HTMS Self assessment Anatomy Introduction by Dr Furqan Ali Khan.

INTRODUCTION

Skeletal System

I. Bones

II. Joints

Muscular System

I. Muscle

II. Structures Associated with Muscles

Nervous System

I. Nervous System

II. Neurons

III. Central Nervous System

IV. Peripheral Nervous System

V. Autonomic Nervous System

Circulatory System

I. Vascular System

II. Lymphatic System

Organ Systems

I. Digestive System

II. Respiratory System

III. Urinary System

IV. Reproductive System

V. Endocrine System

VI. Integumentary

1. A 22-year-old man presented to his family physician with a laceration of the fibrous sheets or bands that cover his body under the skin and invest the muscles. Which of the following structures would most likely be injured?

(A) Tendon

(B) Fascia

(C) Synovial tendon sheath

(D) Aponeurosis

(E) Ligament

2. On the basis of the examination at her doctor’s office, a patient is told that her parasympathetic nerves are damaged.

Which of the following muscles would most likely be affected?

(A) Muscles in the hair follicles

(B) Muscles in blood vessels

(C) Muscles that act at the elbow joint

(D) Muscles in the gastrointestinal (GI) tract

(E) Muscles enclosed by epimysium

3. A 46-year-old male patient with high blood pressure was examined in the emergency department, and his physician found a leakage of blood from the blood vessel that normally carries richly oxygenated blood. Which of the following

vessels would most likely be damaged?

(A) Superior vena cava

(B) Pulmonary arteries

(C) Pulmonary veins

(D) Portal vein

(E) Coronary sinus

4. A 16-year-old patient received a stab wound, and axons of the general somatic efferent (GSE) neurons to the shoulder muscles were severed. The damaged axons:

(A) Would carry impulses toward the cell bodies

(B) Would carry impulses away from the cell bodies

(C) Would carry pain impulses

(D) Are several in numbers for multipolar neurons

(E) Are found primarily in the gray matter

5. A 16-year-old patient received a laceration of the posterior intercostal nerves by a penetrated knife blade. A pathologist obtained needle biopsy tissues and observed numerous degenerated cell bodies of the unipolar or pseudounipolar

neurons. Which of the following structures would most likely provide the abnormal cell morphology?

(A) Ventral horn of the spinal cord

(B) Lateral horn of the spinal cord

(C) Dorsal horn of the spinal cord

(D) Dorsal root ganglion

(E) Sympathetic chain ganglion

6. A 19-year-old college student came to his doctor’s office for a neurologic examination. His physician told him that normally synapses are absent in or on which of the following structures?

(A) Anterior horn of the spinal cord

(B) Dorsal root ganglia

(C) Sympathetic chain ganglia

(D) Dendrites

(E) Cell bodies

7. A 27-year-old woman involved in a car accident is brought into the emergency department. Her magnetic resonance imaging reveals that she has a laceration of the spinal cord at the L4 spinal cord level. Which of the following

structures would you expect to be intact?

(A) Dorsal horn

(B) Lateral horn

(C) Ventral horn

(D) Gray matter

(E) White matter

8. A 33-year-old male patient complains of feeling severe pain when he tries to turn his neck. The physician realizes that the problem is in his pivot (trochoid) joint. Which of the following joints would most likely be examined?

(A) Atlantooccipital joint

(B) Atlantoaxial joint

(C) Carpometacarpal joint

(D) Proximal tibiofibular joint

(E) Intervertebral disks

9. A patient presents with a loss of sensation to the skin over the shoulder. Injury to which of the following nerve cells would most likely affect the conduction of sensory information to the central nervous system?

(A) Multipolar neurons

(B) Bipolar neurons

(C) Unipolar or pseudounipolar neurons

(D) Neurons in the ventral horn

(E) Neurons in sympathetic chain ganglia

10. A 7-year-old girl comes to the emergency department with severe diarrhea. Tests show that the diarrhea is due to decreased capacity of normal absorption in one of her organs. Which of the following organs is involved?

