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Paper1

Total questions: 30

Worksheet time: 30mins

Name
Class
Date
1.

An angiogram of a 50-year-old man revealed a blockage of a coronary artery. This artery supplies both ventricles and is accompanied by the middle cardiac vein. Select the most likely affected artery.

a)

Anterior interventricular artery

b)

Left coronary artery

c)

Posterior interventricular artery

d)

Right coronary artery

e)

Right marginal artery

2.

A 40-year-old man complained of chest pain, radiating to the tip of the left shoulder. He was diagnosed to have pericarditis. The most likely nerve causing the referred pain is the

a)

intercostal nerve

b)

phrenic nerve

c)

recurrent laryngeal nerve

d)

sympathetic nerve

e)

vagus nerve

3.

A 40-year-old poultry farmer was planned for thoracocentesis due to pleural effusion. Select the most likely site to perform the procedure.

a)

Fourth left intercostal space at the midclavicular line

b)

Ninth left intercostal space at the midaxillary line

c)

Second left intercostal space at the midaxillary line

d)

Seventh left intercostal space at the midaxillary line

e)

Sixth left intercostal space at the midclavicular line

4.

During a lobectomy procedure, a surgeon needs to separate the pleura from the thoracic wall. Select the most likely layer that provides the natural cleavage plane for this separation.

a)

Endothoracic fascia

b)

Innermost intercostal muscle

c)

Internal intercostal muscle

d)

Parietal pleura

e)

Superficial fascia

5.

This abdominal horizontal plane is used as a landmark during locating a suitable vertebral level prior to performing lumbar puncture. The most likely plane described is the

a)

subcostal plane

b)

supracristal plane

c)

transpyloric plane

d)

transtubercular plane

e)

transumbilical plane

6.

A houseman tried to locate the internal jugular vein in the triangle of the neck to measure the jugular venous pressure in a patient with heart failure. Select the most likely structures that form this triangle.

a)

Anterior border of trapezius, posterior border of sternocleidomastoid muscle and inferior belly of omohyoid

b)

Body of hyoid, bilateral anterior belly of digastric muscles

c)

Inferior border of mandible, anterior and posterior belly of digastric muscles

d)

Superior belly of omohyoid, anterior border of sternocleidomastoid muscle and median line of the neck

e)

Superior belly of omohyoid, posterior belly of digastric, anterior border of sternocleidomastoid muscle

7.

This deep cervical fascia encircles the neck and encloses both the parotid and submandibular glands. It thickens to form the stylomandibular ligament. Select the most likely feature of this fascia

a)

It blends with the pericardium

b)

It encloses the trapezius muscle

c)

It forms the anterior wall of the carotid sheath

d)

It forms the axillary sheath laterally

e)

It fuses with the endothoracic fascia

8.

A 15-year-old student was bitten by a stray cat on the medial side of her forearm and developed low grade fever. Later, she noticed a lump in the axilla. The most likely affected group pf lymph node is the

a)

apical lymph nodes

b)

central lymph nodes

c)

lateral lymph nodes

d)

pectoral lymph nodes

e)

subscapular lymph nodes

9.

A 40-year-old motorcyclist sustained a midshaft fracture of the humerus following MVA. Physical examination revealed inability to extend the wrist with intact elbow joint extension. Select the most likely reason.

a)

Lateral head of triceps arises above the spiral groove

b)

Long head of triceps arises from the infraglenoid tubercle of the scapula

c)

Long head of triceps receives its innervation proximal to the site of lesion

d)

Medial head of triceps arises below the spiral groove

e)

Triceps recieves dual innervation

10.

A 22-year-old footballer suffered injury to his right thigh during a match. He was unable to flex his right hip and knee joints. The most likely muscle involved is the

a)

rectus femoris

b)

sartorius

c)

vastus intermedius

d)

vastus lateralis

e)

vastus medialis

11.

A group of students were discussing the derivatives of the aortic arches. The most likely derivative of the third aortic arch is the

a)

first part of internal carotid artery

b)

hyoid artery

c)

maxillary artery

d)

right subclavian artery

e)

stapedial artery

12.

A denstist performed a nerve block. Following this, the mucous membrane of the lower lip and the skin of the chin was anaesthetised. The most likely nerve which has been blocked is the

a)

buccal nerve

b)

inferior alveolar nerve

c)

marginal mandibular nerve

d)

mental nerve

e)

superior alveolar nerve

13.

A carotid bypass was performed on the common carotid artery in a 50-year-old man. In order to access the artery, the carotid sheath was opened. The most likely structure found within the carotid sheath is the

a)

accessory nerve

b)

ansa cervicalis

c)

external jugular vein

d)

internal jugular vein

e)

phrenic nerve

14.

A 25-year-old college student had diplopia while reading. The ophthalmologist observed that the patient was unable to abduct and laterally rotate the eyeball. The most likely affected muscle is the

a)

inferior oblique

b)

inferior rectus

c)

medial rectus

d)

superior oblique

e)

superior rectus

15.

During cranial nerve examination, the gag reflex of a patient was found to be absent. The most likely nerve affected is the

a)

facial nerve

b)

hypoglossal nerve

c)

trigeminal nerve

d)

vagus nerve

e)

vestibulocochlear nerve

16.

