USMLE TEST BANK - Questions and Answers Latest Updated 2024 (Graded A+)

USMLE TEST BANK - Questions and Answers Latest Updated 2024 (Graded A+) What gland is found in the muscular triangle of the neck? Correct Answer: Thyroid gland Is an afferent or efferent pupillary defect described as B/L pupillary constriction when light is shined in the unaffected eye and B/L paradoxical dilation when light is shined in the affected eye? Correct Answer: Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III), B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye. What is the name of the spinal cord passing within the subarachnoid space and forming the spinal nerves that exit the lumbar and sacral foramina? Correct Answer: Cauda equina Name the laryngeal muscle described by the following: • Pulls the arytenoids cartilages closer to the thyroid, relaxing the vocal ligaments and thereby decreasing the pitch Correct Answer: Thyroarytenoid muscles Name the laryngeal muscle described by the following: • Tenses the vocal ligaments, increasing the distance between the cartilages, thereby increasing the pitch Correct Answer: Cricothyroid muscles Name the laryngeal muscle described by the following: • Adducts the vocal ligaments, closes the air passageway during swallowing, and allows phonation Correct Answer: Lateral cricoarytenoid muscles Name the laryngeal muscle described by the following: • Only muscle to abduct the vocal cords Correct Answer: Posterior cricoarytenoid muscles Where does the parotid (Stensen's) duct enter the oral cavity? Correct Answer: Opposite the second upper molar tooth From what aortic arch are the following structures derived? • Common and internal carotid arteries Correct Answer: Third aortic arch MS CARD is my mnemonic for the aortic arch derivatives From what aortic arch are the following structures derived? • Degenerates Correct Answer: Fifth MS CARD is my mnemonic for the aortic arch derivatives From what aortic arch are the following structures derived? • Stapes artery Correct Answer: Second MS CARD is my mnemonic for the aortic arch derivatives From what aortic arch are the following structures derived? • Maxillary artery Correct Answer: First MS CARD is my mnemonic for the aortic arch derivatives From what aortic arch are the following structures derived? • Arch of the aorta and right subclavian artery Correct Answer: Fourth MS CARD is my mnemonic for the aortic arch derivatives From what aortic arch are the following structures derived? • Right and left pulmonary arteries and the ductus arteriosus Correct Answer: Sixth MS CARD is my mnemonic for the aortic arch derivatives What abdominal muscle contributes to the anterior layer of the rectus sheath, forms the inguinal ligament, and in men gives rise to the external spermatic fascia of the spermatic cord? Correct Answer: External abdominal oblique Name the compartment of the lower extremity and the nerve based on its movements. • Adduct the thigh and flex the hip Correct Answer: Medial compartment of the thigh, obturator nerve Name the compartment of the lower extremity and the nerve based on its movements. • Plantar flex the foot, flex the toes, and invert the foot Correct Answer: Posterior compartment of the leg, tibial nerve Name the compartment of the lower extremity and the nerve based on its movements. • Dorsiflex the foot, extend the toes, and invert the foot Correct Answer: Anterior compartment of the leg, deep peroneal nerve Name the compartment of the lower extremity and the nerve based on its movements. • Flex the hip and extend the knee Correct Answer: Anterior compartment of the thigh, femoral nerve Name the compartment of the lower extremity and the nerve based on its movements. • Extend the hip and flex the knee Correct Answer: Posterior compartment of the thigh, tibial nerve Name the compartment of the lower extremity and the nerve based on its movements. • Plantar flex the foot and evert the foot Correct Answer: Lateral compartment of the leg, superficial peroneal nerve What are the five branches of the posterior cord of the brachial plexus? Correct Answer: STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis Name the correct artery. • The right recurrent laryngeal nerve passes around it. Correct Answer: Right brachiocephalic artery Name the correct artery. • The left recurrent laryngeal nerve passes around it. Correct Answer: Arch of the aorta The inferior mesenteric artery drains into it. Correct Answer: The splenic vein Are the quadrate and caudate lobes of the liver functionally part of the left or right lobe? Correct Answer: Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver. What bones make up the acetabulum? Correct Answer: Pubis, ilium, and ischium What is the anatomic positioning of the right and left gastric nerve plexus of the esophagus as they pass through the diaphragm? Correct Answer: LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!) What vessel is lacerated in an