A 36-year-old woman is hospitalized for treatment of a stomach ulcer that has been getting progressively worse over several months. Radiographic studies reveal the site of involvement to be along the greater curvature, approximately 4cm away from the pyloric sphincter. That night, the ulcer perforates, and there is considerable intra-abdominal bleeding. Surgery reveals that the ulcer has eroded through the stomach wall and has damaged the artery supplying the involved region of the stomach. Which artery was likely involved?

A woman who recently gave birth has elevated prolactin levels. The gland responsible for secretion of this hormone is derived from which of the following structures?

A previously normal 56-year-old woman comes to the emergency department because of a "flu-like" illness. She complains of nausea and vomiting, unilateral tingling in the leg, and a headache involving the eye and forehead. She is alert and fully oriented. Motor, sensory, gait, and coordination examinations are normal. Cranial nerve examination is normal, aside from the visual field disorder indicated in the plot below. The neurologic examination suggests an occlusion of which of the following vessels?

A 49-year-old Vietnamese man is diagnosed with tuberculosis. On physical examination, large flocculent masses are noted over the lateral lumbar back, and a similar mass is located in the ipsilateral groin. This pattern of involvement strongly suggests an abscess tracking along which of the following muscles?

A 24-year-old man is stabbed in the neck. Neurologic examination reveals left-sided hemiparesis. There is complete loss of discriminatory joint position and vibration sensation below C8 on the left side. On the right side, there is loss of pain and temperature sensation below C8. It ca be expected that an MRI of the cervical spinal cord will show which of the following findings?

A 2-year-old boy is brought to the pediatrician by his mother because he has had several episodes of rectal bleeding. Evaluation with a technetium-99m perfusion scan reveals a 3-cm ileal outpouching located 60cm from the ileocecal valve. This structure most likely contains which of the following types of ectopic tissue?

A 34-year-old man is examined in the prison infirmary after sustaining a superficial stab wound to the superolateral aspect of the thoracic wall at the level of the third rib. There is little bleeding and no difficulty breathing; however, the medial border of the scapula on the injured side pulls away from the body wall when the arm is raised. In addition, the arm cannot be abducted above the horizontal. Which of the following muscles is paralyzed?

A histologist is examining cells arrested at various stages of oogenesis. He discovers a follicle within the stroma of the ovary that has developed an antrum. This follicle would be classified as

A 54-year-old man has cirrhosis, with obstruction of the portal circulation within the liver. Portal blood could still be conveyed to the caval system via which of the following?

A 47-year-old man presents to his neurologist with an unsteady, broad-based gait and slow, slurred speech. Neurologic examination reveals dysdiadochokinesia, intention tremor, hypotonia, and nystagmus. The patient's lesion in a brain structure that derives from which of the following embryonic structures?

A 47-year-old woman with a history of rheumatic fever is examined by her physician. Physical examination is significant for a low-pitched, rumbling, diastolic murmur preceded by an opening snap. The affected valve can be best evaluated by auscultation at which of the following locations?

A newborn girl is noted to hae abnormal accommodation of the lens. Further evaluation reveals an abnormal production of aqueous humor. A malformation of the structure responsible for these functions that is continuous posteriorly with the choroid might be due to abnormal development of

A neuroscientist decides to perform a study that requires him

to increase the concentration of norepinephrine in the cortex of an

animal subject. He does this by electrically stimulating a nucleus

in the brain. Which of the following nuclei is the most important

source of noradrenergic innervation to the cerebral cortex?

A surgeon tells a medical student to tap the side of the face of

a patient who just had thyroid surgery. The surgeon is most

worried about damage to which of the following vessels?

A 45-year-old man comes into the emergency department

with abdominal pain that has progressively worsened since the

previous night. He also notes nausea and vomiting, but is afebrile.

Upper gastrointestinal radiographic studies reveal that a loop of

small intestine has passed through the epiploic foramen into the

omental bursa and is constricted by the margins of the foramen as

the intestine fills. The constriction should not be surgically

relieved by opening the epiploic foramen because this procedure

would risk cutting the

A 26-year-old man is stabbed in the left chest during a bar

brawl. Several days after he is treated, he returns to the physician

complaining of decreased function in his left arm. Physical

examination reveals a winged left scapula and an inability to raise

his left arm above the horizontal. Which of the following nerves

is most likely affected?

