Hacking the MRCS Exam - Part A MCQS Part 2

By Dr.Atef Ahmed

Are you ready to conquer the MRCS exam and take a significant step towards your dream of becoming a proficient surgeon? Look no further! "Hacking the MRCS Exam – Part A MCQS (Part 2)" is the ultimate guide designed to empower aspiring surgeons like you with the knowledge, strategies, and confidence needed to ace the MRCS Part A MCQS section.

Building upon the success of the first part, Dr. Atef Ahmed, a seasoned surgeon and educator, presents a comprehensive sequel that dives deep into the intricacies of the MRCS exam. This book is more than just a study resource; it's a roadmap to success carefully crafted to guide you through the challenges of the Part A MCQS section.

Key Features:

Strategic Learning: Dr. Ahmed introduces proven strategies to help you absorb and retain knowledge effectively. Say goodbye to rote memorization and hello to understanding and applying concepts with finesse.

Clinical Context: Gain a clear understanding of how to apply theoretical knowledge in real-life clinical scenarios. Master the art of clinical decision-making and critical thinking, essential skills for any aspiring surgeon.

Comprehensive Coverage: Covering a wide range of topics, the book ensures you're prepared for every aspect of the MRCS Part A MCQS. From surgical principles to anatomy and pathology, you'll find all you need to succeed.

Practice Makes Perfect: Engage with practice questions and mock exams designed to simulate the real exam experience. Sharpen your skills, manage your time effectively, and eliminate the fear of the unknown.

Expert Guidance: Dr. Ahmed's years of experience in both surgery and education shine through. Benefit from his insights, tips, and recommendations that provide a competitive edge in your exam preparation.

Whether you're a dedicated student or a busy professional, "Hacking the MRCS Exam – Part A MCQS (Part 2)" is your companion on the journey to becoming a remarkable surgeon. It's not just a book; it's a mentor, a study partner, and a source of inspiration that propels you toward success.

Empower yourself with the knowledge to excel in the MRCS Part A MCQS section. Add "Hacking the MRCS Exam – Part A MCQS (Part 2)" to your cart and take the next step towards realizing your surgical dreams. Your success story starts here. (986 pages )

• Language: English
• Publisher: Dr.Atef Ahmed
• Release date: Apr 25, 2024
• ISBN: 9798223945635

Book preview

The Aim of the Book:

The aim of Hacking the MRCS Exam - Part A MCQS (Part 2) is to provide you, the reader, with a strategic approach to mastering the challenges posed by the Part A MCQS section of the MRCS exam. The book equips you with the tools needed to navigate through the vast ocean of medical knowledge, enabling you to not only answer questions accurately but also understand the underlying principles that guide clinical decision-making. The content is structured to facilitate both learning and retention, enhancing your ability to recall and apply information under the pressure of examination conditions.

My Recommendations:

To my esteemed readers and MRCS exam candidates, I offer a few heartfelt recommendations:

Dedication: Approach your studies with unwavering dedication and commitment. The path to surgical excellence is demanding but immensely rewarding.

Strategic Learning: Utilize the strategies outlined in this book to efficiently absorb and retain knowledge. Focus on understanding concepts rather than rote memorization.

Practice with Purpose: Engage in practice questions and mock exams regularly. This not only refines your knowledge but also familiarizes you with the exam format and timing.

Self-Care: Remember to care for your physical and mental well-being. Balancing your studies with relaxation and self-care is essential for peak performance.

Believe in Yourself: Approach the exam with confidence in your preparation. You have come a long way, and your dedication will bear fruit.

N.B .1-  Human errors can occur with anybody .so any errors like repeated questions can occur.

Your feedback are welcomed  .

2-The questions and answers in part 2 are completely different than in part 1

In closing, I extend my deepest thanks to each of you for choosing this book as a companion on your MRCS journey. Remember that success is a culmination of not only knowledge but also the courage to step forward and embrace challenges. May this book empower you to conquer the Part A MCQS section of the MRCS exam and set you on a path toward becoming exceptional surgeons.

With warm regards,

Dr. Atef Ahmed

DRATEF.NET

[e-mail]

Twitter/@dratefahmed

Insta/@dr.atefahmed

threads /@dr.atefahmed

Youtube/@no1doctor927

facebook/dratefahmedsurgeon

tiktok.com/@dr.atefahmed

Applied surgical anatomy

Which nerve passes through the obturator foramen?

A. Femoral nerve

B. Obturator nerve

C. Sciatic nerve

D. Tibial nerve

E. Common fibular nerve

Explanation: The obturator nerve passes through the obturator foramen. The femoral nerve passes underneath the inguinal ligament. The sciatic nerve passes through the greater sciatic foramen. The tibial and common fibular nerves are branches of the sciatic nerve in the posterior thigh.

Which muscle forms the floor of the inguinal canal?

A. Rectus abdominis

B. Internal oblique

C. Transversus abdominis

D. External oblique

E. Cremaster

Explanation: The transversus abdominis forms the floor of the inguinal canal. The internal oblique forms the roof, the external oblique forms the anterior wall, and the cremaster covers the spermatic cord.

Which nerve innervates the teres minor muscle?

A. Axillary nerve

B. Radial nerve

C. Musculocutaneous nerve

D. Median nerve

E. Ulnar nerve

Explanation: The axillary nerve innervates the teres minor muscle. The radial nerve innervates the triceps brachii, brachioradialis and extensor muscles of the forearm. The musculocutaneous nerve innervates the coracobrachialis, biceps brachii and brachialis muscles. The median and ulnar nerves supply the flexor compartment of the forearm.

Which artery supplies blood to the anterior tibialis muscle?

A. Anterior tibial artery

B. Posterior tibial artery

C. Dorsalis pedis artery

D. Fibular artery

E. Popliteal artery

Explanation: The anterior tibial artery supplies blood to the anterior tibialis muscle. The posterior tibial artery supplies the posterior compartment calf muscles. The dorsalis pedis artery is a continuation of the anterior tibial artery. The fibular artery supplies the lateral compartment calf muscles. The popliteal artery branches into the anterior and posterior tibial arteries at the lower border of the popliteus muscle.

Which nerve innervates the gemellus superior muscle?

A. Femoral nerve

B. Obturator nerve

C. Sciatic nerve

D. Pudendal nerve

E. Superior gluteal nerve

Explanation: The superior gemellus muscle is innervated by the nerve to obturator internus, a branch of the sacral plexus. The femoral nerve innervates the iliopsoas muscle. The sciatic nerve innervates the hamstrings. The pudendal nerve supplies the external genitalia. The superior gluteal nerve innervates the gluteus medius, gluteus minimus and tensor fascia latae muscles.

Which muscle forms the rotator cuff of the shoulder joint?

A. Teres major

B. Subscapularis

C. Latissimus dorsi

D. Deltoid

E. Coracobrachialis

Explanation: The rotator cuff consists of the subscapularis, supraspinatus, infraspinatus and teres minor muscles. These muscles originate from the scapula and insert on the humerus, stabilizing the shoulder joint.

Which nerve provides sensory innervation to the medial aspect of the arm?

A. Radial nerve

B. Median nerve

C. Ulnar nerve

D. Medial cutaneous nerve of arm

E. Medial cutaneous nerve of forearm

Explanation: The medial cutaneous nerve of the arm provides sensation to the medial aspect of the arm. The radial nerve supplies the lateral arm. The median and ulnar nerves supply the forearm. The medial cutaneous nerve of the forearm supplies the medial forearm.

Which muscle action flexes and laterally rotates the hip joint?

