Anatomy MCQs for NEET PG
941 worked Anatomy questions across 82 areas. Each one has its own page with the reasoning for every option.
What this set is
Anatomy in NEET PG is mostly applied: where a nerve runs, what an injury at that level does, and which structure is damaged in a given deficit. Pure memorisation of names pays far less than knowing relations.
This page lists the 941 Anatomy questions that have a full worked page: 701 application questions that put a fact to use on a patient or a finding, and 240 multi-step questions that combine two or more ideas. Plain one-fact recall items are left out here on purpose. The Anatomy practice bank in the app is larger, with 3,992 questions in all, and is where timed tests and daily practice draw from.
How to use it
- Pick an area you are weak in, below.
- Answer first, then read why each wrong option fails.
- Write a three-line note for every miss, and revisit it in a week.
- Move to a timed Anatomy test once an area feels steady.
These are original practice items, not recalled exam questions, and they are not yet reviewed by independent faculty. Confirm important facts in a standard textbook.
What Anatomy covers in the exam
- General anatomy and histology
- Upper limb and brachial plexus
- Lower limb
- Thorax
- Abdomen and pelvis
- Head and neck
- Neuroanatomy
- Embryology
- Medical genetics
A study map from the standard curriculum; the NBEMS bulletin is the authority. See the Anatomy study guide.
Worked questions by area
82 areas, largest first. Open an area to see its questions.
Neuroanatomy127
- Neuroanatomy · ApplicationOcclusion of which artery most typically causes lateral medullary (Wallenberg) syndrome?
- Neuroanatomy: internal capsule · Multi-stepA 62-year-old hypertensive man develops sudden, equal weakness of the left face, arm and leg. Sensation, vision and language are normal and there is no cortical sign. T…
- Neuroanatomy: visual pathway · Multi-stepA 45-year-old woman with a right temporal lobe tumour has loss of the upper quadrant of the visual field on the left side in both eyes. Which structure is most likely i…
- Neuroanatomy: cerebral arteries · ApplicationA patient develops contralateral weakness and sensory loss that affect the leg much more than the arm or face, with a grasp reflex and abulia. Which artery is occluded?
- Neuroanatomy: Broca area · ApplicationA 60-year-old right-handed man after a stroke speaks slowly and with effort in short telegraphic phrases. He understands commands, but cannot repeat sentences, and has…
- Neuroanatomy: Wernicke aphasia · ApplicationA 68-year-old man has fluent, well-articulated but meaningless speech with made-up words, and cannot follow commands. He has a right superior quadrantanopia but no limb…
- Neuroanatomy: cerebellar vermis · ApplicationA 5-year-old child has morning vomiting and a wide-based gait with a tendency to fall backwards. Finger-to-nose testing is normal. MRI shows a midline mass arising from…
- Neuroanatomy: Brown-Sequard syndrome · Multi-stepA man is stabbed in the back and has a hemisection of the left half of the spinal cord at T10. Which pattern of deficit is expected below the lesion?
- Neuroanatomy: syringomyelia · ApplicationA 30-year-old man has painless burns on his hands. He has loss of pain and temperature in a cape-like distribution over both shoulders and arms, with preserved touch an…
- Neuroanatomy: posterior column disease · ApplicationA 55-year-old man has lightning-like leg pains and an unsteady gait that is worse in the dark. Romberg sign is positive, ankle jerks are absent, and the pupils are smal…
- Neuroanatomy: Horner syndrome · ApplicationA 62-year-old smoker with an apical lung mass has a drooping right upper eyelid, a small right pupil and absent sweating on the right side of the face. Paralysis of whi…
- Neuroanatomy: oculomotor nerve compression · Multi-stepA 50-year-old woman has a sudden severe headache. The right eye is deviated down and out with ptosis, and the right pupil is dilated and unreactive. Which explanation b…
- Neuroanatomy: Weber syndrome · ApplicationA 65-year-old man has drooping of the right upper eyelid with the right eye down and out and the pupil dilated, plus weakness of the left arm, leg and lower face. Where…
- Neuroanatomy: medial medullary syndrome · ApplicationAfter a vertebral artery branch occlusion, a man's tongue deviates to the right on protrusion. He has left hemiparesis sparing the face and loss of vibration sense on t…
- Neuroanatomy: internuclear ophthalmoplegia · Multi-stepA 28-year-old woman with multiple sclerosis cannot adduct her left eye on looking to the right. The right eye abducts with nystagmus. Convergence is preserved. Where is…
- Neuroanatomy: dorsal midbrain syndrome · ApplicationA 14-year-old boy with headache and vomiting cannot look upwards, his eyelids are retracted, and pupils react better to accommodation than to light. MRI shows a pineal…
- Neuroanatomy: afferent pupillary defect · Multi-stepIn a patient with optic neuritis the swinging flashlight test is performed. When the light is moved from the left eye to the right eye, both pupils dilate; when moved b…
- Neuroanatomy: obstructive hydrocephalus · Multi-stepAn infant has an enlarging head. CT shows dilated lateral ventricles and a dilated third ventricle, but the fourth ventricle is of normal size. Where is the obstruction?
- Neuroanatomy: meningeal haemorrhage · ApplicationA 75-year-old alcoholic man fell three weeks ago and now has drowsiness and confusion. CT shows a crescent-shaped hypodense collection across the right hemisphere. Whic…
- Neuroanatomy: hypothalamic nuclei · ApplicationAfter a severe head injury a man passes about 8 litres of dilute urine a day. Serum sodium is high and urine osmolality is low. Neurons of which hypothalamic nuclei pro…
- Neuroanatomy: subthalamic nucleus · ApplicationA 70-year-old hypertensive woman suddenly develops violent, flinging movements of the right arm and leg. Where is the lesion most likely to be?
- Neuroanatomy: amnestic syndromes · ApplicationA chronic alcoholic recovering from Wernicke encephalopathy cannot form new memories and fills the gaps with fluent but false stories. Which structures are characterist…
- Neuroanatomy: lumbar puncture · Multi-stepA lumbar puncture is performed in the midline of an adult at the L3-L4 interspace. Which is the correct order of structures traversed after the skin and subcutaneous ti…
- Neuroanatomy: cerebellopontine angle · ApplicationA 52-year-old woman has progressive hearing loss in the right ear, tinnitus and unsteadiness. MRI shows an enhancing mass in the internal acoustic meatus extending into…
- Neuroanatomy: ventral pontine syndrome · Multi-stepA 62-year-old woman has sudden right facial weakness involving the forehead, inability to abduct the right eye, and left-sided arm and leg weakness. Where is the lesion?
- Neuroanatomy: parietal lobe syndromes · ApplicationA 58-year-old right-handed man after a stroke cannot write, cannot perform simple calculations, cannot name his own fingers, and confuses left and right. Where is the l…
- Neuroanatomy: nigrostriatal pathway · ApplicationA 65-year-old man has resting tremor, bradykinesia and rigidity. Degeneration of dopaminergic neurons in the substantia nigra pars compacta primarily deprives which str…
- Neuroanatomy: dorsal midbrain · Multi-stepA 16-year-old boy has headache, vomiting and papilloedema. He cannot look upward, his pupils react poorly to light but briskly to near, and he has convergence-retractio…
- Neuroanatomy: oculomotor nerve · Multi-stepAfter a head injury a patient develops an enlarging extradural haematoma, and the ipsilateral pupil becomes fixed and dilated before eye movements are lost. Why are the…
- Neuroanatomy: limbic system · ApplicationA 50-year-old man with chronic alcohol use has confusion, ataxia and nystagmus. Weeks later he has severe anterograde amnesia with confabulation. Which structure is cha…
- Neuroanatomy: ventricular system · Multi-stepA 35-year-old man has sudden severe headaches that appear on changing head position and ease on lying down, with brief drop attacks. CT shows a round hyperdense mass at…
- Neuroanatomy: vertebrobasilar circulation · Multi-stepA 65-year-old man with atrial fibrillation develops sudden drowsiness, loss of upward gaze and bilateral visual loss with preserved pupillary reflexes. Embolic occlusio…
- Neuroanatomy: cerebral arteries · ApplicationA hypertensive 62-year-old man has sudden pure motor hemiparesis of the face, arm and leg without sensory or cortical deficit. MRI shows a small infarct in the posterio…
- Neuroanatomy: ascending tracts · ApplicationSecond-order neurons of the dorsal column-medial lemniscus pathway arise in the gracile and cuneate nuclei. A small medullary lesion interrupts their crossing to the op…
- Neuroanatomy: ventricular system and CSF · Multi-stepAn 8-month-old infant recovering from bacterial meningitis develops enlarging head size and bulging fontanelle. CT shows dilatation of all ventricles including the four…
- Neuroanatomy: cerebellum · ApplicationA child with a midline cerebellar medulloblastoma has truncal ataxia and cannot sit without support, while limb coordination is relatively preserved. Which deep cerebel…
- Neuroanatomy: autonomic nervous system · ApplicationAfter a fracture-dislocation at the conus medullaris, a man has an atonic bladder, overflow incontinence and loss of the defecation reflex. Which outflow is mainly inte…
- Neuroanatomy: brainstem nuclei development · ApplicationA section through the developing hindbrain shows columns of neuroblasts lying lateral to the sulcus limitans. Which adult nucleus develops from this region?
- Neuroanatomy: midbrain syndromes · ApplicationA man has a right oculomotor palsy with a dilated pupil and a coarse tremor of the left arm. There is no weakness. Which lesion is most likely?
- Neuroanatomy: circle of Willis · Multi-stepA 60-year-old man has 90% stenosis of the right internal carotid artery and no neurological deficit. Angiography shows the right anterior cerebral artery filling from t…
- Neuroanatomy: dural venous sinuses · Multi-stepA child with chronic otitis media has spiking fever, tenderness over the mastoid and a thrombus in the sigmoid sinus on MRI venography. Why does mastoid infection exten…
- Neuroanatomy: language areas · Multi-stepAfter a stroke, a right-handed man speaks fluently with normal grammar and understands commands, but cannot repeat the sentence he has just heard and substitutes wrong…
- Neuroanatomy: trochlear nerve · Multi-stepA midbrain haemorrhage destroys the right trochlear nucleus. Which superior oblique is paralysed, and why?
- Neuroanatomy: brainstem syndromes · ApplicationAfter a basilar artery thrombosis, an alert man is quadriplegic and mute, with bilateral facial weakness and no horizontal eye movements. By which movements can he comm…
- Neuroanatomy: cauda equina syndrome · Multi-stepA 40-year-old man with a large central L4-L5 disc prolapse has saddle anaesthesia, urinary retention and reduced anal tone. Which finding favours a cauda equina lesion…
- Neuroanatomy: cerebellar lesions · Multi-stepA 55-year-old man has an infarct of the right cerebellar hemisphere. On which side are the finger-nose incoordination and falls, and what explains this?
- Neuroanatomy: vascular supply and aneurysms · ApplicationA 45-year-old woman has a sudden thunderclap headache, neck stiffness and blood in the subarachnoid space on CT. Angiography shows a saccular aneurysm. Which site is th…
- Neuroanatomy · Multi-stepA man has sudden severe back pain with saddle anaesthesia, early urinary retention, symmetrical bilateral leg weakness with brisk reflexes and prominent upper motor neu…
- Neuroanatomy · ApplicationA man after a right middle cerebral artery stroke fails to shave the left side of his face and denies his left arm weakness. Which lesion best explains it?
- Neuroanatomy · ApplicationA man has right-sided face and arm weakness with loss of speech, though comprehension is preserved. Which artery is most likely occluded?
- Neuroanatomy · Multi-stepA man with a posterior cerebral artery infarct has a right homonymous hemianopia, but the central vision of the right fields is preserved. What explains this macular sp…
- Neuroanatomy · Multi-stepAfter herpes encephalitis, a man puts objects in his mouth, shows no fear and becomes unusually calm and hypersexual. Which structure is damaged on both sides?
- Neuroanatomy: Papez circuit · Multi-stepIn the Papez circuit, output from the mammillary bodies reaches the anterior nucleus of the thalamus through which tract?
- Neuroanatomy: dorsal spinocerebellar tract · Multi-stepUnconscious proprioception from the lower limb passes to the cerebellum through a tract that arises from cells in Clarke's nucleus. How does this tract reach the cerebe…
- Neuroanatomy: Lissauer tract · ApplicationThe dorsolateral tract of Lissauer lies at the tip of the dorsal horn. What is its role?
- Neuroanatomy: area postrema · ApplicationChemotherapy induces vomiting by acting on the chemoreceptor trigger zone in the floor of the fourth ventricle. Why can circulating drugs stimulate it?
- Neuroanatomy: artery of Percheron · Multi-stepA patient has sudden drowsiness, vertical gaze palsy and memory loss. MRI shows bilateral paramedian thalamic infarcts with the rostral midbrain involved. Which vascula…
- Neuroanatomy: cranial nerve exits from the medulla · ApplicationFrom which groove on the lateral aspect of the medulla do the glossopharyngeal, vagus and cranial accessory nerves emerge?
- Neuroanatomy: spinothalamic lamination · Multi-stepA patient with an extramedullary tumour compressing the cord from outside first loses pain and temperature in the sacral dermatomes, and the level later rises. What exp…
- Neuroanatomy: mesencephalic nucleus of the trigeminal nerve · Multi-stepWhich trigeminal nucleus contains the cell bodies of primary afferent neurons carrying jaw proprioception, and is unusual because these cell bodies lie inside the centr…
- Neuroanatomy: subacute combined degeneration · ApplicationA 58-year-old strict vegan has tingling in both feet, loss of vibration and joint position sense, spastic weakness of the legs, brisk knee jerks and extensor plantar re…
- Neuroanatomy: false-localising hemiparesis · Multi-stepA 45-year-old man with a large right-sided acute subdural haematoma has a dilated, unreactive right pupil but weakness of the right arm and leg. Which mechanism best ex…
- Neuroanatomy: anterior choroidal artery · Multi-stepA 66-year-old man has sudden left hemiparesis, left hemisensory loss and a left homonymous hemianopia. MRI shows an infarct of the posterior limb of the right internal…
- Neuroanatomy: border-zone infarction · Multi-stepA 60-year-old man has profound hypotension during a cardiac arrest and resuscitation. Afterwards he has bilateral weakness of the shoulders and proximal arms with relat…
- Neuroanatomy: disconnection syndromes · Multi-stepAfter a left posterior cerebral artery infarct, a right-handed teacher has a right homonymous hemianopia. She speaks normally and can write a sentence from dictation, b…
- Neuroanatomy: frontal eye field · ApplicationA patient with an acute infarct of the left middle frontal gyrus has both eyes deviated to the left and cannot voluntarily look to the right. Which cortical area is des…
- Neuroanatomy: motor posturing · Multi-stepAfter a pontine haemorrhage a comatose man shows extension and internal rotation of all four limbs with plantar flexion of the feet. At which level of the brainstem is…
- Neuroanatomy: cholinergic basal forebrain · ApplicationA 72-year-old woman has progressive memory loss and shows a modest response to an acetylcholinesterase inhibitor. Neuronal loss in which basal forebrain nucleus, the ma…
- Neuroanatomy: lateral pontine syndrome · Multi-stepA 64-year-old man has sudden vertigo, vomiting, right-sided deafness and tinnitus, right lower motor neuron facial palsy, right facial numbness, a right Horner syndrome…
- Neuroanatomy: hindbrain malformations · ApplicationAn infant has an enlarging head. MRI shows a large cystic dilatation of the fourth ventricle, an absent or hypoplastic cerebellar vermis and an elevated tentorium. What…
- Neuroanatomy: Chiari II malformation · ApplicationA newborn with a lumbosacral myelomeningocele develops progressive hydrocephalus. Which finding on MRI is characteristic of the associated hindbrain malformation?
- Neuroanatomy: tonsillar herniation · ApplicationA patient with a large cerebellar tumour and raised intracranial pressure collapses minutes after a lumbar puncture, with irregular breathing progressing to apnoea and…
- Neuroanatomy: subfalcine herniation · Multi-stepA patient with a large right frontal tumour has CT evidence of midline shift, with the cingulate gyrus displaced beneath the free edge of the falx cerebri. Which new de…
- Neuroanatomy: blood-CSF barrier · Multi-stepThe capillaries of the choroid plexus are fenestrated, yet the CSF it produces differs in composition from plasma. Which structure forms the blood-CSF barrier at this s…
- Neuroanatomy: neuroglia · ApplicationMost cells of the central nervous system develop from the neuroectoderm of the neural tube. Which resident cell of the CNS instead originates from mesoderm-derived haem…
- Neuroanatomy: lumbosacral root lesions · ApplicationA 35-year-old man with sciatica has weak plantar flexion, numbness along the lateral border of the foot and an absent ankle jerk. A disc prolapse is compressing which n…
- Neuroanatomy: motor neuron disease · ApplicationA 55-year-old man has wasting and fasciculations of the small hand muscles together with spasticity and brisk reflexes in the legs. Sensation and sphincter function are…
- Neuroanatomy: hypothalamic feeding centres · ApplicationA child develops voracious eating, rapid weight gain and rage attacks after surgery for a craniopharyngioma. Damage to which hypothalamic region is most likely?
- Neuroanatomy: basal ganglia circuitry · Multi-stepIn Parkinson disease, loss of dopaminergic input to the striatum produces bradykinesia through which change in basal ganglia circuitry?
- Neuroanatomy: optic radiation · Multi-stepA 50-year-old woman with a right parietal lobe tumour notices that she misses objects on the floor to her left, with a field defect below the horizontal meridian in bot…
- Neuroanatomy: abducens nucleus · Multi-stepA pontine infarct produces a right lower motor neuron facial palsy and inability to move both eyes to the right. Which structure beneath the floor of the fourth ventric…
- Neuroanatomy: central auditory pathway · ApplicationA stroke destroys the right primary auditory cortex but causes only mild hearing loss with difficulty localising sound. Why is deafness not complete?
- Neuroanatomy: Foster Kennedy syndrome · Multi-stepA patient with an olfactory groove meningioma has optic atrophy in the right eye and a swollen optic disc in the left eye. What produces the swollen disc?
- Neuroanatomy: pupillary light reflex in cortical blindness · ApplicationAfter bilateral posterior cerebral artery infarcts a man walks into furniture, yet insists his vision is normal. Both pupils constrict briskly to light. Which feature o…
- Neuroanatomy: thalamic pain syndrome · Multi-stepA 63-year-old man recovering from a right thalamic infarct develops severe burning pain and hypersensitivity on the left half of his body after initial hemisensory loss…
- Neuroanatomy: central cord syndrome · Multi-stepA 68-year-old man with cervical spondylosis hyperextends his neck in a fall and has greater weakness in both arms than legs, with burning hands. Perianal sensation is p…
- Neuroanatomy: Argyll Robertson pupil · Multi-stepA man with long-standing untreated syphilis has small, irregular pupils that constrict on near focus but not to light. Which site is damaged?
- Neuroanatomy: caloric test in coma · Multi-stepIn a comatose patient with an intact brainstem, 30 mL of ice-cold water is irrigated into the right ear canal. What is the expected eye response?
