adduction. The covering of the ovary (choice D) is cuboidal epithelium. and the individual would push . deep peroneal nerve B. sciatic nerve E. muscular tube measuring approximately 13 cm in length. Which nerve controls this type of movement? A. and cysts within the ovary can be lined by cuboidal or nonciliated columnar epithelium. the ampulla. The endometrium (choice B) is lined by columnar epithelium (although a few ciliated cells may be present). The femoral nerve (choice B) is responsible for knee extension. The deep peroneal nerve (choice A) controls dorsiflexion of the foot. The motion described is hip abduction. This fact is also sometimes clinically helpful because dilated and deformed fallopian tubes can be microscopically distinguished from cystic ovarian tumors by the presence of the cilia. Each uterine tube is divided into three regions: the infundibulum. and the isthmus.The fallopian tube is the only structure in the female genital tract with a ciliated columnar epithelium. femoral nerve C.

a dental student notes a fibrous band that runs on the visceral surface of the liver." If you read the question too quickly and thought you were going to be asked to identify the structure described. ductus venosus B. this structure corresponds to the A. however. This question could have tricked you if you didn't catch the key words. ligamentum venosum D. The ductus venosus is an embryonic vessel that allows blood to bypass the fetal liver. Elevation of the acromion . ligamentum teres C. During anatomy lab. this fibrous band is actually the ductus venosus.his/her legs together against the machine's resistance. In the embryo. umbilical vein The correct answer is A. The sciatic nerve (choice D) controls knee flexion. In the embryo. you probably chose choice C (ligamentum venosum) because that is indeed the structure in question. umbilical arteries E. The embryonic umbilical vein (choice E) actually becomes the fibrous ligamentum teres (choice B). Damage to the upper fibers of the trapezius muscle would most likely impair which of the following movements? A. The ligamentum teres is located in the free margin of the falciform ligament. "in the embryo. The embryonic umbilical arteries (choice D) become the medial umbilical ligaments. this prevents the depletion of oxygen and nutrient-rich blood in the hepatic sinusoids. Depression of the medial end of the scapula B. It is attached on one end to the inferior vena cava and on the other end to the left branch of the portal vein.

The sternoclavicular joint is quite strong and dislocates only with difficulty. Trachea The correct answer is E. Aorta B. The sternocleidomastoids are important in extension of the head at the atlanto-occipital joint and flexion of the cervical vertebral column (choice C). The upper fibers.5 cm and a length of approximately . causing a posterior displacement of the clavicle at the sternoclavicular joint. Superior vena cava E. The trapezius is a large muscle arising in the posterior midline from the superior nuchal line of the skull. The upper fibers serve to elevate the acromion. and the lateral third of the clavicle. Esophagus C. particularly posterior dislocations. insert on the crest of the spine of the scapula. Contraction of a single sternocleidomastoid muscle is important in turning of the face sideways (choice E) in the contralateral direction. The rhomboids and levator scapulae are important in raising the medial border of the scapula (choice D). Heart D. Dislocations. The lower fibers of the trapezius depress the medial end of the scapula (choice A). Which of the following structures would be most at risk? A. ligamentum nuchae. which are potentially damaged by wounds to the posterior and lateral neck. Turning of the face sideways The correct answer is B. The trachea is a tough flexible tube with a diameter of approximately 2. and spinous processes of all of the thoracic vertebrae. the medial border of the acromion.C. A man's chest is compressed during a car accident. are occasionally seen and may be dangerous because of impingement onto the trachea. causing respiratory difficulties. Flexion of the neck D. Raising of the medial border of the scapula E.

