2005 10 24 Review Answers

Richard T.
Kiok
October 24, 2005
1) A. Superficial branch of Radial

2) D. Primitive Streak. The teratoma has remnants of all three germ layers, which are present
in the Primitive Streak.
3) E. None of the Above. The foramen lacerum is covered with a membrane. The ICA runs
just superior to it.
4) D. The phyarngobasilar fascia extends from superior constrictor to basilar portion of
occipital bone.
5) C. Filiform. These are pressure and temperature sensors.
6) D. Scarpa’s fascia – more fibrous, superficial layer, predominant in inferior abdomen.
7) D. "claw hand". The ulnar nerve innervates the medial two lumbricals, and the median
nerve innervates the lateral two lumbricals. Over the metacarpophalangeal joints, the
lumbricals are flexors. Therefore, palsy of those muscles from a lesion in the nerves
innervating them will cause the joints to be hyperextended. Over the interphalangeal
joints, the lumbricals are extensors because they pass dorsally as they move distally in the
finger. So, palsy of the lumbricals will cause curling, or flexion, of the interphalangeal
joints. Dr Lopez referred to an ulnar lesion as causing "claw hand", with just the fourth and
fifth digits affected. Dr Shea said that this term is also used to refer to "clawing" of the four
non-thumb digits.
8) E. Flexor pollicis brevis – only one not innervated by Deep Palmar Branch of Ulnar nerve.
Innervated by Recurrent branch of Median Nerve.
9) D. The inferior belly of omohyoid is found in the Posterior Cervical Triangle.
10) B. ulnar and median nerves. The radial artery can be found BETWEEN the extensors and
flexors in the the forearm. The flexors, originating from the medial epicondyle of the
humerus, are innervated by the ulnar and median nerves. The extensors, originating on the
lateral epicondyle, are innervated by the radial nerve (ie, posterior interosseus nerve).
11) B. The Opthalmic Artery and Optic Nerve are the structures transmitted through the optic
canal.
12) B. Ulnar a.
13) C. Pronator Teres m. This muscle crosses at the distal end of the cubital fossa and the
ulnar artery proceeds deep to it.
14) C. The hypoglossal n. goes through Hypoglossal canal. The rest go through Jugular
Foramen.
15) T8 – remember the mnemomic; I ate 10 eggs at 12. I = inferior vena cava (T8), eggs =
esophagus (T10), at = descending aorta (T12) (8/25/05 Dr Schmidt, Posterior Abdominal
Wall, slide 23)
16) D. Superior Mesenteric a. It sends middle and right colic aa that anastomose to form that
portion of the marginal a (frontnotes 8/25/05 Posterior Abdominal Wall pp10-11; BRS,
p223).
17) E. Mental n. – recall, the mnemonic “two zebras bit my cheek.” The “m” is “mandibular.”
The mental nerve is a branch of V3, via the inferior alveolar n. (09/21/05, 8am, Schmidt –
Face).
18) B. Subacromial bursa (10/20/05, Lopez, slide 13 – UL joints)
19) A. Triceps brachii (long head) – illustration (couldn’t find this in notes or lectures, but it’s
true; follow the link for an explanation & illustration)
20) A. Splenic and Superior Mesenteric vv. (frontnotes 8/25/05 Posterior Abdominal Wall p4)
Practice Written Exam Answers
Human Form & Development
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© 2005 Richard T. Kiok
Richard T. Kiok
October 24, 2005
21) C. Long Thoracic n. The long thoracic nerve innervates the serratus anterior, which
originates from the ribs and inserts onto the medial aspect of the scapula, thereby helping
to hold it in place. if the nerve wasnt working, muscle wouldn’t work, scapula would fly
up. (8/11/05, Schmidt – Pectoral Region & Thoracic Wall lecture, slide 17)
22) A. Pudendal. As the pudendal n (s2-4) enters the lesser sciatic foramen, it ramifies to
produce the dorsal n. of the penis, the perineal n., and the inferior rectal n. (8/26/05, Dr
Mehta, slide 38 – male perineum)
23) A. Superior Oblique. Remember the mnemonic: SO4LR6 remainder3 – superior oblique –
cn4; lateral rectus cn6; remainder of extraocular mm – cn3 (10/3/05 orbital anatomy
lecture, frontnotes pp2-3)
24) C. Splenic. The celiac trunk produces left gastric, splenic, and common hepatic aa. Netter
256, 290 (8/23/05 Schmidt – supracolic lecture, slide 14)
25) B. A pancoast's tumor impinging on the stellate ganglion. A Pancoast's (or superior
pulmonary sulcus) tumor is a malignant neoplasm of the lung apex, which causes
Pancoast's syndrome. Pancoast's syndrome involves lower trunk brachial plexopathy
(severe pain to the shoulder along the medial aspect of the arm and weakness/atrophy of
forearm and hand muscles). Horner's syndrome results from injury or lesion to the
cervical sympathetic nerves and is characterized by the aforementioned symptoms.
Infection of the cavernous sinus is not correct because it would result, among other things,
in protrusion of the eye, not retraction. The key to answering this question is realizing that
these symptoms are due to an injury to sympathetics, and identification of the Pancoast's
tumor by the hoarse voice. The close proximity of the apex of the lung to the
cervicothoracic or stellate ganglion (in front of the neck of the first rib) indicates that (B) is
the correct response.
26) C. The phrenic nerves are in the middle mediastinum, all the other structures are in the
posterior mediastinum. Remember the mnemonic: a great POSTERIOR will get you
DATESS [Duct (thoracic) Azygos system, Thoracic aorta, Esophagus (and vagus),
Sympathetics & Splanchnics]. (See also 8/17/05 mediastinum lecture, slide 8; frontnotes
8/16/05 heart & pericardium p1)
27) D. Sympathetic presynaptic fibers, sympathetic postsynaptic fibers, and visceral afferent
accompanying the sympathetic fibers
28) D. Proximal to the septal cusp of the tricuspid valve. The atrioventricular node of the AV
conduction system is located in the right atrium, above the septal cusp of the tricuspid
valve (Netter plate 219). The AV bundle runs from the AV node along the membranous
part of the interventricular septum. In the muscular part of the interventricular septum, it
the AV bundle splits into right and left branches (BRS 164).
29) D. The circumflex coronary artery is a branch off of the LCA that travels around the heart
in the AV groove supplying the left atrium and part of the left ventricle. It then
anastomoses with the RCA.
30) E. Stylopharyngeus (BRS 428)
31) B. Atresia most commonly located in the fourth portion of the duodenum
32) C. Vocalis (see Gray's text pg 958, BRS 440). Vocalis runs parallel to vocal ligament,
adjust tension in vocal folds (frontnotes 10/3/05 Eisenberg – Pharynx & Larynx, p4-10-b-
iv).

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33) D. posterior ramus (see Gray's text pg. 70). intrinsic mm are innervated by segmental
branches of the posterior rami of spinal nn (8/9/05 Dr. Ariyo – Back lecture, slide 22).
34) C. teres major (upper limb musculature lecture). Teres major innervated by lower
subscapular n (c5, c6, c7) (10/10/05 Dr. Lopez ULMm lecture, slide 23). According to
BRS 48, subscapularis (D) is also correct.
35) C. between mid. and inf. constrictors (pharnyx lecture). Internal laryngeal n travels
through pharyngeal wall between middle & inferior constrictor mm (10/3/05 Dr.
Eisenman, Pharynx & Larynx lecture, slide 5).
36) C. Ascending Colon. The ascending colon is supplied by middle mesenteric a. (Netter
plate 296)
37) B. Flexor Hallucis Longus. Flexor hallucis longus insertion is located on the fibula.
(Netter plate 497)
38) A. It is more common in females. Unilateral renal agenesis is present in 1/1000 newborns
and is more prevalent in males. The left kidney is more commonly absent, and its absence
is usually not determined until after birth. This condition is compatible with life. (see
Moore 299)
39) C. Oligohydraminos is associated. This condition, in which both kidneys are absent, is
present in about 1 in 3000 newborns. It is associated with oligohydramnios (low volumes
of amniotic fluid) because little or no urine is excreted. Prenatally, kidneys supplement the
amniotic fluid. Malformed kidneys are unable to supplement the fluid properly yielding
too little amniotic fluid. The condition is often accompanied by other congenital defects,
and it is incompatible with postnatal life.
40) D. External laryngeal nerve. The superior laryngeal nerve is a branch off of the vagus
nerve (CN X) which then branches into the internal and external laryngeal nerves. The
only muscle innervated by the external laryngeal nerve is the cricothyroid muscle. (Can be
found in the pharynx/larynx notes or on page 311 of the dissector.)
41) C. Flexor digitorum longus muscle. Only the FDL originates on the posterior tibia. The
soleus does have an origin point on the tibia also, but also originates on the fibula as well.
(Can be seen on Netter Plate 497.)
42) A. triangular space of the arm. (BRS 34 and Netter 409)
a) The triangular space of the arm is bound by the long and medial head of the triceps,
and teres major. The radial nerve and deep brachial artery pass through here.
b) The upper triangular space (of the shoulder) is bounded by the subscapularis
(posteriorly) or teres minor (anteriorly), teres major, and long head of triceps. The
circumflex scapular artery passes through here.
c) The quadrangular space is bounded superiorly by the teres minor m (anterior) or
subscapularis m (posterior), surgical neck of the humerus laterally, long head of the
triceps m, and teres major inferiorly. It transmits the axiallary nerve and posterior
circumflex humeral artery.
d) The Triangle of Ascultation is bounded by the upper border of the Latissimus Dorsi
m., lateral border of the Trapezius m., and the medial border of the scapula. The
floor is formed by the Rhomboid Major m. Breath shounds are heard here most
clearly.
43) B. lateral head of triceps brachii muscle

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44) C. Flexion of the PIP joints of digits 3 and 4. When cutting the ventral side of the wrist, the
first tendons cut would be the tendons of flexor digitorum superficialis. These tendons help
flex the metacarpophalangeal and proximal interphalangeal joints, but not the distal
interphalangeal joints. Flexor digitorum profundus (which has deeper tendons) is
responsible for flexing the distal interphalangeal joints. To understand the next part of the
question, look at Netter plates 430 and 431. The tendons of flexor digitorum superficialis
are arranged in a packet with two superficial tendons and two deeper tendons. The tendons
that go to fingers 3 and 4 are superficial, while the ones to finger 2 and 5 are underneath.
So, the tendons to fingers 3 and 4 will be cut, impairing flexion of the proximal
interphalangeal joints of digits 3 and 4.
45) C. Ilioinguinal. A direct inguinal hernia is caused by a weakness in the abdominal muscles
which prevents a patient from contracting these muscles strongly. If this patient can't
contract his muscles, he can't pull the falx inguinalis down to cover the thin area of weak
fascia on the posterior wall of the inguinal canal. The ilioinguinal nerve is important for
innervating the muscles of the lower abdominal wall. So, if this nerve was damaged during
the appendectomy, the man might not be able to contract his abdominal muscles and pull
the falx inguinalis over the weak fascia. This could have led him to develop the direct
inguinal hernia. The genitofemoral nerve innervates the cremaster muscle. An injury to this
muscle would lead to an inability to elevate the testes, but it would not compromise the
strength of the abdominal wall. The subcostal nerve and the ventral primary ramus of T10
innervate muscles, skin & fascia of the upper abdominal wall. These nerves are too
superior to affect the inguinal region.
a) According to BRS (197), answers C, D, and E could all be correct. The transverses
abdominis m and internal abdominal oblique make the conjoint tendon (falx
inguinalis), and both are innervated by all three of those choices.
46) C. The action of the supraspinatus muscle is the first 15-30 degrees of abduction (the
middle portion of the deltoids to the rest of the abduction). The subscapular is like the
infraspinatus muscle in attachment (greater tubercle) and innervation (suprascapular n. C5-
C6), but not in action.
47) B. The obturator nerve innervates muscles of the medial thigh – gracilis, pectineus,
adductor longus, adductor magnus, adductor brevis, and obturator externus.
48) D. The deep branch of the radial n. doesn't extend into the hand. The other nerves continue
indirectly as branches innervating the superficial digital skin or the digital muscles.
49) C. The cricoid cartilage is the only one the forms a complete ring, and thus cricoid pressure
compresses the esophagus so the doctor can see the opening of the trachea. The thyroid
cartilages and tracheal rings form "C" shapes and are open posteriorly, so they won't help.
The aytenoids were just thrown in because I needed another answer choice and they're in
the larynx.
50) B. The right mainstem bronchus is more vertical than the left and the middle lobar branch
is the most posterior on the right side.
51) A. Greater Auricular Nerve. The greater auricular nerve is responsible for cutaneous
innervation of the skin of the earlobe and the angle on the mandible. Taken from a quiz on
Netter’s Interactive Atlas.
52) C. Intercostobrachial Nerve. Taken from a quiz on Netter’s Interactive Atlas.

