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WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER

POSTGRADUATE INTERNSHIP PROGRAM

ANATOMY AND HISTOLOGY

NAME: _________________________________ DATE: ___________________ SCORE: ____________

CHOOSE THE BEST ANSWER:

1. With your knowledge of the dermatomal levels of the spinal nerves, pain of the myocardial infarction
in the diaphragmatic surface will most likely be referred to which area of the body?
A. Medial part of arm
B. Jaw
C. Neck
D. Epigastric
2. Which valve when closed allows blood to flow to the coronary arteries?
A. Mitral
B. Tricuspid
C. Aortic
D. Pulmonic
3. Obstruction of flow of blood to the distal part of the anterior interventricular artery will cause
infarction of which of the following?
A. Inferior wall
B. Apex
C. Interventricular septum
D. Anterior wall
4. Stab wound on the right 4th ICS near sternal border with trajectory perpendicular to the chest wall
will most likely injure which of the following chamber of the heart?
A. Right atrium
B. Right ventricle
C. Left ventricle
D. Left atrium
5. Pain of myocardial infarction radiating to medial side of the arm is from stimulation of which branch
of the following nerves:
A. Intercostobrachial nerve
B. Musculocutaneous
C. Median
D. Axillary
6. During coronary artery bypass graft surgery, the Cardiac Surgeon harvested an artery in the anterior
chest wall to bypass the anterior interventricular artery, this is most likely the:
A. Anterior intercostals
B. Musculophrenic
C. Internal thoracic
D. Pericardiophrenic
7. On median sternotomy, the cardiac surgeon was very careful not to injure a nerve located at the
lateral sides of the pericardium. Injury to this nerve will cause:
A. Loss of sensation of the epicardium
B. Loss of sensation of the peripheral sides of the diaphragm
C. Paralysis of the diaphragm on the same side
D. Paralysis of the intercostal muscles on the same side
8. At the 5th LICS MCL, one will appreciate the following EXCEPT:
A. The sound of the aortic valve
B. The apex of the heart
C. The point of maximal impulse of the heart
D. Left inferior border of the heart
9. Blood supply to the sinoatrial node and atrioventricular nodes originates from which coronary
artery?
A. Circumflex
B. Anterior interventricular
C. Marginal
D. Right
10. Characteristic of the left ventricle compared to the right:
A. Thinner wall
B. Has 2 papillary muscles
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C. Crescentic chamber
D. Has moderator band
11. In midline vertical incision the following structure is traversed after the skin and superficial fascia:
A. Extraperitoneal tissue
B. Fascia transversalis
C. Linea alba
D. Rectus sheath
12. A tumor in the uncinate process of the pancreas will most likely compress which of the following
structures?
A. Splenic artery
B. Main pancreatic duct
C. Portal vein
D. Superior mesenteric artery
13. Which of the following pairs of veins form a portal-caval anastomosis?
A. Hepatic veins and IVC
B. Superior rectal vein and IVC
C. Azygous and left gastric
D. Suprarenal and renal
14. In superior mesenteric artery occlusion, the following structure will be spared of ischemia and
necrosis:
A. Ascending colon
B. rectum
C. cecum
D. ileum
15. The scrotal skin is markedly wrinkled when it is cold, this is due to the muscle derivative of which of
the following?
A. Camper’s fascia
B. Scarpa’s fascia
C. Fascia transversalis
D. Peritoneum
16. Which of the following rectal injury will result in fecal peritonitis?
A. Laceration of the anterior wall of the distal third
B. Laceration of the posterior wall of the middle third
C. Laceration of the anterior wall of the proximal third
D. All of the following
17. An 18y/o male was stabbed in the right upper quadrant resulting into a gaping wound. An intestinal
segment protruded through the wound; no teniae coli, no sacculations/haustations noted. The part
eviscerated is most likely:
A. Descending colon
B. Ileum
C. Transverse colon
D. Jejunum
18. During cholecystectomy, the surgeon identified the cystic duct this structure forms which part of the
triangle of calot?