epidural hematoma? Correct Answer: Middle meningeal artery True or false? Below the arcuate line, all the aponeurotic fibers run anterior to the rectus abdominis. Correct Answer: TRUE What ocular muscle • Adducts the eyeball and is involved in horizontal conjugate gaze? Correct Answer: Medial rectus (CN III) (LR6 SO4)3 What ocular muscle • Elevates and adducts the eyeball? Correct Answer: Superior rectus (CN III) (LR6 SO4)3 What ocular muscle • Depresses and abducts the eyeball? Correct Answer: Superior Oblique (CN IV) (LR6 SO4)3 What ocular muscle • Elevates and abducts the eyeball? Correct Answer: Inferior Oblique (CN III) (LR6 SO4)3 What ocular muscle • Abducts the eyeball and is involved in horizontal conjugate gaze? Correct Answer: Lateral rectus (CN VI) (LR6 SO4)3 What ocular muscle • Depresses and adducts the eyeball? Correct Answer: Inferior rectus (CN III) (LR6 SO4)3 Which muscles of the eye are under parasympathetic control? Correct Answer: Constrictor pupillae and ciliary muscles Which direction does the uvula deviate in a left vagus nerve lesion? Correct Answer: A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.) Is a subdural hematoma an arterial or venous bleed? Correct Answer: Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus. Which CNs are found in the midline of the brainstem? Correct Answer: CN I, II, III, VI, and XII Add 1 + 1 = 2, 1 + 2 = 3, 1 + 2 + 3 = 6, 1 + 2 + 3 + 6 = 12 What muscles insert in or on the intertubercular groove of the humerus? Correct Answer: "Lady between two Majors": latissimus dorsi, pectoralis major, and teres major What nerve supplies taste sensation to the anterior two-thirds of the tongue? Correct Answer: Chorda tympani of CN VII What part of the heart forms • The right border? Correct Answer: Right atrium What part of the heart forms • Left border? Correct Answer: Left ventricle and auricle of left atrium What part of the heart forms • Apex? Correct Answer: Tip of the left ventricle What part of the heart forms • Base? Correct Answer: Left atrium and tip of the right atrium What part of the heart forms • Superior border? Correct Answer: Conus arteriosus of the right ventricle and right and left auricles What part of the heart forms • Anterior wall? Correct Answer: Right ventricle What part of the heart forms • Posterior wall? Correct Answer: Left atrium What part of the heart forms • Diaphragmatic wall? Correct Answer: Left ventricle and tip of right ventricle What nerves carry the sensory and motor components of the blink reflex? Correct Answer: CN V1 carries the sensory and CN VII carries the motor component of the blink reflex. What muscle keeps the stapes taut against the oval window? Correct Answer: Stapedius muscle Name the components of the femoral canal, working laterally to medially. Correct Answer: NAVEL: Femoral Nerve, Artery, Vein, Empty space, and Lymphatics/Lacunar ligament What muscle is most superior in the orbit? Correct Answer: Levator palpebrae superioris What portion of the pericardium adheres to the tunica adventitia of the great vessels? Correct Answer: Fibrous pericardium What two veins form the portal vein? Correct Answer: The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein. What CNs are responsible for the sensor and motor components of the light reflex? Correct Answer: CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation. Arrange the following layers in the correct sequence through which a needle must pass in a lumbar puncture. • Skin • Subarachnoid space • Interspinous ligament • Dura mater • Deep fascia • Epidural space • Superficial fascia • Interlaminar space • Supraspinous ligament • Arachnoid mater Correct Answer: During a lumbar puncture the needle passes through the interlaminar space in the midline of L3-L4, with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspinous ligament 5. Interspinous ligament 6. Interlaminar space 7. Epidural space 8. Dura mater 9. Arachnoid mater 10. Subarachnoid space. (They ask this in some variation every year, so know it.) What ocular ganglion is affected if the pupil on the affected side sluggishly responds to light with normal accommodation? Correct Answer: Ciliary ganglion producing a tonic pupil What is the name for the most prominent spinous process? Correct Answer: Vertebra prominens (C7 in 70% of cases, C6 in 20%, T1 in 10%) What muscles make up the rotator cuff? Correct Answer: SITS—Subscapularis, Infraspinatus, Teres minor, Supraspinatus What is the function of white rami communicantes? Correct Answer: They are preganglionic sympathetic axons. They are white because they are myelinated. What muscle or muscles are innervated by the following nerves? • Suprascapular nerve Correct Answer: Supraspinatus and infraspinatus What muscle or muscles are innervated by the following nerves? • Upper subscapularis nerve Correct Answer: Subscapularis What muscle or muscles are innervated by the following nerves? • Thoracodorsal nerve Correct Answer: Latissimus