Download GROSS ANATOMY 205 MIDTERM EXAMINATION

GROSS ANATOMY 205 MIDTERM EXAMINATION......................OCTOBER 10, 1995
There are 50 questions on this examination. You have 90 minutes to complete this examination.
This copy will be returned to you when grading is completed.
MULTIPLE CHOICE QUESTIONS (choose the one correct answer and fill
in the circle on the General Purpose Answer sheet)
1. Pronounced weakness in supination of the forearm is most likely
the result of damage to which of the following nerves?
a. median
b. ulnar
c. musculocutaneous
d. anterior interosseous
e. superficial radial
2. Ulnar nerve injury commonly occurs where the nerve passes behind
the medial epicondyle of the humerus. Injury to the ulnar nerve may result
in all of the following symptoms except
a. loss of sensation on the medial surface of the palm and digits 4 and 5
b. loss of abduction of the wrist
c. loss of flexion at distal interphalangeal joints of digits 4 and 5
d. loss of abduction of digit 5
e. loss of adduction of the thumb
3. All of the following muscles are lateral rotators of the thigh
at the hip joint except
a. sartorius
b. obturator externus
c. obturator internus
d. gracilis
e. quadratus femoris
4. Gait or walking involves the initial contact and controlled lowering
of one foot to the floor. Loss of this component of normal gait is referred
to as "foot-drop." This condition may be characterized by all
of the following statements except
a. the tibialis anterior muscle is paralyzed
b. the common fibular (peroneal) nerve is damaged
c. the patient has a high stepping gait so that the toes do not hit the ground
d. there is loss of sensation from the skin over the anterolateral surface of the leg
e. there is loss of sensation from the skin over the sole of the foot
7-10. A UCLA quarterback was tackled from behind while his right
arm was fully abducted as he was about to throw the football. His right
shoulder joint was dislocated anteriorly so that the head of the humerus
came to lie inferior to the glenoid cavity.
7. The dislocated humeral head came to rest directly against the
tendon of which of the following muscles?
a. supraspinatus
b. infraspinatus
c. subscapularis
d. teres minor
e. teres major
8. The subglenoid dislocation forced the humeral head into the quadrangular
space which may cause damage to which of the following nerves?
a. musculocutaneous
b. suprascapular
c. radial
d. axillary
e. ulnar
9. If the above-mentioned nerve had been damaged in this patient,
all of the following symptoms would occur except
a. some loss of sensation on the lateral aspect of the upper limb
b. some weakness in lateral rotation at the shoulder joint
c. some weakness in medial rotation at the shoulder joint
d. impaired ability to abduct the arm
e. impaired ability to adduct the arm
10. Several weeks after his shoulder dislocation was reduced, the
quarterback complains of persistent pain when he abducts his arm to throw
a football. Because it is commonly damaged in shoulder dislocations, you
suspect a persistent injury and inflammation of the tendons of which of
the following muscles?
a. supraspinatus
b. infraspinatus
c. subscapularis
d. teres minor
e. teres major
11. The saphenous nerve is a sensory branch of which of the following
nerves?
a. sciatic
b. femoral
c. obturator
d. common fibular (peroneal)
e. tibial
12. All of the following nerves and arteries are in contact with
the humerus, and may be damaged in fractures of the humerus, except
a. posterior humeral circumflex artery
b. profunda brachii artery
c. ulnar artery
d. ulnar nerve
e. radial nerve
13. Which of the following muscles is innervated by posterior
primary rami of spinal nerves?
a. trapezius
b. latissimus dorsi
c. serratus posterior
d. erector spinae
e. rhomboideus major
14-15. A young man is brought into the UCLA emergency room with a
deep and jagged laceration extending from just behind his medial malleolus
down on to the medial aspect of the sole of his foot.
14. You are concerned that his injury may have damaged all of the
following muscles except
a. abductor hallucis
b. flexor hallucis brevis
c. flexor hallucis longus
d. flexor digitorum longus
e. tibialis posterior
15. Your examination reveals minimal muscle damage but the laceration
has severed the medial plantar nerve. You would expect that all of the following
muscles would be paralyzed except
a. abductor hallucis
b. adductor hallucis
e. flexor hallucis brevis
d. flexor digitorum brevis
e. first lumbrical
16. All of the following statements about the knee joint are correct except
a. the principal movements of the knee joint are flexion and extension
b. when the knee is fully extended, the anterior cruciate ligament prevents posterior
displacement of the femur on the tibia and hyperextension of the knee
c. when the knee is fully flexed, the posterior cruciate ligament
prevents anterior displacement of the femur on the tibia and stabilizes the knee when
walking downstairs
d. when the knee is fully extended, it "locks" because of lateral rotation of the
femur on the tibia
e. the popliteus muscle contracts to "unlock" the knee so that flexion of the knee can occur
25. Two muscles form the floor of the femoral triangle on the front
of the thigh. Which of the following muscles forms the medial part
of the floor?
a. pectineus
b. vastus medialis
c. adductor longus
d. rectus femoris
e. iliopsoas
27. In the sole of the foot, layer 2 consists of intrinsic muscles
and tendons of extrinsic muscles. Therefore, all of the following muscles
are considered part of layer 2 except
a. flexor digitorum longus
b. flexor digitorum brevis
c. flexor hallucis longus
d. quadratus plantae
GROSS ANATOMY 205 FINAL WRITTEN EXAMINATION 12/12/95
Multiple Choice (select the one best answer).
1. All of the following muscles help to elevate the larynx during the act of swallowing. Which muscle also depresses (lowers) the hyoid bone?
a.
b.
c.
d.
e.
thyrohyoid
geniohyoid
mylohyoid
anterior digastric
stylopharyngeus
2. Which of the following lymph nodes drains the oropharynx and often are referred to as the "tonsillar nodes" because they
become inflammed in cases of tonsillitis?
a.
b.
c.
d.
e.
submandibular
subclavian
subdigastric or jugulo-digastric
bifurcation or jugulo-carotid
jugulo-omohyoid
3. Damage to the facial (VII) nerve near the geniculate ganglion results in all of the following symptoms except
a.
b.
c.
d.
e.
absence of blinking reflex on affected side
absence of lacrimal secretion on affected side
corner of mouth pulled to affected side
hyperacusia or sensitivity to loud sounds
reduced secretion of saliva into oral cavity
4. When the middle meningeal artery is ruptured but the meninges remain intact, blood enters the
a.
b.