A. Gluteus medius

B. Gluteus minimus

C. Piriformis

D. Obturator internus

E. Superior gemellus

Explanation: The piriformis muscle flexes and laterally rotates the hip joint. The gluteus medius and minimus abduct the hip. The obturator internus and superior gemellus laterally rotate the hip.

Which artery supplies blood to the pectoralis major muscle?

A. Lateral thoracic artery

B. Thoracoacromial artery

C. Posterior circumflex humeral artery

D. Subscapular artery

E. Anterior circumflex humeral artery

Explanation: The pectoralis major muscle receives its blood supply from the pectoral branch of the thoracoacromial artery. The lateral thoracic artery supplies the serratus anterior. The posterior and anterior circumflex humeral arteries supply the shoulder joint. The subscapular artery supplies the subscapularis muscle.

Which cranial nerve innervates the muscles of mastication?

A. Trigeminal nerve

B. Facial nerve

C. Glossopharyngeal nerve

D. Vagus nerve

E. Hypoglossal nerve

Explanation: The muscles of mastication are supplied by the mandibular division of the trigeminal nerve (CN V). The facial nerve (CN VII) innervates the muscles of facial expression. The glossopharyngeal (CN IX), vagus (CN X) and hypoglossal (CN XII) nerves supply muscles of the pharynx and tongue.

Which nerve root level gives rise to the phrenic nerve?

A. C3-C5

B. C4-C6

C. C5-C7

D. C6-C8

E. C7-T1

Explanation: The phrenic nerve arises from the cervical nerve roots C3-C5. It provides motor innervation to the diaphragm. Nerve roots C6 to T1 form the brachial plexus for the upper limb.

Which artery provides the main blood supply to the small intestine?

A. Celiac trunk

B. Superior mesenteric artery

C. Inferior mesenteric artery

D. Gastric artery

E. Splenic artery

Explanation: The small intestine receives its arterial supply from the superior mesenteric artery. The celiac trunk provides three arterial branches - left gastric, splenic and common hepatic. The inferior mesenteric artery supplies the descending and sigmoid colon.

Which muscle retracts and laterally rotates the scapula?

A. Rhomboid major

B. Levator scapulae

C. Pectoralis minor

D. Trapezius

E. Serratus anterior

Explanation: The rhomboid major and minor retract and rotate the scapula. Levator scapulae elevates the scapula. Pectoralis minor depresses and protracts the scapula. Trapezius elevates, depresses and rotates the scapula. Serratus anterior protracts the scapula.

Which nerve innervates the extensor carpi radialis longus?

A. Median nerve

B. Ulnar nerve

C. Radial nerve

D. Musculocutaneous nerve

E. Axillary nerve

Explanation: The extensor carpi radialis longus is innervated by the radial nerve. The median nerve supplies the flexor compartment forearm muscles. The ulnar nerve supplies medial forearm muscles. The musculocutaneous nerve innervates anterior arm muscles. The axillary nerve supplies shoulder girdle muscles.

Which muscle opposes the action of the popliteus?

A. Semimembranosus

B. Semitendinosus

C. Biceps femoris

D. Gracilis

E. Sartorius

Explanation: The popliteus muscle medially rotates the knee joint. The lateral rotation of the knee is performed by the biceps femoris muscle. The other hamstring muscles (semimembranosus, semitendinosus) flex the knee. The gracilis and sartorius medially rotate the knee when flexed.

Which cranial nerve innervates the stylohyoid muscle?

A. Trigeminal nerve

B. Facial nerve

C. Glossopharyngeal nerve

D. Vagus nerve

E. Accessory nerve

Explanation: The stylohyoid muscle is innervated by the facial nerve (CN VII). The trigeminal nerve (CN V) provides sensation to the face. The glossopharyngeal (CN IX), vagus (CN X) and accessory (CN XI) nerves supply muscles involved in swallowing.

Which artery provides the major blood supply to the head of the femur?

A. Obturator artery

B. Medial circumflex femoral artery

C. Lateral circumflex femoral artery

D. Superior gluteal artery

E. Inferior gluteal artery

Explanation: The main blood supply to the head and neck of the femur is from the medial circumflex femoral artery. The lateral circumflex femoral artery supplies the greater trochanter. The obturator artery contributes supply to the head. The superior and inferior gluteal arteries supply the gluteal muscles.

Which cranial nerve passes through the jugular foramen?

A. Glossopharyngeal nerve

B. Vagus nerve

C. Accessory nerve

D. Hypoglossal nerve

E. Vestibulocochlear nerve

Explanation: The glossopharyngeal (CN IX), vagus (CN X) and accessory (CN XI) nerves exit the skull through the jugular foramen. The hypoglossal nerve (CN XII) passes through the hypoglossal canal. The vestibulocochlear nerve (CN VIII) passes through the internal acoustic meatus.

Which muscle extends and adducts the thigh?

A. Pectineus

B. Adductor longus

C. Gracilis

D. Obturator externus

E. Piriformis

Explanation: The pectineus muscle extends and adducts the thigh at the hip. The adductor longus, brevis and magnus also adduct the thigh. The gracilis adducts and medially rotates the thigh. The obturator externus laterally rotates the thigh. The piriformis medially rotates and abducts the thigh.

Which dermatome is associated with sensation over the tip of the index finger?

A. C5

B. C6

C. C7

D. C8

E. T1

Explanation: The dermatome corresponding to the index finger tip is C6. C5 corresponds to the shoulder region. C7 is associated with the middle finger. C8 corresponds to the little finger. T1 corresponds to the medial forearm.

Which artery passes between the sternal and clavicular heads of pectoralis major?

A. Thoracoacromial artery

B. Lateral thoracic artery

C. Internal thoracic artery

D. Subclavian artery

E. Axillary artery

Explanation: The lateral thoracic artery courses between the sternal and clavicular heads of the pectoralis major muscle. The thoracoacromial artery supplies the pectoral muscles. The internal thoracic artery supplies the anterior chest wall. The subclavian and axillary arteries travel above the clavicle.

Which nerve root level is associated with weakness of wrist flexion?

A. C5

B. C6

C. C7

D. C8

E. T1

Explanation: Weakness of wrist flexion indicates injury to the C8 nerve root. C5-C7 lesions cause shoulder and elbow weakness. C8-T1 lesions cause hand intrinsic muscle weakness. Preserved wrist extension helps localize the lesion to C8.

WHICH MUSCLE IS INVOLVED in depression and downward rotation of the scapula?

A. Levator scapulae

B. Upper trapezius

C. Rhomboid major

D. Serratus anterior

E. Pectoralis minor

Explanation: The lower fibers of trapezius depress and downwardly rotate the scapula. Levator scapulae elevates the scapula. Rhomboids retract the scapula. Serratus anterior protracts the scapula. Pectoralis minor depresses the scapula.

Which statement correctly describes the boundaries of the popliteal fossa?

A. Biceps femoris, semitendinosus, semimembranosus

B. Vastus medialis, lateralis, intermedius

C. Sartorius, gracilis, semitendinosus

D. Biceps femoris, plantaris, popliteus

E. Rectus femoris, vastus lateralis, medialis

Explanation: The boundaries of the popliteal fossa are the biceps femoris posteriorly, the semimembranosus medially, and the plantaris, gastrocnemius and lateral head of gastrocnemius laterally.

Which nerve innervates levator ani and coccygeus muscles?

