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ANAT2020 final Exam 2017

Anatomy (University of the Witwatersrand, Johannesburg)

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ANAT 2020 NOVEMBER 2017 EXAMINATION

3 HOURS 02/ 11 / 2017 EXAMS OFFICE USE ONLY

University of the Witwatersrand, Johannesburg

Course or topic No(s) ANAT 2020

Course or topic name(s) HUMAN ANATOMY MORPHOLOGICAL, HISTOLOGY

Paper Number & title AND EMBRYOLOGY
FINAL EXAMINATION

Examination to be NOVEMBER 2017

Held during month of

Year of Study SECOND

(Arts & Science leave blank)

Degree/Diplomas for which BACHELOR OF MEDICINE & BACHELOR OF SURGERY

This course is prescribed BACHELOR OF HEALTH SCIENCES & BSc (BIOMEDICAL
ENGINEEING)

Faculty/ies presenting FACULTY OF HEALTH SCIENCES

Candidates

Internal examiner(s) PROFESSOR AO IHUNWO (011 – 717 – 2767)

And telephone extension MRS A JOVANOVIC (011 – 717 – 2432)
Number(s)

External examiner(s) PROFESSOR G LEBONA and

DR P ACKERMANN

Special materials required

(graph/music/drawing paper)
maps, diagrams, tables,
computer cards, etc.

Time allowance Course No. ANAT 2020 HOURS THREE

Instructions to candidates ANSWER ALL QUESTIONS. RELEVANT AND

(Examiners may wish to use this CORRECTLY LABELLED DIAGRAMS MAY BE USED TO
space to indicate, inter alia, the ENHANCE YOUR ANSWERS. ONLY SCRIPTS WRITTEN
contribution made by this IN BLUE OR BLACK INK WILL BE MARKED. PENCIL MAY
examination or test towards the BE USED ONLY FOR DRAWINGS.
year mark, if appropriate)

Internal Examiners or Heads of Department are requested to sign the declaration overleaf.

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ANAT 2020 NOVEMBER 2017 EXAMINATION

UNIVERSITY OF THE WITWATERSRAND, JOHANNESBURG

SCHOOL OF ANATOMICAL SCIENCES

(ANAT 2020) HUMAN ANATOMY FOR MBBCH II, BHSc & BSc (Biomed Eng):
END OF YEAR EXAMINATION: 2ND NOVEMBER 2017

TIME: 3 HOURS TOTAL MARKS: 150

TOTAL NUMBER OF QUESTIONS = 25 MCQ AND 13 SHORT WRITTEN QUESTIONS

Instructions:

1. Answer all questions.

2. Write your Anatomy number on each answer book/MCQ sheet.

3. SECTION A: MCQ’s 50 MARKS

i) Write your name, the degree for which you are registered, your student
number, and anatomy test number on the “Faculty of Health Sciences” side
of the computer sheet.

ii) On the “circles” side of the computer sheet in the block headed “student
number” write your student number. Fill in the circles with a soft HB
pencil.

iii) There are five (5) options each must be marked as either CORRECT or
INCORRECT. For each question at least one of the options will be correct
and one incorrect. You need to have an answer for each of the five (5)
statements.

iv) DO NOT use CORRECTION FLUID on your MCQ sheet. You may use an
eraser with care.
v) DO NOT fold or bend the computer card.
vi) The computer sheet MUST be filled in during the examination time. NO
TIME WILL BE ALLOWED after the end of the examination for filling in the
sheet.

4. SECTION B: WRITTEN ANSWER QUESTIONS: 100 MARKS

i) Answer all Mophorlogical Anatomy questions in the GREEN book, all

Histology and Embryology questions in the WHITE book.
ii) Relevant and correctly labelled diagrams may be used to enhance your
answers.
iii) ONLY scripts written in blue or black ink will be marked. Pencil may be used
ONLY for drawings.

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ANAT 2020 NOVEMBER 2017 EXAMINATION

SECTION A: MULTIPLE CHOICE QUESTIONS TOTAL: 50 MARKS

Questions 1-25 Below are X-type MCQs (2 marks each)

1. With regard to the brachial plexus:

a. It originates from the ventral rami of C5, C6, C7, C8 and T1.
b. The trunks emerge between scalenus anterior and scalenus medius
muscles.
c. The anterior divisions of upper and lower trunks form the lateral cord.
d. The ulnar nerve is derived from the medial cord.
e. Injury of the lower trunk results in Erb-Duchenne palsy.

