SURGICAL ANATOMY

1. Air in the pleural cavity:

a) Is a normal finding
b) Is called pneumothorax
c) Is called hydrothorax
d) Is called haemothorax
e) Is called pyothorax

2. Cervical rib:
a) Is a common rib finding
b) It can be a fibrous band
c) No complication is recorded from its presence
d) Commonly arise from the 5th cervical vertebra
e) More common in female

3. Bronchoiectasis:
a) It is narrowing of bronchi
b) Irreversible damage of the medium sized bronchi
c) It is easy to treat
d) It causes no problem for breathing
e) More common among females

4. One of the following is a common finding in congenital diaphragmatic hernia?

a) Normal breathing
b) Distended abdomen
c) Scaphoid abdomen
d) Normal x-ray abdomen
e) Abnormal heart sounds

5. Hernia through foramen of Morgagnio

a) Is a hernia through the diaphragm
b) Is incisoanal hernia
c) Hernia through anterior abdominal wall
d) Muscle hernia
e) Hernia through posterior abdominal wall

6. Linea semilunaris:
a) Located at the middle of the rectus abdominis muscle
b) Located at the medial border of the rectus abdominis
c) Located transversely above the umbilicus
d) Located at the lateral border of the rectus abdominis
e) Located transversely below the umbilicus
7. Transversalis Fascia:
a) Is an anterior boundary of the femoral ring
b) Is a posterior boundary of the femoral ring
c) Is an anterior boundary of the inguinal canal
d) Is a posterior boundary of the inguinal canal
e) It forms the roof of the inguinal canal

8. The cystic artery most frequently arises from:

a) Coeliac axis
b) Gastroduodenal artery
c) Left hepatic artery
d) Right hepatic artery
e) Superior mesenteric artery

9. The appendix:
a) Located at the distal of the ileum
b) Blood supply from the inferior mesenteric artery
c) It has no submucosa
d) Blood supply from the superior mesenteric artery
e) Not found in young adults

10. The Meckel's diverticulum:

a) Is found in the large bowel
b) Can be hernial content
c) Found on mesenteric border of the small bowel
d) Found in 80% of people
e) The length is usually 30cm

11. The common cause of an early death in thoracic trauma is:

a) Hypoxaemia
b) Hyponatraemia
c) Hyperkalaemia
d) Hypervolaemia
e) Acid-base balance disturbance

12. In flail chest:

a) The chest wall moves inwards during expiration
b) The chest wall movement is not affected
c) The chest wall moves inwards during inspiration
d) The chest wall moves outwards during inspiration
e) The chest wall moves outwards during inspiration

13. Patient with simple rib fracture:

a) Needs immediate fixation of the fractured rib
b) Needs strapping of the chest wall
c) Needs analgesia and chest physiotherapy
d) Needs emergency surgery
e) Needs immobilization of the chest wall
14. Fracture of the first rib:
a) Is a common rib fracture
b) Is a rare rib fracture
c) It can occur with a minor trauma
d) Does not need assessment to the other organs
e) It does not alert the surgeon to other injuries
15. Pneumothorax;
a) It is presence of blood in the pleural cavity
b) Presence of blood in the pericardial cavity
c) Presence of air in the pleural cavity
d) Presence of fluid in the pleural cavity
e) Presence of air in the pericardial cavity

16. The chest tube drain:

a) Commonly inserted at the 5th intercostal space midclavicular line
b) Commonly inserted at the 5th intercostal space midaxillary line
c) Commonly inserted at the 7th intercostal space
d) Commonly inserted at the 9th intercostal space
e) Commonly inserted at the 2nd intercostal space

17. Cervical rib:

a) Is a normal rib
b) It is always bony
c) It originates from the 1st thoracic vertebra
d) It is commonly symptomatic
e) It can be present with vascular and neurological symptoms

18. Diaphragmatic hernia:

a) If it is congenital appear late in life
b) It is common on the right side
c) If it is congenital appear early in life
d) Usually asymptomatic
e) It usually causes abdominal distension

19. Foramen Ovale:

a) It is an opening between the two ventricles
b) An opening between the two atria
c) Communication between the aorta and the pulmonary vein
d) Communication between the aorta and the pulmonary artery
e) Communication between the pulmonary artery and the pulmonary vein