c.
d.
e.
subdural space
epidural space
subarachnoid space
cavernous sinus
sigmoid sinus
5. Which of the following muscles causes abduction of the vocal cords during quiet breathing?
a.
b.
c.
d.
e.
cricothyroids
thyroarytenoids
posterior cricoarytenoids
lateral cricoarytenoids
oblique interarytenoids
6. All of the following structures are located within the carotid sheath except
a.
b.
c.
d.
e.
internal jugular vein
internal carotid artery
common carotid artery
vagus (X) nerve
sympathetic chain
7. All of the following conditions or actions result from stimulation of the short ciliary nerves except
a.
b.
c.
d.
e.
contraction of the ciliary muscle
enhanced vision for distant objects
decreased size of the pupil
increased thickness of the lens
altered blood flow to capillaries in the iris
8. All of the following structures enter the orbit by passing through the anulus tendineus (common tendinous ring) except
a.
b.
c.
d.
e.
optic (II) nerve
trochlear (IV) nerve
abducens (VI) nerve
nasociliary nerve
ophthalmic artery
9. The accessory meningeal artery passes through which foramen to supply the trigeminal ganglion?
a.
b.
c.
d.
e.
foramen ovale
foramen spinosum
foramen rotundum
foramen lacerum
foramen cecum
17. All of the following muscles attach to the thyroid cartilage except
a.
b.
c.
d.
e.
cricopharyngeus
stylopharyngeus
inferior pharyngeal constrictor
cricothyroid
sternothyroid
18. If food enters the larynx, the laryngeal muscles go into spasm and the rima glottidis closes. If the food can not be dislodged,
the person is in danger of asphyxiation and an emergency midline incision is made into which structure to open the airway?
a.
b.
c.
d.
e.
median thyrohyoid ligament
median cricothyroid ligament
cricotracheal ligament
vocal ligament
thyroid cartilage
19. Which part of the larynx is most directly concerned with voice production?
a.
b.
c.
d.
e.
aditus
vestibule
glottis
ventricle
infraglottic cavity
20. Damage to the sympathetic trunk in the neck interrupts the sympathetic nerve supply to the head and neck on that side. This
condition is known as the Horner syndrome which consists of all of the following symptoms except
a.
b.
c.
pupillary constriction
ptosis or drooping of upper eyelid
vasoconstriction
d.
e.
absence of sweating
apparent retraction of the eye into the orbit (enophthalmus)
21. Which of the following branches of the vagus (X) nerve supplies motor innervation to muscles of both the pharynx and
larynx?
a.
b.
c.
d.
e.
pharyngeal nerve
superior laryngeal nerve
external laryngeal nerve
internal laryngeal nerve or
recurrent laryngeal nerve
22. Which of the following paranasal sinuses drains into the nasal cavities above the middle nasal conchae?
a.
b.
d.
e.
sphenoid
maxillary
c. anterior ethmoidal
middle ethmoidal
posterior ethmoidal
23-26. A 19 year old male victim of a drive-by shooting presents in the emergency room with a .22 caliber bullet wound in the
left infratemporal fossa, just below the zygomatic arch and about one inch anterior to the external auditory meatus. The bullet
passed through the mandibular notch and imbedded at the base of the pterygoid process of the sphenoid bone. Following a
relatively uncomplicated surgical extraction, the patient had paresis (weakness) and paralysis of his left masticatory muscles.
23. What structure was most likely severed by the bullet?
a.
b.
c.
d.
e.
facial (VII) nerve
maxillary (V2) nerve
maxillary artery
mandibular (V3) nerve
retromandibular vein
24. With damage to the above structure, what other symptoms might you expect to see in this patient?
c.
a. numbness of the left side of the eyelid and forehead
b. numbness of the left ear or
numbness of the left side of the tongue and sublingual region
d. numbness of the left side of the oropharynx
e. numbness of the left cheek and side of the nose
25. If the sense of taste from the anterior two-thirds of the tongue is normal, you might conclude that which of the following
nerves was not damaged by the bullet?
a.
b.
c.
d.
e.
hypoglossal (XII)
lingugl branch of V3
lesser petrosal branch of IX
chorda tympani branch of VII
greater petrosal branch of VII
26. Since secretions from the left parotid gland are reduced greatly, but sublingual and submandibular secretions are normal,
which of the following ganglia was damaged?
a.
b.
c.
d.
e.
geniculate
submandibular
otic
trigeminal
pterygopalatine
27-29. You and a classmate decide to play racketball after class but neither of you are wearing safety glasses. During the
game, your classmate is struck in the right eye by the ball and complains that her cheek and upper lip are numb and that she can
not look upward with her right eye. Suspecting that she has sustained a blowout fracture of the orbit, you take her to the
emergency room.
27. When you reach the emergency room, your suspicions about the fracture are confirmed and you are told by the attending
physician that the following has occurred?
a.
b.
the medial rectus muscle is entrapped by a fracture of the medial wall of
the orbit
the superior rectus muscle is entrapped by a fracture of the roof of the
c.
d.
e.
orbit
the lateral rectus muscle is entrapped by a fracture of the zygomatic
bone
the inferior rectus muscle is entrapped by a fracture of the maxillary
bone
the superior rectus muscle has detached from the eyeball
28. Since she is complaining of persistent numbness of her cheek and upper lip, which nerve has most likely been damaged by
this fracture?
a.
b.
c.
d.
e.
supraorbital
infraorbital
supratrochlear
infratrochlear
buccal
29. There is no damage to the left orbit and, when your classmate is asked to look upward her left eye moves normally. The
ability to look upward requires the simultaneous contractions of which two extraocular muscles?
a.
b.
c.
d.
e.
superior rectus and superior oblique
superror rectus and inferior oblique
superior oblique and inferior oblique
inferior rectus and inferior oblique
inferior rectus and superior oblique
30. A 10 year old child is admitted to the hospital with a very high fever, rapid pulse and respiration, and complaining of a very
sore throat. Your examination reveals bloody pus in her sputum and an abscess in her tonsillar area. A chest x-ray shows fluid
accumulation in the superior and posterior mediastinum. The fluid (pus) in the thorax indicates that the infection had penetrated
into which of the following spaces?
a.
b.
c.
d.
e.
sublingual space
pyriform recess
pharyngeal recess
retrovisceral space
carotid sheath
31. Hyperflexion of the head and upper cervical vertebrae is limited primarily by which of the following?
a.
b.