2. In the arm:
a. The profunda brachii artery is closely related to the surgical neck of the
humerus.
b. Biceps brachii supinates and flexes the arm.
c. The brachial artery may be palpated just medial to the biceps brachii
muscle.
d. The musculocutaneous nerve continues as the lateral cutaneous nerve of
the forearm.
e. Brachial veins unite to form the cephalic vein.

3. With regard to the right ventricle:

a. It has three papillary muscles.
b. The septomarginal band extends from the septum to the base of the
anterior papillary muscle.
c. It contains pectinate muscles.
d. The outflow portion of the chamber inferior to the pulmonary orifice is
called the infundibulum.
e. It receives arterial blood supply from the left marginal branch of left
coronary artery.

4. Regarding the lungs, the:

a. Lingula is found in the right lungs.
b. Cardiac notch is present in the left lung.
c. Base of the right lung is more concave.
d. Superior vena cava impression is found in the left lung.
e. Lower border of the lung lies in the midclavicular line at Rib 6.

5. With regard to the posterior triangle of the neck:

a. It is subdivided into omoclavicular and occipital triangles.
b. The ansa cervicalis innervates the infrahyoid muscles.
c. The lesser occipital nerve (C2) runs across the sternocleidomastoid
muscle.
d. The inferior belly of omohyoid forms part of the floor.
e. The anterior jugular veins are superficial contents.

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6. Regarding the mandibular branch of the trigeminal nerve:

a. It runs within the infratemporal fossa.
b. It exits the skull through the foramen rotundum.
c. It provides sensory innervation to the anterior two-thirds of the tongue via
the lingual nerve.
d. Its buccal branch supplies motor innervation to the buccinator muscle.
e. It provides motor innervation to the tongue.

7. The oculomotor nerve:

a. Supplies the levator palpebrae superioris muscle.
b. Passes through the lateral wall of the cavernous sinus.
c. Passes through the optic canal in its course.
d. Supplies the superior oblique muscle.
e. Has a parasympathetic nucleus, the Edinger-Wesphal, which lies in the
midbrain.

8. Regarding the blood supply to the brain, occlusion of which of the following
arteries will lead to stroke?
a. Charcot’s artery of cerebral haemorrhage.
b. Basilar artery.
c. Labyrinthine artery.
d. Anterior inferior cerebellar artery.
e. Anterior cerebral artery.

9. The pancreas
a. Is intraperitoneal.
b. Forms part of the viscera of the stomach bed.
c. Has the union of the superior mesenteric and splenic veins as a posterior
relation to its neck.
d. Is supplied by branches of the superior mesenteric artery.
e. Has an uncinate process that is derived from the dorsal pancreatic bud.

10. With regard to the inguinal canal, the

a. Deep ring is located lateral to the inferior epigastric artery.
b. Deep ring is formed by evagination of the transversalis fascia.
c. Inguinal herniation is prevented at the superficial ring by the medial and
lateral crura of the external oblique muscle.
d. ilioinguinal nerve is a content in males only.
e. direct inguinal herniation usually projects through the superficial ring.

11. The following are likely locations of a cryptorchid testis:

a. Inguinal canal.
b. Posterior abdominal wall.
c. Abdominal cavity.
d. Epigastrium.
e. Scrotum.

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ANAT 2020 NOVEMBER 2017 EXAMINATION

12. Regarding the external anal sphincter:

a. It consists of concentric layers of smooth muscle which surround the lower
end of the anal canal.
b. It is located in the anal triangle of the perineum.
c. The superficial part fuses with the puborectalis muscle.
d. It is innervated by the inferior rectal nerve, a branch of the pudendal nerve.
e. Its arterial supply is from the internal pudendal artery.

13. The sural nerve is formed by contributions from the:

a. Tibial nerve.
b. Posterior tibial nerve.
c. Common fibular nerve.
d. Superficial fibular nerve.
e. Deep fibular nerve.