dorsi What muscle or muscles are innervated by the following nerves? • Long thoracic nerve Correct Answer: Serratus anterior What nerve is associated with the following functions? • Flex the wrist and digits, pronate the wrist and the LOAF (Lumbricales, Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis) muscles of the hand Correct Answer: Median nerve What nerve is associated with the following functions? • Flex the shoulder, flex the elbow, and supinate the elbow Correct Answer: Musculocutaneous nerve What nerve is associated with the following functions? • Innervation of the flexor carpi ulnaris, flexor digiti profundus (pinky and ring fingers), and the intrinsic muscles of the hand Correct Answer: Ulnar nerve What nerve is associated with the following functions? • Supinate the wrist, extend the wrist and digits, extend the shoulder and elbow Correct Answer: Radial nerve What abdominal muscle runs horizontally, contributes to the posterior rectus sheath, and contributes to form the conjoint tendon? Correct Answer: Transverse abdominis Which CNs act as the sensory and motor components of the gag reflex? Correct Answer: The sensory limb is via CN IX, and the motor limb is from CN X. Which kidney is lower? Why? Correct Answer: The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies. What two regions of the vertebral column are considered primary curvatures? Correct Answer: Thoracic and sacral What vein drains the lower third of the thoracic wall? Correct Answer: Hemiazygous vein At what point does the axillary artery become the brachial artery? Correct Answer: When it crosses the teres major What direction would the tongue protrude in a left CN XII lesion? Correct Answer: Left CN XII lesion would result in the tongue pointing to the left (points at the affected side). At what vertebral level does the common carotid artery bifurcate? Correct Answer: C4 (the upper border of the thyroid cartilage) True or false? Males are more likely to develop femoral hernias than females. Correct Answer: False. Females are more likely to develop femoral hernias then males (remember Female's Femoral). In what compartment of the thigh is the profundus femoris artery found? Correct Answer: Anterior compartment (it's the blood supply to the posterior compartment) Where is the cupola of the lung in relation to the subclavian artery and vein? Correct Answer: The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture. True or false? The first cervical vertebra has no vertebral body. Correct Answer: True. The odontoid process of C2 acts as the vertebral body of C1 allowing lateral rotation of the head. What is the largest muscle in the body? Correct Answer: Gluteus maximus At what vertebral levels does the aortic arch begin and end? Correct Answer: It both begins and ends at T4 (sternal angle [of Louis]). What artery travels with the following veins? • Great cardiac vein Correct Answer: Left anterior descending artery What artery travels with the following veins? • Middle cardiac vein Correct Answer: Posterior interventricular artery What artery travels with the following veins? • Small cardiac vein Correct Answer: Right coronary artery The ophthalmic artery is a branch of what vessel? Correct Answer: Internal carotid artery What structure or structures cross the diaphragm at • T8 level? Correct Answer: IVC Remember: 1 at T8, 2 at T10, and 3 at T12 What structure or structures cross the diaphragm at • T10 level? Correct Answer: Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8, 2 at T10, and 3 at T12 What structure or structures cross the diaphragm at • T12 level? Correct Answer: Aorta, azygos vein, and thoracic duct Remember: 1 at T8, 2 at T10, and 3 at T12 Is the carotid sinus sensitive to pressure or oxygen? Correct Answer: The carotid sinus is a pressuresensitive (low) receptor, while the carotid body is an oxygen-sensitive (low) receptor. (Remember "Sinus Pressure"). What nerve or nerves supply general sensation and taste to the posterior third of the tongue? Correct Answer: CN XI and X Which muscle of the eye is under sympathetic control? Correct Answer: Dilator pupillae muscle True or false? both the left and right lungs have an oblique fissure? Correct Answer: True. on the right lung the oblique fissure divides the middle from the inferior lobe and the horizontal fissure further divides the middle from the upper lobe. On the left the oblique divides the superior from the inferior lobe. What are the three branches of the lateral cord of the brachial plexus? Correct Answer: 1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus What is the major difference between the veins in the face and the veins in the rest of the body? Correct Answer: There are no valves and no smooth muscle in the walls of the veins in the face. Name the bony articulations of the following sites. Be specific. • Shoulder Correct Answer: Clavicle, acromion, and glenoid fossa of the scapula and the humerus Name