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53) C. Inferiorly and Medially, see the extraocular PPT Schmidt posted, physical exam portion
on the right side or p 842 Grays Note: the 4th cranial n, rochlear, inn's the SO, the
ACTION of the SO is to look Inferiorly and laterally, but you need to isolate it in order to
test it.
54) C. Ant IV, aka LAD, aka the widow-maker, see p 173 Grays. Related Point: Note that the
RCA is from the aortic sinus of R semilunar cusp of Aorta, LCA from L cusp.
55) D. Pelvic Splanchnic nerves are the only splanchnic nerves that carry PS fibers according
to our ANS lecture and the book.
56) B. According to pectoral & thoracic wall lecture & BRS page 30: The costocorachoid
membrane “is a part of the clavipectoral fascia that covers the deltopectoral triangle & an
interval between the subclavius and pectoralis minor muscles.”
57) A. Palatoglossus m. is innervated by CN X
58) A. Orbit lecture & BRS page 410. Tears enter the lacrimal canaliculi through their
lacrimal puncta (which is on the summit of the lacrimal papilla) before draining into the
lacrimal sac, nasolacrimal duct, and finally the inferior nasal meatus (BRS 410).
59) D. Inf. laryngeal n. is below the inferior constrictor
60) D. Tilting the head to one side. Maxillary sinus drains into the middle meatus via the
hiatus semilunaris when tilting the head to the side.
61) A. Vagus is parasympathetic for GI tract until the left colic flexure, then Pelvic Splanchnic
takes over.
62) C. Lunate. The tubercles of the scaphoid/trapezium participate in the lateral border while
the pisiform and the hook of the hamate participate in the medial border.
63) B. Central Retinal Artery. This artery, a branch of the ophthalmic artery from the internal
carotid is the only branch in this region with no anastomotic connections. It is located
within the course of the Optic Nerve, CN 2. If occluded, sudden onset unilateral loss of
vision will occur.
64) C. Short head of biceps femoris. The hamstring group originates from the ischial
tuberosity and is innervated by the tibial nerve. Short head of biceps femoris originates on
the linea aspera and is innervated by the common fibular nerve.
65) D. Maxilla. The anterior lacrimal crest is on the maxillary bone. The posterior lacrimal
crest is on the lacrimal bone. The lacrimal fossa is between the crests; it contains the
lacrimal sac (not lacrimal gland!).
66) C. Gonadal veins. Important relationships to the following is basis for positive psoas sign:
(1) kidneys, (2) ureters, (3) cecum, (4) appendix, (5) pancreas, (6) sigmoid colon, (7)
lumbar vertebrae, (8) lumbar lymph nodes. Taken from 8/25/05 Posterior Abdominal Wall
lecture – slide 9, or frontnotes p 2.
67) D. Subscapularis. The subscapularis muscle inserts on the lesser tubercle of the humerus
(it is the only rotator cuff muscle which does not insert on the greater tubercle.)
68) B. Ulnar nerve. Erb’s Palsy does not produce lesions of the Ulnar nerve (C8-T1). It is an
injury to C5 and C6 (and sometimes C7) and produces lesions of the axillary,
musculocutaneous and suprascapular nerves. It produces “waiter’s tip” hand because it
paralyzes the lateral rotators of the arm (teres minor and infraspinatus) which are
innervated by the axillary and suprascapular nerves. The frontnotes say the supraspinatus
is a lateral rotator that is paralyzed because it is innervated by supraspinatus. However,

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although it may be paralyzed it is primarily responsible for the first 15-30 degrees of
abduction.
69) D. Annulus Fibrosis. Annulus fibrosis, the outer portion of the intervertebral disc, is
fibrocartilage (Found in Gray’s p. 41 and Supportive Tissue lecture/frontnotes).
70) C. Anterior Clinoid Process. The internal occipital protuberance, crista galli, and frontal
crest are all attachment sites for the falx cerebri. Other sites of attachment for the
tentorium cerebelli are the posterior clinoid process, superior border of the petrous part of
the temporal bone, the internal surface of the occipital bone along the grooves for the
transverse sinuses. (Gray’s p. 783 and backnotes)
71) D. Upper lobe of the left lung. Page 143 of Gray.
72) C. SA node Æ AV node Æ AV bundle of His Æ Purkinje fibers. Page 177 of Gray. One
key thing to remember is that the SA node is the pacemaker of the heart.
73) D. Quadrate lobe of liver. P. 267 of Gray.
74) B. Internal spermatic fascia, from transversalis fascia. P. 262 of Gray.
75) B. Failure of the urethral groove to fuse. Malposition of the genital tubercle results in
epispadias, failure of the palatine processes to fuse would affect development of the palate,
and triomy 21 is Downs syndrome. (genital system development lecture)
76) A. Lateral wall of the nasal cavity. It is in the lecture slides on nasal cavity. The incisive
canal runs between the oral and nasal cavities.
77) A. Dorsiflexion is controlled by the deep fibular nerve while cutaneous innervation of the
lateral lower leg is superficial. Therefore, with cutaneous lateral innervation intact, but
dorsiflexion not intact, the injury must be to the deep fibular nerve. Cannot be in the
common fibular b/c then the person would have no lateral leg muscle or cutaneous
innervation.
78) B. flexor digitorum brevis
79) D. Inferior tracheobronchial nodes (Lungs & Pleura lecture).
80) C. Hepatoduodenal (Supracolic Region lecture).
81) E. The ulnar nerve runs posterior to the medial epicondyle in a groove, making it
susceptible to damage upon fracturing the medial epicondyle. Plus, none of the other
nerves are in contact with the medial epicondyle. (See Gray's p. 685 "In the clinic" or
Chung's BRS Gross Anatomy p 79, #48)
82) E. Of these, only the hemiazygous vein is in the posterior mediastinum, which itself lies
posterior to the pericardium between the mediastinal pleurae. The braciocephalic veins,
trachea, and aortic arch are in the superior mediastinum, whereas the arch of the azygous
vein is in the middle mediastinum. (See pp. 192 & 196 in Gray's or BRS p 191, #23)
83) C. Cervical spinal nerves exit through the intervertebral foramen above their respective
vertebral pedicle (e.g. spinal nerve C3 exits the foramen b/t C2 and C3), keeping in mind
that C8 exits the intervertebral foramen below C7 because it is an “extra” (so-to-speak)
cervical spinal nerve. Thoracic and lumbar spinal nerves, however, exit through the
intervertebral foramen BELOW their respective vertebral pedicle (e.g. spinal nerve L4
exits the foramen between L4 and L5) BUT above the corresponding intervertebral disc
(e.g. L4 nerve exits the L4/L5 intervertebral foramen above the L4/L5 disc). If the L2/L3
disc is protruding, it will affect L3 and not L2 because L2 will have passed out of the
foramen before the L2/L3 disc. It does not affect the spinal nerves below L3 because it is a
lateral protrusion instead of a medial protrusion (the more inferior the spinal nerve, the
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more medial it lies as it courses downward to its corresponding foramen – i.e. S5 is medial
to S4, which is medial to S3, which is medial to S2 within the vertebral canal, and so on).
Therefore, if it would have been a medial protrusion, it could have affected the spinal
nerves below. For a pictorial explanation, look at Netter Plate 154.
84) B. Thoracentesis is a procedure that aspirates fluid from the pleural cavity of the thorax.
This fluid should be drained from the costodiaphragmatic recess, i.e. the potential space
between the visceral pleura and diaphragmatic pleura. To avoid puncturing the lungs, liver,
diaphragm, etc. the fluid can be drained between either the 8th or 9th intercostal space,
which are the spaces below the 8th and 9th ribs, respectively. Finally, the puncture should
always be placed immediately above the superior margin of the rib to avoid the intercostal
neurovascular bundles (V.A.Ns) that rest in the costal grooves (on the posteroinferior
surface) of their corresponding ribs. (There is a slight discrepancy b/t Dr. Schmidt’s lecture
and the BRS, with the BRS saying that fluid can also be obtained from the 7th intercostals
space, but Dr. Schmidt saying that during passive breathing the lungs descend to the 8th rib
along the midaxillary line, which would imply that you cannot puncture the 7th intercostal
space.) For further reference, check out Schmidt’s “Pectoral Region and Thoracic Wall”
Lecture, pg. 7, 3rd slide, with a diagram of thoracentesis and intercostals nerve blocks.
Also, if you have access, check out BRS p. 150, red box 4.19.
85) C. The internal spermatic fascia is formed by transversalis fascia, not the transversus
abdominus muscle. See Gray p. 257.
86) D. Subscapularis. All other answers are wrong because they are not rotator cuff muscles
and therefore play no role in stabilizing the shoulder joint. The one other rotator cuff
muscle is supraspinatus, however this muscle abducts the arm, it doesn't adduct.
Subscapularis m. fits the description perfectly.
87) C. Through the posterior cervical triangle. Explanation: Clearly stated in Dr. Eisenman's
lecture (and frontnotes). All the other answers are just plain wrong. Erb's point is the site
of emerging branches of the cervical plexus, not brachial.
88) C. The stomach is not in the right hypochondriac region, but is in the other three. If a
subcostal plane (vertebral level S3) was used the stomach wouldn't be in the umbilical
either. Using the transpyloric plane (L1) makes the very bottom of the stomach part of the
umbilical region. See Gray’s p272.
89) C. This question is from Grays p 286 where it says the liver is NOT covered by visceral
peritoneum on the porta hepatis, region of the gallbladder, or bare area. The attachment of
the lesser omentum is not mentioned so we can assume that it is covered by visceral
peritoneum.
90) A. The foregut begins in the second, or desceding, part of the duodenum below both
papillae. The minor papilla is superior to the major. See Grays 289 and 295.
91) D. They are small tributaries of the portal vein. Grays 303.
92) C. The superior rectal artery is from the IMA. The Middle rectal is a direct branch from the
anterior branch of the internal iliac. The inferior rectal is a branch of the internal pudendal
which comes off the anterior internal iliac. The inferior vesicle is not involved.
93) E. the geniculate ganglion only contains cell bodies for sensory neurons. All the other
choices are true. (Gray’s pp. 804 and 869-870; also in ear lecture).
94) B. The superficial fibular nerve splits into medial dorsal cutaneous nerve and intermediate
dorsal cutaneous nerve, which pass superficial to the extensor retinaculum to innervate the
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dorsum of the foot (Netter plate 524). Everything else passes deep to the extensor
retinaculum (Netter plate 512).
95) D. 4th LICS. Question taken from Schmidt's "Heart and Pericardium Lecture," pg 9, slide
titled "Auscultation of Cardiac Valves." "C" is the only choice that is NOT a position to
listen for ANY heart sounds. A = aortic valve, B = pulmonic valve, D = tricuspid valve
and E = bicuspid/mitral valve. Also text/picture on pp 204-205 of Gray's that demonstrates
this.
96) E. Refer to pages 377 & 379 of the Moore Embryology text. A swiss cheese VSD refers
to multiple small muscular VSDs, the less common form. VSDs occur more frequently in
males, while ASDs (atrial septal defects) occur more commonly in females. The most
common form of ASD is a patent foramen ovale. In a VSD, blood would be shunted from
left-to-right because the pressure on the left side of the heart is higher than that on the right
side.
97) A. The tibial and common fibular nerves are the most superficial of the neurovasculature
structures, and the popliteal artery is the deepest. The common fibular nerve exits
LATERALLY, across the head of the fibula to innervate structures in the lateral
compartment of the leg. There are anterior and posterior TIBIAL arteries and a fibular
nerve (from the posterior tibial a) from the popliteal a. (Gray 542)
98) B. The sphenopalatine a is the terminal branch of the maxillary artery in the
pterygopalatine fossa. It reaches the nasal cavity through the sphenopalatine foramen and
supplies both the lateral walls and the septum. It anastamoses with anterior and posterior
ethmoidals (from opthalmic a, which is from ICA). It also has anastamoses with the
greater palatine artery, but it does not travel with the artery through the greater palatine
foramen. (Refer to pp. 978 & 979 of Gray's; Netter Plate 37.)
99) D. The Vidian Nerve is formed by the union of the greater petrosal nerve (from the facial
n, carrying presynaptic parasympathetic fibers) and the deep petrosal n (from the carotid
plexus, carrying postsynamptic sympathetic fibers). It travels in the pterygoid canal to
reach the pterygopalatine ganglion. (Netter 125 & 127)
100) D. The deep ring is located lateral to the inferior epigrastrics. A direct inguinal hernia will
be located medial to the inferior epigastrics because a direct hernia does not go through the
deep ring. A direct hernia will pass through Hesselbach’s triangle which is bordered
laterally by the inferior epigastrics, medial by the lateral border of the rectus sheath and
inferiorly by the inguinal ligament. The roof of the inguinal canal is made by arching
fibers of the IAO and TA not transversalis fasica. The testis/ovaries drain into pre-aortic
and lumber lymph nodes, while the scrotum/labia majora drain into the superficial inguinal
nodes. The conjoint tendon (joining of IAO and TA) reinforces the posterior wall of the
inguinal canal. The anterior wall is reinforced by the IAO and the floor is reinforced by
the inguinal ligament.
101) A. 1st part.
102) D. Right ureter. The root of the mesentery is also crossed by the 3rd and 4th parts of the
duodenum, the abdominal aorta, the IVC, right psoas and right gonadal. From Infracolic
lecture slides
103) B. From mediastinum lecture notes
104) D. The anterior cardiac vv empty directly into the right atrium (Gray's p 175).