The astrocytes are the largest and most numerous glial cells.11 cm. Which of the following cell types is derived from neuroepithelial cells? A. which of the following is responsible for producing the majority of the new bone that will reunite the two fragments? . Astrocytes B. Schwann cells The correct answer is A. creating a threedimensional framework for the central nervous system. Odontoblasts E. Both the aorta (choice A) and the superior vena cava (choice D) are more posterior than the trachea and are therefore less vulnerable. Enterochromaffin cells C. the sensory ganglia of cranial nerves V. and controlling the interstitial environment. and the leptomeninges (pia and arachnoid). Following a fracture of the humerus. which. IX. At this point. Other neural crest derivatives include the neurons of the parasympathetic and sympathetic ganglia (including the adrenal medulla). These cells are responsible for maintaining the blood-brain barrier. Melanocytes D. VII. Other neuroepithelial cell derivatives include neuroblasts and ependymal cells. Astrocytes and oligodendrocytes are both derived from glioblasts. it branches to form the right and left primary bronchi. All the other choices are derived from neural crest cells. the dorsal root ganglia of the peripheral nervous system. The esophagus (choice B) is located behind the trachea and is less vulnerable. The trachea begins anterior to the vertebra C6 in a ligamentous attachment to the cricoid cartilage and ends in the mediastinum at the level of vertebra T5. The heart (choice C) lies below the clavicle and would not be at particular risk. and X. are derived from neuroepithelial cells. performing repairs in damaged neural tissues. in turn.

This portion of the lesser omentum has no significant blood vessels within it and may be incised for . Marrow E. Gastrohepatic ligament C. Falciform ligament B. Periosteum The correct answer is E. Heterotopic ossification (bone formed outside the regular bone) can occur as a complication of fracture if some of the osteoblastic cells are misdirected into adjacent tissues. Pre-existing cancellous bone (choice A) and compact bone (choice C) are not the major source of osteoblasts that form the new bone. When the periosteum is torn during a fracture. Cartilage C. Cancellous bone B. Cartilage (choice B) and marrow (choice D) do not contribute to new bone formation after fracture. Gastrosplenic ligament D. The gastrohepatic ligament is the part of the lesser omentum that separates the greater peritoneal sac from the right portion of the lesser peritoneal sac. Splenorenal ligament The correct answer is B. Compact bone D. Which membrane is in the way is you try to reach the lesser peritoneal sac and head of the pancreas after penetrating the greater peritoneal sac? A. This cellular layer functions in bone growth and participates in repair after an injury. The periosteum assists in the attachment of the osteoblasts to surrounding tissues and to associated tendons and ligaments. it supplies cells that develop into osteoblasts and are the major producers of the new bone that reunites the two ends.A. Hepatoduodenal ligament E.

Incision of this structure would be the appropriate surgical approach to gain access to the left side of the lesser peritoneal sac. splenic vein. This ligament is within the greater peritoneal sac and does not separate it from the lesser peritoneal sac. Two basic things about cerebellar circuitry that are well-worth knowing are that Purkinje cells of the cerebellar cortex project to the deep cerebellar nuclei and that these nuclei project out of the cerebellum. and the tail of the pancreas. Climbing fibers (choice A) are afferents to the cerebellum. The gastrosplenic ligament (choice C) passes from the greater curvature of the stomach to the spleen. It forms the anterior border of the epiploic foramen. Golgi cell C. the hepatoduodenal ligament contains the common bile duct. This ligament contains the splenic artery.surgical access. Purkinje The correct answer is E. Specifically. the proper hepatic artery. and therefore may not be incised to gain access to the lesser peritoneal sac. It separates the greater peritoneal sac from the left portion of the lesser peritoneal sac. It separates the greater peritoneal sac from the left portion of the lesser peritoneal sac. Granule cell D. Which of the following fibers provide the only output from the cerebellar cortex? A. Climbing B. Mossy E. The hepatoduodenal ligament (choice D) is part of the lesser omentum and separates the greater peritoneal sac from the right portion of the lesser peritoneal sac. The falciform ligament (choice A) is a mesenteric membrane between the liver and the anterior abdominal wall. enter the cerebellum through the inferior cerebellar . and therefore may not be incised for surgical access. The splenorenal ligament (choice E) passes from the spleen to the parietal peritoneum on the anterior surface of the left kidney. However. Purkinje cells are located in the second (Purkinje) cell layer of the cerebellar cortex and form inhibitory synapses on the deep cerebellar nuclei. they originate from the medullary olivary nuclear complex. and the portal vein.