the bony articulations of the following sites. Be specific. • Elbow Correct Answer: Humerus with ulna (major) and radius (minor) Name the bony articulations of the following sites. Be specific. • Wrist Correct Answer: Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember, for major articulations, wrist/radius and humerus/ulna = elbow) What is the only laryngeal muscle innervated by the external laryngeal nerve? Correct Answer: Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve. What seven structures are found in more than one mediastinum? Correct Answer: Esophagus, SVC, vagus nerve, azygos vein, thoracic duct, thymus, and phrenic nerve How many bronchopulmonary segments are on the right lung? Left lung? Correct Answer: There are 10 bronchopulmonary segments on the right and 8 on the left. The duodenal-jejunal flexure is suspended from the posterior abdominal wall by what? Correct Answer: Ligament of Treitz What is the only tongue muscle innervated by CN X? Correct Answer: Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII. What abdominal muscle runs in a posteroinferior direction, splits to contribute to the rectus sheath, contributes to the formation of the conjoint tendon, and in men gives rise to the middle spermatic fascia and the cremasteric muscle of the spermatic cord? Correct Answer: Internal abdominal oblique What are the five branches of the superior mesenteric artery? Correct Answer: Inferior pancreaticoduodenal, middle colic, right colic, ileocolic, and 10 to 15 intestinal arteries What spinal nerves contribute to the pelvic splanchnic (parasympathetic) nerves that innervate the detrusor muscle of the urinary bladder? Correct Answer: S2, S3, S4—keeps the pee-pee off the floor! What connects the third and the fourth ventricles? Correct Answer: Cerebral aqueduct What nerve and artery could be affected in a humeral neck fracture? Correct Answer: Axillary nerve and posterior humeral artery What type of hernia is described as passing through the deep lateral ring of the inguinal canal? Correct Answer: Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle. What two vessels come together to form the external jugular vein? Correct Answer: 1. Posterior auricular vein 2. Posterior division of the retromandibular vein What is the only vein in the body with a high O2 content? Correct Answer: The pulmonary vein, which carries oxygenated blood from the lung to the left atrium. What are the three branches of the celiac trunk? Correct Answer: The left gastric, splenic, and common hepatic arteries What region of the pharynx does the eustachian tube enter? Correct Answer: Nasopharynx What is the only muscle of the soft palate that is innervated by CN V3? Correct Answer: The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X. How many pairs of spinal nerves exit from the spinal cord? Correct Answer: 31 pairs What artery turns into the dorsalis pedis when it crosses the extensor retinaculum? Correct Answer: Anterior tibial artery What is the term for pupils that react normally to accommodation but have bilateral loss of constriction in response to light? Correct Answer: Argyll Robertson pupils What connects the lateral ventricles to the third ventricle? Correct Answer: Foramen of Monro What nerve supplies general sensation to the anterior two-thirds of the tongue? Correct Answer: Lingual nerve of CN V3 What type of pleura is adherent to the surface of the organ? Correct Answer: Visceral pleura What artery supplies the left ventricle, left atrium, and interventricular septum? Correct Answer: Left coronary artery Where are the tonsillar tissues? Correct Answer: Waldeyer's ring What is the name of the superficial subcutaneous fascia of the abdomen containing fat? Correct Answer: Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.) What are the three anatomic characteristics that differentiate the large bowel from the small bowel and the rectum? Correct Answer: 1. Tinea coli 2. Haustra 3. Epiploic appendages What area of the posterior aspect of the eye has no photoreceptors? Correct Answer: The optic disk is the blind spot. At the level of rib 6, the internal thoracic artery divides into what two arteries? Correct Answer: Musculophrenic and superior epigastric arteries What is the name of inflammation of the prepatellar bursa? Correct Answer: Housemaid's knee What nerve roots constitute the cervical plexus? Correct Answer: C1 through C4 Name the compartment of the mediastinum associated with the following thoracic structures: • Heart and pericardium Correct Answer: Middle Name the compartment of the mediastinum associated with the following thoracic structures: • Descending aorta Correct Answer: Posterior Name the compartment of the mediastinum associated with the following thoracic structures: • Thymus Correct Answer: Superior and anterior Name the compartment of the mediastinum associated with the following thoracic structures: • Phrenic nerve Correct Answer: Superior and middle