5TH EDITION
• AUTHOR(S)RICHARD L. DRAKE
TEST BANK
1
Reference
Ch. 1 — The Body — What is anatomy?
Stem
A novice clinician interprets a patient’s weakness as a
“muscular” problem based only on gross inspection. To decide
whether the problem is at the level of muscle fiber, the
neuromuscular junction, or motor neuron, which anatomical
scale and approach best supports targeted assessment and
imaging choice?
Options
A. Prioritize surface anatomy and inspection because gross
changes always reflect the primary lesion.
B. Start with microscopic (histological) scale since cellular
pathology is the most likely cause of acute weakness.
,C. Use a tiered approach from regional gross anatomy to
neuroanatomical pathways to pinpoint lesion localization.
D. Assume imaging is unnecessary and treat empirically because
anatomy rarely changes acute presentations.
Correct answer
C
Rationales
Correct (C): Gray emphasizes using anatomical scale
appropriately: begin with regional (gross) anatomy to localize
limb or segment, then interpret relationships to peripheral
nerves, neuromuscular junction, or muscle architecture to
choose EMG, MRI, or biopsy. This tiered, structure-to-function
approach guides targeted testing and increases diagnostic yield.
Incorrect (A): Surface anatomy is useful but insufficient; many
lesions (e.g., nerve root compressions) produce minimal surface
changes while producing weakness.
Incorrect (B): Histology is rarely the first step in acute
weakness—it's invasive and follows localization by anatomy and
imaging.
Incorrect (D): Empiric treatment without anatomical localization
risks missing structural lesions that require specific
interventions.
Teaching point
Localize using gross/regional anatomy, then refine by
neuroanatomical pathways.
,Citation
Drake, R. L. (2024). Gray’s Anatomy for Students (5th Ed.). Ch. 1.
2
Reference
Ch. 1 — The Body — Imaging
Stem
A trauma patient arrives with blunt chest impact and
hypotension. You suspect aortic injury. Which initial imaging
orientation and modality best evaluates the relationship of the
aorta to surrounding thoracic structures rapidly and why?
Options
A. Plain AP chest radiograph — because it shows cross-sectional
relationships of mediastinal structures.
B. Contrast-enhanced CT in axial (transverse) orientation —
because it provides rapid cross-sectional detail of vessel wall
and surrounding tissues.
C. Coronal MRI without contrast — because coronal views best
show major vessels and require no radiation.
D. Ultrasound with longitudinal probe orientation — because
ultrasound always visualizes thoracic aorta in trauma.
Correct answer
B
Rationales
Correct (B): Gray’s imaging principles note CT angiography
, provides rapid, high-resolution axial cross-sectional views to
assess aortic contour, wall, and relationships to mediastinal
structures—critical in trauma for detecting intimal tears or
extravasation.
Incorrect (A): AP radiograph may suggest mediastinal widening
but lacks sensitivity and cross-sectional resolution to confirm
aortic injury.
Incorrect (C): MRI can show vessels but is slower, less available
in acute trauma, and coronal alone lacks the cross-sectional
detail of CT.
Incorrect (D): Transthoracic ultrasound is limited by air in lungs
and chest wall; it cannot reliably visualize the thoracic aorta in
most blunt trauma.
Teaching point
Contrast-enhanced axial CT gives rapid, high-resolution cross-
sectional vascular detail in chest trauma.
Citation
Drake, R. L. (2024). Gray’s Anatomy for Students (5th Ed.). Ch. 1.
3
Reference
Ch. 1 — The Body — Imaging
Stem
A young pregnant patient presents with suspected
nephrolithiasis. You must choose an imaging modality that