- Neuroanatomy: spinal shock · ApplicationA man with an acute complete T6 cord transection has flaccid paralysis, absent reflexes and loss of tone below the level for several days. What mainly explains this ear…
- Neuroanatomy: hypothalamic thermoregulation · ApplicationAfter surgery near the base of the brain, a patient cannot dissipate heat and becomes hyperthermic in a warm room, with absent sweating and cutaneous vasodilation. Whic…
- Neuroanatomy: trigeminal neuralgia · ApplicationA 62-year-old woman has brief electric-shock pains in the cheek triggered by chewing. MRI shows a vessel loop compressing the trigeminal root near the pons. Which arter…
- Neuroanatomy: normal pressure hydrocephalus · Multi-stepA 72-year-old man has a short-stepped, magnetic gait, urinary urgency and mild cognitive slowing. CT shows enlarged ventricles without cortical atrophy, and the opening…
- Neuroanatomy: choroid plexus papilloma · ApplicationAn infant has an enlarging head and communicating hydrocephalus. MRI shows a lobulated intraventricular mass in the atrium of the lateral ventricle with no obstruction…
- Neuroanatomy: recurrent artery of Heubner · Multi-stepAn infarct of the head of the caudate nucleus and the anterior limb of the internal capsule causes contralateral weakness of the face and arm more than the leg. Which a…
- Neuroanatomy: orbitofrontal syndrome · ApplicationAfter a road accident a man becomes socially disinhibited, makes tactless jokes and shows poor judgement, but has normal memory and no weakness. Which area is most like…
- Neuroanatomy: neurogenic bladder after cord injury · Multi-stepA man with a cervical cord injury regains reflex bladder emptying, but the detrusor and the external sphincter contract at the same time, leaving a large residual volum…
- Neuroanatomy: Duret haemorrhage · Multi-stepA comatose patient with a large temporal haematoma and a fixed dilated pupil dies, and autopsy shows linear midline haemorrhages in the midbrain and upper pons. Which v…
- Neuroanatomy: hippocampal vulnerability · ApplicationA man who survives a cardiac arrest has persistent anterograde amnesia. MRI shows selective loss of neurones in the hippocampal sector most vulnerable to hypoxia. Which…
- Neuroanatomy: deep cerebellar nuclei · ApplicationWhich deep cerebellar nucleus receives output from the lateral cerebellar hemisphere and projects through the superior cerebellar peduncle to the contralateral ventrola…
- Neuroanatomy · ApplicationWhich lobe is primarily responsible for voluntary motor initiation?
- Neuroanatomy · ApplicationWhat structure connects the two cerebral hemispheres?
- Neuroanatomy · ApplicationWhich part of the brainstem contains respiratory and cardiovascular centers?
- Neuroanatomy · ApplicationWhat brain region coordinates balance and fine motor activity?
- Neuroanatomy · ApplicationWhat structure relays most sensory information to the cerebral cortex?
- Neuroanatomy · ApplicationWhich meningeal layer closely adheres to the surface of the brain?
- Neuroanatomy · ApplicationWhich lobe is primarily responsible for visual processing?
- Neuroanatomy · ApplicationWhat structure contains the cell bodies of lower motor neurons in the spinal cord?
- Neuroanatomy · ApplicationWhat pathway carries pain and temperature from the body to the brain?
- Neuroanatomy · ApplicationWhich lobe initiates voluntary motor activity?
- Neuroanatomy · ApplicationWhat structure connects the cerebral hemispheres?
- Neuroanatomy · ApplicationWhich brainstem region contains key cardiovascular centers?
- Neuroanatomy · ApplicationWhich artery is a major branch of the internal carotid artery supplying the lateral cerebral hemisphere?
- Neuroanatomy · ApplicationWhich spinal tract primarily carries pain and temperature sensation from the body to the brain?
- Neuroanatomy · ApplicationWhich artery supplies the lateral surface of most cerebral hemisphere?
- Neuroanatomy · ApplicationWhich thalamic nucleus relays body somatic sensation from the trunk and limbs to the cerebral cortex?
- Neuroanatomy: internal capsule · ApplicationA lacunar infarct in the posterior limb of the internal capsule is most likely to produce which deficit?
- Neuroanatomy: spinal cord · Multi-stepA hemisection of the right spinal cord at T10 causes loss of pain and temperature on which side below the lesion?
- Neuroanatomy: dorsal columns · ApplicationWhich tract carries vibration and conscious proprioception from the lower limb?
- Neuroanatomy: cerebellum · ApplicationA right cerebellar hemisphere stroke produces limb ataxia on which side?
- Neuroanatomy: midbrain · ApplicationA posterior communicating artery aneurysm causes a dilated pupil with ptosis and a 'down and out' eye. Which nerve is compressed?
- Neuroanatomy · ApplicationWhich structure produces cerebrospinal fluid in the ventricles?
- Neuroanatomy · ApplicationWhich lobe contains the primary visual cortex?
- Neuroanatomy · ApplicationWhich cranial nerve exits the brainstem from the dorsal surface?
- Neuroanatomy: internal capsule · ApplicationA small infarct of the posterior limb of the internal capsule most likely causes which deficit?
- Neuroanatomy: cerebellum · ApplicationA lesion of the right cerebellar hemisphere most likely causes which sign?
- Neuroanatomy: spinal tracts · ApplicationWhich tract carries pain and temperature sensation from the body to the contralateral thalamus?
- Neuroanatomy: circle of Willis · ApplicationWhich artery connects the anterior cerebral arteries in the circle of Willis?
Lower limb99
- Lower limb: tarsal tunnel · ApplicationA 40-year-old runner has burning pain and numbness over the sole of the foot that worsens after standing. Percussion behind the medial malleolus reproduces the symptoms…
- Lower limb: anterior cruciate ligament · Multi-stepA footballer pivots sharply and feels a pop in the knee. Within hours the knee is swollen with a haemarthrosis. On the Lachman test the tibia translates excessively for…
- Lower limb: menisci of the knee · ApplicationIn twisting injuries of the knee the medial meniscus is torn more often than the lateral meniscus. Which anatomical feature best explains this?
- Lower limb: great saphenous vein and nerve · ApplicationAfter stripping of the great saphenous vein from ankle to groin for varicose veins, a woman reports numbness over the medial side of the leg and the medial border of th…
- Lower limb: obturator nerve injury · ApplicationA woman undergoes pelvic lymph node dissection in the obturator fossa. Afterwards she cannot cross one leg over the other, her thigh tends to abduct while walking, and…
- Lower limb: hamstring innervation · ApplicationAfter a gunshot injury, a surgeon finds selective damage to the common fibular division of the sciatic nerve high in the thigh. Which muscle of the posterior compartmen…
- Lower limb: posterior hip dislocation · ApplicationAfter a head-on car collision, a 30-year-old man lies with his right leg shortened, flexed, adducted and internally rotated at the hip. Which nerve is most at risk from…
- Lower limb: arches of the foot · ApplicationA 55-year-old woman develops progressive flatfoot after degeneration of the tibialis posterior tendon. Which ligament, which directly supports the head of the talus and…
- Lower limb: lateral ankle ligaments · ApplicationA 22-year-old basketball player inverts his plantar-flexed foot on landing. There is swelling and tenderness just anterior and inferior to the lateral malleolus, and th…
- Lower limb: compartments of the leg · Multi-stepA 25-year-old man has a tibial shaft fracture. Eight hours later he has severe pain out of proportion, a tense swelling lateral to the tibia, and pain on passive flexio…
- Lower limb: femoral artery puncture · Multi-stepAn interventional cardiologist plans a femoral artery puncture for angiography and wants the artery to be compressible after the procedure while avoiding a retroperiton…
- Lower limb: L5 radiculopathy versus fibular neuropathy · Multi-stepA 48-year-old man has right foot drop. Examination shows weak ankle dorsiflexion, weak great toe extension and weak hip abduction. Knee flexion, plantar flexion and the…
- Lower limb: lumbar disc and nerve roots · ApplicationA 38-year-old man lifts a heavy box and develops back pain radiating down the posterolateral thigh and lateral leg to the dorsum of the foot, with weak great toe extens…
- Lower limb: gluteus maximus · ApplicationAfter a posterior approach to the hip a man walks normally on level ground, but cannot climb stairs or rise from a squat without pushing on his thigh. Knee extension is…
- Lower limb: popliteal artery · Multi-stepA young man has a traumatic dislocation of the knee in a motorcycle crash. After reduction his foot is cool and the distal pulses are absent. Which anatomical feature m…
- Lower limb: plantar digital nerves · ApplicationA 45-year-old woman has burning pain in the forefoot on wearing high-heeled shoes. Squeezing the forefoot reproduces a painful click and the pain is relieved by removin…
- Lower limb: patellar stability · ApplicationA 17-year-old girl with a wide pelvis and increased Q angle has recurrent lateral dislocation of the patella. Strengthening of which muscle component is most useful as…
- Lower limb: obturator canal · ApplicationAn emaciated 80-year-old woman has small bowel obstruction. She also has pain along the medial thigh and knee that worsens on extension and medial rotation of the thigh…
- Lower limb: popliteal artery · Multi-stepA 25-year-old footballer has a posterior knee dislocation. His foot is pale and cool with absent pedal pulses. Which anatomical feature makes the popliteal artery parti…
- Lower limb: lateral femoral cutaneous nerve · ApplicationA 45-year-old obese man who wears a tight belt has burning pain and numbness over the anterolateral thigh with no weakness. Reflexes and power are normal. Where is the…
- Lower limb: compartment syndrome · Multi-stepA 20-year-old man has severe leg pain 6 hours after a closed tibial shaft fracture. The leg is tense, passive flexion of the toes is very painful, and sensation is lost…
- Lower limb: sciatic nerve injury · Multi-stepA front-seat passenger in a road crash has a limb that is shortened, flexed, adducted and internally rotated. After reduction she has foot drop and loss of sensation on…
- Lower limb: gluteal region · ApplicationA nurse plans an intramuscular injection in the gluteal region of an adult. To avoid the sciatic nerve and superior gluteal vessels, which site should be chosen?
- Lower limb: leg and foot · Multi-stepA man's popliteal fossa is lacerated by a broken bottle, and the tibial nerve is completely transected high in the fossa. Which deformity of the foot develops over time?
- Lower limb: venous drainage · ApplicationA 55-year-old woman has long-standing varicose veins and a pigmented ulcer above the medial malleolus. Duplex shows reflux in the perforating veins of the calf. How do…
- Lower limb: femoral triangle · ApplicationAn anaesthetist palpates the femoral pulse below the mid-inguinal point to place a central venous catheter in the femoral vein. Where should the needle be directed rela…
- Lower limb: sciatic nerve · ApplicationFor foot surgery, an anaesthetist injects local anaesthetic around the nerve about 8 cm above the popliteal crease so that both the tibial and common peroneal component…
- Lower limb: leg compartments · ApplicationAfter a lateral leg incision for a fasciotomy, a patient has weak foot eversion and numbness over the dorsum of the foot and lower lateral leg. Dorsiflexion and toe ext…
- Lower limb: popliteal fossa · ApplicationA clinician cannot feel the popliteal pulse with the patient's knee extended. Which approach and anatomical reason is correct?
- Lower limb: adductor canal · ApplicationAn anaesthetist performs an ultrasound-guided block in the mid-thigh beneath sartorius to give analgesia after knee surgery while preserving quadriceps strength. Which…
- Lower limb: hip fracture · ApplicationA 78-year-old woman falls at home and has groin pain and inability to bear weight. Radiographs show a displaced subcapital fracture of the femoral neck. How does the af…
- Lower limb: dermatomes · ApplicationA 40-year-old man has back pain with numbness over the medial malleolus, a diminished knee jerk and weakness of ankle dorsiflexion. Which nerve root is most likely comp…
- Lower limb · ApplicationA bulge below and lateral to the pubic tubercle is irreducible, and surgery shows the neck passing medial to the femoral vein. Which structure forms the medial boundary…
- Lower limb · ApplicationA middle-aged woman has a progressively flat medial arch with inability to rise on tiptoe on the affected side and a talar head sagging downwards. Which tendon failure…
- Lower limb: pes anserinus · Multi-stepA runner has tenderness over the anteromedial proximal tibia just below the knee joint line. The bursa lies deep to the tendons of sartorius, gracilis and semitendinosu…
- Lower limb: iliotibial tract · ApplicationA thickened band of fascia lata inserts on the anterolateral tibial condyle at Gerdy's tubercle. Which two muscles insert into this tract?
- Lower limb: midtarsal joint · ApplicationA surgeon performs a midtarsal (Chopart) disarticulation of the foot. Which two joints form this line?
- Lower limb: tibial nerve lesion · Multi-stepAfter a posterior knee dislocation, a patient cannot plantar flex or invert the foot, cannot curl the toes, and has numbness over the sole. Dorsiflexion and eversion ar…
- Lower limb: popliteal cyst · ApplicationA 55-year-old woman with knee osteoarthritis has a soft swelling in the popliteal fossa that is more prominent on knee extension. It communicates with the joint. Which…
- Lower limb: sural nerve · ApplicationA surgeon harvests a sensory nerve graft that runs beside the short saphenous vein and behind the lateral malleolus. Which nerve is this, and what area does it supply?
- Lower limb: rectus femoris origin · ApplicationA teenage footballer feels a sudden pain in the groin when kicking and an X-ray shows avulsion of a bony fragment from the anterior inferior iliac spine. Which muscle w…
- Lower limb: pectineus nerve supply · Multi-stepWhich muscle of the medial thigh typically has a dual nerve supply from the femoral nerve and the obturator nerve?
- Lower limb: anterior tibial artery · Multi-stepA displaced fracture of the proximal tibia and fibula compromises the foot pulse. Through which structure does the anterior tibial artery pass to reach the anterior com…
- Lower limb: deltoid ligament · ApplicationA footballer rolls the ankle into marked eversion and has medial ankle pain and swelling. Which strong, triangular ligament of the medial ankle is injured?
- Lower limb: Lisfranc injury · Multi-stepAfter a twisting injury to the foot, a patient has midfoot swelling, plantar bruising and widening between the base of the second metatarsal and the medial cuneiform on…
- Lower limb: femoral canal node · ApplicationDuring repair of a femoral hernia, the surgeon notes the uppermost of the deep inguinal lymph nodes. In which space does it lie?
- Lower limb: congenital talipes · ApplicationA newborn has a rigid foot with the heel pulled upward, the hindfoot turned inwards, the forefoot adducted and an increased arch. Which combination of deformities defin…
- Lower limb: cruciate anastomosis · Multi-stepLigation of a branch of the profunda femoris is considered during hip surgery. Which artery joins the first perforating artery in forming the cruciate anastomosis at th…
- Lower limb: oblique popliteal ligament · ApplicationWhich structure forms an expansion across the back of the knee joint capsule and prevents hyperextension, arising from the insertion of semimembranosus?
- Lower limb: flexor hallucis longus · Multi-stepA ballet dancer has posterior ankle pain and the big toe catches when she moves from plantarflexion to dorsiflexion. Which tendon runs in a groove on the back of the ta…
- Lower limb: quadratus femoris · ApplicationWhich lateral rotator of the hip lies below the inferior gemellus, arises from the ischial tuberosity and inserts on the quadrate tubercle of the femur?
- Lower limb: ischial apophysis · ApplicationA 15-year-old sprinter feels a sudden tearing pain in the buttock on starting a race. X-ray shows avulsion of the ischial tuberosity. Which muscle group was responsible?
- Lower limb: lateral knee · Multi-stepAt the lateral side of the knee, the fibular collateral ligament does not attach to the lateral meniscus. Which tendon passes between the ligament and the meniscus?
- Lower limb: childhood avascular necrosis · Multi-stepA 6-year-old boy has a painless limp, and X-ray shows a flattened, sclerotic femoral capital epiphysis. At this age the femoral head depends mainly on which vessels?
- Lower limb: gluteus medius lurch · Multi-stepA woman with weak right abductors after surgery walks with her trunk leaning to the right over the stance leg, to keep the pelvis level. Which term describes this compe…
- Lower limb: posterior femoral cutaneous nerve · ApplicationA man develops numbness over the posterior thigh and the lower buttock after prolonged sitting on a hard bench, without weakness of the hamstrings. Which nerve is most…
- Lower limb: plantaris tendon · ApplicationA surgeon harvests a long, thin tendon from the calf for use as a graft. Between which two muscles does it run before reaching the medial side of the calcaneal tendon?
- Lower limb: bursae of the knee · ApplicationA carpet layer who kneels for long periods has a tender fluctuant swelling directly under the skin in front of the lower patella, with a normal range of knee movement.…
- Lower limb: neck-shaft angle · Multi-stepA radiograph of the adult hip shows a femoral neck-shaft angle of about 105 degrees. Which term applies, and what is the typical effect on the limb?
- Lower limb: pubofemoral ligament · ApplicationDuring hip examination, extreme abduction is limited by tension in a ligament that passes from the pubic part of the acetabular rim to the intertrochanteric line below.…
- Lower limb: popliteal lymph nodes · Multi-stepA man has an infected wound on the lateral border of the heel and tender swollen nodes behind the knee. Along which superficial vessel do the lymphatics from this area…
- Lower limb: layers of the sole · ApplicationIn the second layer of the sole, a rectangular muscle with two heads inserts into the lateral side of the flexor digitorum longus tendon and straightens its line of pul…
- Lower limb: medial plantar nerve · ApplicationEntrapment of the medial plantar nerve in the foot paralyses which of these intrinsic muscles?
- Lower limb: tributaries of the great saphenous vein · Multi-stepBefore stripping the great saphenous vein, a surgeon ligates flush at the saphenofemoral junction and separately ties the tributary that drains the skin of the lower ab…
- Lower limb: fibular collateral ligament · ApplicationA basketball player takes a blow to the inner knee while the foot is planted and the knee is extended. The joint gaps on the lateral side with varus stress. Which ligam…
- Lower limb: hip joint capsule · Multi-stepAt the hip, the capsule attaches in front to the intertrochanteric line, but behind it attaches to the neck about halfway along. What is the consequence?
- Lower limb: blood supply of the cruciate ligaments · ApplicationThe cruciate ligaments of the knee are intra-articular and covered by synovium. Which artery provides their principal blood supply?
- Lower limb: fibularis tertius · ApplicationA muscle that dorsiflexes and everts the foot, supplied by the deep fibular nerve, is missing in a small proportion of people. Which muscle is it?
- Lower limb: Osgood-Schlatter disease · ApplicationA 13-year-old footballer has pain and swelling over the tibial tuberosity that worsens with kneeling and running. Radiographs show fragmentation of the tuberosity. What…
- Lower limb: talar neck fracture · Multi-stepA man in a road accident has a displaced fracture through the neck of the talus. Months later, the body of the talus shows increased density and collapse. Why is the bo…
- Lower limb · ApplicationWhich nerve supplies quadriceps?
- Lower limb · ApplicationWhich muscle dorsiflexes ankle?
- Lower limb · ApplicationWhich muscle extends knee?
- Lower limb · ApplicationWhich nerve supplies hamstrings mainly?
- Lower limb · ApplicationWhich artery is palpated behind knee?
- Lower limb · ApplicationWhich nerve is commonly affected in foot drop?
- Lower limb · ApplicationWhich muscle is the principal extensor of the hip?