Laryngoscopic examination in a 60-year-old patient revealed loss of abduction of the vocal cords. The most likely muscle affected is the

a)

cricothyroid

b)

lateral cricoarytenoid

c)

posterior cricoarytenoid

d)

thyroarytenoid

e)

vocalis

17.

A 21-year-old male was diagnosed with hyperacusis due to paralysis of the stapedius muscle. The most likely nerve involved is the

a)

auriculotemporal nerve

b)

facial nerve

c)

glossopharyngeal nerve

d)

greater auricular nerve

e)

vestibulocochlear nerve

18.

A 45-year-old chronic smoker presented with a non healing ulcer of the lateral border of the tongue on the right side. Neck palpation showed that the malignant mass had spread to the draining lymph nodes. Select the most likely group of lymph nodes involved.

a)

deep cervical

b)

jugulodigastric

c)

jugulo-omohyoid

d)

retropharyngeal

e)

submandibular

19.

A 35-year-old male was diagnosed with sphenoid meningioma. This mass compressed structures passing through the left superior orbital fissure. The most likely structure affected is the

a)

branches of the middle meningeal artery

b)

infraorbital nerve

c)

lacrimal nerve

d)

ophthalmic vein

e)

supratrochlear nerve

20.

Motor nerve supply to the pharynx is derived from the pharyngeal plexus. All muscles of the pharynx are supplied by the vagus nerve except the stylopharyngeus. The most likely nerve which supplies this muscle is the

a)

accessory nerve

b)

glossopharyngeal nerve

c)

hypoglossal nerve

d)

mandibular nerve

e)

superior laryngeal nerve

21.

A 25-year-old female was admitted to the emergency department following an MVA. CT scan of the head revealed a lens shaped hematoma at the right lateral side. Select the most likely affected blood vessel.

a)

Anterior communicating artery

b)

Middle cerebral artery

c)

Middle meningeal artery

d)

Superior cerebral vein

e)

Superior sagittal sinus

22.

A 45-year-old man presented with severe headache and blurring of vision. A CT of the head revealed distension of the lateral ventricle on the left side due to presence of a tumour. Select the most likely site of obstruction of the ventricular system

a)

central canal of the spinal cord

b)

cerebral aqueduct

c)

foramen of Luschka

d)

foramen of Magendie

e)

interventricular foramen

23.

This dural septum is a sickle shaped fold that lies in the midline between the two cerebral hemisphere. The dural venous sinus within its free inferior margin is most likely the

a)

inferior sagittal sinus

b)

sigmoid sinus

c)

straight sinus

d)

superior sagittal sinus

e)

transverse sinus

24.

A 50-year-old male experience difficulty in looking to his side mirror while driving. Examination revealed involvement of an extraocular muscle responsible for abduction of the eye. The most likely nerve affected is the

a)

abducent nerve

b)

oculomotor nerve

c)

optic nerve

d)

trigeminal nerve

e)

trochlear nerve

25.

A 40 year-old male had paralysis of the muscles of facial expression at the left lower half of his face. A diagnosis of right upper motor neuron facial nerve palsy was made upon further examination. Select the best explanation for this patient's presentation

a)

Its lower motor neurons are located in main motor nucleus

b)

Its main motor nucleus is located deep in the reticular formation of the lower part of the pons

c)

Its upper motor neurons are located in the primary somatomotor cortex

d)

Lower part of the facial nucleus receives corticonuclear fibres from opposite cerebral hemisphere

e)

Upper part of the facial nucleus receives corticonuclear fibres from both cerebral hemisphere

26.

A patient with temporal bone fracture presented with dryness of the eye secondary to dysfunction of the lacrimal gland on the affected side. The cell bodies of postganglionic parasympathetic axons supplying the lacrimal gland are most likely in the

a)

ciliary ganglion

b)

geniculate ganglion

c)

otic ganglion

d)

pterygopalatine ganglion

e)

trigeminal ganglion

27.

Musculature of this arch includes the posterior belly of digastric and stylohyoid muscles. Select the most likely cranial nerve associated with this arch.

a)

Facial nerve

b)

Glossopharyngeal nerve

c)

Recurrent laryngeal nerve

d)

Superior laryngeal nerve

e)

Trigeminal nerve

28.

Pituitary hormones are not synthesized in the pituitary glands but in the neurosecretory cells located in the paraventricular nucleus of hypothalamus. Select the most likely site where the hormones will be transported by the axons.

a)

Infundibulum

b)

Pars distalis

c)

Pars intermedia

d)

Pars tuberalis

e)

Posterior lobe

29.

Fractures of this bone of the skull causes deleterious effect on the pituitary gland, leading to post traumatic endocrine dysfunction. The most likely bone which lodges this gland is the

a)

ethmoidal bone

b)

frontal bone

c)

lacrimal bone

d)

maxillary bone

e)

sphenoid bone

30.

This structure of the brainstem lies between the anterior median fissure and the anterolateral sulcus. It is composed of bundles of corticospinal tracts. The structure which best fits the above description is the

a)

basilar groove

b)

cuneate tubercle

c)

gracile tubercle

d)

olive

e)

pyramid