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105) C. When lying on the right side, aspirated objects find their way into the posterior segment
of the superior lobe. (Page 7 of notes on the Lungs & Pleura)
106) D. Stylopharyngeus m.
107) D. Lacrimal n.
108) C. Stomach
109) B. Injury to the radial n results in paralysis of the muscles in the posterior compartment of
the forearm. Patients may also present with an inability to extend the elbow.
110) D. The thoracodorsal nerve is a branch of the Posterior cord while the nerve to subclavius
and the suprascapular nerve come from the superior trunk and the dorsal scapular nerve
comes from the root of C5.
111) B. (all information taken from notes/supracolic lectures)
a) the duct of Santorini is the minor pancreatic duct. the statement describes the major
pancreatic duct (or Wirsung).
b) Sphincter of Oddi is another name for the sphincter of ampulla.
c) major and minor pancreatic ducts normally join (Gray's 288). uncinate process is
normally collected by the accessory bile duct.
d) the duodenal papilla are normally found in the 2nd (descending) part of the
duodenum.
e) gall stones found at the spiral folds will only prevent bile from entering/exiting the
gall bladders. the gall bladder is only for storage, and does not make bile, so there is
not a build-up of bile in the gall bladder.
f) minor duodenal papilla (of Vater) is normally proximal to the major duodenal
papilla.
112) C. Retrocecal
113) C. Lungs
a) A. the kidney lies in a retroperitoneal position. No specific name is associated with
its covering. The order of structures (internal to external) is: renal capsule,
perinephric (perirenal) fat, renal fascia, paranephric (pararenal) fat, transversalis
fasic. The renal fascia must be incised in any approach to the kidney (Gray's 321).
b) B. Liver is surrounded by Glisson's capsule
c) C. Correct answer. Also the cervical pleura, which protrudes out of the thorax and is
vulnerable to injury.
d) D. Pancreas is secondarily retroperitoneal (Gray's 288)
e) E. the spleen is covered by a very thin fasia and is vulnearble to rupture even if the
surface is not damaged. Location of the spleen is on the left side at ribs 9-12 (?)
f) F. Suprarenal glands are surround by the perinephric (perirenal) fat and the renal
fascia (Gray's 327).
114) C. CN X
115) D. joint between the occipital bone and parietal bones
116) A. pharyngobasilar fascia
117) C. zygomatic, Netter plate 4
118) B. palatoglossus, see Dr. Eisenman's lecture on the oral cavity, pg. 4
119) C. Adenoids may block the opening of the auditory tube in the nasopharynx. This can lead
to hearing impairment. An infection in the nasopharynx can also spread to the middle ear
through the auditory tube, resulting in otitis media.
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120) False. The Edinger-Westphal nucleus in the brainstem gives rise to pre-ganglionic,
parasympathetic fibers that travel to the Cilliary ganglion via the inferior division of the
occulomotor nerve. (Orbital anatomy lecture.)
121) A. upper lobe, posterior segment. The object goes into the trachea Æ right main bronchus
Æ upper segmental bronchus Æ posterior segment. (from notes)
122) D. left ventricle - Anatomical relationships: left ventricle is the only one that doesn't
contact the esophagus.
123) D. posterior wall. The posterior wall is composed of transversalis fascia and is reinforced
medially by the conjoint tendon(composed of internal oblique and transversus abdominus
aponeurosis).
124) D. The chorda tympani carries pre-ganglionic parasympathetic fibers to the sublingual
ganglion, from where POST-ganglionic parasympathetic fibers run to provide
secretomotor innervation to the submandibular and sublingual glands.(Infratemporal Fossa
lecture)
125) A. Sibson’s Fascia (taught in the Lungs and Pleura lecture). If you seriously chose E, drop
out already. (That comment is from the author, but I loved the answer choice so much that
I kept it.)
126) D. S2. taught to us in the Spinal Cord lecture in week 1.
127) C. facial nerve. A facial nerve branch, the greater petrosal nerve, synapses at the
pterygopalatine ganglion and it's postganglionic fibers travel with V2 (maxillary div.-
trigeminal) to the lacrimal gland providing secretomotor innervation.
128) A. kidney. It is retroperitoneal.
129) E. Preganglionic parasympathetic fibers that originate from CN IX enter the otic ganglion
Æ postganglionic parasympathetic fibers carried by V3 exit the ganglion and innervate the
parotid gland.
130) B. The abducens nerve and internal carotid artery travel through the cavernous sinus. The
oculomotor, trochlear, ophthalmic, and maxillary nerves travel through the lateral wall of
the cavernous sinus. (Gray's p 796 and BRS Gross Anatomy 4th ed. p342)
131) A. The malleus receives vibrations from the tympanic membrane which it passes on to the
incus which is passed on to the stapes which is in direct contact with the oval window of
the vestibule. The round window is involved in pressure relief. (Gray's p 858)
132) A. The isthmus is at the level of the 2nd and 3rd thyroid gland.
133) A. Occurs at the radioulnar joints.
134) C. recurrent laryngeal
a) is associated with the superior thyroid artery
b) runs with the carotids and the internal jugular
c) Correct answer. See Netter pg 72 (bottom picture)
d) is associated with the superior laryngeal artery
135) C. Thickening of the lens for near vision. This action is controlled by parasympathetic
fibers. When the short ciliary nerve is severed, postganglionic parasympathetic fibers from
the ciliary ganglion will not reach the eye. However, sensory and sympathetic fibers may
reach the eyeball from the nasociliary nerve. (See Gray's 849-850 and figure 8.100)
136) D. The coronary sinus drains to the right atrium, of which the crista terminalis is a
characteristic feature. The trabeculae carnae is a feature of both the right and left

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ventricles; the conus arteriosus and the pulmonary valve are both characteristic of the right
ventricle; and the mitral valve is between the left atrium and ventricle.
137) C. An injury to the PCL will cause a SAG sign due to the posterior displacement of the
tibia relative to the femur.
138) C. The coronary sinus opening is located in the Right atrium, medial to the opening of the
IVC,
139) A. Middle meningeal a.
140) B. tendon of flexor digitorium profundus
141) B. CN 10
142) D. Tetralogy of Fallot is characterized by four developmental defects: VSD, overriding
aorta, pulmonary stenosis, and right ventricular hypertrophy.
143) C. The epiglottis is composed of elastic cartilage.
144) D. The esophagus can be constricted in the following areas: 1) Distal Pharnyx, 2) Arch of
the Aorta, 3) Left Main Bronchus, 4) Esophageal Hiatus at T10. The Aortic Hiatus lies at
T12. An easy way to remember the esophageal constricters is DALE (Distal Pharnyx,
Arch of Aorta, Left Main Bronchus, Esophageal Hiatus). Also, in these areas food travels
slower, and exposure to certain acids would cause more erosion here.
145) C. Guyon's canal is formed by the flexor retinaculum on top and the pisihamate ligament at
the bottom (floor). The deep branch of the ulnar nerve and the deep branch of the ulnar
artery both run through this canal. [from hand lecture by Dr. Lopez]
146) B. the sigmoid sinus is a continuation of the transverse sinus and passes through the
jugular foramen to become the internal jugular vein. [from Dr. Eisenman's cranial fossae
lecture]
147) B. If you got b, then neato for you! Just check out p. 893 of Gray's.
148) C. Shooooooooow me POTATO SALAD! 50 POINTS ON THE BIG BOARD! If you
got c, you win a hearty handshake from Richard Karn (aka Al Borland). If you didn't
check out p.55 of Gray's.
149) C. 2-3%
150) C. Celiac trunk. The others supply the superior, middle, and inferior suprarenal arteries.
The middle comes directly off of the abdominal aorta.
151) B. Ilio-inguinal (p. 262 in Gray's). Gentle touch at and around the skin of the medial
aspect of the superior part of the thigh stimulates the sensory fibers in the ilio-inguinal
nerve (L1). At this level, the sensory fivers stimulate the motor fibers carried in the genital
branch of the genitofemoral nerve (L1/L2).
152) D. Olfactory (CN I) (p. 805 in Gray's). The facial nerve provides parasympathetic
innervation of the lacrimal gland via the greater petrosal nerve and the pterygopalatine
ganglion. It also provides parasympathetic innervation of the submandibular gland and the
sublingual glands via the chorda tympani nerve and the submandibular ganglion. The
glossopharyngeal nerve innervates the parotid gland with parasympathetics via the lesser
petrosal nerve and the otic ganglion. The oculomotor nerve provides parasympathetic
innervation of the pupillae muscles via the oculomotor nerve (from Edinger-Westphal
nucleus) and the ciliary ganglion. The olfactory nerve uses sensory afferent nerve fibers
for smell, but does not utilize parasympathetics.