A patient is transported to the emergency department with a

knife wound to the right fifth intercostal space at the midaxillary

line. Which of the following structures is likely to have been

damaged?

A couple comes to the physician for advice about

contraception and family planning. The physician provides advice

about various methods of birth control. While discussing the

option of using an intrauterine device, a discussion of the process

of implantation comes up. At what stage of embryonic

development does an embryo normally begin to implant in the

endometrium?

A newborn male is found to have urethral openings along the

ventral surface of the penis. The physician explains to the parents

that the bilateral structures that should have fused in the midline

failed to fuse completely, and this resulted in the defect. The

parents are very concerned, but the physician reassures them that

this can easily be surgically corrected. Which of the following

structures in a female normally develop from the same structures

that failed to fuse in this boy?

A 19-year-old woman comes to the emergency department

after falling while on roller-blades. There is a 3-cm laceration

over the lateral aspect of the knee penetrating so deep that the

head of the fibula is apparent. A radiograph of the leg is negative

for any fractures. A noticeable foot-drop occurs while the patient

walks. Further examination reveals inability to dorsiflex or evert

the foot. Which of the following best explains her injury?

A resident physician is performing a pelvic examination on a

young woman. The fingers of one of her hands are in the patient’s

vagina, palpating the cervix. The other hand is pressing on the

abdomen. With the palm of this hand, the physician feels a bony

structure in the lower midline. This structure is most likely the

A 45-year-old man with a history of stable angina presents to

the emergency department with an episode of chest pain that is

not relieved by rest or nitroglycerin. After stabilization in the

telemetry unit for 2 days, he undergoes a thallium stress test. The

results show reduced perfusion of the lateral wall of the left

ventricle. Which artery is most likely occluded?

A 41-year-old man is injured in a motorcycle accident. He is

taken to the hospital by a rescue helicopter and treated for

abdominal, spinal, and head injuries. Three weeks later he is

examined by a neurologist, who notes that the patient has leftsided

facial swelling and discoloration, slight drooping of the left

eyelid, and a constricted pupil on the left side. There are no other

motor or sensory abnormalities. Which of the following is the

most likely cause of this patient’s ocular disorder?

A 4-day-old boy is brought to the pediatric clinic because of

breathing difficulties and poor feeding. He coughs, chokes, and

spits up milk very soon after beginning to suckle. Physical

examination and radiographs reveal the presence of the most

common type of tracheoesophageal fistula. The infant’s defect

likely resulted from

A 40-year-old man complains of loss of sensation over the

right scrotum and on the medial right thigh. Damage to which of

the following nerves would result in such symptoms?

A neonate has a prominent defect at the base of his spine

through which his meninges and spinal cord protrude. A failure of

which of the following processes is the most common cause of

this type of defect?

A surgeon is first on the scene after a serious automobile

accident. He finds a passenger bleeding profusely from the neck

and correctly surmises that the bleeding is from the carotid artery.

To control the bleeding, the surgeon can compress the carotid

artery against the anterior tubercle of which of the following

vertebrae?

An intravenous pyelogram is performed on a patient to

evaluate the function and structure of her kidneys. Examination of

the resulting radiographs reveals that the left kidney is normal but

that there is a duplication of the ureter and renal pelvis on the

right side. Further testing reveals that kidney function is normal.

This variation is a result of abnormal development of which of the

following structures?

MRI reveals that a 62-year-old man has a brain tumor

growing in his interhemispheric fissure at the level of the central

sulcus. The tumor produces neurologic dysfunction of the

cerebral cortex on either side of the tumor. A neurologic

examination of this patient would most likely reveal

Brunner’s glands secrete an alkaline product that helps

achieve optimal pH for the activity of pancreatic enzymes. Where

are these glands located?

A 24-year-old man presents with pain in his right wrist that

resulted when he fell hard on his outstretched hand. Radiographic

studies indicate an anterior dislocation of a proximal row carpal

bone that articulates with the most lateral proximal row carpal

bone. Which of the following bones was dislocated?