- Lower limb · ApplicationThe femoral artery becomes the popliteal artery after passing through what?
- Lower limb · ApplicationWhich muscle is the principal dorsiflexor of the ankle?
- Lower limb · ApplicationWhich vessel is commonly used to palpate the pulse on the dorsum of the foot?
- Lower limb · ApplicationWhat structure passes posterior to the medial malleolus?
- Lower limb · ApplicationWhich muscle group extends the knee?
- Lower limb · ApplicationWhat vessel is commonly palpated on the dorsum of the foot?
- Lower limb · ApplicationCompression in the tarsal tunnel behind the medial malleolus would most directly affect which nerve?
- Lower limb · ApplicationWhich nerve is commonly injured at the neck of the fibula?
- Lower limb · ApplicationWhat muscle is the principal extensor of the hip?
- Lower limb · ApplicationWhich nerve is vulnerable at the neck of the fibula and can produce foot drop?
- Lower limb · ApplicationWhich muscle group is primarily responsible for extension at the knee?
- Lower limb · ApplicationWhich muscle forms most of the medial border of the femoral triangle?
- Lower limb · ApplicationWhat structure passes through the adductor hiatus to become the popliteal artery?
- Lower limb: femoral triangle · ApplicationWithin the femoral triangle, which structure lies immediately lateral to the femoral artery?
- Lower limb: common fibular nerve · ApplicationA tight plaster cast around the fibular neck causes foot drop. Which movement is most directly lost?
- Lower limb: hip · ApplicationA posterior dislocation of the hip most commonly endangers which nerve?
- Lower limb · ApplicationWhich nerve injury produces loss of foot eversion?
- Lower limb · ApplicationWhich artery lies in the femoral triangle lateral to the femoral vein?
- Lower limb: femoral nerve · ApplicationA pelvic mass compresses the femoral nerve. Which movement is most weakened?
- Lower limb: common fibular nerve · ApplicationA patient develops foot drop after pressure at the neck of the fibula. Which nerve is injured?
- Lower limb: superior gluteal nerve · ApplicationWhen standing on the right leg, a patient's left pelvis drops. Weakness of which muscle on the right is responsible?
- Lower limb: tarsal tunnel · ApplicationCompression posterior to the medial malleolus causes numbness over the sole of the foot. Which nerve is compressed?
Embryology95
- Embryology · ApplicationFrom which embryonic structure does the anterior pituitary (adenohypophysis) develop?
- Embryology: midgut · ApplicationA 2-year-old has painless rectal bleeding. At surgery a small diverticulum is found on the antimesenteric border of the ileum, containing ectopic gastric mucosa. Which…
- Embryology: diaphragm · ApplicationA newborn has respiratory distress, a scaphoid abdomen and bowel sounds in the left chest. Failure of which embryonic structure to close explains this defect?
- Embryology: aortic arch derivatives · ApplicationDuring thyroid or mediastinal surgery, which structure on the left forms a landmark around which the recurrent laryngeal nerve hooks, and derives from the sixth pharyng…
- Embryology: annular pancreas · ApplicationA newborn with Down syndrome has bilious vomiting and a double bubble sign. At surgery, pancreatic tissue encircles the second part of the duodenum. What is the embryol…
- Embryology: conotruncal septation · Multi-stepA newborn has hypocalcaemic seizures, an absent thymic shadow on chest radiograph and a single arterial trunk leaving the heart. Which embryological structures failed t…
- Embryology: tetralogy of Fallot · ApplicationA cyanotic infant has right ventricular outflow obstruction, a ventricular septal defect, an overriding aorta and right ventricular hypertrophy. What is the primary emb…
- Embryology: atrial septation · ApplicationA 35-year-old woman has a stroke, and echocardiography with bubble study shows a small right-to-left shunt at the atrial level with a flap-like valve. What is the embry…
- Embryology: ostium primum defect · ApplicationAn infant with Down syndrome has a murmur, and echocardiography shows an atrial septal defect low in the septum with a cleft anterior mitral leaflet. Which embryonic st…
- Embryology: ventricular septum · ApplicationThe most common congenital cardiac defect in children is a ventricular septal defect, usually located high in the septum. Which part of the septum fails to form?
- Embryology: laterality · ApplicationA 25-year-old man with recurrent sinusitis, bronchiectasis and infertility has dextrocardia on chest radiograph. A defect in which structure best explains the abnormal…
- Embryology: tracheoesophageal fistula · ApplicationA newborn with maternal polyhydramnios chokes, coughs and turns cyanotic on the first feed, and a nasogastric tube coils in the upper chest while the abdomen shows gas.…
- Embryology: pulmonary hypoplasia · ApplicationA newborn with bilateral renal agenesis, low-set ears and flattened facies has severe respiratory failure and small lungs at autopsy. What is the explanation for the lu…
- Embryology: pharyngeal pouches · Multi-stepDuring parathyroidectomy for hyperparathyroidism, a surgeon finds an inferior parathyroid adenoma in the anterior mediastinum within the thymus. Which embryological fac…
- Embryology: branchial cleft cyst · ApplicationA 22-year-old man has a painless cystic swelling at the anterior border of the upper third of sternocleidomastoid that enlarges after an upper respiratory infection. As…
- Embryology: urachus · ApplicationA 2-week-old boy has clear fluid leaking from the umbilicus that increases when he cries, and the fluid has a high creatinine level. Which embryonic structure has faile…
- Embryology: neural tube defects · ApplicationA woman at 16 weeks has a raised maternal serum alpha-fetoprotein, and ultrasound shows absence of the cranial vault with exposed brain tissue. Which developmental even…
- Embryology: somite derivatives · ApplicationA child has selective weakness of the deep intrinsic muscles of the back. Which embryonic division of the myotome forms these muscles, and which ramus of the spinal ner…
- Embryology: placenta accreta · Multi-stepA multiparous woman with previous caesarean sections has a placenta that does not separate after delivery and requires hysterectomy. Histology shows chorionic villi att…
- Embryology: complete hydatidiform mole · ApplicationA woman at 10 weeks has vaginal bleeding, a uterus larger than dates and a snowstorm appearance on ultrasound without a fetus. The villi are diffusely swollen. What is…
- Embryology: twinning · Multi-stepUltrasound of a twin pregnancy shows one placenta with a thin membrane dividing two amniotic sacs and no lambda sign. At what stage did the embryo most likely divide?
- Embryology: Mullerian duct anomalies · ApplicationA 24-year-old woman has a double uterus with two separate cervices and a longitudinal vaginal septum. Which developmental event failed?
- Embryology: horseshoe kidney · ApplicationA 10-year-old girl with Turner syndrome is found to have fused lower poles of both kidneys lying low in the abdomen. Which structure prevents the ascent of the fused ki…
- Embryology: enteric nervous system · Multi-stepA term newborn does not pass meconium for 48 hours and has abdominal distension. Contrast enema shows a narrow rectosigmoid with a dilated proximal colon, and rectal bi…
- Embryology: tetralogy of Fallot · ApplicationA cyanotic infant has a systolic ejection murmur and a boot-shaped heart on radiography. Echocardiography confirms tetralogy of Fallot. Which embryological defect under…
- Embryology: pharyngeal pouches and neural crest · Multi-stepA newborn has hypocalcaemic seizures, persistent truncus arteriosus, a cleft palate and an absent thymic shadow. Which embryological explanation and genetic abnormality…
- Embryology: atrial septation · Multi-stepA child with Down syndrome has an atrial septal defect, left axis deviation on the electrocardiogram and mitral regurgitation caused by a cleft in the anterior mitral l…
- Embryology: neural tube closure · ApplicationA fetus at 20 weeks has an absent cranial vault, with raised maternal serum alpha-fetoprotein and polyhydramnios. Which developmental event failed, and what is the mech…
- Embryology: renal ascent · ApplicationA 25-year-old woman with Turner syndrome (45,X) has recurrent urinary infections. Imaging shows fused lower poles of both kidneys lying low in the abdomen, with the ist…
- Embryology: ureteric duplication · Multi-stepA 5-year-old girl has continuous urinary dribbling despite normal voiding. Ultrasound shows a duplex kidney with a hydronephrotic upper moiety. Where does the upper moi…
- Embryology: 5-alpha reductase deficiency · Multi-stepA 16-year-old raised as a girl has primary amenorrhoea. She is 46,XY with testes in the inguinal canal, a normal testosterone level with a raised testosterone to dihydr…
- Embryology: pancreas divisum · Multi-stepA 32-year-old man has recurrent idiopathic acute pancreatitis. MRCP shows the dorsal duct draining most of the gland through the minor papilla, with a small ventral duc…
- Embryology: face and palate · ApplicationA newborn has a unilateral cleft lip extending into the alveolar ridge, with an intact secondary palate. Failure of fusion of which structures on that side explains the…
- Embryology: enteric nervous system · ApplicationA full-term neonate has not passed meconium for 48 hours and has abdominal distension. A rectal examination is followed by an explosive release of stool and gas. A suct…
- Embryology: heart · ApplicationA 6-year-old has an ejection systolic murmur at the left upper sternal edge and fixed splitting of the second heart sound. Echocardiography shows an ostium secundum atr…
- Embryology: sexual differentiation · Multi-stepAt herniorrhaphy in an infant with male external genitalia, a uterus and fallopian tubes are found in the hernial sac, and the karyotype is 46,XY with normal testes. Wh…
- Embryology: fertilisation and implantation · ApplicationA woman with scarring from previous pelvic inflammatory disease is counselled about her risk of ectopic pregnancy. Where does fertilisation normally occur, and when doe…
- Embryology: germ cell tumours · ApplicationA newborn girl has a large mass projecting from the sacrococcygeal region and a high serum alpha-fetoprotein. Which embryological origin explains this tumour?
- Embryology: heart development · ApplicationA cyanotic newborn has an egg-on-string heart shadow on chest radiograph. Echocardiography shows the aorta arising from the right ventricle and the pulmonary trunk from…
- Embryology: abdominal wall defects · ApplicationA newborn has a midline defect at the umbilicus through which bowel loops protrude, covered by a thin transparent sac of amnion and peritoneum. What is the embryologica…
- Embryology: placental villi · Multi-stepA pathologist examines placental villi from a first-trimester specimen and a term placenta by electron microscopy. In both, which layer forms the outermost covering of…
- Embryology: gubernaculum · ApplicationDuring repair of an inguinal hernia in a girl, the surgeon finds a fibromuscular cord running through the deep inguinal ring to the labium majus. This cord is a remnant…
- Embryology: neural crest · ApplicationA patient with MEN 2B has a medullary thyroid carcinoma, a phaeochromocytoma and mucosal neuromas. Which pair of normal structures both arise from neural crest?
- Embryology: urinary system · Multi-stepA boy has unilateral renal agenesis on ultrasound and is later found to lack the ipsilateral vas deferens. What explains this association?
- Embryology: hypospadias · ApplicationA newborn boy has the urethral meatus opening on the ventral surface of the penile shaft, with a dorsally hooded prepuce and ventral curvature of the penis. What is the…
- Embryology: umbilical cord · ApplicationA mid-trimester anomaly scan shows a two-vessel umbilical cord with one artery and one vein. Which associated findings should the obstetrician look for?
- Embryology · ApplicationA boy has an empty right scrotum and a mass in the inguinal canal, and the testis fails to descend. Which fetal structure normally guides the descent of the testis?
- Embryology · ApplicationA newborn has a small receding jaw, downslanting palpebral fissures, malar hypoplasia and conductive hearing loss. Which embryological structure failed to develop norma…
- Embryology: development of the trigone · ApplicationOn cystoscopy the triangular area at the base of the bladder is smooth, with the mucosa firmly attached to the muscle. From which structure does the mesodermal tissue o…
- Embryology: second arch cartilage · ApplicationWhich structure develops from the cartilage of the second pharyngeal arch (Reichert's cartilage)?
- Embryology: duodenal atresia · ApplicationA newborn with Down syndrome has bilious vomiting on day 1 and a double bubble sign on the abdominal film. Which embryological process has failed?
- Embryology: bladder exstrophy · Multi-stepA newborn has exposed bladder mucosa on the lower abdominal wall, a wide pubic symphysis and epispadias. What is the embryological basis?
- Embryology: Gartner duct cyst · ApplicationA woman has a small cystic swelling in the anterolateral wall of the vagina. Which embryological remnant does it arise from?
- Embryology: cerebellar development · ApplicationThickened dorsolateral margins of the metencephalic alar plates bend over the fourth ventricle and fuse across the midline to form the cerebellar plate. What are these…
- Embryology: retinoid teratogenicity · ApplicationA newborn has anotia, micrognathia, a conotruncal heart defect and a small thymus. The mother took a drug for severe cystic acne during the first trimester. Which drug…
- Embryology: caudal regression · ApplicationA newborn of a mother with poorly controlled pregestational diabetes has sacral agenesis, hypoplastic lower limbs and absent lower lumbosacral vertebrae. What is the di…
- Embryology: gastroschisis · ApplicationA newborn has loops of bowel outside the abdomen through a defect just to the right of a normally inserted umbilical cord. There is no covering sac and the bowel is thi…
- Embryology: intestinal atresia · Multi-stepA newborn has bilious vomiting. Laparotomy shows a blind-ending proximal ileum and a V-shaped mesenteric defect, with no features of Down syndrome. Which mechanism most…
- Embryology: anorectal malformation · ApplicationA newborn boy has no anal opening and passes meconium in the urine. Which embryological error is responsible?
- Embryology: spleen development · ApplicationAn accessory splenic nodule is found in the greater omentum at surgery. From which embryonic tissue does the spleen develop?
- Embryology: stomach rotation · Multi-stepAt vagotomy a surgeon finds that the anterior vagal trunk is derived mainly from the left vagus nerve and the posterior trunk from the right. Which embryological event…
- Embryology: tongue development · ApplicationA patient's posterior third of the tongue loses general sensation and taste after glossopharyngeal nerve injury. From which embryonic structure is the mucosa of this re…
- Embryology: optic cup · ApplicationA child has a keyhole-shaped pupil with a notch in the inferior iris. Failure of closure of which embryonic structure is responsible?
- Embryology: limb patterning · Multi-stepIn a chick embryo, grafting mesenchyme from the posterior margin of one limb bud onto the anterior margin of another produces mirror-image digit duplication. Which sign…
- Embryology: digit separation · ApplicationA newborn has fusion of the skin and soft tissue between the third and fourth fingers. Failure of which process during the seventh and eighth weeks is responsible?
- Embryology: sutures and skull shape · ApplicationAn infant has a long, narrow skull with a prominent forehead and occiput and a palpable ridge along the midline. Early fusion of which suture is responsible?
- Embryology: oogenesis · ApplicationAt the moment of ovulation, at which stage of meiosis is the human oocyte arrested?
- Embryology: trophoblast · ApplicationA urine pregnancy test detects human chorionic gonadotrophin. Which tissue secretes this hormone from the time of implantation?
- Embryology: paramesonephric duct anomalies · Multi-stepA 17-year-old girl has primary amenorrhoea. She has normal breast development, normal pubic and axillary hair, a short blind-ending vagina and a 46,XX karyotype. Ultras…
- Embryology: sex determination · Multi-stepA phenotypic female has primary amenorrhoea, a normal uterus and streak gonads, and a 46,XY karyotype. Which gene is most likely mutated?
- Embryology: aortic arch anomalies · Multi-stepA 40-year-old woman has mild dysphagia. Barium swallow shows an oblique posterior indentation of the oesophagus, and angiography shows the right subclavian artery arisi…
- Embryology: fetal vessels · ApplicationA surgeon laparoscopically identifies a fibrous cord running from the internal iliac artery to the umbilicus, raising the medial umbilical fold on the inner anterior ab…
- Embryology: neural crest disorders · ApplicationA child has a white forelock, irises of different colours and sensorineural deafness. Disturbed development of which embryonic cell population explains these findings?
- Embryology: Pierre Robin sequence · Multi-stepA newborn has a small receding chin and airway obstruction when supine, with a wide U-shaped cleft of the posterior palate. Why does the palate fail to close?
- Embryology: Treacher Collins syndrome · ApplicationA child has downslanting palpebral fissures, malar and mandibular hypoplasia, microtia and conductive deafness, with normal intelligence. The primary defect is in which…
- Embryology: ACE inhibitor fetopathy · ApplicationWhich fetal complication is characteristic of maternal ACE inhibitor use in the second and third trimesters?
- Embryology: warfarin embryopathy · ApplicationA baby born to a mother who took warfarin in the first trimester has nasal hypoplasia and stippled epiphyses on X-ray. Which mechanism explains the bone changes?
- Embryology: diethylstilbestrol exposure · Multi-stepA 19-year-old woman has clear cell adenocarcinoma of the vagina. Her mother received a synthetic oestrogen during pregnancy. Which uterine anomaly is typical in such wo…
- Embryology: spina bifida occulta · ApplicationAn asymptomatic child has a tuft of hair over the lumbosacral region, and X-ray shows a gap in the L5 vertebral arch. Which description fits the defect?
- Embryology: ovotesticular disorder · ApplicationA child with ambiguous genitalia has an ovary on one side and an ovotestis on the other. Which karyotype is most common in this condition?
- Embryology: 21-hydroxylase deficiency and Mullerian ducts · Multi-stepA 46,XX newborn with raised 17-hydroxyprogesterone has an enlarged clitoris and fused labioscrotal folds, but ultrasound shows a uterus and ovaries. Why are the interna…
- Embryology: chordoma · ApplicationA 40-year-old has a destructive midline lesion of the clivus, and biopsy shows physaliferous cells. The tumour arises from remnants of which embryonic structure?
- Embryology: pleuropericardial membranes · ApplicationWhich embryonic structure gives rise to the fibrous pericardium?
- Embryology: velamentous cord insertion · Multi-stepAt rupture of membranes a woman has painless vaginal bleeding and fetal bradycardia, and the blood is of fetal origin. Vessels were seen crossing the membranes over the…
- Embryology: amniotic band syndrome · ApplicationA newborn has a constriction ring around one leg with distal oedema, asymmetrical digit amputations and craniofacial clefts that do not follow embryonic fusion lines. W…
- Embryology: posterior urethral valves · ApplicationA male newborn has a palpable bladder, a poor urinary stream and bilateral hydronephrosis. Ultrasound shows a thick-walled bladder. The obstructing valves lie in which…
- Embryology: vertebral column development · ApplicationDuring development of the vertebral column, each vertebral body is formed from which parts of the sclerotomes?
- Embryology · ApplicationWhich germ layer gives rise to the epidermis and nervous system?
- Embryology · ApplicationWhat fetal vessel bypasses most hepatic circulation by connecting umbilical vein to inferior vena cava?
- Embryology: pharyngeal arches · ApplicationWhich muscle is derived from the first pharyngeal arch?
- Embryology: gut rotation · ApplicationFailure of the embryonic midgut to return to the abdominal cavity results in bowel herniation covered by a membrane at the umbilicus. What is this defect?
- Embryology: neural tube · ApplicationFailure of closure of the caudal neuropore most directly produces which defect?
- Embryology · ApplicationWhat embryological structure forms the adult ligamentum arteriosum?
- Embryology · ApplicationWhich embryological structure becomes the fossa ovalis after birth?