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153) D. Pisiform is the only proximal carpal bone that does not articulate with the radius It is
said to be a sesamoid poind contained in the flexor carpi ulnaris tendon. (p. 23 of the 4th
ed BRS)
154) C. superior cervical ganglion, The ciliary ganglion receives postganglionic sympathetic
fibers derived from the superior cervical ganglion that reach the dilator pupillae by way of
the sympathetic plexus on the internal carotid artery, the long ciliary nerve and/or the
ciliary ganglion without synapsing, and hte short ciliary nerves. (p. 353 of the 4th ed.
BRS)
155) B. intercostobrachial nerve. The picture of cutaneous innervation can be found on 341 of
the dissecter (haha. that is where I came up with the question from!) The
intercostobrachial nerve goes from the second intercostal space, pierces the serratus
anterior, crosses the axilla, and innervates the upper medial quadrant of the arm. This
nerve does not provide any funtion to the arm.
156) A. scaphoid. The explaination can be found page 715 of Grays. Pain in the snuffbox is
related to a fracture of the scaphoid.
157) D. look at Netter plate 415 to find the answer.
158) C. look at Gray's page 675, Fig 7.65 also Netter plate 417.
159) Look up.
160) Look up.
161) D. Posterior auricular.
a) gray's 827 - posterior ramus C2
b) gray's 827 - cervical plexus (anterior ramus C2)
c) gray's 818 - branch of V3
d) gray's 820 - supplies occipital belly of occipitofrontalis muscle
e) gray's 827 - from cervical plexus (C2-C3)
162) C. Sphenopalatine a. (BRS 376).
163) D. Skeletal muscle is innervated by somatic nerves.
164) C. The pectoral girdle consists of the acromioclavicular joint, scapulothoracic joint, and
sternoclavicular joint.
165) B. the azygous V arches over the root of the right lung.
166) D. The great saphenous v. ascends superficial to the fascia lata. It courses ANTERIOR to
the medial malleolus and POSTERIOR to the medial condyles of tibia and femur. The
SMALL saphenous v. drains into the popliteal v. The great saphenous v. doesn't run
anywhere near the femoral artery. It is a superficial v.
167) C. Trapezius (spinal accessory nerve), and I got this off of Netter's Flashcards.
168) D. cervical and thoracic. The superolateral aspect of these vertebral bodies curl superiorly
and articulate with the inferolateral surface of the next superior vertebral body in the
cervical and upper thoracic regions. This is straight out of the backnotes from the first
lecture on the back.
169) D. The lacrimal nerve, opthalmic vein, and trochlear nerve all travel through the superior
orbital fissure but outside the Annulus of Zinn. The optic nerve travels through the
Annulus of Zinn but through the optic canal not the superior orbital fissure.
170) C. Semispinales, multifidus, and rotares are all part of the transversospinales group and
thus would be affected by a disorder involving the transverse processes. Splenius cervicis

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is a member of the spinotransversales group and thus would also be affected. Levator
costarum is a segmental intrinsic back muscle that attaches to the ribs.
171) E. Parietal pleura is derived from somatic mesoderm and thus would result in sharp, highly
localized pain. The first 6 anterior intercostal arteries are in fact derived from the internal
thoracic. However, the internal thoracic then bifurcates to the superior epigastric and the
musculophrenic. The latter continues to supply the anterior thoracic wall. The apex of the
heart is formed by the left NOT the right ventricle. The left vagus recurs around the
ligamentum arteriosum (the right recurs around the subclavian) but travels
posteroinferiorly across the root of the left lung.
172) B. the bicipital aponeurosis. The median cubital vein is a superficial structure that is
separated from the deep contents of the cubital fossa by the bicipital aponeurosis.
173) B. Pharyngeal tonsils.
174) B. The right and left pleural cavities do NOT communicate with each other, period. The
visceral and parietal layers are continuous with each other, however, at the root of the
lungs. (from backnotes LUNGS and PLEURA pg 1)
175) C. In this senario, the parasympathetic division of the autonomic nervous system will be at
work, preparing the body to "rest and digest." The parasympathetic division lowers heat
rate and increases blood flow to core (abdomen) in order to digest. (Contrary, the
sympathetic division prepares the body for "fight or flight" accelerating heart rate and
dialating the blood vessels in the periphery.) Vagus, which carries parasympathetic fibers
only, carries the parasympathetic fibers for the heart and GI system.
176) E. Splenic artery gives off the left gastro-omental artery, which supplies the greater
curvature of the stomach, and the shory gastrics, which supply the fundus of the stomach.
The rest of the areas are supplied by other branches of the celiac trunk.
177) B. Triceps brachii. The triceps brachii would be partially spared of paralysis (i.e. it would
be weakened) because only the medial head is affected in this case (long & lateral heads
receive innervation superior to the radial groove). All muscles in the posterior
compartment of the forearm are supplied by more distal branches of the radial nerve &
would thus completely lose innervation and therefore be paralyzed. See Moore textbook,
clinical “blue box,” page 795.
178) D. ADDuction of the thumb. (Moore textbook, p 843-4; used tables 6.11 and 6.13 in
Moore for reference/explanation.)
a) The Opponens pollicis, Abductor pollicis brevis, and the Flexor pollicis brevis
(superficial head) are all innervated by the Recurrent (Thenar) branch of the Medain
Nerve, which arises from the median nerve as it passes DISTALLY to the flexor
retinaculum. Thus, since these functions involve innervation DOWNSTREAM of the
injury described, they will necessarily be affected.
b) The ADDuctor pollicis is innervated by the deep branch of the ULNAR nerve and
therefore would not be affected by this injury.
c) The lateral two lumbricals (which relate to function of digits 2 & 3) are innervated
by the Median Nerve as it becomes superficial proximal to the wrist & before it
passes under the flexor retinaculum; this is the area of injury described and would
therefore affect movement of digits 2 & 3.
179) A. Chorda tympani (CN7) is carries taste sensation to the anterior 2/3 of the tongue. It's
also responsible for bringing preganglionic parasympathetics to the submandibular
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ganglion, which has postganglionic targets of the sublingual and submandibular glands.
Therefore, cutting the chorda tympani would result in lack of synapse in the submandibular
ganglion for the sublingual and submandibular glands (infratemporal fossa lecture),
resulting in decreased salivation. (Infratemporal Fossa Lecture)
180) B. ciliary – CN3 (oculomotor), inf division, pterygopalatine – CN7 (great petrosal nerve),
otic – CN9 (glossopharyngeal, lesser petrosal), and submandibular – CN7 (chorda
tympani).
181) A. The right phrenic enters with the IVC. The left phrenic enters alone, the thoracic duct
enters with the aorta, and both vagus nerves enter with the esophagus.
182) C. Appendicitis. The appendix is one of the structures that is tested in the psoas test and so
a positive psoas test may indicate appendicitis.
183) D. The other parts of the deltoid ligament are the anterior and posterior tibiotalar ligaments
and the tibiocalcaneal ligament. The tibia rotate laterally on the femur in the last 5 degrees
of leg extension (Screw-Home mechanism). The lateral collateral ligament of the knee
limits medial motion and lateral rotation of the knee. The inner 2/3 of the menisci are
avascular.
184) B. Flexor digitorum brevis. The medial plantar nerve also innervates ABductor hallucis,
the 1st lumbrical, and flexor hallucis brevis. The ADductor halluci and flexor digiti
minimi are innervated by the lateral plantar nerve and the extensor digitorum brevis is
innervated by the deep fibular nerve.
185) B. Iliofemoral. The ligamentum teres carries the acetabular branch of the obturator artery
to the head of the femur. The pubofemoral ligament limits abduction and the
ischiofemoral ligament limits medial rotation of the hip. The iliofemoral, pubofemoral and
ischiofemoral all limit hip extension.
186) D. Fibularis brevis. Tibialis anterior inserst into medial cuneiform and base of 1st
metatarsal. Tibialis posterior inserts into the tuberosity of the navicular. Fibularis longus
inserts into the first metatarsal and medial cuneiform and traverses a groove in the cuboid.
187) D. the superior meatus. This is from the Nasal Region lecture with Dr. Eisenmann. There
is a good table in the back notes from this lecture showing where all of the paranasal
sinuses drain into. The frontal sinus, anterior ethmoid sinus, and maxillary sinus drain into
the middle meatus via the semilunar hiatus, the middle ethmoid air cells drain into the
middle meatus via the ethmoid bulla, the nasolacrimal duct drains into the inferior meatus,
and the sphenoid sinus drains into the sphenoethmoidal recess.
188) B. glossopharyngeal nerve. From the larynx and pharynx lecture with Dr. Eisenman. The
glossopharyngeal nerve travels through the pharyngeal wall between the superior and
middle constrictors. This nerve innervates the stylopharyngeus muscle, which also travels
between the superior and middle constrictors.
189) C. Ober Test. From Lower Limb Joints lecture with Dr. Howard. The Faber Test (stands
for Flexion, Abduction, External Rotation) tests for a tight hip joint capsule (patient lies on
back and crosses ankle over opposite knee; if knee sticks up and is not parrallel to the
table, the patient has tight hip joint capsule or adductors). The Thomas Test tests for tight
hip flexors (clinician moves the patient's hip into flexion until the lumbar region of the
back is flat, and the opposite leg should remain flat on the table, but if it lifts off the table,
the patient has tight hip flexors). The McMurray test is for meniscal injury, and the
clinician presses the tibial plateau to the femoral condyle and rotates at different angles and
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if this causes pain or a clickign sound, there may be a meniscal injury. In the Ober Test,
the patient lies on side while the clinician stabilizes the hip and passively lowers the leg to
the table. If the ITB is shortened, the knee won't hit the table.
190) C. Middle finger. Middle Finger Look at Fig. 7-80 (p692) in Grey's, or check out your
own arm during supination/pronation.
191) B. Extensor Indicis Tendon. The lateral border of the snuffbox is formed by the tendons of
the abductor pollicis longus and extensor pollicis brevis. The medial border is formed by
the extensor pollicis longus tendon. (Grey's p715)
192) A. Anastamoses with bronchial arteries. None of the others are a source of oxygenated
blood to the lungs, nor do they anastamose with pulmonary arteries.
193) C. superior epigastric vessels. Page 237 in BRS (Chung), Netter plate 247. Superior
epigastric vessels are directly inferior to the anterior ribs and anastomose with the inferior
vessels superior to the arcuate line.
194) C. Common bile duct. A block in cystic duct from gallbladder causes cholecystitis but not
hepatitis. block in the common hepatic duct causes hepatitis but not cholecystitis. block in
the common bile duct causes hepatitis and cholecystitis. block in the ampulla of Vater -
where common bile duct joins with major pancreatic duct of Warsung - would produce
cholecystitis and heptatis, as well as block the flow of pancreatic enzymes.
195) B. central artery of the retina. Slides 27 thru 30 of Dr. Schmidt's Orbital Anatomy lecture.
196) C. Deep cervical a. Netter's plate 131.
197) A. Ulnar a. and n. Guyon's canal is located on the medial portion of the plantar side of the
wrist. Its contents, the ulnar a. and n., are held in place by the pisihamate ligament.
198) C. Waiter's tip is a result of Erb's Palsy, an upper lesion of C5,C6 caused by delivery
through the birth canal.
199) B. The axillary nerve is accompanied by the posterior circumflex humeral artery through
the quandrangular space. the circumflex scapular artery goes through the triangular space
and the deep artery of the arm accompanies the radial artery through the triangular interval.
the subscapular artery does not pass through a space, but is the first branch off the 3rd part
of the axillary artery.
200) B. Anterior/Anteroinferior dislocations are most common because of the distribution of the
rotator cuff muscles around the joint (weakest anteroinferiorly b/c no cuff muscles there).
They are also often associated with fracture.
201) D. "The Axiallary Nerve may be injured by direct compression of the humeral head on the
nerve inferiorly as it passes through the quadrangular space" (Gray 632)
202) C. The root of the mesentery crosses the 3rd and 4th part of the duodenum, not the 1st and
2nd. (see lecture notes - infracolic region)
203) D. Quoted from the lecture on the infracolic region (Dr. Schmidt)-" Vagal innervation
stops near the distal end of the transverse colon; remainder of colon is innervated by pelvic
splanchnic nerves via inferior hypogastric nerve plexus." The other options are scattered
around somewhat, but can be found in Dr. Eisenman's lecture on the pharynx (slides 5 and
9), and Netter plates 112 & 120.
204) A. The posterior ethmoidal air cells are the exception out of the 3 regions of the ethmoid
sinus and drain into the superior sinus. All others drain into the middle. This can be
confirmed by slides 16-19 of Dr. Eisenman's lecture on the nasal region.
205) A. Psoas major.
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a) Structures superior to wrong answers:

b) Quadratus lumborum - lateral arcuate ligament
c) iliacus - iliac crest
d) aortic hiatus - median arcuate ligament
206) A. sartorius muscle. The lateral rotators of the hip joint are known as the PGOGOQ-Max
muscles: Piriformis, sup. Gemellus, Obturator Internus, inf. Gemellus, Obturator externus,
Quadratus femoris, and gluteus Maximus. (BRS p. 123)
207) C. medial rotation. The superior gluteal nerve innervates the tensor fasciae latae, gluteus
medius, and gluteus minimus mm. The gluteus medius and minimus are both ABductors
and medial rotators; tensor fasciae latae functions in flexion and medial rotation. (BRS
p.123)
208) C. the L5 vert level posterior to the Right common iliac artery. See netter plate 258 and
PAW lecture.
209) B. lunate bone. The scaphoid bone would be the most likely fractured bone, but the lunate
bone is most likely dislocated because of its shape. (Grant's Dynamic Human Anatomy
Board Review Question)
210) D. the Chorda Tympani Nerve is running very close behind the tympanic membrane and
could potentially be injured.
211) B. preganglionic sympathetic will be short and myelinated (hence why they go into the
sympathetic trunk using white rami (white for myelination).
212) C. the inferior mesenteric artery. the left branch of the middle colic artery (off of the
SMA) anastomoses with the left colic artery.
213) A. the mitral valve. For example in rheumatic fever.
214) D. (Greater petrosal n.) The lacrimal n. innervates the lacrimal gland and is a branch of the
opthalmic division of the trigeminal n. (CN V1). However, the lacrimal n. does NOT
receive its secretomotor fibers from CN V1. The secretomotor fibers to the lacrimal gland
come from preganglionic parasympathetic fibers that run in the facial n. (CN VII) Æ
greater petrosal n. Æ vidian n.(n. of the pterygoid canal) Æ synapse in pterygopalatine
ganglion with postsynaptic parasympathetic neurons Æ maxillary n. (CN V2) Æ
zygomatic n. (from CN V2) Æ zygomaticotemporal branch Æ lacrimal n. (terminal
portion) Æ lacrimal gland. [The lesser petrosal n. carries preganglionic parasympathetic
secretomotor fibers to the parotid gland. The deep petrosal gland contains postganglionic
sympathetic fibers.] For confirmation, see p. 835 - 836 Gray's, also Dr. Schmidt's orbital
lecture slides 34 & 37.
215) E. The anterior scalene inserts on the first rib, is innervated by cervical nerves C4-C7, and
passes anterior to the root of the brachial plexus, but posterior to the subclavian vein. For
confirmation, see Gray’s p. 921 & 924.
216) B. By the end of the Pseudoglandular period (6-16 weeks), development has progressed
through the formation of segmental bronchi and terminal brochioles, but no structures
involved in gas exchange have yet developed. The Terminal Saccular period (26 weeks-
birth) may be characterized by continued development of terminal saccules. During the
Alveolar Period (from birth to 8 years), alveolar cells increase in number and mature.
217) B. The Maxillary nerve transmits POSTGANGLIONIC parasympathetic fibers from
pterygopalatine ganglion via orbital, palatine, nasal, and pharyngeal branches. Oculomotor
(CN3) carries preganglionic parasympathetics to the ciliary ganglion. Facial nerve (CN7)
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gives off the greater petrosal nerve, which will synapse in the pterygopalatine ganglion,
and the chorda tympani, whose preganglionic fibers will synapse in the submandibular
ganlgion. Glossopharyngeal nerve (CN9) gives off Jacobsen's nerve/Lesser Petrosal nerve,
which synapses at the otic ganglion. The Vagus nerve (CNX) carries preganglionic
parasympathetic fibers to the larynx, trachea, lungs, heart, and stomach.
218) D. 3 because they attach chordae tendinae to the cusps of the TRIcuspid valve. See
heart/pericardium lecture notes.
219) C. 1. There are 2 that supply the left lung. The artery of the R lung is derived from the 3rd
posterior intercostal a; the arteries of the L lung are from the anterior surface of the
thoracic aorta. Frontnotes/backnotes from the lung lecture. Netter plate 195.
220) C. is the correct answer-pg 628 in Gray's.
a) Wrong because median nn doesn't enervate anywhere near that joint but does the
radiocarpal joint.
b) Wrong (along with D) because they both have joint capsules and are synovial joints.
221) C. osteoblasts and fibrocartilage both secrete type 1 collagen (as per the notes in class).
Hyaline and elastic cartilage secrete type II collagen and osteoclasts degrade bone.
222) B. The teratomers come from all three germ layers because they are formed by pluripotent
stem cells. The remaining statements are listed in Moore so I hope they are true! haha
page 63.
223) C. Oxycephaly. Source: Slide 20 on Dr. Schmidt’s lecture “MusSkel05.” Oxycephaly
involves premature closure of the coronal sutures. Scaphocephaly involves closure of the
sagittal sutures. Plagiocephaly involves closure of the coronal or lambdoid suture on one
side only. Trigonocephaly involves closure of the frontal suture. We did not specifically
learn about this last type of craniosynostosis. I just needed a fourth choice.
224) D. Inferior Division of the Occulomotor Nerve. Source: Slides 45 and 46 on Dr. Schmidt’s
lecture “Orbit_05.” The EW nucleus sends parasympathetic fibers to the ciliary ganglion.
The parasympathetic division is also known as the “Rest and Digest” division of the
autonomic nervous system. Therefore, this results in constriction of the pupil.
225) D. Great auricular n. The trigeminal nerves provide sensory innervation to the skin
covering the face except for the angle and lower border of the ramus of the mandible which
are innervated by the great auricular and transverse cervical, respectively.
226) The posterior circumflex a. branches off of the 3rd part of the axillary a. to pass through
the quadrangular space with the axillary n. to wrap around the surgical head of the
humerous. The superior thoracic a. is a branch of the 1st part of the axillary a. The
thoraco-acromial a. and lateral thoracic a. are branches off the second part of the axillary
a. The subscapular, anterior and posterior circumflex humeral aa. Branch from the third
part of the axillary a. There is no 4th part!
227) D. Digastric. pg 202 of lab manual.. You can remember this becase "di" means two.
228) A - end of lecture on female pelvic anatomy arterial supply above the pectinate line is from
superior rectal artery off the Inferior Mesenteric Artery. Arterial supply described in "a" is
for below the pectinate line.
229) B. Chorda Tympani. In the tympanic cavity, middle ear, It passes between the malleus &
incus before exiting the middle ear through the Petrotympanic fissure to join the lingual
nerve in the infratemporal fossa. Note that the greater petrosal nerve is given off the

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geniculate ganglion "in between" internal and middle ears and then travels toward the
hiatus for the greater petrosal nerve (GRAYs PP 869-870).
230) C. short ciliary. Note that the oculomotor is the only nerve to SYNAPSE at the ganglion.
Others just pass through on their way to the orbit. Answer in orbit lecture.
231) C. Phrenic n. all of the other answers are present in the posterior mediastinum.
232) B. Direct inguinal hernia. The direct inguinal hernia which is also known as an acquired
type of hernia is the one which takes place medial to the inferior epigastric vessels in the
inguinal triangle.
233) D. The external surface of the tympanic membrane is innervated by "Five and Dime" (CN
V and CN X): the auriculotemperal branch of V and the auricular branch of X. The internal
surface of the tympanic membrane is innervated by the glossopharyngeal nerve (CN IX).
Please see Moore pg 580.
234) B. Excessive contraction of the lateral pterygoids can cause the heads of the mandible to
dislocate anteriorly. It is the "true" muscle of active openning of the mouth and especially
of yawning. See Moore pg 553.
235) B. through the membranous part of the interventricular septum, the bundle of His begins at
the AV node, runs along the membranous part, then splits into Purkinje fibers along
ventricular walls.
236) C. the sigmoid and descending colons are not innervated by the vagus nerve. The vagus
nerve innervates all of the abdominal viscera except for the sigmoid and descending
colons, which are innervated by pelvic splanchnic nerves. (Board Review Series "Gross
Anatomy" pg. 176)
237) C. between T1-L2. This is region is where the sympathetic part of the autonomic division
of the PNS leave the thoracolumbar region of the spinal cord with the somatic components
of spinal nerves T1-L2. This region of the spinal cord is the only one that has white rami
communicantes, whereas gray rami communicantes are associated with all levels of the
spinal cord. (BRS "gross anatomy" pg. 8, 9. "Gray's anatomy for students" pg. 81.
238) D. The thoracoepigastric vein is formed by the anastomosis between the lateral thoracic
vein (off the axillary) and the superficial epigastric veins (off the femoral). When the SVC
becomes blocked, over time the thoracoepigastric vein can reverse its flow. Instead of
going from the axillary Æ subclavian Æ brachiocephalic Æ SVC blood flows from the
axillary back into the lateral thoracic Æ thoracoepigastric Æ inferior epigastric Æ femoral
Æ iliacs Æ IVC to reach the heart. In this process epigastric Æ femoral Æ iliacs Æ the
veins involved will dilate to accomodate the increased venous flow.
239) B. All of the lymph nodes mentioned are sites of lymphatic drainage from the breast in
addition to the supraclavicular nodes and those in the opposite breast, however 75-80% of
lymph from the breast drains to the axillary lymph nodes.
240) B. mandibular division of trigeminal and vagus nerve, respectively, via pharyngeal branch
of vagus and branch to medial pterygoid.
241) C. Geniohyoid and thyroid. note (b) is innervated by nerve to mylohyoid from inferious
alveolar of V3.
242) D. Trochlear n.
243) C. Cephalic
244) A. Radial n. and Profundus Brachii
245) B. Uterine. Remember that the ovarian is in suspensory ligament of ovary.
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246) D. People with AIS have a normal 46, XY constitution but at the cellular level there was a
resistance to testosterone in the genital tubercle and labioscrotal and urogential folds. They
therefore have a blind-pouched vagina with either absent or rudimentary unterus and
uterine tubes. They externally (socially and legally) are female but have testes in the
abdomen, inguinal canals, or labia majora.
247) C. This condition would be due to pressure placed on the inguinal ligament causing
impingement of the lateral cutaneous nerve of the thigh. The common fibular nerve is not
in the thigh region. The perforating cutaneous nerve is S2-5, supplying the skin over the
inferomedial part of the gluteus maximus. The anterior cutaneous branches of the femoral
nerve are in the thigh but are located medial to his parathesia.
248) D. Inferior. Anatomy of the Back pg. 4.
249) C. Great cardiac. eart and Pericardium lecture pg. 1.
250) A. Thoracic splanchnic nerves. Mediastinum lecture pg. 2.
251) C. Infracolic Lectures slides, pg2-3. The root of the mesentery does NOT cross the LEFT
ureter, only the RIGHT. FYI: the root of the mesentery is listed as being ~15cm in length,
while the length of the mesentery itself is ~20cm.
252) D. all other choices prevent bile made in liver to be transport to duodenum while stones in
the gall bladder occlude only the cystic duct.
253) D. All other answers are openings to various vessels runnings through pterygopalatine
fossa.
a) sphenopalatine artery runs through pterygomaxillary fissure into sphenopalatine
foramen
b) greater palatine nerves and arteries run through greater palatine foramen
c) orbital branches of pterygopalatine ganglion run through infraorbital fissure
d) correct answer
e) nasopalatine nerve and sphenopalatine artery runs through incisice canal
254) C. Thoracic duct.
255) D. Stedman's Med Dictionary, see Median Nerve in APP 79, also Netter 432 and 433.
256) C. Trochlear. pg. 823 Moore's Clinical Anatomy
257) D. Infraspinatus. In Erb's Palsy, the supraspinatus, infraspinatus, and teres minor muscles
chronically cause medial rotation of the humerus.
258) D. All of the other veins anastomose with either a portal or caval vein
a) paraumbilical vein anastomoses with epigastric veins
b) middle rectal vein anastomoses with superior rectal vein
c) lumbar vein anastomoses with colic veins in the retroperitoneal portions of colon
d) renal vein just comes off the IVC and does not directly anastomose with portal
system
e) short gastric veins anastomose with splenic vein
259) C. A lesion of the Radial Nerve results in an inability to extend the elbow joint, wrist joint
and fingers. This is due to the paralysis of triceps, anconeus, & long extensors of wrist.
The most lesion of the Radial nerve is due to a fracture in the shaft of the Humerus.
260) B. A lesion of the Femoral Nerve would not result in the paralysis of the Adductor Magnus
muscle. The Femoral Nerve provides innervation to the Anterior compartment of the leg
including Sartorius, Pectineus, Vastus Lateralis, Vastus Medialis, Vastus Intermedius, and

