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Richard T. Kiok October 24, 2005

1) A. Superficial branch of Radial2) 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. Scarpas 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, thelumbricals are flexors. Therefore, palsy of those muscles from a lesion in the nervesinnervating 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 thefinger. 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 fournon-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 thehumerus, are innervated by the ulnar and median nerves. The extensors, originating on thelateral 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 opticcanal.

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 AbdominalWall, slide 23)

16) D. Superior Mesenteric a. It sends middle and right colic aa that anastomose to form thatportion 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 (couldnt find this in notes or lectures, but its

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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21) C. Long Thoracic n. The long thoracic nerve innervates the serratus anterior, whichoriginates from the ribs and inserts onto the medial aspect of the scapula, thereby helpingto hold it in place. if the nerve wasnt working, muscle wouldnt work, scapula would flyup. (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, DrMehta, 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 anatomylecture, frontnotes pp2-3)

24) C. Splenic. The celiac trunk produces left gastric, splenic, and common hepatic aa. Netter256, 290 (8/23/05 Schmidt supracolic lecture, slide 14)

25) B. A pancoast's tumor impinging on the stellate ganglion. A Pancoast's (or superiorpulmonary sulcus) tumor is a malignant neoplasm of the lung apex, which causesPancoast'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 thecervical 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 thatthese symptoms are due to an injury to sympathetics, and identification of the Pancoast'stumor by the hoarse voice. The close proximity of the apex of the lung to thecervicothoracic or stellate ganglion (in front of the neck of the first rib) indicates that (B) isthe correct response.

26) C. The phrenic nerves are in the middle mediastinum, all the other structures are in theposterior mediastinum. Remember the mnemonic: a great POSTERIOR will get youDATESS [Duct (thoracic) Azygos system, Thoracic aorta, Esophagus (and vagus),Sympathetics & Splanchnics]. (See also 8/17/05 mediastinum lecture, slide 8; frontnotes8/16/05 heart & pericardium p1)

27) D. Sympathetic presynaptic fibers, sympathetic postsynaptic fibers, and visceral afferentaccompanying the sympathetic fibers

28) D. Proximal to the septal cusp of the tricuspid valve. The atrioventricular node of the AVconduction system is located in the right atrium, above the septal cusp of the tricuspidvalve (Netter plate 219). The AV bundle runs from the AV node along the membranouspart of the interventricular septum. In the muscular part of the interventricular septum, itthe 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 heartin the AV groove supplying the left atrium and part of the left ventricle. It thenanastomoses with the RCA.

30) E. Stylopharyngeus (BRS 428)31) B. Atresia most commonly located in the fourth portion of the duodenum32) 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 segmentalbranches 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 lowersubscapular n (c5, c6, c7) (10/10/05 Dr. Lopez ULMm lecture, slide 23). According toBRS 48, subscapularis (D) is also correct.

35)

C. between mid. and inf. constrictors (pharnyx lecture). Internal laryngeal n travelsthrough 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. (Netterplate 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 newbornsand is more prevalent in males. The left kidney is more commonly absent, and its absenceis usually not determined until after birth. This condition is compatible with life. (seeMoore 299)

39)

C. Oligohydraminos is associated. This condition, in which both kidneys are absent, ispresent in about 1 in 3000 newborns. It is associated with oligohydramnios (low volumesof amniotic fluid) because little or no urine is excreted. Prenatally, kidneys supplement theamniotic fluid. Malformed kidneys are unable to supplement the fluid properly yieldingtoo 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 vagusnerve (CN X) which then branches into the internal and external laryngeal nerves. Theonly muscle innervated by the external laryngeal nerve is the cricothyroid muscle. (Can befound 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. Thesoleus 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. Thecircumflex scapular artery passes through here.

c) The quadrangular space is bounded superiorly by the teres minor m (anterior) orsubscapularis m (posterior), surgical neck of the humerus laterally, long head of thetriceps m, and teres major inferiorly. It transmits the axiallary nerve and posteriorcircumflex humeral artery.

d) The Triangle of Ascultation is bounded by the upper border of the Latissimus Dorsim., lateral border of the Trapezius m., and the medial border of the scapula. Thefloor is formed by the Rhomboid Major m. Breath shounds are heard here mostclearly.

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, thefirst tendons cut would be the tendons of flexor digitorum superficialis. These tendons helpflex the metacarpophalangeal and proximal interphalangeal joints, but not the distalinterphalangeal joints. Flexor digitorum profundus (which has deeper tendons) isresponsible 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 superficialisare arranged in a packet with two superficial tendons and two deeper tendons. The tendonsthat 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 proximalinterphalangeal joints of digits 3 and 4.