A. Obturator nerve

B. Femoral nerve

C. Sciatic nerve

D. Pudendal nerve

E. Inferior gluteal nerve

Explanation: The levator ani and coccygeus muscles are innervated by branches of the sacral plexus - the perineal branch of the pudendal nerve and nerve to the levator ani. The obturator nerve supplies medial thigh muscles. The femoral nerve supplies anterior thigh muscles. The sciatic nerve supplies the posterior thigh. The inferior gluteal nerve supplies gluteus maximus.

Which artery often requires ligation during a hemicolectomy?

A. Middle colic artery

B. Right colic artery

C. Ileocolic artery

D. Superior mesenteric artery

E. Inferior mesenteric artery

Explanation: The ileocolic artery, a branch of the superior mesenteric artery, supplies the ascending colon and must often be ligated during right hemicolectomy. The middle colic artery branches from the superior mesenteric artery. The right colic artery arises from the superior mesenteric artery. The inferior mesenteric artery supplies the distal colon.

Which nerve root level is associated with weakness in extending the interphalangeal joint of the small finger?

A. C7

B. C8

C. T1

D. T2

E. T3

Explanation: Weakness in extending the IP joint of the small finger indicates involvement of the T1 nerve root. C8 lesions cause weakness of finger abduction. T2 lesions cause weakness of finger adduction. T3 lesions involve the triceps brachii muscle.

Which thoracic nerve root contributes to the phrenic nerve?

A. T1

B. T2

C. T3

D. T4

E. T5

Explanation: The phrenic nerve arises from C3-C5 nerve roots. There is no contribution from the thoracic spinal nerves. Phrenic nerve injury results in paralysis of the ipsilateral hemidiaphragm.

Which nerve provides sensory innervation to the trapezius muscle?

A. Dorsal scapular nerve

B. Long thoracic nerve

C. Suprascapular nerve

D. Spinal accessory nerve

E. Cervical plexus

Explanation: Sensory innervation to the trapezius muscle is via the cervical plexus (C3,C4). The spinal accessory nerve provides motor supply. The other nerves listed provide motor supply to scapular stabilizing muscles.

Which muscle rotates the hip joint laterally?

A. Superior gemellus

B. Obturator internus

C. Obturator externus

D. Pectineus

E. Adductor brevis

Explanation: The obturator externus muscle laterally rotates the hip joint. The superior gemellus and obturator internus medially rotate the hip. The pectineus and adductor brevis adduct the thigh at the hip joint.

Which nerve root level is associated with weakness in elbow flexion?

A. C5

B. C6

C. C7

D. C8

E. T1

Explanation: Weakness of elbow flexion indicates injury to the C6 nerve root. C5 lesions cause weakness of shoulder abduction. C7 lesions cause weakness of elbow extension. C8 lesions cause hand intrinsic muscle weakness. T1 lesions cause medial forearm sensory loss.

Which layer of the abdominal wall fascia contributes to the inguinal ligament?

A. External oblique aponeurosis

B. Internal oblique aponeurosis

C. Transversus abdominis aponeurosis

D. Transversalis fascia

E. Extraperitoneal fascia

Explanation: The inguinal ligament is formed by the external oblique aponeurosis. The internal oblique forms the conjoint tendon. The transversus abdominis and transversalis fascia form the posterior wall of the inguinal canal.

Which cranial nerve innervates the superior oblique muscle?

A. Oculomotor nerve

B. Trochlear nerve

C. Trigeminal nerve

D. Abducens nerve

E. Facial nerve

Explanation: The superior oblique muscle is innervated by the trochlear nerve (CN IV). The oculomotor nerve supplies the superior, medial and inferior recti, inferior oblique, levator palpebrae and iris sphincter muscles. The trigeminal nerve conveys sensation from the face. The abducens nerve controls lateral rectus. The facial nerve controls muscles of facial expression.

Which statement correctly describes the boundaries of the femoral triangle?

A. Sartorius, adductor longus, adductor magnus

B. Sartorius, adductor longus, gracilis

C. Sartorius, vastus medialis, adductor longus

D. Sartorius, vastus lateralis, adductor brevis

E. Rectus femoris, vastus lateralis, vastus intermedius

Explanation: The boundaries of the femoral triangle are the sartorius medially, the adductor longus laterally, and the inguinal ligament superiorly. The adductors and vasti muscles are located in the thigh, not the femoral triangle.

Which dermatome corresponds to the skin overlying the hip joint?

A. L1

B. L2

C. L3

D. L4

E. L5

Explanation: The L1 dermatome corresponds to sensation over the hip joint region. L2 is medial thigh. L3 is anterior thigh. L4 is medial leg. L5 is big toe.

Which nerve root level corresponds to weakness in ankle dorsiflexion?

A. L4

B. L5

C. S1

D. S2

E. S3

Explanation: Ankle dorsiflexor weakness indicates an L5 nerve root lesion. L4 lesions cause weakness in ankle inversion. S1 affects plantarflexion. S2, S3 affect foot intrinsic muscles. Preserved ankle eversion helps localize the lesion to L5.

Which muscle opposes the actions of pectineus at the hip joint?

A. Adductor brevis

B. Adductor longus

C. Gracilis

D. Sartorius

E. Rectus femoris

Explanation: The pectineus adducts and flexes the hip joint. This action is opposed by the gluteus medius and minimus, which abduct the hip. The other muscles listed are hip adductors.

Which nerve innervates the brachioradialis muscle?

A. Radial nerve

B. Median nerve

C. Ulnar nerve

D. Musculocutaneous nerve

E. Axillary nerve

Explanation: The brachioradialis muscle is innervated by the radial nerve in the spiral groove of the humerus. The median nerve supplies the forearm flexors. The ulnar nerve supplies the medial forearm muscles. The musculocutaneous nerve supplies the biceps brachii. The axillary nerve supplies the deltoid and teres minor.

Which muscle retracts the lower lip?

A. Buccinator

B. Depressor anguli oris

C. Depressor labii inferioris

D. Mentalis

E. Orbicularis oris

Explanation: The depressor anguli oris muscle retracts the corner of the mouth and lower lip. Buccinator compresses the cheek. Depressor labii inferioris depresses the lower lip. Mentalis raises and protrudes the lower lip. Orbicularis oris closes the lips.

Which dermatome corresponds to sensation over the lateral aspect of the foot?

A. L4

B. L5

C. S1

D. S2

E. S3

Explanation: The lateral foot is supplied by the S1 dermatome. L4 corresponds to the medial leg. L5 corresponds to the big toe. S2 is the posterior thigh. S3 is the perineum.

Which artery is often harvested as a conduit for coronary artery bypass grafting?

A. Radial artery

B. Ulnar artery

C. Brachial artery

D. Deep brachial artery

E. Superior ulnar collateral artery

Explanation: The radial artery is commonly used as a graft in coronary artery bypass surgery due to its accessibility and diameter. The ulnar and brachial arteries provide major blood supply to the arm and hand. The deep brachial and superior ulnar collateral arteries are small branches.

Which nerve root level corresponds to weakness in shoulder abduction?

A. C4

B. C5

C. C6

D. C7

E. C8

Explanation: Weakness of shoulder abduction indicates injury to the C5 nerve root. C4 lesions cause sensory changes over the shoulder. C6 lesions cause weakness in elbow flexion. C7 affects triceps brachii. C8 affects hand intrinsic muscles.

Which muscle opposes thumb adduction?

A. Adductor pollicis

B. First dorsal interosseous

C. Flexor pollicis longus

D. Abductor pollicis brevis

E. Opponens pollicis

Explanation: Thumb adduction is opposed by abductor pollicis brevis. Adductor pollicis adducts the thumb. The first dorsal interosseous abducts the index finger. Flexor pollicis longus flexes the distal phalanx of the thumb. Opponens pollicis opposes the thumb.