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Biceps Femoris muscles. The innervation of Adductor Magnus is provided by the

posterior branch of the Obturator Nerve and Sciatic Nerve.
261) C. At the lateral fossa. See backnotes for the Peritoneal Cavity, August 19, 2004, Page 2
262) The right atrium and right ventricle. Netter 216.
263) B. Confirmed in the 2nd to last paragraph of Gray's p 688
264) A. Confirmed in the 2nd to last paragraph of Gray's p 688
265) C. USMLE Road Map: Gross Anatomy p 44, middle of the page.
266) Two ligaments support the base of the body of the penis: the suspensory ligament of penis
(attached superiorly to the pubic symphysis) and the funiform ligament (attached above to
the linea alba of the anterior abdominal wall and splits into two bands that pass on each
side of the penis and unit inferiorly).
267) Gray’s 134
268) E.
269) C. All of the other answers are innervated by the suboccipital nerve (dorsal rami of C1).
The splenius capitis is innervated by the middle and lower cervical nerves.
270) B. Parathyroid. Refer to the supportive tissue lecture, slide 14. Parathyroid regulates the
production of RANKL, M-CSF and osteoprotegrin. Parathyroid hormone activates
production of RANKL and M-CSF, allowing for osteoclast activation. On the other hand,
PTH blocks osteoprotegrin production, an osteoclast inhibitor.
271) C. The long thoracic nerve is intimately associated with the axillary lymph nodes that drain
the breast. Severing this nerve will result in winging of the scapula, where the scapula
protrudes when an object is pushed on. See Netter plate 177 for diagram.
272) B. trochlear nerve. This came directly from our notes. There are two slides that describe
the contents that go through the Annulus of Zinn to reach the orbit and those that do no.
Contents going through are optic nerve, opthalmic artery, nasociliary nerve, abducens
nerve, oculomotor nerve (superior & inferior divisions). NOT passing through annulus are
frontal nerve, lacrimal nerve, trochlear nerve, superior opthalmic nerve. The annulus of
zinn is basically a common tendon made up of the tendons of the four rectus muscles.
(Netter plate 79, notes orbit, board review series by chung pg 409, 412)
273) D. anterior cardinal vein. Remember that all the surface coronary veins, except for the
anterior cardial veins, drain into the coronary sinus before entering the right atrium. The
coronary sinus is located on the posterior aspect of the heart. For review, the great cardiac
vein runs with the anterior interventricular artery (or LAD). The middle cardiac vein runs
with theposterior descending branch of the right coronary artery. The small cardiac vein
runs with the right coronary artery. The coronary sinus opens into the right atrium
between the IVC and AV opening. The anterior cardinal vein drains the right ventricle and
ends directly in the right atrium.
274) C. the IVC. the Quuadrate lobe and the Caudate lobe are separated by the porta hepatis or
the "doorway of the liver" that contains the hepatic portal vein, hepatic artery, and common
hepatic duct. the Quadrate lobe is in between the falciform lig and the gallbladder, while
the caudate lobe is between the IVC and the fissure for the ligamentum venosum.
(backnotes for supracolic region, page 4)
275) B. The conjoint tendon medially reinforces the posterior wall of the inguinal canal. answer
choice d is what forms the inguinal ligament. c is nothing but the MUSCLE forms the
cremaster m. a is what forms the lacunar ligament, which medially reinforces the floor of
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the inguinal canal. (backnotes for the anterior abdominal wall, page 2, and for the inguinal
region, pg 2).
276) (a) The tensor tympani muscle is derived from the 1st pharyngeal arch and receives
Innvervation via the V3 of the Trigeminal Nerve.
277) (d) The palatoglossus revieves its innervation from the cranial root of CN XI via
pharyngeal branch of CN X.
278) (d) Scarpa’s fascia of the lower anterior abdominal wall is continuous with Colle’s fascia.
279) (b) The bulbourethral glands are contents of the Deep perineal space in the male.
280) B. from the Lopez lecture on the brachial plexus The axillary nerve innervates the deltoid,
which accounts for the weakness in abduction lateral rotation and teres minor, which is
also innervated by the axillary nerve, also laterally rotates the arm. Supraspinatus, which is
innervated by the suprascapular nerve, also helps abduct the arm so that function is not
completely lost.
281) B. "waiter's tip" hand. "claw hand" and "funny bone" symptoms are seen due to ulnar nerve
injury. "wrist drop" is characteristic of injury to the radial nerve due to paralysis of the
posterior compartment of the arm. The brachial plexus lecture contains information
relating to these problems.
282) its posterior interosseus branch does not innervate hte flexor carpi ulnaris; this muscle is
innervated by the ulnar n.
283) the circumflex artery is a branch of the left coronary artery.
284) B (see BRS pg.24 - cc 2.14). Referred pain to shoulder most probably indicates
involvement of the phrenic nerve (or diaphragm), because the supraclavicular nerve(C3-4),
which supplies sensory fibers over the shoulder, has the same origin as the phrenic nerve
(C3-5), which supplies the diaphragm.
285) B. Suprascapular nerve innervates supraspinatus and infraspinatus muscles, which is
responsible for first part of abduction and lateral rotation, respectively. Suprascapular
nerve is a branch from the superior trunk of brachial plexus, so injury to superior trunk
would damage suprascapular nerve and limit actions of muscles it innervates.
286) D. humerus is medially rotated because of the pectoralis major pulls the bone toward body.
287) C. Colles fracture causes the distal fragment of the radius to be displaced dorsally, causing
shortened radius.
288) A. Parietal pleura is supplied by branches of internal thoracic, superior phrenic, posterior
intercostal, and superior intercostal arteries. Visceral pleura is supplied by the bronchial
arteries. As a side note, cervical part of parietal pleura, also referred as cupula, project into
the neck above the first rib as is reinforced by Sibson's fascia, which is a thickened portion
of the endothoracic fascia (See BRS pg.148).
289) B. lingula is a portion of the UPPER lobe of the left lung (see BRS pg.151).
290) C . Pulmonary arteries supply the respiratory portion of the lung such as alveoli, whereas
bronchial arteries supply non-respiratory tissues of the lung such as walls of bronchi, blood
vessels, and connective tissue (See front note for lungs and pleura lecture, slide 20).
291) E. all four statements are correct(See BRS pg.154).
292) D. when performing cholecystectomy and bleeding occurs, one can perform Pringle
Maneuver, which entails squeezing the hepatoduodenal ligament and slowly releasing
pressure to locate where the bleeding is originating. As a side note, the hepatoduodenal

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ligament contains portal vein(posteriorly), bile duct(ant.right), and hepatic artery