- Embryology: neural tube · ApplicationFailure of closure of the caudal neuropore most directly causes which defect?
Head and neck80
- Head and neck: facial nerve branches · ApplicationAfter middle ear surgery a patient loses taste over the anterior two-thirds of the tongue on one side and has reduced salivation from the submandibular gland. Which ner…
- Head and neck: thyroid surgery · ApplicationAfter total thyroidectomy a singer reports loss of high-pitched notes and easy voice fatigue, with a normal-sounding speaking voice and normal cords on laryngoscopy. Wh…
- Head and neck: posterior triangle · ApplicationA 30-year-old man has a lymph node biopsy from the posterior triangle of the neck. Afterwards he cannot shrug the right shoulder and the scapula looks slightly drooped.…
- Head and neck: cavernous sinus thrombosis · ApplicationA 19-year-old squeezes a pustule on the upper lip near the nose. Three days later he has fever, severe headache, proptosis, chemosis and a painful ophthalmoplegia. Whic…
- Head and neck: Ludwig angina · Multi-stepA 52-year-old diabetic man with a decayed mandibular third molar has bilateral submandibular swelling, an elevated tongue, trismus and noisy breathing. Which anatomical…
- Head and neck: facial nerve · Multi-stepA 35-year-old man has lower motor neuron facial palsy, hyperacusis and loss of taste over the anterior two-thirds of the tongue, but normal tear production. Where is th…
- Head and neck: middle ear · ApplicationIn a patient with facial palsy, the ipsilateral acoustic (stapedial) reflex is absent on impedance audiometry. Which nerve carries the efferent limb of this reflex?
- Head and neck: pharyngeal arches · ApplicationA patient has an injury to the mandibular nerve in the infratemporal fossa. Which of the following muscles, derived from the first pharyngeal arch, would be affected al…
- Head and neck: facial nerve branches · ApplicationAfter superficial parotidectomy for a pleomorphic adenoma, a woman cannot wrinkle her right forehead or raise the right eyebrow. The rest of her face moves normally. Wh…
- Head and neck: submandibular duct · ApplicationA surgeon plans transoral removal of a stone from the distal submandibular (Wharton) duct and takes care not to injure the nerve that loops under the duct from lateral…
- Head and neck: carotid sheath · ApplicationA surgeon performing carotid endarterectomy opens the carotid sheath along the anterior border of sternocleidomastoid. Which relationship of the vagus nerve is correct…
- Head and neck: extraocular muscles · ApplicationA man has a complete right oculomotor nerve palsy from a posterior communicating artery aneurysm. Which extraocular muscles of the right eye still function?
- Head and neck: subclavian artery · ApplicationA surgeon exposes the first part of the right subclavian artery, medial to scalenus anterior. Which branches arise from this part?
- Head and neck · ApplicationA 2-year-old with stridor after a long period of intubation is found to have subglottic narrowing. Why is this the narrowest part of the child's airway?
- Head and neck · ApplicationA child has recurrent bleeding from the front of the nasal septum. Which arterial anastomosis in the anterior septum is the likely source?
- Head and neck · ApplicationA man has pain and swelling below the jaw during meals, and a stone is palpated beside the frenulum. Why does the gland commonly form stones?
- Head and neck · ApplicationA woman yawning widely is unable to close her mouth, and a hollow is felt in front of the tragus. How is the dislocation reduced?
- Head and neck · ApplicationA child with recurrent ear infections and mouth breathing is found to have a mass of lymphoid tissue in the roof of the nasopharynx. To which collection does this belong?
- Head and neck: nerve of the pterygoid canal · Multi-stepA skull base tumour in the pterygopalatine fossa gives dry eye and dry nasal mucosa. Parasympathetic secretomotor fibres reach the pterygopalatine ganglion through whic…
- Head and neck: lingula of the mandible · ApplicationA dentist injects local anaesthetic near the mandibular foramen to block the inferior alveolar nerve. The bony lingula that guards this foramen gives attachment to whic…
- Head and neck: annulus of Zinn · Multi-stepIn a patient with an orbital apex mass, which structure normally passes through the superior orbital fissure outside the common tendinous ring?
- Head and neck: atlas fracture · Multi-stepA diver strikes the pool floor head first. A lateral cervical film shows a ring fracture with the lateral masses displaced outward. Which vertebra is fractured and whic…
- Head and neck: trigeminal ganglion · ApplicationA neurosurgeon performs percutaneous radiofrequency rhizotomy of the trigeminal ganglion in Meckel's cave for neuralgia. The ganglion contains cell bodies of which neur…
- Head and neck: corneal reflex pathway · Multi-stepTouching the left cornea with cotton wool produces no blink in either eye, but touching the right cornea makes both eyes blink. Where is the lesion?
- Head and neck: congenital torticollis · Multi-stepA 6-week-old infant has the head tilted to the right and the chin rotated to the left, with a firm non-tender lump in the right neck. Which muscle is involved?
- Head and neck: buccal nerve · Multi-stepA dentist extracts a lower third molar after a successful inferior alveolar nerve block. The buccal gingiva remains sensitive, so a further injection is needed. Which n…
- Head and neck: lateral pterygoid muscle · Multi-stepA patient has an isolated weakness of one muscle of mastication. When she opens her mouth wide, her jaw deviates to the right. Which muscle is weak?
- Head and neck: soft palate palsy · Multi-stepWhen a patient says 'ah', the uvula deviates to the left and the right side of the soft palate fails to rise. A lesion of which nerve is responsible?
- Head and neck: pharyngeal tonsil · ApplicationA 5-year-old child snores, breathes through the mouth and has recurrent otitis media with effusion. The enlarged lymphoid tissue blocking the nasopharynx is the pharyng…
- Head and neck: nasopalatine nerve · ApplicationA dentist plans extraction of the upper central incisors. To anaesthetise the palatal mucosa behind them, the needle is placed in the incisive papilla. Which nerve is b…
- Head and neck: eyelid glands · ApplicationA 30-year-old woman has a firm, painless nodule in the upper eyelid that has persisted for weeks, with the lid margin normal. Obstruction of which glands is responsible?
- Head and neck: stellate ganglion block · ApplicationA physician performs a stellate ganglion block for a painful arm and the patient develops sudden breathlessness and a collapsed lung. Which relation of the ganglion exp…
- Head and neck: gaps in the pharyngeal wall · Multi-stepWhich of the following structures passes through the gap between the base of the skull and the upper border of the superior constrictor muscle?
- Head and neck: thyroid veins · Multi-stepDuring thyroidectomy the surgeon must ligate a short, wide, thin-walled vein, with no accompanying artery, to rotate the lobe medially. This vein drains directly into w…
- Head and neck: C1 fibres in the strap muscles · Multi-stepA surgeon dissecting the anterior triangle sees C1 fibres running with the hypoglossal nerve. Which infrahyoid muscle receives its supply directly from these fibres rat…
- Head and neck: nerve to mylohyoid · ApplicationA lesion of a branch of the inferior alveolar nerve that arises just before the mandibular foramen leads to weakness of two muscles in the floor of the mouth region. Wh…
- Head and neck: superficial cervical plexus · ApplicationAn anaesthetist infiltrates local anaesthetic at the midpoint of the posterior border of sternocleidomastoid to block the superficial cervical plexus. Which set of nerv…
- Head and neck: great auricular nerve · ApplicationAfter parotidectomy a man has numbness over the lobule of the ear and the skin over the angle of the mandible, and the facial muscles work normally. Which nerve was div…
- Head and neck: hangman fracture · ApplicationA lateral cervical radiograph after a high-speed deceleration injury shows forward slip of C2 on C3 with fractures through both pars interarticularis of the axis. Which…
- Head and neck: Le Fort fractures · Multi-stepAfter a road accident, a patient's upper teeth and hard palate move as a single unit independent of the rest of the face. The nasal bridge and orbital margins are stabl…
- Head and neck: central retinal artery · Multi-stepA 65-year-old man suddenly loses vision in one eye without pain. The fundus shows a pale retina with a cherry-red macula. The artery responsible for the inner retinal b…
- Head and neck: subclavian steal · Multi-stepA man has dizziness and left arm weakness during exercise, and the left brachial blood pressure is lower than the right. Imaging shows stenosis of the left subclavian a…
- Head and neck: parotid secretomotor pathway · Multi-stepA tumour of the middle ear damages the nerve that carries the preganglionic secretomotor fibres for the parotid gland. Which sequence correctly traces these fibres to t…
- Head and neck: lacrimal sac and medial palpebral ligament · ApplicationA baby has a red tender swelling at the medial canthus caused by infection of the lacrimal sac. A surgeon uses a ligament that crosses in front of the sac as a landmark…
- Head and neck: maxillary sinus and teeth · ApplicationAfter extraction of an upper first molar, fluid taken in through the mouth escapes through the nose and a probe passes freely into the sinus. Which anatomical relations…
- Head and neck: epiglottic vallecula · ApplicationDuring direct laryngoscopy with a curved blade, the anaesthetist places the tip in a mucosal recess between the base of the tongue and the epiglottis and lifts, which i…
- Head and neck: sphenoethmoidal recess · ApplicationA patient with chronic sinusitis has pus seen high in the nasal cavity, above the superior concha, in the recess between the concha and the sphenoid. Which sinus drains…
- Head and neck: ciliary ganglion · ApplicationA young woman has a unilaterally dilated pupil that reacts very slowly to near and almost not to light, with absent knee jerks. Damage to which parasympathetic relay in…
- Head and neck: fibres passing through the ciliary ganglion · Multi-stepFibres of three types pass through the ciliary ganglion, but only one type synapses in it. Which fibres traverse it without synapsing?
- Head and neck: spread of dental infection to the cavernous sinus · Multi-stepA man with an infected upper molar develops swelling in the face, then proptosis and ophthalmoplegia. Through which route did infection most likely reach the cavernous…
- Head and neck: pretracheal fascia · ApplicationA thyroid swelling moves upward when the patient swallows. Which fascial layer, which also attaches to the larynx and trachea, explains this movement?
- Head and neck: thyroidea ima artery · ApplicationDuring an emergency low tracheostomy, unexpected brisk bleeding comes from a small midline vessel ascending in front of the trachea toward the isthmus. Which artery is…
- Head and neck: cribriform plate fracture · ApplicationAfter a head injury, a man has loss of smell and a clear watery nasal discharge that leaves a halo on a handkerchief. Which part of the skull base is most likely fractu…
- Head and neck: innervation of the lacrimal gland · Multi-stepParasympathetic secretomotor fibres from the pterygopalatine ganglion reach the lacrimal gland by joining which nerve, before entering the lacrimal nerve?
- Head and neck: alar ligaments · ApplicationWhich pair of ligaments passes from the sides of the dens to the medial surfaces of the occipital condyles and limits excessive rotation of the head?
- Head and neck: paratonsillar vein · ApplicationA child has brisk haemorrhage after tonsillectomy, from a vein descending from the soft palate and crossing the lateral wall of the tonsillar fossa. Which vein is this?
- Head and neck: vertebral artery in the suboccipital triangle · Multi-stepA young woman develops vertigo, ataxia and visual disturbance soon after vigorous neck rotation. Which part of the vertebral artery, lying in a groove on the posterior…
- Head and neck: relations of scalenus anterior · ApplicationIn the root of the neck, which structure passes anterior to scalenus anterior as it crosses the first rib?
- Head and neck · ApplicationWhat cranial nerve supplies muscles of facial expression?
- Head and neck · ApplicationWhich cranial nerve carries visual information?
- Head and neck · ApplicationWhat is the largest salivary gland?
- Head and neck · ApplicationWhich cranial nerve controls the lateral rectus muscle?
- Head and neck · ApplicationWhich cranial nerve carries facial sensation?
- Head and neck · ApplicationWhat bone forms the lower jaw?
- Head and neck · ApplicationWhich artery is palpated in front of the ear?
- Head and neck · ApplicationWhich cranial nerve elevates the shoulder through trapezius?
- Head and neck · ApplicationWhich cranial nerve supplies facial-expression muscles?
- Head and neck · ApplicationWhich bone contains the hypophyseal fossa for the pituitary gland?
- Head and neck · ApplicationWhat is the largest major salivary gland?
- Head and neck · ApplicationWhich salivary gland drains through Stensen duct opposite the upper second molar?
- Head and neck · ApplicationWhich cranial nerve carries motor fibres to muscles of facial expression?
- Head and neck · ApplicationWhich structure traverses the cavernous sinus alongside the internal carotid artery?
- Head and neck: facial nerve · ApplicationA parotidectomy patient cannot close the right eye tightly but has preserved facial sensation. Which cranial nerve branch is affected?
- Head and neck: cavernous sinus · Multi-stepA cavernous sinus lesion causes impaired abduction of one eye. Which cranial nerve is affected?
- Head and neck: pituitary · ApplicationA pituitary macroadenoma produces bitemporal hemianopia by compressing which structure?
- Head and neck · ApplicationWhich artery is palpated at the anterior border of masseter near the lower mandible?
- Head and neck · ApplicationWhich cranial nerve carries taste from the posterior one third of tongue?
- Head and neck: cavernous sinus · ApplicationWhich cranial nerve lies within the cavernous sinus alongside the internal carotid artery?
- Head and neck: parotid gland · ApplicationWhich structure passes through the parotid gland but does not innervate it?
- Head and neck: facial nerve · ApplicationA lesion of the facial nerve before it gives off the chorda tympani can impair taste from which area?
Thorax77
- Thorax: thoracic duct · Multi-stepA 55-year-old man develops a milky pleural effusion with a triglyceride level of 420 mg/dL on the fifth day after transthoracic oesophagectomy. The thoracic duct was in…
- Thorax: pericardial sinuses · ApplicationDuring cardiac surgery the surgeon passes a finger behind the aorta and pulmonary trunk to place a clamp or tape around both great arteries together. Through which peri…
- Thorax: pericardiocentesis · ApplicationA 30-year-old man with a stab wound to the chest has hypotension, raised jugular venous pressure and muffled heart sounds. Emergency pericardiocentesis is performed by…
- Thorax: coronary dominance · ApplicationA 62-year-old man has chest pain with ST elevation in leads II, III and aVF. Coronary angiography shows occlusion of the artery that gives off the posterior interventri…
- Thorax: right ventricle · ApplicationA surgeon repairing a ventricular septal defect notes a muscular bridge crossing from the interventricular septum to the base of the anterior papillary muscle of the ri…
- Thorax: right atrium and ablation · Multi-stepA patient with typical atrial flutter undergoes catheter ablation of a narrow strip of tissue that forms the slow-conduction limb of the re-entry circuit. Which pair of…
- Thorax: surface anatomy of valves · ApplicationA murmur of aortic stenosis radiates to the neck and is loudest at the aortic auscultatory area. Where is this area located?
- Thorax: left atrium relations · Multi-stepA 40-year-old woman with long-standing rheumatic mitral stenosis has a hoarse voice and mild dysphagia. A barium swallow shows indentation of the oesophagus. Which anat…
- Thorax: bronchopulmonary segments · ApplicationA 7-year-old child who was sitting upright while eating peanuts inhales one and later develops pneumonia confined to the right lower lobe. Into which segment is the for…
- Thorax: costodiaphragmatic recess · ApplicationA 45-year-old man with early pleural effusion has blunting of the costophrenic angle on a standing chest radiograph. Why is fluid seen first in this location?
- Thorax: breast anatomy · ApplicationA 52-year-old woman has a firm lump in the upper outer quadrant of the breast with skin dimpling and nipple retraction. Which anatomical structures shortened by the tum…
- Thorax: oesophagus constrictions · ApplicationA child swallows a coin and it lodges in the oesophagus about 25 cm from the incisor teeth. Which adjacent structures cause the constriction at this level?
- Thorax: sternal angle · ApplicationA clinician palpates the sternal angle (angle of Louis) to count intercostal spaces on a patient. Which structure lies in the same transverse plane internally?
- Thorax: mediastinum · ApplicationA 35-year-old woman has ptosis and fatigable weakness, and CT shows a mass in the anterior mediastinum in front of the great vessels. Which normal structure resides in…
- Thorax: conduction system · Multi-stepDuring catheter ablation for an atrioventricular nodal re-entry tachycardia, the operator targets the slow pathway low in the right atrium while avoiding the compact no…
- Thorax: papillary muscles · Multi-stepA 66-year-old man develops acute severe mitral regurgitation 4 days after an inferior myocardial infarction. Echocardiography shows rupture of a papillary muscle. Why i…
- Thorax: collateral circulation in coarctation · Multi-stepA 14-year-old boy with hypertension in the arms and weak femoral pulses has notching of the inferior borders of the ribs on a chest radiograph. Which collateral route c…
- Thorax: cervical rib · ApplicationA 28-year-old woman has weakness and numbness along the medial forearm and hand, and a diminished radial pulse on abduction of the arm. A radiograph shows a rib arising…
- Thorax: tracheobronchial tree · ApplicationA 2-year-old child suddenly chokes while eating peanuts and develops a unilateral wheeze. At bronchoscopy the foreign body is most likely to be found in which structure…
- Thorax: bronchopulmonary segments · Multi-stepA surgeon plans a segmentectomy for a small lesion confined to one bronchopulmonary segment and wants to separate it from its neighbours along a natural plane. Which st…
- Thorax: conduction system · Multi-stepA surgeon closes a perimembranous ventricular septal defect through the right atrium. After surgery the patient develops complete heart block. Which conduction structur…
- Thorax: breast lymphatics · ApplicationA 40-year-old woman has a 2 cm carcinoma in the upper inner quadrant of the breast, and the axillary nodes are clinically negative. Which additional nodal group is at p…
- Thorax: lungs and segments · ApplicationA 7-year-old child with pneumonia has a chest radiograph in which the left heart border is obliterated, while the left hemidiaphragm outline is still sharp. Which part…
- Thorax: lymphatic drainage of the lung · ApplicationA patient with bronchogenic carcinoma has enlarged tracheobronchial (carinal) nodes on CT. Which vessel normally carries lymph from these nodes onward on each side?
- Thorax: coronary arteries · Multi-stepA 62-year-old man has an acute anterior myocardial infarction. The next day ECG shows new right bundle branch block with left anterior fascicular block. Which vessel is…
- Thorax: azygos system · ApplicationA 35-year-old man with inferior vena cava thrombosis has dilated veins that drain upward over the flanks and back. Which deep pathway provides collateral return of lowe…
- Thorax · ApplicationA middle-aged man with heartburn has an endoscopy showing the gastro-oesophageal junction above the diaphragm and a barium swallow showing it moving up and down with re…
- Thorax · ApplicationAt open heart surgery, the right atrial wall shows a smooth posterior part and a rough anterior part separated by a vertical ridge. What is this ridge?
- Thorax: suprapleural membrane · ApplicationA thickening of the endothoracic fascia extends from the transverse process of C7 to the inner border of the first rib and covers the cervical pleura. What is its funct…
- Thorax: eparterial bronchus · ApplicationOn a CT of the right hilum, the upper lobe bronchus arises above the level of the right pulmonary artery, whereas on the left the artery arches over the main bronchus.…
- Thorax: first rib relations · ApplicationOn the superior surface of the first rib, the scalene tubercle gives attachment to scalenus anterior. Which structure lies in the groove immediately behind the tubercle?