Which artery passes deep to the inguinal ligament?

A. Superficial epigastric artery

B. Superficial iliac circumflex artery

C. External pudendal artery

D. Deep external pudendal artery

E. Inferior epigastric artery

Explanation: The inferior epigastric artery crosses deep to the inguinal ligament. The other arteries listed are superficial branches. The deep external pudendal artery is a branch of the femoral artery in the femoral triangle.

Which muscle extends the hip and flexes the trunk?

A. Rectus femoris

B. Sartorius

C. Tensor fascia latae

D. Adductor longus

E. Pectineus

Explanation: The rectus femoris muscle acts to extend the hip joint and flex the trunk at the waist. Sartorius, tensor fascia latae and pectineus flex, abduct and medially rotate the thigh. Adductor longus adducts the thigh.

Which statement correctly describes the origin of pectoralis minor?

A. Medial half of clavicle

B. Lateral surface of ribs 1-4

C. Superior border of scapula

D. Coracoid process

E. Inferior surface of clavicle

Explanation: Pectoralis minor originates from ribs 3-5 and inserts on the coracoid process of the scapula. It depresses and protracts the scapula. Pectoralis major originates from the medial clavicle, sternum and cartilage of ribs 2-6.

Which muscle opposes thumb abduction?

A. Adductor pollicis

B. First dorsal interosseous

C. Opponens pollicis

D. Flexor pollicis brevis

E. Abductor pollicis longus

Explanation: Thumb abduction is opposed by adductor pollicis. Abductor pollicis brevis abducts the thumb. Opponens pollicis opposes the thumb. Flexor pollicis brevis flexes the thumb. Abductor pollicis longus abducts and extends the thumb.

WHICH CRANIAL NERVE passes through the superior orbital fissure?

A. Optic nerve

B. Oculomotor nerve

C. Trochlear nerve

D. Trigeminal nerve

E. Abducens nerve

Explanation: Cranial nerves passing through the superior orbital fissure include CN III (oculomotor), CN IV (trochlear), CN V1 (ophthalmic division of trigeminal nerve) and CN VI (abducens nerve). The optic nerve passes through the optic canal.

Which nerve root level corresponds to weakness in shoulder external rotation?

A. C4

B. C5

C. C6

D. C7

E. C8

Explanation: Weakness of shoulder external rotation (infraspinatus muscle) indicates injury to the C5 nerve root. C4 lesions cause sensory changes over the shoulder region. C6 lesions cause elbow flexion weakness. C7 lesions cause triceps weakness. C8 lesions cause hand intrinsic muscle weakness.

Which muscle contributes to forming the quadriceps tendon?

A. Sartorius

B. Gracilis

C. Semimembranosus

D. Rectus femoris

E. Vastus intermedius

Explanation: The quadriceps tendon is formed by the fusion of the tendons of the rectus femoris, vastus lateralis, vastus medialis and vastus intermedius muscles. The sartorius, gracilis and semimembranosus are not part of the quadriceps muscle group.

Which dermatome corresponds to sensation over the tip of the nose?

A. V1

B. V2

C. V3

D. C2

E. C3

Explanation: The tip of the nose is supplied by the ophthalmic division of the trigeminal nerve (V1). V2 is the maxillary division, supplying the upper lip. V3 is the mandibular division. C2 dermatome covers the back of the head. C3 covers the clavicle.

Which artery supplies the anterior and posterior choroid plexus?

A. Anterior cerebral artery

B. Middle cerebral artery

C. Posterior cerebral artery

D. Superior cerebellar artery

E. Anterior inferior cerebellar artery

Explanation: The anterior and posterior choroid plexus receive their arterial supply from the posterior cerebral artery. The anterior and middle cerebral arteries supply the anterior circulation. The superior and anterior inferior cerebellar arteries are branches of the vertebral artery supplying the cerebellum.

Which cranial nerve passes through the jugular foramen?

A. Glossopharyngeal nerve

B. Vagus nerve

C. Accessory nerve

D. Hypoglossal nerve

E. All of the above

Explanation: The glossopharyngeal (CN IX), vagus (CN X), and accessory (CN XI) nerves exit the posterior cranial fossa through the jugular foramen. The hypoglossal nerve (CN XII) passes through the hypoglossal canal.

Which artery supplies the piriformis muscle?

A. Superior gluteal artery

B. Inferior gluteal artery

C. Internal pudendal artery

D. Obturator artery

E. Lateral sacral artery

Explanation: The piriformis muscle is supplied by the superior gluteal artery, which exits the pelvis above piriformis and enters the gluteal region. The inferior gluteal, internal pudendal and obturator arteries are below the piriformis. The lateral sacral artery supplies the sacrum.

Which dermatome corresponds to the umbilicus?

A. T9

B. T10

C. T11

D. T12

E. L1

Explanation: The umbilicus corresponds to the T10 dermatome. T9 corresponds to the epigastrium. T11 is the groin. T12 is the pubic region. L1 covers the inguinal region.

Which nerve root level corresponds to wrist drop?

A. C5

B. C6

C. C7

D. C8

E. T1

Explanation: Wrist drop, or weakness of wrist and finger extension, indicates injury to the C7 nerve root. C5 lesions cause shoulder weakness. C6 causes elbow flexion weakness. C8 causes hand intrinsic muscle weakness. T1 causes medial forearm sensory loss.

Which artery is often used for coronary artery bypass of distal right coronary circulation?

A. Left internal thoracic artery

B. Right internal thoracic artery

C. Right gastroepiploic artery

D. Left radial artery

E. Right radial artery

Explanation: The right gastroepiploic artery may be used to bypass distal segments of the right coronary artery because of its accessibility in the abdomen. The internal thoracic arteries are used for left coronary circulation. The radial arteries are used for coronary artery grafts as well.

Which cranial nerve passes through the superior orbital fissure?

A. Optic nerve

B. Oculomotor nerve

C. Trochlear nerve

D. Trigeminal nerve

E. All of the above except the optic nerve

Explanation: The superior orbital fissure transmits CN III (oculomotor), CN IV (trochlear), CN V1 (ophthalmic division of trigeminal), and CN VI (abducens). The optic nerve (CN II) passes through the optic canal separately.

Which nerve innervates the popliteus muscle?

A. Femoral nerve

B. Sciatic nerve

C. Tibial nerve

D. Common fibular nerve

E. Obturator nerve

Explanation: The popliteus muscle is innervated by the tibial nerve, a branch of the sciatic nerve. The femoral nerve supplies anterior thigh muscles. The common fibular nerve supplies the lateral leg compartment. The obturator nerve supplies medial thigh muscles.

Which muscle retracts and rotates the scapula?

A. Rhomboid major

B. Pectoralis minor

C. Levator scapulae

D. Upper trapezius

E. Serratus anterior

Explanation: The rhomboid major and minor retract and rotate the scapula. Pectoralis minor protracts the scapula. Levator scapulae elevates the medial border of the scapula. Upper trapezius elevates and rotates the scapula. Serratus anterior protracts the scapula.

Which artery arises from the abdominal aorta at approximately the L2 vertebral level?

A. Celiac trunk

B. Superior mesenteric artery

C. Inferior mesenteric artery

D. Renal artery

E. Gonadal artery

Explanation: The superior mesenteric artery branches from the abdominal aorta around the level of L1-L2. The celiac trunk is at T12-L1. The gonadal arteries arise inferior to the renal arteries at L2. The inferior mesenteric is distal to the left colic artery.