proper(ant. left).
293) C. there is a free communication between supracolic and infracolic compartments via
paracolic gutters; fluid can drain along these gutters.
294) A. testis develops on posterior abdominal wall in the upper lumbar region in the
extraperitoneal fat, outside of peritoneal cavity.
295) B. Some internal oblique muscle fibers forming roof of inguinal canal come down and
attach to the spermatic cord and form the cremaster muscle of the spermatic cord. They
receive innervation by the genital branch of the genitofemoral nerve.
296) C. Floor of inguinal canal is formed by superior aspect of inguinal ligament and is
reinforced medially by lacunal ligament which is an extension of external oblique muscle
aponeurosis. Spermatic cord or round ligament may lie on lacunar ligament. Lacunar
ligament passes backward from the inguinal ligament to the pubic tubercle. If you follow
it further, it attaches to the pectinate line of pubis and forms Cooper's (pectineal) ligament,
which is an extension that passes backward along the line of pubis. (See frontnote for
inguinal region lecture) As a side note, conjoint tendon is formed by internal oblique and
transversus abdominis, and reinforces posterior wall of inguinal canal near superficial ring.
297) B. Stroking inner aspect of upper thigh stimulates the sensory fibers of the ilioinguinal
nerve which stimulate the motor fibers carried in the genital branch of the genitofemoral
nerve. Since cremaster muscle is innervated by genital branch of genitofemoral nerve, this
is the basis of efferent limb of the cremasteric reflex.
298) E. Direct inguinal hernia pushes through posterior wall of inguinal canal (formed by
transversalis fascia, reinforced by conjoint tendon at superficial ring) MEDIAL to inferior
epigastric vessels. This makes sense because the site of direct hernia is the Hesselbach's
(inguinal) triangle, which is bounded laterally by lateral umbilical fold, which includes
inferior epigastric vessels.
299) C. Wrist-drop is due to the denervation of the hand extensors, which are normally
innervated by the radial nerve. The radial nerve only corresponds to the mid-shaft. All
other landmarks listed do not receive, come in contact with, or could potentially lacerate
the radial nerve.
300) D. The cutaneous branch of the radial nerve only provides sensory innervation for the
lateral dorsal aspect of the hand. All other aspects and the finger tips are innervated by
cutaneous branches from the median or ulnar nerves.
301) C. from Supracolic region lecture and from pg 450 in Gray's.
302) C. this question combined a few slides from the heart lecture.
303) B. the sources is the supracolic region lecture and the embryology of the GI tract lecture.
304) C. Oxycephaly is the premature closure of both coronal sutures and results in a high,
towerlike forehead. Premature closure of the sagittal suture is termed Scaphocephaly, and
results in elongated cranium. Premature closure of one either one coronal or one lamboid
suture is termed plagiocephaly and results in a twisted, asymmetrical skull. (see page 394
of Moore)
305) B. In approximately 1 in 500 live births, a fused "horseshoe" kidney's ascent is blocked by
the root of the IMA. (see page 206 of Moore).
306) Hand & Wrist Lecture – pg. 8
307) Urinary System Development Lecture – pg. 5
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308) D.
309) C.
310) D (Cystic Artery). The triangle of Calot is formed by the cystic duct laterallly, common
hepatic duct medially, and superiorly by the inferior border of the liver. The cystic artery,
off the right hepatic artery, travels through this triangle to supply the gall bladder. The
cystic artery must be ligated before removing the gallbladder. I remember during our
dissection of this region that Dr. Schmidt pointed this out several times and that this
relationship appeared on our first practical exam. Can be seen in Netter Plate 292.
311) B (Hirschprung's Disease). Hirsschprung's disease (or agonglionic megacolon) is caused
by a lack of postganglionic parasympathetic nerve cells from migrating neural crest cells.
The portions of the GI tract which lack these nerve cells cannot undergo peristalsis, and
thus there is a build up of fecal material causing an enlarged colon (megacolon).
312) D (Adduction of thumb). The median nerve is the only nerve that travels through the
carpal tunnel, and the median nerve innervates the 3 thenar muscles (flexor pollicis brevis,
abductor pollicis brevis, and opponens pollicis, which flex, abduct, and medially rotate the
thumb, respectively). The main adductor of the thumb, adductor pollicis, is innervated by
the deep branch of the ulnar nerve. Therefore, adduction of the thumb woud be unaffected
by carpal tunnel syndrome.
313) D the Sphenoid sinus drains into the sphenoethmoid recess above the superior conchae
NOT the middle meatus.
314) A. Epiglottis = elastic cartilage, Trachea and Femur = hyaline cartilage
315) C. anterior scalene Æ first part of subclavian is medial to anterior scalene m., second part
of subclavian a. is posterior to anterior sclane, third part of subclavian a. is lateral to
anterior scalene The axillary artery is divided into three parts by pectoralis minor. The
maxillary artery is divided into three parts by lateral ptyergoid muscle.
316) C. L1/L2 The spinal cord essentially ends at vertebral level L1/L2 where there after it is
only the cauda equina within the meningeal covering. Therefore, a spinal tap is done
mostly between L3/L4 or sometimes L4/L5.
317) C.
a) Bonus Question: Say my pen breaks and the person is face down sitting at the table
still wondering why i just stabbed them; where will the ink flow?
318) B. I made up poplteal. I don’t even know if such a thing exists.
319) D. left goonadal vein, it is a tributary of the left renal vein. Gray's pg 332.
320) A. posterior lobe is prone to to cnacer while the middle(median) lobe is prone to BPH.
BRS 281.
321) C. subacromial bursitis. Gray’s pg 632 and BRS pg 25 under rupture of rotator cuff.
322) C. lateral head of the triceps. the quadrangular space has four different muscles that form
its borders b/c it has a differnent superior muscle bordering it anteriorly and posteriorly.
the teres major is inferior border, the lateral border is the surgical neck of the humerus, the
medial border is the long head of the tricpes and hte supeiror border is made up of the teres
minor (posteriorly) and subscapularis (anteriorly). the long head of the triceps is the medial
border of the triangular space of the arm.
323) The injection is usually given where the pudendal nerve crosses the lateral aspect of the
sacrospinous ligament near its attachment to the ischial spine. During childbirth, a finger
inserted into the vagina can palpate the ischial spine. The needle is passed
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transcutaneously to the medial aspect of the ischial spine and around the sacrospinous
ligament. Infiltration is performed and the perineum is anesthetized. answer = D Grays
p425.
324) The maxillary nerve and its zygomatic brach pass through the inferior orbital fissure.
Passing through the superior orbital fissure are: the superior and inferior branches of the
occulomotor nerve III, the trochlear nerve IV, the abducent nerve VI, the lacrimal, frontal,
and nasociliary branches of the ophthalmic nerve V1, and the superior ophthalmic vein.
325) C. herniation of the abdominal contents into the thoracic cavity interferes with the
development of the lung (there isn't enough space for the lung(s) to develop. CDH is the
only relatively common congenital anomaly of hte diaphragm (1/2,200 newborns).
326) B. phrenic n. The phrenic nerve is the ONLY motor supply of the diaphragm, but is also
responsible for sensory innervation, particularly in the case of referred pain to
neck/shoulders. Intercostals and the subcostal nerve also provide sensory innervation to
the parietal pleura on edges of diaphragm and periphery of diaphragm, respectively, but
these nerves would not "refer" pain up to the neck, shoulder, as they travel horizontally
near the diaphragm. The phrenic nerve travels in the neck/shoulder region.
327) The umbilicus is the dividing line for venous drainage of the AAW. The AAW does not
include the viscera of the abdominal cavity, so would not drain to the portal system. Above
the level of the umbilicus, drainage is to the SVC. Below the level of the umbilicus, it will
be to the IVC. Therefore, C is the correct answer. This is straight from Schmidt's AAW
lecture powerpoints.
328) The first three answers are all contents of the deep perineal space. The greater vestibular
glands are located in the superficial perineal space. The correct answer is D. This is from
the perineum lecture given by Dr. Mehta.
329) C. The borders of the cubital fossa are the pronator teres m. and the brachioradialis m. All
the other structures are the chief contents of the cubital fossa; the common interosseous a.
is located distal to the cubital fossa.
330) A. The clavicle (of the upper limb) meets the sternum (axial skeleton), and is the only
joint uniting the upper limb with the axial skeleton.
331) B. Serratus Ant. is involved in depression and protraction of the scapula (as well as to
prevent winging). See Grant's Atlas of Anat. pg. 509 for more.
332) C.
333) E.
334) A. The anterior 2/3 of tongue is innerv. by the lingual nerve, a branch of the mandibular
division of trigeminal (V3).
335) D. Digastric posterior innerv. by facial n. Digastric anterior innerv. by trigeminal n.
336) A. Stylohyoid innervated by facial. Styloglossus innerv. by hypoglossal. Stylopharyngeus
innerv. by glossopharyngeal.
337) B. see gray’s p.639 The quadrangular space provides a passageway from the anterior
axillary region to the posterior scapular region. The boundaries are created by the inferior
margin of teres minor, the surgical neck of the humerus, the superior margin of teres major,
and the lateral margin of the long head of triceps brachii. The most important thing to
realize is that the posterior circumflex humeral artery and vein and the axillary nerve are
the structures which pass through the quadrangular space. Hypertrophy of the muscles of
the quadrangular space will shrink the space and impinge on the structures passing through
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it. Impingement of the axillary nerve will most affect the muscles which it innervates.
The axillary nerve innervates the teres minor and deltoid muscles. The only muscle
innervated by the axillary nerve in the answer choices above is teres minor. The correct
answer, then, is “B.”
338) B. see gray’s p.887 The glossopharyngeal nerve (CN IX) provides parasympathetic,
autonomic innervation to the parotid gland. The otic ganglion, located within the
infratemporal fossa, is the site for preganglionic parasympathetic glossopharyngeal
(CNIX) fibers to synapse. Presynaptic fibers are carried to the otic ganglion within the
lesser petrosal nerve. Postsynaptic fibers are carried to the parotid gland within the
auriculotemporal nerve branch of the mandibular nerve (CNV3). The ciliary ganglion is
the site for preganglionic parasympathetic oculomotor (CNIII) fibers to synapse. The
pterygopalatine ganglion and sublingual ganglion receive presynaptic fibers originating
within the facial nerve (CNVII). The geniculate ganglion is the sensory ganglion of the
facial nerve (CNVII). Also, its worth noting that the lesser petrosal nerve should not be
confused with the great petrosal or deep petrosal nerves. The deep petrosal nerve carries
sympathetic fibers from the internal carotid plexus, while the greater petrosal nerve is a
branch of the facial nerve (CNVII) that carries fibers to the pterygopalatine ganglion.
339) D. the superficial and deep petrosal nerves meet in the pterygoid canal to form the vidian
nerve. The vidian nerve then continues on to the pterygopalatine ganglion.
340) B. the cricoid cartilage is considered an unpaired cartilage of the larynx. The rest of the
choices are all paired cartilages.
341) D. Gray's page 76-77 about myotomes. Basically, the muscles responsible for abducting
the arm are the deltoid and the supraspinatus, which are innervated by axillary (C5-6) and
suprascapular (C5-6) nerves, respectively.
342) A. Netter plates 28-9, 412, Ant. Cervical Triangle lecture slides. The superior thoracic
comes off the 1st part of the axillary a., the lateral thoracic off the 2nd part of the axillary
a, the internal thoracic off the 1st part of the subclavian, the supreme intercostal (also
called the highest intercostal - Ant. Cervical Triangle lecture slides) off the costocervical
trunk (from the 2rd part of the subclavian), and the left and right superior intercostals are
actually veins located above the hemiazygos and azygous, respectively, draining the first 3-
4 intercostal veins. (I apologize for the trick last option, but I just thought it might be
helpful in determining the differences between all these similar-sounding vessels.)
343) C. See netter, plate 81 and notes from orbit lecture. The central retinal artery is a true
terminal branch of the opthalmic artery, and occlusion of it causes irreversible blindness.
This occlusion can occur, for example, by compression of the optic nerve since in runs
right through it.
344) C. Lecture Slides for Poster Abdominal Wall (pg. 2). Netter pg. 319.
345) B. Lecture Slides for Infracolic Region (pg. 3). Netter pg. 270.
346) D. Schmidt talked about these in supportive tissues lecture. Also in cartilage backnotes.
347) C. Netter 427
348) B. the medial circumflex femoral artery supplies most of the head of the femur, the lateral
circumflex supplies the neck of the femur, the superior gluteal artery does not supply any
portion of the femur and the acetabular branch of the obturator artery is not well developed
and is insufficient to feed the head of the femur.