The femoral triangle is bounded superiorly by the inguinal

ligament. Which of the following structures form the lateral and

medial borders of the femoral triangle?

A 43-year-old woman is diagnosed with a condition that

causes excruciating pain near her nose and mouth. The involved

nerve innervates which of the following branchial arches?

An infant is born with an abnormally developed falciform

ligament. The hepatogastric and hepatoduodenal ligaments are

also malformed. These developmental anomalies are most likely

due to abnormal development of the

An autopsy is performed on a man who died of an unknown

cause. The pathologist discovers that the man has a small atrial

septal defect. The defect is seen in the portion of the atrial septum

near the upper border of the fossa ovalis. Which of the following

was the likely functional manifestation of this defect during life?

A 6-year-old boy is brought to the office for evaluation of a

neck mass. His mother reports that he first developed the mass 3

days ago, and it has not resolved. Further questioning reveals that

he has recently recovered from a viral upper respiratory infection.

He is otherwise healthy and is up to date on all recommended

vaccinations. Physical examination shows a 2-cm neck mass in

the midline immediately above the thyroid cartilage notch. The

mass elevates when he sticks his tongue out of his mouth. Which

of the following is the most likely diagnosis?

When removing an impacted mandibular third molar, the oral

surgeon must warn the patient of possible lasting numbness of the

tip of the tongue. This loss of general sensation is due to damage

to the

A resident physician is demonstrating the correct technique

for inserting a subclavian central venous line. He has a medical

student palpate the clavicle, then the chest wall below it. The first

bony structure that can be palpated below the inferior margin of

the medial portion of the clavicle is the

A 34-year-old woman bursts through the doors of the

emergency department. She is straining to take a breath but can

only mouth the phrase: “I can’t br—” before collapsing. She is

placed on a stretcher. Her tongue is swollen and protruding from

her mouth. The patient has only minimal air movement with bagmask

ventilation. Oxygen saturation is approximately 80%.

Attempts at oral intubation are unsuccessful due to massive soft

tissue edema of her pharynx. A decision is made to perform a

cricothyrotomy. The necessary instrument tray is collected, and

the patient’s neck is quickly prepped. After palpating the neck to

identify the appropriate landmarks, an incision should be made at

which of the following locations?

An infant born to an alcoholic mother had microcephaly and

cardiac abnormalities and died despite resuscitative efforts.

During which of the following periods of pregnancy is alcohol

most teratogenic?

A 15-year-old girl with a history of chronic rhinitis, allergy,

asthma, and nasal polyposis presents with fever and dental pain.

She is diagnosed with maxillary sinusitis. Mucopurulent exudate

would be most likely to drain through an ostium in the

A patient presents to the physician complaining of “something

wrong with her foot” that causes her to trip and fall. Physical

examination reveals an inability to dorsiflex (extend) the foot and

a loss of sensation between the first and second toes. There is no

other motor or sensory loss. Which of the following nerves was

most likely injured?

During a routine physical examination, a 71-year-old man is

found to have a 7-cm pulsatile mass deep in the abdomen,

between the xiphoid and the umbilicus. He has a history of

untreated hypertension. The endothelial lining of the affected

structure is composed of which of the following tissue types?

One week following a sexual encounter at a ski resort in

Colorado, a young woman develops a painful, swollen knee joint.

The emergency department physician suspects gonococcal

arthritis and wants to confirm this by sending joint fluid for

bacterial culture. He uses the standard suprapatellar approach and

passes a needle from the lateral aspect of the thigh into the region

immediately proximal to the patella. Through which of the

following muscles does the needle pass?

A 67-year-old man has an abnormal neurologic exam. An

electroencephalogram is subsequently performed and reveals

delta waves over his left frontal lobe. Which of the following was

the most likely abnormal finding on his neurologic exam?

A 23-year-old woman wearing high-heeled shoes inverts and

sprains her ankle while running down a flight of stairs. Which of

the following ligaments did she most likely injure?

A surgeon performing an appendectomy makes an incision

through the ventrolateral abdominal wall. The layers of the

abdominal wall are shown below.