A. Superior
B. Anterior
C. Medial
D. Lateral
19. In appendectomy, the structure that can be traced as a guide for looking for the appendix:
A. Haustra
B. Appendices epiplocae
C. Taenia coli
D. Sacculations
20. Perforation of the posteriorly located duodenal ulcer will most likely erode which of the following
vessel?
A. Right gastric
B. Common hepatic
C. Gastroduodenal
D. Inferior pancreaticoduodenal
21. Trauma to the L1-L2 sympathetic outflow would result in inability of this muscle to contract thus
allowing the semen to enter the urinary bladder during ejaculation:
A. Bulbospongiosus
B. Detrussor
C. External urethral sphincter
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D. Internal urethral sphincter

22. Blood supply to the superior portion of the urinary bladder arises from which of the following:
A. Inferior gluteal
B. Middle rectal
C. Umbilical
D. Uterine
23. A male patient who complains of dysuria and frequency was diagnosed to have BPH which
causes the enlargement of which structure?
A. Interureteric crest
B. Prostatic utricle
C. Sphincter urethra
D. Uvula
24. The artery that supplies blood to the major erectile body of both male and female:
A. Artery of the bulb
B. Prostatic utricle
C. Sphincter urethra
D. Uvula
25. The part of the male reproductive organ that conveys semen within the prostate gland:
A. Ductus deferens
B. Ejaculatory duct
C. Prostatic urethra
D. Seminal vesicle
26. What part of the ischirectal fossa extends deep into the sacrotuberal ligament?
A. Anterior recess
B. Genital hiatus
C. Posterior recess
D. Pudenal canal
27. An elderly man had prostatitis. The seminal colliculus of his prostate gland is infected and its
openings are closed. Which of the following structures are most likely affected?
A. Ducts of the prostate gland
B. Prostatic utricle
C. Ejaculatory ducts
D. Ducts of the seminal vesicle
28. An MRI exam of a 3-year old boy reveals that he has double ureter. Which of the following
embryonic structures is most likely to develop abnormally?
A. Mesonephric duct
B. Paramesonephric duct
C. Ureteric bud
D. Metanephros
29. The boundaries of the perineum include the following except:
A. Ischiopubic rami
B. Ischial tuberosity
C. Tip of the coccyx
D. Ischial spine
30. The sphincter vesicae receives its innervation from the colon:
A. Pudendal
B. Hypogastric plexus
C. Obturator
D. Inferior rectal
31. The vagus nerve passes into the abdomen by passing through which opening of the respiratory
diaphragm?
A. Aortic hiatus
B. Esophageal hiatus
C. foramen
D. Lateral arcuate ligament
32. Part of the lavatory ani inserted into the perineal body and acts like a vaginal sphincter:
A. Ilio coccyges
B. Pubovaginalis
C. Pubococcygus
D. Puborectalis
_____33. During the ovary (OOPHORECTOMY), which ligaments are we going to cut to eliminate its
blood supply?
A. suspensory ligament
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B. ovarian ligament
C. round ligament of the uterus
D. broad ligament
_____34. During childbirth, which 2 landmarks may be used when giving a pudendal block?
A. ischial spine & ischial tuberosity
B. ischial spine & sacrospinous ligament
C. perineal & anococcygeus bodies
D. perineal body & fourchette
_____35. An obstetrician performs a median episiotomy on a woman before parturition. If the perineal
body is damaged, the function of which of the following muscles might be impaired?
A. Ischiocavernosus and external anal sphincter
B. Deep transverse perineal and sphincter urethrae
C. Bulbospongiosus and levator ani
D. Bulbospongiosus and ischiocavernosus
_____36. Inability to expel the last drops of urine at the end of micturition because of paralysis of the
external urethral sphincter and bulbospongiosus may occur as a result of injury to which of the
ff structures?
