Anatomy review

Which of the following statements is true regarding the posterior

intercostal artery?
A. The posterior intercostal artery originates from the internal
thoracic artery.
B. The posterior intercostal artery passes in the plane between the
external and internal intercostal muscles.
C. The posterior intercostal artery passes in the plane between the
internal and innermost intercostal muscles.
D. The posterior intercostal artery anastomoses (meets) the
corresponding posterior intercostal artery from the other side.
E. The posterior intercostal artery runs along the lateral margin of
the sternum.
Answer: __D___

In which of the following tissue layers may the bleeding of the

scalp extend into the eyelids causing the “black eye”?
A. the skin
B. the dense connective tissue
C. the aponeurotic layer
D. the loose connective tissue
E. the pericranium
Answer: __D___

The mediastinum is divided into a superior and an inferior

mediastinum by a transverse plane:
A. extending from the upper margin of the sternum to the
intervertebral disc between the 3rd and 4th thoracic vertebrae.
B. extending from the upper margin of the sternum to the
intervertebral disc between the 4th and 5th thoracic vertebrae.
C. extending from the sternal angle to the intervertebral disc
between the 5th and 6th thoracic vertebrae.

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D. extending from the sternal angle to the intervertebral disc
between the 3rd and 4th thoracic vertebrae.
E. extending from the sternal angle to the intervertebral disc
between the 4th and 5th thoracic vertebrae.
Answer: ___E__

Which of the following nerves innervates the platysma?

A. the facial nerve
B. the cervical plexus
C. the trigeminal nerve
D. the brachial plexus
E. the phrenic nerve
Answer: __A___

Which of the following structures is enveloped in the carotid

sheath?
A. the subclavian artery
B. the external caroid artery
C. the trigeminal nerve
D. the facial nerve
E. the vagus nerve
Answer: __E___

Which of the following structures is located in the pterygopalatine

fossa?
A. the superficial temporal artery
B. the internal carotid artery
C. the pterygoid venous plexus
D. the mandibular nerve (V3)
E. the maxillary nerve (V2)
Answer: _E____

Which of the following structures is located in the posterior cervical

triangle?
A. the carotid artery
B. the cervical plexus

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C. the internal jugular vein
D. the trachea
E. the phrenic nerve
Answer: __E___

During the laboratory sessions, after you removed the heart and
pericardium, which organ did you observe in front of the vertebral
column?
A. the trachea
B. the pulmonary artery
C. the sympathetic trunk.
D. the esophagus
E. the descending aorta
Answer: __D___

Which of the following structures does NOT pass through the

parotid gland?
A. the facial nerve
B. the internal carotid artery
C. the external carotid artery
D. the facial vein (or retromandibular vein)
E. the small parotid ducts
Answer: ___E_

Tracheotomy is a surgical procedure to make an incision in the

trachea to keep air pathway open. Which of the following veins
may be damaged during the tracheotomy?
A. the facial vein
B. the subclavian vein
C. the external jugular vein
D. the jugular venous arch
E. the internal jugular vein
Answer: __E___

Which of the following statements is true regarding the parietal

pleura?

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A. The parietal pleura covers the mediastinum.
B. The parietal pleura is the external membrane of the lung.
C. The parietal pleura is continuous with the parietal layer of the
pericardium.
D. The parietal pleura is not continuous with the visceral pleura.
E. The parietal pleura is fully limited within the thoracic cavity.
Answer: __E__

Which of the following statements is true regarding the pleural

cavity?
A. The pleural cavities are continuous with each other.
B. The pleural cavities extend above the level of the first ribs.
C. The pleural cavities are lined by multiple layers of flat cells.
D. The pleural cavities contain air.
E. The pleural cavities communicate with the pericardium
Answer: _B____

Which organ does the middle mediastinum contain?

A. the trachea
B. the heart
C. the lung
D. the sympathetic trunk.
E. the descending aorta
Answer: _B___

At which of the following levels does the adult spinal cord usually
end?
A. the T12 level
B. the L1/L2 level
C. the L5 level
D. the S2 level
E. the S5 level
Answer: _B____

Which of the following statements is true regarding the thoracic

aorta?