1. Internal oblique

2. External oblique

3. Peritoneum

4. Transversus abdominis

Which of the following corresponds to the order of

penetration of the layers of the abdominal wall?

A 49-year-old woman comes to the emergency department

because of right upper quadrant pain, nausea, vomiting, and fever.

She also complains of pain in her right shoulder. A right upper

quadrant ultrasound reveals multiple gallstones and

pericholecystic fluid. Which of the following dermatomes is most

likely involved in her shoulder pain?

A 57-year-old man has hematuria and left-sided flank pain.

Diagnostic studies show a left-sided renal mass with extension

into the renal vein. A radical nephrectomy is performed, and the

specimen is sent for pathologic evaluation. Which of the

following structures present in this patient’s specimen is lined

with epithelium derived from mesoderm of the ureteric bud?

A woman comes to the physician for a prenatal visit.

Examination reveals that her uterus is considerably larger than her

gestational age would predict. An ultrasound examination is

ordered and reveals that she has polyhydramnios. Which of the

following congenital defects of the fetus would be most likely to

be associated with this abnormality?

A gastric biopsy is performed on a 42-year-old man. As the

pathologist inspects the specimen, he observes numerous, normal

cuboidal-to-columnar cells with apical membrane-bound

secretion granules in the gastric glands. From which area of the

stomach was the biopsy specimen most likely taken?

During a football game, a player sustains a powerful blow to

the lateral side of his weight-bearing leg. He experiences

excruciating knee pain and is unable to walk. The three structures

most likely to be injured are the

A mother brings her 5-year-old daughter to the physician

complaining that the child still seems to regularly wet herself

despite having been toilet-trained. The physician orders an IV

pyelogram, which demonstrates a complete duplication of the

ureter on the right side. Although one ureter opens normally into

the bladder, the other opens ectopically into the vagina. This

congenital anomaly is caused by

A newborn baby is observed to be cyanotic immediately after

birth. Diagnostic studies, including an ultrasound, reveal that the

baby has persistent truncus arteriosus. Which of the following

additional defects is this baby most likely to have?

A 61-year-old woman undergoes surgery to remove a solitary

painless mass just anterior to the tragus of her left ear. Pathologic

examination shows a wellcircumscribed, yellowish-white tumor

with a proliferation of epithelial and myoepithelial cells in duct

formations within a background of loose myxoid tissue. During

the surgery, particular attention is paid to the nerve that exits the

skull via the stylomastoid foramen, passes lateral to the styloid

process, and then enters this affected structure. Injury to the lower

division of this nerve during surgery will most likely result in

An arteriogram is performed on a patient with atherosclerosis.

Luminal narrowing of which of the following vessels would

compromise blood flow through the renal arteries?

Nissl bodies correspond to which of the following cytoplasmic organelles?

A 42-year-old man undergoes surgery for medullary

carcinoma of the thyroid. After the surgery, he complains of a

“noisy quality” to his voice. This condition was most likely

caused by damage to the

After an amniocentesis, a 29-year-old woman who is carrying

twins learns that one fetus has XY chromosomes and the other

has XX chromosomes. At 37 weeks’ gestation, the woman

delivers two healthy babies. Which of the following structures is

likely to be present in the baby with the XY chromosomes but not

in the one with XX chromosomes?

During an automobile accident, a person sustains a “broken

neck” and dies after a small bony fragment is driven into his

spinal cord. From which of the following bones was this fragment

most likely derived?

A patient is complaining of difficulty swallowing. A barium

contrast x-ray shows a constriction of the esophagus at the level

of the third thoracic vertebra. An aortogram shows that the patient

has a double aortic arch. Which of the following developmental

abnormalities explains this finding?

Because she is too weak to go to the cafeteria, a 93-year-old

nursing-home resident on a liquid diet is fed in bed. She refuses to

sit up, so the aide has to feed her while she is lying on her back.

Halfway through the feeding, the patient aspirates the liquid and

subsequently develops pneumonia. Which of the following is the

most likely site of this pneumonia?