45) C. Ilioinguinal. A direct inguinal hernia is caused by a weakness in the abdominal muscleswhich prevents a patient from contracting these muscles strongly. If this patient can'tcontract 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 forinnervating the muscles of the lower abdominal wall. So, if this nerve was damaged duringthe 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 directinguinal hernia. The genitofemoral nerve innervates the cremaster muscle. An injury to thismuscle would lead to an inability to elevate the testes, but it would not compromise thestrength of the abdominal wall. The subcostal nerve and the ventral primary ramus of T10innervate muscles, skin & fascia of the upper abdominal wall. These nerves are toosuperior 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 (falxinguinalis), 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 (themiddle portion of the deltoids to the rest of the abduction). The subscapular is like theinfraspinatus 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 continueindirectly 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 pressurecompresses the esophagus so the doctor can see the opening of the trachea. The thyroidcartilages 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 inthe larynx.

50) B. The right mainstem bronchus is more vertical than the left and the middle lobar branchis the most posterior on the right side.

51) A. Greater Auricular Nerve. The greater auricular nerve is responsible for cutaneousinnervation of the skin of the earlobe and the angle on the mandible. Taken from a quiz onNetters Interactive Atlas.

52) C. Intercostobrachial Nerve. Taken from a quiz on Netters Interactive Atlas.


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53) C. Inferiorly and Medially, see the extraocular PPT Schmidt posted, physical exam portionon the right side or p 842 Grays Note: the 4th cranial n, rochlear, inn's the SO, theACTION of the SO is to look Inferiorly and laterally, but you need to isolate it in order totest 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 accordingto our ANS lecture and the book.

56) B. According to pectoral & thoracic wall lecture & BRS page 30: The costocorachoidmembrane is a part of the clavipectoral fascia that covers the deltopectoral triangle & aninterval between the subclavius and pectoralis minor muscles.

57) A. Palatoglossus m. is innervated by CN X58) 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 thelacrimal 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 thehiatus 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 locatedwithin 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 ischialtuberosity and is innervated by the tibial nerve. Short head of biceps femoris originates onthe linea aspera and is innervated by the common fibular nerve.

65) D. Maxilla. The anterior lacrimal crest is on the maxillary bone. The posterior lacrimalcrest is on the lacrimal bone. The lacrimal fossa is between the crests; it contains thelacrimal 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 Walllecture 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. Erbs Palsy does not produce lesions of the Ulnar nerve (C8-T1). It is aninjury to C5 and C6 (and sometimes C7) and produces lesions of the axillary,musculocutaneous and suprascapular nerves. It produces waiters tip hand because itparalyzes the lateral rotators of the arm (teres minor and infraspinatus) which areinnervated by the axillary and suprascapular nerves. The frontnotes say the supraspinatusis 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, isfibrocartilage (Found in Grays 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 thetentorium 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 thetransverse sinuses. (Grays p. 783 and backnotes)

71) D. Upper lobe of the left lung. Page 143 of Gray.72) C. SA node AV node AV bundle of His 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 incisivecanal runs between the oral and nasal cavities.

77) A. Dorsiflexion is controlled by the deep fibular nerve while cutaneous innervation of thelateral lower leg is superficial. Therefore, with cutaneous lateral innervation intact, butdorsiflexion not intact, the injury must be to the deep fibular nerve. Cannot be in thecommon fibular b/c then the person would have no lateral leg muscle or cutaneousinnervation.

78) B. flexor digitorum brevis79) 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 othernerves are in contact with the medial epicondyle. (See Gray's p. 685 "In the clinic" orChung's BRS Gross Anatomy p 79, #48)

82) E. Of these, only the hemiazygous vein is in the posterior mediastinum, which itself liesposterior to the pericardium between the mediastinal pleurae. The braciocephalic veins,trachea, and aortic arch are in the superior mediastinum, whereas the arch of the azygousvein 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 respectivevertebral pedicle (e.g. spinal nerve C3 exits the foramen b/t C2 and C3), keeping in mindthat 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 theintervertebral foramen BELOW their respective vertebral pedicle (e.g. spinal nerve L4exits 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/L3disc is protruding, it will affect L3 and not L2 because L2 will have passed out of theforamen before the L2/L3 disc. It does not affect the spinal nerves below L3 because it is alateral protrusion instead of a medial protrusion (the more inferior the spinal nerve, the


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dorsum of the foot (Netter plate 524). Everything else passes deep to the extensorretinaculum (Netter plate 512).