both reside in and project to the cerebellar cortex. metatarsals (choice C). The femurs (choice B). Femurs C. Therefore. Granule cells (choice C) reside in the granule cell layer of the cerebellar cortex and send their axons to the moleculary layer. Phalanges E. portal blood could still be conveyed to the caval system via which of the following? . Granule cells.peduncle. absence of part of the clavicles accompanies a broad skull and facial and dental anomalies. These fibers project to deep cerebellar nuclei and glomeruli in the granular layer of the cerebellar cortex. and project to the deep cerebellar nuclei and the lateral cerebellar hemispheres. Golgi cell bodies (choice B) reside in the granule cell layer of the cerebellar cortex and project predominantly to the granule cells. phalanges (choice D). where they bifurcate into parallel fibers. therefore. Clavicles B. Tibias The correct answer is A. where they form inhibitory synapses. A child who has had abnormal development of the membranous bones has a broad skull with associated facial and dental anomalies. In a syndrome called cleidocranial dysostosis. Metatarsals D. Which other bones are most likely to also be affected? A. This syndrome affects bones formed by intramembranous ossification. If cirrhosis causes obstruction of the portal circulation within the liver. Mossy fibers (choice D) consist of all of the afferents (except the climbing fibers) to the cerebellum. they reside in and project to the cerebellar cortex. and tibias (choice E) are cartilaginous (formed by endochondral ossification) rather than membranous bones.

These vessels have no anastomoses with portal veins. portal blood may enter the superior vena cava via the azygos system. surrounding the striated duct . the ovarian vein communicates with the uterovaginal plexus). The esophageal venous plexus. The internal iliac veins (choice C). surrounding the intercalated duct C. have no demonstrated portal anastomoses. inside secretory acini B. Internal iliac veins D. and the colic and splenic veins with renal veins and veins of the posterior body wall.A. which drain most of the pelvis and much of the inferior extremities. The gonadal veins (choice B) exclusively drain the gonads (although in the female. Other important portacaval connections include the superior rectal vein with the middle and inferior rectal veins. Vesical venous plexus The correct answer is A. has anastomoses with branches of the left gastric vein. which drains into the azygos and hemiazygos veins within the thorax. The vesical venous plexus (choice E). The splenic vein (choice D) is incorrect because it's in itself a component of the portal venous system. paraumbilical veins and epigastric veins (engorgement of these vessels results in caput medusae). between secretory cells and the basal lamina D. Thus. following blockage of the portal vein. Splenic vein E. Gonadal veins C. which is situated well within the pelvis and drains the bladder and the prostate (or uterus and vagina) has no association with portal vessels. Secretory basket cells are located A. Azygos and hemiazygos veins B.

Right medial pterygoid D. Spermatid D. Intercalated duct cells are nonspecialized cuboidal epithelial cells. Left medial pterygoid B. Striated duct cells are columnar epithelial cells with striations (stripes) of rows of mitochondria used for ATP generation for active transport. Primary spermatocyte B. The are found between secretory cells and the basal lamina and exert pressure on the secretory cells to release their secretions. There are two methods for answering this question. the left side will act as a stationary pivot point while the right side protrudes outward and also toward the left (medially). Secretory acini themselves are composed of mucous or serous secreting cells. Secondary spermatocyte C. Which muscle is the chief mover of the mandible TOWARD the left? A. Spermatozoa . Right lateral pterygoid The correct answer is D. Left lateral pterygoid C. Which of the following cells is the germ cell closest to the basal lamina in the seminiferous tubule? A. The formula method states that the right lateral pterygoid moves the mandible left. The understanding method begins with the idea that the medial pterygoid is a closer (elevator). The lateral pterygoid connects to the condyle and is a protruder. The name implies that they are epithelial cells with muscle-like contractile properties.The correct answer is C. whereas the left lateral pterygoid moves the mandible right. Secretory basket cells are found in salivary gland acini and are also called myoepithelial cells. If the right lateral pterygoid pulls the right condyle out while the left lateral pterygoid and condyle remain stable. Spermatogonia E.

