After studying Gross Anatomy for the National Board Exams a second
year student left Sackler at 1:00am and was mugged on Harrison Avenue.
During the attack the student held his arm up to protect his head and was
knifed on his forearm. Subsequently, while waiting to be seen in the emergency
room at NEMCH, the student realized that he could no longer adduct his
thumb.
- He immediately concluded that the knife must have directly injured
his:
- A) Median Nerve
- B) Musculocutaneous Nerve
- C) Radial Nerve
- D) Ulnar Nerve
- E) Axillary Nerve
- To confirm his diagnosis, the student should check for absence of sensation
in which part of his hand:
- A) Thumb
- B) Little Finger (pinkie)
- C) Index finger
- D) Middle finger
- He also should check for specific signs of:
- A) Claw Hand
- B) Wrist Drop
- C) Ape Hand
- D) Carpal Tunnel Syndrome
During a little league game one of the players accidently struck her
teammate with her bat. When the bat hit the boy's arm there was an audible
crack and the boy fell to the ground in pain. Luckily, one of the mothers
watching was a physician and she rushed to the boy's aid. Quick examination
showed her that the boy had a closed fracture in his upper arm.
- After watching him abduct and rotate the arm, she diagnosed damage to
the:
- A) Musculocutaneous Nerve
- B) Axillary Nerve
- C) Ulnar Nerve
- D) Radial Nerve
- E) Median Nerve
- Damage to this nerve normally occurs when injury is located at the:
- A) Lateral Epicondyle of the Humerus
- B) Anatomical Neck of the Humerus
- C) Surgical Neck of the Humerus
- D) Deltoid Tuberosity of the Humerus
While rollerblading to school a third year medical student slipped
on some wet pavement and crashed into a building. When he got up from his
fall he noticed he could not support his right arm and he had lost
feeling on his shoulder. As he slowly made his way to the hospital he reviewed
his knowledge of the shoulder joint.
- He remembered that the rotator cuff muscles associated with supporting the shoulder joint
consist of all of the following except:
- A) Supraspinatus Muscle
- B) Deltoid Muscle
- C) Infrapinatus Muscle
- D) Teres Minor
- E) Subscapularis
A fourth year medical student fell off a ladder while installing a
flood light above his garage and put his arm through a garage door window.
When he got up from his fall he realized the glass had deeply cut the anterior
aspect of his wrist and so he decided to go to the nearest emergency room.
During his trip to the ER he studied his wrist and began to make an initial
diagnosis. Remembering his training, he initially assumed that the cut
had affected all of the muscles in his wrist and he proceeded to examine
all of them.
- Since he was able to flex the distal phalangeal joints of his
four medial digits and his thumb, he concluded the following muscles were
uninjured:
- A) Flexor Carpi Radialis
- B) Palmaris Longus
- C) Flexor Digitorum Profundus
- D)Flexor Pollicus Longus
- E) Two of the above. Both Flexor Digigitorum Profundus and Flexor Pollicus Longus
- He then concludes that the following nerve(s) to the muscle(s) must
also be intact:
- A) Musculocutaneous
- B) Radial
- C) Ulnar
- D) Median
- E) Two of the above. Both the Ulnar and Median Nerves must be intact
- On further inspection he notes an inability to flex the proximal interphalengeal
joints of his four medial fingers. He concludes from this information that
he has injured his:
- A) Palmaris Longus Muscle
- B) Flexor Carpi Radialis Muscle
- Flexor Digitorum Superficialis Muscle
- D) Flexor Carpi Ulnaris Muscle
- E) Two of the above
Rollerblading to class one morning without her wrist guards on Elizabeth
hit a curb and fell onto her outstretched left hand. When she got to school
she noted tenderness in her wrist in the area of her anatomical snuff box
and was concerned she may have fractured one of the bones in her wrist.
- The carpal bone forming part of the floor of the anatomical snuff box which
is most often fractured is the:
- A) Triquetral Bone
- B) Pisiform Bone
- C) Scaphoid Bone
- D) Lunate Bone
- The medial wall of the anatomical snuff box consists of the tendon from:
- A) Extensor Pollicus Brevis
- B) Flexor Pollicus Longus
- C) Flexor Carpi Radialis
- D) Extensor Pollicus Longus
- E) Abductor Pollicus Longus
- If Elizabeth did fracture one of her carpal bones in the snuff box of the
wrist there might be a danger of bone necrosis. The artery travelling through
the snuff box and supplying the bones in this area is the:
- Radial Artery
- Ulnar Artery
- Median Artery
- Thenar Artery
- None of the above
While performing his first physical examination during a third year
clerkship a self-conscious medical student performs a cursory breast exam.
After quickly glancing at the woman's breasts and palpating them haphazardly,
the student concludes that they are unremarkable for any signs of breast
cancer. However, remembering back to the first year anatomy course, the
student pauses and inspects the area of tissue beneath the woman's armpits,
the Tail of Spence . Under the woman's right armpit he discovers a slightly
enlarged lymph node. Upon closer inspection of the right breast, the student
also discovers a small patch of thickened skin that is slightly dimpled
in appearance (peau d'orange). When he relates these observations to the
supervising resident they order a mammogram which supports their preliminary
diagnosis of breast cancer.
- In addition to the axillary nodes, the lymphatic drainage of the breast
involves direct connections to all of the following except:
- A) Parasternal Lymph Nodes
- B) Abdominal Lymph Nodes
- C) Inguinal Lymph Nodes
- D) All of the above
- E)Two of the above
- The five groups of lymph nodes in the axilla consist of all of the following
except:
- A)Central Group
- B) Lateral Group and Central Group
- C) Pectoral Group
- D) Subscapular Group
- E) Cervicle Group
- The thickened skin in one area of the patient's right breast is most
likely due to:
- A) Necrotic Breast Tissue
- B) Swollen Glandular Tissue
- C) Blocked Lactiferous Duct
- D) Calcified Fat Lobule
- E) Interference with Lymphatic Drainage
- The dimpling of the skin observed in the breast is probably due to:
- A)Necrotic Breast Tissue
- B) Shortened Cooper's Ligaments
- C)Interference with Lymphatic Drainage
- D)Blocked Lactiferous Duct
- E)Swollen Glandular Tissue