95) D. 4th LICS. Question taken from Schmidt's "Heart and Pericardium Lecture," pg 9, slidetitled "Auscultation of Cardiac Valves." "C" is the only choice that is NOT a position tolisten 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 demonstratesthis.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 inmales, while ASDs (atrial septal defects) occur more commonly in females. The mostcommon form of ASD is a patent foramen ovale. In a VSD, blood would be shunted fromleft-to-right because the pressure on the left side of the heart is higher than that on the rightside.

97) A. The tibial and common fibular nerves are the most superficial of the neurovasculaturestructures, and the popliteal artery is the deepest. The common fibular nerve exitsLATERALLY, 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 fibularnerve (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 andsupplies both the lateral walls and the septum. It anastamoses with anterior and posteriorethmoidals (from opthalmic a, which is from ICA). It also has anastamoses with thegreater palatine artery, but it does not travel with the artery through the greater palatineforamen. (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 facialn, carrying presynaptic parasympathetic fibers) and the deep petrosal n (from the carotidplexus, carrying postsynamptic sympathetic fibers). It travels in the pterygoid canal toreach the pterygopalatine ganglion. (Netter 125 & 127)

100) D. The deep ring is located lateral to the inferior epigrastrics. A direct inguinal hernia willbe located medial to the inferior epigastrics because a direct hernia does not go through thedeep ring. A direct hernia will pass through Hesselbachs triangle which is borderedlaterally by the inferior epigastrics, medial by the lateral border of the rectus sheath andinferiorly by the inguinal ligament. The roof of the inguinal canal is made by archingfibers of the IAO and TA not transversalis fasica. The testis/ovaries drain into pre-aorticand lumber lymph nodes, while the scrotum/labia majora drain into the superficial inguinalnodes. The conjoint tendon (joining of IAO and TA) reinforces the posterior wall of theinguinal canal. The anterior wall is reinforced by the IAO and the floor is reinforced bythe 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 Infracoliclecture slides

103) B. From mediastinum lecture notes104) 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 segmentof 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 nervecomes 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 theduodenum.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 isnot a build-up of bile in the gall bladder.

f) minor duodenal papilla (of Vater) is normally proximal to the major duodenalpapilla.

112) C. Retrocecal113) C. Lungs

a) A. the kidney lies in a retroperitoneal position. No specific name is associated withits covering. The order of structures (internal to external) is: renal capsule,perinephric (perirenal) fat, renal fascia, paranephric (pararenal) fat, transversalisfasic. The renal fascia must be incised in any approach to the kidney (Gray's 321).

b) B. Liver is surrounded by Glisson's capsulec) 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 X115) D. joint between the occipital bone and parietal bones116) A. pharyngobasilar fascia117) C. zygomatic, Netter plate 4118) B. palatoglossus, see Dr. Eisenman's lecture on the oral cavity, pg. 4119) 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 earthrough 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 theocculomotor nerve. (Orbital anatomy lecture.)

121) A. upper lobe, posterior segment. The object goes into the trachea right main bronchusupper segmental bronchus posterior segment. (from notes)

122)

D. left ventricle - Anatomical relationships: left ventricle is the only one that doesn'tcontact 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 abdominusaponeurosis).

124) D. The chorda tympani carries pre-ganglionic parasympathetic fibers to the sublingualganglion, from where POST-ganglionic parasympathetic fibers run to providesecretomotor innervation to the submandibular and sublingual glands.(Infratemporal Fossalecture)

125) A. Sibsons Fascia (taught in the Lungs and Pleura lecture). If you seriously chose E, dropout 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

postganglionic parasympathetic fibers carried by V3 exit the ganglion and innervate theparotid gland.

130) B. The abducens nerve and internal carotid artery travel through the cavernous sinus. Theoculomotor, 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 theincus 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 arteryb) runs with the carotids and the internal jugularc) 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 parasympatheticfibers. When the short ciliary nerve is severed, postganglionic parasympathetic fibers fromthe ciliary ganglion will not reach the eye. However, sensory and sympathetic fibers mayreach 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 acharacteristic 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 rightventricle; 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 thetibia 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 profundus141) B. CN 10142) 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 atT12. 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 atthe bottom (floor). The deep branch of the ulnar nerve and the deep branch of the ulnarartery 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 fossaelecture]

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'tcheck 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-inguinalnerve (L1). At this level, the sensory fivers stimulate the motor fibers carried in the genitalbranch of the genitofemoral nerve (L1/L2).

