Download Spring 03

Systemic Anatomy Exam IV
Prepared especially for the trimester one class, Spring 2003
Please place the single best answer in the space provided (unless designated by the letters MACA, which in this
case mark all correct answers that apply) on your scantron sheet. The faculty will not answer any of your
questions (unless you find a typo) once the exam begins, as interpretation of the question is a part of the
examination. Good luck.
FORM A
A 51 year old man suffers an injury to the right shoulder during an automobile accident. An AP
radiograph of the right shoulder reveals an anterior shoulder dislocation in which the head of the
humerus lies in a subglenoid position. You perform a physical exam and determine the axillary nerve has
been damaged as a result of this injury.
1) Injury to this nerve could result in which motor or sensory deficit?
a) weakness in extension of the forearm at the elbow against resistance
b) weakness in flexing the forearm at the elbow against resistance
c) partial loss of sensation on the medial aspect of the upper arm
d) weakness in lateral rotation of the humerus against resistance
e) weakness in pronation of the forearm against resistance
2) Injury to this nerve could cause paresis or paralysis of which of the following muscles? (MACA)
a) deltoid m.
b) biceps brachii m.
c) teres major m.
d) teres minor m.
e) pronator teres m.
3) Injury to the above nerve would cause this patient to have the most difficulty _______.
a) adducting the arm at the shoulder joint
b) abducting the arm at the shoulder joint
c) flexing the carpus and digits
d) extending the carpus and digits
4) The above mentioned nerve is derived from what cord of the brachial plexus?
a) posterior cord
b) lateral cord
c) medial cord
d) two of the above
5) Would the head of the humerus in the above mentioned case most likely be medial or lateral to the glenoid
fossa?
a) medial
b) lateral
page 1, SA Exam IV, Q.# 1-5
A 28 year old woman suffers an injury to the left arm during a fall off of her bicycle. Radiographs done
at your clinic show an oblique fracture through the mid-shaft of the humerus.
6) Which nerve is most likely to be injured by the mid-shaft fracture of the humerus?
a) axillary nerve
b) radial nerve
c) median nerve
d) musculocutaneous nerve
e) ulnar nerve
7) Injury to this nerve could result in ALL BUT WHICH ONE of the following motor deficits?
a) weakness in extending the hand at the wrist against resistance
b) weakness in flexing the hand at the wrist against resistance
c) weakness in abducting the hand at the wrist against resistance
d) weakness in adducting the hand at the wrist against resistance
e) weakness in supinating the forearm against resistance
8) Each of the following muscles is a chief abductor or adductor of the hand at the wrist EXCEPT:
a) brachioradialis m.
b) extensor carpi ulnaris m.
c) flexor carpi ulnaris m.
d) extensor carpi radialis longus m.
e) extensor carpi radialis brevis m.
9) The above mentioned nerve is derived from what cord of the brachial plexus?
a) lateral cord
b) medial cord
c) posterior cord
A 23 year old male suffers an injury after a fall while he was skate boarding. Radiographs at your clinic
reveal a displaced fracture of the medial epicondyle of the humerus.
10) Which nerve is most likely involved in the patient with a displaced fracture of the medial epicondyle of the
humerus?
a) axillary nerve
b) radial nerve
c) musculocutaneous nerve
d) ulnar nerve
e) median nerve
11) Injury to the above nerve could result in any of the following deficits EXCEPT:
a) loss of sensation to the skin of the thenar eminence
b) difficulty adducting the hand at the wrist against resistance
c) atrophy of the small muscles of the hand
d) difficulty abducting the fingers against resistance
e) loss of sensation of the skin of the hypothenar eminence
12) The above mentioned nerve is derived from what cord of the brachial plexus?
a) medial cord
b) lateral cord
c) posterior cord
d) two of the above
page 2, SA Exam IV, Q.# 6-12
A 24 year old man is thrown from a pick-up truck during an accident and sustains an injury to the left
neck, shoulder and upper limb. Examination in the emergency room does not reveal any cuts, fractures
or dislocations and he is sent home. The following day he is suffering several maladies and seeks help
from you at your clinic. You do your exam and find the patient has suffer a lateral traction injury to the
superior roots of the brachial plexus.