A patient has a tiny (0.2 cm) but exquisitely painful tumor

under the nail of her index finger. Local anesthetic block to a

branch of which of the following nerves would be most likely to

provide adequate anesthesia for the surgical removal of the mass?

A 3-year-old boy has repeated episodes of sore throat and

fever. He undergoes surgery to remove collections of lymphoid

tissue that lie on each side of the oropharynx between the

palatoglossal and palatopharyngeal arches. The removed

structures developed from which of the following pharyngeal

pouches?

A 35-year-old woman with severe dysmenorrhea and

prolonged menstrual periods due to large uterine fibroids

undergoes a hysterectomy. Which of the following structures is

the gynecologist most likely to inadvertently ligate during

surgery?

A pregnant woman comes to her physician with questions

about the effect that ingested substances may have on her unborn

child. The physician explains that large molecules do not pass

between the mother and fetus because of the placental barrier. The

physician adds that fetal blood is in the fetal blood vessels of the

villi of the placenta and the mother’s blood is in the maternal

blood vessels, and that these blood vessels do not connect. The

placental villi are formed from which of the following cells?

A 32-year-old man complains of progressive, severe,

generalized headaches that began 3 months ago, are worse in the

mornings, and lately have been accompanied by projectile

vomiting. He has also lost his upper gaze, and on physical

examination the upper part of the sclera is visible above the

downward looking irises. Which of the following is the most

likely diagnosis?

A prostate-specific antigen (PSA) level is drawn from a 54-

year-old man as part of a routine health evaluation. Which of the

following embryonic structures gives rise to the organ being

screened for carcinoma?

A football player is examined by the team physician following

a shoulder injury during a game. Preliminary x-ray films show an

inferior dislocation of the humerus. On further examination, there

is weakness in lateral rotation and abduction of the arm. The

nerve most likely affected is the

During anatomy laboratory, a first-year medical student is

dissecting the atrial chambers of the heart. At the upper border of

the fossa ovalis, she discovers a small opening through which the

tip of her probe can be passed from the right into the left atrium.

The laboratory instructor identifies this as a probe patency of the

atrial septum. This probe patency resulted from which of the

following developmental events?

A 20-year-old man is stabbed immediately to the left of the

body of the sternum at the fifth intercostal space. The knife most

likely penetrated the

A 5-month old girl has fatigue on exertion. She was born at

full-term with a birth weight of 9 lb and had an uncomplicated

perinatal period. She has been bottlefed, and there have been no

feeding problems. She is alert and appears well. Physical

examination reveals a loud holosystolic murmur in the left

parasternal region with an associated systolic thrill. The first and

second heart sounds are normal. There is no gallop or diastolic

murmur. Her blood pressure is normal in all four extremities, and

she has palpable peripheral pulses. There is no peripheral edema

or cyanosis. Which of the following is the most likely diagnosis?

An elderly woman with osteoporosis is taken to the

emergency department following a fall. One of her legs appears

shortened and is externally rotated. A fracture of which part of the

femur is suggested by these findings?

An otherwise healthy first-year medical student visits the

student health office for a physical examination. He is taking no

medications. He is concerned because he has noticed several

painless uniform “large bumps” at the back of his tongue. These

are most likely

An oblique x-ray view of a patient with right middle lobar

pneumonia demonstrates an area of consolidation bounded by

sharp, intersecting, relatively straight lines above and below.

These lines correspond to which of the following?

During an interview, a 34-year-old psychiatric patient

suddenly becomes aggressive. The patient is quickly taken to a

quiet, private room and given an intramuscular injection of

haloperidol in the upper outer quadrant of the buttock. The

injection is given at this specific location to prevent damage to

which of the following nerves?

A 21-year-old man is brought to the hospital by emergency

medical technicians after he was involved in a car accident.

Examination reveals a clear fluid draining from his left ear.

Laboratory studies confirm that the fluid is cerebrospinal fluid.

Which of the following is the most likely site of trauma that has

resulted in the leakage of this fluid?

During a bar fight, a 20-year-old man is stabbed with an ice

pick. The weapon passes through the superior orbital fissure.

Which of the following is most likely to be severed as the ice pick

passes through this fissure?