Which muscle extends the hip and flexes the knee?

A. Gracilis

B. Sartorius

C. Semimembranosus

D. Semitendinosus

E. Popliteus

Explanation: The sartorius muscle flexes the knee and hip joints. Gracilis adducts the thigh and flexes the knee. The semimembranosus and semitendinosus muscles extend the hip and flex the knee. Popliteus medially rotates the knee.

Which nerve root level corresponds to weakness of the gluteus medius muscle?

A. L2

B. L3

C. L4

D. L5

E. S1

Explanation: The gluteus medius is innervated by the superior gluteal nerve arising from L4-S1 nerve roots, mainly L4 and L5. L2/L3 lesions cause weakness in thigh adduction. L5 lesions cause weakness in ankle dorsiflexion. S1 lesions cause plantarflexion weakness.

Which artery supplies the biceps brachii muscle?

A. Axillary artery

B. Brachial artery

C. Radial artery

D. Musculocutaneous artery

E. Deep brachial artery

Explanation: The biceps brachii muscle receives its arterial supply from the musculocutaneous artery, a branch of the axillary artery. The other arteries listed provide blood supply to the more distal upper limb.

Which vein drains into the cephalic vein?

A. Basilic vein

B. Brachial vein

C. Median cubital vein

D. Radial vein

E. Ulnar vein

Explanation: The median cubital vein, formed by the anastomosis of the cephalic and basilic veins in the cubital fossa region, drains into the cephalic vein proximally. The brachial, radial and ulnar veins drain into the basilic vein.

Which nerve innervates the gemellus superior muscle?

A. Obturator nerve

B. Sciatic nerve

C. Nerve to quadratus femoris

D. Pudendal nerve

E. Superior gluteal nerve

Explanation: The superior gemellus muscle is innervated by the nerve to obturator internus, arising from the sacral plexus. The obturator nerve supplies hip adductors. The sciatic nerve supplies the posterior thigh. The pudendal nerve supplies the perineum. The superior gluteal nerve supplies the gluteus medius/minimus.

Which muscle retracts the mandible?

A. Masseter

B. Medial pterygoid

C. Lateral pterygoid

D. Temporalis

E. Digastric

Explanation: The posterior fibers of the temporalis muscle retract the mandible after protraction by the lateral pterygoid. Masseter elevates the mandible. Medial pterygoid elevates and protracts the mandible. Digastric depresses the mandible.

WHICH STATEMENT CORRECTLY describes the origin of the diaphragm?

A. Xiphoid process and ribs 5-12

B. Lumbar vertebrae

C. Arcuate ligaments at psoas major

D. Median arcuate ligament at aorta

E. Median arcuate ligament and psoas major

Explanation: The diaphragm originates from the xiphoid process, costal cartilages of ribs 7-12, and lumbar vertebrae. The arcuate ligaments are thickened portions, not areas of origin. The diaphragm inserts on the central tendon.

Which muscle elevates the hyoid bone?

A. Geniohyoid

B. Mylohyoid

C. Digastric

D. Stylohyoid

E. Sternohyoid

Explanation: The digastric muscle elevates the hyoid bone using its posterior belly. Geniohyoid and mylohyoid depress the mandible. Stylohyoid elevates and retracts the hyoid bone. Sternohyoid depresses the hyoid bone.

Which nerve root level corresponds to weakness in hip abduction?

A. L1

B. L2

C. L3

D. L4

E. L5

Explanation: Weakness of hip abduction indicates an L5 nerve root lesion, affecting gluteus medius/minimus innervation. L4 lesions cause ankle inversion weakness. L2/3 lesions cause thigh adductor weakness. L1 corresponds to weakness of hip flexion.

Which muscle opposes the action of tibialis posterior at the ankle joint?

A. Tibialis anterior

B. Flexor digitorum longus

C. Flexor hallucis longus

D. Peroneus longus

E. Peroneus brevis

Explanation: Tibialis posterior plantarflexes and inverts the ankle. This action is opposed by peroneus longus and brevis, which cause eversion of the ankle joint. Tibialis anterior is also antagonistic as an ankle dorsiflexor.

Which artery supplies blood to the gluteus maximus muscle?

A. Superior gluteal artery

B. Inferior gluteal artery

C. Internal pudendal artery

D. Obturator artery

E. Deep artery of the thigh

Explanation: The gluteus maximus muscle receives its arterial supply from the inferior gluteal artery, a branch of the internal iliac artery. The superior gluteal artery supplies gluteus medius/minimus. The other arteries listed supply pelvic structures and thigh muscles.

Which cranial nerve passes through the jugular foramen?

A. Glossopharyngeal

B. Vagus

C. Accessory

D. Hypoglossal

E. All of the above except hypoglossal

Explanation: CN IX (glossopharyngeal), CN X (vagus), and CN XI (accessory) pass through the jugular foramen. The hypoglossal nerve (CN XII) passes through the hypoglossal canal separately.

Which nerve innervates the gluteus minimus muscle?

A. Inferior gluteal nerve

B. Sciatic nerve

C. Superior gluteal nerve

D. Tibial nerve

E. Obturator nerve

Explanation: The gluteus minimus is innervated by the superior gluteal nerve (L4-S1). The inferior gluteal nerve supplies gluteus maximus. The sciatic nerve supplies the posterior thigh. The tibial nerve supplies the calf. The obturator nerve supplies the medial thigh.

Which muscle abducts and flexes the arm at the shoulder joint?

A. Teres major

B. Latissimus dorsi

C. Deltoid

D. Supraspinatus

E. Infraspinatus

Explanation: The supraspinatus muscle abducts the arm at the shoulder joint and assists in flexion. Teres major extends and adducts the arm. Latissimus dorsi extends, adducts and medially rotates the arm. Deltoid abducts the arm. Infraspinatus laterally rotates the arm.

Which artery supplies blood to the sigmoid colon?

A. Middle colic artery

B. Left colic artery

C. Sigmoid arteries

D. Superior rectal artery

E. Inferior mesenteric artery

Explanation: The sigmoid colon receives arterial supply from several sigmoid arteries, branches of the inferior mesenteric artery. The other arteries listed supply proximal segments of the large intestine.

Which nerve root level corresponds to decreased sensation in the medial calf?

A. L2

B. L3

C. L4

D. L5

E. S1

Explanation: Decreased sensation in the medial calf indicates involvement of the L5 nerve root. L4 lesions cause decreased sensation over the medial leg and ankle. S1 corresponds to the lateral leg and foot. L2/3 lesions cause thigh sensory changes.

Where does the facial nerve exit the skull?

A. Superior orbital fissure

B. Foramen rotundum

C. Foramen ovale

D. Internal acoustic meatus

E. Stylomastoid foramen

Explanation: The facial nerve (CN VII) exits the skull through the stylomastoid foramen, located between the mastoid process and styloid process of the temporal bone. The other options listed are exits for other cranial nerves.

Which muscle opposes the action of gastrocnemius at the ankle joint?

A. Soleus

B. Tibialis anterior

C. Tibialis posterior

D. Flexor digitorum longus

E. Flexor hallucis longus

Explanation: The gastrocnemius muscle plantarflexes the ankle joint. This action is opposed by the tibialis anterior, which dorsiflexes the ankle. Soleus acts synergistically with gastrocnemius as an ankle plantarflexor.

Which vascular structure passes between the left brachiocephalic vein and aortic arch?

A. Left phrenic nerve

B. Left vagus nerve

C. Left recurrent laryngeal nerve

D. Thoracic duct

E. Superior vena cava

Explanation: The left recurrent laryngeal nerve loops under the aortic arch and between the arch and left brachiocephalic vein. The thoracic duct also passes behind the left brachiocephalic vein.