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349) C. the ilium makes up the superior portion of the acetabulum, the ischium makes up the
posteroinferior portion and the pubis makes up the anteromedial portion.
350) B. The esophageal hiatus permits passage of the esophagus at or near the level of T10 and
it is formed by the RIGHT CRUS of the diaphragm. The anterior (formerly left) and
posterior (formerly right) VAGAL TRUNKS pass through the esophageal hiatus with the
esophagus, whereas the left vagus nerve pieces the diaphragm and the right vagus nerve
courses through with the inferior vena caba through its hiatus in the central tendon at the
T8 level. The suspensory muscle of the duodenum (ligament of Treitz) attaches to the
right crus of the diaphragm, which makes up the esophageal hiatus. This structure
suspends the ascending (4th) part of the duodenum at the duodenojejunal flexure and is a
surgical landmark. See Netter plate 262b and BRS p. 235.
351) C. CN3 palsy is *complete* ptosis. Schmidt power point slides: Orbit Anatomy. Slide 14.
352) C. unlike intramembranous ossification where growth occurs on the surface (apositional
growth), endochondral ossification is characterized by proliferation from within at the
proliferative zone. The proliferating chondrocytes run away from the ossification front,
thus expanding the length of cartilage. Therefore, the most distal region in a growing long
bone is epiphyseal cartilage.
353) D. The posterior basal and lateral basal segments do not frequently combine to form one
segment in the left lung. The others do, according to slides from Dr. Schmidt's lungs and
pleura lecture. This is clinically significant because the bronchopulmonary segment is the
smallest portion of the lung that can be damaged/removed without further jeopardizing
more lung tissue. PS. I remember this by noting that two of the pairs that can combine
contact each other (the anterior basal and medial basal segments are directly
posteroinferior to the lingula, though they are separated by the oblique fissure), and then
the other pair that can combine is on the top (apical and posterior). See lecture slides and
Netter plate 197b.
354) C. ulnar. Reference: Eisenman power points: Post Triangle. Slide 34.
355) B. the bulbourethral glands are in the deep perineal space.
356) E. Descending colon. The Vagus N provides parasympathetic innervation as far inferior as
the spenic flexure. After the splenic flexure, parasympathetic innervation is provided by
the pelvic splanchic nerves (S2-S4) via the inferior hypogastric plexus.
357) C. the ilioinguinal nerve. All others are components of the spermatic cord which enter via
the deep ring and exit via the superficial ring. The ilioinguinal nerve enters the inguinal
canal laterally between the transversus abdominus and internal abdominal oblique muscles
and exits via the superficial ring. It does not enter the canal through the deep ring.
358) B. adductor pollicis is from the ulnar. My general anatomy teacher taught us that the
median nerve has a muscular innervation of 1/2 loaf (1st and 2nd lumbricals, opponens
pollicis, abductor pollicis brevis, flexor pollicis brevis).
359) D. Mehta lecture hand outs: Formation of Gametes.1st lecture ever, pg 3-4. Klinefelters
(XXY) is a male with abnormal female characteristics and is a non-disjunction syndrome.
So is Turners (XO) and Downs Syndrome.
360) B. Mehta lecture hand outs: Formation of Gametes, pg 7.
361) A. Schmidt lecture handouts: Trilaminar Disc, pg 4.
362) False, it's on the posterior femur.
363) True.
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Richard T. Kiok
October 24, 2005
364) C. sigmoid colon. The kidneys are both retroperitoneal, as well as the ascending and
descending colons. The transverse and sigmoid colons are surround by peritoneum and
have their own mesenteries. The mesentery of the sigmoid colon is the sigmoid mesocolon.
(Chung BRS p. 211)
365) C. the skin over the thenar eminence is innervated by the palmar cutaneous branch of the
median nerve, which does not enter the carpal tunnel. the three thenar muscles (abductor
pollicis brevis, flexor pollicis brevis and opponens pollicis) are innervated by the motor
(recurrent) branch of the median nerve and are responsible for abduction, flexion and
opposition. the median nerve (via carpal tunnel) also provides sensory distribution to the
palmar side of the lateral three and a half digits. (BRS page 41. and Dr. Lopez's lecture on
nerves of the upper limb has a great diagram demonstrating median nerve innervation via
carpal tunnel versus that of the palmar cutaneous branch.)
366) B. erb's palsy results from lesion of C5 and C6 and the resulting paralysis of the muscles
innervated by the musculocuateneous nerve cause inability to supinate.
367) A. rrln loops around the right subclavian artery which is found above the first rib and
therefore is outside the boundaries of teh superior mediastinum.
368) C. Resulting symptoms include a medially rotated humerus, not lateral.
369) D. The epiglottis cartilage is an unpaired cartilage of the larynx.
370) B. The vestibular nerve runs to the membranous labyrinth in the inner ear. The only
nerves found in the tympanic cavity are branches of the facial and glossopharyngeal
nerves.
371) C. Infraorbital nerve. Netter plate 41.
372) B. Above the pectinate line, lymphatic drainage is to the internal iliac nodes. From Female
Pelvic anatomy front notes (and BRS Anatomy p.287):
a) Pectinate line (Line of Hilton): connects all valves
i) Arterial supply
(a) Above PL: superior rectal artery from IMA
(b) Below PL: inferior rectal artery
ii) Venous drainage
(a) Above PL: internal rectal venous plexus Æ SRA Æ IMV Æ portal system
(b) Below PL: inferior rectal venous plexus Æ IRV Æ MRV Æ internal iliac
veins Æ caval system
iii) Lymphatic drainage
(a) Above PL: internal iliac lymph nodes to common iliac and lumbar
(b) Below PL: superficial inguinal nodes
iv) Innervation
(a) Above PL: autonomic
(b) Below PL: somatic
v) Hemorrhoids
(a) Usually occur above PL
(b) Above PL: internal; almost no pain
(c) Below PL: external; very painful
373) D. Scaphocephaly is a premature closure of the sagital suture (in the notes on
musculoskeletal embryology) A is most likely Peirre-Robins (1st arch syndrome), B is
most likely an overstretched LCL, C is Syndactally.
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Richard T. Kiok
October 24, 2005
374) B. (in the notes on supportive tissues - in the cartilage part) A is an Isogenous group, C is
a Haversian System (osteon), D is something random that we didn't learn about.
375) C.
376) D.
377) B.
378) C.
379) B.
380) D.
381) C.
382) B. (Netter's plates 403, 415, and 464, Gray's p. 626) Fracture of the proximal humerus
occurs most frequently at the surgical neck, rather than the anatomical neck, which is much
thicker in cross section. Sometimes such a fracture can result in injury to the posterior
circumflex humeral artery, causing substantial blood loss; and/or injury to the axillary
nerve, resulting in weakened lateral rotation, abduction, and loss of sensation on the
outside of the shoulder (region supplied by superior lateral cutaneous nerve of the arm, a
branch of the axillary n.).
383) E. (backnotes 8/31/04)
384) B. (Gray's pp. 403-405, 419, BRS Anatomy 2005 p. 299) The male urethra takes two
turns en route from the bladder to the external urethral orifice. At these bends (both in the
spongy part of the urethra and both in the superficial perineal space) the wall of the urethra
is thin, and it is especially susceptible to rupture during catheterization. The extravasated
urine may travel superiorly into the abdominal wall, inferiorly into the scrotum, and
anteriorly around the penis. It cannot travel into the ischioanal fossa because of the
perineal membrane, or into the thigh because of the fascia lata. The last two are just red
herrings.
385) C. Golfers elbow affects the medial epicondyle where the flexors of the forearm are
attached. (Chung, p. 37. cc.2.22.)
386) E. All of the above. The zygomatic branch (Maxillary Division V2 off of infraorbital
nerve) carries postsynaptic sympathetic and parasympathetic fibers to the lacrimal gland.
Or these fibers may also hop a ride on the Lacrimal Nerve (Opthalmic division of V1) The
Greater palatine nerve carries postsynaptic sympathetic and parasympathetic fibers to hard
palate. The lesser palatine nerve carries postsynaptic sympathetic and parasympathetic
fibers to the soft palate. The pharyngeal nerve carries postsynaptic sympathetic and
parasympathetic fibers to the pharynx.
387) C. Hyaline cartilage is the most prevalent form of cartilage in the body, not elastic
cartilage. The other three choices are true of both hyaline and elastic cartilage.
388) C. Osteons are arranged perpendicular to Volkmann's canals.
389) A. Scaphocephaly results from premature closure of the sagittal suture. Oxycephaly
results from a premature closure of the coronal suture. Plagiocephaly results from a
premature closure of the coronal suture on one side. Trigonalcephaly results from
premature closure of the frontal suture.
390) B. Gastosplenic. The short gastric arteries are branches from teh splenic artery that go to
the fundus of teh stomach through teh gastrosplenic. The actual splenic artery travels
through the splenorenal ligament. (BRS 205)

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Richard T. Kiok
October 24, 2005
391) C. the internal thoracic branches into the musculophrenic and the superior epigastric! (BRS
144)
392) C. This question comes directly from the "Heart and Pericardium" lecture from the first
exam. Afferents travel from the heart with the vagus nerves and sympathetics, but vagus
nerve fibers are responsible for cardiac reflexes, whereas pain sensation is carried in
sympathetic fibers to the symp. trunk, and to the SC. This can cause referred pain in areas
supplied by the same spinal cord level. (BRS says that A may also be an appropriate
answer.)
393) B. The Glossopharyngeal nerve innervates the stylopharyngeus m. and provides taste and
general sensation to the posterior 2/3 of the tongue. (BRS 428)
394) B. (backnotes 8/5/04)
395) A.
396) D. The bronchial arteries supply blood to the tissues of the lung. There are 2 bronchial
arteries on the left side that are branches of the thoracic aorta. There is 1 bronchial artery
on the right side that is a branch of the 3rd posterior intercostal artery. There are also
anastomoses between the pulmonary and bronchial arteries at the precapillary level.
397) A. A Jefferson fracture is a fracture of one or both sides of one or both bony arches of the
Atlas. The lateral masses with the articular surfaces of the Atlas are shaped like wedges,
with their thick sides laterally. Thus if there is a vertical pressure, such as would occur if
one dove into a shallow swimming pool, the pressure of the skull pushing downward and
the axis pushing upward would force the lateral masses apart. This does not necessarily
cause a spinal cord injury as it makes the vertebral foramen larger. This is also known as a
burst fracture. See Moore's Clinical Anatomy pages 485-6.
398) C. Pronator syndrome is entrapment of the median nerve near the elbow, between the
heads of the pronator teres. Patients may experience paresthesia in the lateral 3 1/2 fingers
just like in carpal tunnel syndrome. However, there are several ways to differentiate the
two syndromes. Pronator syndrome affects the median nerve much more proximally than
carpal tunnel, and will cause weakness in wrist flexion and flexion at the proximal
interphalangeal joints (1st-3rd digits) and distal interphalangeal joints (2nd-3rd digits,
distal joint in 1st digit) because these are muscles of the anterior compartment of the
forearm innervated by the median nerve before it enters the carpal tunnel. Interestingly,
sensation to the palm is also lost in pronator syndrome and not in carpal tunnel syndrome
because this area is innervated by the palmar cutaneous branch which enters the hand
outside of the carpal tunnel. Patients will also have pain in tenderness in the proximal
anterior forearm.
399) B. 3 arteries. one to the right (usually from the third posterior intercostal) Two left, from
the anterior portion of the thoracic aorta. (page 5 of the lungs and pleura lecture).
400) Inferior lobe Because of the sharp angle of the oblique fissure, the posterior surface of the
left lung is almost entirely comprised of the inferior lobe. So, a stab wound halfway
between the apex and diaphragmatic surface of the lung would result in injury to the
inferior lobe.
401) The gastroduodenal artery lies behind the superior part of the duodenum. It has three
branches: the posterior superior pancreaticoduodenal artery, the anterior superior
pancreaticoduodenal artery, and the right gastroomental artery.

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Richard T. Kiok
October 24, 2005
402) E. The body of the pubis does not define any of the four boundaries. It does, however,
serve as ana attachment for the medial crus of the superficial ring (the lateral crus attaches
to the pubic tubercle). The ant. wall is comprised of the aponeurosis of the EAO muscle
and is reinforced laterally by fibers of the IAO muscle. The post. wall is comprised of the
transversalis fascia and is reinforced medially by the conjoint tendon (which is the union of
the aponeurotic fibers from the IAO muscle and the TA muscle). The roof is comprised of
arching fibers from the IAO and TA muscles. Finally, the floor is comprised of the
inguinal ligament and is reinforced medially by the lacunar ligament.
403) B. Contraction of the salpingopharyngeus, tensor veli palatini, and levator veli palatini
muscles opens the pharyngotympanic tube.
404) E. None of the above. About 75-80% of GI tract blood flows through the portal veins (TO
the liver) and then through the hepatic veins (AWAY from the liver). In a diseased liver,
blood doesn't always go through the normal Portal vein, IVC, heart route. Rather, it the
blood backs up, increasing the tension in the portal veins (portal hypertension). The blood
is usually re-routed to the heart via one of four Portal-Caval Anastamoses.
a) The gastroesophogeal junction – distal esophogeal veins to azygous vein to the
Superior Vena Cava... (clinical sign: esophageal varices).
b) The opposite end of the GI tract (rectum) – superior rectal vein (of portal system)
and the external iliac veins (part of the caval system). (clinical sign: hemorrhoids),
c) Umbilicus – blood flows to vein in the falciform ligament (paraumbilical vein)
(clinical correlate: Caput Medusa)
d) (NOT IN GRAY's!) Behind ascending and descending colon into Lumbar veins and
then back into IVC.
405) A. Prontor teres syndrom is also called anterior interosseus syndrome. It results from lesion
to the anterior interosseus nerve, which innervates the flexor pollicis longus m and flexor
½ of the flexor digitorum profundus m.
406) B. The anterior interosseus nerve innervates the flexor pollicis longus m and flexor ½ of
the flexor digitorum profundus m. These muscles are responsible for the OK movement.
An intact median nerve allows him to move his thumb and index finger by innervating the
intrinsic muscles of the hand but does not allow him to maintain the position.
407) These are the classis signs of carpal tunnel syndrome. The palmar cutaneus branch comes
off the median nerve before the flexor retinaculum and carpal tunnel and innervates the
lateral palm. the median nerve passing through the carpal tunnes innervates ¾ of the thenar
muscles, and the lateral 2 lumbricals, therefore these would be weak or even atrophy. The
median nerve also gives sensory innervation to the palm and the palmar side of digits one,
two three, and half of four.
408) H. All of the above. I hope that everyone finds this exercise helpful. It took a great deal of
time and energy to compile and verify, but I hope that it will demonstrate that a little bit of
effort from everyone yields great results for everyone as well.

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Richard T.

1) A. Superficial branch of Radial

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