A. Prostatic plexus
B. Pudendal nerve
C. Pelvic splanchnic nerve
D. Sacral splanchnic nerve
_____37. A 12 year old presents with a big hematoma in the ischiorectal fossa. Ligation of bleeders
after evacuation of the hematoma was done. Two days post op she complained of fecal
incontinence. Which of the ff nerves is most likely injured?
A. Pudendal
B. Perineal
C. Ilioinguinal
D. Inferior rectal
_____38. All of the following supply blood to the ureters EXCEPT:
A. Superior vesical artery
B. Inferior vesical artery
C. Renal artery
D. Gonadal artery
_____39. Pelvic examination done on a patient shows that the uterine body is tipped away from the
urinary bladder and the fundus is tipped posteriorly. Which of the following describes the
position of the uterus?
A. Anteverted, Anteflexed
B. Anteverted, Retroflexed
C. Retroverted, Anteflexed
D. Retroverted, Retroflexed
_____40. All of the following structures can be found in the deep perineal space EXCEPT:
A. Cowper’s gland
B. Sphincter urethrae muscle
C. Dorsal nerve of the penis/clitoris
D. Internal pudendal vessels
_____41. A patient consulted with a 1-month history of right sided ear fullness, blood tinged, mucoid
post nasal drip and an enlarged ipsilateral non-tender, fixed upper jugular lymph node. Which
of the following areas is the most likely source of the adenopathy?
A. Upper lip
B. Tip of tongue
C. Nasopharynx
D. Larynx
_____42. During thyroid gland development, it remains connected to the tongue by a narrow canal that
later disappears. This canal is known as:
A. Hyoid canal
B. Cricothyroid duct
C. Thyroglossal duct
D. Thyroid canal
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_____43. A patient consulted due to a 2-day history of painful thyroid enlargement. In this condition,
which fascial layer is involved?
A. Investing layer
B. Pretracheal layer
C. Prevertebral layer
D. Superficial cervical fascia
_____44. Inferior parathyroid glands embryologically develop from the:
A. Floor of the pharynx
B. 2nd pharyngeal pouch
C. 3rd pharyngeal pouch
D. 4th pharyngeal pouch
_____45. One day after total thyroidectomy, the patient complained of circumoral numbness, and
tingling sensation on tips of finger and toes as well as muscle cramps. What clinical maneuver
can be done to confirm the cause of these symptoms?
A. Tapping the parotid gland over the facial nerve to induce facial muscle spasm
B. Tapping of the median nerve to elicit carpopedal spasm
C. Deep palpitation of the post-op site to elicit a cough reflex
D. Stimulating the sole of the foot with a blunt instrument to induce plantar reflex
_____46. Which of the following muscles of mastication opens the mouth and pulls the neck of the
mandible forward?
A. Masseter
B. Temporalis
C. Lateral pterygoid
D. Medial pterygoid
_____47. Which of the following muscles of mastication opens the mouth and pulls the neck of the
mandible forward?
A. Nasal
B. Ethmoid
C. Palatine
D. Sphenoid
_____48. An 8 month old baby boy was brought to the emergency room because of unresponsiveness
and seizures. The caregiver admitted that she shook the baby boy vigorously out of sheer
frustration from his incessant crying and notice thereafter that the child was becoming
lethargic and had sudden onset of generalized seizures. An impression shaken baby syndrome
was made. The child most likely suffered from a/an?