c.
d.
e.
posterior longitudinal ligament
anterior longitudinal ligament
posterior atlanto-occipital membrane
mandible encountering the sternum or lower neck
alar or check ligaments
32. Paralysis or spasticity of which of the following muscles would prevent full opening of the mouth (depression of the
mandible)?
a.
b.
c.
d.
e.
medial pterygoid
lateral pterygoid
masseter
temporalis
posterior digastric
33. Damage to the external laryngeal nerve during thyroid surgery will result in the patient's inability to
a.
b.
c.
d.
e.
relax the vocal cords
tense the vocal cords
abduct the vocal cords
adduct the vocal cords
swallow normally
34. Each of the following sensory nerves is a branch of the cervical plexus except
a.
b.
c.
d.
e.
great auricular
transverse cervical
greater occipital
lesser occipital
supraclavicular
35. All of the following muscles receive their motor innervation from the pharyngeal branch of the vagus (X) nerve except
a.
b.
c.
d.
e.
salpingopharyngeus
stylopharyngeus
palatopharyngeus
superior pharygneal constrictor
palatoglossus
36. All of the following statements concerning the pterygopalatine fossa are correct except
a.
b.
c.
d.
e.
the maxillary nerve enters the fossa through the foramen
rotundum
the maxillary artery enters the fossa through the pterygomaxillary
fissure
the zygomatic nerve exits the fossa through the inferior orbital
fissure
the nasopalatine nerve exits the fossa through the greater palatine
foramen
the posterior superior alveolar nerves exit the fossa through the
pterygomaxillary fissure
37. All of the following statements concerning the sublingual region of the oral cavity are correct except
a.
b.
c.
d.
e.
the duct of the submandibular gland opens lateral to the frenulum of the
tongue
the submandibular ganglion sends postganglionic parasympathetic fibers
to the sublingual gland via branches of the lingual nerve
the lingual artery lies lateral to the hyoglossus muscle
the hypoglossal nerve enters the region by passing above the posterior
margin of the mylohyoid muscle
the lingual nerve supplies general sensory innervation to the sublingual
mucosa
38-41. A 50 year old white male developed chronic rhinitis, an inflammation of the nasal mucosa with excessive mucus
secretion and occasional epistaxis or profuse nose bleeding. His symptoms did not respond to medication and surgery was
discussed to relieve his chronic nasal discharge.
38. This condition can be treated surgically by resection of which of the following ganglia?
a
b.
c.
d.
e.
superior cervical
ciliary
submandibular
sublingual
pterygopalatine
39. Preganglionic fibers which synapse in this ganglion are found in which of the following nerves?
a.
b.
c.
d.
e.
greater petrosal
lesser petrosal
deep petrosal
nasopalatine
sympathetic chain
40. As a result of this surgery, secretions will be reduced in all of the following tissues except
a.
b.
c.
d.
e.
pharyngeal mucosa above the soft palate
mucosa lining the soft palate
mucosa lining the hard palate
sublingual gland
lacrimal gland
41. Nose bleeding often originates at Kiesselbach's area where there is anastomosis of the septal branches of all of the
following arteries except
a.
b.
c.
d.
e.
sphenopalatine
greater palatine
superior labial
anterior ethmoidal
posterior ethmoidal
42. During general anesthesia, care must be taken to prevent the tongue from falling back and blocking the patient's airway
because of total relaxation of which of the following muscles?
a.
b.
c.
d.
e.
genioglossus
styloglossus
palatoglossus
hyoglossus
mylohyoid
43. All of the following statements concerning the ear are correct except
a.
b.
c.
d.
e.
the mucosa of the middle ear is innervated by the tympanic plexus which
contains the tympanic branch of IX and the caroticotympanic nerves
the sensory innervation to the external ear and outer surface of the
tympanic membrane is supplied by the auriculotemporal nerve
the promontory is located on the medial wall of the middle ear and is
produced by the basal coil of the cochlea
the tegmen tympani is a thin plate of bone that separates the middle ear
from the middle cranial fossa
the spiral organ of Corti rests on the basilar membrane within the scala
tympani of the cochlea
44. Which of the following conditions is least likely to result from the spread of infection from otitis media, an inflammation of
the middle ear?
a.
b.
c.
d.
e.
meningitis
encephalitis
mastoiditis
rhinitis
laryngitis
45. The labyrinthine artery supplies blood to the inner ear and is a branch of which of the following arteries?
a.
b.
c.
d.
e.
internal carotid
superior cerebellar
posterior cerebral
basilar
vertebral
46-50. Each of the following glands receives its blood supply from branches of one of the arteries listed on the right. Match
each gland with the most appropriate artery.
46. parotid
__A___
a. external carotid
47. prostate
__C___
b. internal carotid
48. lacrimal
__B___
c. inferior vesical
49. parathyroid
50. greater vestibular
__E___
__D___
d. internal pudendal
e. thyrocervical
GROSS ANATOMY Final Written Examination 12/10/91
1. A large malignant tumor of bone invades the floor of the middle
cranial fossa. Knowing the anatomy of the middle cranial fossa, you
look for symptoms that would indicate tumor invasion in all of the
following structures, except:
A.
B.
C.
D.
E.
foramen spinosum.
internal auditory meatus.
foramen lace rum.
foramen ovale.
foramen rotundum.
2. A patient suffers from a dry and painful right cornea, numbness of the right nasal cavity as well as a loss of sensation along the right
side of the palate in the oral cavity. Which of the following could be the cause of these symptoms?
A. a small tumor pressing on the trigeminal ganglion.
B.
C.
D.
E.
a growth in the pterygopalatine fossa that compresses the
pterygopalatine ganglion.
a loss of cell bodies in the pterygopalatine ganglion.
compression of the geniculate ganglion.
a tumor that compresses the structures in the superior
orbital fissure.
3. The following statements about the drainage of the paranasal sinuses are correct, except:
A.
B.
C.
D.
E.
The sphenoid sinus drains into the sphenoethmoidal recess.
The maxillary sinus drains into the middle meatus.
The frontal sinus drains into the inferior meatus.
The posterior ethmoidal sinus drains into the superior
meatus.
The anterior ethmoidal sinus drains into the ethmoidal
infundibulum/middle meatus.
4. Each of the following statements regarding veins in the head and
A.
B.
C.
D.
E.
neck is true, except:
The retromandibular and facial veins unite to form the common
facial vein.
The external jugular vein lies superficial to the
sternocleidomastoid muscle.