13) Which of the following signs would not be seen in this patient?
a) dropped left shoulder
b) left scapula falls laterally
c) loss of medial rotators of the humerus
d) paresis of muscles of the anterior aspect of left arm
e) left forearm pronates due to loss of biceps brachii m.
14) Loss of tone to the levator scapulae m. in the above patient indicates damage to _____.
a) the posterior cord of the brachial plexus
b) C5 spinal nerve root
c) the middle trunk of the brachial plexus
d) the suprascapular nerve
e) none of the above
15) Which of the following nerves would NOT be involved in the patient with the above injury?
a) suprascapular nerve
b) musculocutaneous nerve
c) axillary nerve
d) ulnar nerve
e) levator scapulae nerve
A middle aged woman has been a stenographer for the past 20 years. She presents to your clinic
complaining of a problem with her left forearm and hand. You do your exam and find signs and
symptoms consistent with carpal tunnel syndrome.
16) What nerve is involved in this condition?
a) ulnar nerve
b) axillary nerve
c) median nerve
d) radial nerve
e) musculocutaneous nerve
17) This patient described above would most likely have abnormal sensations where?
a) posterior hand
b) lateral aspect of the palmar surface
c) medial aspect of the palmar surface
d) anterior forearm
e) posterior forearm
18) The above mentioned nerve is derived from what components of the brachial plexus?
a) posterior cord
b) lateral cord
c) medial cord
d) two of the above
page 3, SA Exam IV, Q.# 13-18
A 29 year old man sustains a severe nerve compression injury to his left upper leg as a result of a fall
from a motorcycle. Examination of this patient at your office reveals a contusion surrounding the head
and neck of the fibula.
19) Which nerve is susceptible to direct injury by a severe compression force applied to the lateral aspect of the
head and neck of the fibula?
a) common peroneal nerve
b) tibial nerve
c) obturator nerve
d) saphenous nerve
e) femoral nerve
20) Injury to this nerve could result in weakness in all of the following movements, EXCEPT:
a) inversion of the foot
b) eversion of the foot
c) dorsiflexion of the foot
d) flexion of the toes
e) extension of the toes
-------------------------------------------------------------end of case studies--------------------------------------------------21) If I cut the femoral nerve, could I still extend the knee?
a) yes
b) no
22) The chief adductor muscles of the thigh are innervated by the _____.
a) inferior gluteal nerve
b) superior gluteal nerve
c) obturator nerve
d) tibial nerve
e) sciatic nerve
23) The extensor muscles of the thigh are innervated by the _____. (MACA)
a) inferior gluteal nerve
b) superior gluteal nerve
c) obturator nerve
d) tibial nerve
e) common peroneal nerve
24) All of the following muscles are innervated by the tibial nerve EXCEPT:
a) tibialis posterior m.
b) gastrocnemius m.
c) short head of biceps femoris m.
d) flexor hallucis longus m.
e) hamstring portion of the adductor magnus m.
25) All of the following statements concerning the innervation of the muscles of the thigh are correct
EXCEPT:
a) the most powerful flexor of the thigh is innervated by nerves derived from the lumbar plexus
b) all of the extensor muscles of the thigh are innervated by nerves derived from the sacral plexus
c) the chief abductors of the thigh are innervated by nerves derived from the lumbar plexus
d) all of the adductors of the thigh are innervated by nerves derived from the lumbar plexus
e) all of the medial rotators of the thigh are innervated by nerves derived from the sacral plexus
page 4, SA Exam IV, Q. # 19-25
26) If I cut the tibial nerve, could I still flex the knee?
a) yes
b) no
27) Denticulate ligaments are made of ______.
a) dura mater
b) pia mater
c) arachnoid
28) The spinal cord ends at what vertebral level?
a) T1
b) T6
c) L1
d) L6
e) S1
29) Ventral root carries ____ information.