152) D. Olfactory (CN I) (p. 805 in Gray's). The facial nerve provides parasympatheticinnervation of the lacrimal gland via the greater petrosal nerve and the pterygopalatineganglion. It also provides parasympathetic innervation of the submandibular gland and thesublingual glands via the chorda tympani nerve and the submandibular ganglion. Theglossopharyngeal nerve innervates the parotid gland with parasympathetics via the lesserpetrosal nerve and the otic ganglion. The oculomotor nerve provides parasympatheticinnervation of the pupillae muscles via the oculomotor nerve (from Edinger-Westphalnucleus) and the ciliary ganglion. The olfactory nerve uses sensory afferent nerve fibersfor 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 issaid to be a sesamoid poind contained in the flexor carpi ulnaris tendon. (p. 23 of the 4thed BRS)

154) C. superior cervical ganglion, The ciliary ganglion receives postganglionic sympatheticfibers 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 theciliary 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!) Theintercostobrachial nerve goes from the second intercostal space, pierces the serratusanterior, crosses the axilla, and innervates the upper medial quadrant of the arm. Thisnerve does not provide any funtion to the arm.

156) A. scaphoid. The explaination can be found page 715 of Grays. Pain in the snuffbox isrelated 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 C2b) gray's 827 - cervical plexus (anterior ramus C2)c) gray's 818 - branch of V3d) gray's 820 - supplies occipital belly of occipitofrontalis musclee) 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. TheSMALL saphenous v. drains into the popliteal v. The great saphenous v. doesn't runanywhere 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 thecervical and upper thoracic regions. This is straight out of the backnotes from the firstlecture on the back.

169) D. The lacrimal nerve, opthalmic vein, and trochlear nerve all travel through the superiororbital fissure but outside the Annulus of Zinn. The optic nerve travels through theAnnulus 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 andthus 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. Levatorcostarum 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, highlylocalized pain. The first 6 anterior intercostal arteries are in fact derived from the internalthoracic. 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 theheart is formed by the left NOT the right ventricle. The left vagus recurs around theligamentum arteriosum (the right recurs around the subclavian) but travelsposteroinferiorly across the root of the left lung.

172) B. the bicipital aponeurosis. The median cubital vein is a superficial structure that isseparated 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 thelungs. (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 heatrate and increases blood flow to core (abdomen) in order to digest. (Contrary, thesympathetic division prepares the body for "fight or flight" accelerating heart rate anddialating the blood vessels in the periphery.) Vagus, which carries parasympathetic fibersonly, carries the parasympathetic fibers for the heart and GI system.

176) E. Splenic artery gives off the left gastro-omental artery, which supplies the greatercurvature 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 wouldbe weakened) because only the medial head is affected in this case (long & lateral headsreceive innervation superior to the radial groove). All muscles in the posteriorcompartment 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 inMoore 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 MedainNerve, which arises from the median nerve as it passes DISTALLY to the flexorretinaculum. Thus, since these functions involve innervation DOWNSTREAM of theinjury described, they will necessarily be affected.

b) The ADDuctor pollicis is innervated by the deep branch of the ULNAR nerve andtherefore would not be affected by this injury.

c) The lateral two lumbricals (which relate to function of digits 2 & 3) are innervatedby the Median Nerve as it becomes superficial proximal to the wrist & before itpasses under the flexor retinaculum; this is the area of injury described and wouldtherefore affect movement of digits 2 & 3.

179) A. Chorda tympani (CN7) is carries taste sensation to the anterior 2/3 of the tongue. It'salso 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 submandibularganglion 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 (chordatympani).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 degreesof leg extension (Screw-Home mechanism). The lateral collateral ligament of the kneelimits medial motion and lateral rotation of the knee. The inner 2/3 of the menisci areavascular.

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 digitiminimi are innervated by the lateral plantar nerve and the extensor digitorum brevis isinnervated by the deep fibular nerve.

185) B. Iliofemoral. The ligamentum teres carries the acetabular branch of the obturator arteryto the head of the femur. The pubofemoral ligament limits abduction and theischiofemoral ligament limits medial rotation of the hip. The iliofemoral, pubofemoral andischiofemoral all limit hip extension.

186) D. Fibularis brevis. Tibialis anterior inserst into medial cuneiform and base of 1stmetatarsal. Tibialis posterior inserts into the tuberosity of the navicular. Fibularis longusinserts 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. Thereis a good table in the back notes from this lecture showing where all of the paranasalsinuses drain into. The frontal sinus, anterior ethmoid sinus, and maxillary sinus drain intothe middle meatus via the semilunar hiatus, the middle ethmoid air cells drain into themiddle 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. Theglossopharyngeal nerve travels through the pharyngeal wall between the superior andmiddle constrictors. This nerve innervates the stylopharyngeus muscle, which also travelsbetween the superior and middle constrictors.