The internal jugular vein is formed by the union of the
inferior petrosal and sigmoid sinuses.
The straight sinus is formed by the union of the superior and
inferior sagittal sinuses.
The facial vein lies superficial to the submandibular gland
in the submandibular triangle.
6. Your room mate finally indicates that he has been rather subdued
because he has had a persistent headache for about two weeks.
Having Just started your ophthalmology clerkship, you examine his
eyes and find that he has bilateral papilledema (edema of the
optic disc) and congested retinal veins. You immediately suspect
some intracranial pathology that has increased his cerebrospinal
fluid pressure. The reason for your diagnosis is:
A. Since the retina is an outgrowth of the brain it reflects all
neuropathology of the brain by developing papilledema.
B. Since the optic nerve is covered with the meninges, an
increase in the pressure of the cerebrospinal fluid will
compress the
optic nerve and the venous drainage of the
retina leading to papilledema.
C. Since the opthalmic artery is so small, increased
intracranial pressure compromises blood flow through it as it
enters the orbit.
D. Since the vitreous humor communicates with the subarachnoid
space, its pressure rises when cerebrospinal fluid pressure
rises.
E. The pain associated with an increase in intracranial pressure
causes a reflex constriction of the central artery of the retina.
9. You and your date are sharing an extra thick milkshake. To impress your date with your new knowledge of anatomy, you tell her: "I will be
able to suck more of the milkshake into my straw because I have stronger facial muscles, namely, the following pair:
A.
B.
C.
D.
E.
levator labii superioris and zygomaticus minor.
buccinator and orbicularis oris.
platysma and zygomaticus major.
risorius and levator anguli oris.
depressor anguli oris and mentalis.
10. A teenage girl with acne was in the habit of picking at the
pimples on her face. As a result, one pimple located near the corner of
her mouth became infected. Within a few days the girl complained of a
bad headache and noticed a faint red streak that extended
subcutaneously from the infected pimple toward the medial angle of her
eye. Within a few days her condition worsened. She felt weak and
fatigued and showed signs of exophthalmos (bulging of the eye), ptosis
(drooping of the eyelid) and impairment of normal movements of the
eyeball on her left side. She finally consulted an ophthalmologist who
placed her immediately in the hospital and administered massive doses
of antibiotics to treat her meningitis. The following conclusions about
this girl's condition are true, except:
A. The infection from her picked pimple spread to her cavernous
sinus.
B. The facial vein, which has no valves, communicates with the
dural venous sinuses through the ophthalmic vein.
C. The three cranial nerves supplying the extra ocular muscles
pass through or along the wall of the cavernous sinus, thus
explaining their involvement in her symptoms.
D. Her meningitis is due to the fact that the cavernous sinus
drains directly into the transverse sinus.
E. Impairment of some sympathetic innervation can be expected
because the internal carotid artery and its overlying plexus
of sympathetic fibers do course through the cavernous sinus.
12. During a gang fight, one of the combatants receives a knife wound
which penetrates into the substance of his parotid gland. In the
Emergency Room you would look for damage to the following structures,
except:
A.
B.
C.
D.
E.
external carotid artery.
great auricular nerve.
facial nerve.
retromandibular vein.
mental nerve
14. The following areas of mucous membrane are innervated by the named
nerve, except:
A. cheek - buccal branch of the mandibular nerve.
B. posterior nasal septum - nasopalatine nerve. most of the hard
palate - lesser (posterior) palatine nerve.
C. vestibular folds (false vocal cords) - internal laryngeal
nerve.
E. frontal sinus - supraorbital nerve.
15. You have a bad head cold, but have to fly to Boston for your
interview as a resident. Take-off is quite painful for you because your
stuffed-up auditory tube makes equalizing pressure in you middle ear
difficult. To take your mind off the discomfort during landing you try
to remember the names of the muscles which, because of their attachment
to the auditory tube, could help equalize middle ear pressure. As your
ears "pop," you remember that these are the muscles, with one
exception. Indicate that exception.
A.
B.
C.
D.
E.
levator palati.
tensor palati.
tensor tympani.
stapedius.
salpingopharyngeus.
16. Through the various foramina in the skull, structures enter and leave the cranial cavity. The following are correct statements, except:
A.
B.
C.
D.
E.
The spinal and cranial components of the spinal accessory
nerve enter the cranial cavity through the foramen magnum.
The middle meningeal artery enters the cranial cavity through
the foramen spinosum.
Sensory information from the retina enters the cranial cavity
through the optic canal.
Efferent fibers of the twelfth cranial nerve leave the
cranial cavity by passing through the hypoglossal canal.
Blood in the dural sinus system leaves the cranial cavity by
passing through the jugular foramina.
17. The following muscular attachments are correct, except:
A.
B.
C.
D.
E.
superior constrictor - pterygomandibular raphe.
buccinator - pterygomandibular raphe.
middle constrictor - thyroid cartilage.
inferior constrictor - cricoid cartilage.
musculus uvulae - hard palate.
18. As an academic physician you discover the first case of an hypertrophied annul us tendineus which compresses those structures
which pass through it. You expected and found symptoms of malfunction of the following nerves, except:
A.
B.
C.
D.
E.
optic nerve.
trochlear nerve.
abducent nerve.
nasociliary nerve.
oculomotor nerve.
19. Each of the following statements regarding muscle action is correct, except:
A.
B.
C.
D.
E.
the posterior cricoarytenoid muscles adduct the vocal cords.
the lateral rectus muscles abduct the eyeballs.
the stylopharyngeus elevates the larynx and pharynx during
the genioglossus muscles protrude the tongue.
the mylohyoid muscles elevate the hyoid bone.
swallowing.
21. The following statements about the temporo-mandibular joint are correct, except:
A. As the jaw is opened the contraction of the medial pterygoid muscles pulls the mandible forward so that the articular disc
moves forward onto the articular tubercle of the temporal bone.
B. During closure of the mouth, the posterior fibers of the
temporalis pull the mandible back into the mandibular fossa.
C. The digastrics, geniohyoid and mylohyoid muscles depress the jaw.
D. Elevation of the mandible involves contraction of the temporalis and masseter.
E. Lateral chewing movements are produced by alternating protruding and retracting each side of the mandible.
22. The following structures are derived from the indicated branchial arch, except:
A.
B.
C.
D.