A patient presents to the emergency department after

sustaining a laceration of the first web space of his hand in a rockclimbing

accident. Which of the following structures is also likely

to be injured?

After a motor vehicle accident, a patient is brought to the

emergency room. X-rays reveal that she has fractures of her left

ninth and tenth ribs. She has a rapid heart rate and low blood

pressure. Peritoneal lavage reveals free blood in the peritoneal

cavity. A surgeon is able to stop the bleeding by placing a clamp

across which of the following structures?

A football player experiences an anterior dislocation of the

shoulder. Cutaneous sensation over the lower half of the deltoid

muscle is impaired. These findings suggest damage to which of

the following nerves?

A 45-year-old garbage collector has severe neck pain and

weakness in his left upper extremity. He has gotten no relief from

over-the-counter medications. He denies any history of trauma.

On examination the patient is thin and walks with his neck tilted

to the left side. The patient has limited neck flexion and extension

secondary to pain. The patient has a normal motor and sensory

examination of all extremities, with the exception of the left upper

extremity. His left radial forearm and thumb are numb to the

touch (decreased sensation to light touch). The patient has a

decreased brachioradialis reflex and slight weakness of his wrist

extensors. Plain radiographs appear normal. Which of the

following is the most likely diagnosis?

A patient with a left adrenal mass is scheduled for surgery.

The surgeon is planning to approach the suprarenal area by

removing the twelfth rib. With this approach, the surgeon should

take particular care to avoid damaging which of the following

structures?

A 45-year-old man has an obvious mass on the right side of

his face. It is determined that he has a benign tumor of the parotid

gland, and the tumor is excised. After surgical excision of the

tumor, it is noted that the patient’s mouth droops on the right side

and, when asked to smile, his smile is asymmetrical. The patient

is able to open and close both eyes normally and can wrinkle his

forehead symmetrically and raise both eyebrows. Sensation is

normal on both sides of his face. Which of the following is the

most likely cause of the findings?

During anatomy lab, a medical student notes a fibrous band

that runs on the visceral surface of the liver. It is attached on one

end to the inferior vena cava and on the other end to the left

branch of the portal vein. In the embryo, this structure

corresponds to the

While examining a newborn baby in the nursery, a physician

notes that urine is draining from the umbilicus. Contrast dye is

introduced into the bladder through the urethra, and it is

confirmed radiologically that dye is passing to the umbilicus.

Which of the following embryonic structures has abnormally

persisted in this patient?

A 4-year-old boy with recurrent urinary tract infections is

evaluated for renal/urinary tract abnormalities with a voiding

cystourethrogram (VCUG). Reflux is discovered, so an

intravenous pyelogram (IVP) is performed. The renal anatomy

appears normal. On the IVP, which of the following structures

would have been seen emptying into the renal pelvis?

A neonate is observed to have a small notch in the transitional

zone and a vermillion border of the lip. Which of the following is

the most likely etiology of this malformation?

A patient’s left hypoglossal nerve (CN XII) is injured during a

carotid endarterectomy. Which of the following would most likely

result from this injury?

During a physical examination a physician elicits a pupillary

light reflex by shining a light into a patient’s eye. The iris

contracts, thereby constricting the pupil. Where are the cell bodies

of the preganglionic neurons found that are responsible for this

response?

A 69-year-old woman fractures her humerus during a motor

vehicle accident. Which of these types of bone will most likely be

seen in a biopsy taken from the healing area?

A 58-year-old man with lymphoma has shortness of breath

and chest pain. A chest x-ray shows bilateral blunting of the

costophrenic angle. A thoracocentesis is performed. During this

procedure, it is important to pass the needle immediately above

the rib to prevent damage to which of the following structures in

the subcostal groove?

A newborn boy does not pass meconium until 48 hours after

his birth. Several weeks later his mother complains that he has not

been passing stool regularly. Anorectal manometry reveals

increased internal anal sphincter pressure on rectal distention with

a balloon. The patient’s disorder may be attributed to

A 38-year-old woman slips on an icy sidewalk and falls,

hitting the ground with her right elbow. She reports that she is

experiencing severe pain in her upper limb. Examination reveals

that she cannot extend her hand at the wrist. She has diminished

sensation on the lateral portion of the dorsum of her hand. Which

of the following is the most likely site of her fracture?