189) C. Ober Test. From Lower Limb Joints lecture with Dr. Howard. The Faber Test (standsfor Flexion, Abduction, External Rotation) tests for a tight hip joint capsule (patient lies onback and crosses ankle over opposite knee; if knee sticks up and is not parrallel to thetable, the patient has tight hip joint capsule or adductors). The Thomas Test tests for tighthip flexors (clinician moves the patient's hip into flexion until the lumbar region of theback 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 theclinician 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 tothe 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 yourown 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 bythe extensor pollicis longus tendon. (Grey's p715)

192) A. Anastamoses with bronchial arteries. None of the others are a source of oxygenatedblood to the lungs, nor do they anastamose with pulmonary arteries.

193) C. superior epigastric vessels. Page 237 in BRS (Chung), Netter plate 247. Superiorepigastric vessels are directly inferior to the anterior ribs and anastomose with the inferiorvessels superior to the arcuate line.

194) C. Common bile duct. A block in cystic duct from gallbladder causes cholecystitis but nothepatitis. block in the common hepatic duct causes hepatitis but not cholecystitis. block inthe 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 producecholecystitis 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 spaceand 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 partof the axillary artery.

200) B. Anterior/Anteroinferior dislocations are most common because of the distribution of therotator 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 thenerve 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 and2nd. (see lecture notes - infracolic region)

203) D. Quoted from the lecture on the infracolic region (Dr. Schmidt)-" Vagal innervationstops near the distal end of the transverse colon; remainder of colon is innervated by pelvicsplanchnic nerves via inferior hypogastric nerve plexus." The other options are scatteredaround somewhat, but can be found in Dr. Eisenman's lecture on the pharynx (slides 5 and9), and Netter plates 112 & 120.

204) A. The posterior ethmoidal air cells are the exception out of the 3 regions of the ethmoidsinus and drain into the superior sinus. All others drain into the middle. This can beconfirmed 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 ligamentc) iliacus - iliac crestd) 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 ABductorsand medial rotators; tensor fasciae latae functions in flexion and medial rotation. (BRSp.123)

208) C. the L5 vert level posterior to the Right common iliac artery. See netter plate 258 andPAW lecture.

209) B. lunate bone. The scaphoid bone would be the most likely fractured bone, but the lunatebone is most likely dislocated because of its shape. (Grant's Dynamic Human AnatomyBoard Review Question)

210)

D. the Chorda Tympani Nerve is running very close behind the tympanic membrane andcould 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 NOTreceive its secretomotor fibers from CN V1. The secretomotor fibers to the lacrimal glandcome from preganglionic parasympathetic fibers that run in the facial n. (CN VII) greater petrosal n. vidian n.(n. of the pterygoid canal) synapse in pterygopalatineganglion with postsynaptic parasympathetic neurons maxillary n. (CN V2) zygomatic n. (from CN V2) zygomaticotemporal branch lacrimal n. (terminalportion) lacrimal gland. [The lesser petrosal n. carries preganglionic parasympatheticsecretomotor fibers to the parotid gland. The deep petrosal gland contains postganglionicsympathetic fibers.] For confirmation, see p. 835 - 836 Gray's, also Dr. Schmidt's orbitallecture slides 34 & 37.

215) E. The anterior scalene inserts on the first rib, is innervated by cervical nerves C4-C7, andpasses anterior to the root of the brachial plexus, but posterior to the subclavian vein. Forconfirmation, see Grays p. 921 & 924.

216) B. By the end of the Pseudoglandular period (6-16 weeks), development has progressedthrough the formation of segmental bronchi and terminal brochioles, but no structuresinvolved in gas exchange have yet developed. The Terminal Saccular period (26 weeks-birth) may be characterized by continued development of terminal saccules. During theAlveolar Period (from birth to 8 years), alveolar cells increase in number and mature.

217) B. The Maxillary nerve transmits POSTGANGLIONIC parasympathetic fibers frompterygopalatine 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 submandibularganlgion. Glossopharyngeal nerve (CN9) gives off Jacobsen's nerve/Lesser Petrosal nerve,which synapses at the otic ganglion. The Vagus nerve (CNX) carries preganglionicparasympathetic fibers to the larynx, trachea, lungs, heart, and stomach.

218)

D. 3 because they attach chordae tendinae to the cusps of the TRIcuspid valve. Seeheart/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 thethoracic 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 pluripotentstem cells. The remaining statements are listed in Moore so I hope they are true! hahapage 63.