E.
muscles of mastication - first arch.
stapes and stapedius - second arch.
cricoid cartilage and cricothyroid - third arch.
posterior belly of digastric and stylohyoid - second arch.
tensor palati and tensor tympani - first arch
23. An aneurysm of either the posterior cerebral or superior cerebellar artery might very likely compress one or both of the following pair of
nerves because they pass between these two arteries as they emerge from the brain:
A.
B.
C.
D.
E.
vagus and glossopharyngeal.
abducens and vagus.
abducens and glossopharyngeal.
optic and oculomotor.
oculomotor and trochlear.
24. The following statements regarding the parasympathetic ganglia in the head are correct, except:
A.
B.
C.
D.
E.
Fibers of the greater petrosal nerve synapse in the pterygopalatine ganglion.
Fibers of the deep petrosal nerve synapse in the pterygopalatine ganglion.
Fibers of the lesser petrosal nerve synapse in the otic ganglion.
Fibers of the chorda tympani nerve synapse in the submandibular ganglion.
Fibers running in the inferior division of the oculomotor nerve synapse in the ciliary ganglion.
25. Which of the following routes of the parasympathetic innervation to the eye is correct?
A.
B.
C.
D.
E.
inferior division of the oculomotor - ciliary ganglion- short
ciliary nerves - ciliary body and pupillary constrictor.
nasociliary nerve - ciliary ganglion- short ciliary nerves ciliary body and pupillary dilator.
inferior division of the oculomotor - nasociliary nerve ciliary ganglion- ciliary body.
superior division of the oculomotor - ciliary ganglion- long
ciliary nerves - pupillary dilator.
nasociliary nerve - communicating branch to the ciliary ganglion- ciliary ganglion- infratrochlear nerve – arteries to the retina.
26. With respect to the skull of the newborn infant, the following statement(s) is(are) true:
1.
2.
3.
4.
The paranasal air sinuses are already formed.
The facial bony skeleton represents about the same percentage that the face comprises in the adult skull.
At birth the mandible is already a single bone.
The different bones of both the neurocranium and facial skeleton form by intramembranous or intracartilaginous bone formation.
CODE: A(1,2,3); B(1,3); C (2,4); D(4); E(all).
27. The chorda tympani nerve
1.
2.
3.
4.
carries taste fibers from the posterior one-third of the
courses on the promontory of the middle ear.
contains preganglionic fibers for the otic gang lion.
joins the lingual nerve.
tongue.
29. As reiterated in this year's radiology lecture on the head and neck, the pharyngobasilar fascia may serve as a plane through which
infection or cancer may spread out of the pharynx. In "weak" regions of the pharynx, gaps occur in the constrictor muscle layer surrounding the
pharyngobasilar fascia. Regions where these gaps are found include:
1.
2.
3.
4.
at the base of the skull above the superior constrictor.
posterior to the cricothyroid joint.
in the bed of the palatine tonsil.
directly posterior to the hyoid bone.
CODE: A(1,2,3); B(1,3); C(2,4); D(4); E(all).
30. Because of their lymphatic drainage, infections of the following structures may lead to palpable swellings of the indicated lymph nodes:
1.
2.
3.
4.
tip of the tongue - submental nodes.
back of the scalp - occipital nodes.
the middle ear - parotid nodes.
maxillary air sinus - submandibular nodes.
CODE: A(1,2,3); B(1,3); C(2,4); D(4); E(all).
31. In a very competitive game, a student who is not wearing goggles is hit directly on the right eye by the racquet ball. After seeing her
in the Emergency Room, you request a head X-ray, suspecting a blow-out fracture of the orbital floor. Which observation(s) would most directly
support your diagnosis?
1.
2.
3.
4.
the patient has a loose right incisor.
the patient is unable to look up with the right eye.
the patient has pain in the right ear.
the patient's right upper lip and lateral nose are numb.
CODE: A(1,2,3); B(1,3); C(2,4); D(4); E(all).
32. The above diagram from your text has been modified. The illustration(s) which demonstrate(s) the correct action of the
indicated extra ocular muscle acting alone is(are):
1.
2.
3.
4.
Superior Rectus.
Superior Oblique.
Inferior Rectus.
Inferior Oblique.
CODE: A(1,2,3); B(1,3); C(2,4); D(4); E(all).
33. Indicate the correct match(es).
1.
2.
3.
4.
ophthalmic artery - superior orbital tissue.
vestibulocochlear nerve - internal auditory meatus.
mandibular nerve - foramen rotundum.
middle meningeal artery - foramen spinosum.
CODE: A(1,2,3); B(1,3); C(2,4); D(4); E(all).
34. After reviewing gross anatomy until 3 AM, the medical student was accosted on the way to his car. In the ensuing struggle, he received a
penetrating knife cut in the side of his neck. In the Emergency Room you examine the patient and find that he has difficulty turning his
head to the left and shrugging his right shoulder. When asked to protrude his tongue it deviates to the right. From these symptoms you
conclude that the knife had damaged the following cranial nerve(s):
l.
2.
3.
4.
XI (spinal accessory).
IX (glossopharyngeal).
XII (hypoglossal).
VII (facial).
CODE: A(1,2,3); B(1,3); C(2,4); D(4), E(all).
36. The glossopharyngeal nerve
1.
2.
3.
4.
provides sensory innervation to the posterior tongue.
supplies the stylopharyngeus muscle.
sends preganglionic fibers to the otic gang lion.
supplies sensory fibers to the carotid sinus.
CODE: A(1,2,3); B(1,3); C(2,4); D(4); E(all).
37. Nerve(s) formed from posterior primary rami of spinal nerves include(s):
1.
2.
3.
4.
suboccipital nerve
third occipital nerve.
greater occipital nerve.
lesser occipital nerve.
39. During thyroidectomy the surgeon accidentally cuts the left recurrent laryngeal nerve. The symptom(s) resulting from this accident
include(s):
1.
2.
3.
4.
a hoarse voice.
loss of sensation above the vocal chords.
a weakened cough.
a denervated cricothyroid muscle.
42. Very loud noises could cause extreme deflection of the ear drum
these vibrations.
were it not for the __________________ muscle which damps down
43. An elderly man developed an aneurysm of the right internal carotid artery just below the base of the skull, about at the level of the second
cervical vertebra. Within 3 months, he demonstrated the following symptoms: miosis (constricted pupil), anhydrosis (absence of sweating),
ptosis (drooping eyelid) and vasodilation of peripheral arteries causing flushing - all on the right side of his face. You recognize that these
symptoms were probably all due to the aneurysm compressing the _______________________________.
