Upper Limb
A 45-year-old woman presents to the clinic with discomfort in her left shoulder. She recently underwent a left mastectomy and axillary dissection for breast cancer. Physical examination shows a notable protrusion of the posterior left shoulder blade when she is asked to push up against the wall. Which of the following spinal nerve roots give rise to the most likely affected nerve branch?
C3-C5
C5-C6
C5-C7
C8-T1
T2-T3
C5-C7
A 25-year-old track athlete comes to the clinic because of right groin pain and lower extremity weakness for the past 2 months. He notes worsening of symptoms with exercise. On examination, the patient has atrophy of the medial compartment of the right thigh with weakened adduction. Injury to which of the following nerves is the most likely cause of this patient’s presentation?
Femoral nerve
Inferior gluteal nerve
Obturator nerve
Sciatic nerve
Tibial nerve
Obturator nerve
A 34-year-old woman comes to the emergency department because of nasal congestion and headache for the past 3 weeks. She noticed increased facial pressure and pain, prompting her to seek medical attention. When asked about where she feels the most amount of pain and pressure, she points to the left side of her face, lateral to her nose and inferior to her eye.
Cavernous Sinus
Ethmoid Sinus
Frontal Sinus
Mastoid Sinus
Maxillary Sinus
Sphenoid Sinus
Maxillary Sinus
Name the first branch of the subclavian artery
Vertebral Artery
What is the name given to muscles that are responsible for closing the atrioventricular valves?
Pectinate Muscles
Papillary Muscles
Trabeculae Carneae
Chordae Tendinae
Papillary Muscles
A 17-year-old boy is brought to the clinic with shooting pain in his right hand following a snowboarding accident, in which he directly struck a tree with his arms raised. On physical examination, the right fingers are held in flexion at the proximal and distal interphalangeal joints. The patient also has decreased sensation over the medial aspect of his right palm, atrophy of the hypothenar eminence, and inability to maintain finger abduction against resistance. Which of the following parts of the brachial plexus is most likely injured in this patient?
Lateral Cord
Lower Trunk
Middle Trunk
Posterior Trunk
Upper trunk
Lower Trunk
A 60-year-old man visits a new physician to establish care. He reports one major illness as a child, after which he developed a limp. On physical examination, the patient stands on his right leg and subsequently the left hip drops and his trunk leans slightly toward the right. No abnormalities are seen when the patient stands on his left leg. Which of the following nerves is most likely injured in this patient?
Left femoral nerve
Left superior gluteal nerve
Right obturator nerve
Right superior gluteal nerve
Ventral rami of L2 & L3
Right superior gluteal nerve
A 3-year-old boy is brought to the hospital by his parents because of sudden difficulty breathing. His mother says he was sitting in the playground, playing with toys in a sandbox, when he began coughing. He was previously healthy and has received all scheduled childhood immunizations. Physical examination reveals chest retractions with accessory muscle use. Wheezing is heard on lung auscultation.
Which of the following lung structures is most likely affected in this child’s condition?
Left basilar bronchioles of the lower lobe
Left main bronchus
Lingula
Medium sized airways in the right lower lobe
Right posterior apex
Medium sized airways in the right lower lobe
A 16-year-old boy is brought to the emergency department by ambulance for severe leg pain after sustaining an injury during a football game. He was tackled from behind by another player and was hit in the back of his knee, landing with his knee bent. Physical examination is limited due to pain, but reveals a swollen extended right knee, a hypermobile patella, and no palpable pulses at the dorsalis pedis or posterior tibial artery. The toes are dusky red and decreased sensation over the lower leg is noted. Which of the following structures was most likely injured in this patient?
Anterior tibial artery
Common femoral artery
Deep femoral artery
Fibular artery
Popliteal artery
Posterior tibial artery
Popliteal artery
Name the coronary artery famously known as the "widow maker"
Left Anterior Descending Artery (LAD)
A 27-year-old man is brought to the emergency department after falling off a ladder from the height of the roof. An x-ray of the patient’s right arm shows a mid fracture of the humerus. Which of the following neurologic deficits is most likely to occur as a result of his fracture?
A protruding scapula
Inability to abduct the arm fully
Inability to hold a piece of paper between the fingers
Pain over the palmar aspect of the first three and a half digits
Weakness in wrist extension
Weakness in wrist extension
A 15-year-old boy is brought to the emergency department after falling off his skateboard. He reports numbness on the outside of his right leg. Physical examination reveals a swollen right knee. He is unable to dorsiflex or evert the right ankle. In addition, there is decreased sensation to the lateral leg and dorsum of the right foot. While walking, he raises the right leg high off the ground, and his foot subsequently slaps the ground. X-ray of the right lower leg shows a fracture.
Which of the following nerves is most likely to be compromised by the fracture?
Peroneal nerve
Deep peroneal nerve
Femoral nerve
Superficial peroneal nerve
Tibial nerve
Common fibular/peroneal nerve
A 3-year-old boy is brought to the pediatrician for a well-child checkup. He and his family recently immigrated to the United States. Physical examination reveals a gap in his left upper lip. When the boy closes his lips, his left central and lateral incisors are visible. His nares, palate, tongue, and sublingual area are intact. No other abnormalities are noted.
Which of the following prominences most likely failed to fuse, resulting in this patient’s presentation?