A. Subdural hematoma
B. Epidural hematoma
C. Subgaleal hemorrhage
D. Intracerebral hemorrhage
_____49. Which of the following structures is NOT contained in the carotid sheath?
A. Internal jugular vein
B. Vagus nerve
C. Recurrent laryngeal nerve
D. Internal carotid artery
_____50. Which of the following is TRUE regarding the gag reflex?
A. The afferent limb is supplied by the trigeminal nerve
B. The afferent limb is supplied by the glossopharyngeal nerve
C. The afferent limb is supplied by the facial nerve
D. The afferent limb is supplied by the vagus nerve
_____51. Which of the following examination will test for cranial nerve VII?
A. Taste sensation
B. Pain on anterior 2/3 of tongue
C. Closing of lips
D. Close eyes
_____52. When you ask a patient to raise his eyebrows, you are testing for which muscle?
A. Procerus
B. Corrugator supercilli
C. Levator palpebra
D. Occipitofrontalis muscle
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_____53. Several days after superficial parotidectomy, right, the patient noted that he sweats on the
right side of the face whenever he eats, this is secondary to the damage of which of the
following structure:
A. Parotid duct injury resulting in leak of saliva to the skin over post operative site
B. Great auricular nerve causing continuous secretion of the sweat glands over the post
operative site
C. Auriculotemporal nerve that joined the fibers of the great auricular nerve producing
sweat instead of saliva
D. Terminal branches of the facial nerve that joined the fibers of the great auricular
simulating it to produce sweat
_____54. After thyroidectomy, the patient was noted to have difficulty of breathing and stridor with no
note of enlarging hematoma or bleeding. This results from injury to which nerve?
A. Internal laryngeal
B. External laryngeal
C. Recurrent laryngeal
D. Vagus
_____55. The movement of the thyroid gland during swallowing is:
A. A common sheath with the larynx and the trachea derived from the pretracheal layer
B. The vascular pedicles supplying the thyroid gland is in close proximity to the larynx
C. The thyroid gland is loosely attached to the sternocleidomastoid muscle which is
responsible for its movement on deglutition
D. The continuity of the covering of the thyroid gland with the pharynx which is derived
from the investing layer
_____56. An infected pimple over the tip of the nose can cause cavernous sinus thrombosis by way of
facial or angular vein through the:
A. Ophthalmic vein
B. Emissary vein
C. Diploic vein
D. Retromandibular vein
_____57. Peau d orange or orange peel appearance in breast carcinoma is brought about by cancer cells
invading the:
A. Suspensory ligaments of Cooper
B. Axillary tail of Spence
C. Subdermal Lymphatics
D. Lactiferous ducts and glands
_____58. Loss of sensation over the medial aspect of the arm and lateral side of the thorax after
mastectomy is secondary to the damage of the intercostobrachial nerve which is usually
originates from which intercostal nerve?
A. 1
B. 2
C. 3
D. 4
_____59. During mastectomy, the surgeon encountered spurting blood vessel over the lateral to the
medial border of the breast. This is a branch of which vessel?
A. Lateral thoracic
B. Thoracoacromial
C. Internal thoracic
D. Thoracodorsal
_____60. Which structure forms the landmark in doing segmental resection the lungs?
A. Pulmonary vein
B. Pulmonary artery
C. Pulmonary nerve
D. Segmental bronchus
_____61. Fastest emergency airway that can be done outside the hospital by a 1st year medical student:
A. Crico-thyroidotomy
B. Nasotracheal intubation
C. Endotracheal intubation
D. Tracheostomy
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_____62. Post total thyroidectomy, a 50 year old female developed stridor and cyanosis immediately
after extubation. Re-intubation was done, the anesthesiologist noted that both vocal cords are
in median position. Injury to which of the following nerve(s) caused the median position of the
vocal cords?
A. Unilateral superior external laryngeal
B. Bilateral superior external laryngeal
C. Unilateral recurrent laryngeal
D. Bilateral recurrent laryngeal
_____63. Which of the following landmark separates the upper respiratory from the lower respiratory
tract?
A. Thyroid notch
B. Cricoid cartilage
C. Bifurcation of the trachea
D. Lower border of the manubrium
_____64. During normal inspiration, the tracheal bifurcation will be located at which of the following
levels?