20. The following is one of Fallot's Tetralogy:

a) Pulmonary vein stenosis
b) Left ventricular hypertrophy
c) Right ventricular hypertrophy
d) Aortic stenosis
e) Atrial septal defect
21. Concerning bones of the upper limb, all of the following statements are true
except:
a) Avulsion fracture of the coracoid process occurs to vigorous contraction of
the brachialis muscle
b) The clavicle is usually fractured at its middle third
c) Avulsion fracture of the greater tuberosity of the humerus is due to vigorous
contraction of the supraspinatus
d) Fracture of the shaft of the humerus may be complicated with radial nerve
injury
e) Supracondylar fracture of the humerus may be complicated with
Volkmann's ischaemia of the forearm

22. The fingernail of the index finger requires removal because of an underlying
abscess. The nerve that require blocking by a local anesthetic agent is the:
a) Dorsal digital branch of the ulnar nerve
b) Dorsal digital branch of the radial nerve
c) Palmer digital branch of the ulnar nerve
d) Palmer digital branch of the median nerve
e) Terminal branches of the posterior interosseous nerve

23. The ulnar nerve was damaged by a deep laceration to the wrist when a 17-
year-old male put his hand through a plate glass window. Select the correct
statement(s) about the patient's symptoms:
a) He cannot adduct his ring finger and holds a piece of paper between his ring
and middle fingers
b) The motor innervation to the flexor digiti minimi brevis and the 3rd and 4th
lumbrical is lost so that the ring and little finger are hyperextended at the
metacarpophalangeal joints
c) He is able to hold a toothpick between the pads of his thumb and index
finger
d) The middle and distal phalanges of the ring and little finger are flexed at the
proximal and distal interphalangeal joints
e) All of the above

24. Following surgical removal of a firm nodular cancer swelling in the right
breast and exploration if the right axilla, on examination the patient was found
to have a winged right scapula. Most likely this could have occurred due to
injury to the:
a) Subscapular muscle
b) Coracoid process of scapula
c) Long thoracic nerve
d) Circumflex scapular artery
25. The most important stabilizer against valgus deformity in flexed elbow is:
a) Radial head
b) Medial joint capsule
c) Anterior bundle of the medial collateral ligament
d) Posterior bundle of the medial collateral ligament
e) Transverse bundle of the medial collateral ligament

26. Regarding the anterior cruciate ligament:

a) It is tense when the knee is flexed
b) It is tense when the knee is extended
c) Inserted into the lateral aspect of the lateral condyle of the femur
d) Is less commonly torn than the posterior cruciate
e) It is avascular

27. Which of the following causes foot drop only:

a) Injury to the common peroneal nerve
b) Injury to the sural nerve
c) Injury to the deep peroneal nerve
d) Injury to the saphenous nerve
e) Injury to the femoral cutaenous nerve

28. During a direct lateral approach to the hip joint, which neurovascular
structures may be injured by excessive retraction of the gluteus medius muscle:
a) The femoral nerve
b) The superior gluteal nerve
c) The sciatic nerve
d) The inferior gluteal nerve
e) The medial femoral circumflex artery

29. A vascular necrosis of the femoral head occurs in the following state:
a) Subcapital fracture of the femoral head
b) Subtrochanteric fracture
c) Intertrochanteric fracture
d) Immediately reduced posteriorly dislocated hip
e) Fracture shaft of femur

30. During an automobile accident, a patient fractured the neck of her right
radius and damaged a closely related nerve. At physical examination, the patient
exhibited the following except:
a) Weakness in extending the terminal phalanx of the thumb
b) A loss of skin sensation on the lateral part of the dorsum of the hand
c) An inability to extend the metacarpophalangeal joint of the index finger
d) A normal ability to adduct the thumb at the carpometacarpal joint
e) Normal skin sensation down the medial border of the hand
31. Diminsihed sweating and increased warmth and vasodilation of the skin
vessels over the hypothenar eminence as well as the ring and little fingers could
result from the following except:
a) A lesion of the posterior cord of the brachial plexus
b) Ulnar nerve damage behind the medial epicondyle of the humerus
c) A lesion of the medial cord of the brachial plexus
d) A lesion of the eighth cervical nerve
e) Ulnar nerve damage over the front of the wrist

32. After a football injury, an orthopedic surgeon noted that the right tibia could
be moved anteriroly with excessive freedom when the knee was flexed. In this
patient, which ligament is most likely torn?
a) The lateral collateral ligament
b) The posterior cruciate ligament
c) The anterior cruciate ligament
d) The medial collateral ligament
e) The patellar ligament

33. Normal venous flow in the lower limbs:

a) Assisted by gravity
b) One way, because valve system is in 3 types of veins
c) Multi-directional
d) From deep to superficial veins
e) Not enhanced by calf and thigh muscle activity

34. Vascular Necrosis occurs most commonly after:

a) Fractured metatarsal bone
b) Fractured shaft of femur
c) Fractured shaft of tibia
d) Fractured neck of femur
e) Fractured peroneal malleolus