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A. The thoracic aorta is continuous with the ascending aorta.
B. The thoracic aorta begins at the lower edge of the 4th thoracic
vertebra.
C. The thoracic aorta gives off the internal thoracic artery.
D. The thoracic aorta is the inferior segment of the descending
aorta.
E. The thoracic aorta passes through the superior mediastinum.
Answer: _B____

Which of the following orders of the tissue layers is correct when

the lumbar puncture is performed from the skin to the extra- or epi-
dural space?
A. the superficial fascia > supraspinous ligament > interspinous
ligament > ligamentum flava
B. the supraspinous ligament > interspinous ligament > superficial
fascia > ligamentum flava
C. the superficial fascia > interspinous ligament > supraspinous
ligament > ligamentum flava
D. the superficial fascia > supraspinous ligament > ligamentum
flava > interspinous ligament
E. the superficial fascia > ligamentum flava > supraspinous
ligament > interspinous ligament
Answer: _A____

Which of the following structures passes through the scalenus

triangle?
A. the thoracic duct
B. the cervical plexus
C. the subclavian vein
D. the subclavian artery
E. the phrenic nerve
Answer: __D___

The thoracic cavity is subdivided into:

A. the thoracic wall, mediastinum, and pleural cavities.
B. the thoracic wall, diaphragm, and pleural cavities.

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C. a left and a right pleural cavity, and mediastinum.
D. the diaphragm, mediastinum and pleural cavities.
E. a left and a right pleural cavity, and thoracic wall.
Answer: _C__
Which of the following structures demarcates the trunk and lower
limb?
A. the interior margin of the gluteus maximus
B. the superior margin of the gluteus maximus
C. the upper border of the sacrum
D. a horizontal line at the level of the anterior superior iliac spine
E. the inguinal ligament
Answer: __E___

Which of the following structures is NOT located within the femoral

sheath?
A. the femoral canal
B. the femoral vein
C. the femoral artery
D. the femoral nerve
E. the deep inguinal lymph nodes
Answer: _D____

Which of the following structures passes through both greater and

lesser sciatic foramens?
A. the superior gluteal nerve
B. the inferior gluteal nerve
C. the pudendal nerve
D. the sciatic nerve
E. the obturator nerve
Answer: _C____

Which of the following nerves is most likely damaged when the

neck of the fibula is fractured?
A. the femoral nerve
B. the common fibular nerve
C. the tibial nerve

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D. the pudendal nerve
E. the sciatic nerve
Answer: __B___

Which of the following spinal nerves is TYPICALLY affected by the

intervertebral disc prolapse at the L4/5 level?
A. the L2 spinal nerve
B. the L3 spinal nerve
C. the L4 spinal nerve
D. the L5 spinal nerve
E. the S1 spinal nerve
Answer: _C___

Which of the following structures is located in the infratemporal

fossa?
A. the superficial temporal artery
B. the internal carotid artery
C. the pterygoid venous plexus
D. the facial artery
E. the hyoid bone
Answer: _C____

During the laboratory sessions, after you removed the infrahyoid

muscles, which organ did you observe?
A. the trachea.
B. the pulmonary artery.
C. the sympathetic trunk.
D. the heart.
E. the descending aorta.
Answer: __A___

Case 1
A 57-year-old man fell off the porch and then was confirmed a
fracture of his right humerus. Several weeks later, a typical clinical
sign called “wrist-drop” was shown, that is inability to extend the
wrist and fingers at the metacarpophalangeal joints.

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26. What nerve was injured to induce the “wrist-drop”?
A. the median nerve
B. the radial nerve
C. the ulnar nerve
D. the musculocutaneous nerve
Answer: __B___

27. What muscles were completely paralyzed?

A. the extensor muscles of the forearm
B. the extensor muscles of the upper arm
C. the extensor muscles of the upper arm and forearm
D. the flexor muscles of the forearm
Answer: ___A__

28. Where was the fracture located?

A. the surgical neck of the humerus
B. the radial groove of the humerus
C. the distal part of the humerus
D. the medial epicondyle of the humerus
Answer: _B____

Case 2
A 42-year-old male executively complains of abdominal pain that
began about 6 months previously, is constant in nature especially
after meals, and located in the upper midabdomen superior to the
umbilicus. He also reports some “heartburn” that has been
occurring during the previous year. He has been under a lot of job-
related stress and has been self-medicating himself with over-the-
counter antacids, which some relief. He states his stools have
changed in color over the previous 2 months and now are
intermittently dark and tarry in consistency. The physician tests the
patient’s stool and finds occult blood. Based on mentioned –
above, the patient‘s diagnosis is peptic ulcer disease.