(A) Stomach

(B) Gallbladder

(C) Large intestine

(D) Liver

(E) Pancreas

11. A 16-year-old girl with urinary diseases comes to a local hospital. Her urologist’s examination and laboratory test results reveal that she has difficulty in removing wastes from the blood and in producing urine. Which of the following

organs may have abnormal functions?

(A) Ureter

(B) Spleen

(C) Urethra

(D) Bladder

(E) Kidney

12. A 53-year-old man with a known history of emphysema is examined in the emergency department. Laboratory findings along with examination indicate that the patient is unable to exchange oxygen in the air and carbon dioxide in the blood. This exchange occurs in which portion of the respiratory system?

(A) Bronchi

(B) Alveolar (air) sac

(C) Nasal cavity

(D) Larynx

(E) Trachea

13. A 26-year-old woman has an amenorrhea, followed by uterine bleeding, pelvic pain, and pelvic mass. Her obstetrician performed a thorough examination, and the patient was diagnosed as having an ectopic pregnancy. Which of the following organs is most likely to provide a normal site of fertilization?

(A) Fundus of the uterus

(B) Ampulla of the uterine tube

(C) Fimbriae

(D) Infundibulum of the uterine tube

(E) Body of the uterus

14. A 29-year-old woman with abdominal pain was admitted to a local hospital, and examination shows that a retroperitoneal infection is affecting a purely endocrine gland. Which of the following structures is infected?

(A) Ovary

(B) Suprarenal gland

(C) Pancreas

(D) Liver

(E) Stomach

15. A 36-year-old woman received a first-degree burn on her neck, arm, and forearm from a house fire. Which of the following skin structures or functions is most likely damaged or impaired?

(A) GSE nerves

(B) Parasympathetic general visceral efferent nerves

(C) Trophic hormone production

(D) Exocrine gland secretion

(E) Vitamin A production

16. A 9-year-old boy is diagnosed with multiple sclerosis (MS). Which of the following nervous structures would most likely be affected by this disease?

(A) Trigeminal ganglion

(B) Superior cervical ganglion

(C) Optic nerve

(D) Facial nerve

(E) Spinal accessory nerve

Answers with explanation

1. The answer is B. The fascia is a fibrous sheet or band that covers the body under the skin and invests the muscles. Although fasciae are fibrous, tendons connect muscles to bones or cartilage, aponeuroses serve as the means of origin or insertion of a flat muscle, and ligaments connect bones to bones or cartilage. Synovial tendon sheaths are tubular sacs filled with synovial fluid that wrap around the tendons.

2. The answer is D. Smooth muscles in the gastrointestinal tract are innervated by both parasympathetic and sympathetic nerves. Smooth muscles in the wall of the blood vessels and arrector pili muscles in hair follicles are innervated only by sympathetic nerves. Muscles that act at the elbow joint and muscles enclosed by epimysium are skeletal muscles that are innervated by somatic motor (general somatic efferent [GSE]) nerves.

3. The answer is C. Pulmonary veins return oxygenated blood to the heart from the lungs. Pulmonary arteries carry deoxygenated blood from the heart to the lungs for oxygen renewal. The portal vein carries deoxygenated blood with nutrients from the intestine to the liver. The superior vena cava and coronary sinus carry deoxygenated blood to the right atrium.

4. The answer is B. The axons of the neurons carry impulses away from the cell bodies, and dendrites carry impulses to the cell bodies. The axons contain sensory or motor fibers. Multipolar neurons have several dendrites and one axon. The GSE neurons do not carry sensory impulses. The gray matter of the central nervous system consists largely of neuron cell bodies, dendrites, and neuroglia, whereas the white matter consists largely of axons and neuroglia.

5. The answer is D. Ventral, lateral, and dorsal horns and sympathetic chain ganglia contain

multipolar neurons, whereas the dorsal root ganglion contains unipolar or pseudounipolar

neurons. A laceration of the intercostal nerve injures GSE, postganglionic sympathetic general visceral efferent (GVE), general visceral afferent (GVA), and general somatic afferent (GSA) fibers, whose cell bodies are located in the anterior horn, sympathetic chain ganglia, and dorsal root ganglia.

