S1 Practice Questions For Lab Practical Pt. 2
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- 1.
A 20-year-old male presents to you with a high steppage gait on the right side. You suspect that he uses this compensatory gain because he suffers from foot drop. What scenario is the most plausible regarding his condition?
- A.
He was playing basketball and landed on an inverted foot
- B.
He was playing football and someone fell on his everted foot
- C.
He was slashed with a knife near the lateral knee by a hoodlum on a skateboard
- D.
He was playing beer pong and passed out using his arm as a pillow
- E.
He was playing soccer and made a quick right turn as he ran after the ball
Correct Answer
C. He was slashed with a knife near the lateral knee by a hoodlum on a skateboardExplanation
Damage to the common fibular nerve results in foot drop. This nerve is most
commonly injured near the fibular head or neck because it is very superficial at this
location, and in close proximity to the bone.Rate this question:
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- 2.
Which tarsal bone articulates with more than one metatarsal bone?
- A.
Medial Cuneiform
- B.
Intermediate cuneiform
- C.
Lateral cuneiform
- D.
Cuboid
- E.
Calcaneus
Correct Answer
D. CuboidExplanation
Cuboid articulates with the 4th and 5th metatarsalsRate this question:
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- 3.
The superficial fibular nerve is severed near its origin. What motor deficit(s) would you expect in a patient with this injury?
- A.
Weak dorsiflexion, weak eversion
- B.
Weak dorsiflexion, absent eversion
- C.
Weak eversion
- D.
Absent eversion
- E.
No motor deficit because this nerve is purely sensory
Correct Answer
C. Weak eversionExplanation
Superficial fibular nerve innervates the lateral compartment muscles, both of
which are evertors of the foot (as well as very weak plantarflexors). Fibularis tertius is innervated by deep fibular nerve (intact in this patient), and so it can still provide
some ability for eversion.Rate this question:
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- 4.
A patient presents to the emergency department with shortness of breath (dyspnea) and cold clammy hands. Your team determines that the patient suffers from a cardiac tamponade (due to blood within the pericardial sac, putting pressure on the heart). You are asked to perform a pericardiocentesis to save the patient’s life. You select your needle and insert it in which location in order to minimize risk?
- A.
Left parasternal 2nd intercostal space
- B.
Right parasternal 2nd intercostal space
- C.
Right infrasternal angle
- D.
Left infrasternal angle
- E.
Left 5th intercostal space in the mid-axillary line
Correct Answer
D. Left infrasternal angleExplanation
The pericardium can be accessed from the anterior thorax through the Bare Area,
so called because the cardiac notch in the left lung (and its pleural covering) leaves
part of the pericardium exposed at this location. This is an area where the left lung
deflects laterally creating a dull space in the thorax. It is located in the Left
infrasternal angle, which is between the xiphoid process and costal margin, and can
also be accessed through the left 5th and 6th intercostal space immediately to the left
of the sternum.Rate this question:
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- 5.
While performing pericardiocentesis, you unintentionally pierce a vessel running parasternally within the internal thorax. What vessel has most likely been damaged?
- A.
Thoracic aorta
- B.
5th anterior intercostal artery
- C.
Inferior vena cava
- D.
Internal thoracic artery
- E.
Superior epigastric artery
Correct Answer
D. Internal thoracic arteryExplanation
The internal thoracic artery (aka internal mammary artery) is a branch of the
subclavian artery; it runs immediately lateral to the sternum (i.e., parasternally) along
the internal thorax, and thus may be damaged during pericardiocentesis. This artery
has 2 terminal branches: the superior epigastric and musculophrenic arteries.Rate this question:
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- 6.
During open heart surgery, you are instructed by the surgeon to clamp the outflow vessels of the heart. The anatomical space through which you will place the clamp is called:
- A.
The oblique pericardial sinus
- B.
The coronary sulcus
- C.
The transverse pericardial sinus
- D.