Which nerve innervates the gluteus maximus muscle?

A. Superior gluteal nerve

B. Inferior gluteal nerve

C. Tibial nerve

D. Common fibular nerve

E. Sciatic nerve

Explanation: The gluteus maximus is supplied by the inferior gluteal nerve arising from L5-S2 nerve roots. The superior gluteal nerve supplies gluteus medius/minimus. The sciatic nerve branches into the tibial and common fibular nerves in the posterior thigh.

Which nerve root level corresponds to weakness in hip adduction?

A. L2

B. L3

C. L4

D. L5

E. S1

Explanation: Weakness of hip adduction indicates an L3 nerve root lesion, affecting the superior gluteal nerve innervating the gluteus medius/minimus. L2 lesions cause weakness in thigh flexion. L4 lesions cause ankle inversion weakness. L5 lesions cause dorsiflexion weakness.

Which muscle elevates the soft palate?

A. Tensor veli palatini

B. Palatoglossus

C. Palatopharyngeus

D. Levator veli palatini

E. Musculus uvulae

Explanation: The levator veli palatini muscle elevates the soft palate. Tensor veli palatini tenses the soft palate. Palatoglossus and palatopharyngeus depress the soft palate. Musculus uvulae shortens and elevates the uvula.

Which muscle opposes the action of the inferior oblique muscle?

A. Superior oblique

B. Superior rectus

C. Lateral rectus

D. Medial rectus

E. Inferior rectus

Explanation: The inferior oblique muscle extorts, abducts and elevates the eyeball. This action is opposed by the superior rectus, which depresses and adducts the eyeball.

Which artery supplies blood to the head of the femur?

A. Obturator artery

B. Lateral circumflex femoral artery

C. Medial circumflex femoral artery

D. Superior gluteal artery

E. Inferior gluteal artery

Explanation: The medial circumflex femoral artery supplies blood to the head and neck of the femur. The lateral circumflex femoral artery supplies the greater trochanter. The superior and inferior gluteal arteries mainly supply the gluteal muscles.

Which cranial nerve carries general sensation from the anterior two-thirds of the tongue?

A. Facial

B. Glossopharyngeal

C. Vagus

D. Trigeminal

E. Hypoglossal

Explanation: General sensation from the anterior two-thirds of the tongue is carried by the lingual branch of the mandibular division of the trigeminal nerve (CN V). The facial (CN VII) and hypoglossal (CN XII) nerves control movements of the face and tongue. The glossopharyngeal (CN IX) and vagus (CN X) nerves provide general sensation from the posterior one-third of the tongue.

Which muscle rotates the hip joint laterally?

A. Tensor fascia lata

B. Piriformis

C. Superior gemellus

D. Obturator internus

E. Gluteus medius

Explanation: The piriformis muscle laterally rotates the hip joint in addition to abducting and flexing it. Tensor fascia lata medially rotates the hip. Superior gemellus and obturator internus medially rotate the hip. Gluteus medius abducts the hip.

Which cranial nerve innervates the superior oblique muscle?

A. Oculomotor

B. Trochlear

C. Trigeminal

D. Abducens

E. Facial

Explanation: The superior oblique muscle is innervated by the trochlear nerve (CN IV). The oculomotor nerve (CN III) supplies the other extraocular muscles except lateral rectus. The trigeminal (CN V), abducens (CN VI) and facial (CN VII) nerves are not involved in eye movement.

Which nerve root level corresponds to weakness in extending the knee?

A. L2

B. L3

C. L4

D. L5

E. S1

Explanation: Weakness of knee extension indicates an L2 nerve root lesion, affecting the femoral nerve innervating the quadriceps muscles. L3 lesions cause weakness in thigh adduction. L4 lesions cause ankle inversion weakness. L5 lesions cause dorsiflexion weakness.

Which artery supplies blood to the sternocleidomastoid muscle?

A. Occipital artery

B. Posterior auricular artery

C. Superficial temporal artery

D. Facial artery

E. Lingual artery

Explanation: The sternocleidomastoid muscle receives its arterial supply from the sternocleidomastoid branch of the occipital artery. The other arteries listed supply the scalp and face.

Where does the hypoglossal nerve exit the cranium?

A. Internal acoustic meatus

B. Jugular foramen

C. Foramen ovale

D. Hypoglossal canal

E. Optic canal

Explanation: The hypoglossal nerve (CN XII) exits the skull through the hypoglossal canal in the occipital bone. The other options listed are exits for other cranial nerves.

Which muscle opposes thumb opposition?

A. Abductor pollicis longus

B. Extensor pollicis brevis

C. Adductor pollicis

D. Opponens pollicis

E. Flexor pollicis longus

Explanation: Thumb opposition is performed by opponens pollicis. This action is opposed by adductor pollicis, which adducts the thumb. Abductor pollicis longus and brevis abduct the thumb. Flexor pollicis longus flexes the distal phalanx of the thumb.

Which nerve innervates the iliopsoas muscle?

A. Femoral nerve

B. Obturator nerve

C. Lumbosacral trunk

D. Superior gluteal nerve

E. Inferior gluteal nerve

Explanation: The iliopsoas muscle (psoas major and iliacus) is innervated by direct branches from the lumbar plexus via the lumbosacral trunk. The femoral, obturator and gluteal nerves arise from the sacral plexus.

Which muscle depresses the mandible?

A. Masseter

B. Medial pterygoid

C. Lateral pterygoid

D. Temporalis

E. Digastric

Explanation: The anterior belly of the digastric muscle depresses the mandible after elevation by the masseter, medial pterygoid and temporalis. Lateral pterygoid protracts the mandible.

Which artery supplies the spermatic cord?

A. Testicular artery

B. Deep artery of penis

C. Ductus deferens artery

D. Cremasteric artery

E. Inferior vesical artery

Explanation: The cremasteric artery, a branch of the inferior epigastric artery, supplies blood to the spermatic cord. The testicular artery supplies the testis itself. The other arteries listed supply pelvic organs.

Which nerve innervates the soleus muscle?

A. Tibial nerve

B. Common fibular nerve

C. Obturator nerve

D. Femoral nerve

E. Sciatic nerve

Explanation: The soleus muscle is innervated by the tibial nerve, a terminal branch of the sciatic nerve. The common fibular nerve supplies the lateral leg muscles. Femoral and obturator nerves supply the thigh.

Which muscle opposes the actions of the lateral pterygoid?

A. Temporalis

B. Medial pterygoid

C. Masseter

D. Lateral pterygoid

E. Digastric

Explanation: The lateral pterygoid protracts the mandible. This action is opposed by the masseter, temporalis and medial pterygoid which retract the mandible. Digastric depresses the mandible.

Which artery supplies the rectus abdominis muscle?

A. Superior epigastric artery

B. Deep circumflex iliac artery

C. Inferior epigastric artery

D. Subcostal artery

E. Lumbar arteries

Explanation: The rectus abdominis muscle receives its arterial supply from the superior epigastric artery, a terminal branch of the internal thoracic artery. The other arteries listed supply the anterolateral abdominal wall.

Which nerve passes through the greater sciatic foramen superior to the piriformis muscle?

A. Sciatic nerve

B. Posterior femoral cutaneous nerve

C. Superior gluteal nerve

D. Inferior gluteal nerve

E. Pudendal nerve

Explanation: The superior gluteal nerve and vessels pass above the piriformis muscle to enter the gluteal region. The other nerves listed pass inferior to piriformis through the greater sciatic foramen.