A. TV3-TV4
B. TV4-TV5
C. TV5-TV6
D. TV6-TV7
_____65. Few minutes prior to consultation, a 4 year old male accidentally swallowed a 1 peso coin. He
had difficulty of swallowing and breathing. On Chest X-ray, the coin appeared circular
on the longitudinal view at the level of the manubrium, the coin is most likely lodged in
the:
A. Pharynx
B. Esophagus
C. Trachea
D. Right Primary bronchi
_____66. Where would you expect the pleural fluid t gravitate in a patient examined on an upright
position with a left sided pleurisy?
A. Oblique fissure
B. Cardiac fissure
C. Costomediastinal recess
D. Costodiaphragmatic recess
_____67. A 32 year old male, has tension pneumothorax, needle thoracentesis is contemplated. The
needle should be inserted in which of the following locations?
A. Upper border of the rib, 2nd intercostal space, midclavicular line
B. Lower border of the rib, 2nd intercostal space, midclavicular line
C. Upper border of the rib, 4th intercostal space, anterior axillary line
D. Lower border of the rib, 4th intercostal space, anterior axillary line
_____68. On which of the following two ribs is thoracentesis best performed to avoid puncturing the
lung in a patient with pleural effusion?
A. Ribs 1 & 3
B. Ribs 3 & 5
C. Ribs 5 & 7
D. Ribs 9 & 11
_____69. The anatomic snuff box is an important landmark for which carpal bone?
A. Scaphoid
B. Triquetrum
C. Lunate
D. Pisiform
_____70. A medical student sustained a fracture on the proximal shaft of his humerus. He has inability
to extend his elbow joint and has loss of sensation over infero-posterior surface of his arm.
The signs are indicative of injury to the:
A. Axillary nerve
B. Radial nerve
C. Musculocutaneous nerve
D. Median nerve
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_____71. After a match, a 30 year old boxer complained of shoulder pain, on physical examination he
has difficulty in doing shoulder abduction past 70 degrees. No sensory deficits were noted.
This results from injury to which of the following?
A. Deltoid
B. Supraspinatus
C. Subscapularis
D. Teres major
_____72. Damage to which of the ff nerve is suspected in an open and comminuted fracture of the
midshaft of the right humerus with concomitant wrist drop deformity?
A. Median
B. Musculocutaneous
C. Radial
D. Ulnar
_____73. Which of the following is/are true regarding the signs and symptoms seen in carpal tunnel
syndrome?
A. Decreased pinch strength due to weakness of adductor pollicis
B. Unable to do finger abduction and adduction
C. The ulnar muscle atrophy is due to compression of the recurrent motor branch of the
median nerve in the carpal tunnel
D. Numbness over the little and media half of the ring finger is due to compression of the
median nerve underneath the transverse carpal ligament
_____74. After falling on his outstretched right hand, immediate wrist pain and swelling and tenderness
over the anatomical snuffbox was noted. Which bone is most likely fractured?
A. Lunate
B. Trapezium
C. Scaphoid
D. Trapezoid
_____75. A 30 year old policeman sustains a gunshot wound near his left inguinal area. In the ER, he
was unable to extend hi left knee. Numbness on the medial leg was also noted. Which nerve
is most likely injured?
A. Saphenous nerve
B. Obturator nerve
C. Femoral nerve
D. Medial cutaneous nerve of the thigh
_____76. A child hurt the tip of his big toe against a wooden platform, the pain is transmitted by which
of the following nerve?