The sulcus terminale
- E.
The coronary sinus
Correct Answer
C. The transverse pericardial sinusExplanation
is correct because the transverse pericardial sinus is the space behind the
ascending aorta and pulmonary trunk, but anterior to the SVC.Rate this question:
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- 7.
A 2-year-old child presents with a ventricular septal defect, but he does not have Tetralogy of Fallot. With this congenital anomaly, which valve is most likely to be insufficient?
- A.
Tricuspid valve
- B.
Mitral valve
- C.
Aortic valve
- D.
Pulmonary valve
- E.
All valves
Correct Answer
A. Tricuspid valveExplanation
The tricuspid valve has 3 cusps (anterior, posterior, septal); because it
has a septal cusp, it is most likely affected by a ventricular septal defect. The
majority of VSDs occur in the membranous part, which is near to where the septal
cusp would be attached to the septum via the septal papillary muscles.Rate this question:
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- 8.
A 50 year-old male presents to his family physician for a well checkup. His past medical history is significant for Rheumatic Fever as a child. During heart auscultation, you hear a holosystolic murmur loudest in the left 5th intercostal space, midclavicular line. What do you suspect?
- A.
Mitral Regurgitation
- B.
Mitral Stenosis
- C.
Tricuspid Regurgitation
- D.
Aortic Stenosis
Correct Answer
A. Mitral RegurgitationExplanation
holosystolic murmur loudest over apex is likely mitral regurgitation, which can be
caused by rheumatic heart disease.Rate this question:
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- 9.
The base of the heart is mostly occupied by which chamber?
- A.
Right Atrium
- B.
Left Atrium
- C.
Right Ventricle
- D.
Left Ventricle
Correct Answer
B. Left AtriumExplanation
The opposite of the apex is the base of the heart, which is mainly comprised of the
left atrium.Rate this question:
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- 10.
One of the recurrent laryngeal nerves is usually shorter than the other. Which one and why?
- A.
Left; starts at ligamentum arteriosum
- B.
Left; starts at left subclavian artery
- C.
Right; starts at ligamentum arteriosum
- D.
Right; starts at right subclavian artery
Correct Answer
D. Right; starts at right subclavian arteryExplanation
The right recurrent laryngeal nerve loops under the right subclavian artery, while
the left RLN loops under the ligamentum arteriosum (between aortic arch and
pulmonary trunk); this makes the right one significantly shorter than the left one.Rate this question:
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- 11.
The right pulmonic border of the heart consists mainly of what chamber?
- A.
Right Atrium
- B.
Left Atrium
- C.
Right Ventricle
- D.
Left Ventricle
Correct Answer
A. Right AtriumExplanation
Right atrium forms right border of heart; on x-rays, this appears as a mostly
vertical line.Rate this question:
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- 12.
The inferior border of the heart is mainly supplied directly by what artery?
- A.
Right Coronary Artery
- B.
Right Marginal Artery
- C.
Posterior Interventricular Artery
- D.
Left Coronary Artery
- E.
Left Anterior Descending Artery
- F.
Left Circumflex Artery
Correct Answer
B. Right Marginal ArteryExplanation
Right marginal artery (aka acute marginal artery) is a branch of the right coronary
artery and runs along the inferior border, supplying most of the cardiac tissues along
this region.Rate this question:
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- 13.
The Middle Cardiac Vein travels with which artery?
- A.
Right Coronary Artery
- B.
Right Marginal Artery
- C.
Posterior Interventricular Artery
- D.
Left Coronary Artery
- E.
Left Anterior Descending Artery
- F.
Left Circumflex Artery
Correct Answer
C. Posterior Interventricular ArteryExplanation
Middle cardiac vein runs in the posterior interventricular grooveRate this question:
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- 14.
You see a pharmaceutical commercial advertising a revolutionary drug to treat Mitral Valve Prolapse that “tugs on the heartstrings.” Its mechanism of action most likely involves which muscles that act on the chordae tendinae?