An infant is brought to the emergency department with a

temperature of 40° C (104° F). The physician notes that the infant

has a “bulging anterior fontanelle.” The third-year medical

student reads the physician’s note and wants to evaluate this

physical finding, but she forgot where the anterior fontanelle is. In

evaluating this finding, the medical student should look for which

of the following anatomic landmarks?

A 63-year-old man has blood-streaked stools and constipation.

Barium enema shows a right-sided obstructing lesion. Surgery is

performed, and pathologic evaluation reveals a welldifferentiated,

colonic adenocarcinoma. Observation of a

hematoxylin and eosin-stained microscopic slide from the

specimen reveals that the nuclei of the cells are blue. What is the

basis for this observation?

On physical examination, the upper body of a 7-year-old boy

appears much more developed than his lower body. Blood

pressure in the upper extremities exceeds that of the lower

extremities. On cardiac examination, there is a midsystolic

murmur over the anterior chest and back. The child’s lower

extremities are cold, and femoral pulses are absent. The part of

the vascular system that is affected in this disorder is derived

from which of the following embryologic structures?

A urologist performs a cystoscopy to examine the bladder and

the openings of the ureters into the bladder. After distention of the

bladder with air, the physician slowly passes the cystoscope up

the urethra into the bladder. In which direction should she turn the

head of the cystoscope to see the ureteric orifices and examine for

blockage?

After receiving a punch to the left eye, a 16-year-old boy

complains of double vision. During clinical testing, he has

difficulty when asked to look medially, inferolaterally,

superolaterally, and superomedially. The affected muscles are

derived from which of the following structures?

Which of the following structures constitutes part of

the ventricles of the heart?

the nucleus that lies immediately medial (and deep) to the uncus is the

which of the following is a derivative of second pharyngeal arch?

which of the following renal structures is most medially located?

Which of the following veins empties into the left renal vein?

an infant is born with an abnormally developed falciform ligament. the hepatogastric and hepatoduodenal ligaments are also malformed. these developmental anomalies are most likely due to abnormal development of the

The interlobular arteries of the kidney result from subdivision of the

the septum transversum in the fetus gives rise to which of the following adult structures?

the primordium of the respiratory system that forms the internal epithelial lining of the trachea, bronchi, and lungs is derived entirely from which of the following embryologic entities?

the endothelial lining of the aorta is composed of which of the following tissue types?

a patient with acute cholecystitis experiences referred pain to the right shoulder. which of the following dermatomes is most likely involved?

which of the following embryonic structures gives rise to the adrenal cortex?

which of the following is the embryologic precursor of the fibrous remnant that runs in a fissure on the visceral surface of the liver?

following thyroidectomy, hoarseness of the voice may occur. this condition is caused by damage to the

which of the following pharyngeal pouches develops into the palatine tonsil?

a 35yo woman with severe dysmenorrhea and prolonged menstrual periods due to large uterine fibroids undergoes a hysterectomy. which of the following structures is the gynecologist most likely to inadvertently ligate during surgery?

which of the following structure does the fetal allantoic duct become in the adult?

most afferents to the cerebral cortex derive from the

which of the following fibers provide the only output from the cerebellar cortex?

early degeneration of the ureteric bud results in which of the following congenital renal abnormalities?

the hippocampus projects to the mammillary bodies via which of the following structures?

the intraembryonic mesoderm is formed during the 3rd week of embryonic life is principally derived from

which of the following prevents hyperextension of the knee?

which of the following hormones is secreted by ant. pituitary cells that stain with acidic dyes?

a neonate is observed to have a cleft lip. which of the following is the most likely etiology of this malformation?

incomplete fusion of the embryonic endocardial cushions can produce which of the following congenital defects?

a newborn boy does not pass meconium until 48 hours after his birth. several weeks later his mother complains that he has not been passing stool regularly. anorectal manometry reveals increased internal anal sphincter pressure on rectal distention with a balloon.the patient's disorder may be attributed to

a blockage of the cerebral aqueduct will produce an increase in pressure initially in the