6. The answer is B. Dorsal root ganglia consist of cell bodies of the unipolar or pseudounipolar neurons and have no synapses. Axosomatic and axodendritic synapses are the most common, but axoaxonal and dendrodendritic contacts are also found in many nerve tissues.

7. The answer is B. The lateral horns are found in the gray matter of the spinal cord between T1 and L2 and also between S2 and S4. Therefore, the lateral horns are absent at the L4 spinal cord level.

8. The answer is B. The atlantoaxial joint is the pivot or trochoid joint. The atlantooccipital joints are the condyloid (ellipsoidal) joints, the carpometacarpal joint of the thumb is the saddle (sellar) joint, and the proximal tibiofibular joint is the plane (gliding) joint. The intervertebral disk is the secondary cartilaginous (symphysis) joint.

9. The answer is C. Sensation from the skin is carried by GSA fibers, and their cells are unipolar or pseudounipolar types located in the dorsal root ganglia. Multipolar neurons and neurons in the ventral horn and in sympathetic chain ganglia are motor neurons. Bipolar neurons are sensory neurons, but they are not somatic sensory neurons.

10. The answer is C. The large intestine absorbs water, salts, and electrolytes. Hence, the patient’s diarrhea stems from an absorption problem. The stomach mixes food with mucus and gastric juice, which contains hydrochloric acid and enzymes, and forms chyme. The gallbladder receives bile, concentrates it, and stores it. The liver produces bile, whereas the pancreas secretes pancreatic juice, which contains digestive enzymes and which releases hormones, such as insulin and glucagon

11. The answer is E. The urinary system includes the kidneys, which remove wastes from the

blood and produce the urine; the ureters, which carry urine; the urinary bladder, which stores urine; and the urethra, which conveys urine from the bladder to the exterior of the body. The spleen filters blood to remove particulate matter and cellular residue, stores red blood cells, and produces lymphocytes. Because the patient is not producing urine properly, the malfunctioning organs are the kidneys.

12. The answer is B. The respiratory portion of the lung contains the alveolar (air) sacs or alveoli, which are surrounded by networks of pulmonary capillaries. Oxygen and carbon dioxide exchange occurs across the thin walls of the alveoli and blood capillaries with the aid of the diaphragm and thoracic cage. The nasal cavity, larynx, trachea, and bronchi are air-conducting portions.

13. The answer is B. Fertilization occurs in the ampulla of the uterine tube, and a fertilized oocyte forms a blastocyst by day 7 after fertilization and becomes embedded or implanted in the wall of the uterus during the progestational (secretory) phase of the menstrual cycle. Fertilization is the process beginning with the penetration of the secondary oocyte by the sperm and completed by fusion of the male and female pronuclei.

14. The answer is B. The suprarenal gland is a retroperitoneal organ and is a purely endocrine gland. The pancreas is a retroperitoneal organ and contains endocrine cells, but it is not a purely endocrine gland. The liver and stomach contain endocrine cells, but they are not purely endocrine glands and also are surrounded by peritoneum. The ovary contains endocrine cells and is located in the pelvic cavity.

15. The answer is D. Skin has sweat glands and sebaceous glands, which are exocrine glands. Skin produces vitamin D, but it does not produce a trophic hormone and does not produce vitamin

A. In addition, skin contains no GSE and parasympathetic GVE nerve fibers.

16. The answer is C. Multiple sclerosis affects only axons in the CNS (spinal cord and brain) that have myelin sheaths formed by oligodendrocytes. The optic nerve is considered to be part of the CNS, as it is derived from an outpouching of the diencephalon. All other nervous structures are in the PNS and have their myelin sheaths formed by Schwan cells.

Reference: 

1. BRS Gross anatomy.

2. Gross Anatomy: The Big Picture. 

3. High Yield Gross Anatomy.

4. Clinical Anatomy by Regions, Snell. 

5. Grays Anatomy .

6. LAST Anatomy