44. Otitis media is an inflammation of the middle ear cavity and is commonly caused by spread of an infection from the nasopharynx via
the auditory tube. Pain associated with this condition is carried by what nerve? ______________________________ (be specific).
45. In addition to the first and fifth, the only other odd numbered cranial nerve that does not carry preganglionic parasympathetic
fibers is _____________________________.
46. During swallowing, ingested fluids pass lateral to the laryngeal
inlet through the ______________________________ fossa.
48. You and your husband, who is a computer engineer, have your first baby. Your husband gets quite concerned every time the baby cries, he
believes that she has a serious cold because her nose runs. As the physician in the family you point out that your baby doesn't have a cold, it's
just that,her tears are transported to the nasal cavity through the ______________________ ducts.
49. All taste fibers in the chorda tympani nerve have their cell bodies in the _______________________ ganglion.
2. All of the following muscles receive motor innervation from the tibial division of the sciatic nerve except
a. semitendinosus
b. semimembranosus
c. long head of biceps femoris
d. short head of biceps femoris
e. popliteus
6. In addition to weakening flexion at the elbow joint, partial damage to the musculocutaneous nerve will also weaken
a. abduction of the arm
b. pronation of the forearm
c. supination of the forearm
d. abduction of the hand
e. adduction of the hand
7. Your patient is a major league baseball pitcher who comes to you complaining of pain in his right shoulder and difficulty in lifting the
arm over his head. Since damage to the "rotator cuff" is common in pitchers, you suspect damage to the tendon of the
a. subscapularis
b. supraspinatus
c. infraspinatus
d. teres minor
e. deltoid
10 - 12. A young woman is thrown from her horse while riding in the Santa Monica mountains. As she lands, the right side of her neck and
shoulder strike a fallen tree trunk. When you examine her several day later, you observe that her right arm hangs limply and is medially
rotated. Her forearm is pronated and she complains of numbness along the lateral side of her arm.
10. Which part of the brachial plexus was most likely damaged in the fall?
a. superior trunk
b. middle trunk
c. inferior trunk
d. medial cord
e. lateral cord
11. Because her arm is medially rotated, the nerve supply to which of the following was not completely damaged?
a. supraspinatus
b. infraspinatus
c. subscapularis
d. teres minor
e. deltoid
12. To account for the unopposed pronation of her forearm, which of the following muscles is paralyzed?
a. biceps brachii
b. triceps brachii
c. brachialis
d. coracoobrachialis
e. brachioradialis
13. When you stop your car suddenly to avoid a jogger, your right knee hits the dashboard with such force that the tibia is driven posteriorly
on the femur. You suspect ligament damage which, if not repaired, would make walking down stairs difficult. Which of the following
ligaments of the knee joint was torn?
a. patellar
b. anterior cruciate
c. posterior cruciate
d. tibial collateral
e. fibular collateral
18. In the hand, the four lumbrical muscles arise from tendons of the ______________________________ muscle, wind around the radial side of
the fingers and insert into the tendons of the ______________________________ muscle.
19. Adduction of the fingers occurs at the ________________________ joints when the ___________________________ muscles contract.
Adduction of the thumb occurs at the ___________________________ joint when the ____________________________ muscle contracts.
20. The axillary nerve is derived from the ________________________ cord of the brachial plexus. It passes through the
_________________________ space with the __________________________ artery and supplies motor innervation to the
______________________ and ____________________________ muscles.
21. Collateral circulation around the scapula could provide blood to the upper arm if the second part of the axillary artery becomes occluded. The
flow of blood in the _____________________ artery and its major branch, the _______________________ artery, is reversed when
these collateral channels are used to supply the upper limb.
23 - 25. A young man has sustained a deep wound on the sole of this foot. He stepped on a piece of broken glass while jogging barefoot on the
beach. The severe bleeding which resulted from damage to his deep plantar arch is difficult to control.
23. You recall that the deep plantar arch is formed when the deep plantar branch of the _________________________ artery joins the
_________________________(medial/lateral) plantar branch of the _____________________________ artery.
24. To control his bleeding, you try digital pressure to compress the first artery against the navicular bone just ________________________
(medial/lateral) to the tendon of extensor hallucis longus.
25. You also try to compress the other artery as it passes behind the medial malleolus and enters the sole of the foot along with the tendons of the
_____________________________________ and ____________________________ and ________________________ muscles.
1. Hyperacusia or excessive sensitivity to loud sounds results from damage to the
a. facial (VII) nerve
b. vestibulocochlear (VIII) nerve
c. glossopharyngeal (IX) nerve
d. tympanic membrane
e. cochlear membrane
2. Damage to the nerves passing through the foramen ovale would result in all of the following symptoms except
a. loss of taste sensation from the anterior two-thirds
b. loss of general sensation from the floor of the oral
c. loss of general sensation from the lower lip
d. reduced salivary secretions
e. weakness of soft palate movements during swallowing
of the tongue
cavity
3. Pressure on the oculomotor (III) nerve within the middle cranial fossa could result in all of the following symptoms except
a. loss of accommodation for near vision
b. pupillary dilation
c. lateral deviation of the eyeball
d. ptosis or drooping of the eyelid
e. loss of the corneal blink reflex
4. Local anesthetics injected midway along the posterior border of the sternocleidomastoid muscle produce a superficial cervical block. All of the
following nerves would be anesthetized except
a. great auricular
b. greater occipital
c. lesser occipital
d. transverse cervical
e. supraclavicular
5. A tumor of the vestibulocochlear (VIII) nerve has compressed all of the structures in the internal auditory meatus and produced each of the
following symptoms except
a. loss of hearing
b. nystagmus (involuntary eye movements)
c. loss of lacrimal secretion
d. difficulty in chewing
e. difficulty in swallowing
6. The paranasal sinus whose opening is in the poorest position for drainage when the head is held erect is the
a. frontal
b. sphenoid
c. maxillary
d. anterior ethmoid
e. posterior ethmoid
7. The intrinsic muscles of the larynx can be divided into two groups; 1) those concerned with protecting the larynx during swallowing, and 2)
those concerned with adjustments during phonation and respiration. A muscle of the first group is the
a. cricothyroid
b. posterior cricoarytenoid
c. transverse interarytenoid
d. aryepiglotticus
e. vocalis
8. Infection of the middle ear can spread to surrounding areas by all of the following pathways except
a. through the tegmen tympani to the middle cranial fossa
b. through the medial wall to the labyrinth
c. through the floor to the internal jugular vein
d. through the aditus to the mastoid antrum and air cells
e. through the epitympanic recess to the internal
auditory meatus
9. The temporomandibular joint usually dislocates anteriorly during yawning. Spasm of which muscles would cause the heads of the mandible
to dislocate anterior to the articular tubercles?