Bilateral lateral nasal prominences
Bilateral medial nasal prominences
Mandibular and medial nasal prominences
Maxillary and lateral nasal prominences
Maxillary and medial nasal prominences
Maxillary and medial nasal prominences
Name the 2 structures that run through the quadrangular space.
Axillary nerve & Posterior Circumflex humeral artery
In the fetus, deoxygenated blood from the pulmonary artery passes to the descending aorta via the _______
Blood going to the fetus via the umbilical vein is conducted through the ______ into the IVC, bypassing hepatic circulation.
Ductus Arteriosus & Ductus Venosus
A 20-year-old woman is brought to the emergency department after cutting her wrists in a suicide attempt. Physical examination reveals several superficial lacerations on the medial side of the ventral left wrist. She has some sensory loss over the left fifth digit. Surgical exploration of the wounds reveals a nerve injury. The function of which of the following muscles is most likely affected by this patient’s nerve injury?
Abductor Pollicis Brevis
Adductor Pollicis
Extensor Pollicis brevis
Lumbricals (1 & 2)
Opponens Pollicis
Adductor Pollicis
A 20-year-old man is brought to the student health clinic after sustaining a knee injury during rugby practice. He says he landed with a planted knee and was kicked by another player on the lateral side of the knee. On examination of the injured knee, the tibia is displaced anteriorly from the femur in the flexed position; and a click is heard when the patient’s knee is externally rotated and passively extended from 90 degrees to 0 degree. Which of the following structures are most likely injured?
Lateral collateral ligament, anterior cruciate ligament, medial meniscus
Lateral collateral ligament, posterior cruciate, lateral meniscus
Medial collateral ligament, anterior cruciate ligament, medial meniscus
Medial collateral ligament, posterior cruciate, lateral meniscus
Medial collateral ligament, posterior cruciate, medial meniscus
Medial collateral ligament, anterior cruciate ligament, medial meniscus
A 45-year-old woman presents to the clinic with hoarseness following surgical removal of the parathyroid glands to treat her hyperparathyroidism. With visualization using a laryngoscope, the right vocal cord adducts to the midline, but the left vocal cord is fixed in the paramedian position.
Which of the following nerves is most likely injured in this patient?
Hypoglossal Nerve
Left external laryngeal nerve
Left recurrent laryngeal nerve
Right external laryngeal nerve
Right recurrent laryngeal nerve
Left recurrent laryngeal nerve
I originate just anterior to medial malleolus, runs along the medial aspect of the calf giving off 3 calf perforator branches at 3, 5 and 10cm above the medial malleolus and along the medial thigh to join the femoral vein in the groin. What vein am I?
Long Saphenous Vein
The smooth part of the right atrium (sinus venarum) is derived from which embryonic structure?
Right horn of sinus venosus
Left horn of sinus venosus
Primitive atrium
Primitive ventricle
Right horn of sinus venosus
A 21-year-old man comes to the physician for follow-up examination 2 months after being treated for a knife wound to the neck. He was stabbed on the right side just posterior and inferior to the angle of the mandible. He reports that recovery has been slow and that he is having sharp, shooting pain that radiates from his neck to his upper back and down his right arm. He has also noticed that he cannot lift his arm above shoulder level. On examination, there is drooping of the right shoulder. The pain is worse when pressure is applied to the right shoulder. Shoulder shrug is weaker on the right side and the patient has difficulty flexing his head to that side. Which of the following muscles is most likely involved in this patient’s weakness?
Deltoid
Levator Scapulae
Scalene
Sternocleidomastoid
Splenius Capitis
Trapezius
Trapezius
A 69-year-old man comes to the office because of pain in his right leg. The pain starts in his lower back and right buttock and shoots down his leg. It is worse when he tries to bend over. On physical examination, a straight leg raise on the right reproduces the pain. Active dorsiflexion is weaker in the right foot. Flexion of the hip against resistance is normal. There is decreased sensation in the plantar aspect of the right foot. The nerve most likely affected in this patient passes between which of the following two muscles as it leaves its origin?
Gastrocnemius and Soleus
Gluteus maximus and gluteus medius
Gluteus maximus and obturator internus
Peroneus longus and extensor digitorum longus
Piriformis and Superior Gamellus
Piriformis and Superior Gamellus
A 65-year-old man comes to the clinic with hoarseness that began after a thyroidectomy for follicular thyroid carcinoma. An electromyogram reveals paralysis of all intrinsic laryngeal muscles except one. Which of the following is the embryologic origin of the nerve that most likely supplies the nonparalyzed muscle?
Pharyngeal Arch 1
Pharyngeal Arch 4
Pharyngeal Arch 6
Pharyngeal Cleft 1
Pharyngeal Pouch 2
Pharyngeal Pouch 3
Pharyngeal Arch 4
A 70-year-old woman comes to her physician because of increasing right hip pain. Two years ago she underwent open operative reduction and pinning of a right femoral head fracture after a fall. The surgery was uncomplicated, as was the postoperative recovery. On examination, there is limited motion of the right hip with severe pain during active and passive motion. An MRI scan shows areas of bone infarction and bony destruction in the femoral head. Injury to which of the following arteries is most likely responsible for this patient’s current findings?
Deep femoral artery
Inferior gluteal artery
Lateral femoral circumflex artery
Medial femoral circumflex artery
Obturator artery
Medial femoral circumflex artery
A patient presents to the emergency room with muffled heart sounds, hypotension and distended neck veins. Name the clinical syndrome.
Cardiac Tamponade