Phrenic and vagus E. Along this route the developing sperm are nurtured by sertoli cells. These mature into secondary spermatocytes (2N) (choice B). If a person has normal musculature. pharynx. C4. The upper 2/3 of the esophagus contains striated muscle. The phrenic nerve (choices A and D). or CN XII. The glossopharyngeal nerve (choice C). innervates the muscle of the diaphragm. The seminiferous tubules of a reproductive-age male should exhibit all stages of maturation. The vagus nerve has mixed sensory and motor functions. or CN IX. Spermatids undergo spermiogenesis to become mature spermatozoa (choice E). no longer associated with sertoli cells. and a flagellum forms from microtubules. which nerves should be tested for function? A. Glossopharyngeal and vagus D. and respiratory and cardiovascular systems. derived from C3. Spermatogonia are 2N cells and mature into larger primary spermatocytes (4N) (choice A). but has difficulty swallowing. and finally into spermatids (1N) (choice C). swallowing. The sensory fibers innervate the sensory nuclei and autonomic centers of the medulla oblongata. and C5. . It is derived from the pharyngeal arches and innervated by the vagus nerve (CN X). Acrosomes form from the Golgi apparatus. Hypoglossal and splanchnic C.The correct answer is D. with mature flagellated sperm in their centers. functions in taste. The hypoglossal nerve (choices A and B). Splanchnic and vagus The correct answer is E. and salivation. Maturation of germ cells (spermatogenesis) within the seminiferous tubules occurs in a concentric pattern. moves the tongue. with the less mature spermatogonia near the basal lamina and the mature forms near the tubule center. Hypoglossal and phrenic B. The motor fibers innervate muscles of the palate. Unneeded organelles are shed. The lower 1/3 contains smooth muscle from splanchnic mesoderm and is innervated by the splanchnic plexus.

Remember. the right adrenal vein and right gonadal vein drain directly into the inferior vena cava. Inferior vena cava C. The left adrenal vein and the left gonadal vein (either testicular or ovarian) drain into the left renal vein. The left renal vein then drains into the inferior vena cava. In contrast. The superior mesenteric vein (choice E) receives venous drainage from much of the intestinal tract. The splenic vein is part of the portal venous system. Left renal vein D. The inferior vena cava (choice B) receives the direct venous drainage from the right adrenal vein. No visceral organs drain directly to the azygos or hemiazygos veins. Which of the following is present in males but not in females? A. The left adrenal vein drains directly into which of the following veins? A. The splenic vein (choice D) receives the venous drainage from the spleen and part of the pancreas and stomach. Bulbospongiosus muscle B. It is part of the portal venous system and joins with the splenic vein to form the portal vein. The hemiazygos vein (choice A) receives the venous drainage from the body wall on the left side of the thorax and abdomen. but not the left adrenal vein. Bulbourethral gland .as well as monitoring the activity of the carotid body. the inferior vena cava is on the right side of the abdomen. Splenic vein E. Hemiazygos vein B. Superior mesenteric vein The correct answer is C.

Corpus cavernosum D. Celiac trunk C. Common iliac artery D. passing . Superior mesenteric artery The correct answer is A. The homologous female structures are the greater vestibular (Bartholin's) glands. The membranous urethra (choice D) is the portion of the urethra that passes through the urogenital diaphragm in both males and females. Perineal body The correct answer is B. Membranous urethra E. Inferior mesenteric artery E.C. consisting of cavernous erectile tissue that form a large portion of the penile shaft in males and of the body of the clitoris in females. which are located in the superficial perineal pouch. It separates the urogenital area from the anal area and is an important obstetric landmark. Their ducts pass to the spongy urethra. embedded within the sphincter urethrae. The bulbospongiosus muscles (choice A) lie superficial to the bulb of the penis in males and to the bulbs of the vestibule in females. The corpora cavernosa (choice C) are paired structures. Luminal narrowing of which of the following vessels would compromise blood flow through the renal arteries? A. The perineal body (choice E) is the centrally located tendinous structure that provides attachment for perineal musculature in both males and females. The renal arteries emerge from the abdominal aorta at about the level of the L1/L2 intervertebral disk and travel at nearly right angles to it (on the right. Abdominal aorta B. The bulbourethral glands are paired structures located within the deep perineal pouch.

an unascended pelvic kidney may be supplied by the common iliac artery. The common iliac artery (choice C) gives off the internal and external iliac arteries. intestinal (ileal and jejunal). middle colic. In addition. Fibers from the inferior head enter the bony head of the mandibular condyle. The celiac trunk (choice B) gives off the common hepatic. Lateral pterygoid E. sigmoid. and ileocolic arteries. and left colic arteries. Only the lateral pterygoid enters the temperomandibular joint (TMJ). These fibers are from the superior head of the muscle. Masseter The correct answer is D. Medial pterygoid and masseter primarily elevate (close) the mandible. Buccinator forms the substance of the cheek and is also a muscle of facial expression. splenic. depresses (opens) it. and left gastric arteries. Which muscle has fibers that enter the articular disc and capsule? A. Which of the following bronchopulmonary segments would this foreign object most likely enter? . The lateral pterygoid protrudes the mandible. Its fibers join the articular disc and capsule. None of the other muscles listed enter the TMJ. right colic. whereas temporalis elevates (anterior fibers) and retrudes (posterior fibers). It is not a muscle of mastication.posterior to the inferior vena cava) to enter the hilum of the kidney. a child aspirates a peanut. Medial pterygoid B. The superior mesenteric artery (choice E) gives off the inferior pancreaticoduodenal. Temporalis D. The inferior mesenteric artery (choice D) gives off the superior rectal. While lying supine in bed eating. Buccinator C. and moves it left and right.