a) motor
b) sensory
30) The roots of the brachial plexus combine to directly form ______.
a) divisions
b) terminal branches
c) trunks
d) cords
31) _______ the level of T6 the medial branch of the dorsal ramus carries predominately sensory information.
a) superior
b) inferior
32) The cervical plexus if formed by the dorsal rami of which of the following spinal nerves?
a) C5,6,7,8,T1
b) C1,2,3,4
c) C4,5,6,7
d) C6,7,8
e) none of the above
33) Which neurons would I find in the greatest concentration in the ventral horn of the spinal cord?
a) pseudounipolar
b) multipolar
c) bipolar
34) Which of the following functional neuron classifications would be found in the sciatic nerve? (MACA)
a) GSE
b) GSA
c) GVE
d GVA
e) SSA
35) The majority of sodium ions are found ___ the cell.
a) inside of
b) outside of
page 5, SA Exam IV, Q.# 26-35
36) The internal voltage at which the neuron will spontaneously depolarize is called _______.
a) resting membrane potential
b) depolarization
c) threshold
d) voltage gaited channels
e) all or none response
37) The influx of chloride ions into a neuron cell will result in a stimulus of ___ strength being required to
cause that neuron to depolarize.
a) greater
b) lesser
38) The dural sac ends at the level of _____.
a) T6
b) L1
c) L3
d) S3
e) there is no such thing as a dural sac
39) Choose the INCORRECT match.
a) depurant – cleansing or purifying
b) edentulous – loose of teeth
c) iatrogenic – of unknown origin
d) fremitus – a palpable vibration
e) juxtaspinal – next to the spine
40) Choose the INCORRECT match.
a) jaundice – icterus
b) melena – a black tar like stool
c) epistaxis – nose bleed
d) enuresis – urea in the blood stream
e) palsy – paralysis
41) Ascending tracts in the posterior funiculus of the spinal cord carry __ information.
a) sensory
b) motor
42) If I was looking for the specific segment of the spinal cord that gives rise to the spinal nerve that exits the
IVF formed between L4 and L5 vertebrae, at what vertebral level would I look?
a) T1
b) T6
c) T12
d) L5
e) S5
43) The branch of the spinal nerve that carries GSE and GSA information from the medial aspect of the palmer
surface of the hand is the _____.
a) rami communicantes
b) dorsal ramus
c) ventral ramus
d) meningeal ramus
e) rami gigglimano
page 6, SA Exam IV, Q. # 36-43
44) The nerve which is motor to the diaphragm is derived from spinal nerves ____.
a) C2,3,4
b) C3,4,5
c) C5,6,7
d) C6,7,8
e) none of the above
45) Looking at a superficial view of the muscles of the posterior scalp, which nerve is most medial?
a) lesser occipital nerve
b) greater auricular nerve
c) greater occipital nerve
d) third occipital nerve
e) scalpus medialis nervus
46) To prevent flexion of the elbow, I would have to cut which of the following nerves? (MACA)
a) radial nerve
b) axillary nerve
c) median nerve
d) ulnar nerve
e) musculocutaneous nerve
47) The nipple is located at what dermatomal level?
a) T1
b) T4
c) T8
d) T12
e) varies from person to person and from male to female
48) For a reflex to be intact, which of the following components must be functioning normally? (MACA)
a) receptor
b) sensory neuron
c) association neuron
d) motor neuron
e) effector organ
49) The nerve that innervates the skin of the perineum is derived from spinal nerves ____. (MACA)
a) S1
b) S2
c) S3
d) S4
e) S5
50) Choose the INCORRECT match of muscle to nerve(s) that innervates it.
a) biceps femoris m. – tibial nerve, common peroneal nerve
b) adductor magnus m. – obturator nerve, tibial nerve
c) brachialis m. – musculocutaneous nerve, radial nerve
d) pectineus m. – obturator nerve, femoral nerve
e) flexor digitorum profundus m. – median nerve, radial nerve
page 7, SA exam IV, Q.# 44-50