14. The following anterior compartment muscles of the thigh have a dual
innervation:
a. Adductor longus.
b. Rectus femoris.
c. Pectineus.
d. Sartorius.
e. Iliopsoas.

15. The muscles that keeps the pelvis level while walking is:
a. Tensor fascia lata.
b. Gluteus maximus.
c. Gluteus medius.
d. Quadratus femoris.
e. Obturator externus.

16. With regard to the following epithelia:

a. Simple squamous epithelium lines the lumen of the transitional bronchiole.
b. Simple columnar epithelium lines the lumen of the jejunum.
c. Stratified cuboidal epithelium forms the duct of a sweat gland.
d. Stratified squamous non-keratinised epithelium has absorptive function.
e. Transitional epithelium has umbrella cells.

17. Loose connective tissue:

a. Has little ground substance.
b. Is found in the lamina propria of hollow organs.
c. Has sparse collagen fibres.
d. Is initial site of immune reaction.
e. Is classified as a connective tissue with a solid matrix.

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ANAT 2020 NOVEMBER 2017 EXAMINATION

18. With regard to the process of endochondral ossification:

a. A pre-existing cartilage model is required.
b. It occurs around the 4th week of development.
c. It gives rise to long bones.
d. Osteoclasts proliferate to form primary ossification centres.
e. Secondary ossification centres develop within the epiphysis of long
bones.

19. With regard to epidermis of skin:

a. Melanin pigment is stored in melanocytes.
b. Epidermal ridges interlink with dermal papillae.
c. It is avascular.
d. It is classified as “stratified squamous non-keratinised epithelium”.
e. Cells of the stratum granulosum are involved in keratinization.

20. Bronchiole:
a. Has a “pseudostratified ciliated columnar epithelium with goblet cells”.
b. Has a “thick band of smooth muscle forming the muscularis mucosa”.
c. Has Clara cells.
d. Has mucoserous cells in the lamina propria.
e. Is part of the conducting portion of the respiratory system.

21. With regard to the histology of the central nervous system:

a. Pyramidal cells are located in “the white matter of the cerebrum”.
b. Purkinje cells are located in “the cortex of the cerebellum”.
c. White matter consists primarily of neuron cell bodies.
d. Astrocytes form part of the blood-brain barrier.
e. Oligodendrocytes are involved in myelination.

22. In relation to the developing pancreas:

a. Its parenchyma is derived from the ectoderm of the gastrointestinal tube.
b. Grows into the septum transversum.
c. It has both a ventral and a dorsal bud.
d. The ventral bud and its duct system will “migrate” through 270° in total to
reach the adult position.
e. An annular pancreas results when the dorsal pancreatic bud splits into
two.

23. In relation to the development of the diaphragm:

a. The pleuropericardial membranes form the posterolateral aspects.
b. The septum transversum forms the central tendon.
c. The diaphragm arises at cervical levels.
d. The phrenic nerves penetrate the diaphragm on its superior aspect.
e. The pleuroperitoneal membranes form the posterolateral aspects.

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24. The permanent kidney is formed by the following:

a. Ureteric bud.
b. Metanephric mesoderm.
c. Mesonephric duct.
d. Intermediate mesoderm.
e. Mesonephros.

25. With regard to the zona glomerulosa of the suprarenal gland:

a. The cells are arranged in oval clusters.
b. The cells are surrounded by fenestrated capillaries.
c. It has chromaffin cells.
d. The cells are arranged in “long, straight cords”.
e. The cells secrete aldosterone.

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ANAT 2020 NOVEMBER 2017 EXAMINATION

SECTION B: SHORT ESSAY QUESTIONS TOTAL: 100 MARKS

MORPHOLOGICAL ANATOMY 60 MARKS

QUESTION 1
Describe the function and innervation of flexor digitorum profundus. Explain how the
integrity of the muscle’s innervation can be tested in a clinical setting. (5 marks)

QUESTION 2
Describe the formation of the azygous veins and list its tributaries. (5 marks)

QUESTION 3
a. Redraw the table into your answer book. Name any two (2) features that are
associated with each of the boundaries of the middle ear indicated. (5 marks)

Boundary Feature 1 Feature2

Roof /tegmental wall:

Lateral (Membranous) wall:
Medial (Labyrinthine) wall:
Posterior (Mastoid) wall:
Anterior (Carotid) wall:

b. List the intrinsic muscles of the middle ear and their innervation. (2 marks)
[Total 7 marks]
QUESTION 4
a. In which gyri and/or sulci in the cerebral hemisphere are the following functions
located? (3 marks)
i. Primary motor area –
ii. Primary somatosensory –
iii. Primary auditory area –
iv. Primary visual area –
v. Limbic cortex –
vi. Broca’s speech area –

b. Complete the following table with regard to the origins of the sympathetic and
parasympathetic fibers. The relevant cranial nerves should be named and not
numbered. (3 marks)

Autonomic Nervous Parasympathetic Sympathetic

System
Brain stem nuclei of 1.1
cranial nerves:
1.2
1.3
1.4
Spinal nerve segments: 1.5 1.6

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c. What structures are found deep to the following external features of the medulla
oblongata. (2 marks)

External features on the medulla Structure found deep

oblongata
Pyramid
Olive
Gracile tubercle
Cuneate tubercle
[Total 8 marks]

QUESTION 5
a. Copy the table below in your answer paper. Describe the differences between
indirect and direct inguinal hernias. (7 marks)

Feature Indirect Inguinal Hernia Direct Inguinal Hernia

Predisposing factor
Course of hernia
Extra coverings of
herniating sac
Spermatic Cord
Relation of inferior
epigastric vessels
Frequency
Gender frequency

b. List the structures that are related to the diaphragmatic and visceral surfaces
respectively of the spleen. (3 marks)
[Total 10 marks]

QUESTION 6
a. Describe the three positions of the uterus. Which position is the most common?
(4 marks)

b. List the structures that constitute the boundaries of the pelvic brim or inlet.
(3 marks)

c. Describe the innervation to the scrotum. (3 marks)

[Total 10 marks]

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QUESTION 7
a. The structures within the femoral triangle are sometimes used as an access route
to measure pressure in the right side of the heart. Draw a well labelled diagram of
the femoral triangle to illustrate the borders and contents as seen on an anterior
view of the thigh. (4 marks)

b. The great saphenous vein is often used to administer fluid to haemodynamically

compromised patients.
i. Write short notes on the origin, course and termination of the great
saphenous vein. (4 marks)
ii. How are the superficial veins connected to the deep veins? (½ mark)
iii. What structure normally ensures blood flow from superficial veins to
deep veins? (½ mark)

c. Explain why the lateral meniscus is less often torn in contact sports compared to
the medial meniscus? (4 marks)

d. A 51-year old patient presents with inability to dorsiflex his right foot.
i. List THREE muscles that are affected in this case. (1½ marks)
ii. Which nerve supplies the muscles mentioned in (i)? (½ mark)
[Total 15 marks]

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HISTOLOGY AND EMBRYOLOGY TOTAL MARKS: 40

ANSWER QUESTION 1-6 IN THE WHITE BOOK

QUESTION 1
Describe the histological structure of hyaline cartilage. (6 marks)

QUESTION 2
Describe the histological structure of the respiratory mucosa. Your answer should
include all the constituents of the three distinct mucosal sub-layers. (8 marks)

QUESTION 3
Answer the following questions related to the histological structure of the kidney:
a. List the three components of the juxtaglomerular apparatus and indicate the
location of each component within the kidney. (3 marks)
b. The blood supply of the kidney is unusual in that it has two capillary systems.
Describe the two capillary systems and also explain how each is formed and
what the function of each is. (3 marks)
[Total: 6 marks]

QUESTION 4
Describe the events that take place within the endometrium during the secretory
phase of the menstrual cycle. Your answer should also include a brief explanation of
how the hormones of the hypothalamic-pituitary-ovarian axis influence the changes
mentioned above. (8 marks)

QUESTION 5
Write notes on the embryonic development of the paramesonephric ducts. Include in
your answer the location/course and the derivatives of the ducts. (6 marks)

QUESTION 6
a. Describe the embryonic development of the palate. Do not include ossification of
the palate. (5 marks)
b. Describe one abnormality associated with mal-development of the palate and
indicate its cause. (1 mark)
[Total: 6 marks]

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