a. mylohyoids
b. medial pterygoids
c. lateral pterygoids
d. masseters
e. temporalis
10. Most of the pain associated with a traumatic dislocation of the temporomandibular joint is carried by which nerve?
a. zygomaticotemporal branch of V2
b. auriculotemporal branch of V3
c. posterior auricular branch of VII
d. auricular branch of X
e. tympanic branch of IX
16. The cell bodies for the special sensory (taste) fibers which are located in the oropharynx are found in which of the following ganglia?
a. trigeminal (V)
b. geniculate (VII)
c. inferior ganglion of IX
d. inferior ganglion of X
e. both c. and d.
20. The only muscles which open the rima glottidis are the
a. cricothyroids
b. posterior cricoarytenoids
c. lateral cricoarytenoids
d. thyroarytenoids
e. interarytenoids
21. Each of the following neck muscles is innervated by anterior primary rami of cervical spinal nerves except the
a. posterior scalene
b. rectus capitis lateralis
c. longus colli
d. rectus capitis posterior major
e. middle scalene
22. When you ask your patient to protrude his tongue, it deviates to the right side. You immediately suspect paralysis of which muscle?
a. right styloglossus
b. right hyoglossus
c. right genioglossus
d. left genioglossus
e. left styloglossus
23. Sustained tension of the vocal cords is lost and the voice "tires easily" when which of the following muscles is paralyzed?
a. cricothyroid
b. posterior cricoarytenoid
c. lateral cricoarytenoid
d. thyroarytenoid
e. vocalis
24. Each of the following arteries is a branch of the internal carotid artery except
a. anterior cerebral
b. middle cerebral
c. posterior cerebral
d. posterior communicating
e. ophthalmic
25. During surgical removal of an impacted "wisdom" tooth, the right lingual nerve is severed inadvertently as it passes just below the
third mandibular molar. This patient would show ipsilateral loss of all of the following except
a. general sensation from anterior two-thirds of tongue
b. taste sensation from anterior two-thirds of tongue
c. secretions from submandibular and sublingual glands
d. general sensation from floor of the mouth
e. general sensation from the lower lip
26. When you ask your patient to open wide and say "Ah," you noticethat his soft palate deviates to the right side. You immediately
suspect damage to which of the following nerves?
a. right trigeminal (V)
b. right glossopharyngeal (IX)
c. left glossopharyngeal (IX)
d. left vagus (X)
e. right vagus (X)
27. During reconstructive surgery to protrude or slide forward the lower jaw of a micrognathic patient, you must take care not to sever
the inferior alveolar nerve. Recalling the anatomy of the infratemporal fossa, you would transect (saw through) the mandible
a. below the lingula
b. above the lingula
c. below the mandibular foramen
d. through the middle of the mylohyoid ridge
e. just posterior to the mental foramen
28. Swelling of the optic disc or papilledema occurs when venous return from the retina is slowed due to increased pressure of the
a. aqueous humor in the anterior chamber
b. aqueous humor in the posterior chamber
c. vitreous humor behind the lens
d. cerebrospinal fluid around the optic nerve
e. blood in the ophthalmic artery
29. During general anesthesia, the risk of airway obstruction is overcome by inserting a tube into the patient's larynx. This is done because total
relaxation of which of the following muscles could lead to suffocation?
a. genioglossus
b. hyoglossus
c. styloglossus
d. palatoglossus
e. aryepiglotticus
30. Herpes zoster is a viral infection causing blisters and rash in regions supplied by the sensory branches of a peripheral nerve. You
observe such eruptions on the oropharynx and in the middle ear cavity and suspect involvement of which cranial nerve?
a. trigeminal (V)
b. facial (VII)
c. vestibulocochlear (VIII)
d. glossopharyngeal (IX)
e. vagus (X)
31. During baseball practice, a batter was hit on the side of the head by a wild pitch. Because he was not wearing protective gear, he was
stunned initially but recovered quickly. Several hours later, he lost consciousness and was brought to the emergency room. You suspect that
his intracranial pressure is elevated because of epidural hemorrhaging from the
a. middle meningeal artery
b. middle cerebral artery
c. basilar artery
d. deep temporal artery
e. superficial temporal artery
32. Severe bleeding can occur after tonsillectomy because the palatine tonsils are supplied by branches of all of the following arteries
except
a. descending palatine
b. ascending pharyngeal
c. lingual
d. facial
e. sphenopalatine
33. Preganglionic parasympathetic fibers exit the brainstem in each of the following cranial nerves except
a. oculomotor (III)
b. trigeminal (V)
c. facial (VII)
d. glossopharyngeal (IX)
e. vagus (X)
34. A metastatic tumor arising in a scalene (deep cervical) lymph node destroys the cervical sympathetic chain in the root of the neck. Which
of the following symptoms will you observe in this patient?
a. drooping of the eyelid
b. dilation of the pupil
c. loss of lacrimal secretion
d. loss of accommodation
e. all of the above
35. Because the oropharynx drains directly into them, which of the following lymph nodes would most likely be enlarged due to spread of
infection from the palatine tonsils?
a. submandibular
b. retropharyngeal
c. jugulo-digastric
d. jugulo-omohyoid
e. subclavian
Match each cranial nerve (listed on the left) with the deficit seen when it is damaged (listed on the right).
36. Oculomotor (III) ____ a. absence of gag reflex
37. Trochlear (IV)
____ b. inability to look up and out
38. Abducens (VI)
____ c. inability to look down and out
39. Facial (VII)
____ d. absence of blink reflex
40. Glossopharyngeal(IX) ____ e. diplopia (double vision) on lateral gaze
Match the area of mucous membrane (listed on the left) with its appropriate sensory nerve (listed on the right). You may use any nerve
more than once.