Radial only E. flexion. Because the right main bronchus is wider and more vertical than the left. The superior segmental bronchus of the lower lobar bronchus is the only segmental bronchus that exits from the posterior wall of the lobar bronchi. when the patient is supine. None of the segmental bronchi of the left lung (choices A and D) are likely to receive the object because the object is less likely to enter the left main bronchus. Median and radial B. Median only D. the object is most likely to enter the superior segmental bronchus of the lower lobe. although rotation. The apical segment of the right upper lobe (choice B) is not likely to receive the foreign object because of the sharp angle that the upper lobar bronchus makes with the right main bronchus and the sharp angle that the apical segmental bronchus makes with the lobar bronchus. the effect of gravity will tend to prevent the object from entering this segmental bronchus. if a patient is supine at the time of aspiration. foreign objects are more likely to be aspirated into the right main bronchus. Therefore. Therefore. Medial segment of the right middle lobe D. and opposition are normal. abduction. A physician notes weakness of a patient's thumb in extension. Superior segment of the right lower lobe The correct answer is E. Which of the following nerves is most likely involved? A.A. Apical segment of the left upper lobe B. Median and ulnar C. The medial segmental bronchus of the right middle lobe (choice C) arises from the anterior wall of the right middle lobar bronchus. Posterior basal segment of the left lower lobe E. Ulnar only . Apical segment of the right upper lobe C. adduction.

All three of the nerves listed innervate muscles that supply the thumb. The facial artery (choice B) arises from the external carotid artery. which adducts the thumb. The ophthalmic artery (choice D) arises from the internal carotid artery immediately after the internal carotid artery emerges from the cavernous sinus. The sphenopalatine artery is the terminal branch of the maxillary artery. occipital. posterior auricular. Facial C. flex. The ophthalmic artery passes through . maxillary. The external carotid artery (choice A) arises from the common carotid artery at the carotid bifurcation. The artery then passes through the pterygomaxillary fissure to enter the pterygopalatine fossa. The median nerve (choices A. which are innervated by the radial nerve. and rotate. The ulnar nerve (choices E and B) supplies the adductor pollicis. Transverse facial The correct answer is C. External carotid B. Ophthalmic E. Maxillary D. The nasal cavity (particularly the anterior portion) receives some of its blood supply from branches of the facial artery. which allows the thumb to oppose. The maxillary artery arises from the external carotid artery and then passes through the infratemporal fossa. and superficial temporal arteries. particularly in the posterior region of the nasal cavity. ascending pharyngeal.The correct answer is D. lingual. B. facial. From which of the following arteries does the sphenopalatine artery arise? A. Extension is provided by the extensors pollicis longus and brevis. abduct. and C) supplies the thenar group. The external carotid artery has eight branches that supply the head and neck region: the superior thyroid. It provides blood supply to much of the facial region. The terminal branch then passes through the sphenopalatine foramen to enter the nasal cavity and supply much of the nasal mucosa. giving off branches to structures in this region.

which form channels allowing communication between cells. Connexon C. Gap junctions consist of a hexagonal lattice of tubular proteins called connexons (choice B). such as a basement membrane. Left B. Tight junctions (choice E). Adherent junctions (choice A). It supplies blood to structures in the upper portion of the lateral face. On attempting to open. or zonula adherens are bandlike junctions that help attach adjacent epithelial cells to each other. the patients mandible will move: A. Desmosomes are specializations of the lateral surface of the cell formed from the juxtaposition of two disc-shaped structures in adjacent cells. A patient is involved in an accident which tears the left lateral pterygoid muscle completely. The transverse facial artery (choice E) is a branch of the superficial temporal artery. or a seal around the cell. Hemidesmosome E.the optic canal to supply structures in the orbit. or zonula occludens. Tight junction The correct answer is D. just beneath the apical poles. Hemidesmosomes are basically desmosomes between a single cell and an extracellular matrix structure. are formed by the fusion of the outer leaflets of apposed cell membranes on the lateral cell surfaces. Right . Adherent junction B. acting much like spot welds between the two cells. Gap junction D. Which of the following helps to anchor an epithelial cell to the basement membrane? A. They form a barrier to permeability.