35. Which of the following is not a clinical feature of acute arterial ischemia of
the lower limb?
a) Swelling
b) Pain
c) Pallor
d) Paralysis
e) Paraesthesia

36. Pott's fracture involves a) fracture of the fibula 4-7cm proximal to the lateral
malleolus and b) rupture of the deltoid ligament or avulsion of the medial
malleolus. This condition is likely produced by forced:
a) Planter flexion
b) Dorsiflexion
c) Eversion
d) Inversion
e) Lateral rotation
37. With regard to rib fractures following blat chest injuries:
a) Ribs usually fracture near costochondral junctions
b) The first and second ribs are easily fractured
c) In flail chest, ribs dislocate at the dislocate fracture
d) Ribs fracture easily in children compared to adults

38. The Pterion:

a) Is the point where the greater wing of the sphenoid meets with the zygoma
b) It is 8cm above the mid point of the zygomatic arch
c) It is marked by an eminence
d) Has the posterior branch of the middle meningeal artery beneath it
e) Is the thinnest part of the lateral wall of the skull

39. In the thyroid gland:

a) The middle thyroid vein in intimately related to the recurrent laryngeal
nerve
b) The superior thyroid artery is intimately related to the external laryngeal
nerve
c) The inferior pole of the gland contains the trunk of the inferior thyroid
artery
d) The plane between the false and true capsule is very vascular
e) The thyroida ima artery is found in the majority of subjects

40. With regard to intercostal spaces:

a) The neurovascular bundle lies between the external oblique and internal
oblique muscles
b) The intercostal vein lies below the intercostal artery in the subcostal groove
c) The pleura which lines the intercostal muscles in insensitive to pain
d) The seventh to eleventh intercostals nerve supply the skin of the abdominal
wall
e) Intercostal drains should be inserted just below the upper rib of the chosen
intercostal space

41. Mallet finger is due to:

a) Avulsion of the extension tendon from the distal phalanx of a finger
b) Avulsion of the extensor tendon from the proximal phalanx of a finger
c) Avulsion of a flexor digitorum profundus tendon from a finger
d) Avulsion of flexor digitorum superficialis tendon from a finger
e) Avulsion of the abductor pollicis tendon

42. A young man sustained trauma to his right shoulder and found to have a
fracture of the surgical neck of the humerus. On examination, he has difficulty in
abduction of his right arm. The nerve which is injured is:
a) Radial nerve
b) Ulnar nerve
c) Long thoracic nerve
d) Suprascapular nerve
e) Axillary nerve
43. In venous thrombosis:
a) Superficial thrombosis is more serious
b) The thrombosis can reach the kidney
c) It may cause pulmonary embolism
d) Is common to young men
e) Is common among young women

44. The following are features of thyrotoxicoisis except:

a) Tiredness
b) Heat intolerance
c) Palpitation
d) Weight gaining
e) Excessive appetite

45. The common source for a pulmonary embolus is:

a) The lower limb veins
b) The left atrium
c) The superior vena cava
d) The renal vein
e) The portal vein

46. The following are early features of congenital diaphragmatic hernia except:
a) Respiratory distress
b) Presence of bowel in the chest
c) Distended abdomen
d) Bowel air in the chest X-Y
e) Nasogastric tube to be ended the chest

47. The following are features of the right main bronchus except:
a) It is short
b) It is wider
c) It is oblique in course
d) It is a common site for F-B
e) Its blood supply is from the aorta

48. The ligamentum teres:

a) Is the remnant of the ductus venosus
b) Is the remnant of the right umbilical vein
c) Is the remnant of the left umbilical vein
d) Is the remnant of the ductus venosus
e) Is the remnant of the left umbilical artery

49. The ductus venosus:

a) It is a duct between the superior vena cava and inferior vena cava
b) It is a duct between the left umbilical vein and superior vena cava
c) It is a duct between the left umbilical vein and inferior vena cava
d) It is a duct between the left and right umbilical veins
e) It is a duct between the right umbilical vein and inferior vena cava
50. Regarding pneumothorax the following statements are true except:
a) It can be associated with hemothorax in chest injuries
b) Can be defined as abnormal presence of air in the pleural space
c) It can cause shock by decreasing the cardiac output
d) Is caused only by penetrating injuries to the chest
e) Can be treated initially by inserting a wide pore needle in the second
intercostal space

51. Pneumothorax can be defined as presence of air in the pleural space, it can be
caused accidently by the surgeon's knife when operating on:
a) The gall-bladder
b) The kidney
c) The duodenum
d) The small bowel
e) The pancreas