41. Pyriform recess
____ a. glossopharyngeal (IX)
42. Pharyngeal recess ____ b. recurrent laryngeal (X)
43. infraglottic cavity ____ c. internal laryngeal (X)
44. oropharynx
____ d. pharyngeal branch of V2
45. valleculae (taste) ____ e. pharyngeal branch of X
MIDTERM - SEPTEMBER 23, 1992
A. FILL-IN BLANKS (be as precise as possible)
1. In general, flexor muscles in the limbs are supplied by_______________(ventral/dorsal) nerve divisions whereas extensor muscles are supplied
by _______________(ventral/dorsal) nerve divisions.
2. The dorsal interosseous muscles of the hand are innervated by the __________________ nerve and the dorsal interosseous muscles of the foot
are supplied by the _____________________ nerve.
3. Is it the anterior (ventral) or the posterior (dorsal) primary rami of spinal nerves that supply the muscles of the limbs? ______________
4. The tendon of the ________________ muscle forms the medial border of the "anatomical snuff box."
5. Eversion of the foot is produced mainly by the contraction of the_______________ and the _______________ muscles.
6. The ______________ artery courses through the adductor canal, passes through the hiatus in the _______________ muscle and becomes the
_________________ artery.
7. In the superior mediastinum, the most posterior structure (tube) is the ______________.
8. Cardiac veins drain into the ____________ which empties into the ______________ atrium.
9. In the superior mediastinum, the recurrent laryngeal branch of the _______________ (right/left) vagus nerve "recurs" around the
___________________ just behind the ___________________.
10. The cusps of the atrioventricular valves are attached to papillary muscles by the _______________.
11. The _____________ vein arches over the root of the right lung and drains into the _____________________.
13. The actions at the shoulder joint which are produced by the pectoralis major, latissimus dorsi and teres major are ______________ and
__________________.
14. The brachioradialis is innervated by the _________________ nerve and acts as a __________________(flexor/extensor) at the elbow joint.
15. The principal action of the obturator internus muscle at the hip joint is ____________________.
16. In the forearm, the common interosseous artery is a branch of the _______________ artery and the anterior interosseous nerve is a branch of
the _______________ nerve.
17. Which of the following muscles produces lateral rotation of the arm
at the shoulder joint?
a. supraspinatus
b. infraspinatus
c. teres major
d. pectoralis major
e. subscapularis
20. A ruptured tendo calcaneus ("Achilles tendon") would result in severe impairment or loss of which of the following movements?
a. plantarflexion
b. dorsiflexion
c. inversion
d. eversion
e. rotation
21. Which of the following muscles is not an abductor?
a. gluteus maximus
b. gluteus medius
c. deltoid
d. supraspinatus
e. dorsal interosseous
22. All of the following structures pass through the respective space or foramen except
a. axillary nerve - quadrangular space
b. circumflex scapular artery - triangular space
c. suprascapular artery - suprascapular foramen
d. posterior humeral circumflex artery - quadrangular space
e. suprascapular nerve - suprascapular foramen
23. A young woman is brought to the emergency room after being struck by an automobile while jogging. As she crossed a busy intersection, the
front bumper of the automobile collided with her left leg and she was thrown to the ground. You observe a large traumatic bruise on the lateral
side of her left leg just below the knee. Remembering your gross anatomy, you warn her that she may experience all of the following symptoms
except
a. footdrop or the inability to dorsiflex her foot
b. inability to evert her foot
c. inability to flex her toes
d. loss of sensation on the dorsum (top) of her foot
e. a possible fracture of the fibula
25. A young man is brought to the emergency room after falling from a tree. As he began to fall, he grabbed for a branch with his left arm. This
caused avulsion (pulled out of the spinal cord) of the spinal roots which form the lower trunk of the brachial plexus. Remembering your gross
anatomy, you inform the young man that he will have difficulty in
a. shrugging his shoulder
b. rotating his arm laterally
c. flexing arm at his elbow
d. abducting his thumb
e. adducting and abducting his fingers
26. Contraction of the flexor digitorum profundus muscle produces flexion at the
a. distal interphalangeal joints
b. middle interphalangeal joints
c. metacarpophalangeal joints
d. radiocarpal (wrist) joint
e. all of the above
27. Which of the following muscles is innervated by the lateral plantar nerve?
a. abductor hallucis
b. abductor digiti minimi
c. flexor hallucis brevis
d. flexor digitorum brevis
e. first lumbrical
28. Which of the following muscles are used during forced respiration?
a. pectoralis major
b. serratus anterior
c. serratus posterior
d. all of the above
e. none of the above
29. Which of the following muscles is not innervated by the obturator
nerve?
a. pectineus
b. adductor brevis
c. adductor longus
d. adductor magnus
e. gracilis
31. A 25 year old man suffered a deep laceration of his left medial
forearm approximately 2 to 2 1/2 inches proximal to the wrist. There
was some damage to the flexor carpi ulnaris muscle tendon. The patient
cannot abduct or adduct his fingers.
a. the loss of muscle function in the hand is most likely due to damage to the ______________ nerve.
b. he can not adduct fingers 2,4,5 because the ____________________ muscles are paralyzed.
c. he can not abduct fingers 2,3,4,5 because the ___________________ and __________________ muscles are paralyzed.
d. he can not _______________(abduct/adduct) his thumb.
e. he has loss of sensation to the skin over the ______________ (thenar/hypothenar) eminence.
E. MATCHING COLUMN
34. Match the structure listed in the right column with the most
appropriate structure in the left column (i.e. muscle - action or
nerve supply, artery - branch, bone - process or joint surface)
adductor magnus
_________ A. external oblique
abductor pollicis longus _________ B. internal oblique
abductor hallucis
_________ C. obturator nerve
biceps brachii
_________ D. radial nerve
plantar arch
_________ E. medial plantar nerve
superficial palmar arch _________ F. lateral plantar artery
cephalic vein
_________ G. ulnar artery
coronary sinus
_________ H. right atrium
mitral valve
_________ I. left ventricle
intercostal vein
_________ J. azygos vein
inguinal ligament
_________ K. axillary vein
cremaster muscle
_________ L. supination
35. Match the anatomical structure listed in the left column with the
appropriate clinical symptom or problem listed in the right column.
median nerve
_________ A. wrist-drop
radial nerve
_________ B. foot-drop
common peroneal nerve
_________ C. heart murmur
superior gluteal nerve
_________ D. angina pectoris
femoral ring
_________
E. shoulder separation
mitral valve
_________ F. shoulder dislocation
coronary artery
_________ G. femoral hernia
acromioclavicular joint
_________ H. carpal tunnel syndrome
glenohumeral joint
_________ I. gluteal gait or gluteus medius limp