- Thorax: persistent left superior vena cava · Multi-stepA cardiac catheter passed through the left subclavian vein in a young man enters a vessel that descends in front of the left lung root and ends in the posterior atriove…
- Thorax: internal thoracic artery · ApplicationA cardiac surgeon harvests the left internal thoracic artery as a pedicle graft. Behind the costal cartilages it descends about a centimetre from the sternal edge. Into…
- Thorax: cardiac pain pathway · Multi-stepA 58-year-old man with acute myocardial ischaemia feels pain in the chest and along the inner side of the left arm, although the heart itself has no somatic sensory sup…
- Thorax: inferior pulmonary ligament · ApplicationDuring a right lower lobectomy, a thin sheet of tissue hanging below the root of the lung is divided before the lobe can be mobilised. This structure is best described…
- Thorax: aortic sinuses · ApplicationDuring coronary angiography the operator engages the coronary ostia just above the aortic valve. Which of the aortic sinuses does not give origin to a coronary artery?
- Thorax: sensory supply of the pericardium · Multi-stepA 30-year-old man has sharp chest pain that eases on leaning forward and is felt at the tip of the left shoulder. A friction rub is heard. Which nerve carries the pain…
- Thorax: breast areolar glands · ApplicationDuring pregnancy a woman notices small raised nodules scattered around her areola. What are these structures?
- Thorax: autonomic effect on the lungs · ApplicationThe pulmonary plexus at the lung root receives fibres from the vagus nerves and the upper thoracic sympathetic trunk. What is the effect of vagal stimulation on the bro…
- Thorax: left heart border in mitral stenosis · Multi-stepIn long-standing mitral stenosis, a postero-anterior chest film shows straightening of the left heart border between the pulmonary trunk and the left ventricle. Which s…
- Thorax: foramen of Morgagni · ApplicationA 55-year-old obese woman has a smooth opacity in the right cardiophrenic angle on a chest film. CT shows omental fat herniating into the chest through a defect just be…
- Thorax: middle cardiac vein · ApplicationIn a right-dominant heart, a cardiac vein runs in the posterior interventricular groove beside the posterior descending artery and ends in the right part of the coronar…
- Thorax: bronchial arteries · ApplicationA man with long-standing bronchiectasis has life-threatening haemoptysis and is sent for angiographic embolisation. Which vessels are usually the source of the bleeding?
- Thorax: superior intercostal artery · ApplicationThe supreme (highest) intercostal artery supplies the first two posterior intercostal spaces. From which trunk of the subclavian artery does it arise?
- Thorax: lymphatic drainage of the oesophagus · ApplicationStaging of an adenocarcinoma in the lower third of the thoracic oesophagus is most likely to show first-station nodal spread to which group?
- Thorax: venous drainage of the thymus · ApplicationDuring thymectomy through a median sternotomy for myasthenia gravis, a surgeon ligates the thymic veins as they leave the gland. Which vessel do they chiefly enter?
- Thorax: aberrant right subclavian artery · Multi-stepA 45-year-old woman has long-standing difficulty swallowing solids. A barium swallow shows an oblique indentation of the posterior oesophageal wall at about T3-T4, runn…
- Thorax: aspiration in the supine position · ApplicationA bedridden elderly man, nursed flat on his back, aspirates gastric contents during a seizure. Which lung segment is the most likely to collect the aspirated material?
- Thorax: mitral valve and aortic valve continuity · ApplicationOn echocardiography, the anterior leaflet of the mitral valve is seen to lie in fibrous continuity with another valve. This places the leaflet between the left ventricu…
- Thorax: Eustachian valve in the fetal heart · ApplicationIn the fetal right atrium, a crescentic fold at the lower margin of the caval opening helps to direct oxygen-rich blood across the foramen ovale. What is this fold call…
- Thorax: oblique pericardial sinus · ApplicationA surgeon lifts the apex of the heart upward and passes a hand behind it, entering a blind-ended pericardial recess that lies behind the left atrium between the pulmona…
- Thorax · ApplicationWhich nerve passes posterior to root of lung?
- Thorax · ApplicationWhich chamber pumps blood to lungs?
- Thorax · ApplicationWhich vessel returns oxygenated blood from lungs?
- Thorax · ApplicationWhat is the main motor nerve to the diaphragm?
- Thorax · ApplicationWhich cardiac chamber forms most of the base (posterior surface) of the heart and receives the pulmonary veins?
- Thorax · ApplicationWhich vessel carries oxygenated blood from lungs to the heart?
- Thorax · ApplicationWhich lung has three anatomical lobes?
- Thorax · ApplicationWhat structure lies between the lungs in the thoracic cavity?
- Thorax · ApplicationWhich valve is best auscultated at the cardiac apex in the left fifth intercostal space?
- Thorax · ApplicationOn a normal chest specimen, which lung contains a horizontal fissure in addition to an oblique fissure?
- Thorax · ApplicationOn axial thoracic imaging, which central compartment contains the heart, trachea, and esophagus between the pleural cavities?
- Thorax · ApplicationDuring ventricular systole, which left-sided atrioventricular valve prevents regurgitation into the atrium?
- Thorax · ApplicationWhich lung lobe contains the lingula?
- Thorax · ApplicationWhat vessel arches over the root of the right lung?
- Thorax · ApplicationWhich valve lies between the left ventricle and ascending aorta?
- Thorax · ApplicationWhich vessel carries oxygenated blood from lungs to heart?
- Thorax · ApplicationWhich nerve provides the main motor supply to the diaphragm?
- Thorax · ApplicationWhich nerve provides motor supply to the diaphragm?
- Thorax · ApplicationWhere is the cardiac apex normally auscultated most clearly?
- Thorax: phrenic nerve · ApplicationA mediastinal mass produces paralysis of one hemidiaphragm. Which spinal cord segments supply the affected phrenic nerve?
- Thorax: recurrent laryngeal nerve · ApplicationA left hilar tumour causes hoarseness by compressing a nerve that loops under which vessel?
- Thorax · ApplicationWhich structure passes through the diaphragm at T10?
- Thorax · ApplicationWhich pleural recess is used for thoracocentesis of a pleural effusion?
- Thorax: recurrent laryngeal nerve · ApplicationWhy is the left recurrent laryngeal nerve vulnerable to pathology in the aortopulmonary window?
- Thorax: coronary circulation · ApplicationWhich coronary artery most commonly supplies the anterior interventricular septum and anterior wall of the left ventricle?
- Thorax: pleura · ApplicationWhich pleural layer is most sensitive to pain from pleurisy?
Medical genetics51
- Medical genetics: chromosomal abnormalities · ApplicationA newborn has midline facial clefting, scalp cutis aplasia and postaxial polydactyly. MRI shows a single fused cerebral ventricle, and karyotype shows trisomy 13. What…
- Medical genetics: mosaicism · ApplicationA boy has mild features of Down syndrome with near-normal intelligence. Karyotype shows 47,+21 in 30% of lymphocytes and 46 in the rest. What is the mechanism?
- Medical genetics: prenatal diagnosis · ApplicationA 38-year-old woman at 11 weeks of gestation has a nuchal translucency of 4 mm and wishes the earliest diagnostic karyotype. Which procedure is most appropriate?
- Medical genetics: pedigree · ApplicationA disorder is seen in three generations of a family. An affected man has both an affected son and an affected daughter, and the disorder appears in every generation. Wh…
- Medical genetics: uniparental disomy · Multi-stepA child has cystic fibrosis. Only the mother is a carrier, the father is not, and paternity is confirmed. Genotyping shows the child is homozygous for the mother's muta…
- Medical genetics: Turner syndrome · ApplicationA newborn girl with 45,X karyotype has puffy swelling over the dorsum of the hands and feet and redundant skin at the back of the neck. What is the cause of these featu…
- Medical genetics: Edwards syndrome · ApplicationA newborn is small for gestational age with a prominent occiput, micrognathia and low-set ears. Both hands are clenched, with the index finger overlapping the third and…
- Medical genetics: trinucleotide repeat disorders · Multi-stepA boy develops chorea and cognitive decline at age 12. His father developed similar symptoms at age 45, and the boy has 70 CAG repeats in HTT whereas his father has 45.…
- Medical genetics · ApplicationAn infant with a high-pitched cat-like cry, microcephaly and hypotonia has a chromosomal abnormality. Which deletion is responsible?
- Medical genetics: germline mosaicism · Multi-stepTwo healthy parents have had two children with severe autosomal dominant osteogenesis imperfecta. Neither parent carries the mutation in blood DNA. What is the most lik…
- Medical genetics: Williams syndrome · ApplicationA child has an elfin face, a very sociable personality, supravalvular aortic stenosis and hypercalcaemia. Which cytogenetic abnormality is responsible?
- Medical genetics: Noonan syndrome · Multi-stepA 9-year-old boy has webbed neck, short stature, pectus excavatum and pulmonary valve stenosis. His karyotype is 46,XY. Which description fits this condition?
- Medical genetics: founder effect · ApplicationA rare autosomal recessive disease is unusually common in an isolated village founded by a few families, one of whom carried the allele. What is the mechanism?
- Medical genetics: isochromosome · Multi-stepA girl with short stature and features of Turner syndrome has the karyotype 46,X,i(Xq). What is the structural change?
- Medical genetics: X-linked dominant inheritance · ApplicationIn a family with hypophosphataemic rickets, an affected man has affected daughters but all of his sons are unaffected. Affected women pass the disorder to half of their…
- Medical genetics: anticipation · ApplicationA woman has mild myotonia and early cataracts. Her daughter has severe hypotonia and respiratory difficulty at birth, and the CTG repeat in the causative gene is much l…
- Medical genetics: two-hit hypothesis · Multi-stepChildren who inherit one mutant RB1 allele usually develop multiple bilateral retinoblastomas, whereas sporadic cases usually have a single unilateral tumour. What expl…
- Medical genetics: variable expressivity · ApplicationA mother with neurofibromatosis type 1 has only a few cafe-au-lait spots and axillary freckling. Her son, with the same mutation, has numerous neurofibromas and an opti…
- Medical genetics: androgen insensitivity · ApplicationA phenotypic female has primary amenorrhoea with normal breast development, scant pubic and axillary hair, a blind-ending vagina and testes in the inguinal canals. Her…
- Medical genetics: origin of nondisjunction · ApplicationIn most cases of trisomy 21 with a standard 47,XX,+21 karyotype, in which parent and at which stage did the error occur?
- Medical genetics: triploidy · Multi-stepA woman at 11 weeks has vaginal bleeding. Ultrasound shows a thickened placenta with cystic spaces and an abnormal fetus. Tissue karyotyping shows 69,XXY. How did this…
- Medical genetics: cystic fibrosis mutation · ApplicationA newborn passes no meconium, has abdominal distension and a raised sweat chloride. The most common causative mutation lies on chromosome 7. What is its molecular nature?
- Medical genetics: imprinting overgrowth syndrome · Multi-stepA newborn has macroglossia, an omphalocele, neonatal hypoglycaemia and asymmetric overgrowth of one limb. Which tumours need surveillance by regular abdominal ultrasoun…
- Medical genetics: achondroplasia · ApplicationA short-limbed child with a large head and a trident hand is born to parents of average height. Which statement best explains the cause?
- Medical genetics: Philadelphia translocation · ApplicationA 45-year-old man has marked leucocytosis with all stages of granulocyte maturation and splenomegaly. Cytogenetics shows a translocation between chromosomes 9 and 22. W…
- Medical genetics: recombination · ApplicationGenetic recombination between homologous chromosomes depends on crossing over. During which phase of meiosis does crossing over take place?
- Medical genetics: Friedreich ataxia · Multi-stepA 14-year-old boy has progressive gait ataxia, scoliosis, pes cavus, loss of vibration and joint position sense, absent ankle jerks and hypertrophic cardiomyopathy. His…
- Medical genetics: spinal muscular atrophy · Multi-stepA 6-month-old infant is floppy with tongue fasciculations, areflexia and a bell-shaped chest, but is alert with normal sensation. Which neurons are lost and which gene…
- Medical genetics: cleidocranial dysplasia · ApplicationA child can bring both shoulders together at the midline and has absent clavicles, wide open fontanelles and delayed tooth eruption. Which gene, encoding an osteoblast…
- Medical genetics: Holt-Oram syndrome · ApplicationA newborn has hypoplastic thumbs with absent radii and an atrial septal defect with first-degree atrioventricular block. The father has similar upper limb anomalies. Wh…
- Medical genetics: dominant negative effect · Multi-stepA baby with a glycine substitution in a COL1A1 chain has multiple fractures at birth, blue sclerae and a severe phenotype, while a parent with a null COL1A1 allele has…
- Medical genetics: Prader-Willi syndrome · Multi-stepAn infant with severe hypotonia and poor feeding later develops hyperphagia, obesity, hypogonadism and learning difficulty. What is the most common genetic mechanism?
- Medical genetics: Duchenne and Becker muscular dystrophy · Multi-stepDuchenne and Becker muscular dystrophy both arise from deletions in the dystrophin gene on Xp21, yet Duchenne is much more severe. What explains the difference?
- Medical genetics: mitochondrial inheritance · ApplicationA young man has sudden painless central visual loss in one eye. In his family, affected women transmit the disease to children of both sexes, but affected men never do.…
- Medical genetics: Klinefelter syndrome diagnosis · Multi-stepA tall 24-year-old man with infertility has gynaecomastia, small firm testes and azoospermia. FSH and LH are raised and testosterone is low. Which test confirms the cau…
- Medical genetics: chromosomal microarray · Multi-stepWhich abnormality would a chromosomal microarray fail to detect?
- Medical genetics: tuberous sclerosis · ApplicationAn infant has infantile spasms, hypopigmented ash-leaf macules and multiple echogenic cardiac masses. Which genes are mutated in this condition?
- Medical genetics: von Hippel-Lindau disease · ApplicationA man has a retinal haemangioblastoma, a cerebellar haemangioblastoma and a clear cell renal carcinoma, and his father had similar tumours. On which chromosome is the r…
- Medical genetics: familial adenomatous polyposis · ApplicationA 17-year-old has hundreds of adenomatous colonic polyps and a family history of colorectal cancer in his father. Which gene is mutated?
- Medical genetics: Lynch syndrome · ApplicationA 40-year-old woman has right-sided colon cancer, and her mother had endometrial cancer. The tumour shows microsatellite instability. Which DNA repair process is defect…
- Medical genetics: BRCA and PARP inhibition · Multi-stepA woman with BRCA1-mutated ovarian cancer responds to a PARP inhibitor. Why does the drug kill tumour cells but spare normal cells?
- Medical genetics: locus heterogeneity · ApplicationRetinitis pigmentosa can be autosomal dominant, autosomal recessive or X-linked, and mutations in many different genes produce the same clinical picture. Which term des…
- Medical genetics: quadruple test · ApplicationAt 16 weeks, maternal serum screening shows low alpha-fetoprotein, low unconjugated oestriol, high hCG and high inhibin A. Which fetal condition does this pattern sugge…
- Medical genetics: cell-free DNA screening · Multi-stepA pregnant woman at 12 weeks has a high-risk result for trisomy 21 on cell-free DNA testing. What is the best next step?
- Medical genetics: balanced translocation carrier · ApplicationA couple has had three first-trimester miscarriages. The husband is phenotypically normal, and his karyotype shows 46,XY,t(4;11), a balanced reciprocal translocation. W…
- Medical genetics: Fanconi anaemia · ApplicationA 6-year-old with short stature, absent radii, cafe-au-lait spots and pancytopenia is suspected of an inherited marrow failure. Which test confirms the diagnosis?
- Medical genetics: xeroderma pigmentosum · ApplicationA child has severe sunburn after minimal exposure, freckling of the face and several skin cancers by age 5. Which DNA repair process is deficient?
- Medical genetics: Rett syndrome · ApplicationA girl develops normally until 12 months and then loses purposeful hand use, develops hand-wringing movements, seizures and deceleration of head growth. Which gene is m…
- Medical genetics: Down syndrome and Alzheimer disease · ApplicationAdults with Down syndrome develop Alzheimer-type dementia early. Which gene on chromosome 21 contributes through its extra dosage?
- Medical genetics: autosomal dominant polycystic kidney disease · ApplicationA 40-year-old has bilateral flank masses, hypertension and haematuria, and his mother died of a subarachnoid haemorrhage. Which gene is most often mutated in this condi…
- Medical genetics: pedigree analysis · ApplicationIn a pedigree, an affected father has an affected son. Which mode of inheritance is excluded by this finding?
Abdomen46
- Abdomen: peritoneal relations · ApplicationWhich of the following organs is secondarily retroperitoneal, having been intraperitoneal in the embryo?
- Abdomen: duodenum · Multi-stepA thin young woman after rapid weight loss has postprandial epigastric pain and bilious vomiting relieved by lying prone or in the knee-chest position. The compression…
- Abdomen: mesenteric blood supply · ApplicationAn elderly man with heart failure develops left-sided abdominal pain and bloody diarrhoea after a hypotensive episode. Colonoscopy shows ischaemia at the splenic flexur…
- Abdomen: testicular venous drainage · Multi-stepA 22-year-old man has a left scrotal swelling that feels like a 'bag of worms' and enlarges on standing. A 60-year-old man develops a new right-sided swelling of the sa…
- Abdomen: rectus sheath · ApplicationDuring a lower midline laparotomy, a surgeon finds that below the arcuate line the rectus abdominis lies directly on the transversalis fascia. Which arrangement of the…
- Abdomen: indirect inguinal hernia · ApplicationA 4-year-old boy has an intermittent, reducible groin swelling that descends into the scrotum. At surgery the sac enters at the deep inguinal ring. What is its relation…
- Abdomen: functional liver anatomy · ApplicationA surgeon plans a right hepatectomy and divides the liver along the plane that separates the functional right and left lobes. Which description of this plane is correct?
- Abdomen: caudate lobe venous drainage · Multi-stepA 30-year-old woman on oral contraceptives has painful hepatomegaly and ascites. Doppler shows no flow in the main hepatic veins, and CT shows an enlarged, well-perfuse…
- Abdomen: hepatocystic triangle · ApplicationDuring laparoscopic cholecystectomy, a surgeon dissects the hepatocystic triangle (of Calot) to achieve the critical view of safety. Which artery is usually found in th…
- Abdomen: pancreatic head relations · Multi-stepA 62-year-old man has progressive painless jaundice, weight loss and a palpable, non-tender gallbladder. Which anatomical relation explains the obstructive jaundice fro…
- Abdomen: left renal vein · Multi-stepA 24-year-old thin woman has left flank pain and episodic haematuria, and Doppler shows high flow velocity in the left renal vein just before it crosses the aorta. The…
- Abdomen: suprarenal veins · ApplicationA surgeon plans a right adrenalectomy for an aldosterone-producing adenoma and is wary of the short adrenal vein, since tearing it causes brisk caval bleeding. Where do…
- Abdomen: abdominal wall hernia · ApplicationA 60-year-old obese woman has a small tender bulge lateral to the rectus abdominis near the level of the arcuate line, with a cough impulse. The sac lies between the mu…
- Abdomen: splenic vein and pancreas · Multi-stepA 45-year-old man with chronic pancreatitis has haematemesis. Endoscopy shows gastric fundal varices without oesophageal varices. The spleen is enlarged, and liver func…
- Abdomen: left renal vein · Multi-stepA tall, thin 22-year-old woman has recurrent left flank pain and painless macroscopic haematuria. Doppler shows a dilated left renal vein proximal to the point where it…
- Abdomen: liver segments · Multi-stepA 35-year-old woman with polycythaemia vera has painful hepatomegaly, ascites and absent hepatic vein flow on Doppler. CT shows an enlarged caudate lobe with preserved…
- Abdomen: lymphatic drainage of testis · ApplicationA 28-year-old man has a painless testicular mass, and histology after radical orchidectomy shows seminoma. To which lymph node group does the tumour first spread?