223) C. Oxycephaly. Source: Slide 20 on Dr. Schmidts lecture MusSkel05. Oxycephalyinvolves premature closure of the coronal sutures. Scaphocephaly involves closure of thesagittal sutures. Plagiocephaly involves closure of the coronal or lambdoid suture on oneside only. Trigonocephaly involves closure of the frontal suture. We did not specificallylearn 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. Schmidtslecture 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 theautonomic nervous system. Therefore, this results in constriction of the pupil.

225) D. Great auricular n. The trigeminal nerves provide sensory innervation to the skincovering the face except for the angle and lower border of the ramus of the mandible whichare 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 throughthe quadrangular space with the axillary n. to wrap around the surgical head of thehumerous. The superior thoracic a. is a branch of the 1st part of the axillary a. Thethoraco-acromial a. and lateral thoracic a. are branches off the second part of the axillarya. The subscapular, anterior and posterior circumflex humeral aa. Branch from the thirdpart 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" isfor 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 lingualnerve 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 thehiatus 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 acquiredtype of hernia is the one which takes place medial to the inferior epigastric vessels in theinguinal triangle.

233) D. The external surface of the tympanic membrane is innervated by "Five and Dime" (CNV and CN X): the auriculotemperal branch of V and the auricular branch of X. The internalsurface 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 todislocate anteriorly. It is the "true" muscle of active openning of the mouth and especiallyof 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 alongventricular 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 descendingcolons, which are innervated by pelvic splanchnic nerves. (Board Review Series "GrossAnatomy" pg. 176)

237) C. between T1-L2. This is region is where the sympathetic part of the autonomic divisionof the PNS leave the thoracolumbar region of the spinal cord with the somatic componentsof spinal nerves T1-L2. This region of the spinal cord is the only one that has white ramicommunicantes, whereas gray rami communicantes are associated with all levels of thespinal 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 thoracicvein (off the axillary) and the superficial epigastric veins (off the femoral). When the SVCbecomes blocked, over time the thoracoepigastric vein can reverse its flow. Instead of going from the axillary subclavian brachiocephalic SVC blood flows from theaxillary back into the lateral thoracic thoracoepigastric inferior epigastric femoral

iliacs IVC to reach the heart. In this process epigastric femoral iliacs theveins 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 inaddition 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 branchof vagus and branch to medial pterygoid.

241) C. Geniohyoid and thyroid. note (b) is innervated by nerve to mylohyoid from inferiousalveolar of V3.

242) D. Trochlear n.243) C. Cephalic244) A. Radial n. and Profundus Brachii245) 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 aresistance to testosterone in the genital tubercle and labioscrotal and urogential folds. Theytherefore have a blind-pouched vagina with either absent or rudimentary unterus anduterine tubes. They externally (socially and legally) are female but have testes in theabdomen, inguinal canals, or labia majora.

247)

C. This condition would be due to pressure placed on the inguinal ligament causingimpingement of the lateral cutaneous nerve of the thigh. The common fibular nerve is notin the thigh region. The perforating cutaneous nerve is S2-5, supplying the skin over theinferomedial part of the gluteus maximus. The anterior cutaneous branches of the femoralnerve 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 inthe 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

foramenb) greater palatine nerves and arteries run through greater palatine foramenc) orbital branches of pterygopalatine ganglion run through infraorbital fissured) correct answere) 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 Anatomy257) 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 veinsb) middle rectal vein anastomoses with superior rectal veinc) lumbar vein anastomoses with colic veins in the retroperitoneal portions of colond) renal vein just comes off the IVC and does not directly anastomose with portal

systeme) 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 jointand 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 Magnusmuscle. The Femoral Nerve provides innervation to the Anterior compartment of the legincluding Sartorius, Pectineus, Vastus Lateralis, Vastus Medialis, Vastus Intermedius, and


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Biceps Femoris muscles. The innervation of Adductor Magnus is provided by theposterior branch of the Obturator Nerve and Sciatic Nerve.

261) C. At the lateral fossa. See backnotes for the Peritoneal Cavity, August 19, 2004, Page 2262) 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 688265) 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 tothe linea alba of the anterior abdominal wall and splits into two bands that pass on eachside of the penis and unit inferiorly).