Which nerve root level corresponds to decreased sensation in the medial forearm?

A. C5

B. C6

C. C7

D. C8

E. T1

Explanation: Decreased sensation in the medial forearm indicates involvement of the T1 nerve root, which innervates this region. C8 corresponds to the ulnar aspect of the hand. C6 and C7 supply the radial aspect of the forearm and hand.

Which muscle elevates the mandible?

A. Masseter

B. Lateral pterygoid

C. Medial pterygoid

D. Temporalis

E. Mylohyoid

Explanation: The masseter, medial pterygoid and temporalis muscles work together to elevate the mandible during jaw closure. Lateral pterygoid protracts the mandible. Mylohyoid depresses the mandible.

Where does the ulnar nerve originate in relation to the brachial plexus?

A. Lateral cord

B. Posterior cord

C. Medial cord

D. Anterior division of inferior trunk

E. Posterior division of inferior trunk

Explanation: The ulnar nerve arises from the medial cord of the brachial plexus. The lateral cord gives rise to the musculocutaneous nerve. The posterior cord gives rise to the radial and axillary nerves.

Which muscle causes inversion of the foot at the subtalar joint?

A. Tibialis anterior

B. Tibialis posterior

C. Flexor digitorum longus

D. Flexor hallucis longus

E. Peroneus brevis

Explanation: Inversion of the foot is performed by tibialis posterior. Tibialis anterior is responsible for dorsiflexion. The toe flexors assist in plantarflexion. Peroneus brevis everts the foot.

Which artery supplies the psoas major muscle?

A. Lumbar arteries

B. Lateral sacral artery

C. Median sacral artery

D. External iliac artery

E. Obturator artery

Explanation: The psoas major muscle receives its arterial supply from the lumbar arteries branching off the posterior abdominal aorta. The other options provide arterial supply to pelvic structures.

Which nerve provides motor innervation for the levator ani muscle?

A. Obturator nerve

B. Pudendal nerve

C. Pelvic splanchnic nerve

D. Superior gluteal nerve

E. Inferior gluteal nerve

Explanation: The levator ani and coccygeus muscles receive motor supply from the nerve to the levator ani originating from the sacral plexus (S3-S5). The pudendal nerve provides sensory innervation.

Which muscle acts to plantarflex and evert the ankle joint?

A. Tibialis anterior

B. Tibialis posterior

C. Peroneus longus

D. Peroneus brevis

E. Gastrocnemius

Explanation: Peroneus longus and brevis act to evert the foot at the subtalar joint and plantarflex the ankle. Gastrocnemius plantarflexes the ankle while tibialis anterior and posterior act antagonistically as dorsiflexors.

Which nerve innervates the lateral pterygoid muscle?

A. Mandibular nerve

B. Buccal nerve

C. Auriculotemporal nerve

D. Lingual nerve

E. Chorda tympani

Explanation: The lateral pterygoid muscle is innervated by the buccal branch of the mandibular nerve (CN V3). The other branches listed also come off CN V3.

Which muscle opposes the action of the inferior rectus?

A. Superior oblique

B. Superior rectus

C. Medial rectus

D. Lateral rectus

E. Inferior oblique

Explanation: The inferior rectus muscle depresses and adducts the eyeball. This action is opposed by the superior rectus, which elevates and adducts the eyeball.

Which artery supplies the ovary?

A. Ovarian artery

B. Uterine artery

C. Vaginal artery

D. Middle rectal artery

E. Internal pudendal artery

Explanation: The ovary receives its arterial supply from the ovarian artery, a branch of the abdominal aorta. The uterine artery supplies the uterus. The vaginal artery supplies the vagina. The other arteries supply rectal and perineal structures.

Which cranial nerve innervates the superior oblique muscle?

A. Oculomotor

B. Trochlear

C. Abducens

D. Optic

E. Trigeminal

Explanation: The superior oblique muscle is innervated by the trochlear nerve (CN IV). The oculomotor nerve (CN III) supplies the other extraocular muscles except lateral rectus. The abducens nerve (CN VI) controls lateral rectus.

Which nerve root level corresponds to weakness in foot eversion?

A. L4

B. L5

C. S1

D. S2

E. S3

Explanation: Weakness in foot eversion indicates an L5 nerve root lesion affecting the superficial fibular (peroneal) nerve supplying peroneus longus and brevis. L4 lesions cause ankle inversion weakness. S1 lesions cause plantarflexion weakness.

Which muscle inserts on the greater tubercle of the humerus?

A. Pectoralis major

B. Latissimus dorsi

C. Teres major

D. Subscapularis

E. Supraspinatus

Explanation: The supraspinatus tendon inserts on the greater tubercle of the humerus. Pectoralis major and latissimus dorsi insert on the intertubercular groove. Subscapularis inserts on the lesser tubercle.

Which statement correctly describes the origin of the diaphragm?

A. Ribs 7-12 and lumbar vertebrae 1-3

B. Xiphoid process and ribs 5-12

C. Median arcuate ligament

D. Psoas major muscle

E. Central tendon

Explanation: The diaphragm originates from the xiphoid process, costal margins of ribs 7-12, and lumbar vertebrae 1-3. The median arcuate ligament is a thickened central portion, not an origin site.

Which nerve passes through the obturator canal?

A. Femoral nerve

B. Saphenous nerve

C. Obturator nerve

D. Tibial nerve

E. Common fibular nerve

Explanation: The obturator nerve passes through the obturator canal formed by the obturator membrane. The other nerves listed innervate lower extremity structures.

Which muscle adducts the thigh at the hip joint?

A. Sartorius

B. Tensor fascia latae

C. Rectus femoris

D. Vastus lateralis

E. Pectineus

Explanation: The pectineus adducts and flexes the thigh at the hip joint. Sartorius, tensor fascia latae and rectus femoris flex/abduct the thigh. The vasti muscles extend the knee.

Which nerve carries parasympathetic fibers to the lacrimal gland?

A. Trigeminal

B. Facial

C. Glossopharyngeal

D. Vagus

E. Oculomotor

Explanation: Parasympathetic innervation to the lacrimal gland is via the zygomatic branch of the facial nerve (CN VII). The lacrimal nucleus is located in the pons.

Where does the maxillary division of the trigeminal nerve (CN V2) exit the cranium?

A. Superior orbital fissure

B. Foramen rotundum

C. Foramen ovale

D. Foramen spinosum

E. Internal acoustic meatus

Explanation: CN V2 exits the cranium through the foramen rotundum to enter the pterygopalatine fossa. CN V1 passes through the superior orbital fissure. CN V3 passes through the foramen ovale.

Which artery supplies the anterior two-thirds of the tongue?

A. Facial artery

B. Lingual artery

C. Ascending pharyngeal artery

D. Posterior auricular artery

E. Occipital artery

Explanation: The lingual artery, branching from the external carotid artery, supplies the anterior two-thirds of the tongue. The facial artery supplies facial muscles and structures. The other arteries supply external regions of the head and neck.

Which cranial nerve mediates the corneal reflex?

A. Trigeminal

B. Facial

C. Optic

D. Oculomotor

E. Trochlear

Explanation: The corneal reflex requires an intact trigeminal nerve (CN V) and facial nerve (CN VII). The trigeminal nerve detects corneal stimulation and the facial nerve mediates blinking.

Which muscle is responsible for flexion of the leg at the knee joint?

A. Biceps femoris

B. Semimembranosus

C. Semitendinosus

D. Popliteus

E. Sartorius

Explanation: The hamstring muscles - semimembranosus, semitendinosus and biceps femoris - flex the knee joint. Popliteus medially rotates the knee. Sartorius flexes and externally rotates the knee.