- Abdomen: liver peritoneal reflections · ApplicationA man with an amoebic liver abscess in the posterosuperior part of the right lobe develops a right pleural effusion as the pus ruptures upward. Which feature of the liv…
- Abdomen: duodenum · Multi-stepAfter a handlebar injury a boy has epigastric pain and vomiting. CT shows gas bubbles around the right kidney and the duodenum, but no free air under the diaphragm. A r…
- Abdomen: pancreatic head blood supply · ApplicationIn pancreaticoduodenectomy for a periampullary tumour, the surgeon also removes the duodenum along with the pancreatic head. Which arteries, forming anastomosing arcade…
- Abdomen · ApplicationWhich organ lies in left upper quadrant?
- Abdomen · ApplicationWhich ligament attaches liver to anterior abdominal wall?
- Abdomen · ApplicationWhich organ produces bile?
- Abdomen · ApplicationWhich organ stores bile?
- Abdomen · ApplicationWhich organ lies primarily in the left upper abdominal quadrant?
- Abdomen · ApplicationWhat is the arterial supply of the midgut?
- Abdomen · ApplicationWhich structure passes through the esophageal hiatus of the diaphragm?
- Abdomen · ApplicationThe quadrate lobe is a surface feature of which abdominal organ that produces bile?
- Abdomen · ApplicationWhich part of the large intestine is located in the right iliac fossa?
- Abdomen · ApplicationWhat structure connects the stomach to the duodenum?
- Abdomen · ApplicationWhat ligament attaches the liver to the anterior abdominal wall?
- Abdomen · ApplicationWhich organ lies retroperitoneally?
- Abdomen · ApplicationWhich segment of small intestine is immediately distal to the stomach?
- Abdomen · ApplicationWhich bowel segment joins the cecum at the ileocecal valve?
- Abdomen · ApplicationWhat artery supplies the embryologic midgut?
- Abdomen · ApplicationWhat structure passes through the esophageal hiatus?
- Abdomen · ApplicationThe portal vein is usually formed by union of which two veins?
- Abdomen · ApplicationWhich organ is primarily retroperitoneal rather than intraperitoneal?
- Abdomen: portal-systemic anastomoses · ApplicationCaput medusae in portal hypertension reflects dilation of veins around which structure?
- Abdomen: hepatobiliary triangle · ApplicationDuring laparoscopic cholecystectomy, the cystic artery is normally identified within the triangle bounded by the cystic duct, common hepatic duct and which structure?
- Abdomen: spleen · ApplicationWhich rib is used as a surface landmark for the long axis of a normal spleen?
- Abdomen · ApplicationWhich artery supplies the midgut from distal duodenum to proximal colon?
- Abdomen · ApplicationWhich vein receives blood from the gut and delivers it to the liver?
- Abdomen: portal-systemic anastomoses · ApplicationEsophageal varices form at an anastomosis between the left gastric vein and which systemic venous system?
- Abdomen: inguinal canal · ApplicationWhich structure passes through the deep inguinal ring in a male?
- Abdomen: retroperitoneum · ApplicationWhich organ is retroperitoneal rather than intraperitoneal?
Abdomen and pelvis45
- Abdomen and pelvis: inguinal canal · ApplicationAn adult has a large indirect inguinal hernia that has descended into the scrotum. The muscular covering of the sac is the cremasteric layer of the spermatic cord. From…
- Abdomen and pelvis: duodenum and mesenteric vessels · Multi-stepA 19-year-old woman with anorexia nervosa has lost 15 kg in 3 months and has postprandial epigastric pain with bilious vomiting. Barium meal shows abrupt cut-off of con…
- Abdomen and pelvis: biliary tract · ApplicationA small gallstone becomes impacted at the major duodenal papilla, and the patient develops jaundice and acute pancreatitis. In which part of the duodenum does the hepat…
- Abdomen and pelvis: stomach · ApplicationA man with a chronic posterior-wall gastric ulcer in the body of the stomach has persistent back pain after meals. Through the lesser sac, the ulcer has most probably p…
- Abdomen and pelvis: coeliac trunk · ApplicationCT angiography of a 30-year-old woman with postprandial epigastric pain shows narrowing of the aortic branch that arises behind the median arcuate ligament at the level…
- Abdomen and pelvis: portal vein · ApplicationA 60-year-old man has an adenocarcinoma at the neck of the pancreas. CT shows involvement of a confluence of veins immediately behind the neck. Which veins join at this…
- Abdomen and pelvis: liver segments · ApplicationA patient has a solitary metastasis confined to the part of the left liver lying to the left of the falciform ligament. A left lateral sectionectomy is planned. Which C…
- Abdomen and pelvis: ureter · ApplicationA 35-year-old man with renal colic has a stone lodged at the pelvic brim on CT. Which vessel is the ureter crossing at this site?
- Abdomen and pelvis · ApplicationIn Hesselbach triangle, which structure forms the lateral boundary, helping a surgeon identify a direct inguinal hernia?
- Abdomen and pelvis · Multi-stepA patient with cirrhosis and ascites has bleeding oesophageal varices, but no caput medusae. A shunt from bowel to the posterior abdominal wall veins is suspected. Thes…
- Abdomen and pelvis · ApplicationA surgeon repairing a hernia notes the deep inguinal ring lies lateral to the inferior epigastric artery. Through which structure's opening is the deep ring formed?
- Abdomen and pelvis · ApplicationA man with cirrhosis has dilated veins around the umbilicus radiating outward. Which portosystemic anastomosis is responsible?
- Abdomen and pelvis · ApplicationA child has painless rectal bleeding and a technetium scan shows uptake in the right lower abdomen. Which rule describes the usual location and frequency of this anomaly?
- Abdomen and pelvis · ApplicationA woman has intense pain during defaecation with a streak of blood and a tear seen at the 6 o'clock position in the lithotomy position. Why is the posterior midline the…
- Abdomen and pelvis: prostatic urethra landmark · Multi-stepDuring transurethral resection of the prostate the surgeon identifies a rounded elevation on the posterior wall of the prostatic urethra where the ejaculatory ducts ope…
- Abdomen and pelvis: rectovesical fascia · Multi-stepIn a man with a low rectal cancer, anterior spread is initially restrained by a membranous layer lying between the rectum and the seminal vesicles and prostate. Which f…
- Abdomen and pelvis: valves of Houston · ApplicationA sigmoidoscope passed into the rectum meets three transverse semilunar folds. The largest and most constant fold lies at the level of the anterior peritoneal reflectio…
- Abdomen and pelvis: inferior lumbar triangle · Multi-stepA 62-year-old thin woman has a reducible bulge in the flank just above the iliac crest. The defect is bounded below by the iliac crest, laterally by the external obliqu…
- Abdomen and pelvis: ductus epididymis histology · Multi-stepA scrotal biopsy shows a long, highly coiled tube lined by tall pseudostratified columnar cells bearing long non-motile stereocilia, surrounded by a thin circular layer…
- Abdomen and pelvis: Hartmann pouch · Multi-stepA stone impacted in the neck of the gallbladder (Hartmann's pouch) compresses the common hepatic duct and causes obstructive jaundice. What is this named?
- Abdomen and pelvis: retrocaecal appendix · ApplicationA 24-year-old man with right iliac fossa pain has a positive psoas sign: passive extension of the right hip aggravates the pain. Which anatomical position of the append…
- Abdomen and pelvis: horseshoe ischiorectal abscess · Multi-stepA man has a large abscess in the right ischiorectal fossa. Two weeks later a similar abscess forms in the left fossa although no skin has been breached across the midli…
- Abdomen and pelvis: greater vestibular gland · ApplicationA 28-year-old woman has a painful, tender swelling in the posterior part of the left labium majus. The gland involved is the female counterpart of which male structure?
- Abdomen and pelvis: surface anatomy of the gallbladder · ApplicationA 40-year-old woman with cholecystitis has a catch in inspiration when the examiner presses at the junction of the lateral border of the right rectus abdominis and the…
- Abdomen and pelvis: visceral pain pathway of the pancreas · Multi-stepA patient with an unresectable pancreatic carcinoma has severe constant epigastric pain radiating to the back. A neurolytic block is performed around the coeliac trunk…
- Abdomen and pelvis: testicular artery · ApplicationDuring retroperitoneal dissection, the testicular artery is identified as it leaves the aorta. Where does it normally arise?
- Abdomen and pelvis: patent processus vaginalis · ApplicationA 6-month-old boy has a soft scrotal swelling that is small in the morning and larger by evening. It transilluminates, and the fluid can be squeezed into the abdomen. W…
- Abdomen and pelvis: replaced right hepatic artery · Multi-stepWhile performing a pancreaticoduodenectomy, a surgeon palpates an arterial pulsation behind the portal vein in the hepatoduodenal ligament, separate from the hepatic ar…
- Abdomen and pelvis: laparoscopic inguinal fossae · Multi-stepAt laparoscopic hernia repair a surgeon sees a bulge between the medial umbilical fold and the lateral umbilical fold, which contains the inferior epigastric vessels. W…
- Abdomen and pelvis: superior hypogastric plexus · ApplicationA woman with chronic central pelvic pain unresponsive to treatment is considered for presacral neurectomy. Which plexus is divided in front of the fifth lumbar vertebra…
- Abdomen and pelvis: peritoneal covering of the rectum · ApplicationA rigid sigmoidoscope biopsy 4 cm above the anal verge in a man perforates the rectal wall. The patient develops pelvic cellulitis but no peritonitis. Which anatomical…
- Abdomen and pelvis: bladder trauma · ApplicationA man with a full bladder after drinking alcohol is kicked in the lower abdomen. Free fluid collects in the paracolic gutters and urinary ascites develops. Which part o…
- Abdomen and pelvis: lymphatic spread from the uterine fundus · Multi-stepA woman with endometrial carcinoma of the fundus has an enlarged node in the superficial inguinal group although the pelvic nodes are normal. Which lymphatic route expl…
- Abdomen and pelvis: cremasteric reflex · Multi-stepA 14-year-old boy with sudden severe testicular pain has an absent cremasteric reflex on the affected side. Which nerve carries the efferent limb of this reflex?
- Abdomen and pelvis: marginal artery of the colon · ApplicationA 70-year-old man has the inferior mesenteric artery ligated at its origin during aortic aneurysm repair, yet the left colon stays viable. Which continuous channel alon…
- Abdomen and pelvis: obstetric conjugate · ApplicationWhich anteroposterior diameter of the pelvic inlet is the shortest, being the most useful obstetrically, and cannot be measured directly in a living woman?
- Abdomen and pelvis: diagonal conjugate · ApplicationOn vaginal examination, the examiner touches the sacral promontory with the tip of the middle finger and marks where the hand meets the lower border of the pubic arch.…
- Abdomen and pelvis: android pelvis · ApplicationA pelvis has a heart-shaped inlet, prominent ischial spines, convergent side walls and a narrow subpubic angle. Labour in a woman with this type is prone to deep transv…
- Abdomen and pelvis: caudal epidural block · ApplicationA 5-year-old child has a caudal epidural block for herniotomy. After palpating the sacral cornua, the needle gives a characteristic give as it enters the sacral canal.…
- Abdomen and pelvis: internal anal sphincter · ApplicationIn chronic anal fissure with a hypertonic sphincter, a lateral sphincterotomy divides part of an involuntary muscle ring that is the thickened lower end of the circular…
- Abdomen and pelvis: cisterna chyli · Multi-stepAfter retroperitoneal surgery near the right crus of the diaphragm at L1-L2, a man develops milky ascites. A dilated lymphatic sac lies here, receiving the lumbar and i…
- Abdomen and pelvis: Meckel diverticulum · ApplicationA 2-year-old child passes large painless maroon stools. A technetium pertechnetate scan shows uptake in the right lower abdomen. The lesion is a remnant of which embryo…
- Abdomen and pelvis: culdocentesis · ApplicationA woman with a positive pregnancy test, abdominal pain and hypotension has free fluid on ultrasound. A needle passed through the posterior vaginal fornix enters which p…
- Abdomen and pelvis: psoas abscess · ApplicationA 30-year-old man with tuberculosis of the lumbar spine has a fluctuant swelling in the right femoral triangle. Along which fascial sheath did the pus track from the ve…
- Abdomen and pelvis: appendix testis · Multi-stepAt exploration for acute scrotal pain in a 9-year-old boy, a twisted infarcted nodule is found at the upper pole of the testis. This small appendage is a remnant of whi…
Upper limb42
- Upper limb · ApplicationA 24-year-old man falls on his shoulder and fractures the surgical neck of the humerus. Which nerve is most at risk, and what would you expect on examination?
- Upper limb · ApplicationWhich tendon does NOT pass through the carpal tunnel?
- Upper limb: shoulder · ApplicationA 55-year-old painter has pain and difficulty starting to lift his arm out to the side. MRI shows a tear of the tendon passing beneath the acromion and above the humera…
- Upper limb: median nerve · ApplicationA woman has nocturnal tingling of the thumb, index and middle fingers and weakness of thumb abduction. Sensation over the thenar eminence is normal. Which anatomical fa…
- Upper limb: nerve injury · ApplicationAfter a radical mastectomy with axillary clearance, a woman finds that the medial border of the scapula protrudes when she pushes against a wall. Which nerve and muscle…
- Upper limb: ulnar nerve · Multi-stepTwo patients have complete ulnar nerve palsy: one from a cut at the wrist, the other from an injury at the elbow. The patient with the wrist injury has the more obvious…
- Upper limb: radial nerve in the spiral groove · ApplicationA 30-year-old man sustains a fracture of the mid-shaft of the humerus in a road accident. He has wrist drop and loss of sensation over the dorsum of the first web space…
- Upper limb: posterior interosseous nerve · Multi-stepA 40-year-old woman has a slowly growing lipoma near the head of the radius. She cannot extend the metacarpophalangeal joints of her fingers and thumb, but when asked t…
- Upper limb: median nerve · Multi-stepAfter a supracondylar fracture a man cannot flex the thumb, index and middle fingers and has weak forearm pronation. When he tries to make a fist the index and middle f…
- Upper limb: scapular anastomosis · Multi-stepA stab wound requires ligation of the axillary artery just proximal to the origin of the subscapular artery, yet the hand stays warm and viable. Which collateral channe…
- Upper limb · ApplicationWhich nerve supplies deltoid?
- Upper limb · ApplicationWhich artery is palpated in anatomical snuffbox?
- Upper limb · ApplicationWhich muscle flexes elbow strongly?
- Upper limb · ApplicationWhich nerve is injured in wrist drop?
- Upper limb · ApplicationWhich nerve supplies interossei?
- Upper limb · ApplicationAfter axillary-node surgery, a patient has scapular winging when pushing against a wall. Which nerve was most likely injured?
- Upper limb · ApplicationWhat artery is palpated at the wrist on the lateral side?
- Upper limb · ApplicationCompression of which nerve in Guyon canal can cause sensory symptoms in the little finger and medial half of the ring finger?
- Upper limb · ApplicationWhich muscle initiates abduction of the arm?
- Upper limb · ApplicationWhich artery continues as the brachial artery beyond the lateral border of teres major?
- Upper limb · ApplicationWhich nerve supplies the intrinsic muscles of the hand most commonly affected in clawing?
- Upper limb · ApplicationWhich muscle flexes the elbow and is supplied by the musculocutaneous nerve?
- Upper limb · ApplicationWhich nerve supplies the triceps brachii muscle?
- Upper limb · ApplicationWhat landmark contains the brachial artery and median nerve at the elbow?
- Upper limb · ApplicationWhich rotator-cuff muscle is chiefly tested by resisted external rotation?
- Upper limb · ApplicationWhat artery is palpated at the lateral wrist?
- Upper limb · ApplicationWhat vein is commonly used for venepuncture in the cubital fossa?
- Upper limb · ApplicationWhich nerve is compressed in the carpal tunnel at the wrist?
- Upper limb · ApplicationInjury to which nerve most directly causes wrist drop after a humeral shaft fracture?
- Upper limb · ApplicationWhich structure is palpated in the anatomical snuffbox after a fall onto an outstretched hand to assess possible scaphoid injury?
- Upper limb · ApplicationWhich nerve is most vulnerable in a fracture of the surgical neck of the humerus?
- Upper limb · ApplicationWhich movement is primarily lost after injury to the long thoracic nerve?
- Upper limb · ApplicationWhich artery is palpated lateral to the flexor carpi radialis tendon at the wrist?
- Upper limb: brachial plexus · ApplicationA fracture of the surgical neck of the humerus leaves a patient unable to abduct the arm from 15 to 90 degrees and causes numbness over the lateral shoulder. Which nerv…
- Upper limb: carpal tunnel · ApplicationWhich structure passes superficial to the flexor retinaculum and therefore is not compressed in carpal tunnel syndrome?
- Upper limb · ApplicationWhich muscle initiates the first 15 degrees of shoulder abduction?
- Upper limb · ApplicationWhich nerve supplies the first dorsal interosseous muscle?
- Upper limb · ApplicationWhat structure passes through the carpal tunnel with the median nerve?
- Upper limb: brachial plexus · ApplicationA patient cannot abduct the arm from 15 to 90 degrees and has numbness over the lateral shoulder after dislocation. Which nerve is injured?
- Upper limb: median nerve · ApplicationA laceration at the wrist causes inability to oppose the thumb and wasting of the thenar eminence. Which nerve is damaged?
- Upper limb: ulnar nerve · ApplicationWhich action is most impaired by an ulnar nerve lesion at the elbow?
- Upper limb: radial nerve · ApplicationA humeral shaft fracture is followed by wrist drop and inability to extend the metacarpophalangeal joints. Which nerve is most likely injured?
General anatomy and histology30
- General anatomy and histology: cell junctions · ApplicationA 78-year-old woman has tense, itchy blisters on the flexures. Biopsy shows a subepidermal split, and immunofluorescence shows linear IgG along the basement membrane di…
- General anatomy and histology: compact bone · ApplicationA ground transverse section of a cortical bone shows several complete osteons. Between them lie angular fragments of lamellae that do not surround any central canal. Wh…
- General anatomy and histology: tight junctions · Multi-stepA 6-year-old boy has recurrent urinary stones, nephrocalcinosis and low serum magnesium. Urinary calcium and magnesium excretion are both high. Genetic testing shows lo…
- General anatomy and histology: skeletal muscle ultrastructure · ApplicationAn electron micrograph of mammalian skeletal muscle shows, at the junction of each A band and I band, a central transverse tubule closely flanked on either side by a di…
- General anatomy and histology · ApplicationA jejunal biopsy shows pyramidal cells at the base of the crypts with bright eosinophilic apical granules. What do these cells chiefly secrete?