267) Grays 134268) 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 activatesproduction 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 drainthe breast. Severing this nerve will result in winging of the scapula, where the scapulaprotrudes 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 describethe 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, abducensnerve, oculomotor nerve (superior & inferior divisions). NOT passing through annulus arefrontal 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 theanterior cardial veins, drain into the coronary sinus before entering the right atrium. Thecoronary sinus is located on the posterior aspect of the heart. For review, the great cardiacvein runs with the anterior interventricular artery (or LAD). The middle cardiac vein runswith theposterior descending branch of the right coronary artery. The small cardiac veinruns with the right coronary artery. The coronary sinus opens into the right atriumbetween the IVC and AV opening. The anterior cardinal vein drains the right ventricle andends directly in the right atrium.

274) C. the IVC. the Quuadrate lobe and the Caudate lobe are separated by the porta hepatis orthe "doorway of the liver" that contains the hepatic portal vein, hepatic artery, and commonhepatic duct. the Quadrate lobe is in between the falciform lig and the gallbladder, whilethe 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. answerchoice d is what forms the inguinal ligament. c is nothing but the MUSCLE forms thecremaster 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 inguinalregion, pg 2).

276) (a) The tensor tympani muscle is derived from the 1st pharyngeal arch and receivesInnvervation 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) Scarpas fascia of the lower anterior abdominal wall is continuous with Colles 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 isalso innervated by the axillary nerve, also laterally rotates the arm. Supraspinatus, which isinnervated by the suprascapular nerve, also helps abduct the arm so that function is notcompletely lost.

281) B. "waiter's tip" hand. "claw hand" and "funny bone" symptoms are seen due to ulnar nerveinjury. "wrist drop" is characteristic of injury to the radial nerve due to paralysis of theposterior 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 isinnervated 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 isresponsible for first part of abduction and lateral rotation, respectively. Suprascapularnerve 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 bronchialarteries. As a side note, cervical part of parietal pleura, also referred as cupula, project intothe neck above the first rib as is reinforced by Sibson's fascia, which is a thickened portionof 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, bloodvessels, 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 releasingpressure 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 arteryproper(ant. left).

293) C. there is a free communication between supracolic and infracolic compartments viaparacolic 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 andattach to the spermatic cord and form the cremaster muscle of the spermatic cord. Theyreceive innervation by the genital branch of the genitofemoral nerve.

296) C. Floor of inguinal canal is formed by superior aspect of inguinal ligament and isreinforced medially by lacunal ligament which is an extension of external oblique muscleaponeurosis. Spermatic cord or round ligament may lie on lacunar ligament. Lacunarligament passes backward from the inguinal ligament to the pubic tubercle. If you followit 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 foringuinal 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 ilioinguinalnerve which stimulate the motor fibers carried in the genital branch of the genitofemoralnerve. Since cremaster muscle is innervated by genital branch of genitofemoral nerve, thisis the basis of efferent limb of the cremasteric reflex.

298) E. Direct inguinal hernia pushes through posterior wall of inguinal canal (formed bytransversalis fascia, reinforced by conjoint tendon at superficial ring) MEDIAL to inferiorepigastric 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 includesinferior epigastric vessels.

299) C. Wrist-drop is due to the denervation of the hand extensors, which are normallyinnervated by the radial nerve. The radial nerve only corresponds to the mid-shaft. Allother landmarks listed do not receive, come in contact with, or could potentially laceratethe radial nerve.

300) D. The cutaneous branch of the radial nerve only provides sensory innervation for thelateral dorsal aspect of the hand. All other aspects and the finger tips are innervated bycutaneous 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, andresults in elongated cranium. Premature closure of one either one coronal or one lamboidsuture is termed plagiocephaly and results in a twisted, asymmetrical skull. (see page 394of Moore)

305) B. In approximately 1 in 500 live births, a fused "horseshoe" kidney's ascent is blocked bythe root of the IMA. (see page 206 of Moore).

306) Hand & Wrist Lecture pg. 8307) 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 ourdissection of this region that Dr. Schmidt pointed this out several times and that thisrelationship 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 causedby 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, andthus 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 thecarpal 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 thethumb, 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 unaffectedby 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 cartilage315) C. anterior scalene 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 toanterior scalene The axillary artery is divided into three parts by pectoralis minor. Themaxillary 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 isonly the cauda equina within the meningeal covering. Therefore, a spinal tap is donemostly 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 dont 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. Grays 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, themedial border is the long head of the tricpes and hte supeiror border is made up of the teresminor (posteriorly) and subscapularis (anteriorly). the long head of the triceps is the medialborder of the triangular space of the arm.

323) The injection is usually given where the pudendal nerve crosses the lateral aspect of thesacrospinous ligament near its attachment to the ischial spine. During childbirth, a fingerinserted 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 sacrospinousligament. Infiltration is performed and the perineum is anesthetized. answer = D Graysp425.