- A.
Pectinate muscles
- B.
Trabeculae carnae
- C.
Papillary muscles
- D.
Myocardium
Correct Answer
C. Papillary musclesExplanation
Papillary muscles tense the chordae tendinae during systole, thereby preventing
valve prolapsed (pushback into the atria).Rate this question:
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- 15.
What is the embryological origin(s) of the right atrium?
- A.
Primitive atrium alone
- B.
Primitive atrium and right horn of sinus venosus
- C.
Primitive atrium and left horn of sinus venosus
- D.
Primitive atrium and pulmonary vein outgrowth
- E.
Sinus venosus alone
Correct Answer
B. Primitive atrium and right horn of sinus venosusExplanation
Remember the right atrium has 2 embryological origins. The atrium proper forms
the rough part and the right horn of sinus venosus forms the smooth part.Rate this question:
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- 16.
What structure carries the Right Bundle Branch to the anterior papillary muscles?
- A.
Crista terminalis
- B.
Sulcus terminale
- C.
Supraventricular crest
- D.
Septomarginal trabecula
- E.
Conus arteriosus
Correct Answer
D. Septomarginal trabeculaExplanation
The septomarginal trabecular (aka moderator band) carries right bundle branch
fibers to the anterior papillary muscle.Rate this question:
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- 17.
How many shunts are typically involved in healthy fetal circulation?
- A.
1
- B.
2
- C.
3
- D.
4
- E.
0
Correct Answer
C. 3Explanation
Fetal circulation: Placenta-Left umbilical vein-ductus venosus (1st shunt)-Inferior
vena cava-Right atrium-Foramen ovale (2nd shunt)-LA-LV-Aorta-Ductus arteriosus
(3rd shunt to pulmonary trunk)-Common iliac arteries-Umbilical arteries-PlacentaRate this question:
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- 18.
The radiologist reports back to you on a patient who presented to the clinic with shortness of breath (dyspnea) and chest discomfort: right middle lobe (RML) pneumonia. You know from your days in the anatomy lab that the RML has two segments. What are the functionally equivalent lobe and segments on the left?
- A.
Lower - superior and inferior segments
- B.
Lower - medial and lateral segments
- C.
Lingual - superior and inferior segments
- D.
Lingual - medial and lateral segments
- E.
Oblique - superior and inferior segments
- F.
Oblique - medial and lateral segments
Correct Answer
C. Lingual - superior and inferior segmentsExplanation
Although the left lung has only the superior and inferior lobes, functionally the
lingular portion is equivalent to the right lung's middle lobe. The lingular portion
consists of superior lingular and inferior lingular segments. Remember that even
without a "lingual lobe" the segments are autonomous for blood supply and can be
surgically removed if necessary.Rate this question:
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- 19.
A 50-year-old patient presents with a chief complaint of facial swelling which began several weeks ago. She also reports shortness of breath (dyspnea) with exertion. On examination, the patient is tender over the mediastinum. X-rays and fine needle aspiration reveal a mass consistent with a thymoma. What is the likely mechanism responsible for the patient’s symptoms?
- A.
Lung atelectasis
- B.
Compressed aortic arch
- C.
Underproduction of T lymphocytes
- D.
Compressed left brachiocephalic vein
- E.
Recurrent laryngeal nerve damage
Correct Answer
D. Compressed left brachiocephalic veinExplanation
A thymoma will occupy the most anterior area of the superior mediastinum, that is
just deep to the manubrium of the sternum. And just deep to the thymus gland we
find the left brachiocephalic vein, which would likely be compressed in an
overgrowth of the thymus. This compression may prevent blood from draining from
the left side of the head and neck as well as reduce venous return, producing
various symptoms similar to a superior vena cava syndrome.Rate this question:
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Oct 12, 2023Quiz Edited by
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Nov 29, 2011Quiz Created by
Chachelly
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