29. If the patient’s peptic ulcer has not been controlled, the

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perforation of stomach wall would be happened. So if the posterior
wall of the stomach is perforated, gastric contents will accumulate
in which of the following areas?
A. The left paracolic gutter
B. The left paravertebral gutter
C. The right paravertebral gutter
D. The omental bursa
E. The hepatorenal recess
Answer: D_____

30. Ligation of the common hepatic artery will eliminate the gastric
blood supply through which of the following arteries?
A. the left gastric and short gastric arteries
B. the short gastric and right gastro-omental arteries
C. the right gastro-omental and right gastric arteries
D. the right gastric and left gastric arteries
E. the left gastric and left gastro-omental arteries
Answer: __C___

31. A surgical incision through the fundus of the stomach would

require you to clamp which of the following arteries?
A. the right gastric artery
B. the left gastric artery
C. the right gastro-omental artery
D. the left gastric-omental artery
E. the short gastric arteries
Answer: _E____

Case 3
A 31-year-old woman is in her physician’s office for a fitting for an
intrauterine contraceptive device. The physician performs a pelvic
examination to ensure that the device is placed in the correct
direction. The physical examination shows that the uterine body is
tipped anteriorly.

32. Which of the following describes the position of the uterus?

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A. Anteverted, anteflexed
B. anteverted, retroflexed
C. retroverted, anteflexed
D. retroverted, retroflexed
E. In the center of perineal cavity
Answer: _A____

Case 3 follow-up
2 years later, this woman and her husband want a baby. So she
goes to her physician’s office for taking the contraceptive device
out from her uterus. After several months, she feels faint
sometimes. On one day, she feels painful in the left iliac region
and is transferred to the ER. After the basic examination in ER, the
doctor places a 20-gauge spinal needle through the vagina to
assess whether there is blood in the peritoneal cavity.

33. Which of the following describes the most dependent part of

the peritoneum or pelvis?
A the vesicouterine fold
B the pararectal space
C the paravesical space
D the rectouterine pouch ( of Douglas)
E the vesicouterine pouch
Answer: __D___

15 years later, this woman is having significant uterine bleeding

from uterine fibroids. The radiologist performs an embolization
procedure of the uterine arteries.

34. Through which of the following structures do the uterine

arteries traverse?
A the transverse cervical (cardinal) ligaments
B the uterosacral ligaments
C the vesicouterine fold
D the anterior vaginal fornix
E the posterior vaginal fornix

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Answer: __A___

Case 4
A 44-year-old man complains of discomfort in his right upper thigh
over the past 6 months. He works in the garden department of a
home improvement center. On examination, there is tenderness at
the right inguinal area. When the patient performs a Valsalva
maneuver (bearing down to increase intra-abdominal pressure), a
bulge appears superior to the inguinal crease near the pubic bone.

35. What is the most likely diagnosis?

A the carcinoma of cecum
B the inguinal Hernia
C the abscess
D the enlarged lymph nodes
E the appendicitis
Answer: B_____

36. As a physician examining the inguinal region of this patient, the

inguinal ligament will be a key landmark. This structure is a feature
derived from which of the following structures?
A the superficial fascia
B the fascia lata of the thigh
C the aponeurosis of the external abdominal oblique
D the aponeurosis of the internal abdominal oblique
E the aponeurosis of the transversus abdominis
Answer: _____

37. As you continue your examination to check for the presence of

an inguinal hernia, you insert the tip of your finger into the
superficial inguinal ring. This is an opening in the :
A the superficial fascia
B the fascia lata of the thigh
C the aponeurosis of the external abdominal oblique
D the aponeurosis of the internal abdominal oblique

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E the aponeurosis of the transversus abdominis
Answer: _____

38. You are in the process of repairing a direct inguinal hernia.

Which of the following anatomical relations will you find during
surgery?
A The hernia will enter the deep inguinal ring
B The hernia will enter the femoral ring
C The hernia will lie lateral to the inferior epigastric vessels
D The hernia will lie medial to the inferior epigastric vessels
E The hernia will lie inferior to the inguinal ligament
Answer: _D____

Part II: Please name the structures indicated with English letters
(one mark each).

Figure. A E

A
F

C
D
Answers:

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A. _Duodenum_______________________
B. ___Ascending colon_____________________
C. _Appendix_______________________
D. _illeum_______________________
E. __Stomach______________________
F. ____Pancrease____________________
G. ____superior mensentric artery____________________
H. __jejunum______________________

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Figure B

Answers:
A. _Submandibular triangle_______________________
B. __sternocleidomastoid muscle______________________
C. _carotid triangle_______________________
D. __posterior triangle______________________
E. ___trapezius muscle_____________________
F. __submental triangle______________________
G. __hyoid______________________
H. _____muscular triangle___________________

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Figure C

Answers:
A. ________________________
B. ________________________
C. ________________________
D. ________________________
E. ________________________
F. ________________________
G. ________________________
H. ________________________

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