- General anatomy and histology · Multi-stepA newborn develops blisters from minor friction because the epidermis separates from the dermis. The defect affects the junction that links basal keratinocytes to the b…
- General anatomy and histology · ApplicationA boy with progressive calf hypertrophy and Gowers sign has absent staining for a protein that links the actin cytoskeleton to the sarcolemmal glycoprotein complex. Whi…
- General anatomy and histology · ApplicationA young man in the third week of untreated enteric fever has sudden peritonitis. At laparotomy the perforation is most likely in which part of the gut because of the ly…
- General anatomy and histology · ApplicationA child with dense, fracture-prone bones and cranial nerve compression has osteoclasts that cannot acidify the resorption lacuna. Osteoclasts normally arise from which…
- General anatomy and histology · ApplicationA child has multiple fractures from minimal trauma, blue sclerae and poor dentition. A defect in synthesis of which collagen type underlies the disorder?
- General anatomy and histology: Brunner glands · ApplicationA biopsy from the first part of the duodenum shows branched, coiled mucous glands that cross the muscularis mucosae and lie in the submucosa. What is the main protectiv…
- General anatomy and histology: Nissl substance · ApplicationA motor neuron stained with a basic dye shows dark clumps throughout the cell body and proximal dendrites, but the cone-shaped region where the axon begins is pale. Wha…
- General anatomy and histology: muscle fibre types · ApplicationA marathon runner's muscle biopsy is stained for myoglobin and oxidative enzymes. Most fibres are dark, rich in mitochondria and capillaries, slow to contract and highl…
- General anatomy and histology: synovial membrane · Multi-stepIn the synovial intima, one cell type is fibroblast-like and secretes hyaluronan and lubricin into the joint fluid, while the other is macrophage-like. Which cell secre…
- General anatomy and histology: epidermal water barrier · ApplicationA dermatology student studies why skin is waterproof. Lipid-filled lamellar bodies fuse with the plasma membrane and discharge into the intercellular space at which lev…
- General anatomy and histology: urinary tract lining · ApplicationA bladder biopsy shows a lining whose surface cells are large, dome-shaped, sometimes binucleate, with a thickened asymmetric luminal membrane that resists stretch and…
- General anatomy and histology: Ruffini ending · ApplicationWhich slowly adapting, encapsulated, spindle-shaped receptor of the deep dermis and joint capsule signals sustained skin stretch?
- General anatomy and histology: Golgi tendon organ · ApplicationDuring a very heavy lift, muscle contraction suddenly relaxes to protect the tendon. Which receptor, lying in series with muscle fibres at the musculotendinous junction…
- General anatomy and histology: nerve sheaths · ApplicationElectron microscopy of a peripheral nerve shows a sheath around each fascicle formed by flattened cells joined by tight junctions, creating the blood-nerve barrier. Whi…
- General anatomy and histology: brown adipose tissue · ApplicationA newborn keeps warm through non-shivering thermogenesis in multilocular fat rich in mitochondria. Which inner mitochondrial protein allows this by dissipating the prot…
- General anatomy and histology: Merkel cell · ApplicationA basal epidermal cell contains dense-core granules, is attached to keratinocytes by desmosomes and forms a disc-like contact with a sensory axon as a slowly adapting t…
- General anatomy and histology: Langerhans cell · ApplicationElectron microscopy of epidermis shows a suprabasal dendritic cell with racket-shaped cytoplasmic granules. Which function does this cell serve?
- General anatomy and histology: cartilage growth · ApplicationA section of growing hyaline cartilage shows clusters of chondrocytes in a single lacunar space derived from one parent cell. Which growth pattern do these clusters rep…
- General anatomy and histology: cartilage matrix · ApplicationA large proteoglycan in cartilage carries chondroitin sulfate and keratan sulfate chains and binds to hyaluronic acid, trapping water to resist compression. Which molec…
- General anatomy and histology: Wallerian degeneration · ApplicationA transected peripheral nerve is repaired end to end. In the distal stump, which cells proliferate and line up in columns that guide the regrowing axon sprouts?
- General anatomy and histology: myoepithelial cell · ApplicationA section of a salivary gland acinus shows stellate cells containing actin and myosin that lie between the secretory cells and the basal lamina. What is their function?
- General anatomy and histology: axon hillock · ApplicationA neuron stained with cresyl violet shows basophilic clumps in the soma and proximal dendrites, but a pale, clump-free cone where the axon leaves the soma. What is this…
- General anatomy and histology: retrograde axonal transport · ApplicationAfter a bite from a rabid dog, the virus travels from the peripheral nerve ending up the axon to the spinal cord and brain. Which motor protein drives this movement?
- General anatomy and histology: Weibel-Palade bodies · ApplicationElectron microscopy of an endothelial cell shows rod-shaped membrane-bound granules with parallel tubules. Which substance do they mainly store?
- General anatomy and histology: vasa vasorum · ApplicationThe wall of the thoracic aorta is too thick for oxygen to reach its outer layers by diffusion from the lumen. How is the outer media nourished?
Histology27
- Histology: oesophageal epithelium · ApplicationA 52-year-old man with 15 years of heartburn has salmon-coloured mucosa extending above the gastro-oesophageal junction at endoscopy. Which histological change is expec…
- Histology: basement membrane collagen · ApplicationA 28-year-old smoker has haemoptysis and rapidly progressive glomerulonephritis, with linear IgG deposition along the glomerular basement membrane. The autoantibodies b…
- Histology: growth plate · ApplicationAn obese 12-year-old boy has hip pain and a limp, and a radiograph shows the femoral epiphysis displaced posteriorly and inferiorly on the neck (slipped capital femoral…
- Histology: skeletal muscle sarcomere · ApplicationOn electron microscopy of a skeletal muscle fibre during contraction, the thin filaments slide between the thick filaments. Which band stays the same length during this…
- Histology: lymphoid tissue · ApplicationAn infant has severe T-cell deficiency due to thymic aplasia. In a lymph node biopsy, which region would be depleted of lymphocytes?
- Histology: skin and desmosomes · Multi-stepA 45-year-old man has flaccid blisters, painful oral erosions and a positive Nikolsky sign. Biopsy shows a suprabasal split with a row of intact basal cells attached to…
- Histology: articular cartilage · ApplicationA 22-year-old footballer has a focal full-thickness defect in the articular cartilage of the femoral condyle that heals poorly. Which feature of adult articular cartila…
- Histology: capillary types · ApplicationAlbumin and other plasma proteins pass freely from blood into the space of Disse in the liver. Which capillary type lines the hepatic sinusoids?
- Histology: osteoclast differentiation · ApplicationMature osteoclasts form from haemopoietic monocyte-lineage precursors. Which pair of factors from osteoblast-lineage cells is needed for this differentiation?
- Histology: epithelial metaplasia · ApplicationA 55-year-old man who has smoked for 30 years has a bronchial biopsy. The pseudostratified ciliated columnar epithelium of a segmental bronchus has been replaced by ord…
- Histology: basement membrane collagen · ApplicationA 9-year-old boy has recurrent haematuria, high-tone sensorineural hearing loss and anterior lenticonus. His maternal uncle died of renal failure. Electron microscopy o…
- Histology: spleen · Multi-stepA 24-year-old man has a blood film two weeks after splenectomy for trauma. It shows red cells with single round basophilic nuclear remnants (Howell-Jolly bodies). Which…
- Histology: cell junctions · Multi-stepA 45-year-old woman has flaccid bullae and painful oral erosions with a positive Nikolsky sign. Biopsy shows suprabasal acantholysis, and immunofluorescence shows IgG a…
- Histology: cilia ultrastructure · ApplicationA 28-year-old man has chronic sinusitis, bronchiectasis, dextrocardia on chest radiograph, and infertility with normal sperm count but immotile sperm. Electron microsco…
- Histology: lymph node zones · ApplicationA newborn has hypocalcaemic seizures, a conotruncal cardiac defect and an absent thymic shadow, and a 22q11.2 deletion is found. Which zone of a lymph node would be exp…
- Histology: collagen types · ApplicationA pathologist applies a silver impregnation stain to a spleen section to demonstrate the delicate meshwork of reticular fibres supporting the red pulp. Which collagen t…
- Histology: ganglia · ApplicationA 70-year-old woman has a painful vesicular rash in a band over the left T6 dermatome from reactivation of varicella-zoster virus. In which type of neuron was the virus…
- Histology · ApplicationWhat epithelium lines the alveoli for rapid gas exchange?
- Histology · ApplicationWhich connective tissue cell produces collagen fibers?
- Histology · ApplicationWhich epithelium lines the urinary bladder?
- Histology · ApplicationWhich cell type is responsible for bone resorption?
- Histology · ApplicationWhich tissue type lines blood vessels?
- Histology · ApplicationWhich cell maintains bone matrix after becoming embedded in it?
- Histology · ApplicationWhat epithelium lines the alveoli for gas exchange?
- Histology · ApplicationWhich cell produces collagen in connective tissue?
- Histology · ApplicationWhich epithelium lines the alveoli to allow rapid gas exchange?
- Histology · ApplicationWhich cells line the proximal convoluted tubule?
Upper limb and brachial plexus27
- Upper limb and brachial plexus: plexus architecture · ApplicationDuring a supraclavicular exploration behind the clavicle, a surgeon identifies the posterior divisions of the upper, middle and lower trunks of the brachial plexus. The…
- Upper limb and brachial plexus: intrinsic muscles of the hand · ApplicationA man has an ulnar nerve laceration at the wrist and develops a claw deformity of the ring and little fingers. Which normal action, performed by the medial two lumbrica…
- Upper limb and brachial plexus · Multi-stepA cyclist develops weakness of finger spreading and numbness of the little finger and the ulnar half of the ring finger after prolonged handlebar pressure at the wrist,…
- Upper limb and brachial plexus: ligament of Struthers · Multi-stepA teenager has a bony spur about 5 cm above the medial epicondyle on X-ray, with a fibrous band running from the spur to the epicondyle. He has paraesthesia over the la…
- Upper limb and brachial plexus: epitrochlear nodes · Multi-stepA man has a tender swelling just above the medial epicondyle two days after a septic cut on his little finger. Which lymph node group is enlarged?
- Upper limb and brachial plexus: interscalene block · ApplicationA patient develops shortness of breath and a raised hemidiaphragm on the same side after an interscalene brachial plexus block for shoulder surgery. Which nerve has bee…
- Upper limb and brachial plexus: median nerve high lesion · Multi-stepA man with a deep elbow laceration is asked to make a fist. His index and middle fingers stay extended, his thumb cannot oppose, and he has numbness over the lateral th…
- Upper limb and brachial plexus: late tendon rupture after wrist fracture · Multi-stepEight weeks after a minimally displaced distal radial fracture, a woman suddenly cannot extend the interphalangeal joint of her thumb. Which tendon, running around the…
- Upper limb and brachial plexus: flexor tendon sheath spread · Multi-stepA man with a pus-filled flexor sheath of the little finger develops swelling over the wrist and palm. This pattern of spread occurs because the little-finger sheath is…
- Upper limb and brachial plexus: mallet finger · ApplicationA cricketer is struck on the tip of the finger by the ball. The distal joint now droops in flexion and cannot be actively extended. Which structure is injured?
- Upper limb and brachial plexus: boutonniere deformity · Multi-stepA laceration over the dorsum of a finger is followed by a flexed proximal interphalangeal joint and hyperextended distal joint. Which structure was divided?
- Upper limb and brachial plexus: superficial radial nerve · ApplicationA man wearing tight handcuffs develops tingling over the dorsum of the thumb and the lateral back of the hand, but no weakness. Which nerve is compressed?
- Upper limb and brachial plexus: carrying angle · ApplicationA girl with Turner syndrome has an increased carrying angle at the elbow when the forearm is extended and supinated. What is the term for this deformity?
- Upper limb and brachial plexus: first extensor compartment · Multi-stepA new mother has pain over the radial styloid, worsened when she grasps her baby with the thumb tucked in and the wrist deviated ulnarly. Which pair of tendons in the f…
- Upper limb and brachial plexus: pronator quadratus · ApplicationAfter a supracondylar fracture the anterior interosseous nerve is injured, and the patient cannot flex the thumb interphalangeal joint. Which deep forearm muscle that p…
- Upper limb and brachial plexus: lunate dislocation · Multi-stepAfter a fall on the outstretched hand, a man has wrist swelling, a lunate displaced anteriorly on lateral X-ray, and tingling in the thumb, index and middle fingers. Wh…
- Upper limb and brachial plexus: acromioclavicular joint · ApplicationA cyclist falls onto the tip of the shoulder and has a step deformity over the lateral clavicle with the clavicle riding upward. Which ligament, anchoring the clavicle…
- Upper limb and brachial plexus: painful arc · ApplicationA swimmer feels pain only in the middle range of arm abduction, but not at the start or end of the arc. Which tendon is being compressed beneath the coracoacromial arch?
- Upper limb and brachial plexus: ulnar collateral ligament · ApplicationA baseball pitcher feels medial elbow pain and instability with valgus stress during throwing. Which structure is injured?
- Upper limb and brachial plexus: Kienbock disease · ApplicationA 30-year-old manual labourer has insidious dorsal wrist pain, reduced grip and tenderness just distal to the radius on the dorsum. Radiographs show sclerosis and later…
- Upper limb and brachial plexus: Bennett fracture · ApplicationA boxer punches with a flexed thumb and has pain at the thumb base. A radiograph shows an intra-articular fracture-dislocation of the first metacarpal base with a small…
- Upper limb and brachial plexus: triangular interval · ApplicationA surgeon exposes the back of the arm below the teres major. Which two structures run through the triangular interval, bounded by the teres major, the long head of tric…
- Upper limb and brachial plexus: thoracoacromial artery · ApplicationA surgeon ligates the artery that pierces the clavipectoral fascia and divides into acromial, clavicular, deltoid and pectoral branches. From which part of the axillary…
- Upper limb and brachial plexus: long head of biceps in the shoulder joint · Multi-stepAt arthroscopy of the shoulder, the tendon of the long head of biceps is seen passing over the humeral head inside the joint. Which statement about it is correct?
- Upper limb and brachial plexus: trigger finger · ApplicationA 55-year-old diabetic woman has a ring finger that locks in flexion in the morning and snaps open with a click. A tender nodule is felt in the palm over the metacarpal…
- Upper limb and brachial plexus: supraclavicular block · Multi-stepDuring a brachial plexus block with the needle directed behind the subclavian artery and above the first rib, the patient coughs and becomes breathless. Which structure…
- Upper limb and brachial plexus: median nerve at the wrist · Multi-stepFor a carpal tunnel injection, the surgeon identifies the tendon of palmaris longus just proximal to the wrist crease. Where does the median nerve lie in relation to th…
Genetics24
- Genetics: Hardy-Weinberg calculation · Multi-stepAn autosomal recessive disorder occurs in 1 in 10,000 births in a population in Hardy-Weinberg equilibrium. What is the approximate carrier frequency?
- Genetics: trinucleotide repeat disorders · ApplicationA 7-year-old boy has intellectual disability, autistic features, a long narrow face, prominent ears and hyperextensible finger joints. His maternal uncle is similarly a…
- Genetics: mitochondrial inheritance · ApplicationA family has a disorder with stroke-like episodes and lactic acidosis, and a muscle biopsy shows ragged-red fibres. All children of affected women are affected to varia…
- Genetics: genomic imprinting · Multi-stepA 2-month-old infant has marked hypotonia, a poor suck, almond-shaped eyes and hypogenitalism. Prader-Willi syndrome is suspected. What is the most appropriate first di…
- Genetics: Robertsonian translocation · Multi-stepA phenotypically normal woman has had two children with Down syndrome and a miscarriage, and her husband has a normal karyotype. Her affected child's karyotype is 46,XY…
- Genetics: Turner syndrome · ApplicationA 14-year-old girl is 138 cm tall and has a webbed neck, widely spaced nipples, absent breast development and raised FSH. Which karyotype and gonadal finding are expect…
- Genetics: Klinefelter syndrome · ApplicationA 22-year-old tall man has sparse facial hair, gynaecomastia, small firm testes and azoospermia. What hormone profile and number of Barr bodies are expected?
- Genetics: dystrophin gene mutations · Multi-stepTwo boys have deletions in the dystrophin gene. Boy A loses ambulation at 11 years, and boy B walks until his thirties with milder weakness. Which statement best explai…
- Genetics: X-linked recessive pedigree · ApplicationA man with haemophilia A marries a woman with no family history and no carrier status. What is the genetic outcome for their children?
- Genetics: X-inactivation · Multi-stepA 30-year-old 46,XX woman, whose mother is a carrier of Duchenne muscular dystrophy, has mild proximal weakness, calf pseudohypertrophy and raised CK. How is she sympto…
- Genetics: Marfan syndrome · ApplicationA 17-year-old tall boy has an arm span greater than his height, arachnodactyly, upward dislocation of the lens and aortic root dilatation. Which gene and protein are de…
- Genetics: neurofibromatosis type 1 · ApplicationA 10-year-old child has six café-au-lait macules larger than 5 mm, axillary freckling and Lisch nodules, and the father has similar skin findings. Which gene is mutated…
- Genetics: penetrance and expressivity · Multi-stepIn a family with autosomal dominant retinoblastoma, a man and his son are affected. The man's father had no tumour but carries the same RB1 mutation. Which term describ…
- Genetics: investigation of microdeletion · Multi-stepA 5-day-old infant has cyanosis with a truncus arteriosus, cleft palate and seizures with a serum calcium of 6.2 mg/dL. Which test confirms the suspected underlying gen…
- Genetics: consanguinity · ApplicationIn a community where first-cousin marriages are common, a couple who are first cousins ask about risk to their child. What is the coefficient of inbreeding of their chi…
- Genetics: mitochondrial inheritance · ApplicationA man has a pathogenic mitochondrial DNA point mutation that causes MELAS. His wife is unaffected and has no mutation. What is the risk that their children inherit the…
- Genetics: X-linked Hardy-Weinberg calculation · Multi-stepAn X-linked recessive disorder affects 1 in 10,000 males in a population in Hardy-Weinberg equilibrium. What is the approximate frequency of carrier females?
- Genetics: carrier risk calculation · Multi-stepA healthy woman has a brother with an autosomal recessive disorder, and her parents are healthy. Her unrelated partner has no family history, and the carrier frequency…
- Genetics: trinucleotide repeat expansion · ApplicationA 3-year-old boy has developmental delay and a long face with large ears. His mother carries a premutation of about 90 CGG repeats in FMR1, and he has more than 200 rep…
- Genetics: linkage analysis · Multi-stepA family study of an autosomal dominant disorder gives a maximum LOD score of 3.0 between the disease locus and a DNA marker. How is this result interpreted?
- Genetics: Robertsonian translocation · ApplicationA phenotypically normal woman has had two miscarriages and a child with Down syndrome whose karyotype is 46,XY,rob(14;21),+21. If the mother carries the balanced transl…
- Genetics: sex chromosome aneuploidy · ApplicationA tall 17-year-old boy with long limbs, gynaecomastia, small firm testes and mild learning difficulty has azoospermia. What hormonal profile is expected?