There are two ways to answer this question. Filiform C. and are found primarily on the anterior tongue. If the left lateral pterygoid is torn.C. contain taste buds. A deeper understanding of the question would show that the lateral pterygoid is the primary protruder of the mandible. are the most numerous. The four major lingual papillae types are listed in the answer. have taste buds. Filiform are avasacular. As a result. usually 7-9 in number. The formulaic method says that damage to a lateral pterygoid or the innervation to it will make the mandible deviate toward the side of the damage. vascular. Foliate are on the lateral surface of the tongue in ridges but are usually considered rudimentary and nonfunctional in man. Vallate are largest. and acting as a stationary pivot point. without taste buds. and serous salivary glands of Von Ebner. with the left side remaining stable. Fungiform B. Foliate The correct answer is B. Vallate D. In a direct protruding direction The correct answer is A. Fungiform papillae are fairly numerous. the mandible will pivot out and toward the left (the side of injury). Mucopurulent exudate from maxillary sinusitis would be most likely to drain through an ostium in the . Which of the tongue papillae are NOT vascular? A. and are found in rows. Contraction of both lateral pterygoids produces straight protrusion. In an elevating direction D. Note that damage to muscles or innervation to one side of a tongue will also produce deviation toward the injured side. the right muscle will begin to protrude the right side.

bulla ethmoidalis B. asthma. Left lobe of the liver E. The inferior nasal meatus (choice C) receives fluid from the nasolacrimal duct. exudate may drain into the middle meatus through an ostium in the hiatus semilunaris. which is associated with the triad of nasal polyps. The superior nasal meatus (choice E) is located above the superior concha and contains an opening for the sphenoid sinus. and sinusitis. Left kidney D. will most likely damage which organ? A. also part of the middle meatus. This patient has two risk factors for sinusitis: chronic rhinitis and allergy. between the ninth and tenth rib. She probably also has aspirin allergy. superior nasal meatus The correct answer is B. which drains tears from the medial aspect of the orbit to the nasal cavity. Ascending colon B. The bulla ethmoidalis (choice A). hiatus semilunaris C. sphenoethmoidal recess E. and extending approximately 5 cm deep. In maxillary sinusitis. which contains openings to the frontal and maxillary sinuses and anterior ethmoidal cells. The sphenoethmoidal recess (choice D) is located above the superior concha and contains an opening for the sphenoid sinus.A. Duodenum C. contains an opening to the middle ethmoidal air cells. Spleen . A wound to the posterior left axillary line. inferior nasal meatus D.

it is crossed by rib 12 and usually does not extend above rib 11. The superior pole of the left kidney (choice C) is bordered by the lower part of the spleen. Therefore. it would not be penetrated before the spleen. In addition. It is attached to the stomach by a broad mesenterial band. above the colon. which runs from right to left. Note that the pleural cavity. Most of the duodenum (choice B) is positioned too far to the right to be affected by this injury. and possibly the lower part of the inferior lobe of the lung. The anterior positioning of this structure makes it an unlikely candidate for injury in this case. The spleen follows the long axes of ribs 9 to 11 and lies mostly posterior to the stomach. the gastrosplemic ligament. The left lobe of the liver (choice D) is positioned just beneath the diaphragm. the duodenum lies at about levels L1 to L3. . However. would be pierced before the spleen.The correct answer is E. Even with deep penetration at the correct angle. would still be out of harm's way. Even the third part of the duodenum. The ascending colon (choice A) is on the wrong side (the right) to be penetrated by a sharp instrument piercing the left side. placing it too low to be injured in this case. and partly anterior to the kidney. it is the most likely organ of the group to be pierced by a sharp object penetrating just above rib 10 at the posterior axillary line. just over and anterior to the stomach. It would probably be too low and medial to be injured in this case because this penetration is at the posterior axillary line.

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