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 theonly 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 alsoresponsible for sensory innervation, particularly in the case of referred pain toneck/shoulders. Intercostals and the subcostal nerve also provide sensory innervation tothe parietal pleura on edges of diaphragm and periphery of diaphragm, respectively, butthese nerves would not "refer" pain up to the neck, shoulder, as they travel horizontallynear 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 notinclude the viscera of the abdominal cavity, so would not drain to the portal system. Abovethe level of the umbilicus, drainage is to the SVC. Below the level of the umbilicus, it willbe to the IVC. Therefore, C is the correct answer. This is straight from Schmidt's AAWlecture powerpoints.

328) The first three answers are all contents of the deep perineal space. The greater vestibularglands are located in the superficial perineal space. The correct answer is D. This is fromthe perineum lecture given by Dr. Mehta.

329) C. The borders of the cubital fossa are the pronator teres m. and the brachioradialis m. Allthe 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 toprevent 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 grays p.639 The quadrangular space provides a passageway from the anterior

axillary region to the posterior scapular region. The boundaries are created by the inferiormargin 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 torealize is that the posterior circumflex humeral artery and vein and the axillary nerve arethe 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 muscleinnervated by the axillary nerve in the answer choices above is teres minor. The correctanswer, then, is B.

338) B. see grays p.887 The glossopharyngeal nerve (CN IX) provides parasympathetic,

autonomic innervation to the parotid gland. The otic ganglion, located within theinfratemporal fossa, is the site for preganglionic parasympathetic glossopharyngeal(CNIX) fibers to synapse. Presynaptic fibers are carried to the otic ganglion within thelesser petrosal nerve. Postsynaptic fibers are carried to the parotid gland within theauriculotemporal nerve branch of the mandibular nerve (CNV3). The ciliary ganglion isthe site for preganglionic parasympathetic oculomotor (CNIII) fibers to synapse. Thepterygopalatine ganglion and sublingual ganglion receive presynaptic fibers originatingwithin the facial nerve (CNVII). The geniculate ganglion is the sensory ganglion of thefacial nerve (CNVII). Also, its worth noting that the lesser petrosal nerve should not beconfused with the great petrosal or deep petrosal nerves. The deep petrosal nerve carriessympathetic 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 vidiannerve. 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 thechoices are all paired cartilages.

341) D. Gray's page 76-77 about myotomes. Basically, the muscles responsible for abductingthe arm are the deltoid and the supraspinatus, which are innervated by axillary (C5-6) andsuprascapular (C5-6) nerves, respectively.

342) A. Netter plates 28-9, 412, Ant. Cervical Triangle lecture slides. The superior thoraciccomes off the 1st part of the axillary a., the lateral thoracic off the 2nd part of the axillarya, the internal thoracic off the 1st part of the subclavian, the supreme intercostal (alsocalled the highest intercostal - Ant. Cervical Triangle lecture slides) off the costocervicaltrunk (from the 2rd part of the subclavian), and the left and right superior intercostals areactually 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 behelpful 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 trueterminal 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 runsright 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 427348) 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 anyportion of the femur and the acetabular branch of the obturator artery is not well developedand 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 theposteroinferior 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 andit is formed by the RIGHT CRUS of the diaphragm. The anterior (formerly left) andposterior (formerly right) VAGAL TRUNKS pass through the esophageal hiatus with the

esophagus, whereas the left vagus nerve pieces the diaphragm and the right vagus nervecourses through with the inferior vena caba through its hiatus in the central tendon at theT8 level. The suspensory muscle of the duodenum (ligament of Treitz) attaches to theright crus of the diaphragm, which makes up the esophageal hiatus. This structuresuspends the ascending (4th) part of the duodenum at the duodenojejunal flexure and is asurgical 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 theproliferative 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 onesegment in the left lung. The others do, according to slides from Dr. Schmidt's lungs andpleura lecture. This is clinically significant because the bronchopulmonary segment is thesmallest portion of the lung that can be damaged/removed without further jeopardizingmore lung tissue. PS. I remember this by noting that two of the pairs that can combinecontact each other (the anterior basal and medial basal segments are directlyposteroinferior to the lingula, though they are separated by the oblique fissure), and thenthe other pair that can combine is on the top (apical and posterior). See lecture slides andNetter 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 bythe 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 viathe deep ring and exit via the superficial ring. The ilioinguinal nerve enters the inguinalcanal laterally between the transversus abdominus and internal abdominal oblique musclesand 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 themedian nerve has a muscular innervation of 1/2 loaf (1st and 2nd lumbricals, opponenspollicis, abductor pollicis brevis, flex

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