Which artery provides the largest contribution of blood to the femoral artery?

A. Deep artery of the thigh

B. Lateral circumflex femoral artery

C. Medial circumflex femoral artery

D. Profunda femoris artery

E. Descending genicular artery

Explanation: The profunda femoris artery provides the largest contribution of blood flow to the femoral artery in the thigh. The other arteries listed are smaller branches.

Which cranial nerve mediates the gag reflex?

A. Trigeminal

B. Facial

C. Glossopharyngeal

D. Vagus

E. Accessory

Explanation: The gag reflex is mediated by cranial nerves IX (glossopharyngeal) and X (vagus). The glossopharyngeal nerve provides sensation and the vagus nerve activates motor responses.

WHICH MUSCLE INTERNALLY rotates the arm at the shoulder joint?

A. Infraspinatus

B. Teres minor

C. Teres major

D. Subscapularis

E. Latissimus dorsi

Explanation: The subscapularis muscle internally rotates the arm at the shoulder. Infraspinatus and teres minor laterally rotate the arm. Teres major extends and adducts the arm. Latissimus dorsi extends, adducts and medially rotates the arm.

Which statement correctly describes the boundaries of the femoral canal?

A. Inguinal ligament, pectineus, lacunar ligament

B. Lacunar ligament, pectineus, inguinal ligament

C. Inguinal ligament, iliopsoas, inguinal falx

D. Iliopsoas, femoral vein, inguinal falx

E. Pectineus, femoral vein, lacunar ligament

Explanation: The boundaries of the femoral canal are the lacunar ligament medially, the femoral vein laterally, and the inguinal ligament anteriorly. The pectineus muscle forms the floor of the femoral canal.

Which artery provides the main blood supply to the stomach?

A. Splenic artery

B. Left gastric artery

C. Common hepatic artery

D. Superior mesenteric artery

E. Celiac trunk

Explanation: The left gastric artery arises directly from the celiac trunk and provides the major arterial supply to the stomach. The other arteries listed are branches of the celiac trunk supplying other abdominal organs.

Which muscle elevates the lateral angle of the mouth?

A. Zygomaticus major

B. Zygomaticus minor

C. Levator labii superioris

D. Levator anguli oris

E. Risorius

Explanation: The zygomaticus major and minor muscles pull the corner of the mouth superiorly and laterally, raising the lateral angle of the mouth. Levator labii superioris elevates the upper lip.

Which nerve innervates the infraspinatus muscle?

A. Axillary nerve

B. Upper subscapular nerve

C. Thoracodorsal nerve

D. Lower subscapular nerve

E. Radial nerve

Explanation: The infraspinatus muscle is innervated by the suprascapular nerve, which arises directly from the upper trunk of the brachial plexus before the axillary nerve.

Which muscle extends the hip and flexes the trunk anteriorly?

A. Tensor fasciae latae

B. Sartorius

C. Rectus femoris

D. Iliopsoas

E. Pectineus

Explanation: The rectus femoris muscle acts to extend the hip joint and flex the trunk anteriorly at the waist. Tensor fasciae latae and sartorius medially rotate the hip. Iliopsoas flexes the hip. Pectineus adducts the thigh.

Which cranial nerve carries sensory information from the inner ear?

A. Trigeminal

B. Facial

C. Vestibulocochlear

D. Glossopharyngeal

E. Vagus

Explanation: Sensory innervation of the inner ear is supplied by the vestibulocochlear nerve (CN VIII). The trigeminal, facial, glossopharyngeal and vagus nerves mediate sensation from other head and neck structures.

Which muscle opposes the action of the inferior oblique muscle?

A. Superior oblique

B. Superior rectus

C. Medial rectus

D. Lateral rectus

E. Inferior rectus

Explanation: The inferior oblique muscle extorts, abducts and elevates the eyeball. This action is opposed by the superior rectus, which depresses and adducts the eyeball.

Which nerve passes through the greater sciatic foramen inferior to the piriformis muscle?

A. Superior gluteal nerve

B. Inferior gluteal nerve

C. Posterior femoral cutaneous nerve

D. Sciatic nerve

E. Pudendal nerve

Explanation: The sciatic nerve and pudendal nerve pass inferior to the piriformis muscle through the greater sciatic foramen. The superior gluteal nerve passes above the piriformis.

Which muscle opposes the action of the superior rectus muscle?

A. Lateral rectus

B. Superior oblique

C. Inferior oblique

D. Medial rectus

E. Inferior rectus

Explanation: The superior rectus muscle elevates and adducts the eyeball. This action is opposed by the inferior rectus, which depresses and adducts the eyeball.

Which statement correctly describes the course of the ureters in relation to the gonadal vessels?

A. Ureters pass medial to gonadal vessels

B. Ureters pass lateral to gonadal vessels

C. Ureters pass anterior to gonadal vessels

D. Ureters pass posterior to gonadal vessels

E. No consistent relationship exists

Explanation: The ureters pass medial to the gonadal vessels at the pelvic brim as they descend into the pelvis. Knowledge of this relationship is important during pelvic surgery.

Which muscle acts to plantarflex and invert the foot?

A. Tibialis anterior

B. Tibialis posterior

C. Peroneus longus

D. Peroneus brevis

E. Flexor digitorum longus

Explanation: Tibialis posterior plantarflexes and inverts the foot at the ankle joint. Tibialis anterior dorsiflexes and inverts the foot. The peroneal muscles evert the foot.

WHICH NERVE ROOT LEVEL corresponds to weakness of great toe extension?

A. L3

B. L4

C. L5

D. S1

E. S2

Explanation: Weakness of great toe extension indicates an L5 nerve root lesion, since L5 supplies the deep fibular nerve innervating extensor hallucis longus. L4 lesions affect ankle inversion. S1 lesions cause plantarflexion weakness.

Where do the right recurrent laryngeal nerve and inferior thyroid artery have different anatomical relationships compared to the left side?

A. Cervical region

B. Aortic arch

C. Tracheoesophageal groove

D. Thyroid gland

E. Larynx

Explanation: The right recurrent laryngeal nerve loops under the right subclavian artery while the left nerve loops under the aortic arch. Their relationships differ in the thorax but not in the neck.

Which muscle acts to flex the elbow and supinate the forearm?

A. Brachialis

B. Brachioradialis

C. Pronator teres

D. Flexor carpi radialis

E. Palmaris longus

Explanation: The biceps brachii muscle flexes the elbow and supinates the forearm as one of its dual functions. Brachioradialis flexes the elbow. Pronator teres pronates the forearm. The wrist flexors listed flex the wrist.

Which of the following is not considered part of the five-layered scalp?

A. Skin

B. Connective tissue

C. Aponeurosis

D. Loose areolar tissue

E. Pericranium

Explanation: The five layers of the scalp are: skin, connective tissue, epicranial aponeurosis, loose areolar tissue, and pericranium (skull periosteum).

Where does the vertebral artery enter the skull?

A. Jugular foramen

B. Foramen magnum

C. Foramen lacerum

D. Carotid canal

E. Foramen ovale

Explanation: The vertebral arteries enter the skull through the foramen magnum, along with the spinal cord. The other options listed are foramina for cranial nerves or other vessels.

Which nerve root level corresponds to weakness in hip flexion?

A. L1

B. L2

C. L3

D. L4

E. L5

Explanation: Weakness of hip flexion indicates an L1 nerve root lesion, affecting fibers that contribute to the