A. Saphenous
B. Medial Plantar
C. Lateral Plantar
D. Sural
_____77. In anterior compartment leg syndrome loss of sensation is manifested in which area?
A. Area of the big toe
B. Area between the 1st and 2nd toes
C. Lateral 4 toes
D. Medial 4 toes
_____78. Complete transection of the calcaneal tendon will result in inability to:
A. Do tiptoe
B. Plantar flex foot
C. Dorsiflex foot
D. Invert foot
_____79. Inability to dorsiflex the foot and loss of sensation in the web between the 1st and 2nd toe
results from injury to the:
A. Common peroneal
B. Deep peroneal
C. Superficial peroneal
D. Posterior tibial
_____80. Which muscle is commonly involved in lateral epicondylitis or tennis elbow?
A. Brachioradialis
B. Extensor carpi radialis longus
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C. Extensor carpi radialis brevis

D. Extensor carpi ulnaris
_____81. Which of the ff pierces the interosseous membrane?
A. Anterior Tibial Artery
B. Tibial Nerve
C. Peroneal Artery
D. Deep Peroneal Nerve
_____82. A boxer’s fracture is a fracture of which of the following?
A. 1st metacarpal head
B. 1st metacarpal neck
C. 5th metacarpal head
D. 5th metacarpal neck
_____83. Which is the most prominent coat in the medium-sized vein?
A. Endothelial layer
B. Tunica media
C. Tunica adventitia
D. Tunica intima
_____84. This vessel consists of only a single layer of endothelial cells, with a caliber that is wider in
diameter that contains fibrin coagulum in its lumen:
A. Arteriole
B. Venule
C. Blood capillary
D. Lymphatic capillary
_____85. The “chief” or principal cells of the fundus of the stomach secrete:
A. Pepsinogen
B. HCl
C. Intrinsic factor
D. Gastrin
_____86. Phagocytic stellate-shaped cells lining the hepatic sinusoids are known as:
A. Rokitansky-Aschoff sinuses
B. Kupffer cells
C. Ito cells
D. Portal macrophages
_____87. One of the following is a characteristic of “thin” skin:
A. Numerous arteriovenous anastomoses
B. Thick stratum corneum
C. Moderate number of pila-sebaceous units
D. Abundant sweat glands
_____88. Minute elevations of the skin that result from an obstruction of the excretory ducts of the
sweat glands are known as:
A. Comedones
B. Condyloma acuminate
C. Acne vulgaris
D. Miliaria
_____89. The C-shaped cartilage plates seen in the trachea are made up of:
A. Adult hyaline cartilage
B. Elastic cartilage
C. Fetal hyaline cartilage
D. Fibrocartilage
_____90. The actual receptor organs for smell are the:
A. Glands of Bowman
B. Schneiderian membranes
C. Olfactory bulbs
D. Olfactory cilia
_____91. The growth of the ovarian follicles is made possible by the action of this hormone:
A. Estrogen
B. Progesterone
C. FSH
D. LH
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_____92. Fertilization occurs in one of the following sites:

A. Ovarian cortex
B. Isthmic portion, oviduct
C. Ampullary portion, oviduct
D. Peritoneal cavity
_____93. Testosterone is secreted by the:
A. Sertoli cells
B. Primary spermatocytes
C. Secondary spermatocytes
D. Leydig cells
_____94. Acidophilic bodies found in the lumen of the acini of the prostate gland, esp. in older individual
are known as:
A. Hassall’s bodies
B. Sertoli cells
C. Corpora amylacea
D. Corpora spongiosa
_____95. Which of the following lymphoid organs undergoes “age involution”?
A. Thymus
B. Tonsils
C. Spleen
D. Lymph node
_____96. The only lymphoid organ that filters lymph is the:
A. Thymus
B. Spleen
C. Lymph node
D. Pancreas
_____97. Catecholamines are secreted by which of the following?
A. Adrenal cortex
B. Adrenal medulla
C. Adenohypohysis
D. Mesangium, renal cortex
_____98. The release of this hormone results in the increase of calcium levels in the blood:
A. Calcitonin
B. Parathormone
C. Thyroxine
D. Growth hormone
_____99. Erythropoietin is secreted by the:
A. J-G cells
B. Macula densa
C. Mesangial cells
D. Extraglomerular mesangial cells
_____100. Filtration in the glomerulus takes place thru the:
A. Mesangium
B. Glomerular basement membrane
C. Slit pores
D. Pedicles