- Genetics: connective tissue disorders · Multi-stepA 15-year-old tall boy has arachnodactyly, aortic root dilatation and a dislocated lens displaced upward and outward, with normal intelligence. Which combination of gen…
- Genetics: dystrophinopathies · Multi-stepA 14-year-old boy has mild proximal weakness and calf pseudohypertrophy and still walks independently. Muscle biopsy shows reduced truncated dystrophin. His cousin with…
Pelvis23
- Pelvis: vascular relations · ApplicationNear the lateral vaginal fornix, the ureter is crossed from above by which vessel, a relation of surgical importance in hysterectomy?
- Pelvis: anorectal anatomy · ApplicationA patient has carcinoma of the lower anal canal below the pectinate line. To which lymph nodes will it first drain?
- Pelvis: levator ani and continence · ApplicationA 35-year-old woman has faecal incontinence after an obstetric injury, with loss of the anorectal angle. Which muscle forms a sling pulling the anorectal junction forwa…
- Pelvis: lymphatic drainage of ovary · Multi-stepA 55-year-old woman has ovarian carcinoma. Following the ovarian vessels through the suspensory ligament, which lymph nodes receive the main lymphatic drainage of the o…
- Pelvis: prostate zones · ApplicationA 68-year-old man has a weak stream and nocturia, and rectal examination shows a smooth, symmetrically enlarged prostate. Which zone enlarges to compress the urethra, a…
- Pelvis: pelvic floor · ApplicationDuring normal defecation, relaxation of which muscle straightens the anorectal angle and allows stool to pass?
- Pelvis: autonomic innervation · Multi-stepA 26-year-old man has retroperitoneal lymph node dissection for testicular cancer. Afterwards erections are normal but no semen emerges at orgasm. Injury to which struc…
- Pelvis: anal canal · ApplicationA 45-year-old man has painless bright red bleeding after defecation and a soft mass prolapsing through the anus that returns on its own. Examination shows a grade II in…
- Pelvis: obturator nerve · ApplicationA 28-year-old woman has a cyst in the ovarian fossa and complains of aching pain along the inner thigh. Which nerve accounts for this referred pain?
- Pelvis · ApplicationWhich muscle is part of pelvic diaphragm?
- Pelvis · ApplicationWhich organ lies posterior to bladder in male?
- Pelvis · ApplicationWhich muscle lines the lateral pelvic wall and exits the pelvis through the lesser sciatic foramen with its tendon?
- Pelvis · ApplicationWhich nerve provides parasympathetic supply to pelvic organs?
- Pelvis · ApplicationWhich organ lies posterior to the urinary bladder in females?
- Pelvis · ApplicationWhat is the terminal part of the large intestine?
- Pelvis · ApplicationWhich organ stores urine before micturition?
- Pelvis · ApplicationWhat muscle forms much of the pelvic diaphragm?
- Pelvis · ApplicationWhich nerves provide parasympathetic supply to pelvic organs?
- Pelvis · ApplicationWhich structure passes through the greater sciatic foramen below piriformis?
- Pelvis: pudendal nerve · ApplicationWhich spinal nerve roots form the pudendal nerve that supplies the external anal sphincter?
- Pelvis: ureter · ApplicationDuring ligation of the uterine artery in hysterectomy, which structure must be protected because it passes inferior to the artery?
- Pelvis: pudendal nerve · ApplicationWhich nerve provides the main somatic motor supply to the external anal sphincter?
- Pelvis: uterine blood supply · ApplicationThe uterine artery is usually a branch of which vessel?
Cranial nerves8
- Cranial nerves: abducens · ApplicationA child with a posterior fossa tumour and raised intracranial pressure has diplopia worsening on looking to the left, with the left eye unable to abduct. The nerve invo…
- Cranial nerves: trochlear nerve palsy · Multi-stepAfter head trauma, a man has vertical diplopia that is worst when he looks down and inward, as in descending stairs. He keeps his head tilted to the left. Which lesion…
- Cranial nerves: oculomotor nerve compression · Multi-stepA 60-year-old woman has a sudden severe headache, a drooping right eyelid, an eye turned down and out, and a dilated unreactive right pupil. Why is the pupil involved e…
- Cranial nerves · ApplicationWhich cranial nerve carries smell?
- Cranial nerves · ApplicationWhich cranial nerve controls lateral rectus?
- Cranial nerves · ApplicationWhich cranial nerve supplies sternocleidomastoid?
- Cranial nerves · ApplicationWhich cranial nerve carries motor fibers to muscles of facial expression?
- Cranial nerves · ApplicationWhich cranial nerve is responsible for most tongue movements?
Joints8
- Joints · ApplicationWhat type of joint is the shoulder joint?
- Joints · ApplicationWhich ligament holds the tendon of the long head of biceps in the intertubercular groove of the humerus?
- Joints · ApplicationWhat type of joint is the proximal radioulnar joint?
- Joints · ApplicationWhat movement decreases the angle between two bones?
- Joints · ApplicationWhat joint type permits head rotation between atlas and axis?
- Joints · ApplicationWhich ligament prevents posterior displacement of the tibia relative to the femur?
- Joints · ApplicationWhich movement is permitted at the proximal radioulnar joint?
- Joints · ApplicationWhich meniscus is more firmly attached to the medial collateral ligament?
Neck8
- Neck: thyroglossal cyst · ApplicationA 6-year-old child has a painless 2 cm midline swelling just below the hyoid bone that moves upward when the tongue is protruded. What is the embryological origin?
- Neck: second branchial fistula · ApplicationA 4-year-old child has a small skin opening along the lower third of the anterior border of the sternocleidomastoid that discharges mucus. A complete track from this op…
- Neck: carotid sinus reflex · Multi-stepA 68-year-old man faints when turning his head while wearing a tight collar. Pressure over the carotid sinus produces bradycardia and hypotension. Which nerves form the…
- Neck: fascial spaces · ApplicationA 3-year-old child has fever, drooling, neck stiffness and widening of the prevertebral soft tissue on a lateral neck radiograph, consistent with a retropharyngeal absc…
- Neck: fascial spaces · Multi-stepA child with a retropharyngeal infection develops fever, chest pain and widening of the mediastinum on radiography. Pus has tracked between the alar fascia and the prev…
- Neck · ApplicationWhich artery is palpated in carotid triangle?
- Neck · ApplicationWhich gland lies anterior to trachea?
- Neck · ApplicationWhich nerve is at risk during thyroid surgery and can cause hoarseness if injured?
Hand6
- Hand: palmar fascia · ApplicationA 58-year-old man has a firm nodule in the palm and a gradually worsening flexion deformity of the ring and little fingers that he cannot straighten. Flexor tendons gli…
- Hand: tendon sheaths and bursae · Multi-stepA 35-year-old woman has a pricked little finger that becomes swollen with the finger held flexed and tender along the sheath. Two days later, swelling and tenderness sp…
- Hand: Froment sign · ApplicationA man with an ulnar nerve palsy is asked to grip a sheet of paper between his thumb and the side of the index finger. The thumb interphalangeal joint flexes as the pape…
- Hand: recurrent branch of the median nerve · Multi-stepA 20-year-old man cuts the palm at the base of the thenar eminence on broken glass. He cannot oppose or abduct the thumb, but sensation over the thumb, index and middle…
- Hand: Allen test and palmar arches · Multi-stepBefore radial artery cannulation, an anaesthetist compresses both radial and ulnar arteries while the patient clenches the fist, then opens the hand and releases the ul…
- Hand: hook of hamate and ulnar nerve · Multi-stepA golfer has pain on the ulnar side of the palm after fracture of the hook of the hamate. He has weak grip and cannot spread his fingers, but sensation over the little…
Shoulder6
- Shoulder: subscapularis · ApplicationA 50-year-old man has pain after a fall on the shoulder. When asked to place the back of his hand on the lumbar spine and lift it away from his back, he cannot do so. W…
- Shoulder: suprascapular nerve entrapment · Multi-stepA 28-year-old volleyball player has deep posterior shoulder pain and weakness of external rotation with visible wasting below the spine of the scapula. Initiation of ab…
- Shoulder: anterior dislocation · ApplicationA 24-year-old rugby player has a first anterior dislocation of the shoulder, which is reduced. Imaging shows an impaction defect on the humeral head. Where is the Hill-…
- Shoulder: subscapularis · ApplicationA 58-year-old man cannot lift the back of his hand away from his lumbar spine when the hand is placed behind him (positive lift-off test). Which muscle is weak and wher…
- Shoulder: recurrent dislocation lesions · ApplicationA 20-year-old rugby player has had several anterior dislocations of the shoulder. An MR arthrogram shows detachment of the anteroinferior glenoid labrum. Which lesion i…
- Shoulder · ApplicationWhich rotator-cuff muscle initiates the first part of shoulder abduction?
Vertebral column6
- Vertebral column · ApplicationHow many cervical vertebrae are normally present?
- Vertebral column · ApplicationWhich vertebra is notable for the dens?
- Vertebral column · ApplicationWhat is the normal number of thoracic vertebrae?
- Vertebral column · ApplicationWhat type of vertebrae articulate with ribs?
- Vertebral column · ApplicationWhich cervical vertebra is characterized by the dens?
- Vertebral column · ApplicationWhat distinctive feature identifies the atlas vertebra (C1)?
Brachial plexus5
- Brachial plexus · ApplicationA newborn delivered after a difficult shoulder dystocia holds the arm adducted, internally rotated and extended, the 'waiter's tip' posture. Which part of the brachial…
- Brachial plexus: lower trunk injury · ApplicationA 25-year-old man falls from a tree and grabs a branch, suffering a violent upward pull on his arm. He later has a clawed hand, loss of sensation along the medial forea…
- Brachial plexus: posterior cord · Multi-stepA man has a stab wound in the axilla. He has wrist drop, weak abduction of the arm beyond 15 degrees, and weak adduction and internal rotation of the arm. Biceps functi…
- Brachial plexus: musculocutaneous nerve · ApplicationA man sustains a deep stab wound to the front of the upper arm. He has weakness of elbow flexion with the forearm in supination, a lost biceps reflex and numbness over…
- Brachial plexus: Pancoast syndrome · Multi-stepA 62-year-old heavy smoker has pain along the medial side of the arm and forearm, wasting of the small muscles of the hand and weak finger abduction and adduction. He a…
Brain5
- Brain · ApplicationWhich lobe contains primary visual cortex?
- Brain · ApplicationWhich lobe contains primary auditory cortex?
- Brain · ApplicationWhich structure coordinates movement?
- Brain · ApplicationWhich structure regulates thirst and temperature?
- Brain · ApplicationWhich structure is key for new memory formation?
Elbow4
- Elbow: supracondylar fracture and compartment syndrome · Multi-stepA 7-year-old boy has a displaced supracondylar fracture of the humerus. Hours later he has severe forearm pain on passive finger extension, a pale hand and a weak radia…
- Elbow: radial head subluxation · ApplicationA 2-year-old girl cries after her father pulls her up by the hand to prevent a fall. She now holds her arm slightly flexed and pronated and refuses to move it, with no…
- Elbow: lateral epicondylitis · ApplicationA 42-year-old badminton player has pain over the lateral epicondyle of the humerus, worse on resisted wrist extension with the elbow straight. Which tendon origin is ma…
- Elbow: supracondylar fracture complications · Multi-stepA 6-year-old falls on an outstretched hand and has a displaced extension-type supracondylar fracture of the humerus. The hand is pale and cool, and he cannot flex the t…
Heart4
- Heart · ApplicationThe sinoatrial node artery most commonly arises from which vessel?
- Heart: arterial supply of the conducting system · Multi-stepA 65-year-old man has an acute inferior wall myocardial infarction with ST elevation in leads II, III and aVF, and then develops complete heart block. Angiography shows…
- Heart · ApplicationWhich chamber receives pulmonary veins?
- Heart · ApplicationWhich valve lies between right atrium and ventricle?
Larynx4
- Larynx · ApplicationWhich intrinsic muscle of the larynx is the only abductor of the vocal cords?
- Larynx: cricothyroid membrane · ApplicationDuring an emergency in which a patient cannot be intubated or oxygenated, the anaesthetist performs a surgical airway. Through which structure is the incision made?
- Larynx: internal laryngeal nerve · ApplicationAfter neck trauma a patient coughs poorly when food touches the right piriform fossa and aspirates liquids. The pitch of his voice is normal. Which nerve is injured?
- Larynx · ApplicationWhich muscle abducts vocal folds?
Lymphatics4
- Lymphatics · ApplicationWhich duct drains most of body into venous circulation?
- Lymphatics · ApplicationWhere does right lymphatic duct drain?
- Lymphatics · ApplicationWhich structure drains lymph from the right upper limb?
- Lymphatics · ApplicationWhich nodes first receive lymph from the breast's upper outer quadrant?
Spinal cord4
General anatomy3
- General anatomy: peripheral nerve injury · ApplicationAfter a closed crush injury to the arm, a 30-year-old man has wrist drop. At 3 weeks, electromyography shows fibrillation potentials in the denervated muscles, and the…
- General anatomy: fascial compartments · Multi-stepA 24-year-old man with a tibial shaft fracture has severe leg pain worsened by passive toe flexion, a tense swollen anterolateral leg, weak ankle dorsiflexion and numbn…
- General anatomy: bone development · ApplicationA histologist examines a 12-week fetal femur. There is a thin collar of bone around the mid-shaft, with calcified cartilage and invading blood vessels in the centre. Wh…
Skull3
- Skull: pterion · ApplicationA young man is hit on the side of the head, loses consciousness briefly and then recovers, only to deteriorate hours later with a dilated ipsilateral pupil. Which fract…
- Skull: optic canal · ApplicationWhich nerve passes through optic canal?
- Skull: jugular foramen · ApplicationWhich cranial nerve exits through jugular foramen?
Surface anatomy3
- Surface anatomy · ApplicationWhich vertebral level corresponds approximately to the sternal angle?
- Surface anatomy · ApplicationWhich abdominal quadrant contains the caecum in most people?
- Surface anatomy · ApplicationAt which intercostal space is the trachea normally bifurcated near the sternal angle?
Tongue3
- Tongue: lymphatic drainage · ApplicationA 55-year-old man has a squamous cell carcinoma at the tip of the tongue. Which lymph nodes drain it first?
- Tongue: hypoglossal nerve palsy · ApplicationAfter carotid endarterectomy a 66-year-old man's tongue deviates to the right when protruded and the right half is wasted. Which statement is correct?
- Tongue · ApplicationWhich nerve supplies most tongue muscles?
Ear2
Eye2
Joints of lower limb2
- Joints of lower limb · ApplicationIn the knee, 'unlocking' at the start of flexion from full extension is brought about by which muscle?
- Joints of lower limb · ApplicationAn elderly woman falls and fractures the neck of the femur. Avascular necrosis of the femoral head is a feared complication because the head depends mainly on which art…
Kidney2
Lung2
- Lung: bronchopulmonary segments and aspiration · ApplicationAn elderly man with dysphagia aspirates gastric contents while sitting upright in a chair. Which bronchopulmonary segment is most likely to receive the aspirated materi…
- Lung: middle lobe syndrome · Multi-stepA 9-year-old boy has recurrent cough and a persistent right paracardiac opacity that obscures the right heart border. CT shows collapse of the middle lobe with enlarged…
Orbit2
- Orbit: floor fracture · ApplicationA man is punched in the eye and has diplopia on looking upward, numbness of the cheek and upper lip, and enophthalmos. Which anatomical fact best explains these findings?
- Orbit: superior orbital fissure syndrome · Multi-stepA 40-year-old man after a midface fracture has ptosis, a fixed dilated pupil, complete ophthalmoplegia and loss of sensation over the forehead and upper eyelid. Visual…
Paranasal sinuses2
- Paranasal sinuses: maxillary sinus drainage · ApplicationA 30-year-old man has recurrent maxillary sinusitis despite upright posture. Which anatomical feature predisposes to poor drainage of the maxillary sinus?
- Paranasal sinuses: maxillary sinus drainage · ApplicationA 35-year-old woman has chronic maxillary sinusitis that responds poorly to postural drainage. Which anatomical feature of the maxillary sinus accounts for its poor dra…
Pelvis and perineum2
- Pelvis and perineum · ApplicationA pudendal nerve block is classically given by palpating which bony landmark?
- Pelvis and perineum: urethral injury · Multi-stepAfter a straddle injury a man has a perineal haematoma and cannot void. Urine later infiltrates the scrotum, the penis and the lower anterior abdominal wall, but not th…
Peritoneum2
Pharynx2
- Pharynx: referred otalgia after tonsillectomy · Multi-stepA 25-year-old woman has severe right ear pain on the second day after tonsillectomy, although the ear examines normally. Which nerve pathway explains the referred pain?
- Pharynx: Zenker diverticulum · ApplicationA 70-year-old man has regurgitation of undigested food, halitosis and gurgling in the neck. A barium swallow shows a pouch arising from the posterior pharyngeal wall. T…
Radial nerve2
- Radial nerve: level of injury · Multi-stepTwo patients have wrist drop. Patient A fell asleep with the arm hanging over a chair back and has compression of the nerve in the spiral groove of the humerus. Patient…
- Radial nerve: posterior interosseous syndrome · Multi-stepA 45-year-old man develops inability to extend the fingers at the metacarpophalangeal joints after a fracture of the proximal radius. When he extends the wrist it devia…
Thorax and diaphragm2
- Thorax and diaphragm · ApplicationWhich structure passes through the oesophageal opening of the diaphragm along with the oesophagus?
- Thorax and diaphragm: phrenic nerve · ApplicationA patient with a subphrenic abscess and irritation of the diaphragmatic peritoneum complains of pain at the tip of the right shoulder. Which nerve explains this referre…
Urinary anatomy2
Anatomical terminology1
Cardiac anatomy1
Cranial foramina1
Hepatobiliary anatomy1
Inguinal region1
Lower-limb venous anatomy1
Lymphatic anatomy1
Spinal cord blood supply1
Common questions
How many Anatomy questions are there?
941 original questions across 699 topics, and the bank grows over time.
Which Anatomy topics are covered?
Upper limb, Larynx, Heart, Brachial plexus, Inguinal region, Thorax and diaphragm, Pelvis and perineum, Neuroanatomy, Embryology, Gluteal region, Embryology: midgut, Neuroanatomy: internal capsule, and more.
How difficult are these Anatomy questions?
0 are recall, 701 are application and 240 are multi-step. The tags are our own editorial judgement, not an official difficulty rating.
Are these Anatomy questions from past papers?
No. They are original practice items. NBEMS does not publish its paper or an official key, and we do not use recalled or leaked questions.
Can I practise Anatomy for free?
Yes. The free plan includes 20 practice questions a day across all subjects, and a full Anatomy subject test. A paid term removes the daily limit.
Is there a timed Anatomy test?
Yes. The Anatomy subject test is included on the free plan, with a countdown and a question palette.
How should I use these Anatomy questions?
Answer before you look, read the reason for every option, and write a three-line note for each mistake. A few questions you fully review are worth more than many you skim.
Have these Anatomy questions been reviewed by faculty?
Not yet. They are original and drafted with AI assistance, then edited by our team. Independent faculty review is planned, and each item shows its status. Confirm important facts in a standard textbook.